scholarly journals Endodermal cyst: rare intraaxial brainstem location. Illustrative cases

2021 ◽  
Vol 2 (11) ◽  
Author(s):  
Atul Goel ◽  
Dikpal Jadhav ◽  
Abhidha Shah ◽  
Asha Shenoy ◽  
Naina Goel
Keyword(s):  
Short Duration ◽  
Young Patients ◽  
Brainstem Lesion ◽  
Brainstem Lesions ◽  
Pleasant Surprise ◽  
Rare Location ◽  
Endodermal Cyst ◽  
Long Life

BACKGROUND This report detailed an extremely rare location of an endodermal cyst. Such location of the tumor can pose radiological confusion and a therapeutic dilemma. However, when identified, it can be a pleasant surprise for the surgeon and provide the possibility of a symptom-free long life for the patient. OBSERVATIONS This report discussed two young patients who presented with relatively short-duration reports of ataxia and diplopia. Investigations revealed intraaxial brainstem lesion. During surgery, thick, pus-like fluid was evacuated and part of a wall was resected. Histology revealed that the lesion was an endodermal cyst. Both patients are well and are lesion- and symptom-free for 24 and 72 months. LESSONS Endodermal cysts are some of the few long-standing and benign intraaxial brainstem lesions.

Early magnetic resonance imaging of brainstem lesions after severe head injury

1998 ◽  
Vol 89 (5) ◽  
pp. 707-712 ◽  
Author(s):  
Raimund Firsching ◽  
Dieter Woischneck ◽  
Michael Diedrich ◽  
Susan Klein ◽  
Andreas Rückert ◽  
...  
Keyword(s):  
Head Injury ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Severe Head Injury ◽  
Auditory Evoked Potentials ◽  
Ct Scanning ◽  
Brainstem Lesion ◽  
Content Type ◽  
Brainstem Lesions ◽  
Fine Print

Object. The availability of magnetic resonance (MR) imaging data obtained in comatose patients after head injury is scarce, because MR imaging is somewhat cumbersome to perform in patients requiring ventilation and because, in the first hours after injury, its relevance is clearly inferior to computerized tomography (CT) scanning. The authors assessed the value of MR imaging in the early postinjury period. Methods. In this prospective study MR imaging was performed in 61 consecutive patients within 7 days after they suffered a severe head injury. An initial CT scan had already been obtained. To understand the clinical significance of the lesions whose morphological appearance was identified with MR imaging, brainstem function was assessed by registration of somatosensory and auditory evoked potentials. Brainstem lesions were visualized in 39 patients (64%). Bilateral pontine lesions proved to be 100% fatal and nonbrainstem lesions carried a mortality rate of 9%. In singular cases circumstances allowed for a clear clinical distinction between primary and secondary brainstem lesions. On MR imaging all lesions were hyper- and hypointense after intervals longer than 2 days. Within shorter intervals (< 2 days) after the injury, primary lesions appeared isointense on MR imaging. In one secondary brainstem lesion there were no traces of blood. Conclusions. Because mean intracranial pressure (ICP) levels in patients without brainstem lesions were similar to those in patients with brainstem lesions, the authors conclude that it was not mainly increased ICP that accounted for the high mortality rates in patients with brainstem lesions. The authors also conclude that brainstem lesions are more frequently found in severe head injury than previously reported in studies based on neuropathological or CT scanning data. Early MR imaging after head injury has a higher predictive value than CT scanning.

Abstract 559: Augmented Urinary Angiotensinogen in Young Type-1 Diabetic Subjects Correlates with Hemoglobin A1c and Urinary 8-Isoprostane

Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
L Gabriel Navar ◽  
Akemi Katsurada ◽  
Vivian Fonseca ◽  
Minolfa C Prieto ◽  
Stuart Chalew ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Short Duration ◽  
Excretion Rate ◽  
Human Subjects ◽  
Young Patients ◽  
Response To Therapy ◽  
Control Subjects ◽  
Urinary Angiotensinogen ◽  
Intrarenal Ras

