1/8. Pathological laughter and behavioural change in childhood pontine glioma.Children with pontine glioma usually present classically with ataxia, motor deficits and cranial nerve palsies. The pons has generally not been regarded as a structure that mediates complex affective behaviour. However, we report nine children who either at the time of presentation or progression demonstrated marked behavioural changes manifesting as either "pathological laughter" or separation anxiety in the form of school refusal. A mechanism of how pontine lesions can cause such complex affective and cognitive behaviour has been suggested to consist of the disruption of a network of cerebro-ponto-cerebellar pathways and the evidence for this mechanism is discussed.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/8. Intracranial gliofibroma mimicking a meningioma: a case report and review of literature.Gliofibromas are rare glio-mesenchymal tumors composed of astrocytic and benign mesenchymal components, which commonly occur in the first two decades of life. They are not listed as a distinct entity in the current WHO classification of CNS tumors. Their biological behaviour is unknown, and histogenesis is debatable. We describe a case of histopathologically proven gliofibroma in the region of the left quadrigeminal plate in a 15-year-old child that mimicked a tentorial meningioma both at imaging and surgery. Post-operatively, the residual tumor regrew to a size similar to the initial mass (4 cm x 3.6 cm x 3.5 cm), within one and a half years after the first surgery. The histopathology of the tumor was similar on both occasions. Although a poor prognosis has been characteristically noted in gliofibromas with high-grade glial component, but the present case had recurrence despite being of low-grade, thus highlighting the uncertain behaviour of this rare tumor.- - - - - - - - - - ranking = 0.28571428571429keywords = behaviour (Clic here for more details about this article) |
3/8. Long term survival with early childhood intracerebral tumours.Three young adults are described who presented during early childhood with a seizure disorder due to an underlying intracerebral tumour. The tumours were excised incompletely 14-19 years later. The histological findings were those of a temporal lobe benign capillary haemangioblastoma (Case 1), parietal lobe subependymoma (Case 2), and parietal lobe ganglioglioma (Case 3). After a mean period of follow-up of 22 years (range 18-26), only mild residual physical disabilities exist in each patient. These three cases illustrate (1) the need promptly to investigate children who present with focal seizures or whose EEG shows definite focal abnormalities, (2) the relevant investigations should include cranial CT or MRI in such cases and (3) that certain supratentorial tumours have a favourable outcome due to their benign biological behaviour rather than their location.- - - - - - - - - - ranking = 0.14285714285714keywords = behaviour (Clic here for more details about this article) |
4/8. Gliomatosis cerebri: clinical and histological findings.The clinical and pathological data of ten patients with gliomatosis cerebri are compared with 48 well documented cases from the literature. The most striking clinical findings were behavioural and mental changes, seizures, motor weakness and headaches. Though diagnostic techniques have gained in sophistication, the clinical diagnosis of gliomatosis cerebri remains difficult. Laboratory and radiograph tests are mostly unconclusive. Expectations that computed tomography might lead to an accurate diagnosis were not fulfilled. Histological examination disclosed a diffuse proliferation of glial elements infiltrating normal nervous tissue with destruction of myelin sheaths, but only slight damage to neurons and axons. In two cases, areas typical of oligodendroglioma were also present. Glial fibrillary acidic protein staining showed in seven cases that most of the neoplastic cells were of astrocytic origin. In addition, GFAP negative neoplastic cells with the appearance of oligodendroglia and intermediate elements between astroglia and oligodendroglia and irregularly shaped naked nuclei of unidentified nature were found. On the basis of the two-stage theory of carcinogenesis, it is suggested that this disease might be the result of propagation of initiated glial elements which have not yet undergone the process of tumor conversion.- - - - - - - - - - ranking = 0.14285714285714keywords = behaviour (Clic here for more details about this article) |
5/8. Rapid anaplastic transformation in gliomas of adulthood. "Selection" in neuro-oncogenesis.Rapid change of the phenotypical expression is reported in three adult cases of benign or malignant gliomas. Cases with phenomenologically similar thorough alterations have only infrequently been reported in the literature. In all cases the alteration resulted in uniformly small undifferentiated and aggressive cell populations, which would not have permitted diagnosis of the original tumor. Remnants of the latter and the new undifferentiated portions were blended with each other. In two cases the clinical course was characterized by a rapid deterioration within a few months, following as slowly progressive course or periods with only mild symptoms over many years. In his studies of mammary tumors Foulds (1956) found similar phenomena of circumscribed phenotypical changes, to which he applied the term "focal progression". He outlined progression as a basic mechanism in oncogenesis. Later on it has been interpreted as the result of selection of genetically changed subpopulations of tumor cells with an altered, i.e. enhanced malignant expression. They are favoured due to their less demanding behaviour as to environmental conditions. Thus they gradually or rapidly overgrow the original tumor, changing its phenotype. The author believes that the present observations may be interpreted as examples of rapid focal progression in gliomas in terms of Foulds, with "selection" acting as a basic developmental mechanism.- - - - - - - - - - ranking = 0.14285714285714keywords = behaviour (Clic here for more details about this article) |
6/8. Late detection of cerebral glioma causing seizures in childhood. A case report.Late detection of a cerebral glioma causing convulsions in a 7-year-old girl is reported. Her neurological status was normal but her behaviour deteriorated progressively and her seizures became more frequent and resistant to therapy during the 11/2 years after her first admission to hospital. Computed tomography revealed a zone of low density in the right parietal area which was considered to be due to a cerebrovascular accident affecting the middle cerebral artery. Although it is generally considered that epilepsy beginning in infancy or childhood, even if focal, is only rarely associated with neoplasm, epilepsy which is resistant to treatment and progressive change in a child's behaviour should suggest the possibility of a cerebral neoplasm and further invasive investigations should be performed.- - - - - - - - - - ranking = 0.28571428571429keywords = behaviour (Clic here for more details about this article) |
7/8. Giant cell gliomas of the temporal lobe.Giant cell tumours of the brain are commonly a) monstrocellular sarcomas, b) giant cell glioblastomas or gliosarcomas, or c) "giant cell gliomas", i.e. gliomas characterized by many atypical, giant-sized cells with monstrous nuclei. This last group is commonly found in the temporal region and should not be mistaken for a) and b), because, in spite of their "malignant" appearance, these tumours can present benign biological behaviour. Three such cases are described. In two cases the patients received postoperatively neither radio- nor chemotherapy: seven and three years respectively after operation no signs of recurrences were present. A third patient died within two years after operation. However, his tumour had histological signs of malignancy. The importance of exact histological diagnosis is stressed. This prevents misinterpretations in estimating the efficacy of postoperative therapy.- - - - - - - - - - ranking = 0.14285714285714keywords = behaviour (Clic here for more details about this article) |
8/8. Gliofibroma: mixed glial and mesenchymal tumour. Report of three cases.Gliofibromas are rarely encountered astrocytic tumours comprising of astrocytic and benign fibroblastic components. They commonly occur in first two decades of life. However, the exact behaviour is not fully known and their histogenesis is also still debatable. We report three cases of gliofibroma in which we studied proliferative markers (MIB-1) and p53 protein expression. In these tumours, occurrence in adult life is in contrast to that reported in the literature. Depending upon the morphology and proliferative Labelling Index we classified these tumours into low grade (benign) and high grade (malignant/anaplastic).- - - - - - - - - - ranking = 0.14285714285714keywords = behaviour (Clic here for more details about this article) |