Cystic schwannoma of the trochlear nerve mimicking a brain-stem tumor

1987 ◽  
Vol 67 (6) ◽  
pp. 928-930 ◽  
Author(s):  
Paul Douglas Garen ◽  
Clive Gordon Harper ◽  
Charles Teo ◽  
Ian Hugh Johnston
Keyword(s):  
Brain Stem ◽  
Cranial Nerve ◽  
Clinical Approach ◽  
Trochlear Nerve ◽  
Surgical Biopsy ◽  
Content Type ◽  
Brain Stem Tumors ◽  
Fourth Cranial Nerve ◽  
Cystic Schwannoma ◽  
Fine Print

✓ A case is reported of a rare cystic schwannoma of the fourth cranial nerve which was interpreted as a probable intrinsic brain-stem lesion. The clinical approach to brain-stem tumors in terms of empirical treatment or surgical biopsy is discussed.

Neurilemmoma of the fourth cranial nerve

1979 ◽  
Vol 50 (4) ◽  
pp. 519-521 ◽  
Author(s):  
James E. Boggan ◽  
Mark L. Rosenblum ◽  
Charles B. Wilson
Keyword(s):  
Cranial Nerve ◽  
Trochlear Nerve ◽  
Content Type ◽  
Nerve Sheath ◽  
Trigeminal Nerves ◽  
Fourth Cranial Nerve ◽  
Fine Print

✓ A tumor of the trochlear nerve sheath with an unusual but diagnostic presentation is described. The rarity of reported cases may reflect failure to differentiate tumors originating from the trochlear and trigeminal nerves.

Relationships of the cisternal segment of the trochlear nerve

1998 ◽  
Vol 89 (6) ◽  
pp. 1015-1019 ◽  
Author(s):  
R. Shane Tubbs ◽  
W. Jerry Oakes
Keyword(s):  
Surgical Procedures ◽  
Cranial Nerve ◽  
Anatomical Study ◽  
Free Edge ◽  
Trochlear Nerve ◽  
Content Type ◽  
Tentorium Cerebelli ◽  
Fourth Cranial Nerve ◽  
Surgical Operations ◽  
Fine Print

Object. The cisternal portion of the trochlear nerve (fourth cranial nerve) can easily be injured during intracranial surgical operations. To help minimize the chance of such injury by promoting a thorough understanding of the anatomy of this nerve and its relationships to surrounding structures, the authors present this anatomical study. Methods. In this study, in which 12 cadaveric heads (24 sides) were used, the authors describe exact distances between the trochlear nerve and various surrounding structures. Also described are relatively safe areas in which to manipulate or enter the tentorium, and these are referenced to external landmarks. Conclusions. This information will prove useful in planning and executing surgical procedures in and around the free edge of the tentorium cerebelli.

Brain-stem tumors in childhood: a prospective randomized trial of irradiation with and without adjuvant CCNU, VCR, and prednisone

1987 ◽  
Vol 66 (2) ◽  
pp. 227-233 ◽  
Author(s):  
R. Derek T. Jenkin ◽  
Carl Boesel ◽  
Inta Ertel ◽  
Audrey Evans ◽  
Robert Hittle ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Brain Stem ◽  
Radiation Treatment ◽  
Risk Of Infection ◽  
Content Type ◽  
Standard Methods ◽  
Increased Risk ◽  
Brain Stem Tumors ◽  
A Prospective Study ◽  
Fine Print

✓ Seventy-four children with a brain-stem tumor diagnosed between 1977 and 1980 were entered into a prospective study in which exploration and assessment for resection were optional, radiation treatment using standard methods was required, and randomization occurred with regard to the use of adjuvant chemotherapy (l-(2-chloroethyl)-l-nitrosourea, vincristine, and prednisone) or no further treatment. The overall 5-year survival rate was 20% and was not improved by the adjuvant chemotherapy program. An increased risk of infection was associated with the adjuvant therapy.

CCNU chemotherapy in adult patients with tumors of the basal ganglia and brain stem

1980 ◽  
Vol 53 (3) ◽  
pp. 361-363 ◽  
Author(s):  
Alfredo Pompili ◽  
Antonio Riccio ◽  
Bruno Jandolo ◽  
Maurizio Fontana
Keyword(s):  
Radiation Therapy ◽  
Basal Ganglia ◽  
Brain Stem ◽  
Computerized Tomography ◽  
Surgical Decompression ◽  
Control Group ◽  
Content Type ◽  
Brain Stem Tumors ◽  
Fine Print

✓ The present investigation evaluates those few patients of our series with basal ganglia and brain-stem tumor who refused either surgical decompression and biopsy or radiation therapy. Four patients were suffering from tumors of the basal ganglia and three from brain-stem tumors; all the tumors were diagnosed by classical neuroradiological investigations and computerized tomography. The patients were given CCNU by mouth, 13 mg/sq m every 6 weeks. No toxicity was recorded. Mean survival was 19 weeks for patients with basal ganglia tumors and 48 weeks for those with brain-stem tumors. All patients were evaluated with respect to the quality of survival. Results were compared with those obtained in a control group of patients who received methylprednisolone therapy only.