Previous studies indicate that the intrarenal renin-angiotensin system (RAS) is activated in type-1 diabetes mellitus (T1DM) experimental animal models and human subjects, and is reflected by augmentation of urinary angiotensinogen (uAGT) excretion rate. Studies were performed to evaluate uAGT in young patients with short duration diabetes mellitus (DM) and its relationships with HbA1c and urinary 8-isoprostane excretion rate. Blood and urine samples were collected from 77 young (15±1 years) patients (44 male, 33 female) with short duration T1DM treated only with insulin and 36 (17 male, 19 female) control subjects. Serum glucose levels were 85±4 mg/dl in control subjects and 192±11 mg/dl in DM patients. Urinary Alb/Cr and uPro/Cr ratios were not significantly different in DM patients compared to control (8.6±.9 vs 9.7±.6 and 51±8 vs 62±14 mg/g). However, the uAGT/Cr ratios were significantly elevated in the DM patients (6.8±.8 vs 16.5±1.5 ug/g). Correlation analysis demonstrated highly significant relationships (P<.0001) between uAGT/Cr and HbA1c (R=.44) and urinary 8-isoprostane excretion rate (R=.52) in the DM patients. These results indicate that, even in young non-albuminuric patients with relatively short duration of DM, uAGT excretion rates are increased, suggesting early activation of the intrarenal RAS, and are correlated with HbA1c and urinary 8-isoprostane levels indicative of increased reactive oxygen species. Accordingly, uAGT levels may serve as an early marker of an activated intrarenal RAS and provide a specific index of renal RAS status potentially useful in monitoring clinical response to therapy.

scholarly journals Brainstem biopsies in adults: Review of 80 consecutive cases

2009 ◽  
Vol 28 (04) ◽  
pp. 139-142 ◽  
Author(s):  
Marcos Dellaretti ◽  
Baltazar Leão Reis ◽  
Gustavo Touzet ◽  
Nicolas Reyns ◽  
François Dubois ◽  
...  
Keyword(s):  
Literature Review ◽  
Success Rate ◽  
Stereotactic Biopsy ◽  
Wide Spectrum ◽  
Mortality Rates ◽  
Brainstem Lesion ◽  
Brainstem Lesions ◽  
Impact On Treatment ◽  
The Impact ◽  
Stereotactic Biopsies

Abstract Objective: To retrospectively review the morbidity and mortality rates associated with stereotactic brainstem lesion biopsy, the success rate and the impact on treatment. Material and methods: Eighty consecutive stereotactic biopsies and literature review were performed to analyze clinical, radiographic and histopathological data. Results: Stereotactic biopsy of brainstem lesions conducted to the diagnosis in 96.3%. One death (1.3% of cases) occurred and 10% morbidity was associated with the procedure. Pathology showed that 65% of the adult brainstem intrinsic lesions were gliomas, 11.3% were metastasis, 8.7% were lymphomas and the remaining tumoral lesions were ganglioglioma, ependymoma and craniopharyngeoma. Non-tumoral lesions were the diagnosis in 11 cases. Conclusion: Empiric treatment of adult brainstem lesions is not prudent, because a wide spectrum of pathologies occur in this location. Stereotactic biopsy is a safe and effective method for determining the diagnostic of these lesions.

scholarly journals Juvenile ossifying fibroma of the orbit: a rare location

2021 ◽  
Vol 7 (4) ◽  
pp. 676
Author(s):  
Pedro Clarós ◽  
Sofia Polainas ◽  
Marta Fortuny ◽  
Andres Clarós
Keyword(s):  
Benign Lesion ◽  
Young Patients ◽  
Ossifying Fibroma ◽  
Histopathological Diagnosis ◽  
Orbital Cavity ◽  
Post Surgery ◽  
Juvenile Ossifying Fibroma ◽  
Downward Displacement ◽  
Rare Location ◽  
Progressive Growth

