Rhabdomyosarcoma of the brain

1975 ◽  
Vol 43 (2) ◽  
pp. 215-221 ◽  
Author(s):  
Yasuhiko Matsukado ◽  
Akira Yokota ◽  
Touru Marubayashi
Keyword(s):  
Posterior Fossa ◽  
Fourth Ventricle ◽  
Cerebral Hemisphere ◽  
Content Type ◽  
The Brain ◽  
Fine Print

✓The authors report a case of rhabdomyosarcoma originating in the fourth ventricle and review the eight comparable previous reports of true rhabdomyosarcoma, composed solely of mesenchymal elements. Tumors in most adults arose in the cerebral hemisphere, while those in children arose exclusively in the midline structures of the posterior fossa. The tumor in the authors' case was initially benign and well circumscribed, but within 2 years had changed into a malignant rhabdomyosarcoma. The histological documentation during the interval is presented and discussed.

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.

Hydrocephalus due to membranous obstruction of the fourth ventricle

1971 ◽  
Vol 35 (6) ◽  
pp. 672-676 ◽  
Author(s):  
A. Loren Amacher ◽  
Larry K. Page
Keyword(s):  
Posterior Fossa ◽  
Fourth Ventricle ◽  
Clinical Findings ◽  
Posterior Fossa Tumor ◽  
Cerebellar Development ◽  
Rare Entity ◽  
Content Type ◽  
Operative Findings ◽  
Membranous Obstruction ◽  
Fine Print

✓ Four patients with hydrocephalus due to membranous obstruction of the fourth ventricle are presented. This rare entity produced radiographic and clinical findings suggestive of posterior fossa tumor. Operative findings included normal cerebellar development and a translucent membrane just above the foramen of Magendie. Etiological possibilities are discussed.

Aspergillosis of the fourth ventricle

1975 ◽  
Vol 43 (2) ◽  
pp. 236-238 ◽  
Author(s):  
Amilcar J. E. Correa ◽  
Raul Brinckhaus ◽  
Saul Kesler ◽  
Eugenio Martinez
Keyword(s):  
Fourth Ventricle ◽  
Content Type ◽  
The Brain ◽  
Fine Print

✓ The authors present a case of Aspergillus infection of the brain; this is believed to be the second case of its kind in Argentina, and probably the only reported case involving an intracranial mycetoma.

Germinoma causing wallerian degeneration

1998 ◽  
Vol 88 (1) ◽  
pp. 126-128 ◽  
Author(s):  
Kiyoshi Nagata ◽  
Yuji Nikaido ◽  
Takashi Yuasa ◽  
Kenta Fujimoto ◽  
Yong Jin Kim ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Basal Ganglia ◽  
Cerebral Hemisphere ◽  
Wallerian Degeneration ◽  
Pathological Change ◽  
Internal Capsule ◽  
Resonance Imaging ◽  
Content Type ◽  
The Brain ◽  
Fine Print

✓ Germinomas occurring in the thalamus and basal ganglia sometimes cause atrophy of the cerebral hemisphere on the affected side. The authors present the case of a 12-year-old girl with a germinoma that developed in the basal frontal lobe and cerebral basal ganglia. Magnetic resonance imaging showed atrophy not only of the cerebrum but also of the brainstem. A T2-weighted image revealed an area of high intensity that proved to be wallerian degeneration extending from the corona radiata and internal capsule to the brainstem. The authors suggest that this pathological change may be involved in the development of the symptoms and hemiatrophy associated with germinomas in this region of the brain.

Acute hydrocephalus in posterior fossa injury

1997 ◽  
Vol 86 (4) ◽  
pp. 629-632 ◽  
Author(s):  
Hideharu Karasawa ◽  
Hajime Furuya ◽  
Hiromichi Naito ◽  
Ken Sugiyama ◽  
Junji Ueno ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Fourth Ventricle ◽  
Ct Scanning ◽  
Mortality Rates ◽  
External Ventricular Drainage ◽  
Ventricular Drainage ◽  
Content Type ◽  
Acute Hydrocephalus ◽  
Significant Difference ◽  
Fine Print

