RESUMO
Calcifying pseudoneoplasms of the neuroaxis (CAPNON) are rare, slow-growing, fibro-osseous lesions that can occur throughout the entire neuroaxis with few reported cases. We describe a case of craniocervical CAPNON that was treated by our unit and review the available literature. CAPNON are rare benign lesions occurring throughout the neuroaxis. Although rare, these lesions should be considered in cases of histopathological and radiology features of calcified lesions in both brain and spine. Despite a paucity of reports complete safe surgical resection should remain the goal to obtain the best clinical outcomes.
Assuntos
Articulação Atlantoccipital/patologia , Calcinose/patologia , Idoso , Encéfalo/patologia , Humanos , Masculino , Coluna Vertebral/patologiaRESUMO
PURPOSE: To determine the recommended dose, toxicity profile, and pharmacokinetics of a novel boronated porphyrin (BOPP) for photodynamic therapy (PDT) of intracranial tumors. PATIENTS AND METHODS: BOPP was administered alone in increasing doses (0.25, 0.5, 1.0, 2.0, 4.0, or 8.0 mg/kg) preoperatively in patients with intracranial tumors undergoing postresection PDT until dose-limiting toxicity (DLT) was observed. RESULTS: Twenty-nine assessable patients with intracranial tumors received BOPP intravenously 24 hours before surgery. The recommended dose was 4 mg/kg. Dose escalation was limited by thrombocytopenia. The most common nonhematologic toxicity was skin photosensitivity. Pharmacokinetic parameters showed increased area under the plasma concentration-time curve and maximum concentration with increased dose. Tumor BOPP concentrations also increased with increased dose. CONCLUSION: BOPP at a dose of 4 mg/kg was well tolerated. DLT was thrombocytopenia, and photosensitivity was the only other toxicity of note. The efficacy of PDT using BOPP requires further exploration.
Assuntos
Neoplasias Encefálicas/tratamento farmacológico , Glioblastoma/tratamento farmacológico , Fotoquimioterapia , Protoporfirinas/uso terapêutico , Radiossensibilizantes/uso terapêutico , Adulto , Idoso , Área Sob a Curva , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Protoporfirinas/farmacocinética , Radiossensibilizantes/farmacocinética , Distribuição TecidualRESUMO
A prospective study was undertaken to evaluate the efficacy of spinal cord stimulation (SCS) in the management of chronic pain syndrome. The study included all patients who underwent this procedure at the Royal Melbourne Hospital and the Melbourne Private Hospital over a period of two years. A total of 29 patients were managed by the end of June 1996. These patients were carefully screened by a neurosurgeon (JVR) and a psychiatrist. Of these, 26 patients had a follow up evaluation at the end of August 1996. From the group of 29 patients, four patients failed to obtain any relief during the trial phase of the procedure and thus did not have the stimulator implanted permanently. From the 25 patients who proceeded to have the stimulator implanted, 11 patients had a variable beneficial response, three patients found it to be of marginal benefit, six had no benefit, three patients initially had a good response but subsequently gained no benefit whilst two patients were uncertain of its benefit. It thus appears that SCS was of benefit in 50% of our carefully selected patients with chronic pain syndromes.
Assuntos
Dor nas Costas/terapia , Terapia por Estimulação Elétrica/métodos , Ciática/terapia , Medula Espinal , Adulto , Idoso , Dor nas Costas/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor/métodos , Estudos Prospectivos , Ciática/psicologia , Resultado do TratamentoRESUMO
This report describes an unusual fungal infection of an intrathecal baclofen pump which, to our knowledge, has not been reported previously. We describe a 39-year-old man with severe lower limb spasticity due to secondary progressive multiple sclerosis that was managed with insertion of an intrathecal baclofen pump. He subsequently presented with distinct neurological decline secondary to an intrathecal baclofen pump infection with Aspergillus terreus.
Assuntos
Aracnoidite/etiologia , Baclofeno/administração & dosagem , Infecções Relacionadas a Cateter/tratamento farmacológico , Itraconazol/farmacologia , Espasticidade Muscular/tratamento farmacológico , Adulto , Aracnoidite/tratamento farmacológico , Aracnoidite/parasitologia , Aspergillus/efeitos dos fármacos , Aspergillus/patogenicidade , Infecções Relacionadas a Cateter/parasitologia , Humanos , Bombas de Infusão Implantáveis/efeitos adversos , Itraconazol/administração & dosagem , Masculino , Esclerose Múltipla Crônica Progressiva/complicações , Esclerose Múltipla Crônica Progressiva/tratamento farmacológico , Espasticidade Muscular/etiologia , Resultado do TratamentoRESUMO
This report illustrates the progression and surgical management of a patient with superficial siderosis associated with a cervical pseudomeningocoele.
Assuntos
Siderose/diagnóstico , Siderose/cirurgia , Progressão da Doença , Hemossiderina/metabolismo , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças da Medula Espinal/diagnóstico , Doenças da Medula Espinal/cirurgiaRESUMO
Although prostate adenocarcinoma is the most commonly diagnosed cancer in men, intracranial metastases are rare. We describe a 72-year-old patient with known metastatic prostate cancer, presenting with a dural-based parafalcine lesion on radiological imaging, following a seizure. Total macroscopic excision of the lesion was achieved at surgery, with histopathology confirming prostate adenocarcinoma embedded in an atypical (World Health Organization Grade II) meningioma, fulfilling all the criteria for true tumour-to-tumour metastasis. To our knowledge, this is the first report of prostate cancer metastasising to an atypical meningioma.
Assuntos
Adenocarcinoma/secundário , Neoplasias Meníngeas/patologia , Meningioma/patologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias da Próstata/patologia , Idoso , Humanos , MasculinoRESUMO
A neuroenteric cyst is a rare cause of an intradural, extramedullary mass. We report the MRI findings in a case of a neuroenteric cyst of the craniovertebral junction without associated abnormalities.