1/46. An ACTH-producing pituitary carcinoma developing Cushing's disease.An autopsy case of an ACTH-producing pituitary carcinoma in a 59-year-old man who developed Cushing's disease is reported. The surgically removed pituitary tumor was diagnosed as chromophobe adenoma, however, pulmonary metastases appeared 2 years after the operation. autopsy revealed a residual pituitary tumor in the sella turcica with systemic metastases to the lungs, liver, pulmonary lymph nodes, hypothalamus, dura mater, and the subarachnoid space of the midbrain and spinal cord. immunohistochemistry revealed ACTH positivity in the tumor cells. Further immunohistochemical study showed positive high expression of Ki-67 in the tumor removed at surgery as well as in the autopsied tumor. Ki-67 labeling index provided valuable information about the invasive and proliferative potential compared to noninvasive benign pituitary adenoma.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
2/46. Rare presentation of small bowel leiomyosarcoma with liver metastases.Intraabdominal sarcomas are rare tumours usually diagnosed at an advanced stage. These lesions at presentation are bulky and symptoms are often related to pressure effects on adjacent organs. This case report describes a rare presentation of a small bowel leiomyosarcoma whose initial presentation was free haemorrhage into the abdominal cavity and concomitant liver metastases. This case report also demonstrates that, even with such a rare presentation, an aggressive surgical approach is indicated in this type of tumour and helps a patient with advanced disease to live a few disease-free months with a good quality of life.- - - - - - - - - - ranking = 0.69690413124629keywords = haemorrhage (Clic here for more details about this article) |
3/46. Diffuse leptomeningeal oligodendrogliomatosis: radiologic/pathologic correlation.We present the radiologic and pathologic findings in a boy who presented with diffuse leptomeningeal enhancement and whose clinical status deteriorated over the course of 5 years. During this period, MR images showed progression of the enhancement in the subarachnoid spaces, formation of intraaxial cysts, and hydrocephalus. autopsy findings revealed diffuse oligodendroglioma throughout the leptomeninges of the brain and spine, with no definite intraaxial focus. The radiologic and pathologic features of diffuse leptomeningeal oligodendrogliomatosis are reviewed.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
4/46. meningeal carcinomatosis manifested as bilateral progressive sensorineural hearing loss.OBJECTIVE: meningeal carcinomatosis is defined as the diffuse infiltration of the leptomeninges and subarachnoid space by malignant cells metastasizing from systemic cancer. The authors describe a rare case of meningeal carcinomatosis initially appearing as bilateral progressive sensorineural hearing loss. PATIENT: A 57-year-old man with lung cancer was referred to the authors' clinic because of progressive hearing loss, tinnitus, dizziness, and blurred vision for 1 month. RESULTS: magnetic resonance imaging revealed abnormal leptomeningeal enhancement. meningeal carcinomatosis was diagnosed by the detection of malignant cells in the cerebrospinal fluid after lumbar puncture. The patient died 1 year after diagnosis. CONCLUSIONS: meningeal carcinomatosis must be considered in the differential diagnosis in cancer patients with bilateral progressive sensorineural hearing loss. gadolinium-enhanced magnetic resonance imaging is a useful complementary diagnostic tool before lumbar puncture.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
5/46. In memoriam.So here's the case: a 41-year-old respiratory therapist comes in with a history of a bad headache, now much better. She looks like a rose in the emergency department. Goes for a head computed tomographic (CT) scan, which shows a subarachnoid hemorrhage. Returns to the department and promptly crashes, needs intubation, and starts posturing. She dies about 1 week later.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
6/46. Prolonged cerebral salt wasting syndrome associated with the intraventricular dissemination of brain tumors. Report of two cases and review of the literature.hyponatremia is a frequent event in neurosurgery practice and is usually associated with subarachnoid hemorrhage, head trauma, infections and neoplasms. The two common clinical manifestations are the inappropriate secretion of antidiuretic hormone (SIADH) and the cerebral salt wasting syndrome (CSWS), which were usually attributed to each other due to identical clinical presentation. In contrast to the better-recognized SIADH, there has not been a uniform consensus over the humoral and neural mechanisms of CSWS and functional aspects of renal response. In this article, we report on 2 cases of a primitive neuroectodermal tumor with prolonged CSWS manifested during the intraventricular dissemination of primary disease and the high catabolic stage.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
7/46. Post-traumatic syringomyelia following complete neurological recovery.OBJECTIVE: To describe the later neurologic deterioration secondary to the appearance of a post-traumatic syringomyelic cavity, in a patient who, in the initial phase, had an incomplete spinal cord lesion (asia C), which improved to asia E. methods: A 52-year-old male patient who, at the age of 19 (1965), suffered a spinal cord injury. He presented with a fracture of the sixth and seventh cervical neurological segment at the time of the lesion, evolving to asia E. Nine years after the traumatism, he began to feel pain accompanied by a sensory and motor deficit. RESULTS: With the aid of myelography and MRI, the existence of a syringomyelic cavity was detected, which extended from the fourth to the seventh cervical segments. The patient was operated on, on various occasions, placing a syringo-subarachnoid shunt. The neurological status of the patient continued to deteriorate and, at present, he has a complete lesion below the fourth neurological cervical segment with a partially preserved sensitive area up to T1. CONCLUSION: The development of the syringomyelic cavity could be one of the causes of later neurologic deterioration in patients with traumatic spinal cord injury with neurological recovery 'ad integrum' in the initial phase of spinal cord injury.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
8/46. Slowly progressive dystonia following central pontine and extrapontine myelinolysis.A 28-year-old woman was hospitalized with dysarthria and oro-mandibular and upper limb dystonia. Approximately 8 years prior to the current admission, the woman became severely hyponatremic due to traumatic subarachnoid hemorrhage-related SIADH. brain MRIs showed a signal increase in the central pons, thalamus and striatum on T2 weighted images compatible with central pontine and extrapontine myelinolysis. From a few months after that event, dystonia progressed slowly over the subsequent 8 years. We speculate that the particular damage chiefly to the myelin structures by myelinolytic process may have caused an extremely slow plastic reorganization of the neural structures, giving rise to progressive dystonia.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
9/46. De novo formation and rupture of an azygos pericallosal artery aneurysm. Case report.An azygos pericallosal artery (APCA) aneurysm is a rare anomaly that is closely associated with saccular aneurysms. This is the earliest report to document de novo formation and rupture of an aneurysm at the bifurcation of an unpaired pericallosal trunk. The authors report the case of a woman who presented at the age of 52 years with subarachnoid hemorrhage (SAH) from the rupture of a newly formed APCA bifurcation aneurysm, 7 years after she had undergone surgery to clip a ruptured anterior cerebral artery aneurysm. De novo formation of aneurysms after SAH rarely occurs and certain risk factors like multiple and familial aneurysms, arterial hypertension, or smoking have been postulated. Late follow-up examination with angiography to detect de novo aneurysms should be considered in patients with this vascular anomaly after SAH.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
10/46. Waldenstrom's macroglobulinaemia with intracerebral haemorrhage.A 65-year-old male was admitted for evaluation of severe anaemia, recurrent epistaxis, axillary lymphadenopathy, and hepatomegaly. The diagnosis of Waldenstrom's macroglobulinaemia was made on the basis of clinical and laboratory findings. The patient developed intracerebral haemorrhage without associated hypertension and with normal coagulation profile.- - - - - - - - - - ranking = 3.4845206562315keywords = haemorrhage (Clic here for more details about this article) |
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