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Burgetova A, Vaneckova M, Nytrova P, Matej R, Seidl Z. Coincidence of spinal tumor (astrocytoma) and non-specific encephalomyelitis. NEURO ENDOCRINOLOGY LETTERS 2012; 33:769-772. [PMID: 23391981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Accepted: 09/01/2012] [Indexed: 06/01/2023]
Abstract
The aim of this paper is to demonstrate that differential diagnostics of intra-medullary spinal lesions can sometimes be very difficult, even when the latest complement examinations are used, including magnetic resonance imaging. The particular case dealt with here was complicated by the presence of two different pathological processes. We present the case report, where the case history, clinical course and results of the paraclinical examinations, including the magnetic resonance imaging, suggested an intra-medullary inflammatory/demyelinating process. The post-mortem histological finding was a surprise, because besides signs of non-specific encephalomyelitis, it also displayed signs of a spinal tumor (histological character of diffuse astrocytoma grade II-III). We would like to emphasize some important facts in our discussion, especially from the perspective of the magnetic resonance imaging. Finally, we would like to ask if the presence of both pathologies (astrocytoma and nonspecific myelitis) was coincidental, or if the myelitis had an iatrogenic etiology (by therapy, by infection during the lumbar punctions).
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77
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Isidro ML, Pita F, Ruano B. [Astrocytoma in a patient with multiple endocrine neoplasia type 2A syndrome. May the coexistence of glial tumors and multiple endocrine neoplasia 2A not be casual?]. ENDOCRINOLOGIA Y NUTRICION : ORGANO DE LA SOCIEDAD ESPANOLA DE ENDOCRINOLOGIA Y NUTRICION 2011; 58:501-503. [PMID: 21684225 DOI: 10.1016/j.endonu.2011.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 03/04/2011] [Accepted: 03/09/2011] [Indexed: 05/30/2023]
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Abstract
Much of the literature on tumors arising in the setting of chronic epilepsy focuses on children. This study reviewed 1 institution's 141-patient experience with tumors in adults arising in this clinical setting. The majority of tumors (71.6%) arose in the temporal lobe. The most common tumor types encountered included ganglioglioma (n = 38), low-grade fibrillary astrocytoma (n = 24), and low-grade oligodendroglioma (n = 22). Coexistent focal cortical dysplasia (type IA) was identified in 15 cases (10.6%). The largest group of tumors in adults were World Health Organization (WHO) grade II neoplasms compared with WHO grade I tumors in children. Gangliogliomas are the most commonly encountered neoplasms. Coexistent focal cortical dysplasia may be observed in a significant minority of tumors, suggesting a possible developmental origin for some of these neoplasms.
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79
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Prayson NF, Koch P, Angelov L, Prayson RA. Microscopic thrombi in anaplastic astrocytoma predict worse survival? Ann Diagn Pathol 2011; 15:389-93. [PMID: 21849253 DOI: 10.1016/j.anndiagpath.2011.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 05/12/2011] [Accepted: 05/26/2011] [Indexed: 11/18/2022]
Abstract
The purpose of this study is to determine whether anaplastic astrocytoma patients with intratumoral vascular thrombi have a worse survival than anaplastic astrocytoma patients without thrombi. A retrospective review of 101 patients (60 males; mean age, 53.3 years) with anaplastic astrocytoma (World Health Organization grade III) was conducted. Thrombi were counted relative to the number of involved blood vessels in the initially resected tumor (69 biopsies, 32 subtotal resections) and were correlated with survival and development of postoperative deep venous thrombosis (DVT). Of tumors with thrombi (n = 17), the percentage of blood vessels with thrombi ranged from 1.5% to 20% (mean, 5.6%). Of these patients, 16 died of tumor (mean survival, 15.4 months), and 1 patient was alive with tumor at 180 months. Eighty-four patients with anaplastic astrocytoma had no intravascular tumor thrombi; 75 of these patients died of tumor (mean survival, 26.5 months), 4 patients were alive, and 5 patients were lost to follow-up. Evidence of DVT was found in 2 (18.2%) of 11 tested patients with thrombi vs 10 (18.5%) of 54 patients without thrombi. Patients with microscopic intratumoral thrombi (17% of anaplastic astrocytoma) had a worse survival compared with patients without thrombi; the difference did not reach statistical significance. There was no correlation between the presence of intratumoral thrombi and the development of DVT.
