Necrosis in a meningioma following systemic chemotherapy

1994 ◽  
Vol 81 (2) ◽  
pp. 284-287 ◽  
Author(s):  
Mark Bernstein ◽  
Alfonso Villamil ◽  
George Davidson ◽  
Charles Erlichman
Keyword(s):  
Folinic Acid ◽  
Rectal Carcinoma ◽  
Systemic Chemotherapy ◽  
Clinical Evidence ◽  
Content Type ◽  
Fine Print

✓ Radiological and clinical evidence of acute necrosis in a meningioma following one cycle of chemotherapy with 5-fluorouracil, folinic acid, and levamisole was observed in a patient being treated for invasive rectal carcinoma. The possible mechanisms and implications of this occurrence are discussed.

The significance of bacteriologically positive ventriculoperitoneal shunt components in the absence of other signs of shunt infection

1996 ◽  
Vol 84 (4) ◽  
pp. 617-623 ◽  
Author(s):  
Paul Steinbok ◽  
D. Douglas Cochrane ◽  
John R. W. Kestle
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Clinical Evidence ◽  
Shunt Infection ◽  
Shunt Failure ◽  
Coagulase Negative Staphylococci ◽  
Content Type ◽  
Bacteriological Culture ◽  
Time Period ◽  
Fine Print ◽  
Infecting Organisms

✓ The purpose of this study was to determine the significance of “asymptomatic bacteriological shunt contamination” (ABSC), defined as a positive bacteriological culture found on a ventricular shunt component in the absence of bacteria in the cerebrospinal fluid (CSF) culture and/or clinical evidence of infection. Of 174 ventriculoperitoneal shunt revisions, 19 cases of ABSC were identified and reviewed retrospectively. In all but one case, no antibiotic medications were instituted because of the positive bacteriological culture. The most common infecting organisms were coagulase-negative staphylococci (seven) and propionibacteria (eight). A comparison of the 19 study cases with the authors' overall shunt experience, as documented in the British Columbia's Children's Hospital shunt database for the time period of the study, lead the authors to suggest that ABSC was not of significance in causing the shunt failure at which contamination was identified and, more importantly, did not increase the risk of future shunt malfunction. The results of this study indicate that in the absence of clinical evidence of shunt infection or a positive bacteriological culture from CSF, bacteria in a shunt component removed at revision in a child almost always represents a contaminant that may be ignored. Therefore, the authors advise that routine culture of shunt components removed at revision of a shunt is not indicated.

Cerebral dynamic studies for early detection of recurrent anaplastic intracranial gliomas

1975 ◽  
Vol 43 (2) ◽  
pp. 142-149 ◽  
Author(s):  
Lynn R. Witherspoon ◽  
Moses S. Mahaley ◽  
John R. Leonard ◽  
J. Wendell Tyson ◽  
C. Craig Harris ◽  
...  
Keyword(s):  
Early Detection ◽  
Tumor Growth ◽  
Tumor Progression ◽  
Clinical Evaluation ◽  
Clinical Evidence ◽  
Content Type ◽  
Brain Scans ◽  
Dynamic Studies ◽  
Anaplastic Gliomas ◽  
Fine Print

✓ The authors compared radionuclide cerebral dynamic studies, brain scans, and clinical evaluation as indicators of recurrence of intracranial anaplastic gliomas and found cerebral dynamic studies more sensitive to tumor growth than static brain scans. The former may show changes prior to clinical evidence of tumor progression.

Prognosis of seventh nerve palsy following removal of large acoustic tumors

1977 ◽  
Vol 47 (1) ◽  
pp. 31-34 ◽  
Author(s):  
Donald L. Erickson ◽  
James I. Ausman ◽  
Shelley N. Chou
Keyword(s):  
Facial Palsy ◽  
Nerve Palsy ◽  
Clinical Evidence ◽  
Content Type ◽  
Seventh Nerve ◽  
Facial Function ◽  
Fine Print

✓ Before the advent of microsurgery for acoustic tumors, it was accepted that the majority of seventh nerves would be lost during the removal of large tumors. It is now possible to preserve these attenuated seventh nerves, even with very large tumors. Postoperative facial palsy may be present even with an anatomically intact seventh nerve, but our experience has demonstrated that recovery will ultimately occur. Eight of our nine patients with this situation have regained facial function, although in some the first clinical evidence of recovery did not occur for 1 year.

