1/22. Intracerebral cyst associated with meningioma.A 27-year-old male had experienced an episode of severe headache and nausea, sometimes accompanied by an inability to name objects. magnetic resonance imaging showed a huge cyst within the left temporal lobe and a high degree of brain shift by it. A small round mass, which appeared to be a mural nodule, was located in the tip of left middle fossa. It was highly enhancing together with its attached dura mater, but the cyst wall was not enhanced. Sphenoid ridge meningioma with an associated intracerebral cyst or cystic glioma invading the dura mater was suspected. During surgery the small tumor was found to be arising from the sphenoid ridge and evaginating into the tip of the temporal lobe. The intracerebral cyst had a smooth surface and the tumor was visible outside the cyst through its wall. The tumor was totally removed, but the cyst wall was left without excision. Postoperatively he had no symptoms. Histological examination showed a microcystic meningioma. It is stressed that differentiations of cystic meningiomas from other cystic tumors and, of intratumoral from extratumoral cystic meningiomas using radiological, operative or histological findings are important.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/22. Cerebral vein thrombosis in Behcet's disease.Behcet's disease is a chronic, relapsing multisystem disorder, and nervous system involvement is one of the serious manifestations. Neuro-Behcet is rarely reported in children and may present with a wide variety of symptoms because the entire neuraxis may be affected. A case of cerebral vein thrombosis secondary to Behcet's disease is presented. The patient has recovered without any visual loss and had no complaints at 1-year follow-up.- - - - - - - - - - ranking = 1.4187880057588keywords = nervous system (Clic here for more details about this article) |
3/22. Cerebellar hemangioblastoma in pregnancy. A case report.BACKGROUND: The incidence of symptomatic hemangioblastoma of the posterior fossa during pregnancy is extremely low. Previous reports have noted that pregnancy seems to aggravate the clinical course of intracranial tumors, but little is known about the possible reasons. Various theories have been proposed to explain the rapid neurologic deterioration of hemangioblastoma patients during pregnancy; however, the pathophysiologic behavior and histogenesis of this vascular tumor are still not well understood. CASE: A case of cerebellar hemangioblastoma was diagnosed during pregnancy. Urgent surgery was required due to rapid development of obstructive hydrocephalus and brainstem compression. CONCLUSION: Obstetricians and neurosurgeons should be aware of the rare clinic entity of hemangioblastoma during pregnancy. Surgery might be indicated as soon as the tumor becomes symptomatic.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
4/22. Migraine-type headaches in children receiving chemotherapy and ondansetron.Six children developed severe daily migraine-type headaches during cancer treatment. In addition to chemotherapy drugs, all received daily doses of ondansetron, a 5-hydroxytryptamine type 3 receptor antagonist. 5-Hydroxytryptamine is considered to play a central role in migraine pathogenesis, and ondansetron may have caused headaches by producing 5-hydroxytryptamine dysfunction in the brain. All six children had either a personal or a family history of migraine, and this may be a risk factor for developing ondansetron-associated migraine-type headaches. ondansetron-induced headaches respond to withholding the drug and to standard antimigraine medications, but further study of a larger group of patients is required to confirm this impression.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
5/22. A novel case of a CAT to AAT transversion in codon 179 of the p53 gene in a supratentorial primitive neuroectodermal tumor harbored by a young girl. Case report and review of the literature.BACKGROUND: The most common cytogenetic abnormality encountered in primitive neuroectodermal tumors (PNET)/medulloblastoma is loss of heterozygosity in the region of the short arm of chromosome 17. There is some evidence that supratentorial PNET has different cytogenetic markers than infratentorial PNET/medulloblastoma. Particularly, loss of 17p is more frequent in the latter than in the former. We describe a young girl diagnosed with supratentorial PNET (SPNET). Analysis of the tumor suppressor gene p53 in the tumorous tissue revealed a rare transversion mutational event of CAT to AAT in position 179 of exon 5. To the best of our knowledge, this is the first case of such a transversion at codon 179 in the p53 gene in SPNET. CASE REPORT: A 12-year-old girl was admitted with nausea, headache and vision disturbances. MRI of the brain showed a large space- occupying lesion in the right frontal lobe. Histological examination of the macroscopic resection of the tumor revealed PNET of the brain. polymerase chain reaction-single strand conformation polymorphism analysis of all p53 exons was performed, and a unique variant of a transversion at codon 179 of exon 5 was revealed. Therapy was started according to the Children's Cancer group protocol (CCG-99702) designated for treatment of high-risk central nervous system embryonal tumors. She received an initial course of chemotherapy, consisting of cyclophosphamide and vincristine for mobilizing and harvesting peripheral blood stem cells (PBSCs). Then she was given craniospinal irradiation (3,600 cGy) with a boost to the tumor bed (1,980 cGy) and three consecutive courses of high-dose chemotherapy with carboplatin, vincristine and thiotepa/cyclophosphamide, with PBSCs support after each course. RESULTS: The patient is in complete remission 17 months after diagnosis, based on the results of physical examination and imaging studies. DISCUSSION: The mutation results in an alteration of the amino acid HIS to ASN. The amino acids surrounding position 175 play an important role in stabilizing the p53/dna complex. There are only 12 known mutations of the reported type, and the finding of such a rare mutational event in a low-incidence p53 mutation tumor, such as SPNET, might add additional insight into the p53-SPNET relationship in tumorigenesis. Although not widely accepted, it is possible that different mutations of the p53 gene in patients with brain tumors may imply a different ultimate prognosis. In our case, we cannot exclude the fact that transversion of CAT to AAT in position 179 of exon 5 may explain prolonged survival of a patient with good response to therapy.- - - - - - - - - - ranking = 7.6141229061714keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
