Growth rate of incidental meningiomas

1990 ◽  
Vol 73 (4) ◽  
pp. 545-547 ◽  
Author(s):  
Raimund P. Firsching ◽  
Anette Fischer ◽  
Reinhard Peters ◽  
Frank Thun ◽  
Norfrid Klug

✓ A meningioma was incidentally identified with computerized tomography (CT) in 17 patients without relevant clinical signs. The tumor was not removed, but biopsy confirming a meningioma was obtained from one patient. Tumor growth rate was calculated from repeat CT scans or follow-up magnetic resonance imaging. The annual growth rate ranged from less than 1% to 21%. It is concluded that in nonsymptomatic meningiomas with a low growth rate a nonsurgical approach may be warranted.

2002 ◽  
Vol 97 (5) ◽  
pp. 1217-1220 ◽  
Author(s):  
Sergio Cavalheiro ◽  
Fábio Veiga de Castro Sparapani ◽  
Antonio Fernandes Moron ◽  
Marcia Cristina da Silva ◽  
João Norberto Stávale

✓ The authors present the case of a 34-week-old fetus with a meningeal hemangiopericytoma that was diagnosed in utero by using abdominal magnetic resonance imaging. After birth, the neonate underwent transfontanelle ultrasonography and computerized tomography scanning of the head, which confirmed the presence of an extradural hyperdense lesion. Six hours after birth the neonate underwent a craniotomy, which resulted in complete resection of the mass. The postoperative period was uneventful and the newborn was discharged 7 days later. At 2-year follow-up examination there was no evidence of recurrence of the lesion. The authors have found no mention in the literature of this entity diagnosed in the prenatal period.


1998 ◽  
Vol 89 (5) ◽  
pp. 852-856 ◽  
Author(s):  
H. Alan Crockard ◽  
Ahmed Tammam ◽  
Nigel Mendoza

✓ Posterior cervical stabilization was accomplished in 30 patients (19 females and 11 males) by using sublaminar titanium cables and a new titanium bullet-shaped implant. Seventeen patients underwent occipitocervical fixation and 13 others were treated subaxially. These patients have been followed for 18 to 52 months (mean 36 months), and no implant has failed during the follow-up period.


1986 ◽  
Vol 64 (2) ◽  
pp. 197-208 ◽  
Author(s):  
Toshiki Yamasaki ◽  
Hajime Handa ◽  
Junkoh Yamashita ◽  
Jonathan T. Paine ◽  
Yuzuru Tashiro ◽  
...  

✓The authors review 30 documented cases of intracranial and orbital cavernous angiomas treated at their institution between 1965 and 1984. The diagnosis was based on computerized tomography (CT) or surgery; three patients were treated in the pre-CT era (1965 to 1976) and 27 since the advent of CT. The number of cases diagnosed preoperatively markedly increased after the introduction of CT, and 22 cases were verified histopathologically at surgery. Six cases were in children (aged 2 months to 17 years) and 24 in adults (aged 19 to 73 years). There was no significant sex difference (male:female ratio was 14:16). Nineteen lesions were intraparenchymal, five were intraventricular, three were in the middle fossa, two were intraorbital, and one originated from the tentorium. Symptoms varied according to the site of the lesion; hemorrhage occurred in 11 cases. Calcifications were seen on CT scans in all cases, but on plain skull films in only two. Angiography revealed hypovascular masses in all cases excluding those with lesions in the middle fossa; in two cases, tumor stain could be detected only with prolonged-injection angiography. Radionuclide brain scanning showed a dense hot area in eight of 19 patients. Recent experience has shown that magnetic resonance imaging clarified anatomic relationships that were obscure on CT. The overall outcome was favorable except for one patient who died in the postoperative period. The clinical results in this series are summarized and some diagnostic and therapeutic problems are discussed.


1996 ◽  
Vol 85 (6) ◽  
pp. 1044-1049 ◽  
Author(s):  
Bruce E. Pollock ◽  
Douglas Kondziolka ◽  
John C. Flickinger ◽  
Atul K. Patel ◽  
David J. Bissonette ◽  
...  

