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Li QX, Zhang YQ, Wang WH, Zhang XD, Hong Y, Ahmad A, Xu PK. Gelfoam Padding, an innovative surgical technique improving the total resection rate of cystic gliomas. Clin Neurol Neurosurg 2020; 196:105818. [PMID: 32622108 DOI: 10.1016/j.clineuro.2020.105818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 02/06/2020] [Accepted: 03/26/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The cystic gliomas are the special type of malignant tumors in the brain and often lead to unsatisfied prognosis, but the microsurgical resection is still the most important treatment. However, they are difficult to be totally removed with craniotomy, especially for those who have flimsy cyst walls. Recently, we attempted to resect them via an innovative surgical technique, "Gelfoam Padding", in order to improve the total resection rate of the tumors safely. PATIENTS AND METHODS Fifteen patients suffering intracerebral cystic gliomas underwent surgical intervention via "Gelfoam Padding" technique between 2015 and 2018, and the different histopathological results and their features of cyst walls were recorded. Then, the total resection rate of tumors as well as the complications after surgeries were analyzed to assess the applied value of this technique. RESULTS All the patients were improved in the clinical symptoms after the operations. According to the intraoperative assessment and MRI examinations performed within 72 h after surgery, total resection of the tumor was achieved in all patients. Besides, there were no serious postoperative complications in these cases with this technique. CONCLUSION The cystic glioma with the flimsy wall was the best applied indication of "Gelfoam Padding" technique, which could not only improve the total resection rate of tumors, but also be safe for the patients.
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Affiliation(s)
- Qing-Xin Li
- Department of Neurosurgery, The First Affiliated Hospital, Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China.
| | - Yi-Quan Zhang
- Department of Neurosurgery, The First Affiliated Hospital, Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China.
| | - Wei-Hong Wang
- Department of Neurosurgery, The First Affiliated Hospital, Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China.
| | - Xiao-Dong Zhang
- Department of Neurosurgery, The First Affiliated Hospital, Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China.
| | - Yang Hong
- Department of Neurosurgery, The First Affiliated Hospital, Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China.
| | - Akhlaq Ahmad
- Hefei National Laboratory for Physical Sciences at Microscale and School of Life Sciences, University of Science and Technology of China Hefei, Anhui, 230027, China.
| | - Pei-Kun Xu
- Department of Neurosurgery, The First Affiliated Hospital, Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China.
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Gahine R, Das A, Jain VK, Agrawal A. Rare association of microfilaria with poorly differentiated mucin-secreting metastatic carcinoma in liver aspirate cytology. BMJ Case Rep 2019; 12:12/10/e231618. [PMID: 31645405 DOI: 10.1136/bcr-2019-231618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Filariasis, a neglected tropical disease (NTD), is mainly caused by nematodes-Wuchereria bancrofti, Brugia malayi and B. timori Apart from profoundly disabling and disfiguring major clinical manifestations-lymphoedema, elephantiasis and hydrocoele-asymptomatic microfilaremia is common in endemic areas. Despite this, it is very rare to detect microfilariae in body fluids or aspirates. As per the literature search, this is the third case documenting incidental detection of microfilariae with metastatic deposits in the liver aspirate. Here, a 35-year-old man underwent image-guided fine-needle aspiration cytology of liver nodule. Liver aspirate cytology revealed poorly differentiated mucin-secreting metastatic carcinoma and coincidental presence of microfilariae of W. bancrofti Recently, microfilaria has frequently been found to be associated with the debilitated, immunocompromised condition and various neoplasm/cancer/malignancy. Hence, meticulous investigation should be undertaken to search for hidden pathology, whenever microfilariae are detected; and to deeply scrutinise aspirates for such parasites always, especially in endemic regions.
