SYMPTOMATIC BRAINSTEM CAVERNOMAS

Neurosurgery ◽  
2009 ◽  
Vol 64 (1) ◽  
pp. 61-71 ◽  
Author(s):  
Erik F. Hauck ◽  
Samuel L. Barnett ◽  
Jonathan A. White ◽  
Duke Samson
Keyword(s):  
Surgical Resection ◽  
Recurrent Events ◽  
Event Rate ◽  
Functional Decline ◽  
Surgical Morbidity ◽  
Free Interval ◽  
Complete Surgical Resection ◽  
History Of ◽  
Neurological Event

Abstract OBJECTIVE The goal of this study was to analyze the natural history of symptomatic brainstem cavernomas (medulla, pons, or midbrain) and outcome after surgical resection. METHODS We retrospectively analyzed clinical data of all patients who presented to our institution with symptomatic brainstem cavernomas between 1995 and 2007 (n = 44). RESULTS After a first neurological event, the median event-free interval was 2 years, with an annual event rate of 42%. After a second neurological event (new neurological deficit or significant worsening of the previous deficit), the median event-free interval was only 5 months, with a monthly event rate of 8%. After an observation period of up to 8 years, all patients ultimately underwent surgery. In 95% of the patients, surgery successfully prevented further events during a median follow-up period of 11 months (1 month–7 years; P < 0.001). The postoperative event rate was 5% per year in the first 2 years and 0% thereafter. In the multivariate analysis, only the preoperative modified Rankin scale score was predictive of the surgical outcome (odds ratio, 36.7; P = 0.015). The conditions of 2 patients (5%) were clinically worse compared with their preoperative conditions during the 1-year follow-up period; in one of these patients, this was caused by recurrent events. There was no mortality. CONCLUSION The event rate of symptomatic lesions seems to be high, particularly after recurrent events. Surgical morbidity can be low. Timely and complete surgical resection is recommended for symptomatic brainstem cavernomas to prevent patients' functional decline owing to recurrent events.

Primary facial nerve paraganglioma: report and review of the literature

2020 ◽  
Vol 13 (12) ◽  
pp. e237537
Author(s):  
Jonathan Austin Berry ◽  
Cherie Ann O Nathan ◽  
Ashley B Flowers ◽  
Gauri Mankekar
Keyword(s):  
Facial Nerve ◽  
Surgical Resection ◽  
Facial Paralysis ◽  
Clinical Importance ◽  
Mri Imaging ◽  
Review Of The Literature ◽  
Surveillance Imaging ◽  
Complete Surgical Resection ◽  
History Of ◽  
Ct And Mri

This report describes the diagnosis and treatment of a patient with a rare primary facial nerve paraganglioma as well as a review of the current literature. A 60-year-old male patient presented to our clinic with a 4-month history of left-sided progressive facial paralysis House-Brackmann V. Biopsy taken during facial nerve (FN) decompression confirmed the diagnosis of paraganglioma. The left FN was sacrificed during resection of the mass and a 12-7 jump graft, using the left greater auricular nerve, was performed with acceptable outcomes. The rarity of these tumours does not discount their clinical importance or the necessity to include them in the differential when presented with unilateral FN paralysis. Investigation should begin with CT and MRI imaging to identify and localise the potential mass. Histologic confirmation requires tissue. While surveillance imaging is occasionally an option, often complete surgical resection of the mass and sacrifice of the nerve is necessary.

scholarly journals An Interesting Case Report of Frontal Sinus Keratocyst

2019 ◽  
Vol 9 (1) ◽  
pp. 100
Author(s):  
Alireza Mohebbi ◽  
Mohammad Aghajanpour
Keyword(s):  
Case Report ◽  
Surgical Resection ◽  
Frontal Sinus ◽  
Interesting Case ◽  
Ophthalmological Examination ◽  
Eyelid Edema ◽  
Complete Surgical Resection ◽  
Orbital Wall ◽  
History Of ◽  
The Right

Purpose: To report an unusual case of frontal sinus keratocyst. Case Report: A 31 year old woman presented with a history of swollen right eye and visual field impairment. The ophthalmological examination revealed right superior eyelid edema and some degrees of proptosis. CT scan with iodine injection evidenced the opacification of the right frontal sinus with superior orbital wall lysis. Complete endoscopic surgical resection of a mass containing foul smelling keratin material was performed via Draf type III. The patient became symptomatic after 6 years. Imaging studies showed neo- osteogenesis in the far lateral end of right frontal sinus. Frontal trephination was done and the remnant of keratocyst was removed and the septum interfacing the cell and the right frontal sinus was walled down entirely. Conclusion: Although frontal sinus keratocyst is benign but can spread to the surrounding structures leading to several complications. Therefore, complete surgical resection is necessary to avoid recurrence.

