Supratentorial intra-arachnoid cyst

1971 ◽  
Vol 35 (4) ◽  
pp. 477-482 ◽  
Author(s):  
Nitya R. Ghatak ◽  
Grace J. Mushrush
Keyword(s):  
Brain Stem ◽  
Arachnoid Cyst ◽  
Cerebral Hemisphere ◽  
Arachnoid Cysts ◽  
Neurological Deficits ◽  
Pathological Features ◽  
Content Type ◽  
The Brain ◽  
Clinical And Pathological Features ◽  
Fine Print

✓ The clinical and pathological features of a primary supratentorial arachnoid cyst are described. Expansion of the cyst led to progressive neurological deficits that terminated fatally. There was severe compression and marked distortion of the brain with secondary brain stem hemorrhage. It is suggested that intra-arachnoid cysts may represent a distinct pathological entity among the heterogeneous cysts overlying the cerebral hemisphere.

Cavernous malformations of the brain stem

1991 ◽  
Vol 75 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Richard S. Zimmerman ◽  
Robert F. Spetzler ◽  
K. Stuart Lee ◽  
Joseph M. Zabramski ◽  
Ronald W. Hargraves
Keyword(s):  
Brain Stem ◽  
Cavernous Malformation ◽  
Venous Malformation ◽  
Neurological Status ◽  
Shunt Infection ◽  
Neurological Deficits ◽  
Cavernous Malformations ◽  
Content Type ◽  
The Brain ◽  
Fine Print

✓ Once they become symptomatic, cavernous malformations of the brain stem appear to cause progressive morbidity from repetitive hemorrhage, and can even be fatal. Twenty-four patients with long-tract and/or cranial nerve findings from their cavernous malformations of the brain stem were seen for initial evaluation or surgical consultation and thereafter received either surgical or continued conservative treatment. The decision to operate was based on the proximity of the cavernous malformation to the pial surface of the brain stem, the patient's neurological status, and the number of symptomatic episodes. Sixteen patients were treated by definitive surgery directed at excision of their malformation. In four patients, associated venous malformations influenced the surgical approach and their recognition avoided the risk of inappropriate excision of the venous malformation. Although some of the 16 patients had transient, immediate, postoperative worsening of their neurological deficits, the outcome of all except one was the same or improved. Only one patient developed recurrent symptoms: a new deficit 2½ years after surgery required reoperation after regrowth of the cavernous malformation. She has been neurologically stable since the second surgery. One patient died 6 months postoperatively from a shunt infection and sepsis. The eight conservatively treated patients are followed with annual magnetic resonance imaging studies. One has a dramatic associated venous malformation. Seven patients have either minor intermittent or no symptoms, and the eighth died from a hemorrhage 1 year after his initial presentation. Based on these results, surgical extirpation of symptomatic cavernous malformations of the brain stem appears to be the treatment of choice when a patient is symptomatic, the lesion is located superficially, and an operative approach can spare eloquent tissue. When cavernous malformations of the brain stem are completely excised, cure appears permanent.

Surgical removal of arteriovenous malformations from the brain stem and cerebellopontine angle

1975 ◽  
Vol 43 (6) ◽  
pp. 661-670 ◽  
Author(s):  
Charles G. Drake
Keyword(s):  
Arteriovenous Malformation ◽  
Brain Stem ◽  
Arteriovenous Malformations ◽  
Cerebellopontine Angle ◽  
Neurological Deficits ◽  
Surgical Removal ◽  
Surgical Experience ◽  
Content Type ◽  
The Brain ◽  
Fine Print

✓ The author reports his surgical experience with five cases of arteriovenous malformation of the brain stem and cerebellopontine angle causing multiple hemorrhages and severe neurological deficits. Surgical removal of the lesions had good results in four cases; there was one death.

Arteriovenous malformations in the posterior fossa

1977 ◽  
Vol 47 (1) ◽  
pp. 50-56 ◽  
Author(s):  
Hiroshi Matsumura ◽  
Yasumasa Makita ◽  
Kuniyuki Someda ◽  
Akinori Kondo
Keyword(s):  
Arteriovenous Malformation ◽  
Brain Stem ◽  
Posterior Fossa ◽  
Arteriovenous Malformations ◽  
Cerebellopontine Angle ◽  
Anterior Part ◽  
Content Type ◽  
The Brain ◽  
Fine Print

✓ We have operated on 12 of 14 cases of arteriovenous malformation (AVM) in the posterior fossa since 1968, with one death. The lesions were in the cerebellum in 10 cases (three anteromedial, one central, three lateral, and three posteromedial), and in the cerebellopontine angle in two; in two cases the lesions were directly related to the brain stem. The AVM's in the anterior part of the cerebellum were operated on through a transtentorial occipital approach.