✓ To determine the accuracy of magnetic resonance (MR) imaging in comparison to cerebral angiography after radiosurgery for an arteriovenous malformation (AVM), the authors reviewed the records of patients who underwent radiosurgery at the University of Pittsburgh Medical Center before 1992. All patients in the analysis had AVMs in which the flow-void signal was visible on preradiosurgical MR imaging. One hundred sixty-four postradiosurgical angiograms were obtained in 140 patients at a median of 2 months after postradiosurgical MR imaging (median 24 months after radiosurgery). Magnetic resonance imaging correctly predicted patency in 64 of 80 patients in whom patent AVMs were seen on follow-up angiography (sensitivity 80%) and angiographic obliteration in 84 of 84 patients (specificity 100%). Overall, 84 of 100 AVMs in which evidence of obliteration was seen on MR images displayed angiographic obliteration (negative predictive value, 84%). Ten of the 16 patients with false-negative MR images underwent follow-up angiography: in seven the lesions progressed to complete angiographic obliteration without further treatment. Exclusion of these seven patients from the false-negative MR imaging group increases the predictive value of a negative postradiosurgical MR image from 84% to 91%. No AVM hemorrhage was observed in clinical follow up of 135 patients after evidence of obliteration on MR imaging (median follow-up interval 35 months; range 2–96 months; total follow up 382 patient-years). Magnetic resonance imaging proved to be an accurate, noninvasive method for evaluating the patency of AVMs that were identifiable on MR imaging after stereotactic radiosurgery. This imaging modality is less expensive, more acceptable to patients, and does not have the potential for neurological complications that may be associated with cerebral angiography. The risk associated with follow-up cerebral angiography may no longer justify its role in the assessment of radiosurgical results in the treatment of AVMs.


2002 ◽  
Vol 97 ◽  
pp. 429-432 ◽  
Author(s):  
Berndt Wowra ◽  
Walter Stummer

Object. The authors assessed the efficacy of gamma knife radiosurgery (GKS) for nonfunctioning pituitary adenomas (NPAs) by sequential quantitative determinations of tumor volume and neurological and endocrinological follow-up examinations. Methods. Through May of 2000, 45 patients with NPA were treated by GKS. Complete neurological and endocrinological follow-up information was obtained. In 30 patients (67%), follow-up examinations included stereotactic magnetic resonance imaging involving the GammaPlan software for sequential measurements of the NPA volume. These patients constitute the basis of this study. Sequential volume measurements after GKS were compared with initial tumor volumes at the date of GKS to quantify the therapeutic result. All data were stored prospectively in a computerized database. The median dose to the tumor margin was 16 Gy (range 11–20 Gy). The mean prescription isodose was 55% (range 45–75%). All except one patient (97%) underwent surgery for NPA before GKS. Fractionated radiotherapy was not administered. Median follow up after GKS was 55 months (range 28–86 months). The actuarial long-term recurrence-free survival was 93% with respect to a single GKS and 100% if a repeated GKS was included. Neurological side effects were not detected. The actuarial risk of radiosurgery-induced pituitary damage was calculated to be 14% after 6 years. The volumetric analysis revealed a temporary swelling of the NPA in four patients, followed by shrinkage of the lesion. This is the first time this has been observed in pituitary adenomas. Conclusions. Postoperative GKS for residual or recurrent small fragments of NPAs is effective and safe. With regard to the issues of radioprotection and therapeutic morbidity, it seems superior to fractionated radiotherapy. Quantification of tumor reduction is a valuable tool for documenting a therapeutic response and for identifying tumor recurrence. As part of a radiosurgical standard protocol, the follow-up examination for NPAs should include tumor volumetric analysis.


1994 ◽  
Vol 81 (4) ◽  
pp. 595-600 ◽  
Author(s):  
Thomas J. Manski ◽  
Charles S. Ha worth ◽  
Bertrand J. Duval-Arnould ◽  
Elisabeth J. Rushing

✓ The authors report gigantism in a 16-month-old boy with an extensive optic pathway glioma infiltrating into somatostatinergic pathways, as revealed by magnetic resonance imaging and immunocytochemical studies. Stereotactic biopsies of areas showing hyperintense signal abnormalities on T2-weighted images in and adjacent to the involved visual pathways provided rarely obtained histological correlation of such areas. The patient received chemotherapy, which resulted in reduction of size and signal intensity of the tumor and stabilization of vision and growth velocity.