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80
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Komotar RJ, Starke RM, Connolly ES, Sisti MB. mTOR inhibitors in the treatment of subependymal giant-cell astrocytomas associated with tuberous sclerosis. Neurosurgery 2011; 68:N24-5. [PMID: 21792104 DOI: 10.1227/01.neu.0000395796.64099.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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81
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Nishimoto T, Iida K, Kagawa K, Watanabe Y, Kiura Y, Hashizume A, Sugiyama K, Kurisu K. Late recurrence of intractable epilepsy associated with MRI-occult pilocytic astrocytoma in the temporal lobe nine years after initial removal: a case report with surgical and late-seizure recurrence observations. HIROSHIMA JOURNAL OF MEDICAL SCIENCES 2011; 60:45-49. [PMID: 21970188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A 28-year-old male who presented a relapse of intractable epilepsy consisting of complex partial seizures with occasional secondary generalizations at the age of 26, had undergone removal of a left mesial temporal lobe tumor at another hospital at 18 years old. Pathological examination at that time revealed a low-grade astrocytoma, and the tumor was further treated by complementary adjuvant irradiation therapy. Magnetic resonance imaging (MRI) findings on admission portrayed a post-operative cavity anterior to the atrophied hippocampus on the left side with hyperintense in fluid-attenuated inversion recovery (FLAIR) images. There were no enhanced lesions in T1-weighted gadolinium images. As it was diagnosed as left mesial temporal lobe epilepsy with preoperative evaluations, the patient underwent left anterior temporal lobe resection (TLR). Intraoperative findings revealed that a small lump of grey tissue was attached to the anteromesial side of the sclerotic hippocampus. We surgically removed this and the tissue was a pilocytic astrocytoma. The patient has since remained seizure-free for 2.5 years. Seizure outcomes at postoperative 1-2 years are highly predictive of long-term outcomes after TLR for temporal lobe epilepsy (TLE). Late-seizure recurrence (> postoperative 2 years) with an initially successful outcome rarely occurs in TLR patients. This case report suggests that recurrence of even benign pilocytic astrocytomas may occur when seizure recurs in long-term follow-up.
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82
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Wu FZ, Fu JH, Chen JY, Lai PH. Teaching NeuroImages: Acquired Chiari malformation with syringohydromyelia caused by posterior fossa tumor. Neurology 2010; 75:e59. [PMID: 20921506 DOI: 10.1212/wnl.0b013e3181f612fa] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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83
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Li WQ, Li YM, Lu YC, Yu HY. Bulky subependymal giant cell astrocytoma with profuse blood supply without tuberous sclerosis. NEUROSCIENCES (RIYADH, SAUDI ARABIA) 2010; 15:287-288. [PMID: 20956931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Kita D, Hayashi Y, Watanabe T, Korshunov A, von Deimling A, Nakada M, Kasahara Y, Zen Y, Hamada J, Hayashi Y. Secondary anaplastic astrocytoma developing in a young adult with autoimmune lymphoproliferative syndrome (ALPS). Neuropathol Appl Neurobiol 2010; 37:423-7. [PMID: 20846185 DOI: 10.1111/j.1365-2990.2010.01123.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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85
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Pothiawala S, Hsu MY, Yang C, Kesari S, Ibrahimi OA. Urticarial hypersensitivity reaction caused by temozolomide. J Drugs Dermatol 2010; 9:1142-1144. [PMID: 20865848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Temozolomide is an oral alkylating agent approved for the treatment of glioblastoma and anaplastic astrocytoma, and is currently under clinical investigation for the treatment of brain metastases from a variety of cancers. Temozolomide is well tolerated, and the reported dermatologic side effects of this medication are limited. Here, the authors report the first case of an urticarial hypersensitivity reaction induced by temozolomide. As this drug will likely be increasingly utilized in the near future, it is important to be aware of its potential to cause adverse cutaneous manifestations.
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Tung JN, Tsao TY, Tai CJ, Yeh KT, Cheng YW, Jiang MC. Distribution of lysosome-associated membrane proteins-1 and -2, and cathepsin D in eosinophilic granular bodies: possible relationship to cyst development in pilocytic astrocytomas. J Int Med Res 2010; 38:1354-64. [PMID: 20926008 DOI: 10.1177/147323001003800417] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023] Open
Abstract
Pilocytic astrocytomas are usually cystic; cyst formation within these tumours may result in increased intracranial pressure, due to the effect of their mass, and contribute to cerebral damage. Eosinophilic granular bodies (EGBs) are produced abundantly in pilocytic astrocytomas but their role in disease progression remains unknown. Immunohistochemistry studies showed EGBs to exhibit pronounced reactivity to antibodies against lysosome-associated membrane proteins (LAMP)-1 and LAMP-2, and the lysosomal enzyme cathepsin D. Both LAMP-1 and LAMP-2 showed peripheral rim and granular staining patterns. The EGBs were scattered widely across cysts and, where EGBs aggregated in clusters, were usually close to areas of fluid in the cysts. Most EGBs had nuclei either attached or close by, indicating that the EGBs may be derived from anucleated astrocytes. The results suggest that EGBs, together with other factors, may play a role in the development of cysts in pilocytic astrocytomas.