Successful evacuation of a pontine hematoma secondary to rupture of a pathologically diagnosed “cryptic” vascular malformation

1973 ◽  
Vol 39 (1) ◽  
pp. 104-108 ◽  
Author(s):  
Ben B. Scott ◽  
Joachim F. Seeger ◽  
Richard C. Schneider
Keyword(s):  
Arteriovenous Malformation ◽  
Brain Stem ◽  
Posterior Fossa ◽  
Vascular Malformation ◽  
Nerve Palsy ◽  
Neurological Deficits ◽  
Content Type ◽  
Brain Stem Lesion ◽  
Seventh Nerve ◽  
Fine Print

✓ A posterior fossa exploration was performed on a child thought initially to have an inoperable brain stem lesion. A pontine hematoma was discovered and evacuated. The pathological specimen was designated as a “cryptic” arteriovenous malformation. All preoperative neurological deficits disappeared except for a minimal left seventh nerve palsy.

Cervical spinal cord in experimental hydrocephalus

1972 ◽  
Vol 37 (5) ◽  
pp. 538-542 ◽  
Author(s):  
George J. Dohrmann
Keyword(s):  
Spinal Cord ◽  
Brain Stem ◽  
Cervical Spinal Cord ◽  
Central Canal ◽  
Content Type ◽  
Experimental Hydrocephalus ◽  
Physiological Pressure ◽  
The Brain ◽  
Shunting Procedure ◽  
Fine Print

✓ Adult dogs were rendered hydrocephalic by the injection of kaolin into the cisterna magna. One group of dogs was sacrificed 1 month after kaolin administration, and ventriculojugular shunts were performed on the other group. Hydrocephalic dogs with shunts were sacrificed 1 day or 1 week after the shunting procedure. All dogs were perfused with formalin at physiological pressure, and the brain stem and cervical spinal cord were examined by light microscopy. Subarachnoid granulomata encompassed the superior cervical spinal cord and dependent surface of the brain stem. Rarefaction of the posterior white columns and clefts or cavities involving the gray matter posterior to the central canal and/or posterior white columns were present in the spinal cords of both hydrocephalic and shunted hydrocephalic dogs. Predominantly in the dogs with shunts, hemorrhages were noted in the spinal cord in association with the clefts or cavities. A mechanism of ischemia followed by reflow of blood is postulated to explain the hemorrhages in the spinal cords of hydrocephalic dogs with shunts.

Cerebral cysticercosis with aqueductal obstruction

1980 ◽  
Vol 53 (2) ◽  
pp. 252-255 ◽  
Author(s):  
Tung Pui Poon ◽  
Edward J. Arida ◽  
Wolodymyr P. Tyschenko
Keyword(s):  
Intracranial Hypertension ◽  
Brain Stem ◽  
Normal Pressure Hydrocephalus ◽  
Signs And Symptoms ◽  
Normal Pressure ◽  
Content Type ◽  
Neurological Signs ◽  
Cerebral Cysticercosis ◽  
The Brain ◽  
Fine Print

✓ The authors report a case of cerebral cysticercosis which presented with generalized nonspecific neurological signs and symptoms attributed to acute aqueductal obstruction, with concomitant intracranial hypertension. These were characteristic intracranial calcifications along with angiographically demonstrated signs of hydrocephalus. Contrast encephalography clearly demonstrated aqueductal obstruction. Pathologically, the aqueductal obstruction was shown to be due to parasitic invasion of the brain stem with compression of the aqueduct. The presence of typical intracranial calcification in conjunction with either obstructive or normal-pressure hydrocephalus should alert the observer to the possibility of cerebral cysticercosis.

Clinicopathological study of 53 tumors of the pineal region

1973 ◽  
Vol 39 (4) ◽  
pp. 455-462 ◽  
Author(s):  
Umberto DeGirolami ◽  
Henry Schmidek
Keyword(s):  
General Hospital ◽  
Massachusetts General Hospital ◽  
Pineal Region ◽  
Pathological Features ◽  
Content Type ◽  
Clinicopathological Study ◽  
Ventricular Tumors ◽  
Clinical And Pathological Features ◽  
Fine Print

✓ Fifty-three cases of pineal and posterior-third ventricular tumors seen at the Massachusetts General Hospital from 1920 to 1972 are reviewed. This series includes 35 pathologically verified tumors and 18 cases accepted as pineal neoplasms on clinical and radiographic grounds. A plan of management is proposed based on a correlation between the clinical and pathological features and the response of each type of tumor to the currently available modes of therapy.