✓ This is the first known report of the use of computerized tomography (CT) scanning to examine acute hydrocephalus in posterior fossa injury. Of the 1802 patients with acute head trauma treated at Funabashi Municipal Medical Center, 53 (2.9%) had suffered injury to the posterior fossa. Of these, 12 patients (22.6%) had associated acute hydrocephalus: nine patients with acute epidural hematoma (AEH) and three with intracerebellar hematoma and contusion (IH/C). There was a significant relationship between cases of AEH with hydrocephalus and supratentorial extension, hematoma thickness of 15 mm or more, and abnormal mesencephalic cisterns. In cases of IH/C, bilateral lesions and no visible fourth ventricle were significant causes of hydrocephalus. According to these results, possible mechanisms of acute hydrocephalus in posterior fossa injury may be as follows: in cases of AEH, hematoma that extends to the supratentorial area compresses the aqueduct posteriorly and causes hydrocephalus; in cases of IH/C, hematoma and contusional lesions may directly occlude the fourth ventricle and cause acute hydrocephalus. Seven patients suffering from AEH with acute hydrocephalus underwent evacuation of their hematoma without external ventricular drainage. In these cases, CT scanning showed that the hydrocephalus improved immediately after evacuation of the hematoma. Two patients suffering from IH/C with hydrocephalus underwent a procedure for evacuation of the hematoma and external ventricular drainage. The authors do not believe that ventricular drainage is necessary in treating posterior fossa AEH. However, both evacuation of the hematoma and ventricular drainage are necessary in cases of IH/C with hydrocephalus to provide the patient with every chance for survival. There was no significant difference in mortality rates when cases of AEH with acute hydrocephalus (0%) were compared with cases of AEH without hydrocephalus (7.7%). The observed mortality rates in cases of IH/C with hydrocephalus and those without hydrocephalus were 100% and 15.4%, respectively; this is statistically significant.

A study of safe entry zones via the floor of the fourth ventricle for brain-stem lesions

1993 ◽  
Vol 78 (6) ◽  
pp. 987-993 ◽  
Author(s):  
Kazuhiko Kyoshima ◽  
Shigeaki Kobayashi ◽  
Hirohiko Gibo ◽  
Takayuki Kuroyanagi
Keyword(s):  
Facial Nerve ◽  
Brain Stem ◽  
Fourth Ventricle ◽  
Medial Lemniscus ◽  
Content Type ◽  
Brain Stem Lesions ◽  
Stem Lesions ◽  
Hazardous Procedure ◽  
The Brain ◽  
Fine Print

✓ Direct surgery for intra-axial lesions of the brain stem is considered a hazardous procedure, and morbidity of varying degrees cannot be avoided even with partial removal or biopsy. The main causes of morbidity relate to direct damage during removal of the lesion, selection of an entry route into the brain stem, and the direction of brain stem retraction. The authors examined the possibility of making a medullary incision and retracting the brain stem, taking into account the symptomatology and surgical anatomy, and found two safe entry zones into the brain stem through a suboccipital approach via the floor of the fourth ventricle. These safe entry zones are areas where important neural structures are less prominent. One is the “suprafacial triangle,” which is bordered medially by the medial longitudinal fascicle, caudally by the facial nerve (which runs in the brainstem parenchyma), and laterally by the cerebellar peduncle. The second is the “infrafacial triangle,” which is bordered medially by the medial longitudinal fascicle, caudally by the striae medullares, and laterally by the facial nerve. In order to minimize the retraction-related damage to important brain-stem structures, the brain stem should be retracted either laterally or rostrally in the suprafacial triangle approach and only laterally in the infrafacial triangle approach. Three localized intra-axial brain-stem lesions were treated surgically via the safe entry zones using the suprafacial approach in two and the infrafacial approach in one. The cases are described and the approaches delineated. Both approaches are indicated for focal intra-axial lesions located unilaterally and dorsal to the medial lemniscus in the lower midbrain to the pons. Magnetic resonance imaging is useful in selecting these approaches, and intraoperative ultrasonography is helpful to confirm the exact location of a lesion before a medullary incision is made. These approaches can also be used as routes for aspiration of brain-stem hemorrhage as well as for tumor biopsy.

Preirradiation chemotherapy including “eight drugs in 1 day” regimen and high-dose methotrexate in childhood medulloblastoma: results of the M7 French Cooperative Study

1995 ◽  
Vol 82 (4) ◽  
pp. 608-614 ◽  
Author(s):  
J. C. Gentet ◽  
E. Bouffet ◽  
F. Doz ◽  
P. Tron ◽  
H. Roche ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Posterior Fossa ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Content Type ◽  
Dose Methotrexate ◽  
Group A ◽  
Group B ◽  
The Brain ◽  
Fine Print

