1/22. Hypoglossal neurinoma presenting with intratumoral hemorrhage.Focal or microscopic hemorrhage in a neurinoma is common, but tumor origin from the hypoglossal nerve and extensive symptomatic intratumoral hemorrhage are both rare. A 59-year-old male presented with severe neck pain, nausea and vomiting of 1-day duration, accompanied by right hypoglossal nerve palsy. neuroimaging disclosed a tumor located in the right cerebellomedullary fissure and containing a hematoma. The right hypoglossal canal was slightly dilated. The intracranial tumor was resected via a suboccipital approach. Histological examination demonstrated spindle-shaped tumor cells with nuclear palisading and also relative hypervascularity with hyaline degeneration of the vessels. Extensive hemorrhage was present, as was necrosis. Thickening and hyalinization of arterial walls, a common occurrence in neurinomas, may have contributed to symptomatic intratumoral hemorrhage.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/22. Sixth nerve schwannoma: a case report with literature review.A 40-year-old woman presented with diplopia and left VI nerve palsy. After investigations, diagnosis of a meningioma in the parasellar-prepontine region was considered. Following angiography and embolization, near-total excision of the tumour attached to abducens nerve was performed. Histological examination was consistent with the diagnosis of schwannoma. This is the thirteenth case report of a schwannoma of cranial nerve VI and the first such case where embolization of feeding tumour vessels was performed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/22. Trigeminal neurinoma presenting with intratumoral hemorrhage: report of two cases.We report 2 cases of trigeminal neurinoma presenting with spontaneous intratumoral hemorrhage. There are only 2 similar cases reported in the literature. Presenting symptoms were headache, diplopia, disturbed consciousness and trigeminal disturbance with sudden onset. CT scan showed a typical fluid-fluid level within low-density mass in the cerebellopontine angle in one case. On MRI, one case showed a typical fluid-fluid level on T2-weighted image and another one had mixed signal intensities including hyper- and hypointensities on both T1- and T2-weighted images. Histologically, increased vascularity, consisting of dilated and thin-walled vessels presenting telangiectatic or cavernous angiomatous appearances were observed in the specimens in both cases. The size of these tumors was about 3 cm each in diameter. risk factors for hemorrhage appear to be large tumor size and increased vascularity.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/22. Vascular malformation with radiation vasculopathy after treatment of chiasmatic/hypothalamic glioma.Chiasmatic/hypothalamic gliomas usually are histologically benign astrocytomas that may recur many years after diagnosis and treatment. Three children with chiasmatic/hypothalamic gliomas who were treated at the authors' institution returned 9.5, 11.5, and 2 years, respectively, after radiation therapy (RT) because visual and neurologic deterioration developed. Neuroradiographic studies, including arteriography in two of the patients, showed large mass lesions. These were presumed to be recurrence of tumor, and chemotherapy was administered. Pathologic examination of two children who died and of the third who had a biopsy revealed only a minimal amount of residual, histologically benign astrocytoma, whereas the bulk of the specimen consisted of numerous vessels of variable size. These probably represented incorporation of the rich vasculature in the chiasmal region into the tumor, which underwent degeneration secondary to RT. Radiographic methods did not distinguish progressive tumor growth from the vasculopathy and led to inappropriate clinical diagnoses and treatment.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/22. Solitary fibrous tumor arising from Cranial Nerve VI in the prepontine cistern: case report and review of a tumor subpopulation mimicking schwannoma.OBJECTIVE: The authors present a report of a solitary fibrous tumor (SFT) arising from the intradural component of the VIth cranial nerve as it travels through the prepontine cistern. SFTs of the central nervous system are extremely rare entities that clinically masquerade as dural-based lesions, such as meningiomas or hemangiopericytomas. Because of their infrequency and clinical similarity to other central nervous system (CNS) lesions, diagnosis is largely dependent on pathological features. In this study, the authors define a subpopulation of SFTs that seem to arise directly from nerve, rather than meninges, and clinically mimic the appearance of a schwannoma. CLINICAL PRESENTATION: The patient was a 29-year-old woman with a several-month history of progressive right arm and leg numbness and mild hemiparesis, with the development of diplopia 2 weeks before admission. Outside imaging revealed a 3.9-cm mass in the prepontine cistern with extension into Meckel's cave and the cavernous sinus, resulting in significant brainstem compression. INTERVENTION: The patient underwent preoperative angiography with embolization of feeding vessels off of the left meningohypophyseal trunk. The patient was then taken to the operating room by a combined neurosurgical and ear, nose, and throat team, where the patient underwent a retrolabyrinthine/subtemporal craniotomy for tumor resection. During resection of the prepontine component, the tumor was identified as originating from the left Cranial Nerve VI as it traversed through the prepontine cistern. Resection of the tumor component involving the cavernous sinus and Meckel's cave was deferred for follow-up treatment with intensity-modulated radiation therapy. Pathological examination revealed tissue consistent with the diagnosis of SFT. CONCLUSION: SFTs involving the CNS are rare entities that are almost always diagnosed after tissue is obtained because of their clinical and radiographic similarity to meningiomas. This patient had an SFT masquerading as a VIth cranial nerve schwannoma. Although the natural history of SFTs in the CNS is not completely understood, correct diagnosis is important, given the rate of recurrence found in the more common pleural-based SFT and examples of CNS SFTs with malignant features.