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Affiliation(s)
- Renuka Gahine
- Pathology, Pandit Jawaharlal Nehru Memorial Government Medical College, Raipur, Chhattisgarh, India
| | - Aditi Das
- Pathology, Pandit Jawaharlal Nehru Memorial Government Medical College, Raipur, Chhattisgarh, India
| | - Vishal Kumar Jain
- Radiodiagnosis, Pandit Jawaharlal Nehru Memorial Government Medical College, Raipur, Chhattisgarh, India
| | - Apurva Agrawal
- Pathology, Pandit Jawaharlal Nehru Memorial Government Medical College, Raipur, Chhattisgarh, India
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Shrivastava A, Arora P, Khare A, Goel G, Kapoor N. Central nervous system filariasis masquerading as a glioma: case report. J Neurosurg 2017; 127:691-693. [DOI: 10.3171/2016.9.jns161092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Filariasis, an endemic zoonosis in the Southeast Asia region, has been reported to affect various organs as well as the central nervous system (CNS). Inflammatory reactions mimicking those from neoplastic lesions clinically and radiologically have been reported in the breast and urinary bladder. To date, a CNS manifestation of filarial infestation has been reported in the form of meningoencephalitis. The authors here present an interesting case of a young man presenting in status epilepticus, which on radiological evaluation appeared to be a glioma. However, postoperative histopathological examination changed the provisional diagnosis to a filarial infection of the CNS mimicking a primary CNS neoplasm.
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Affiliation(s)
| | | | - Akriti Khare
- 2Pathology, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India
| | - Garima Goel
- 2Pathology, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India
| | - Neelkamal Kapoor
- 2Pathology, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India
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Berkowitz AL, Raibagkar P, Pritt BS, Mateen FJ. Neurologic manifestations of the neglected tropical diseases. J Neurol Sci 2015; 349:20-32. [PMID: 25623803 DOI: 10.1016/j.jns.2015.01.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 12/24/2014] [Accepted: 01/02/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND The World Health Organization has identified 17 neglected tropical diseases (NTDs) that disproportionately affect the world's poorest populations. The neurologic aspects of many of these NTDs have received relatively little attention. METHODS A review was performed in PubMed (MedLine) for each NTD by disease name, name of its causative organism, and neurology, neurosurgery, neurologist, brain, spinal cord, peripheral nerve, muscle, nervous system, encephalitis, meningitis, encephalopathy, stroke, neuropathy, and myopathy (1968-Sept. 2013). The Oxford Center for Evidence-based Medicine guidelines were used to determine the level of evidence of neurological involvement and treatment based on the reports identified. RESULTS Neurologic manifestations were reported for all NTDs except yaws. Neurologic involvement was described in systematic reviews for four NTDs (Chagas disease, echinococcosis, rabies, cysticercosis) (levels 2a-3a), retrospective cohort studies for six (dengue, human African trypanosomiasis, leishmaniasis, leprosy, onchocerciasis, schistosomiasis) (levels 2b-3b), case series for one (foodborne trematodiasis) (level 4), and case reports for five (Buruli ulcer, dracunculiasis, filariasis, soil-transmitted helminthes, and trachoma). Level 1 evidence for treatment of neurologic manifestations of NTDs was found for human African trypanosomiasis, leprosy, and cysticercosis and level 2 evidence exists for treatment of neurologic involvement in Chagas disease. For the remaining NTDs, treatment of neurologic complications is described in case series and case reports only. CONCLUSIONS Neurologic manifestations of NTDs cause significant morbidity and mortality, although limited evidence exists on how best to treat these neurologic complications. Increased awareness of neurologic manifestations of the NTDs can increase their early identification and treatment, contributing to ongoing elimination and eradication campaigns.
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Affiliation(s)
- Aaron L Berkowitz
- Brigham and Women's Hospital, Department of Neurology, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Pooja Raibagkar
- Brigham and Women's Hospital, Department of Neurology, Boston, MA, United States; Harvard Medical School, Boston, MA, United States; Massachusetts General Hospital, Department of Neurology, Boston, MA, United States
| | - Bobbi S Pritt
- Mayo Clinic, Department of Laboratory Medicine and Pathology, Rochester, MN, United States
| | - Farrah J Mateen
- Harvard Medical School, Boston, MA, United States; Massachusetts General Hospital, Department of Neurology, Boston, MA, United States.
