1/7. Neuropsychological assessment of an 8-year-old child following excision of a right temporal lobe oligodendroglioma.A case of right temporal lobe oligodendroglioma in an 8-year-old female is reported. This case is unusual, because of the rarity of this type of tumour in children, because it was accompanied by seizure activity which is atypical, and because it highlights the difficulties in diagnosis. Prior to diagnosis, the background had included normal early development, followed by gradual development of partial complex seizures with poor response to medication in the absence of clear findings on EEG or CT. Considered to have been present prior to 1 year of age, the tumour was purported to be the aetiological base for seizure activity, which ceased after surgical excision. Post-surgical difficulties with academic progress and behaviour resulted in referral for neuropsychological evaluation, which revealed lowered overall cognitive functioning with deficits in processing speed, abstract verbal reasoning, concept formation, visual perception, visual reasoning, scanning, attention, memory, academic attainment and learning, and clerical motor speed. Behavioural functioning revealed impairment in social skills, irritability, impulsivity, and mood changes. The relative contributions of medication (adverse reaction and toxicity), long term seizure activity, early age of onset, and presence/excision of tumour are difficult to ascertain specifically. Findings appear consistent with those of right temporal lobe brain injury.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/7. The evolution of an oligodendroglioma into a primitive neuroectodermal tumour.Oligodendrogliomas may comprise a biologically heterogenous group of tumours. There is disagreement about the relationship between their histological features and subsequent behaviour, and evolution of histologically typical oligodendrogliomas into more malignant neoplasms has been described. We describe a supratentorial oligodendroglioma in a 4-year-old boy which recurred 9 months after initial resection when it showed foci of histologically primitive cells, not present in the initial specimen. It recurred again at the same site 20 months later following a course of radiotherapy, but showed on this occasion the appearances of a primitive neuroectodermal tumour (PNET) with astrocytic and ependymal, but not oligodendroglial, differentiation. The evidence suggests evolution of an oligodendroglioma into a PNET, and raises the possibility that some oligodendrogliomas may arise by differentiation from a pool of proliferating primitive cells which may occasionally become the dominant population.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
3/7. Complex visual hallucinations in the hemianopic field.From 120 patients with an homonymous hemianopia 16 experienced complex visual hallucinations in the hemianopic field. The brain lesion was located in the occipital lobe, though damage was not limited to this area. Complex hallucinations appeared after a latent period. They were weak in colour and stereotypical in appearance, which allowed differentiation from visual hallucinations of other causes. Different behaviour after saccadic eye movement differentiated between complex visual hallucinations in the hemianopic field and visual auras of an epileptic origin.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
4/7. Metastatic oligodendroglioma presenting as a leukoerythroblastic anaemia.The clinical course of a patient with oligodendroglioma, treated initially with surgery and radiotherapy, is described. The patient later presented with leukoerythroblastic anaemia due to metastasis to bone marrow. This behaviour had not been previously described in oligodendroglioma.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
5/7. 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 = 1keywords = behaviour (Clic here for more details about this article) |
6/7. The transdural extension of gliomas.The extraneural spreading of gliomas is an infrequent occurrence which is not necessarily related to either tumor histology or site. This paper reports two cases, a glioblastoma and an oligodendroglioma, both presenting extradural diffusion. In the first case, where there was severe intracranial hypertension, the tumor found its way out from the neurocranium, far from the site of the operation, perforating the dura and the bone of the cranial base. In the second case, the operation may have facilitated the extraneural invasion. This unusual behaviour of glial tumors is probably less rare than presumed. It may go unnoticed if the attention is concentrated on the usually severe neurological syndrome which is present in these patients.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
7/7. Unilateral frontal lobectomy can produce strategy application disorder.Following a 5 cm left frontal lobectomy for the removal of a mixed astrocytoma-oligodendroglioma, a 51 year old right handed man showed a marked dissociation between his performance on standard neuropsychological tests and his everyday behaviour. In contrast to his intact neuropsychological test performance, he was impaired on a test of "strategy application" which requires goal articulation, plan specification, self-monitoring, and evaluation of outcomes, as well as the establishment of mental "markers" to trigger specific behaviour. Strategy application disorder can therefore be produced by a unilateral circumscribed frontal lobe lesions.- - - - - - - - - - ranking = 2keywords = behaviour (Clic here for more details about this article) |