“Miliary” metastatic tumors in the brain

1997 ◽  
Vol 86 (3) ◽  
pp. 564-566 ◽  
Author(s):  
Chhabi Bhushan
Keyword(s):  
Basal Ganglia ◽  
Primary Tumor ◽  
Metastatic Tumor ◽  
Mass Effect ◽  
Brain Lesions ◽  
Metastatic Tumors ◽  
Content Type ◽  
Brain Parenchymal ◽  
The Brain ◽  
Fine Print

✓ An extremely unusual “miliary” metastatic tumor of the brain in a 69-year-old man is reported. Although there was no known primary tumor, the patient had innumerable brain lesions involving both cerebral and both cerebellar hemispheres, the basal ganglia, and the brainstem. There was no associated edema, mass effect, or brain parenchymal reaction. None of the lesions showed any calcification.

Brain metastasis from malignant pancreatic somatostatinoma

1996 ◽  
Vol 85 (4) ◽  
pp. 681-684 ◽  
Author(s):  
Takumi Abe ◽  
Kinya Oshida ◽  
Kiyoshi Matsumoto ◽  
Masataka Iida ◽  
Naoko Sanno
Keyword(s):  
Brain Metastasis ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Tumor Recurrence ◽  
Brain Lesions ◽  
Endocrine Tumors ◽  
Content Type ◽  
Pancreatic Tail ◽  
The Brain ◽  
Fine Print

✓ Somatostatinomas are rare endocrine tumors that are located primarily in the pancreas. Metastases are seen most frequently in the liver and lymph nodes. The authors present the case of a 63-year-old man who had a malignant somatostatinoma of pancreatic tail origin that metastasized to the brain 10 years after diagnosis of the primary tumor. The metastatic brain lesions were totally removed and the patient is alive without tumor recurrence 12.3 years after the initial diagnosis. To our knowledge, this case represents the first documentation of brain metastasis from a malignant somatostatinoma, as well as the longest survival time of a patient with a somatostatinoma.

Primary osteogenic sarcoma of the brain

1976 ◽  
Vol 44 (1) ◽  
pp. 92-95 ◽  
Author(s):  
Skip Jacques ◽  
Donald B. Freshwater ◽  
C. Hunter Shelden
Keyword(s):  
Primary Tumor ◽  
Osteogenic Sarcoma ◽  
Mesenchymal Cell ◽  
Bone Scanning ◽  
Content Type ◽  
Autopsy Findings ◽  
Tumor Focus ◽  
The Right ◽  
The Brain ◽  
Fine Print

✓ The authors report a case of primary osteogenic sarcoma of the brain. Negative autopsy findings, complete bone radiographs, and bone-scanning techniques were consistent with a primary tumor focus in the right temporoparietal region of the brain. The authors suggest an origin from a primitive multipotential mesenchymal cell.

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.

Preoperative magnetic resonance imaging localization of convexity brain lesions

1995 ◽  
Vol 82 (3) ◽  
pp. 509-510 ◽  
Author(s):  
Ely Ashkenazi ◽  
Shlomo Pomeranz ◽  
Felix Umansky ◽  
John M. Gomori
Keyword(s):  
Magnetic Resonance ◽  
Brain Lesions ◽  
Resonance Imaging ◽  
Cerebral Lesions ◽  
Mr Image ◽  
Content Type ◽  
Preoperative Magnetic Resonance ◽  
The Brain ◽  
Intraoperative Guidance ◽  
Fine Print

✓ The authors present a simple and accurate new technique for preoperative localization of convexity lesions of the brain by means of magnetic resonance (MR) imaging. This method uses measurements from the initial diagnostic MR image and provides precise intraoperative guidance to cortical and subcortical cerebral lesions.

Surgical considerations regarding giant dilations of the perivascular spaces

2004 ◽  
Vol 100 (5) ◽  
pp. 820-824 ◽  
Author(s):  
Paul House ◽  
Karen L. Salzman ◽  
Anne G. Osborn ◽  
Joel D. MacDonald ◽  
Randy L. Jensen ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Mass Effect ◽  
Perivascular Spaces ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Content Type ◽  
Relationship Of ◽  
The Relationship ◽  
The Brain ◽  
Fine Print

Object. Dilations of brain perivascular spaces (PVSs), also known as Virchow—Robin spaces, are routinely identified on magnetic resonance imaging studies of the brain and recognized as benign normal variants. Giant dilations occur only rarely and can be easily misdiagnosed as central nervous system tumors. The relevant surgical literature was reviewed to help establish indications for surgical intervention in these typically benign lesions. Methods. Giant dilations of the PVSs in 12 patients who had undergone surgery for several different indications were identified. Both clinical and radiographic presentations of these patients were reviewed along with the surgical procedures. Conclusions. Dilations of the PVSs can become giant lesions that may necessitate surgical intervention to relieve mass effect or hydrocephalus. The relationship of these lesions to neurological symptoms such as tremor and seizures remains unclear.