Late malignant recurrence of childhood cerebellar astrocytoma

1972 ◽  
Vol 37 (4) ◽  
pp. 470-474 ◽  
Author(s):  
William R. Bernell ◽  
John J. Kepes ◽  
Elson P. Seitz
Keyword(s):  
Clinical Evidence ◽  
Total Excision ◽  
Content Type ◽  
Cerebellar Astrocytoma ◽  
Recurrent Tumors ◽  
Fine Print

✓ Two cases are presented in which childhood cerebellar astrocytomas recurred 20 and 23 years after gross total excision. Both recurrent tumors showed histological or clinical evidence of malignancy. The cases indicate that even two decades of symptom-free follow-up are not necessarily a guarantee of cure with this glioma.

The treatment of oligodendrogliomas and mixed oligodendroglioma-astrocytomas with PCV chemotherapy

1992 ◽  
Vol 76 (5) ◽  
pp. 741-745 ◽  
Author(s):  
Jon Glass ◽  
Fred H. Hochberg ◽  
Michael L. Gruber ◽  
David N. Louis ◽  
David Smith ◽  
...  
Keyword(s):  
Tumor Growth ◽  
Systemic Chemotherapy ◽  
Initial Response ◽  
Anaplastic Oligodendroglioma ◽  
Content Type ◽  
Tumor Mass ◽  
Oligodendroglial Tumors ◽  
Pcv Chemotherapy ◽  
Mixed Tumors ◽  
Fine Print

✓ Malignant oligodendrogliomas have been shown to be responsive to chemotherapy. The authors administered systemic chemotherapy to seven patients with oligodendroglioma or anaplastic oligodendroglioma, and to 14 with mixed oligodendroglioma-astrocytoma. Fourteen patients underwent chemotherapy before and seven after irradiation. The PCV (procarbazine, methyl-1-(2-chloroethyl)-1-nitrosourea (CCNU), and vincristine) chemotherapy was administered every 6 weeks (42-day cycles) for two to five cycles as follows: CCNU, 110 mg/sq m on Day 1; procarbazine, 60 mg/sq m/day on Days 8 to 21; and vincristine, 1.4 mg/sq m/day on Days 8 and 29. Complete or partial (> 50% reduction in tumor mass) responses at 20 to 100+ weeks after treatment were noted in 11 (79%) of the 14 patients treated before irradiation, including two with anaplastic oligodendroglioma and nine with mixed tumors. Complete responses were seen in two patients, one with anaplastic oligodendroglioma and one with a mixed tumor. Partial responses were seen in three of seven patients treated after radiotherapy. Stabilization of tumor growth followed PCV chemotherapy in four patients (two treated before and two after radiotherapy). Tumor growth progressed in two patients during therapy despite an initial response and in two patients despite therapy. The authors conclude that mixed oligodendroglial tumors as well as anaplastic oligodendrogliomas are responsive to PCV chemotherapy.

Cervical spondylotic myelopathy treated by single-stage multilevel anterior decompression

1984 ◽  
Vol 60 (1) ◽  
pp. 81-87 ◽  
Author(s):  
Kirpal S. Mann ◽  
Virender K. Khosla ◽  
Des R. Gulati
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Cervical Spondylosis ◽  
Clinical Evidence ◽  
Positive Contrast ◽  
Single Stage ◽  
Anterior Decompression ◽  
Content Type ◽  
Iliac Bone Graft ◽  
Fine Print

✓ Fifty patients suffering from advanced cervical spondylotic myelopathy were surgically treated to eliminate compression of the cord. All disc protrusions demonstrated by positive-contrast myelography that measured larger than 1.5 mm were excised. Each patient was operated on in a single-stage procedure by anterior discectomy, without bone fusion, for protrusions between 2 and 4 mm, and by vertebral trephination and intercorporeal iliac bone-graft fusion for protrusions larger than 4 mm. There were no serious complications. Improvement by one clear disability grade (as defined by the authors) was observed in 36% of the cases, by two grades in 56%, and by three grades in 8%. No patient showed an improvement of four grades. During a follow-up period varying from 2 to 5 years, none of the patients showed clinical evidence of progression of myelopathy; however, 44% of patients showed definite radiological evidence of progression of cervical spondylosis. This indicates that myelopathy may be arrested and may regress, but the process of cervical spondylosis continues unabated in almost half of the cases.