scholarly journals Infantile hepatic haemangioendothelioma resection in a newborn: A case report and literature review

2020 ◽  
Vol 48 (7) ◽  
pp. 030006052093432
Author(s):  
Xin Long ◽  
Yuwei Wang ◽  
Kai Zheng ◽  
Bixiang Zhang
Keyword(s):  
Liver Transplantation ◽  
Case Report ◽  
Surgical Resection ◽  
Prenatal Ultrasonography ◽  
Imaging Diagnosis ◽  
Liver Mass ◽  
Hepatic Tumour ◽  
Complete Surgical Resection ◽  
Additional Therapy

Infantile hepatic haemangioendothelioma (IHH) is the most common benign hepatic tumour in infants. However, experience of managing IHH is lacking and treatments for symptomatic IHH are controversial. Here we report the case of a patient with IHH treated by liver resection. A liver mass was found in a newborn by prenatal ultrasonography. The patient presented with abdominal distention with a tangible mass. Further imaging diagnosis and biopsy were carried out and complete surgical resection of the mass was performed. Histological examination confirmed IHH. The patient recovered uneventfully after surgery, with no additional therapy after discharge and no recurrence during follow-up. We also summarise previously published resected cases of IHH and review the surgical outcomes. Surgical resection and liver transplantation appear to be effective treatments for symptomatic IHH.

Colorectal Plasmacytomas: A Retrospective Study of Nine Dogs

2006 ◽  
Vol 42 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Patricia A. Kupanoff ◽  
Catherine A. Popovitch ◽  
Michael H. Goldschmidt
Keyword(s):  
Retrospective Study ◽  
Local Recurrence ◽  
Survival Time ◽  
Surgical Resection ◽  
Median Survival ◽  
Median Survival Time ◽  
Complete Excision ◽  
Complete Surgical Resection

Nine cases of colorectal plasmacytomas diagnosed between 1998 and 2001 were reviewed. Treatment consisted of complete surgical resection when possible. Two dogs had multiple plasmacytomas. Two dogs had local recurrence of the tumor at 5 and 8 months after resection. Two dogs were alive at 20 and 23 months with no recurrences at the time of follow-up. The median survival time was 15 months (range 5 to 33 months). Colorectal plasmacytomas are similar to mucocutaneous plasmacytomas, in that they tend to progress slowly and do not recur with complete excision.

Transition to Psychosis: 6-Month follow-up of a Chinese High-Risk Group in Hong Kong

2006 ◽  
Vol 40 (5) ◽  
pp. 414-420 ◽  
Author(s):  
May M.L. Lam ◽  
Se-Fong Hung ◽  
Eric Y.H. Chen
Keyword(s):  
At Risk ◽  
High Risk ◽  
Mental State ◽  
Functional Decline ◽  
High Risk Group ◽  
Psychotic Symptoms ◽  
Syndrome Scale ◽  
History Of ◽  
At Risk Mental State

Objectives: The identification of individuals at high risk of becoming psychotic within the near future creates opportunities for early intervention before the onset of psychosis. This study sets out to identify a group of symptomatic young people in a Chinese population with the high likelihood of transition to psychosis within a follow-up period of 6 months, and to determine the rate of transition to psychosis in this group. Method: Symptomatic individuals with a family history of psychotic disorder, subthreshold psychotic symptoms or brief transient psychotic symptoms were identified using the operationalized criteria of an ‘At Risk Mental State’. The individuals were prospectively assessed monthly on a measure of psychopathology for 6 months. Results: Eighteen out of 62 individuals (29%) made the transition to frank psychosis within a 6 month follow-up period, with the majority occurring within 3 months. In addition, significant differences were found in the intake Positive and Negative Syndrome Scale, Comprehensive Assessment of ‘At Risk Mental State’ and Global Assessment of Functioning scores between the group that ultimately became psychotic and the group that did not. Conclusion: The period of the highest risk of transition to psychosis was within the 3 months after the study began. Thus, distressed youths in our outpatient clinic, who meet the high-risk criteria should be monitored most closely in the initial 3 months, particularly those individuals with high levels of psychopathology and functional decline.

scholarly journals Pixel Lensing: The Key to the Universe

1996 ◽  
Vol 173 ◽  
pp. 365-370
Author(s):  
Andrew Gould
Keyword(s):  
Event Rate ◽  
Virgo Cluster ◽  
Star Formation History ◽  
Powerful Method ◽  
Suppression Factor ◽  
Photon Detection ◽  
Formation History ◽  
History Of ◽  
The Universe

Pixel lensing, the gravitational microlensing of unresolved stars, is potentially a powerful method for detecting and measuring microlensing events. Two groups are currently refining this method in observations toward M31. I show that the technique has wide application, from searching for intra-cluster Machos in the Virgo cluster, to improving the accuracy of follow-up observations of Galactic microlensing events, to measuring the star-formation history of the universe. I derive the equation for the pixel lensing event rate where Qmin is the minimum signal to noise for detection, τ is the optical depth, Nres is the number of telescope resolution elements in the field, is the photon detection rate from a fluctuation magnitude star, and ξ is a suppression factor.