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Liu J, Lu DH, Piao YS, Wang W, Chen L, Wei LF, Yang H. [Expression and diagnostic significance of CD34 in brain tumors of patients with refractory epilepsy]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2010; 39:151-155. [PMID: 20450759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To study the immunohistochemical expression and diagnostic significance of CD34 in brain tumors of patients with refractory epilepsy. METHODS Immunohistochemical study for CD34 was performed on formalin-fixed paraffin-embedded tissue blocks of 54 cases of brain tumors occurring in patients with refractory epilepsy. The tumor types included ganglioglioma (GG, number = 21), dysembryoplastic neuroepithelial tumor (DNT, number = 8), tumors/lesions which had the transitional features that between glioneuronal hamartia and mixed neuronal-glial tumor (number = 21) and pleomorphic xanthoastrocytoma (PXA, number = 4). Cases of glioblastoma (number = 4) and oligoastrocytoma (number = 5) were used as controls. RESULTS Twenty of the 21 cases of GG, 1 of the 8 cases of DNT, 16 of the 21 cases of tumors/lesions which had the transitional features and 3 of the 4 cases of PXA showed cytoplasmic and membranous positivity for CD34. The adjoining brain tissues in 9 of the 18 cases of GG, 6 of the 16 cases of tumors/lesions which had the transitional features and 1 of the 3 cases of PXA also expressed CD34. In contrast, only 1 case of glioblastoma showed membranous positivity for CD34. CONCLUSIONS CD34 preferred to staining for GG and PXA. Which represent a valuable tool for distinguishing GG, PXA and DNT, oligoastrocytoma, glioblastoma.
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88
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Chrastina J, Novák Z, Riha I, Ghallab K. [Primary brain tumor as a rare cause of acute subdural hematoma]. ROZHLEDY V CHIRURGII : MESICNIK CESKOSLOVENSKE CHIRURGICKE SPOLECNOSTI 2009; 88:549-553. [PMID: 20052935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The aim of the study is to present a case report describing patient, admitted for subdural haematoma located on temporal lobe base and brain convexity with intracerebral haematoma located in the depth of temporal lobe. Both haematomas were evacuated from burr holes. Histological analysis of tissue obtained during intracerebral haematoma aspiration has proven tumorous tissue consistent with anaplastic astrocytoma. Contrast enhanced MRI has confirmed the diagnosis and patient underwent tumor surgery. The study brings additional data to differential diagnosis of subdural haematoma, especially of non traumatic origin. When compared with meningiomas and metastatic tumors primary brain glioma is an exceptional cause of subdural haematoma of non traumatic origin.
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Cornwell PL, Murdoch BE, Ward EC, Morgan A. Dysarthria and dysphagia as long-term sequelae in a child treated for posterior fossa tumour. ACTA ACUST UNITED AC 2009; 6:67-75. [PMID: 14534043 DOI: 10.1080/1363849031000139289] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The current case report provides a comprehensive description of the persistent dysarthria and dysphagia evident in a 7.5 year old child treated for recurrent posterior fossa tumour (PFT). AC was assessed on a comprehensive perceptual and instrumental test battery incorporating all components of the speech production system (respiration, phonation, resonance, articulation and prosody) 2 years and 4 months following completion of her treatment. The nature of her swallowing impairment was investigated through the use of videofluoroscopic evaluation of swallowing (VFS). A mild dysarthria with ataxic and LMN components was identified, although overall speech intelligibility was not affected. A moderate dysphagia was also identified with impairment in all three phases of the swallowing process; oral preparatory, oral and pharyngeal. Dysarthria and dysphagia as persistent sequelae in children treated for PFT have implications for the long-term management of these children. The need for appropriate treatment regimes, as well as pre-surgical counselling regarding dysarthria and dysphagia as possible outcomes following surgery are highlighted.
