1/7. Subependymal giant cell astrocytoma: clinical and neuroimaging features of four cases.The clinical history, neuroimaging features, treatments, and outcome of 4 patients with histologically verified subependymal giant cell astrocytomas (SEGA) were retrospectively reviewed. The average age at the time of surgery was 13.3 years. headache related to raised intracranial pressure was the first and only sign in 2 patients, with the remaining 2 being admitted because of sequential neuroimaging studies over several years revealing the growth of 'subependymal nodules' into intraventricular tumours. In each case the tumour was in the region of Monro's foramen and was associated with ventricular dilatation. On computed tomography (CT), multiple subependymal nodules were found in 3 patients, and these well circumscribed isodense SEGAs were markedly enhanced by contrast medium. On magnetic resonance imaging (MRI), which was obtained in 3 patients, 2 SEGAs were isointense with the cerebral cortex and one with the white matter on T1-weighted images, and on T2-weighted images, 2 were isointense with the cortex and one with the white matter. At surgery the tumours appeared to originate from the inferolateral wall of the lateral ventricle in the region of the head of the caudate nuclei. Total macroscopic removal was achieved in 3 patients, and subtotal removal in one patient. Follow up ranged from 4.6 to 13.2 years, and all patients have exhibited similar physical and mental conditions to preoperative. So far there has been no evidence of any recurrences. The diagnosis and the surgical indications for SEGA are discussed, with periodic monitoring with neuroimaging studies being recommended even for asymptomatic patients with 'subependymal nodules'.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/7. meningioma of the lateral cerebral ventricle. A case report.The authors present the case of a 58-year-old woman. At presentation the patient complained of vertigo and noise in the ears with six months history, and from headache, accompanied by nausea and vomiting from three months. The physical examination of the patient found no abnormalities. The neurological examination revealed discoordination syndrome and mild hemiparesis of the left limbs. Computed tomography of the brain without and with contrast medium showed oval tumor, localized in the region of trigonum collaterale and the posterior horn of the right lateral ventricle. Operative intervention was performed after a preoperative management of the patient: transcortical fenestration of the brain in the region of trigonum collaterale and the posterior horn of the right lateral ventricle. The tumor was totally removed. It is well isolated, oval in shape, with feeding blood vessel from plexus chorioideus and was attached to the wall of the ventricle with several thin bridges. Macroscopically the tumor was 3 cm in diameter, with smooth walls, well capsulated, grey-brownish in color and with firm elastic consistence. The histological findings revealed meningioma--meningotheliomatose variant.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/7. Central neurocytoma--case report.A 29-year-old male was admitted with chronic headache on February 26, 1987, when there were no neurological deficits or physical abnormalities. Computed tomographic (CT) scans showed a mixed-density mass with no evidence of calcification in the left lateral ventricle, which was irregularly enhanced by contrast medium. Under a diagnosis of an intraventricular glial tumor, surgery was performed via a left transcortical-transventricular approach on March 31. The highly vascular, nodular tumor, originated from the lateral wall of the left lateral ventricle near the foramen of Monro, was successfully removed. The postoperative course was uneventful and he was discharged 3 months after postoperative irradiation. light microscopic examination revealed the tumor cells with the clear cytoplasm and perinuclear halos characteristic of an oligodendroglioma. However, electron microscopy showed neuronal elements identical with central neurocytoma as reported by Hassoun et al. in 1982. These included large numbers of dense-core or clear vesicles in the cell processes and synaptic structures.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/7. Recurrent aseptic meningitis for 24 years: diagnosis and treatment of an associated lesion.Recurrent meningitis in the absence of an identifiable causative organism or anatomical source is a difficult diagnostic challenge for any infectious disease consultant. We evaluated a 49-year-old woman with episodes of meningitis which occurred on at least nine separate occasions for over 24 years. No causative organism, physical agent, or underlying disease process was identified as the source of this patient's recurrent lymphocytic meningitis. When computerized tomographic head scanning was first performed in 1977, a prominence of the left lateral ventricle was evident. It was not until the area was subsequently evaluated with magnetic resonance imaging techniques 13 years later that a lesion could be clearly identified, removed, and evaluated at pathology. time alone will tell whether the lesion, a cavernous hemangioma, was truly the cause of this patient's recurrent aseptic meningitis for 24 years.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/7. Clinicopathological and radiological features of two cases of intraventricular meningioma in childhood.The clinical, radiological and pathological features of two cases of intraventricular meningioma in a 9-year-old boy and a 9-year-old girl are reported. Presenting features included headache, vomiting and somnolence with no localizing neurological signs on physical examination. Neither patient showed evidence of neurofibromatosis. CT scans were helpful in establishing the preoperative diagnoses with uniformly hyperdense, well-circumscribed lesions showing bright enhancement after contrast within the lateral and third ventricles respectively. Histological examination revealed mixed fibroblastic/angioblastic and fibroblastic patterns, with typical electron-microscopic and immunohistochemical features of meningioma. Successful surgical removal was achieved in both cases.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/7. choroid plexus papilloma in early infants.Four infants with choroid plexus papillomas which were successfully treated with surgery are described. All patients showed the clinical signs of increased intracranial pressure and hydrocephalus within 8 weeks after birth. The tumors were in the lateral ventricles and histologically three of them were benign papillomas and other one was a malignant papilloma. Computerized tomography scan was useful for the diagnosis of both of the tumor and the hydrocephalus that was caused by the overproduction of cerebrospinal fluid and/or the obstruction of it's pathway. The tumor stain on the angiograms was noticed in two patients. Three patients have grown normally in both physical and mental functions after the surgical treatment, whereas one showed psychomotor retardation because of poorly controlled hydrocephalus.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/7. A case of mistaken identity: a fourth ventricular tumor presenting as school phobia in a 12 year old boy.A 12 year old boy was diagnosed as having overanxious disorder of childhood and school phobia. He was later found to be suffering from the effects of a cerebral tumor. Surgical removal of the tumor led to alleviation of the anxiety. The authors utilize this case to illustrate some aspects of differential diagnosis in child psychiatry. In particular, they point out the necessity of comprehensive physical examination in child psychiatry impatient units. The danger of attributing physical symptoms to functional illness purely in the absence of positive physical findings is noted. The importance of utilizing a biopsychosocial diagnostic model in child psychiatry is stressed.- - - - - - - - - - ranking = 3keywords = physical (Clic here for more details about this article) |