✓ The aim of this study was to evaluate the feasibility and efficacy of a protocol that includes “sandwich” chemotherapy, that is, chemotherapy alternated with radiotherapy, and reduced doses of supratentorial irradiation in children with medulloblastoma. Between March 1985 and September 1988, 70 successive children with newly diagnosed medulloblastoma from eight centers were treated in this prospective nonrandomized study. Patients were assigned to two risk groups. Group A included patients with macroscopically complete or subtotal excision, no brainstem involvement, no atypical cells in the cerebrospinal fluid, normal myelography, and who were more than 2 years of age. Group B patients encompassed those who did not fit the criteria for Group A. Two children were excluded from analysis after histological review confirmed ependymoma. Thus, a population of 68 children was selected, with 31 in Group A and 37 in Group B. Treatment consisted of two courses of the “eight drugs in 1 day” (“8/1”) regimen followed by two courses of high-dose methotrexate (12 g/m2). Radiotherapy was begun during the 7th week after surgery in Group A and during the 5th week in Group B. In patients older than 2 years, the median radiation dose to the posterior fossa, the spinal axis, and the brain was 54 Gy, 36 Gy, and 27 Gy, respectively. Group B patients received postirradiation chemotherapy with four 8/1 courses monthly. The median time from surgery to radiation therapy was 50 days (range 21 to 141 days). One fatality due to chicken pox on Day 102 and one World Health Organization Grade IV infection occurred. The estimated 5- and 7-year disease-free survival (DFS) rates were 62% and 59%, respectively. These were 74% and 62% in Group A and 57% and 57% in Group B. Patient age, extent of resection, and radiation dose to the whole brain had no prognostic value. Patients with metastasis had a nonsignificant trend for a worse prognosis than patients with nonmetastatic disease (7-year DFS 45% vs. 68%, p = 0.11). In Group B, the 7-year DFS rates for children who received more or less than 30 Gy to the brain were 69% and 52% respectively (p = 0.15). There were recurrences in the posterior fossa (37%), spine (20%), and brain (20%). After a review of radiotherapeutic treatments, only one supratentorial failure could be blamed on reduction of the supratentorial radiation dose. This “sandwich” chemotherapy appeared to be feasible and did not show adverse survival data when compared to other series.

Mutism after posterior fossa surgery in children

1990 ◽  
Vol 72 (6) ◽  
pp. 959-963 ◽  
Author(s):  
Luigi Ferrante ◽  
Luciano Mastronardi ◽  
Michele Acqui ◽  
Aldo Fortuna
Keyword(s):  
Posterior Fossa ◽  
Fourth Ventricle ◽  
Cranial Nerves ◽  
Speech Disorder ◽  
Posterior Fossa Surgery ◽  
Content Type ◽  
Disturbance Of Consciousness ◽  
Lower Cranial Nerves ◽  
Fine Print

✓ Three patients aged 5½ to 9 years old with mutism after posterior fossa surgery are presented. The entity is discussed with a review of 15 additional previously reported cases in children aged 2 to 11 years. In all 18 patients, a large midline tumor of the posterior fossa (medulloblastoma in nine cases, astrocytoma in five, and ependymoma in four), often attached to one or both lateral recesses of the fourth ventricle, was removed. Mutism developed 18 to 72 hours after the operation (mean 41.5 hours) in patients with no disturbance of consciousness and no deficits of the lower cranial nerves or of the organs of phonation. All of these children had spoken in the first hours after surgery. The disorder lasted from 3 to 16 weeks (mean 7.9 weeks). Speech was regained after a period of dysarthria in six of the 10 cases for whom this information was available. The various hypotheses advanced to explain the pathogenesis of this speech disorder are analyzed.

Congenital hemihypertrophy and abnormalities of the cerebral vasculature

1984 ◽  
Vol 61 (1) ◽  
pp. 163-168 ◽  
Author(s):  
Edwin G. Fischer ◽  
Roy D. Strand ◽  
Frederic Shapiro
Keyword(s):  
Arteriovenous Malformation ◽  
Posterior Fossa ◽  
Giant Aneurysm ◽  
Capillary Hemangioma ◽  
Cerebral Vasculature ◽  
Content Type ◽  
Vascular Abnormalities ◽  
Congenital Hemihypertrophy ◽  
The Brain ◽  
Fine Print

✓ Two patients are described with congenital hemihypertrophy and vascular abnormalities of the brain on the side of the hypertrophy and in the posterior fossa. The abnormalities observed included giant aneurysm, capillary hemangioma, and arteriovenous malformation. Vascular anomalies in the affected limbs are common in congenital hemihypertrophy, and neurological abnormalities and hypertrophy of the brain have been reported. The presence of vascular abnormalities of the brain in this condition may provide an opportunity to further the understanding of the development of cerebrovascular malformations.

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.

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