1/10. A distinctive glioneuronal tumor of the adult cerebrum with neuropil-like (including "rosetted") islands: report of 4 cases.Four examples of a novel glioneuronal neoplasm are presented. All tumors affected adults (including two males and two females aged 25-40 years) as supratentorial, cerebral hemispheric masses with associated seizure activity and, in one case, symptoms of raised intracranial pressure and progressive hemiparesis. CT scans in two cases revealed hypodense masses without calcification. MRI scans at presentation demonstrated, in all cases, solid T1-hypointense and T2-hyperintense tumors with mass effect in one instance but no edema or contrast enhancement. Only one was relatively circumscribed on neuroradiologic study. All were infiltrative in their histologic growth pattern and predominantly glial in appearance, being composed mainly of fibrillary, gemistocytic, or protoplasmic astroglial elements of WHO grade II to III. Their distinguishing feature was their content of sharply delimited, neuropil-like islands of intense synaptophysin reactivity inhabited and rimmed in rosetted fashion by cells demonstrating strong nuclear immunolabeling for the neuronal antigens NeuN and Hu. These cells included small, oligodendrocyte-like ("neurocytic") elements as well as larger, more pleomorphic forms. Two cases contained, in addition, well-differentiated neurons of medium to ganglion-cell size. Proliferative activity was observed principally within the glial compartment; two cases contained mitotic figures and exhibited relatively elevated MIB-1 indices (6.8% and 8.2%). One of the latter progressed and proved fatal at 30 months following subtotal resection and radiotherapy. The three other patients are alive at intervals of 14 to 83 months, two tumor-free and one with extensive disease associated with the appearance of enhancement on MRI. This glioneuronal tumor variant may pursue an unfavorable clinical course.- - - - - - - - - - ranking = 1keywords = ganglion (Clic here for more details about this article) |
2/10. Subcortical modulation of spatial attention including evidence that the Sprague effect extends to man.The Sprague effect is well-established-small tectal lesions restore visual orientation in the hemianopic field of animals with extensive unilateral geniculo-striate lesions. Studies of human midbrain visual functions are rare. This man with a midbrain tumour developed left-neglect through subsequent right frontal damage. Bilateral orientation returned after clear evidence of damage to the superior colliculus contralateral to the cortical lesion (showing the Sprague effect extends to man). Sustained right-neglect developed after probable additional damage to right superior colliculus. The regulation of spatial attention by tecto-pulvinar circuits is discussed, and it is argued that the reduced right tecto-pulvinar activity (consequent to the additional right collicular damage) was offset by over-compensatory increase in thalamic reticular nucleus (TRN) suppression of left pulvinar activity.- - - - - - - - - - ranking = 0.28887152882105keywords = nucleus (Clic here for more details about this article) |
3/10. ganglioglioma, a malignant tumor? Correlation with flow deoxyribonucleic acid cytometric analysis.This study describes the flow cytometric deoxyribonucleic acid (dna) analysis of a resected ganglioglioma. The initial histopathological analysis revealed a benign tumor characterized by a predominance of mature ganglion cells. The flow cytometric dna analysis of the necrotic areas, however, demonstrated an aneuploid population of cells. Further examination by histological analysis of the tumor revealed both benign and atypical foci. The retrospective dna analysis performed from paraffin sections of tissue with benign-histological findings demonstrated euploid populations of cells consistent with a benign, slow-growing lesion. In contrast, dna analysis performed from tissue with atypical histological findings revealed aneuploid populations of cells consistent with a malignant phenotype. Our analysis provides additional data supporting the existence of tumor progression in some gangliogliomas. Results support the concept of tumor cell heterogeneity and the importance of adequate tumor sampling. The finding of aneuploid populations with unfavorable histology further supports the use of flow cytometry as an adjunct method in assessing tumor biology.- - - - - - - - - - ranking = 1keywords = ganglion (Clic here for more details about this article) |
4/10. The anatomical basis of symptomatic hemidystonia.Twenty-eight patients with focal (arm or leg) or hemidystonia due to tumour, arteriovenous malformation, infarction, haemorrhage or hemiatrophy are described. All had typical dystonic movements and/or postures, identical to those seen in idiopathic (primary) torsion dystonia. The site(s) of the lesion responsible, as defined by CT (computerized tomography) scan or pathological examination, was in the contralateral caudate nucleus, lentiform nucleus (particularly the putamen) or thalamus, or in a combination of these structures. review of 13 other patients in the literature with hemidystonia and lesions defined by CT scan, and of 7 other patients with pathologically discrete lesions associated with hemidystonia, also indicated involvement of these structures. dystonia may be due to abnormal input from thalamus to premotor cortex, due to lesions either of the thalamus itself, or of the striatum projecting by way of the globus pallidus to the thalamus.- - - - - - - - - - ranking = 0.5777430576421keywords = nucleus (Clic here for more details about this article) |