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90
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Javadpour M, Khan AD, Jenkinson MD, Foy PM, Nahser HC. Cerebral aneurysm associated with an intracranial tumour: staged endovascular and surgical treatment in two cases. Br J Neurosurg 2009; 18:280-4. [PMID: 15327233 DOI: 10.1080/02688690410001732751] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Two cases are reported in which an anterior communicating artery aneurysm was associated with an intracranial tumour. The tumour was a suprasellar meningioma in one case and an optic chiasm/hypothalamic astrocytoma in the other. In both cases, the aneurysm was successfully embolized using Guglielmi detachable coils. Subsequently craniotomy was performed with complete excision of the meningioma and subtotal removal of the astrocytoma. Endovascular techniques can be employed to make the surgical excision of an intracranial tumour co-existing with an incidental aneurysm safer.
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91
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92
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93
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Lin M, Smith T, Beran RG. Crossed cerebellar hyperperfusion on ictal FDG PET in astrocytoma. J Clin Neurosci 2009; 16:603-4. [PMID: 19231196 DOI: 10.1016/j.jocn.2008.07.073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2007] [Revised: 07/10/2008] [Accepted: 07/13/2008] [Indexed: 02/05/2023]
Abstract
Crossed cerebellar hyperperfusion (CCH) is a rare phenomenon and reflects the close anatomical and functional relationship between the frontal brain region and its mediated remote effect on the contralateral cerebellum via the corticopontocerebellar pathway. Although it is well documented on cerebral single photon emission tomography (SPECT) in patients with epilepsy, it is rarely observed in seizures originating from brain tumours. We report a 41-y-old man who whilst undergoing (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) for investigation of suspected glioma, developed a generalized seizure. The scan performed shortly after seizure onset demonstrated intense metabolic activity in the right superior frontal lobe and in the contralateral cerebellar hemisphere consistent with CCH.
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94
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Freitas MRP, de Muzio SDC, Pessoa RCC, Stávale JN, Borges LRR, Malheiros SMF. [Diffuse bone marrow metastasis in cerebellar high-grade astrocytoma. A case report]. Rev Neurol 2009; 48:242-244. [PMID: 19263392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Cerebellar high-grade astrocytoma is uncommon. Although more prone to present cerebrospinal fluid dissemination, the cerebellar location is not particularly related to the occurrence of extra-cranial metastases, which are also unusual in supratentorial malignant gliomas. CASE REPORT A 46 year-old man with cerebellar anaplastic astrocytoma who developed pancytopenia due to extensive bone marrow metastases. CONCLUSION Extraneural metastases of brain gliomas are rare and the spread to the bone marrow confers an extremely poor prognosis for these patients. The expected improvement in glioma patients' survival due to the combination of more efficient therapies may lead to an increased incidence of this uncommon presentation, justifying a more rigorous follow-up of systemic manifestations.
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Sun FH, Piao YS, Wang W, Chen L, Wei LF, Yang H, Lu DH. [Brain tumors in patients with intractable epilepsy: a clinicopathologic study of 35 cases]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2009; 38:153-157. [PMID: 19575848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To study the clinicopathologic features of brain tumors occurring in patients with medically intractable epilepsy. METHODS The clinical, radiologic and pathologic features of brain tumors occurring in 35 patients with intractable epilepsy encountered during the period from January, 2005 to April, 2008 in Xuanwu Hospital were retrospectively reviewed. RESULTS The mean age of seizure onset and duration of disease were 14.3-year-old and 8.6 years, respectively. Abnormal signals were observed in 94.3% of cases (33/35) by magnetic resonance imaging. The histologic types of brain tumors included ganglioglioma (13/35, WHO grade I and 6/35, WHO grade II), dysembryoplastic neuroepithelial tumor (3/35, WHO grade I), pleomorphic xanthoastrocytoma (3/35, WHO grade II), diffuse astrocytoma (1/35, WHO grade II), oligoastrocytoma (1/35, WHO grade II), angiocentric glioma (1/35, WHO grade I) and meningioangiomatosis (1/35). The 6 remaining cases showed features seen in between glioneuronal hamartoma and mixed neuronal-glial tumor. Most of these tumors were located in the temporal lobe (27/35) and associated with focal cortical dysplasia. Immunohistochemical study showed a remarkable expression of CD34 in gangliogliomas. CONCLUSIONS Brain tumors in patients with medically intractable epilepsy are almost always benign and located in the temporal lobe. Most of them represent mixed neuronal-glial tumors and some show transitional features in-between glioneuronal hamartoma and mixed neuronal-glial neoplasm. The similar morphologic pattern and biological behavior of glioneuronal hamartoma and mixed neuronal-glial tumor may suggest a common pathogenetic mechanism.