Primary demyelinating disease simulating glioma of the corpus callosum

1981 ◽  
Vol 55 (4) ◽  
pp. 620-624 ◽  
Author(s):  
Kenneth G. Rieth ◽  
Giovanni Di Chiro ◽  
Laurence D. Cromwell ◽  
Paul E. McKeever ◽  
Paul L. Kornblith ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Corpus Callosum ◽  
Demyelinating Disease ◽  
Mass Effect ◽  
Periventricular White Matter ◽  
Content Type ◽  
The Central Nervous System ◽  
The Brain ◽  
Fine Print

✓ Computerized tomography (CT) has made it easier to distinguish tumoral from nontumoral diseases of the central nervous system. In the presence of mass effect, however, this distinction may be difficult or impossible to make. Primary demyelinating disease may occasionally present as a focal cerebral mass. The authors report three cases of primary demyelinating disease of the brain involving the corpus callosum and periventricular white matter and associated with mass effect, which proved difficult to differentiate from infiltrating “butterfly” gliomas.

Intracranial malignant lymphoma

1986 ◽  
Vol 65 (5) ◽  
pp. 592-599 ◽  
Author(s):  
Mohamed Jiddane ◽  
François Nicoli ◽  
Pédro Diaz ◽  
Ulf Bergvall ◽  
François Vincentelli ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Malignant Lymphoma ◽  
Age Of Onset ◽  
Mass Effect ◽  
Ct Scans ◽  
Content Type ◽  
Leptomeningeal Involvement ◽  
Immunodeficiency Syndrome ◽  
Open Surgical Approach ◽  
Fine Print

✓ Although primary malignant lymphoma is a rare entity in the gamut of intracranial tumors, it is more frequently seen than the secondary intracranial spread of a primary extracranial lymphoma. In general, the occurrence of lymphomas seems to be provoked by immunosuppression, as with medication (predominantly after transplantation) or with immunodepressive disease such as acquired immunodeficiency syndrome (AIDS). The usual age of onset of this disease is 55 to 65 years; and the male:female patient distribution is roughly 2:1. Characteristically, computerized tomography (CT) scans of lymphomas show a mass which is often large with regular contours, moderate mass effect, and hyper- or isodensity with marked and often homogeneous enhancement. In the series of 30 patients reported, the locations of lesions, in order of decreasing frequency, were the frontocallosal and temporal regions, the basal ganglia, and the cerebellum. Multiple lesions were present in 15% of these cases (20% to 40% in the literature). The following features should raise the suspicion of intracranial lymphoma: mirror lesions of the basal ganglia, bilateral subependymal infiltration, and leptomeningeal involvement contiguous with an intracerebral mass. According to the literature, the angiographic finding typical of lymphoma is an avascular tumor. A blush or vascular encasement of the mass seems to be rare, and the present series was in accordance with other reports in this respect. Differential diagnostic consideration should include meningioma, glioblastoma, metastatic disease, and focal infectious lesions such as toxoplasmosis or multifocal progressive leukoencephalitis, particularly in immunodepressed subjects. Diagnosing lymphoma from CT scans offers the alternative of substituting stereotaxic biopsy and neuropathological diagnosis for the more aggressive open surgical approach, since radiation therapy and possibly chemotherapy usually prove to be the treatment of choice.

Experimental intracerebral hemorrhage: relationship between brain edema, blood flow, and blood-brain barrier permeability in rats

1994 ◽  
Vol 81 (1) ◽  
pp. 93-102 ◽  
Author(s):  
Guo-Yuan Yang ◽  
A. Lorris Betz ◽  
Thomas L. Chenevert ◽  
James A. Brunberg ◽  
Julian T. Hoff
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Basal Ganglia ◽  
Brain Edema ◽  
Time Course ◽  
Mass Effect ◽  
Edema Formation ◽  
Content Type ◽  
Bbb Permeability ◽  
Fine Print