Neurogenic hypertension related to basilar impression

1993 ◽  
Vol 79 (6) ◽  
pp. 924-928 ◽  
Author(s):  
Lawrence D. Dickinson ◽  
Stephen M. Papadopoulos ◽  
Julian T. Hoff
Keyword(s):  
Essential Hypertension ◽  
Clinical Evidence ◽  
Basilar Invagination ◽  
Central Regulation ◽  
Basilar Impression ◽  
Neurogenic Hypertension ◽  
Content Type ◽  
Transoral Odontoidectomy ◽  
Fine Print

✓ The authors report the resolution of essential hypertension following transoral odontoidectomy and medullary decompression in a 39-year-old woman with basilar invagination. Current understanding of central regulation of the cardiovascular system is discussed and the pertinent neuroanatomy illustrated. Experimental and clinical evidence supporting the role of neurogenic mechanisms in the pathogenesis of hypertension is reviewed.

Pineal tumors: analysis of treatment results in 20 patients

2005 ◽  
Vol 102 ◽  
pp. 175-179 ◽  
Author(s):  
Beatriz E. Amendola ◽  
Aizik Wolf ◽  
Sammie R. Coy ◽  
Marco A. Amendola ◽  
Daryl Eber
Keyword(s):  
Systemic Chemotherapy ◽  
Germ Cell Tumors ◽  
Pineal Region ◽  
Tumor Control ◽  
Low Grade ◽  
Primary Tumors ◽  
Pineal Tumors ◽  
Content Type ◽  
Conventional Radiation ◽  
Fine Print

Object. The authors evaluate their results when using gamma knife surgery (GKS) in the management of patients with tumors in the pineal region. Methods. This is a retrospective clinical evaluation of 20 patients with primary tumors of the pineal region treated with GKS from November 1994 through August 2003. There were 13 germ cell tumors, two pineoblastomas, two low-grade gliomas, one primitive neuroectodermal tumor, one teratoma, and one pineocytoma. There were 10 male and 10 female patients. Their median age was 15.5 years (range 5–71 years). The median margin dose was 11 Gy (range 8–20 Gy). The median target volume was 3.1 cm3 (range 0.1–49.9 cm3). Five patients received sequential systemic chemotherapy and four underwent adjuvant conventional radiation therapy. Seventeen (85%) of 20 patients are alive with a median survival of 30.4 months (range 0–-85.7 months). Two patients required retreatment. Three patients died: one of unrelated causes, one who presented with extensive local disease, and the other of meningeal carcinomatosis with local control of the primary tumor. No complications from GKS were noted. Conclusions. This initial experience suggests that GKS is a valuable treatment modality for the management of pineal region tumors. This technique offers excellent local tumor control and minimal patient morbidity, allowing for immediate use of systemic chemotherapy and/or conventional radiation if indicated.

Stereotaxic treatment of frontal-lobe and centrencephalic epilepsy

1973 ◽  
Vol 39 (1) ◽  
pp. 42-51 ◽  
Author(s):  
Richard K. Jelsma ◽  
Claude M. Bertrand ◽  
Sonis N. Martinez ◽  
Pedro Molina-Negro
Keyword(s):  
Frontal Lobe ◽  
Clinical Evidence ◽  
Content Type ◽  
Epileptic Patients ◽  
Fine Print ◽  
Made In

✓ The authors report a series of selected epileptic patients treated by stereotaxic lesions. The treatment was successful in patients with focal motor epilepsy. Stereotaxic lesions made in patients with centrencephalic electroencephalographic abnormalities were only successful if there was also clinical evidence of a frontal focus. The significance of these results is discussed, and a target is described that may be useful in certain cases with clinical evidence of a frontal lobe focus.

Primary leptomeningeal sarcomatosis

1988 ◽  
Vol 68 (5) ◽  
pp. 802-805 ◽  
Author(s):  
Lee L. Thibodeau ◽  
Aurelio Ariza ◽  
Joseph M. Piepmeier
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Clinical Evidence ◽  
Cranial Nerves ◽  
Open Biopsy ◽  
Content Type ◽  
Surgical Exploration ◽  
Spinal Roots ◽  
Meningeal Disease ◽  
Fine Print

✓ This report describes a case of primary leptomeningeal sarcomatosis in a 50-year-old man who presented with progressive deficits involving multiple cranial nerves and spinal roots. Despite the clinical evidence supporting a diffuse process involving the leptomeninges, radiological, serological, and cerebrospinal fluid examinations failed to reveal the cause of the disorder. Consequently, surgical exploration and biopsy were required to obtain a pathological diagnosis. This case report illustrates the difficulty in diagnosing this disease and supports the use of open biopsy in patients with chronic meningeal disease when the diagnosis cannot be established by less invasive methods.

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