Neurofibrosarcoma of the vagus nerve

Neurofibrosarcoma of the intrathoracic vagus nerve. Case report

A rare case of neurofibrosuarcoma of the intrathoracic vagus nerve in a man with von Recklinghausen's neurofibromatosis is reported. Magnetic resonance imaging accurately demonstrated the tumour and its relations to surgically important structures. Resection, in accordance with general recommendations for such tumours, was successfully performed.

[Effectiveness and hemodynamic mechanism of action of blood pressure lowering by intravenous labetalol in patients with a critical increase in blood pressure]

Labetalol (L) was intravenously given to ten patients with an acute elevation of arterial blood pressure above to 200 to 100 mmHg. Blood pressure was controlled in 9 of 10 patients (less than or equal to 170/100 mmHg) with 50 mg in 4, 100 mg in 4 and 200 mg L in 1 patient. In 9 responders, systolic pressure decreased from 207 +/- 20 to 161 +/- 9, diastolic pressure from 107 +/- 11 to 90 +/- 8, and mean pressure from 140 +/- 11 to 113 +/- 5 mmHg, and all pressures remained at these levels during a 25 min control period. Heart rate decreased significantly from 87 +/- 20 to 69 +/- 11 per min and cardiac index from 3.2 +/- 0.8 to 2.6 +/- 0.61/min x m2. Stroke volume index remained unchanged. Total peripheral resistance and pulmonary artery occlusion pressure were not significantly altered but tended to increase, resulting in a small shift to the right of the ventricular function curve. Pulmonary vascular resistance increased significantly from 236 +/- 108 to 314 +/- 132 dyn x sec x cm-5 and mixed venous oxygen saturation decreased from 70 +/- 5 to 65 +/- 8%. Peripheral resistance was considerably higher and cardiac index lower in patients with a heart rate below 70/min. We conclude that L effectively lowers the arterial blood pressure in hypertensive crisis, but the substance should not be used in patients with heart rates below 70/min, as in this case the beta-blocking effect may supervene resulting in a high-resistance low-output state.

Solitary neurofibroma of the vagus nerve in the aortopulmonary window masquerading as a developmental cyst

A rare case of solitary neurofibroma of the vagus nerve in the aortopulmonary window masquerading as a developmental cyst is reported. Its computed tomographic characteristics and magnetic resonance imaging are described and correlated with pathologic findings. Although the features of such imaging modalities are quite characteristic for a neurofibroma, its differentiation from "atypical" developmental cysts may be difficult.