✓ There have been few investigations of brain edema formation after intracerebral hemorrhage (ICH), despite the fact that mass effect and edema are important clinical complications. The present study was designed to investigate the time course for the formation and resolution of brain edema and to determine how changes in cerebral blood flow (CBF) and blood-brain barrier (BBB) permeability are temporally related to edema formation following ICH. Anesthetized adult rats received a sterile injection of 100 µl of autologous blood into the caudate nucleus. Water and ion contents were measured immediately, at 4 and 12 hours, and daily to Day 7 (10 time points, six rats at each time) after experimental ICH. The water content of the ipsilateral basal ganglia increased progressively (p < 0.002) over the first 24 hours, then remained constant until after Day 5, when the edema began to resolve. Edema was most severe in the tissue immediately surrounding the hemorrhage; however, it was also present in the ipsilateral cortex, the contralateral cortex, and the basal ganglia. Measurements of local CBF (using [14C]-iodoantipyrine) and BBB permeability (using [3H]-α-aminoisobutyric acid) were obtained in separate groups of six to eight rats at various time intervals between 1 and 48 hours after ICH. Cerebral blood flow was reduced to 50% of control at 1 hour, returned to control values by 4 hours, but then decreased to less than 50% of control between 24 and 48 hours after ICH. The BBB permeability increased significantly prior to the occurrence of significant edema in the tissue surrounding the clot. However, BBB permeability in the more distant structures remained normal despite the development of edema. These results demonstrate a time course for the formation and resolution of brain edema following ICH similar to that observed during focal ischemia. Brain edema forms in the immediate vicinity of the clot as a result of both BBB disruption and the local generation of osmotically active substances and then spreads to adjacent structures. While local ischemia, due to the mass effect of the hemorrhage, may play a role in producing cytotoxic and vasogenic edema, the release of toxic substances from the clot should also be considered. Since edema is nearly maximal by 24 hours after ICH, therapy directed at reducing edema formation must be instituted within the 1st day.

Radiosurgery for patients with recurrent small cell lung carcinoma metastatic to the brain: outcomes and prognostic factors

2005 ◽  
Vol 102 (Special_Supplement) ◽  
pp. 247-254 ◽  
Author(s):  
Jason Sheehan ◽  
Douglas Kondziolka ◽  
John Flickinger ◽  
L. Dade Lunsford
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Lung Carcinoma ◽  
Small Cell Lung Carcinoma ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Content Type ◽  
The Brain ◽  
Fine Print

Object. Lung carcinoma is the leading cause of death from cancer. More than 50% of those with small cell lung cancer develop a brain metastasis. Corticosteroid agents, radiotherapy, and resection have been the mainstays of treatment. Nonetheless, median survival for patients with small cell lung carcinoma metastasis is approximately 4 to 5 months after cranial irradiation. In this study the authors examine the efficacy of gamma knife surgery for treating recurrent small cell lung carcinoma metastases to the brain following tumor growth in patients who have previously undergone radiation therapy, and they evaluate factors affecting survival. Methods. A retrospective review of 27 patients (47 recurrent small cell lung cancer brain metastases) undergoing radiosurgery was performed. Clinical and radiographic data obtained during a 14-year treatment period were collected. Multivariate analysis was utilized to determine significant prognostic factors influencing survival. The overall median survival was 18 months after the diagnosis of brain metastases. In multivariate analysis, factors significantly affecting survival included: 1) tumor volume (p = 0.0042); 2) preoperative Karnofsky Performance Scale score (p = 0.0035); and 3) time between initial lung cancer diagnosis and development of brain metastasis (p = 0.0127). Postradiosurgical imaging of the brain metastases revealed that 62% decreased, 19% remained stable, and 19% eventually increased in size. One patient later underwent a craniotomy and tumor resection for a tumor refractory to radiosurgery and radiation therapy. In three patients new brain metastases were demonstrating on follow-up imaging. Conclusions. Stereotactic radiosurgery for recurrent small cell lung carcinoma metastases provided effective local tumor control in the majority of patients. Early detection of brain metastases, aggressive treatment of systemic disease, and a therapeutic strategy including radiosurgery can extend survival.

Relief of facial pain after combined removal of precentral and postcentral cortex

1971 ◽  
Vol 34 (4) ◽  
pp. 537-543 ◽  
Author(s):  
Richard A. Lende ◽  
Wolff M. Kirsch ◽  
Ralph Druckman
Keyword(s):  
Facial Pain ◽  
The Other ◽  
Precentral Gyrus ◽  
Nerve Section ◽  
Content Type ◽  
Burning Pain ◽  
Cortical Localization ◽  
The Brain ◽  
Fine Print ◽  
Frontal Lobotomy

✓ Cortical removals which included precentral and postcentral facial representations resulted in relief of facial pain in two patients. Because of known failures following only postcentral (SmI) ablations, these operations were designed to eliminate also the cutaneous afferent projection to the precentral gyrus (MsI) and the second somatic sensory area (SmII). In one case burning pain developed after a stroke involving the brain stem and was not improved by total fifth nerve section; prompt relief followed corticectomy and lasted until death from heart disease 20 months later. In the other case persistent steady pain that developed after fifth rhizotomy for trigeminal neuralgia proved refractory to frontal lobotomy; relief after corticectomy was immediate and has lasted 14 months. Cortical localization was established by stimulation under local anesthesia. Each removal extended up to the border of the arm representation and down to the upper border of the insula. Such a resection necessarily included SmII, and in one case responses presumably from SmII were obtained before removal. The suggestions of Biemond (1956) and Poggio and Mountcastle (1960) that SmII might be concerned with pain sensibility may be pertinent in these cases.

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