Odontoid compression of the brain stem in a patient with rheumatoid arthritis

1980 ◽  
Vol 53 (6) ◽  
pp. 841-845 ◽  
Author(s):  
Harold P. Smith ◽  
Venkata R. Challa ◽  
Eben Alexander
Keyword(s):  
Rheumatoid Arthritis ◽  
Brain Stem ◽  
Neurological Deficit ◽  
Neurological Symptoms ◽  
Direct Compression ◽  
Content Type ◽  
Vertical Subluxation ◽  
Progressive Neurological Deficit ◽  
The Brain ◽  
Fine Print

✓ Cervical spine involvement by rheumatoid arthritis is common; brain-stem compression secondary to vertical subluxation of the odontoid in patients with rheumatoid arthritis is rare. Vertical subluxation results from 1) destruction of the transverse atlantal, apical, and alar ligaments of the atlas and odontoid, and 2) bone resorption in the occipital condyles, lateral masses of the atlas, and basilar processes of the skull. Neurological symptoms result from direct compression of the brain stem or from ischemia secondary to compression of vertebral arteries, anterior spinal arteries, or small perforating arteries of the brain stem and spinal cord. A case is reported in which a slowly progressive neurological deficit developed in a woman with rheumatoid arthritis following a fall from a stretcher. Neurological symptoms represented direct compression of the medulla by the dens, a mechanism confirmed at operation and autopsy. Recognition of progressive neurological deficit is often difficult in patients with rheumatoid arthritis because of their inactivity and their atrophic and immobile joints, but is essential if appropriate decompressive or stabilizing procedures are to be done. In patients with vertical subluxation of the dens, the transoral approach with removal of the odontoid is recommended. Decompression should be extensive, including the fibrous capsule around the odontoid and overlying synovial tissue as well as the odontoid itself.

Vascular malformations of the brain stem

1989 ◽  
Vol 70 (6) ◽  
pp. 847-852 ◽  
Author(s):  
Douglas Chyatte
Keyword(s):  
Brain Stem ◽  
Vascular Malformation ◽  
Vascular Malformations ◽  
Surgical Removal ◽  
Content Type ◽  
Appropriate Treatment ◽  
Complete Obliteration ◽  
Time Of Presentation ◽  
The Brain ◽  
Fine Print

✓ Vascular malformations of the brain stem are unusual lesions that may pose a diagnostic and therapeutic challenge. Seven patients with vascular malformations involving the brain stem were evaluated; six were treated surgically, with complete obliteration of the lesion in five patients. In five patients symptoms developed only after a hemorrhage had occurred, and three of these suffered a rebleed before appropriate treatment was given. Angiography failed to demonstrate lesions in three cases, which did not appear to protect from repeat hemorrhage since two of the three rebled. There were no operative deaths, and no patients were made permanently worse after surgery. Useful recovery occurred commonly after appropriate treatment and appeared to be possible even in patients who had suffered a catastrophic neurological deficit at the time of presentation. These data indicate that surgical removal of the lesion may be warranted in some patients with symptomatic brain-stem vascular malformation.

General and local hypothermia of the brain in the treatment of intractable epilepsy

1970 ◽  
Vol 33 (3) ◽  
pp. 253-259 ◽  
Author(s):  
K. Šourek ◽  
V. Trávníček
Keyword(s):  
Intractable Epilepsy ◽  
Clinical Results ◽  
Emotional Stability ◽  
Local Temperature ◽  
Neurological Deficits ◽  
Content Type ◽  
Postoperative Changes ◽  
Local Hypothermia ◽  
The Brain ◽  
Fine Print

✓ Twenty-five cases of intractable epilepsy were treated by combined deep general and local extravascular brain hypothermia plus single doses of pentothal (Thiopental) or diazepam. The final local temperature of the brain in 21 patients was below 24°C, the rectal temperatures being 27° to 30°C. There was one death 6 weeks after surgery, and in two patients slight neurological deficits were found at 3 and 6 months postoperatively. In 15 patients in whom at least 1 year had elapsed since surgery, the frequency and intensity of the seizures were reduced by 50% in two, reduced to a single seizure in five, eliminated in four, and unaltered in four. The fair and excellent results included 60% of the group. In three patients improvement in behavior and emotional stability were observed postoperatively; this change was independent of the reduction of the frequency of seizures. Postoperative changes in the electroencephalogram were less frequent than changes in the frequency of seizures and also were completely independent of the clinical results.

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