5/10. Transsynaptic degeneration in the inferior olivary nucleus associated with pontine glioblastoma.A case of glioblastoma arising in the pons of a 14-year-old boy in whom transsynaptic degeneration was found in the inferior olivary nucleus is reported. The tumor occupied most of the pons including the tegmental tract and invaded into the midbrain, medulla oblongata, cerebellar peduncles, thalamus, basal ganglia, and meninges. The right inferior olivary nucleus was devoid of the tumorous lesion, but many neurons were severely vacuolated. An immunohistochemical study using glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), and S-100 protein was performed. GFAP and S-100 protein were positive in the reactive glia of the nucleus and NSE gave a faint reaction in some degenerated neurons. These degenerative changes found in neurons of the inferior olivary nucleus were considered to be transsynaptic degeneration due to the destruction of the tegmental tract at the pons and of cerebellar peduncles by invasive pontine glioblastoma.- - - - - - - - - - ranking = 2.3109722305684keywords = nucleus (Clic here for more details about this article) |
6/10. Primary position upbeat nystagmus. A clinicopathologic study.eye movements were studied with electro-oculography in a patient with primary position, large amplitude, upbeat nystagmus. The upbeat nystagmus increased in amplitude on upward gaze, decreased on downward gaze, and was not altered by loss of fixation. The patient could not produce smooth pursuit movements upward or to the left, but had normal saccadic and vestibular induced eye movements in all directions. At necropsy, a low grade glioma was found involving primarily the medulla and caudal pons. The inferior olives and prepositus hypoglossal nuclei were diffusely infiltrated with tumor. These results suggest (1) primary position upbeat nystagmus is due to a defect in the upward smooth pursuit system, (2) the lower brain stem at the level of the inferior olives and nucleus prepositus hypoglossi is important in the mediation of vertical pursuit, and (3) primary position upbeat nystagmus can result from damage to several nuclei and interconnecting pathways in the caudal brain stem and midline cerebellum involved in control of vertical smooth pursuit.- - - - - - - - - - ranking = 0.28887152882105keywords = nucleus (Clic here for more details about this article) |
7/10. Initial experience with MR-imaging of intracranial midline-lesions and lesions of the cervical spine at half Tesla.Fifty-two patients were examined both with computed tomography using a different third generation scanner and by magnetic resonance imaging (MRI) at half Tesla field strength (Philips Gyroscan 5 S). Excellent contrast and spatial resolution as well as initial comparative results of normal anatomy and also selected clinical cases were demonstrated with the spin-echo (SE) and/or inversion recovery (IR) technique. The clinical material included a residual prolactinoma after transphenoidal surgery, follow-up of a recurrent partly calcified solid and cystic intra-/supra-sellar craniopharyngioma, low-grade glioma under stereotactic-like conditions, suspected pinealoma, recurrent astrocytoma (II-III) and ganglioneuroma at the posterior aspect of the middle and/or lower brain stem, small scar after lower brain stem infarction, stenosing degenerative disease of the cervical spine and multicystic lesion with an underlying benign ependymoma of the cervical spinal cord. MRI--although duplicating some CT results--provided better two- or three-dimensional anatomical detail as well as display of relevant vessels without need of contrast agent. It also gave more specific information in suprasellar tumours containing fat, afforded uniquely specific diagnosis in a bleeding venous malformation of the midbrain and defined more sensitively extra-/intra-axial lesions of the brain stem and cervical spinal cord. Small bony structures (erosions) and punctate calcifications may be missed by MRI. Although ferromagnetic material distorts the MR image, compared with CT, it is not impaired by non-ferromagnetic clips. This is an advantage with respect to postoperative control examinations.- - - - - - - - - - ranking = 1keywords = ganglion (Clic here for more details about this article) |
8/10. Afferent pupillary defect in pineal region tumour.A patient is described in whom an afferent pupillary defect was an early sign of a tumour in the pineal region. It is suggested that this was due to involvement of the pupillary afferent fibres between the optic tract and pretectal nucleus contralateral to the affected pupil.- - - - - - - - - - ranking = 0.28887152882105keywords = nucleus (Clic here for more details about this article) |
9/10. Nasal glioma.light and electron microscopic studies in a case of nasal glioma revealed a tumor composed nearly entirely of astrocytes. No ganglion cells or neurons were present and the mass was not surrounded by a capsule reminiscent for meningeal tissue. The vasculature resembled dermal patterns rather than typical central nervous system. No bone defect or connection to endocerebral tissue could be detected in the present case. Nasal glioma represents an ectopic focus of astrocytes, comparable to a hamartoma, rather than a true tumor or a herniation of brain tissue.- - - - - - - - - - ranking = 1keywords = ganglion (Clic here for more details about this article) |
10/10. Sudden, unexpected death in subjects with undiagnosed gliomas.We report two cases in which a medicolegal autopsy disclosed small and previously undiagnosed gliomas. The first case was a 38-year-old woman who was found dead in bed; her autopsy revealed a 1.3-cm low-grade astrocytoma in the right subthalamic area. The second case involved a 32-year-old man who drowned in shallow water after his canoe capsized. A 0.5-cm oligoden-droglioma of the left temporal lobe and a 0.1-cm ganglionic hamartoma of the hypothalamus were found. In both cases the tumors may, directly or indirectly, have been the underlying cause of death. We emphasize the importance of a thorough neuropathological examination for all cases of sudden unexpected death in which no extracerebral cause of death has been found.- - - - - - - - - - ranking = 1keywords = ganglion (Clic here for more details about this article) |
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