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Abstract
Rhizobiales (formerly named Rickettsiales) cause in rare instances meningitis and meningovasculitis, respectively. In case of history of exposure, infection by Rhizobiales needs to be considered since both diagnosis and therapy may be extremely difficult and pathogen-specific. The same applies to protozoa; in this chapter, Babesia species, free-living amoebae and Entamoeba histolytica infection, including severe meningitis and brain abscess, infection by Trypanosoma species (South American and African trypanosomiasis) are discussed with respect to history, epidemiology, clinical signs, and symptoms as well as differential diagnosis and therapy. Parasitic flatworms and roundworms, potentially able to invade the central nervous system, trematodes (flukes), cestodes (in particular, Cysticercus cellulosae), but also nematodes (in particular, Strongyloides spp. in the immunocompromised) are of worldwide importance. In contrast, filarial worms, Toxocara spp., Trichinella spp., Gnathostoma and Angiostrongylus spp. are seen only in certain geographically confined areas. Even more regionally confined are infestations of the central nervous system by metazoa, in particular, tongue worms (=arthropods) or larvae of flies (=maggots). The aim of this chapter is (1) to alert the neurologist to these infections, and (2) to enable the attending emergency neurologist to take a knowledgeable history, with an emphasis on epidemiology, clinical signs, and symptoms as well as therapeutic management possibilities.
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Affiliation(s)
- Erich Schmutzhard
- Department of Neurology, Medical University Hospital Innsbruck, Innsbruck, Austria.
| | - Raimund Helbok
- Department of Neurology, Medical University Hospital Innsbruck, Innsbruck, Austria
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Bhalla D, Dumas M, Preux PM. Neurological manifestations of filarial infections. HANDBOOK OF CLINICAL NEUROLOGY 2013; 114:235-42. [PMID: 23829914 DOI: 10.1016/b978-0-444-53490-3.00018-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Filarial infections cause a huge public health burden wherever they are endemic. These filaria may locate anywhere in the human body. Their manifestations and pathogenic mechanisms, except the most common ones, are rarely investigated systematically. Their neurological manifestations, however, are being increasingly recognized particularly with onchocerciasis or Loa loa infections, Wuchereria bancrofti, or Mansonella perstans. The risk of developing these manifestations may also increase in cases that harbor multiple filariasis or coinfections, for instance as with Plasmodium. The microfilaria of Onchocerca and Loa loa are seen in cerebrospinal fluid. The pathogenesis of neurological manifestations of these infections is complex; however, pathogenic reactions may be caused by mechanical disruption, e.g., degeneration often followed by granulomas, causing fibrosis or mass effects on other tissues, vascular lesions, e.g., vascular block of cerebral vessels, or disordered inflammatory responses resulting in meningitis, encephalitis or localized inflammatory responses. The chances of having neurological manifestations may also depend upon the frequency and"heaviness"of infection over a lifetime. Hence, this type of infection should no longer be considered a disease of the commonly affected areas but one that may produce systemic effects or other manifestations, and these should be considered in populations where they are endemic.
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Affiliation(s)
- Devender Bhalla
- INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France; University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France; Centre Hospitalier Universitaire, Limoges, France
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Singh M, Majumdar K, Shramana M, Ravindra S, Daljit S. Incidental detection of an isolated microfilaria in squash cytology of an oligodendroglioma: the unexpected ‘worm’ in the pie. Cytopathology 2013; 25:61-3. [DOI: 10.1111/cyt.12044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Singh
- Pathology; Department of Neurosurgery, GB Pant Hospital and associated Maulana Azad Medical College; New Delhi India
| | - K. Majumdar
- Pathology; Department of Neurosurgery, GB Pant Hospital and associated Maulana Azad Medical College; New Delhi India
| | - M. Shramana
- Pathology; Department of Neurosurgery, GB Pant Hospital and associated Maulana Azad Medical College; New Delhi India
| | - S. Ravindra
- Pathology; Department of Neurosurgery, GB Pant Hospital and associated Maulana Azad Medical College; New Delhi India
| | - S. Daljit
- Pathology; Department of Neurosurgery, GB Pant Hospital and associated Maulana Azad Medical College; New Delhi India
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Tewarson SL, Mehrotra R, Singh M, Manan R. Detection of microfilaria of Wuchereria bancrofti in cerebrospinal fluid. Cytopathology 2007; 18:393-4. [DOI: 10.1111/j.1365-2303.2006.00376.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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