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Shorman M, Al-Tawfiq JA. Strongyloides stercoralis hyperinfection presenting as acute respiratory failure and Gram-negative sepsis in a patient with astrocytoma. Int J Infect Dis 2009; 13:e288-91. [PMID: 19231269 DOI: 10.1016/j.ijid.2008.11.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2008] [Accepted: 11/27/2008] [Indexed: 11/18/2022] Open
Abstract
In developing countries, Strongyloides stercoralis infection is a common cause of morbidity and mortality. Death from strongyloidosis can result from hyperinfection or disseminated disease. Infections due to S. stercoralis are unusual in Saudi Arabia and are usually diagnosed in immigrants from endemic areas. We report a case in which S. stercoralis was isolated from the sputum of a patient with Gram-negative sepsis and respiratory failure, and review the salient features of this disease. A high index of suspicion should be maintained by clinicians treating patients in endemic areas presenting with new-onset wheezing, acute respiratory distress and/or Gram-negative sepsis to prevent the serious complications of Strongyloides hyperinfection and dissemination.
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Gårde A. Experiences with dexamethasone treatment of intracranial pressure caused by brain tumours. ACTA NEUROLOGICA SCANDINAVICA. SUPPLEMENTUM 2009; 13 Pt 2:439-43. [PMID: 5214323 DOI: 10.1111/j.1600-0404.1965.tb01912.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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98
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Lee CS, Huh JS, Sim KB, Kim YW. Cerebellar pilocytic astrocytoma presenting with intratumor bleeding, subarachnoid hemorrhage, and subdural hematoma. Childs Nerv Syst 2009; 25:125-8. [PMID: 18629510 DOI: 10.1007/s00381-008-0678-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2008] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Massive intracranial hemorrhage is a very rare initial presentation of cerebellar pilocytic astrocytomas. There are no reports in the medical literature on a cerebellar pilocytic astrocytoma presenting with intratumor bleeding (ITB), subarachnoid hemorrhage (SAH), and subdural hematoma (SDH). CASE REPORT A 15-month-old boy presented with lethargy and nausea to our hospital. Magnetic resonance imaging showed a mass with ITB at the left cerebellar hemisphere in addition to SDH in the posterior fossa and SAH at the interpeduncular cistern. The patient underwent emergency surgery. On incising the dura, we found SDH, the tumor was visible at the cerebellar cortex, and near total removal followed. Microscopic examination of tissue sections revealed a pilocytic astrocytoma. DISCUSSION The authors' case is the first report with a presentation including ITB, SAH, and SDH. The presumed mechanism of the SAH and SDH was leaking of the ITB into subarachnoid and subdural spaces.
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French JLH, McCullough J, Bachra P, Bedforth NM. Transversus abdominis plane block for analgesia after caesarean section in a patient with an intracranial lesion. Int J Obstet Anesth 2008; 18:52-4. [PMID: 18996002 DOI: 10.1016/j.ijoa.2008.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2007] [Revised: 04/25/2008] [Accepted: 06/05/2008] [Indexed: 11/18/2022]
Abstract
We present our management of a 24-year-old primigravida with a recently diagnosed low-grade left temporal astroglioma, who was delivered by elective caesarean section. General anaesthesia with supplementary bilateral ultrasound-guided transversus abdominis plane blocks was chosen to reduce the requirements for intra- and postoperative opioids, the risk of postoperative respiratory depression and the potential exacerbation of borderline raised intracranial pressure.
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100
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Li HM, Hsu SS, Wang JS, Weng MJ, Fu JH, Chen CKH, Lai PH. Cerebral pilocytic astrocytoma with spontaneous intracranial hemorrhage in adults. J Chin Med Assoc 2008; 71:587-93. [PMID: 19015059 DOI: 10.1016/s1726-4901(08)70175-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Pilocytic astrocytomas are found predominantly in the pediatric population; reports of these tumors are extremely rare in adults. We report 2 cases of adult pilocytic astrocytoma with intracranial hemorrhage. A 32-year-old male presented with neck stiffness and severe headache, and a 34-year-old male was referred for headache and double vision. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a well-enhanced and circumscribed cystic hemorrhagic tumor with mural nodule over the cerebral hemisphere region. Perfusion-weighted MRI (PWI) was also performed in both patients. The measured relative cerebral blood volume ratios of the mural nodules in these 2 cases were, respectively, 1.34 and 2.81 when compared with normal white matter. After surgical resection, microscopic examination of the lesions showed pilocytic astrocytomas. Since pilocytic astrocytoma and other cystic tumors with mural nodule (such as hemangioblastoma) have similar findings on conventional CT and MRI, PWI is helpful in the differential diagnosis. The literature on hemorrhagic pilocytic astrocytoma is also reviewed.
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