<p class="abstract">Osseous tumors in the craniofacial skeleton of young patients are not very frequent, and tumors involving the walls of the orbital cavity are even more infrequent. Despite being usually slow-growing, even small neoformations can have a local aggressive behavior, displacing and compressing vital structures, and so it is important to perform an early diagnosis in order to avoid the tumor to pose problems on the optic nerve and threaten vision. The case that we are presenting shows an ossifying fibroma in a 19-year-old male from Ethiopia, a benign lesion whose progressive growth caused proptosis and downward displacement of the left eye. Following an adequate radiological diagnosis, we were able to delimit the fibroma existence and location. The surgery was conducted in a conservative form, allowing the patient not to suffer from post-surgery malformations. Histopathological diagnosis was compatible with juvenile ossifying fibroma, psammomatoid variant, arising from an uncommon location – the roof of the orbit.  </p>

scholarly journals Endodermal cyst in pineal region: Rare location

2016 ◽  
Vol 7 (12) ◽  
pp. 279 ◽  
Author(s):  
MiguelAngel Lopez-Gonzalez ◽  
Eugen Dolan
Keyword(s):  
Pineal Region ◽  
Rare Location ◽  
Endodermal Cyst

scholarly journals Stereotactic biopsy of brainstem lesions: Techniques, efficacy, safety, and disease variation between adults and children: A single institutional series and review

2014 ◽  
Vol 5 (01) ◽  
pp. 32-39 ◽  
Author(s):  
N. Manoj ◽  
A. Arivazhagan ◽  
D. I. Bhat ◽  
H. R. Arvinda ◽  
A. Mahadevan ◽  
...  
Keyword(s):  
Local Anesthesia ◽  
Stereotactic Biopsy ◽  
Pediatric Population ◽  
Adult Population ◽  
Brainstem Lesion ◽  
Brainstem Lesions ◽  
Adults And Children ◽  
Initial Biopsy ◽  
Magnetic Resonance Imaging Mri ◽  
Procedure Room

ABSTRACT Background: Stereotactic biopsy of brainstem lesions have been performed with varying indications, with most of the literature reporting on children. Materials and Methods: The present study retrospectively analyzed all cases that underwent stereotactic biopsy for brainstem lesion in both adult and pediatric population between 1994 and 2009 in a single tertiary neurosurgical center. The clinical and radiological features, technique of the procedure, morbidity, diagnostic accuracy, spectrum of diagnosis, and variations in adult and pediatric population were analyzed. Results: Eighty-two patients were included in the study. Computed tomography (CT) was used as guidance in 73 (38 children and 35 adults) patients and magnetic resonance imaging (MRI) in 9 (3 children and 6 adults). The biopsy was performed in a procedure room under local anesthesia in most adults, while children required sedation. Glioblastoma comprised 29.3% of all pathologies in children, compared with only 4.9% of the pathologies in adult population (P = 0.007). Tuberculosis was the next major diagnosis (9.8%). In 12 patients, initial biopsy was inconclusive. Following a repeat biopsy in 5 of these patients, a diagnosis was possible for 75/82 (91.5%) patients by STB. The location of the target, the choice of entry, the radiological characteristic of the lesion, enhancement pattern, and age group did not significantly correlate with the occurrence of inconclusive biopsy. Permanent complications occurred in two patients (2.4%). There was no mortality in this series. Conclusion: Stereotactic biopsy has an important role in brainstem lesions, more significantly in adults, due to wider pathological spectrum. It can be performed safely under local anesthesia through a twist drill craniostomy in most of the adults.

scholarly journals Pure sensory stroke due to brainstem lesion

2019 ◽  
Vol 12 (8) ◽  
pp. e230472
Author(s):  
Ryan McCreery ◽  
Zoltan Fekete
Keyword(s):  
Acute Onset ◽  
Neurological Deficits ◽  
Brainstem Lesion ◽  
Brainstem Lesions ◽  
Left Posterior ◽  
Brainstem Stroke ◽  
Neurological Exam ◽  
Sensory Stroke ◽  
High Index Of Suspicion ◽  
Time Of Presentation