Surgical management of brain-stem tumors in children: results and statistical analysis of 75 cases

1993 ◽  
Vol 79 (6) ◽  
pp. 845-852 ◽  
Author(s):  
Alain Pierre-Kahn ◽  
Jean-François Hirsch ◽  
Mathieu Vinchon ◽  
Christine Payan ◽  
Christian Sainte-Rose ◽  
...  
Keyword(s):  
Brain Stem ◽  
Malignant Tumors ◽  
Benign Tumors ◽  
Patient Age ◽  
Content Type ◽  
Patient Âgé ◽  
Significant Difference ◽  
Brain Stem Tumors ◽  
Subtotal Removal ◽  
Fine Print

A study was made of 75 children treated between 1970 and 1990, with partial, subtotal, or total removal of three intrinsic and 72 exophytic or surface brain-stem tumors. In all cases, the goal of surgery was to remove as much tumor as possible. Extent of removal was defined according to data obtained from postoperative computerized tomography or magnetic resonance imaging, and was considered partial when only a small amount of tumor was removed, subtotal when a few cubic millimeters of tumor was left, and total when no residual tumor was seen on postoperative radiological investigations. An ultrasonic aspirator was used for the 43 most recent operations. Among tumor removals without the aspirator, 24 (75%) were partial, eight (25%) subtotal, and none total; with the use of the aspirator, the number of partial removals decreased to 44.5% while that of subtotal and total removals increased to 32% and 23.5%, respectively. There were 69 gliomas (92%) and 47 benign tumors (62.6%). Forty-nine patients were irradiated postoperatively, and 14 of the 23 patients whose benign tumors were removed totally or subtotally did not undergo irradiation. This study showed that: 1) the overall prognosis of patients with malignant tumors was poor and was not improved by surgery; 2) the survival rate of those with benign tumors was significantly (p < 0.01) lower after partial removal than after total or subtotal removal (52% and 94%, respectively, at 5 years); 3) comparison of means and proportions (Student's and chi-squared tests) between benign and malignant tumors showed a significant difference relating to patient age (p < 0.03), peritumoral hypodensity (p < 0.001), and preoperative duration of symptoms (p < 0.001); 4) stepwise logistic regression analysis confirmed that two of these three variables were related to malignancy: namely, patient age at surgery (p < 0.03) and presence of peritumoral hypodensity (p < 0.001); and 5) routine postoperative irradiation was contraindicated after total or subtotal removal of benign tumors.

Schwannoma of the brain stem

1980 ◽  
Vol 53 (1) ◽  
pp. 121-123 ◽  
Author(s):  
Brahm Prakash ◽  
Subimal Roy ◽  
Prakash N. Tandon
Keyword(s):  
Brain Stem ◽  
Content Type ◽  
Brain Stem Tumors ◽  
Intramedullary Schwannoma ◽  
The Brain ◽  
Fine Print

✓ A case of intramedullary schwannoma of the brain stem is reported, and its possible origin discussed. The importance of a biopsy in brain-stem tumors is emphasized.

Magnetic resonance images of brain-stem encephalitis

1987 ◽  
Vol 66 (2) ◽  
pp. 283-285 ◽  
Author(s):  
Kohkichi Hosoda ◽  
Norihiko Tamaki ◽  
Michio Masumura ◽  
Satoshi Matsumoto
Keyword(s):  
Magnetic Resonance ◽  
Brain Stem ◽  
Pathological Condition ◽  
Magnetic Resonance Images ◽  
Resonance Imaging ◽  
Radiological Findings ◽  
Content Type ◽  
Brain Stem Tumors ◽  
Fine Print ◽  
Brain Stem Encephalitis

✓ The clinical and radiological findings in a case of brain-stem encephalitis are described with special emphasis on the serial magnetic resonance imaging. This pathological condition should be differentiated from brain-stem tumors, which may present with similar symptoms.

