Glioblatoma multiforme presenting angiographically as intracranial atherosclerotic vascular disease

Ectasia and fenestration of the anterior cerebral artery associated with persistent trigeminal artery: case report

Multiple vascular anomalies in a 22-year-old patient who had signs and symptoms of vestibulocochlear dysfunction are reported. Angiography revealed a fenestration of the proximal segment of the left anterior cerebral artery, an ectasia of the left anterior and posterior cerebral arteries, and a persistence of the right trigeminal artery. The rarity of the association is documented, and the clinical significance is discussed.

Transient neurologic disturbances, brain tumors, and normal computed tomography scans

During a 4-year period, four patients presented with transient disturbances in neurologic function that were diagnosed as seizures in two and transient ischemic attacks in the other two. Computed tomography (CT scan), both with and without contrast, was normal in all four patients. Isotopic brain scans (3 patients), cerebral angiograms (4 patients), and lumbar punctures (4 patients) were normal. Electroencephalograms (EEG) were normal in two patients and abnormal in two patients (consisting of focal slowing). Within 4.5 months, all patients developed symptoms and signs of a brain tumor, and in all four, CT scan now revealed a large mass lesion which at surgery was shown to be a malignant astrocytoma. These four patients constituted 4% of the total number of patients with malignant astrocytomas that were seen at the NYU Medical Center during this same time period. It is stressed that the CT scan may be normal early in the course of patients with brain tumors, particularly if they present with a transient disturbance in neurologic function. The first evidence of the tumor in such patients may be a slow-wave abnormality on the EEG. Patients who are suspected of having a brain tumor should, if the initial CT scan is normal, have the scan repeated later.

Narrowing and occlusion of arteries by intracranial tumors. Review of the literature and report of 25 cases

The intracranial arterial obstructions (narrowing or occlusion) found with intracranial tumors are rarely reported. Our 25 cases and those of the literature enable us to draw a statistical view of these facts. Meningiomas and gliomas are often concerned, and they principally involve the main arteries at the base of the brain. The practical interest in such pathology concerns: the risk of a fall in blood pressure during general anesthesia which may result in occlusion of a narrowed artery; the need to estimate the pathological state of one or several arteries passing by a tumor which must be removed; and the possibility of providing an extra-intracranial arterial bypass if necessary.

Morphological aspects of the vessels of brain tumours

The vascular changes associated with cerebral tumours are demonstrated angiographically and histologically.

Fusiform aneurysmal dilatation of pericallosal artery. A sign of lipoma of corpus callosum

Two cases of lipoma of the corpus callosum with aneurysmal dilatation of the pericallosal artery are reported. This appears to be a reliable sign of lipoma of the corpus callosum. Our cases and the literature reveal that 19 of 22 cases with illustrations of carotid angiography have demonstrated such an aneurysmal dilatation.

Multicentric and isolated multifocal glioblastoma multiforme simulating metastatic disease

Single case reports of multicentric glioblastoma multiforme and multifocal glioblastoma multiforme tumours are presented. Multicentric glioblastoma multiforme tumours are those which have no macroscopic or microscopic connection. Multifocal gliomatous tumours, on the other hand, are those with either gross or microsopic continuity or evidence of cerebral spinal fluid spread and/or local metastases. The cerebral scintigram findings, cerebral angiogram studies and pathological description of these entities are presented. These lesions may be mistaken for metastases. In patients with multiple cerebral lesions multiple primary malignancies of brain should be considered when there is no clinical or radiographical evidence for extracranial primary neoplasms.