1011/2332. association of intracranial meningioma with arteriovenous malformation. Simultaneous occurrence of a cerebral arteriovenous malformation and a primary brain tumor is rare. A case of a left occipital meningioma and a right parietotemporal arteriovenous malformation is reported. Clinical, radiological, and postmortem findings are described. Thirty previous reports of arteriovenous malformations associated with primary brain tumors are reviewed. In 18 cases the two lesions were intermixed or in close proximity. This spatial relationship between the lesions suggests more than a coincidental association. Several hypotheses are proposed to explain common causal connections. ( info) |
1012/2332. association of intracranial meningiomas and aneurysms. Report of three cases and review of the literature. The Authors report three personal cases of association between meningioma and arterial aneurysm, both intracranial. Twenty-three similar cases are referred in the literature, bringing the total to 26. Of these 26, the overall average age at diagnosis was 48.3 years: 17 were females and 9 males. The predominant site for the meningioma was the cerebral convexity and for the aneurysm the anterior communicating artery. Meningiomas were multiple in 5 cases and the aneurysms were multiple in the same number of cases. In 21 cases the meningioma was removed: in 11 of these the aneurysm was treated simultaneously. In the majority of cases the aneurysm was an accidental finding during neuroradiological investigation to document the meningioma; panangiography is reported to have been performed only in a few cases. Greater use of the latter would probably have revealed a higher incidence of this rare association. The greater frequency found of the association of aneurysm and multiple meningiomas makes it advisable to perform panangiography in all such cases. The best long-term results were obtained in the cases where the meningioma and aneurysm were operated simultaneously. ( info) |
| foramen magnum tumours are rare. They may present with bizarre symptoms and mimic many conditions. We report a presentation with the sole complaint of hoarseness, never previously described in the literature. voice returned to normal after surgical removal of the foramen magnum meningioma. ( info) |
1014/2332. An unusual complication of silastic dural substitute: case report. A case is presented in which a patient developed an unusual complication after the use of Silastic dural substitute. In 1983, the patient underwent removal of a meningioma with the involved dura. Five years later, he developed around the graft material a very thick connective tissue capsule, which simulated a recurrent meningioma clinically and radiologically. ( info) |
1015/2332. Concurrent intradural and extradural meningiomas of the cervical spine. A case of an extradural spinal meningioma presenting with a separate intradural meningioma at the same cord level is reported. review of the English literature on spinal epidural meningiomas reveals a high incidence of concurrent intradural tumors in patients with epidural meningiomas. This leads to the conclusion that the intradural space should be evaluated carefully when an epidural meningioma is encountered. ( info) |
1016/2332. Tumours at the spinocranial junction: some clinical and electromyographic aspects in relation to the symptomatology. On the basis of six cases of a tumour at the spinocranial junction, the clinical symptomatology is discussed with special reference to the occurrence of astereognosis and amyotrophy of the hand muscles. Possible mechanisms underlying these symptoms are discussed. In the authors' opinion, the frequent association of these symptoms is explained by the association of two pathogenic mechanisms, i.e., compression of the posterior column or interference with the arterial blood flow to the medial lemniscus, leading to astereognosis, and interference with the venous blood flow, leading to amyotrophy of the hand muscles. ( info) |
| blepharospasm-oromandibular dystonia is characterized by the presence of spasms of the orbicularis oculi (blepharospasm) and of the lower facial or oromandibular muscles. A patient with this syndrome is presented in which a left cerebellopontine angle meningioma appeared to act as a triggering mechanism for the development of this disorder. On the basis of this report, we recommend that physicians search for this tumor in patients with this disorder. ( info) |
1018/2332. Meningiomas involving the clivus: a six-year experience with 41 patients. A series of 41 meningiomas involving the clivus operated on from July 1983 to January 1990 is reported. The presenting symptoms and signs of these patients were similar to those reported previously. All the patients were evaluated by pre- and postoperative thin-section, high-resolution computed tomography using soft tissue and bone algorithms. Most of the patients also underwent magnetic resonance imaging. The regions of the clivus involved by tumor were divided into upper, middle, or lower regions on the basis of anatomical landmarks. The diameter of the tumor was measured in three axes, and a tumor volume and a tumor equivalent diameter were computed to categorize tumors as small, medium, large, or giant types. There were 9 medium, 27 large, and 5 giant tumors in this series. Some simple and some complex operative approaches were employed to effect tumor removal. Large and giant tumors often required more than one operative approach to remove the tumor. Intraoperative technical difficulties included tumor consistency, vascularity, dissection from the brain stem, and vascular and cranial nerve encasement. Postoperative computed tomographic scans documented total excision in 32 patients (78%). Residual tumor remained in the clival or cavernous sinus areas. These patients were either being observed, or were treated with gamma knife radiosurgery. There was one operative death due to pneumonia (2%), and three patients (7%) suffered permanent major neurological changes, presumably due to vascular occlusions in the posterior circulation. In the follow-up period, which ranged from 3 to 76 months, 2 patients (6%) with tumors that had appeared to be totally excised experienced recurrence. These patients were treated by a second operation, alone or in combination with radiation therapy. Two patients who had subtotal excisions (25%) had evidence of regrowth. In 2 patients, tumor growth continued despite gamma knife radiosurgery or external beam radiotherapy. ( info) |
| facial nerve involvement in cerebellopontine angle tumors, both during their development and after excision, may be expressed in irreversible dysfunction of the parasympathetic pathways. The exact location of the lesion along the efferent nerve fibers can be established through evaluation of the functional level of those organs supplied by the cholinergic motor secretory components. This report deals with a female patient in whom peripheral facial palsy developed shortly after removal of a right cerebellopontine angle meningioma. She had slight facial asymmetry and deafness in the right ear and complained of prandial flush and sweating of the right malar area. Occult ipsilateral hyposalivation and hypolacrimation were diagnosed. In patients with seventh and ninth cranial nerve pathoses, evaluation of the end organs that are supplied by their associated autonomous nerve fibers is mandatory to prevent late ocular and oral sequelae. ( info) |
1020/2332. Hemiballism as a presentation of a meningioma. A 73-year-old woman with a meningioma presented with hemiballism. This is the report of an unusual presentation of a primary brain tumor. ( info) |