A 40-year-old male patient presented to the emergency department with acute onset right-sided upper and lower extremity numbness/tingling over the past day. Prior to the paraesthesia onset, the patient experienced transient mild ataxia and left ocular pain with complete resolution at the time of presentation. Neurological exam revealed isolated right-sided sensory changes from his hand-to-elbow as well as foot-to-knee. No other focal neurological deficits were noted. MRI brain revealed a small left posterior infarct at the junction between the pons and midbrain. Dual-antiplatelet therapy was initiated and the patient experienced minimal paraesthesia improvement proximally over his 5-day hospital course. This case report highlights an acute brainstem stroke presenting with predominant hemisensory symptoms. Presentations of brainstem lesions can range from subtle, non-specific features to profound deficits. This case serves to emphasise the importance of performing a thorough clinical exam while maintaining a high index of suspicion for brainstem lesions.

Correlation among magnetic resonance imaging findings, prognostic factors for survival, and histological diagnosis of intrinsic brainstem lesions in children

2011 ◽  
Vol 8 (6) ◽  
pp. 539-543 ◽  
Author(s):  
Marcos Dellaretti ◽  
Gustavo Touzet ◽  
Nicolas Reyns ◽  
François Dubois ◽  
Sebastião Gusmão ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Mr Imaging ◽  
High Grade Glioma ◽  
Brainstem Glioma ◽  
Low Grade ◽  
Diffuse Glioma ◽  
High Grade ◽  
Brainstem Lesion ◽  
Brainstem Lesions ◽  
The Mean

Object The aim of this study was to compare MR imaging characteristics with histopathological findings of intrinsic brainstem lesions and also to show the prognostic factors in patients with diffuse brainstem glioma. Methods Between February 1988 and August 2007, 44 brainstem biopsies were performed at the Roger Salengro Hospital in Lille, France, in children with intrinsic brainstem lesions not amenable to excision. Twenty-six were female and 18 male, and the mean age was 6 years. Results Histological evaluation revealed diffuse brainstem glioma in all patients with diffuse nonenhancing brainstem lesions. Diffuse brainstem glioma was found in 18 patients (90%) with diffuse enhancing brainstem lesions. Pathological entities different from diffuse glioma were verified in 2 patients (10%)—1 with ependymoma and 1 with ganglioglioma. In 4 of 5 patients with a focal nonenhancing brainstem lesion, the histopathological diagnosis was diffuse low-grade glioma. In 6 of 10 patients with focal enhancing brainstem lesion, the diagnosis was diffuse brainstem glioma, and pathological entities different from diffuse brainstem glioma were verified in 2 (20%), both with pilocytic astrocytoma. The mean 1-year actuarial survival rates for patients classified with low-grade and high-grade glioma were 80.4% ± 0.08% and 48.6% ± 0.14%, respectively. Conclusions The impact of stereotactic biopsy on intrinsic brainstem lesions was greater in patients with MR imaging–documented enhancing lesions in whom the diagnosis of diffuse glioma was less frequent. Patients with low-grade glioma seem to have longer survival than those with high-grade glioma.

A study of cometary eruptions through OH radio-lines

1999 ◽  
Vol 173 ◽  
pp. 249-254
Author(s):  
A.M. Silva ◽  
R.D. Miró
Keyword(s):  
Short Duration ◽  
Growth Curves ◽  
The Other ◽  
Initial Mass ◽  
Radio Lines ◽  
Other Hand ◽  
Sudden Rise

AbstractWe have developed a model for theH2OandOHevolution in a comet outburst, assuming that together with the gas, a distribution of icy grains is ejected. With an initial mass of icy grains of 108kg released, theH2OandOHproductions are increased up to a factor two, and the growth curves change drastically in the first two days. The model is applied to eruptions detected in theOHradio monitorings and fits well with the slow variations in the flux. On the other hand, several events of short duration appear, consisting of a sudden rise ofOHflux, followed by a sudden decay on the second day. These apparent short bursts are frequently found as precursors of a more durable eruption. We suggest that both of them are part of a unique eruption, and that the sudden decay is due to collisions that de-excite theOHmaser, when it reaches the Cometopause region located at 1.35 × 105kmfrom the nucleus.

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