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/22. Clinicopathologic correlation of retinal to choroidal venous collaterals of the optic nerve head.An optic nerve meningioma developed in an elderly woman and was followed for 13 years until her death. The optic nerve was initially normal. Over time it became swollen and then atrophic and developed retinal venous to choroidal venous collaterals. Five hundred serial sections were prepared through the optic nerve and for approximately 1.5 mm superiorly and inferiorly to the optic nerve to trace the course of the collaterals that were seen ophthalmoscopically and angiographically in the optic nerve head. This clinicopathologic study shows clearly that the abnormal channels are, in fact, retinal venous to choroidal venous collaterals (bypass channels). Four collaterals extended around the end of Bruch's membrane at the optic nerve head. Two more collaterals extended through the retinal pigment epithelium to become continuous with a subretinal pigment epithelial neovascular membrane, the vessels of which connected with the choroidal vessels through a defect in Bruch's membrane.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
7/22. Neurinoma of the spinal accessory nerve: report of a case.We report a patient with neurinoma of the spinal accessory nerve, who complained of intermittent occipital headaches, nausea, vomiting, blurred vision and unsteady gait. Neurological examination revealed papilledema, bilateral horizontal nystagmus and right cerebellar signs. Computed tomography revealed mild hydrocephalus, a low-attenuated lesion with a faint capsule after enhancement and partial compression of the 4th ventricle in the right posterior fossa. Vertebral angiography revealed no definite tumor vessels or stains. Under the impression of a posterior fossa tumor, a suboccipital craniectomy with a C1 and C2 laminectomy was performed. A 4 x 4 x 2.5 cm3 dumbbell tumor arising from the left spinal accessory nerve at the C2 level was found 4 x 4 x 2.5 cm3. The tumor extended upward through the foramen magnum with upward displacement of both tonsils to the right jugular foramen with slight adhesion to the right IX, X and XI cranial nerves. The left spinal accessory nerve was severed from the pedicle at the C2 level, and the tumor was totally removed. diagnosis was made during the operation. The pathological examination showed neurinoma with cystic degeneration. During the following year, atrophy of the left sternocleidomastoid and trapezius muscles were noticed. Up to the time of this writing, there had been no clinical recurrence.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/22. Intraspinal metastases from retinoblastoma.cerebrospinal fluid seeding is a well-known mode of metastasis for intracranial neoplasms such as medulloblastoma, ependymoma, and glioblastoma; however, retinoblastoma is not usually considered. The route of spread appears to be by direct extension into the optic nerve from the retina and into the meningeal spaces by extension from the choroid, or along the central retinal vessels to the subarachnoid space. Four cases are presented.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/22. Opticociliary veins in a primary optic nerve sheath meningioma.A 59-year-old man developed painless visual loss in his left eye over a one-year period, with rapid progression to blindness over three months. Ocular examination of the left eye revealed proptosis, marked optic disk pallor, dilated retinal veins, and congeries of vessels at the disk margin (opticociliary veins). His right eye was unremarkable. fluorescein angiography and histopathologic examination confirmed the presence of opticociliary veins communicating between branches of the central retinal vein and the adjacent choroidal vasculature. Primary orbital optic nerve meningioma associated with opticociliary veins was diagnosed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/22. fluorescein angiography of optociliary shunt vessels.Progressive loss of vision, optic disc pallor, and optociliary shunt vessels (the Hoyt-Spencer sign) constitute the clinical triad of optic nerve sheath meningiomas. However, optociliary shunt vessels may also follow central vein occlusions, and less commonly occur with a few other conditions. This report presents a comparative study of fluorescein angiograms performed on eight patients with optociliary shunt vessels. Four patients had optic nerve sheath meningiomas, and four patients had central retinal vein occlusions. The following differences in the fluorescein angiograms were noted in the two groups. In the optic nerve sheath meningioma group, the shunt vessels fill earlier (in the arteriovenous phase), the flow drains to central venous tributaries, and the late staining is hyperfluorescent to other veins. However, in the central vein occlusion group, the shunts fill later (in the venous phase), show a flow draining to the outer disc margin, and late staining is eufluorescent with other veins. Although optic nerve sheath meningiomas and old vein occlusions are usually rather easily differentiated by a complete examination, the fluorescein angiographic patterns are not only pertinent with regards to the pathogenesis of optociliary vessels, but in certain cases may be clinically helpful in making an important clinical differentiation.- - - - - - - - - - ranking = 9keywords = vessel (Clic here for more details about this article) |
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