Rectal ganglioneuroma in a dog

1999 ◽  
Vol 35 (2) ◽  
pp. 107-110 ◽  
Author(s):  
ME Reimer ◽  
MS Leib ◽  
MS Reimer ◽  
GK Saunders ◽  
SA Johnston
Keyword(s):  
Gastrointestinal Tract ◽  
Surgical Resection ◽  
Large Bowel ◽  
Clinical Signs ◽  
Successful Outcome ◽  
First Report ◽  
History Of ◽  
The Masses

An 18-month-old, spayed female Australian terrier cross was presented with a 10-month history of chronic large bowel diarrhea. Ulceration and two proliferative masses in the rectum were seen on colonoscopy. Surgical resection was performed to remove the masses, and the dog recovered without complications related to surgery. Histopathology was consistent with the diagnosis of ganglioneuroma. The dog had no clinical signs of disease within three months of surgery and was completely normal 2.5 years after diagnosis. This is the first report providing follow-up and successful outcome of a ganglioneuroma in the gastrointestinal tract of a dog.

Conservative Treatment of Multiple Keratocystic Odontogenic Tumors in a Young Patient with Nevoid Basal Cell Carcinoma Syndrome by Decompression: A 7-year Follow-up Study

2017 ◽  
Vol 41 (4) ◽  
pp. 300-304 ◽  
Author(s):  
Su-Hyun Kim ◽  
Min-Seok Oh ◽  
Yo-Seob Seo ◽  
Jin-Young Kim ◽  
Soon-Hyeun Nam ◽  
...  
Keyword(s):  
Basal Cell Carcinoma ◽  
Conservative Treatment ◽  
Cell Carcinoma ◽  
Surgical Resection ◽  
Basal Cell ◽  
Odontogenic Tumors ◽  
Permanent Teeth ◽  
Complete Surgical Resection ◽  
Keratocystic Odontogenic Tumors

Multiple keratocystic odontogenic tumors (KCOT) occurred in a young child is challenging problem in the field of pediatric dentistry, and might have been related to nevoid basal cell carcinoma syndrome (NBCCS). Because of high recurrence rate of KCOTs, complete surgical resection is generally accepted as definitive treatment. However, complete surgical resection could induce negative effect on the development of permanent teeth and growth of jaw. Herein, we reported successful treatment case of young KCOT patient with NBCCS. Although multiple KCOTs occurred continually, the majority of the lesions healed well by decompression and important anatomical structures and permanent teeth were successfully preserved. The purpose of this paper is to report more conservative treatment of multiple keratocystic odontogenic tumors (KCOTs) by repeated decompressions with later peripheral ostectomy during a 7-year follow-up.

scholarly journals Temporal Bone Adenoma: A Comprehensive Analysis of Clinical Aspects and Surgical Outcome on a Very Rare Entity

2020 ◽  
Author(s):  
Hussain Alsalman ◽  
John A. Crowther ◽  
Douglas McLellan ◽  
Georgios Kontorinis
Keyword(s):  
Surgical Resection ◽  
Middle Ear ◽  
Sensorineural Deafness ◽  
Clinical Aspects ◽  
Surgical Morbidity ◽  
Intravenous Contrast ◽  
Presenting Symptoms ◽  
Academic Settings ◽  
Long Term Follow Up

Abstract Objective The aim of this study is to present our experience in dealing with middle ear adenomas (MEAs), very rare tumors of the middle ear. Methods The medical notes of individuals with MEAs treated in tertiary referral; academic settings were retrospectively reviewed. We recorded the presenting symptoms, imaging findings, and pathology results. We additionally examined our surgical outcomes, follow-up period, recurrence, and morbidity. Results We identified four patients with MEAs: two males and two females with an average age of 36.25 years (range = 27–51 years). Despite the detailed imaging studies, including computed tomography and magnetic resonance imaging with intravenous contrast administration, a biopsy was essential in setting the diagnosis. Total surgical resection was achieved in all patients without any recurrence over an average of 6 years (range = 3–10 years). Complete ipsilateral deafness was the commonest surgical morbidity due to footplate infiltration by the tumor. Conclusion Total surgical resection is the treatment of choice in MEAs to minimize the risk for recurrence; this can come with morbidity, mostly sensorineural deafness. Given the very limited literature, long-term follow-up is recommended.

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