6/22. Non-aneurysmal primary subarachnoid hemorrhage in pregnancy-induced hypertension and eclampsia.Clinical as well as neuroimaging studies of women with eclampsia or pregnancy-induced hypertension (PIH) have described a variety of neurologic manifestations, including intraparenchymal brain hemorrhage. autopsy studies have described pia-arachnoid hemorrhage in women who died of eclampsia, but radiographic studies have found only intraparenchymal hemorrhage. The author describes clinical and radiographic features in three women with subarachnoid hemorrhage associated with PIH.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
7/22. Panhypopituitarism as an initial manifestation of primary central nervous system non-Hodgkin's lymphoma.OBJECTIVE: To report an unusual case of primary central nervous system non-Hodgkin's lymphoma in which the initial manifestation was panhypopituitarism. methods: We present a retrospective case review and discuss similar cases from the literature. RESULTS: A 64-year-old woman with nausea, vomiting, diarrhea, and peripheral and periorbital edema was found to have panhypopituitarism. magnetic resonance imaging showed minimal enlargement of the pituitary, and a transsphenoidal biopsy of the pituitary was nondiagnostic. Months later, abnormalities of extraocular movements developed. Repeated imaging and a second transsphe-noidal biopsy did not reveal the ultimate diagnosis. When further neurologic signs and symptoms subsequently developed, a right temporal open craniotomy was performed. It was not until this procedure, the patient's third biopsy, that the cause of her illness was discovered to be diffuse large cell lymphoma. CONCLUSION: Although idiopathic panhypopituitarism is a relatively common clinical entity, it remains a diagnosis of exclusion. The development of associated neurologic signs should prompt the clinician to initiate a new search for an underlying cause. This case underscores the protean manifestations of central nervous system lymphoma, both endocrine and neurologic, and the difficulties that may be encountered in attempts to establish a diagnosis.- - - - - - - - - - ranking = 27.684737437028keywords = central nervous system, nervous system (Clic here for more details about this article) |
8/22. Adenoid glioblastoma arising in a patient with neurofibromatosis type-1.An unusual case of glioblastoma with adenoid structures arising in a 30-year-old Japanese woman with neurofibromatosis type-1 (NF1) is reported. The patient was admitted to University of Miyazaki Hospital, complaining of headache, nausea and vomiting. From the neuroradiological findings the patient was diagnosed as having glioblastoma, and the tumor was surgically resected. Histologically, the tumor consisted mainly of dark basophilic cells showing prominent tubular or glandular structures surrounded by large eosinophilic cells, in addition to the typical glioblastoma features in the periphery of the tumor. Both cells showed strong stainability with glial fibrillary acidic protein (GFAP) and S-100 protein immunohistochemically, so that the tumor was classified as adenoid glioblastoma. Several cases of glioblastoma have been reported to reveal the adenoid or epithelioid differentiation. The patients with NF1 are prone to develop malignant tumors including glioblastoma, but no cases representing adenoid glioblastoma associated with NF1 have been reported. This report is considered to be the first case of adenoid glioblastoma arising in a patient with NF1. The recognition of the existence of epithelial features of glioblastoma would be important in differential diagnosis of epithelioid tumors of the brain including metastatic carcinomas.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
9/22. Postpartum transient blindness probably related to undiagnosed brain tumor.nausea and vomiting are so frequent under regional anesthesia during parturition that these symptoms can be misleading and may cause the clinician to overlook a potential intracranial lesion. In the case we have reported, it was not until the onset of blindness that an intracranial lesion was suspected. Although the incidence of brain tumor during pregnancy is low, it does occur with various manifestations and has been associated with blindness. Therefore, prompt neurologic investigation may be warranted in patients complaining of visual changes, even though transient blindness can occur in the absence of a neurologic lesion.- - - - - - - - - - ranking = 5keywords = brain (Clic here for more details about this article) |
10/22. carbamazepine-responsive paroxysmal nausea and vomiting in a patient with meningeal carcinomatosis.In neurology, paroxysmal syndromes are well-known, eg, as manifestations of multiple sclerosis. We report a patient with meningeal carcinomatosis, who presented with therapy-refractory nausea and vomiting. The clinical suspicion of a paroxysmal syndrome prompted a trial of carbamazepine, which resulted in complete cessation of the symptoms. In cancer patients with central nervous system (CNS) involvement and therapy-refractory symptoms with sudden onset, carbamazepine treatment should be considered.- - - - - - - - - - ranking = 4.6141229061714keywords = central nervous system, nervous system (Clic here for more details about this article) |
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