Stereotactic radiotherapy for the treatment of acoustic neuromas

2004 ◽  
Vol 101 (Supplement3) ◽  
pp. 362-372 ◽  
Author(s):  
Michael T. Selch ◽  
Alessandro Pedroso ◽  
Steve P. Lee ◽  
Timothy D. Solberg ◽  
Nzhde Agazaryan ◽  
...  
Keyword(s):  
Stereotactic Radiotherapy ◽  
Tumor Size ◽  
Cranial Nerve ◽  
Target Volume ◽  
Tumor Control ◽  
Content Type ◽  
Seventh Cranial Nerve ◽  
Acoustic Neuromas ◽  
Fine Print

Object. The authors sought to assess the safety and efficacy of stereotactic radiotherapy when using a linear accelerator equipped with a micromultileaf collimator for the treatment of patients with acoustic neuromas. Methods. Fifty patients harboring acoustic neuromas were treated with stereotactic radiotherapy between September 1997 and June 2003. Two patients were lost to follow-up review. Patient age ranged from 20 to 76 years (median 59 years), and none had neurofibromatosis. Forty-two patients had useful hearing prior to stereotactic radiotherapy. The fifth and seventh cranial nerve functions were normal in 44 and 46 patients, respectively. Tumor volume ranged from 0.3 to 19.25 ml (median 2.51 ml). The largest tumor dimension varied from 0.6 to 4 cm (median 2.2 cm). Treatment planning in all patients included computerized tomography and magnetic resonance image fusion and beam shaping by using a micromultileaf collimator. The planning target volume included the contrast-enhancing tumor mass and a margin of normal tissue varying from 1 to 3 mm (median 2 mm). All tumors were treated with 6-MV photons and received 54 Gy prescribed at the 90% isodose line encompassing the planning target volume. A sustained increase greater than 2 mm in any tumor dimension was defined as local relapse. The follow-up duration varied from 6 to 74 months (median 36 months). The local tumor control rate in the 48 patients available for follow up was 100%. Central tumor hypodensity occurred in 32 patients (67%) at a median of 6 months following stereotactic radiotherapy. In 12 patients (25%), tumor size increased 1 to 2 mm at a median of 6 months following stereotactic radiotherapy. Increased tumor size in six of these patients was transient. In 13 patients (27%), tumor size decreased 1 to 14 mm at a median of 6 months after treatment. Useful hearing was preserved in 39 patients (93%). New facial numbness occurred in one patient (2.2%) with normal fifth cranial nerve function prior to stereotactic radiotherapy. New facial palsy occurred in one patient (2.1%) with normal seventh cranial nerve function prior to treatment. No patient's pretreatment dysfunction of the fifth or seventh cranial nerve worsened after stereotactic radiotherapy. Tinnitus improved in six patients and worsened in two. Conclusions. Stereotactic radiotherapy using field shaping for the treatment of acoustic neuromas achieves high rates of tumor control and preservation of useful hearing. The technique produces low rates of damage to the fifth and seventh cranial nerves. Long-term follow-up studies are necessary to confirm these findings.

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.

Evaluation of brain-stem dysfunction following severe fluid-percussion head injury to the cat

1991 ◽  
Vol 74 (2) ◽  
pp. 270-277 ◽  
Author(s):  
Katsuji Shima ◽  
Anthony Marmarou
Keyword(s):  
Brain Stem ◽  
Content Type ◽  
Fluid Percussion ◽  
Fluid Percussion Injury ◽  
Brain Stem Injury ◽  
Group 2 ◽  
High Level ◽  
Subarachnoid Hemorrhages ◽  
Fine Print ◽  
Group 1

✓ The degree of brain-stem dysfunction associated with high-level fluid-percussion injury (3.0 to 3.8 atm) was investigated in anesthetized cats. Measurements were made of the animals' intracranial pressure (ICP), pressure-volume index (PVI), far-field brain-stem auditory evoked responses (BAER's), and cerebral blood flow (CBF). The animals were classified into two groups based on the severity of neuropathological damage to the brain stem after trauma: Group 1 had mild intraparenchymal and subarachnoid hemorrhages and Group 2 had severe intraparenchymal and subarachnoid hemorrhages. The ICP values in Group 1 were insignificantly lower than those in Group 2, while the PVI values in Group 2 were clearly lower (p < 0.05). Immediately after the injury, peaks II, III, and IV of the BAER's demonstrated a transitory and marked suppression. One Group 1 and two Group 2 animals showed the disappearance of peak V. In Group 1, the latencies of peak II, III, and IV gradually increased until 60 to 150 minutes postinjury, then returned to 95% of baseline value at 8 hours; however, the animals in Group 2 showed poor recovery of latencies. Two hours after brain injury, the CBF decreased to 40% of the preinjury measurement in both groups (p < 0.001). In contrast to Group 2, the CBF in Group 1 returned to 86.8% of the preinjury measurement by 8 hours following the injury. Changes in PVI, BAER, and CBF correlated well with the degree of brain-stem injury following severe head injury'- These data indicate that high-level fluid-percussion injury (> 3.0 atm) is predominantly a model of brain-stem injury.

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