1/5. Cystic lumbar nerve sheath tumours: MRI features in five patients.Intraspinal cystic lumbar nerve sheath tumours constitute an uncommon subset of tumours with distinct clinico-biological behaviour. The MRI findings in five such cases are presented. Four of these were cystic schwannomas and one was a cystic neurofibroma. The pathology, MRI findings and the differential diagnosis of these rare tumours are analysed.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/5. Endoscopic fenestration of symptomatic septum pellucidum cysts: three case reports with discussion on the approaches and technique.OBJECTIVES: We describe three patients with symptomatic septum pellucidum cysts treated by endoscopic fenestration and discuss the different endoscopic approaches to these cysts. CLINICAL PRESENTATION: The patients are an 8-year-old boy, a 7-year-old boy and a 21-year-old woman; this last also had a right frontal cavernous angioma and a pituitary microadenoma. All patients presented with headache, associated with vomiting in two and behavioral changes in one. In all cases magnetic resonance showed a septum pellucidum cyst. INTERVENTION: Two patients were operated upon by posterior approach through a right occipital burr hole and underwent fenestration from the right occipital horn to the cyst, with a second fenestration from the cyst to the left lateral ventricle in one. Another patient underwent microsurgical removal of a right frontal cavernoma and endoscopic cyst fenestration with both lateral ventricles through a right frontal craniotomy. Postoperatively, headache and vomiting resolved in all cases and behaviour changes improved in one. CONCLUSIONS: Endoscopic fenestration is the treatment of choice for septum pellucidum cysts, where it results in immediate relief of the mass effect of the cyst and in the remission of the associated symptoms. We suggest a posterior approach through a right occipital burr hole. It allows one to easily cannulate the occipital horn, which is usually larger than the frontal one, thus avoiding the risk of damaging the vascular and neural structures surrounding the foramen of Monro. Besides, the endoscopic trajectory is in our opinion more direct. The two-window technique, with fenestration of the cyst into both lateral ventricles, improves the chances of long-term patency.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
3/5. Clinical correlates of septum pellucidum cavities: an unusual association with psychosis.Cavities in the septum pellucidum are widely regarded as incidental findings of little clinical importance. The prevalence of such cava on computerized tomography in a mixed sample of 22000 neurological and psychiatric patients is found to be 0.15%. A statistical association between this anomaly and a referral diagnosis of functional psychosis is reported, and 6 cases are described. These cases were male and characterized by an early history of developmental delay, with lifelong disturbances of emotion and behaviour prior to the onset in early adulthood of an atypical schizophrenia-like psychosis with disorders of speech and movement. It is suggested that septal cavities may signal an underlying abnormality of function relevant to the pathogenesis of these illnesses.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
4/5. Further observations on the "bobble-headed doll syndrome".Two patients are presented with a head-bobblng "tic" classically associated with a suprasellar cyst. The first of these showed hypothalamic, neuroendocrinological and limbic abnormalities not previously described, although with a classic arachnoidal suprasellar cyst. The second of these patients showed head-bobbling behaviour during the first years of life as a manifestation of one out of many episodes of ventricular shunt obstruction. This case is therefore the first reported whose head bobbling was observed with an acute lesion.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
5/5. status epilepticus presenting as progressive dysphasia.status epilepticus is usually a straightforward diagnosis when a patient has two or more seizures without regaining consciousness. However, when status is non-convulsive and, in particular, has a temporal lobe flavour the clinical presentation may be misleading. Presentation with automatic or psychic behaviour is well recorded. We report a patient with nonconvulsive status who presented with progressive dysphasia with widespread CT and MRI changes. The dysphasia and imaging changes led to a diagnosis of a probable neoplastic brain process but reversed with anticonvulsant treatment.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |