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Juárez-Belaúnde A, Orcajo E, Lejarreta S, Davila-Pérez P, León N, Oliviero A. Fatigue in patients with acquired brain damage. Neurologia 2024; 39:178-189. [PMID: 38278413 DOI: 10.1016/j.nrleng.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/22/2021] [Indexed: 01/28/2024] Open
Abstract
Fatigue is a complex, multidimensional syndrome that is prevalent in patients with acquired brain damage and has a negative impact on the neurorehabilitation process. It presents from early stages after the injury, and may persist over time, regardless of whether sequelae have resolved. Fatigue is conditioned by upper neuronal circuits, and is defined as an abnormal perception of overexertion. Its prevalence ranges from 29% to 77% after stroke, from 18% to 75% after traumatic brain injury, and from 47% to 97% after brain tumours. Fatigue is associated with factors including female sex, advanced age, dysfunctional families, history of specific health conditions, functional status (eg, fatigue prior to injury), comorbidities, mood, secondary disability, and the use of certain drugs. Assessment of fatigue is fundamentally based on such scales as the Fatigue Severity Scale (FSS). Advances have recently been made in imaging techniques for its diagnosis, such as in functional MRI. Regarding treatment, no specific pharmacological treatment currently exists; however, positive results have been reported for some conventional neurorehabilitation therapies, such as bright light therapy, neurofeedback, electrical stimulation, and transcranial magnetic stimulation. This review aims to assist neurorehabilitation professionals to recognise modifiable factors associated with fatigue and to describe the treatments available to reduce its negative effect on patients.
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Affiliation(s)
- A Juárez-Belaúnde
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España.
| | - E Orcajo
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España
| | - S Lejarreta
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Consorci Sanitari Alt Penedès-Garraf, Departmento de Neurología, Cataluña, España
| | - P Davila-Pérez
- Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España; Hospital Universitario Rey Juan Carlos (HURJC), Departmento de Neurofisiología Clínica, Madrid, España; Health Research Institute - Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), Madrid, España
| | - N León
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España
| | - A Oliviero
- Fundación Instituto San José Hospital, Área de Neurorrehabilitación y Atención al Daño Cerebral, Madrid, España; Unidad avanzada de neurorehabilitación, Hospital Los Madroños, Madrid, España; Hospital Nacional para Paraplégicos (SESCAM), Grupo FENNSI, Toledo, España
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2
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Aliaga D, Mayorga J, Verdú-López F, Gallego JM, Castellá L, Sabater V. Primary central nervous system Hodgkin lymphoma: A case report and review of the literature. Neurocirugia (Astur : Engl Ed) 2022; 33:350-355. [PMID: 36333092 DOI: 10.1016/j.neucie.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 06/01/2021] [Indexed: 06/16/2023]
Abstract
Central nervous system (CNS) involvement in the context of relapsed/refractory Hodgkin lymphoma (HL) is a quite rare, but well-known complication. Nevertheless, primary CNS-HL is an exceedingly rare condition, which diagnosis is based on well-defined morphological and immunohistochemical features, in addition to isolated involvement of the CNS. In spite of limited casuistry (just over twenty cases reported in the literature), available data agree that primary and isolated CNS-HL, when treated with a combination of surgery followed by some form of adjuvant therapy (radiotherapy±chemotherapy), carries a better prognosis than those cases with CNS involvement in the context of relapsed/refractory HL or those with CNS non-Hodgkin lymphoma. We herein report a case of a 55-year-old female patient who was diagnosed with primary CNS-HL. The patient was treated with complete surgical resection followed by intrathecal chemotherapy and whole brain radiotherapy (WBRT), showing fourteen months of disease-free survival at the time of this case report. A review of the available literature is also presented.
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Affiliation(s)
- David Aliaga
- Department of Neurosurgery, Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain.
| | - Juan Mayorga
- Department of Neurosurgery, Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain
| | - Franscisco Verdú-López
- Department of Neurosurgery, Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain
| | - José María Gallego
- Department of Neurosurgery, Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain
| | - Laura Castellá
- Department of Diagnostic Pathology, Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain
| | - Vicente Sabater
- Department of Diagnostic Pathology, Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain
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3
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Andrés Sanz JA, Ruiz Ginés JA, Iliev H, Aguas Valiente J. Primary intracranial melanoma, amelanotic variant: Case report. Neurocirugia (Astur : Engl Ed) 2022; 33:383-388. [PMID: 35248502 DOI: 10.1016/j.neucie.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/27/2021] [Accepted: 08/24/2021] [Indexed: 06/14/2023]
Abstract
Primary brain melanoma is a very rare tumour (only 0.07% of primary CNS neoplasms) which usually shows with abundant melanin content; whereas hypo/melanotic variants have been scarcely described. We introduce the case of a female patient with headache, left brachial paresis and frontallobar syndrome. The MRI image showed a right frontal mass with homogeneous contrast uptake. As treatment, a complete surgical resection was performed. Pathology was diagnostic for melanoma, with very low melanin content and a high proliferative index. A thorough extension study was performed to rule out an extracranial primary origin. Due to several intercurrent complications, the patient evolved unfavorably, not being able to receive further treatment. The amelanotic variant of primary intracranial malignant melanomas has not been described in detail previously. We will review the literature, focusing on the particularities of management and diagnosis of this clinical entity.
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Affiliation(s)
- Julio Alberto Andrés Sanz
- Servicio de Neurocirugía, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Instituto de investigación Sanitaria de Aragón (IISA), Spain.
| | - Juan Antonio Ruiz Ginés
- Servicio de Neurocirugía, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Instituto de investigación Sanitaria de Aragón (IISA), Spain
| | - Hristo Iliev
- Servicio de Anatomía Patológica, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Jesús Aguas Valiente
- Servicio de Neurocirugía, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain; Instituto de investigación Sanitaria de Aragón (IISA), Spain
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4
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Paglia F, Caporlingua A, Armocida D, Rizzo F, Santoro A, D'angelo L. Preoperative 3D volume reconstruction of the posterior wall of the sphenoid sinus with Horos: A free, simple and reliable tool in endoscopic endonasal trans-sphenoidal surgery. Neurocirugia (Astur : Engl Ed) 2022; 33:219-226. [PMID: 36084958 DOI: 10.1016/j.neucie.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/18/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND The purpose of the study was to create computer-aided design models of the sphenoid sinus with a free-source software in order to perform a preoperative planning during trans-sphenoidal endoscopic surgery (TES) and clarify the three-dimensional anatomical features of the sphenoid sinus and its surrounding structures. METHODS For each patient a 3D volume rendering of the sphenoid sinus was obtained from a thin slice head and maxilla-facial CT scan using a free-source DICOM viewer. The 3D models obtained preoperatively were examined preoperatively by six neurosurgeons in order to identify the boundaries of the sella. RESULTS For the main anatomical landmark, all of the observers were able to recognize the anatomical structure at a rate ranging from 80 to 98%, 28 to 60% and 25 to 58% for expert (n=3), inexpert (n=3) and the entire group of observers (n=6), respectively. The analysis of the data shows that both observation groups presented a lower recognition rate of the following parameters: right and left medial and lateral optocarotid recesses and tumor prominence, however, the sellar prominence, clival recess, planum sphenoidalis, right and left ICA prominence, right and left optic prominences represent the main anatomical landmarks to be recognized during TES immediately before the opening of the sellar floor. CONCLUSIONS The use of a preoperative 3D imaging is not in itself a novelty in the literature, however the fact that a simple tool obtained with a free-source software like Horos can represent a considerable help in surgical practice without resorting to the use of more complex software and expensive represents the real utility of this work.
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Affiliation(s)
- Francesco Paglia
- Human Neurosciences Department, Neurosurgery Division, "Sapienza" University, Italy
| | | | - Daniele Armocida
- Human Neurosciences Department, Neurosurgery Division, "Sapienza" University, Italy.
| | - Francesca Rizzo
- Human Neurosciences Department, Neurosurgery Division, "Sapienza" University, Italy
| | - Antonio Santoro
- Human Neurosciences Department, Neurosurgery Division, "Sapienza" University, Italy
| | - Luca D'angelo
- Human Neurosciences Department, Neurosurgery Division, "Sapienza" University, Italy
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5
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Matias TB, Dal Fabbro M, de Souza Queiroz L, Reis F. Myxofibrosarcoma: Another mimicker of meningioma. Neurocirugia (Astur : Engl Ed) 2022; 33:242-249. [PMID: 36084960 DOI: 10.1016/j.neucie.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/17/2021] [Indexed: 06/15/2023]
Abstract
Primary intracranial malignant fibrous histiocytoma (MFH), or myxofibrosarcoma, is an extremely rare condition, with only a few cases reported in the literature. We report a case of a dural-based myxofibrosarcoma in a previously healthy 42-year-old man that was initially presumed to be an atypical meningioma. The findings based on conventional and advanced magnetic resonance sequences, including diffusion-weighted imaging, perfusion weighted imaging and proton magnetic resonance spectroscopy, as well as histopathological aspects, are discussed.
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Affiliation(s)
- Thiago Bezerra Matias
- Department of Radiology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Mateus Dal Fabbro
- Department of Neurology and Neurosurgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Luciano de Souza Queiroz
- Department of Pathology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Fabiano Reis
- Department of Radiology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil.
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6
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Rascón-Ramírez FJ, Salazar-Asencio OA, Trondin A, Vargas-Jiménez AC, Subhi-Issa I, Brin-Reyes JR. [Lipomatous ependymomas of the posterior fossa. An infrequent and little-known subtype. A case report and review of the literature]. Rev Esp Patol 2022; 55:207-211. [PMID: 35779889 DOI: 10.1016/j.patol.2019.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/31/2019] [Accepted: 08/15/2019] [Indexed: 06/15/2023]
Abstract
Ependymomas are well defined glial tumours composed of uniform small cells with round nuclei in a fibrillar matrix. They have characteristic perivascular acellular areas (pseudorosettes) and, in some cases, ependymal rosettes. The three most well-known histological phenotypes are papillary, clear-cell and tanycytic. The WHO classification includes rare cases of ependymoma with lipomatous metaplasia. Lipomatous ependymomas of the posterior fossa are extremely rare; we only found 7reports of cases in adults. They usually arise in the fourth ventricle and may extend into the cerebellum, when they often show extensive vacuolization, pushing the nucleus to the periphery and giving rise to a signet-ring cell appearance. Radiologically, there are few findings characteristic of these tumours. Immunohistochemistry is essential to differentiate this subtype from other more common lesions, such as metastatic adenocarcinoma, especially from breast, intestine and kidney.
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Affiliation(s)
| | | | - Albert Trondin
- Servicio de Neurocirugía, Instituto de Neurociencias, Hospital Clínico San Carlos, Madrid, España
| | - Andrés C Vargas-Jiménez
- Servicio de Neurocirugía, Instituto de Neurociencias, Hospital Clínico San Carlos, Madrid, España
| | - Issa Subhi-Issa
- Servicio de Neuropatología, Hospital Clínico San Carlos, Madrid, España
| | - Juan R Brin-Reyes
- Servicio de Neurocirugía, Instituto de Neurociencias, Hospital Clínico San Carlos, Madrid, España
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7
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Navarro-Olvera JL, Parra-Romero G, Carrillo-Ruiz JD, Aguado-Carrillo G, Soto-Abraham JE, Hernández-Valencia AF. Stereotactic biopsy for intracranial space occupying lesions: Experience in a referral hospital in Mexico. CIR CIR 2021; 89:763-768. [PMID: 34851583 DOI: 10.24875/ciru.20001009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Stereotactic brain biopsy (SBB) is used for establishing the histological diagnosis of intracranial lesions that are not amenable for a direct surgical approach. OBJECTIVE The objective of the study was to describe our experience having an evaluation of the biopsy sample by a neuropathologist during SBB. MATERIALS AND METHODS Retrospective analysis of 140 consecutive patients who underwent SBB between 2014 and 2018 in whom trans-operatory analysis of the sample was performed. RESULTS There were 56% men. The mean age was 45 years. Histological diagnosis was performed in 131 of 140 patients (94% overall diagnostic yield). The presurgical radiological diagnosis was correct in 39%. Neoplastic lesions were reported in 108 cases, and 32 were non-neoplastic. We performed craniotomy and resection after biopsy in 14%. We found complications in 6% of patients. CONCLUSIONS SBB continues to be a safe, useful, and inexpensive procedure. The diagnostic performance of SBB increases when intraoperative cytological evaluation by a neuropathologist is included in the study.
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Affiliation(s)
- José L Navarro-Olvera
- Stereotactic and Radiosurgery Department, Functional Neurosurgery, Mexico General Hospital, Mexico City
| | - Gustavo Parra-Romero
- Stereotactic and Radiosurgery Department, Functional Neurosurgery, Mexico General Hospital, Mexico City
| | - José D Carrillo-Ruiz
- Stereotactic and Radiosurgery Department, Functional Neurosurgery, Mexico General Hospital, Mexico City.,Research Direction, Mexico General Hospital, Mexico City.,Faculty of Health Sciences, Anahuac University North Campus, Mexico City, Mexico
| | - Gustavo Aguado-Carrillo
- Stereotactic and Radiosurgery Department, Functional Neurosurgery, Mexico General Hospital, Mexico City
| | - Julián E Soto-Abraham
- Stereotactic and Radiosurgery Department, Functional Neurosurgery, Mexico General Hospital, Mexico City
| | - Aldo F Hernández-Valencia
- Stereotactic and Radiosurgery Department, Functional Neurosurgery, Mexico General Hospital, Mexico City
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8
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Reséndiz-Castillo LJ, Minjarez B, Reza-Zaldívar EE, Hernández-Sapiéns MA, Gutiérrez-Mercado YK, Canales-Aguirre AA. The effects of altered neurogenic microRNA levels and their involvement in the aggressiveness of periventricular glioblastoma. Neurologia (Engl Ed) 2021; 37:781-793. [PMID: 34810139 DOI: 10.1016/j.nrleng.2019.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 07/08/2019] [Indexed: 10/19/2022] Open
Abstract
INTRODUCTION Glioblastoma multiforme is the most common primary brain tumour, with the least favourable prognosis. Despite numerous studies and medical advances, it continues to be lethal, with an average life expectancy of 15 months after chemo-radiotherapy. DEVELOPMENT Recent research has addressed several factors associated with the diagnosis and prognosis of glioblastoma; one significant factor is tumour localisation, particularly the subventricular zone, which represents one of the most active neurogenic niches of the adult human brain. Glioblastomas in this area are generally more aggressive, resulting in unfavourable prognosis and a shorter life expectancy. Currently, the research into microRNAs (miRNA) has intensified, revealing different expression patterns under physiological and pathophysiological conditions. It has been reported that the expression levels of certain miRNAs, mainly those related to neurogenic processes, are dysregulated in oncogenic events, thus favouring gliomagenesis and greater tumour aggressiveness. This review discusses some of the most important miRNAs involved in subventricular neurogenic processes and their association with glioblastoma aggressiveness. CONCLUSIONS MiRNA regulation and function play an important role in the development and progression of glioblastoma; understanding the alterations of certain miRNAs involved in both differentiation and neural and glial maturation could help us to better understand the malignant characteristics of glioblastoma.
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Affiliation(s)
- L J Reséndiz-Castillo
- Biotecnología Médica y Farmacéutica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, Guadalajara, Jalisco, Mexico
| | - B Minjarez
- Centro Universitario de Ciencias Biológicas y Agropecuarias (CUCBA), Universidad de Guadalajara, Zapopan, Jalisco, Mexico
| | - E E Reza-Zaldívar
- Biotecnología Médica y Farmacéutica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, Guadalajara, Jalisco, Mexico
| | - M A Hernández-Sapiéns
- Biotecnología Médica y Farmacéutica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, Guadalajara, Jalisco, Mexico
| | - Y K Gutiérrez-Mercado
- Biotecnología Médica y Farmacéutica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, Guadalajara, Jalisco, Mexico
| | - A A Canales-Aguirre
- Biotecnología Médica y Farmacéutica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, Guadalajara, Jalisco, Mexico; Unidad de Evaluación Preclínica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, Guadalajara, Jalisco, Mexico.
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Lara-Almunia M, Hernández-Vicente J. Related factors with diagnostic yield and intracranial hemorrhagic complications in frame-based stereotactic biopsy. Review. Neurocirugia (Astur : Engl Ed) 2021; 32:285-294. [PMID: 34743826 DOI: 10.1016/j.neucie.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 11/08/2020] [Indexed: 06/13/2023]
Abstract
The frame-based stereotactic biopsy is a minimally invasive technique that allows us to obtain a sample of brain tissue for subsequent diagnosis and treatment. The scope of this article is to review the published data related to the factors that could condition its diagnostic yield, and the appearance of post-biopsy hemorrhagic complications. PubMed search, last updated June 2020, was conducted using the terms "stereotactic biopsy", "diagnostic yield" and "intracranial post-biopsy hemorrhage". A total of 38 studies, that showed descriptive or analytical results, were included, and reviewed. Our literature review show that some characteristics of the lesion and surgical procedure peculiarities are significantly related with the effectiveness and safety of the technique. In this way, they must be taken into account in order to optimize its results.
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Affiliation(s)
- Mónica Lara-Almunia
- Servicio de Neurocirugía, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
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10
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Juárez-Belaúnde A, Orcajo E, Lejarreta S, Davila-Pérez P, León N, Oliviero A. Fatigue in patients with acquired brain damage. Neurologia 2021:S0213-4853(21)00111-0. [PMID: 34538507 DOI: 10.1016/j.nrl.2021.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/22/2021] [Indexed: 01/05/2023] Open
Abstract
Fatigue is a complex, multidimensional syndrome that is prevalent in patients with acquired brain damage and has a negative impact on the neurorehabilitation process. It presents from early stages after the injury, and may persist over time, regardless of whether sequelae have resolved. Fatigue is conditioned by upper neuronal circuits, and is defined as an abnormal perception of overexertion. Its prevalence ranges from 29% to 77% after stroke, from 18% to 75% after traumatic brain injury, and from 47% to 97% after brain tumours. Fatigue is associated with factors including female sex, advanced age, dysfunctional families, history of specific health conditions, functional status (eg, fatigue prior to injury), comorbidities, mood, secondary disability, and the use of certain drugs. Assessment of fatigue is fundamentally based on such scales as the Fatigue Severity Scale (FSS). Advances have recently been made in imaging techniques for its diagnosis, such as in functional MRI. Regarding treatment, no specific pharmacological treatment currently exists; however, positive results have been reported for some conventional neurorehabilitation therapies, such as bright light therapy, neurofeedback, electrical stimulation, and transcranial magnetic stimulation. This review aims to assist neurorehabilitation professionals to recognise modifiable factors associated with fatigue and to describe the treatments available to reduce its negative effect on patients.
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Affiliation(s)
- A Juárez-Belaúnde
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España.
| | - E Orcajo
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España
| | - S Lejarreta
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España
| | - P Davila-Pérez
- Servicio de Neurofisiología, Hospital Los Madroños, Madrid, España
| | - N León
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España
| | - A Oliviero
- Unidad Avanzada de Neurorrehabilitación, Hospital Los Madroños, Madrid, España; Servicio de Neurofisiología, Hospital Los Madroños, Madrid, España; Grupo FENNSI, Hospital Nacional de Parapléjicos, SESCAM, Toledo, España
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11
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Matias TB, Dal Fabbro M, de Souza Queiroz L, Reis F. Myxofibrosarcoma: Another mimicker of meningioma. Neurocirugia (Astur) 2021; 33:S1130-1473(21)00032-4. [PMID: 33875380 DOI: 10.1016/j.neucir.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/07/2021] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
Primary intracranial malignant fibrous histiocytoma (MFH), or myxofibrosarcoma, is an extremely rare condition, with only a few cases reported in the literature. We report a case of a dural-based myxofibrosarcoma in a previously healthy 42-year-old man that was initially presumed to be an atypical meningioma. The findings based on conventional and advanced magnetic resonance sequences, including diffusion-weighted imaging, perfusion weighted imaging and proton magnetic resonance spectroscopy, as well as histopathological aspects, are discussed.
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Affiliation(s)
- Thiago Bezerra Matias
- Department of Radiology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Mateus Dal Fabbro
- Department of Neurology and Neurosurgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Luciano de Souza Queiroz
- Department of Pathology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Fabiano Reis
- Department of Radiology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil.
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12
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Lara-Almunia M, Hernández-Vicente J. Related factors with diagnostic yield and intracranial hemorrhagic complications in frame-based stereotactic biopsy. Review. Neurocirugia (Astur) 2021; 32:S1130-1473(20)30135-4. [PMID: 33446460 DOI: 10.1016/j.neucir.2020.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/12/2020] [Accepted: 11/08/2020] [Indexed: 11/28/2022]
Abstract
The frame-based stereotactic biopsy is a minimally invasive technique that allows us to obtain a sample of brain tissue for subsequent diagnosis and treatment. The scope of this article is to review the published data related to the factors that could condition its diagnostic yield, and the appearance of post-biopsy hemorrhagic complications. PubMed search, last updated June 2020, was conducted using the terms "stereotactic biopsy", "diagnostic yield" and "intracranial post-biopsy hemorrhage". A total of 38 studies, that showed descriptive or analytical results, were included, and reviewed. Our literature review show that some characteristics of the lesion and surgical procedure peculiarities are significantly related with the effectiveness and safety of the technique. In this way, they must be taken into account in order to optimize its results.
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Affiliation(s)
- Mónica Lara-Almunia
- Servicio de Neurocirugía, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
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13
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Menéndez-Cortezón B, López-García E, Román-Pena P, Gelabert-González M. Spontaneous resolution of colloid cyst of the third ventricle in a pediatric patient. Neurocirugia (Astur) 2020; 32:S1130-1473(20)30100-7. [PMID: 33054998 DOI: 10.1016/j.neucir.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/23/2020] [Accepted: 08/21/2020] [Indexed: 11/23/2022]
Abstract
Colloid cyst are benign intracranial lesions located in the III ventricle in the region of the foramen of Monro. The majority present in the third and fourth decades of life and are rare under the age of ten. We report a case of an incidentally colloid cyst presented in a 2.5 -years-old girl who was managed conservatively; follow-up with MRI showed a progressive reduction in size. We review the four similar case previously reported.
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Affiliation(s)
- Beatriz Menéndez-Cortezón
- Servicio de Neurocirugía, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España
| | - Elena López-García
- Servicio de Neurocirugía, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España
| | - Paula Román-Pena
- Servicio de Neurocirugía, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España; Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Universidad de Santiago de Compostela, Santiago de Compostela, La Coruña, España
| | - Miguel Gelabert-González
- Servicio de Neurocirugía, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España; Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Universidad de Santiago de Compostela, Santiago de Compostela, La Coruña, España.
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14
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Narro-Donate JM, Velasco-Albendea FJ, García-Pérez F, Gomar-Alba M, Castelló-Ruiz MJ, Masegosa-González J. Different radioinducid tumors synchrony in an acute lymphoblastic leukemia survivor. Neurocirugia (Astur) 2020; 32:S1130-1473(20)30101-9. [PMID: 33012645 DOI: 10.1016/j.neucir.2020.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/22/2020] [Accepted: 07/25/2020] [Indexed: 11/21/2022]
Abstract
The cranial radiation-induced tumors appearance in pediatric patients treated for hematological diseases such as leukemia/T-lymphoblastic lymphoma (T-ALL/LBL) is a known phenomenon that may include lesions of different malignant degrees and require neurosurgical treatment. We present the case of a 38-year-old man referred to our department for a sudden diplopia with 6-month progressive left hemiparesis and frequent falls. After imaging tests, different intra and extraxial lesions with different radiological behavior were observed, performing a single surgical approach for their resection. The pathological anatomy confirms four histological variants: meningioma (grade 1 and 2 [atypical]), subependymoma, and cavernoma. We discuss the teratogenic role of ionizing radiation.
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Affiliation(s)
| | | | | | - Mario Gomar-Alba
- Departamento de Neurocirugía, Complejo Hospitalario Torrecárdenas, Almería, España
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15
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Marcó Del Pont F, Ries Centeno T, Villalonga JF, Giovannini SJM, Caffaratti G, Lorefice E, Cervio A. Results in the treatment of intracranial hemangiopericytomas. Case series. Neurocirugia (Astur) 2020; 32:62-68. [PMID: 32473774 DOI: 10.1016/j.neucir.2020.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 02/10/2020] [Accepted: 03/13/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Intracranial hemangiopericytoma (HPC) is a rare central nervous system tumor characterized by its low incidence, high rate of local recurrence and risk of metastasis. The main objectives of this paper are two: to show the results in the treatment of HPC in our institution in the last 20years and to make a review of the literature on this topic. METHODS Retrospective review that includes patients diagnosed with intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC) that have undergone surgery from 1997 to 2017. It includes patients that had nuclear expression of STAT-6 (detected by immunohistochemistry) and gradeII/III histopathological diagnosis (defined by the World Health Organization in 2016). We collected demographic data, tumor characteristics, treatment and survival of these patients. RESULTS A total of 19 patients fulfilled inclusion criteria. The median follow up was 96 months (12-230). The mortality rate was 21% (n=4). 57.9% of patients presented at least one tumor recurrence (n=11) (recurrences of 6%, 67% y 90% at 1, 5 and 10years). Five patients presented extracranial metastasis. Patients with tumors <6cm had greater survival (P<.05). CONCLUSIONS A series of patients undergoing SFT/HPC were presented according to the new WHO criteria. Size is a predictor of survival. Currently there are no validated criteria for surgical resection in this pathology. A classification with surgical guidance would be useful.
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Affiliation(s)
| | | | | | | | | | | | - Andrés Cervio
- Departamento de Neurocirugía, FLENI, Buenos Aires, Argentina
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16
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Reséndiz-Castillo LJ, Minjarez-Vega B, Reza-Zaldívar EE, Hernández-Sapiéns MA, Gutiérrez-Mercado YK, Canales-Aguirre AA. The effects of altered neurogenic microRNA levels and their involvement in the aggressiveness of periventricular glioblastoma. Neurologia 2020; 37:S0213-4853(19)30137-9. [PMID: 31959491 DOI: 10.1016/j.nrl.2019.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/14/2019] [Accepted: 07/08/2019] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Glioblastoma multiforme is the most common primary brain tumour, with the least favourable prognosis. Despite numerous studies and medical advances, it continues to be lethal, with an average life expectancy of 15 months after chemo-radiotherapy. DEVELOPMENT Recent research has addressed several factors associated with the diagnosis and prognosis of glioblastoma; one significant factor is tumour localisation, particularly the subventricular zone, which represents one of the most active neurogenic niches of the adult human brain. Glioblastomas in this area are generally more aggressive, resulting in unfavourable prognosis and a shorter life expectancy. Currently, the research into microRNAs (miRNA) has intensified, revealing different expression patterns under physiological and pathophysiological conditions. It has been reported that the expression levels of certain miRNAs, mainly those related to neurogenic processes, are dysregulated in oncogenic events, thus favouring gliomagenesis and greater tumour aggressiveness. This review discusses some of the most important miRNAs involved in subventricular neurogenic processes and their association with glioblastoma aggressiveness. CONCLUSIONS MiRNA regulation and function play an important role in the development and progression of glioblastoma; understanding the alterations of certain miRNAs involved in both differentiation and neural and glial maturation could help us to better understand the malignant characteristics of glioblastoma.
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Affiliation(s)
- L J Reséndiz-Castillo
- Biotecnología Médica y Farmacéutica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, Guadalajara, Jalisco, México
| | - B Minjarez-Vega
- Centro Universitario de Ciencias Biológicas y Agropecuarias (CUCBA), Universidad de Guadalajara, Zapopan, Jalisco, México
| | - E E Reza-Zaldívar
- Biotecnología Médica y Farmacéutica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, Guadalajara, Jalisco, México
| | - M A Hernández-Sapiéns
- Biotecnología Médica y Farmacéutica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, Guadalajara, Jalisco, México
| | - Y K Gutiérrez-Mercado
- Biotecnología Médica y Farmacéutica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, Guadalajara, Jalisco, México
| | - A A Canales-Aguirre
- Biotecnología Médica y Farmacéutica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, Guadalajara, Jalisco, México; Unidad de Evaluación Preclínica, Centro de Investigación y Asistencia en Tecnología y Diseño del Estado de Jalisco, Guadalajara, Jalisco, México.
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Gómez Roselló E, Quiles Granado AM, Laguillo Sala G, Pedraza Gutiérrez S. Primary central nervous system lymphoma in immunocompetent patients: spectrum of findings and differential characteristics. Radiologia (Engl Ed) 2018; 60:280-289. [PMID: 29482953 DOI: 10.1016/j.rx.2017.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 12/27/2017] [Accepted: 12/27/2017] [Indexed: 10/18/2022]
Abstract
Primary central nervous system (CNS) lymphomas are uncommon and their management differs significantly from that of other malignant tumors involving the CNS. This article explains how the imaging findings often suggest the diagnosis early. The typical findings in immunocompetent patients consist of a supratentorial intraaxial mass that enhances homogeneously. Other findings to evaluate include multifocality and incomplete ring enhancement. The differential diagnosis of primary CNS lymphomas should consider mainly other malignant tumors of the CNS such as glioblastomas or metastases. Primary CNS lymphomas tend to have less edema and less mass effect; they also tend to spare the adjacent cortex. Necrosis, hemorrhage, and calcification are uncommon in primary CNS lymphomas. Although the findings in morphologic sequences are characteristic, they are not completely specific and atypical types are sometimes encountered. Advanced imaging techniques such as diffusion or especially perfusion provide qualitative and quantitative data that play an important role in differentiating primary CNS lymphomas from other brain tumors.
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Affiliation(s)
- E Gómez Roselló
- Sección de Neurorradiología, Servicio de Radiología (IDI), Hospital Universitario Dr. Josep Trueta, Girona, España.
| | - A M Quiles Granado
- Sección de Neurorradiología, Servicio de Radiología (IDI), Hospital Universitario Dr. Josep Trueta, Girona, España
| | - G Laguillo Sala
- Sección de Neurorradiología, Servicio de Radiología (IDI), Hospital Universitario Dr. Josep Trueta, Girona, España
| | - S Pedraza Gutiérrez
- Sección de Neurorradiología, Servicio de Radiología (IDI), Hospital Universitario Dr. Josep Trueta, Girona, España
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18
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Hernández Cancela RM, Pombo Otero J, Concha-Lopez A. A case of multifocal medulloblastoma in an adult patient. Rev Esp Patol 2017; 50:45-48. [PMID: 29179964 DOI: 10.1016/j.patol.2015.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 12/09/2015] [Accepted: 12/15/2015] [Indexed: 11/15/2022]
Abstract
Only five cases of multifocal medulloblastoma in the adult have been reported to date. We present a case in a male patient in his 50th decade of life who presented with three extra-axial lesions associated with a parenchymatous lesion of the right middle cerebellar peduncle. Sputum sample examination revealed larvae compatible with strongyloides stercoralis, which was our main differential diagnosis. Histological and immunohistochemical studies revealed the existence of a desmoplastic medulloblastoma.
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Affiliation(s)
| | - Jorge Pombo Otero
- Department of Pathology, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - Angel Concha-Lopez
- Department of Pathology, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
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Algahtani H, Shirah B, Abdullah A, Bazaid A. Teratoma of the nervous system: A case series. Neurocirugia (Astur) 2017; 29:143-149. [PMID: 28501423 DOI: 10.1016/j.neucir.2017.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 03/22/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
Abstract
Teratoma is a common form of germ cell tumors composed of multiple tissues foreign to the site in which arise with a histological representation of all three germ cell layers. Intracranial teratomas are very rare. In this study, we report three cases of intracranial teratomas with an interesting clinical course, neuroradiology, and outcome. In addition, we review the literature and convey important messages to the neuroscience community regarding issues related to the management of these rare tumors. The present cases are interesting examples of intracranial teratoma in terms of location of the tumor and neuroimaging findings. Delay in surgical intervention may complicate the course of the disease with progressive enlargement of tumors and development of complication including hydrocephalus. Using endoscopic surgical techniques may emerge as the preferred intervention option as compared to other traditional methods. We recommend the establishment of a national and international registry for intracranial tumors.
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Affiliation(s)
- Hussein Algahtani
- King Abdulaziz Medical City/King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
| | - Bader Shirah
- King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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20
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de-Bonilla-Damiá Á, Fernández-López R, Capote-Huelva FJ, de la Cruz-Vicente F, Egea-Guerrero JJ, Borrego-Dorado I. Role of 18F-FDG PET/CT in primary brain lymphoma. Rev Esp Med Nucl Imagen Mol 2017; 36:298-303. [PMID: 28438519 DOI: 10.1016/j.remn.2017.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/02/2017] [Accepted: 03/15/2017] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To study the usefulness of 18F-FDG PET/CT in the initial evaluation and in the response assessment in primary brain lymphoma. MATERIAL AND METHODS A retrospective analysis was carried out on 18 patients diagnosed with primary brain lymphoma, a histological subtype of diffuse large B-cell lymphoma, on whom an initial 18F-FDG PET/CT and MRI was performed, with 7 of the cases being analysed after the completion of treatment in order to assess response and clinical follow up. RESULTS Initial 18F-FDG PET/CT showed 26 hypermetabolic foci, whereas 46 lesions were detected by MRI. The average SUV maximum of the lesions was 17.56 with T/N 3.55. The concordance of both tests for identifying the same number of lesions was moderate, obtaining a kappa index of 0.395 (P<.001). In the evaluation of treatment, MRI identified 16 lesions compared to 7 pathological accumulations observed by 18F-FDG PET/CT. The concordance of both tests to assess type of response to treatment was moderate (kappa index 0.41) (P=.04). In both the initial evaluation and the assessment of the response to treatment, PET/CT led to a change strategy in 22% of patients who had lesions outside the cerebral parenchyma. CONCLUSIONS MRI appears to be the method of choice for detecting brain disease in patients with primary brain lymphoma, whereas 18F-FDG PET/CT seems to play a relevant role in the assessment of extra-cerebral disease.
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Affiliation(s)
- Á de-Bonilla-Damiá
- Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España.
| | - R Fernández-López
- Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - F J Capote-Huelva
- Unidad de Gestión Clínica de Hematología y Hemoterapia, Hospital Universitario Puerta del Mar, Cádiz, España
| | - F de la Cruz-Vicente
- Unidad de Gestión Clínica de Hematología y Hemoterapia, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - J J Egea-Guerrero
- Unidad de Gestión Clínica de Medicina Intensiva, Hospital Universitario Virgen del Rocío, IBiS, CSIC, Universidad de Sevilla, Sevilla, España
| | - I Borrego-Dorado
- Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España
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21
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Montes A, Fernández A, Camacho V, de Quintana C, Gallego O, Craven-Bartle J, López D, Molet J, Gómez-Ansón B, Carrió I. The usefulness of 18F-fluorocholine PET/CT in the detection of recurrence of central nervous system primary neoplasms. Rev Esp Med Nucl Imagen Mol 2017; 36:227-232. [PMID: 28219644 DOI: 10.1016/j.remn.2016.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/15/2016] [Accepted: 11/16/2016] [Indexed: 01/21/2023]
Abstract
AIM To study the usefulness of 18F-fluorocholine (FCH) in detecting the recurrence of primary brain tumours. MATERIAL AND METHODS A prospective study was conducted on brain PET/CT with FCH for compassionate use in 21 patients with suspected recurrence of a primary brain tumour. The distribution by pathology was: three grade ii astrocytomas, three grade iii astrocytomas, one grade ii oligodendroglioma, three grade iii oligodendrogliomas, one grade iii oligoastrocytoma, four glioblastoma multiform, one gliomatosis cerebri, and five meningiomas. Studies in which there was a visually significant uptake in the brain parenchyma were classified as positive. RESULTS A total of 17 patients were classified as positive, with the results being confirmed by histology (10 cases) or clinical follow-up and imaging, with no false positives or negatives. The mean SUVmax for positive patients was 8.02 and 0.94 for the negative ones, which was significantly different (P=.003) CONCLUSION: PET/CT with FCH shows encouraging results in the evaluation of patients with suspected recurrence of primary brain neoplasms.
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Affiliation(s)
- A Montes
- Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
| | - A Fernández
- Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - V Camacho
- Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - C de Quintana
- Servicio de Neurocirugía, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - O Gallego
- Servicio de Oncología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - J Craven-Bartle
- Servicio de Oncología Radioterápica, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - D López
- Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - J Molet
- Servicio de Neurocirugía, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - B Gómez-Ansón
- Servicio de Radiología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - I Carrió
- Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Barcelona, España
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22
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Cuervo-Arango I, Reimunde P, Gutiérrez JC, Aransay A, Rivero B, Pérez C, Budke M, Villarejo F. [Choroid plexus tumour treatment at Hospital Infantil Niño Jesús in Madrid: Our experience over the last three decades]. Neurocirugia (Astur) 2015; 26:209-16. [PMID: 25724620 DOI: 10.1016/j.neucir.2015.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 01/03/2015] [Accepted: 01/08/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To review childhood patients with choroid plexus tumors (CPT) who underwent surgery at Hospital Infantil Niño Jesús of Madrid since January 1981 to September 2014. MATERIAL AND METHODS Registered charts were analyzed based on the epidemiology, tumor grade, clinical profile, location, dissemination characteristics, therapy, prognosis and complications. RESULTS Seventeen childhood patients were recorded with CPT. Cases were distributed so that 9 cases were choroid plexus-papilloma (CPP) (52.9%), 2 cases atypical CPP (11.7%) and 6 cases choroid plexus-carcinoma (CPC) (35.2%). Age at diagnosis was less than 2 years in 14 of the 17 patients (82.3%) and the incidence was higher in males (82.3% of the cases). Gross total resection was performed in 16 patients (94.1%). Adjuvant treatment was used in 6 patients (all this cases with CPC) (35.2%). Two of the 17 patients died (11.7%), showing an incidence density of 0.01 deaths/year. CONCLUSIONS Our case series is consistent with previous published in scientific literature regarding epidemiology, tumor grade, clinical presentation, radiological features and therapeutic approach. Gross total resection is considered the therapeutic gold standard for choroid plexus tumors. Chemotherapy and radiotherapy should be used as adjuvant treatment in CPC and recurrent or remaining atypical CPP.
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Affiliation(s)
- Isabel Cuervo-Arango
- Servicio de Neurocirugía, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, España
| | - Pedro Reimunde
- Servicio de Neurocirugía, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, España.
| | - Julio César Gutiérrez
- Servicio de Neurocirugía, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, España
| | - Ana Aransay
- Servicio de Neurocirugía, Hospital Universitario Niño Jesús, Madrid, España
| | - Belén Rivero
- Servicio de Neurocirugía, Hospital Universitario Niño Jesús, Madrid, España
| | - Carlos Pérez
- Servicio de Neurocirugía, Hospital Universitario Niño Jesús, Madrid, España
| | - Marcelo Budke
- Servicio de Neurocirugía, Hospital Universitario Niño Jesús, Madrid, España
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Alados Arboledas FJ, Millán-Miralles L, Millán-Bueno MP, Expósito-Montes JF, Santiago-Gutierrez C, Martínez Padilla MC. [Neurogenic stunned myocardium in Pediatrics. A case report]. ACTA ACUST UNITED AC 2015; 62:472-6. [PMID: 25530429 DOI: 10.1016/j.redar.2014.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 10/13/2014] [Accepted: 10/30/2014] [Indexed: 01/10/2023]
Abstract
Neurogenic stunned myocardium is an unusual clinical entity. It mimics an acute coronary syndrome with electrocardiographic abnormalities, cardiac dysfunction and elevated cardiac enzymes with absence of obstructive coronary disease. It may occur after a neurosurgical procedure. A case is presented of neurogenic stunned myocardium occurring in a child after removal of a posterior fossa medulloblastoma. The patient developed nodal tachycardia with hemodynamic impairment. The clinical course was satisfactory due to antiarrhythmic therapy, with biochemical, echocardiographic, and clinical improvement within a week.
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24
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López Álvarez A, Rodríguez Fernández P, Román Fernández A, Filgueira Dávila E, Gálvez Gómez D, González Monzón V. [Neurological disorders after cardiac surgery: Diagnosis of cerebral tumors in the postoperative period]. ACTA ACUST UNITED AC 2013; 61:509-12. [PMID: 24295795 DOI: 10.1016/j.redar.2013.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 09/29/2013] [Accepted: 09/30/2013] [Indexed: 11/28/2022]
Abstract
The incidence of neurologic disorders in the postoperative period of cardiac surgery is high and usually due to a combination of pre- and intraoperative factors. We present 2 patients with brain tumors diagnosed in the immediate postoperative period after sudden onset of neurologic dysfunction. Image studies yielded clinically useful information in these 2 cases.
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Affiliation(s)
- A López Álvarez
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Meixoeiro de Vigo, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
| | - P Rodríguez Fernández
- Servicio de Radiodiagnóstico, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España
| | - A Román Fernández
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Meixoeiro de Vigo, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España
| | - E Filgueira Dávila
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Meixoeiro de Vigo, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España
| | - D Gálvez Gómez
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Meixoeiro de Vigo, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España
| | - V González Monzón
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Meixoeiro de Vigo, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España
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25
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Castro-Castro J, Figueiredo-González O, Río-Gómez A, Carballo-Loureiro N, Castro-Bouzas D. [Unknown intracerebral tumour presenting as brainstem compression following unintentional dural puncture]. ACTA ACUST UNITED AC 2013; 61:392-5. [PMID: 24041454 DOI: 10.1016/j.redar.2013.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 06/06/2013] [Accepted: 06/14/2013] [Indexed: 11/19/2022]
Abstract
A 36-year old primigravid of 41 weeks gestation was admitted to the labour ward. Her past medical history included hyperemesis gravidarum and migraine. An accidental dural puncture occurred during labour epidural analgesia. In the postpartum period she presented with continuous headache, and was treated with oral analgesics, oral caffeine, fluid therapy, and tetracosactide. She refused an epidural blood patch. On the seventh day postpartum, the patient was re-admitted to the Emergency Department with decreased level of consciousness and signs of brainstem compression. Cranial computed tomography and magnetic resonance imaging showed a posterior fossa tumour. An emergency craniotomy was performed with complete neurological recovery. This case emphasises the need to consider the differential diagnoses of post-dural puncture headache and to highlight the warning signs in patients who do not respond despite treatment with conventional therapy.
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Affiliation(s)
- J Castro-Castro
- Servicio de Neurocirugía, Complexo Hospitalario Universitario de Ourense, Ourense, España.
| | - O Figueiredo-González
- Servicio de Anestesiología y Reanimación, Complexo Hospitalario Universitario de Ourense, Ourense, España
| | - A Río-Gómez
- Servicio de Anestesiología y Reanimación, Complexo Hospitalario Universitario de Ourense, Ourense, España
| | - N Carballo-Loureiro
- Servicio de Anestesiología y Reanimación, Complexo Hospitalario Universitario de Ourense, Ourense, España
| | - D Castro-Bouzas
- Servicio de Neurocirugía, Complexo Hospitalario Universitario de Ourense, Ourense, España
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