Transtentorial spread of glioblastoma multiforme to cerebellopontine angle – A rare case report

Background: Glioblastoma multiforme (GBM) is the most common central nervous system malignant tumor in adults with 48.3% of cases. Despite it, the presence of transtentorial spread is uncommon, with few patients reported in the literature. In this study, the authors report a case of GBM transtentorial spread to cerebellopontine angle after resection and adjuvant treatment. Case Description: A 55-year-old male patient with GBM, previously submitted to surgical resection and adjuvant treatment with radiotherapy and quemotherapy. Fourteen months after the first surgery, he developed headaches associated with dysphagia and dysphonia. Magnetic resonance imaging showed a recurrence of the left parietal lesion and a new mass in the right cerebellopontine angle. The patient underwent successful surgical resection of both lesions. Chemotherapy was maintained after the surgery. Conclusion: To the best of our knowledge, there are few cases of GBM metastasis to the cerebellopontine angle reported in the literature. Surgical management should be considered in cases of intracranial hypertension and patients with good performance status.

Quantitative evaluation of position sense in patients with parietal lesion

A position reproduction task was performed, in a controlled experimental environment, by seven patients with a parietal lobe lesion. We obtained mainly three findings: (a) even for patients who failed a thumb localization test, the accuracy of position reproduction was adequate and did not deviate from the range of error observed in healthy young participants, (b) the patients showed a centralizing tendency in localization, and (c) they initially moved in the wrong direction when reproducing the remembered positions. The study also indicated that patients whose lesion sites included the postcentral gyrus exhibited stronger exploratory movements than those who had no such lesions and lacked smoothness of movement. In patients without the lesion of the postcentral gyrus, a higher-order dysfunction, rather than the pure position sense problem, was suggested to contributed to their task performance. The present study provided fundamental data for sensorimotor skills of patients with parietal lesion, and these quantitative findings would also contribute to reconsideration of current assessments and rehabilitations for sensory deficits.

Superior Sagittal Sinus Invasion by Malignant Glioma: Case Report and Literature Review

Anaplastic oligodendrogliomas (AOs) correspond to ∼ 23% of all oligodendrogliomas. They correspond to a tumor with malignant histological characteristics, focal or diffuse, associated with a worse prognosis. In the present case report, we describe the case of a 30-year-old female submitted to resection of a right parietal lesion whose histology showed to be an AO. She underwent complementary treatment with chemotherapy and radiotherapy according to the Roger Stupp protocol. Four years after the initial diagnosis, there was tumor recurrence within the superior sagittal sinus, with no evidence of recurrence elsewhere. In the literature, we have found no similar published case reinforcing the rarity of this condition

The Pivotal Role of the Right Parietal Lobe in Temporal Attention

The visual system is extremely efficient at detecting events across time even at very fast presentation rates; however, discriminating the identity of those events is much slower and requires attention over time, a mechanism with a much coarser resolution [Cavanagh, P., Battelli, L., & Holcombe, A. O. Dynamic attention. In A. C. Nobre & S. Kastner (Eds.), The Oxford handbook of attention (pp. 652–675). Oxford: Oxford University Press, 2013]. Patients affected by right parietal lesion, including the TPJ, are severely impaired in discriminating events across time in both visual fields [Battelli, L., Cavanagh, P., & Thornton, I. M. Perception of biological motion in parietal patients. Neuropsychologia, 41, 1808–1816, 2003]. One way to test this ability is to use a simultaneity judgment task, whereby participants are asked to indicate whether two events occurred simultaneously or not. We psychophysically varied the frequency rate of four flickering disks, and on most of the trials, one disk (either in the left or right visual field) was flickering out-of-phase relative to the others. We asked participants to report whether two left-or-right-presented disks were simultaneous or not. We tested a total of 23 right and left parietal lesion patients in Experiment 1, and only right parietal patients showed impairment in both visual fields while their low-level visual functions were normal. Importantly, to causally link the right TPJ to the relative timing processing, we ran a TMS experiment on healthy participants. Participants underwent three stimulation sessions and performed the same simultaneity judgment task before and after 20 min of low-frequency inhibitory TMS over right TPJ, left TPJ, or early visual area as a control. rTMS over the right TPJ caused a bilateral impairment in the simultaneity judgment task, whereas rTMS over left TPJ or over early visual area did not affect performance. Altogether, our results directly link the right TPJ to the processing of relative time.

NEUROCYSTICERCOSIS PRESENTING WITH PAROXYSMAL SENSORY DISTURBANCE

Author reports the case of a 28 years-old woman presenting episodes of paresthesia of the right arm with duration of approximately 4 days which remitted spontaneously, followed after two years by episodes of right hemiparesthesia. Brain MRI followed by brain stereotactic biopsy established the diagnosis of neurocysticercosis. Since electroencephalography showed no spike-wave abnormalities it was difficult to establish if symptoms were secondary to parietal lesion itself or were focal sensory seizures. After treatment with albendazole, methylprednisolone and sodium valproate the patient had a good recovery.