1987 ◽  
Vol 66 (6) ◽  
pp. 830-834 ◽  
Author(s):  
John L. Doppman ◽  
Giovanni Di Chiro ◽  
Andrew J. Dwyer ◽  
Joseph L. Frank ◽  
Edward H. Oldfield

✓ Magnetic resonance imaging (MRI) was performed on 12 patients with spinal arteriovenous malformations (AVM's). Six lesions were intramedullary, five were dural, and one was in a posterior extramedullary location. Serpentine filling defects similar to the classic myelographic findings were demonstrated within the high-signal cerebrospinal fluid on T2-weighted coronal scans. The intramedullary nidus was identified by MRI as an area of low-signal intensity within the cord in all six intramedullary AVM's. Neither the dural nor the posterior extramedullary lesions showed intramedullary components. It is concluded that MRI may noninvasively provide the initial diagnosis of a spinal AVM and distinguish intramedullary from dural and extramedullary lesions.


1988 ◽  
Vol 68 (2) ◽  
pp. 292-296 ◽  
Author(s):  
Kouichi Miyagi ◽  
Jiro Mukawa ◽  
Susumu Mekaru ◽  
Yasunari Ishikawa ◽  
Toshihiko Kinjo ◽  
...  

✓ The case of an 11-year-old Japanese girl with an intradural and extramedullary enterogenous cyst is presented. A mass giving a low-intensity signal in comparison with the spinal cord was demonstrated on magnetic resonance imaging. Histologically, the diagnosis was confirmed on specimens stained with periodic acid-Schiff, alcian blue, mucicarmine, and immunohistochemical staining of carcinoembryonic antigen, and by electron microscopy.


2004 ◽  
Vol 101 (2) ◽  
pp. 310-313 ◽  
Author(s):  
Tsutomu Nakada ◽  
Yukihiko Fujii ◽  
Ingrid L. Kwee

Object. The authors investigated brain strategies associated with hand use in an attempt to clarify genetic and nongenetic factors influencing handedness by using high-field functional magnetic resonance imaging. Methods. Three groups of patients were studied. The first two groups comprised individuals in whom handedness developed spontaneously (right-handed and left-handed groups). The third group comprised individuals who were coercively trained to use the right hand and developed mixed handedness, referred to here as trained ambidexterity. All trained ambidextrous volunteers were certain that they were innately left-handed, but due to social pressure had modified their preferred hand use for certain tasks common to the right hand. Although right-handed and left-handed volunteers displayed virtually identical cortical activation, involving homologous cortex primarily located contralateral to the hand motion, trained ambidextrous volunteers exhibited a clearly unique activation pattern. During right-handed motion, motor areas in both hemispheres were activated in these volunteers. During left-handed motion, the right supplemental motor area and the right intermediate zone of the anterior cerebellar lobe were activated significantly more frequently than observed in naturally right-handed or left-handed volunteers. Conclusions. The results provide strong evidence that cortical organization of spontaneously developed right- and left-handedness involves homologous cortex primarily located contralateral to the hand motion, and this organization is likely to be prenatally determined. By contrast, coerced training of the nondominant hand during the early stages of an individual's development results in mixed handedness (trained ambidexterity), indicating cortical reorganization.


1999 ◽  
Vol 91 (6) ◽  
pp. 1055-1057 ◽  
Author(s):  
Kazunori Arita ◽  
Kaoru Kurisu ◽  
Atsushi Tominaga ◽  
Fusao Ikawa ◽  
Koji Iida ◽  
...  

✓ A size-adjustable plate constructed of pure titanium is proposed for use in the reconstruction of the sella turcica. The plate is composed of two semicircular pieces that are connected by a hinge located at the top of the plate. Using an applicator, the plate is inserted into the sella turcica in a closed position. The same applicator is then used to open and secure the plate. The titanium causes minimal ferromagnetic artifacts on postoperative magnetic resonance imaging.Preliminary findings indicate a possibie clinical use for this plate in the reconstruction of the sella turcica when no suitable piece of bone is available.


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