RESUMO
We present the case of a 8-years-old boy, admitted with a history of headache, nausea and vomiting. Cerebral angiography showed a non-vascular mass on frontal lobe. The patient underwent craniotomy and the lesion was removed. Neuropathological study revealed that the tumor was a ganglioglioma. The patient received pos-operative radiotherapy. On follow-up, 16 years after, a computed tomographic scan showed a recurrence of the tumor, and a second surgery revealed a glioblastoma multiform. Gangliogliomas are rare tumors of the central nervous system containing neoplastic ganglion cells and low grade neoplastic glial cells. The malignant degeneration occurs only in the glial component, so the prognosis of these tumors is related to the grade of that component.
Assuntos
Neoplasias Encefálicas/patologia , Ganglioglioma/patologia , Anaplasia , Criança , Seguimentos , Glioblastoma/patologia , Humanos , Masculino , Recidiva Local de Neoplasia , Tomografia Computadorizada por Raios XRESUMO
The authors present a retrospective review of 13 patients with the diagnostic of intracranial metastatic malignant melanoma. Their ages ranged from 28 to 84 years. The time interval from diagnosis of primary tumor to development of cerebral metastases ranged from 6 to 60 months. There was preoperative evidence of extracranial disease in 9 patients. All patients underwent craniotomy, and the 30-day mortality was zero. The patients survived 2 to 55 months after surgery. Medium survival time for all patients was 14 months. The excision of metastatic melanoma from the brain, although not curative, may increase survival in patients with this metastatic cancer. The criteria for consideration of surgery, radiotherapy and chemotherapy are discussed.
Assuntos
Neoplasias Encefálicas/secundário , Melanoma/secundário , Neoplasias Cutâneas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Melanoma/terapia , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
The case of a 9-year-old girl with intracranial hemorrhage due to a giant aneurysm of distal middle cerebral artery is reported. Cerebral aneurysms are rare in children, particularly in the first decade of life. Aneurysms in childhood occur more frequently in peripheral branches and they are more often giant in size. Clinical features and pathogenesis of this lesion are discussed.
Assuntos
Aneurisma Intracraniano/diagnóstico , Angiografia Cerebral , Artérias Cerebrais/diagnóstico por imagem , Criança , Feminino , Humanos , Aneurisma Intracraniano/cirurgia , Imageamento por Ressonância MagnéticaRESUMO
Thirty five patients with chronic subdural hematoma were treated surgically between 1988 and 1995. The patients, aged 19 to 80 years, were graded retrospectively according to the Bender scale. The clots were removed via burr-holes with irrigation of the subdural space to ensure as complete an evacuation of subdural collection, and craniotomy with membranectomy. The mortality rate was 16.6% with craniotomy and 0% with burr-hole. The patients who died, 80% were in grade III or IV. The pathogenesis and surgical treatment of chronic subdural hematoma has been controversial, and still remains obscure.
Assuntos
Hematoma Subdural/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Craniotomia/mortalidade , Drenagem/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Trepanação/mortalidadeRESUMO
Benign chondroblastoma is a rare bone tumor of immature cartilage cell derivation. This lesion classically occur at the ends of long bones in young persons. Chondroblastoma arising from the occipital bone is extremely rare. We report the case of a 16 year old girl with a benign condroblastoma in the occipital bone, and discuss the clinical, radiological and treatment aspects of this tumor.
Assuntos
Condroblastoma/patologia , Osso Occipital/patologia , Neoplasias Cranianas/patologia , Adolescente , Condroblastoma/cirurgia , Feminino , Humanos , Neoplasias Cranianas/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Angiolipomas of the spine are rare (40 cases in the literature). When they are intraspinal, these masses are epidural in more than 90% of the cases. Angiolipomas are benign tumors containing vascular and mature adipose elements. The clinical symptomatology is non specific, but computed tomography and mostly MRI provide a precise diagnosis. With one additional case and a review of the literature, we define the main characteristics of these tumors.
Assuntos
Angiolipoma/diagnóstico , Neoplasias da Coluna Vertebral/diagnóstico , Vértebras Torácicas , Adulto , Angiolipoma/cirurgia , Espaço Epidural , Humanos , Laminectomia , Imageamento por Ressonância Magnética , Masculino , Neoplasias da Coluna Vertebral/cirurgia , Vértebras Torácicas/cirurgiaRESUMO
The authors present a short review of anatomic and pathophysiological bases of the carpal tunnel syndrome, and its surgical treatment and complications. They report the cases of two patients who developed sympathetic alterations with hand edema and vascular changes (Raynaud phenomenon), and propose an explanation which they name "sympathetic denervation". This is the only complication of their series and it occurred during the immediate post-operative period, coinciding with removal of immobilization of the wrist on the 22nd post-operative day.
Assuntos
Síndrome do Túnel Carpal/fisiopatologia , Síndrome do Túnel Carpal/complicações , Síndrome do Túnel Carpal/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Cystic meningiomas are uncommon lesions. CT image may simulate a glial or a metastatic tumor with cystic or necrotic changes. The correct radiological evaluation and the recognition of this kind of tumor are important for surgical treatment since they are potentially curable neoplasms. In this paper the authors report their experience with the treatment of three cases of cystic meningiomas, and discuss some characteristics of these lesions.
Assuntos
Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Criança , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
This case report refers to a thirty-nine years old female patient with severe head injury and other body injuries who developed symptoms of diabetes insipidus. The patient died eleven days after hospital admission during which magnetic resonance imaging and computerized tomography were done, showing characteristic hypothalamic lesions. This stimulated the authors to review the literature and call attention to the prevention and prognosis of endocrine syndromes which may appear in patients secondarily and late, and whose morbidity may be decreased with early diagnosis and treatment.
Assuntos
Lesões Encefálicas/complicações , Diabetes Insípido/etiologia , Adulto , Lesões Encefálicas/diagnóstico , Feminino , Humanos , Espectroscopia de Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
The authors report two cases of the presence of free air in acute extradural hematomas. This is not an unusual radiological finding which has been infrequently reported in the literature.
Assuntos
Ar , Hemorragia Cerebral/diagnóstico por imagem , Hematoma/diagnóstico por imagem , Adulto , Hemorragia Cerebral/etiologia , Criança , Hematoma/etiologia , Humanos , Masculino , Fraturas Cranianas/complicações , Osso Temporal/lesões , Tomografia Computadorizada por Raios XRESUMO
Fazemos breve revisäo das bases anatômicas e fisiopatológicas da síndrome do túnel do carpo, seu tratamento cirúrgico e suas complicaçöes. Relatamos os casos de duas pacientes que desenvolveram alteraçöes simpáticas como edema da mäo e problemas vasculares (fenômeno de Raynaud) para as quais ensaiamos uma explicaçäo, por nós denominada "denervaçäo, coincidindo com a retirada da imobilizaçäo do punho no 22§ dia pós-operatório
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Síndrome do Túnel Carpal/fisiopatologia , Estudos Retrospectivos , Síndrome do Túnel Carpal/cirurgia , Síndrome do Túnel Carpal/complicaçõesRESUMO
A ocorrência de meningiomas císticos é incomum. As imagens destas lesöes obtidas pela tomografia computadorizada de crânio (TC) podem lembrar lesäo cística de origem glial ou metastática, sendo necessário realizarmos, além da TC, angiografia cerebral e ressonância magnética do crânio para firmarmos diagnóstico correto pré-operatório. O diagnóstico incorreto de glioma pode resultar em tratamento paliativo, ao invés da remoçäo radical desta neoplasia potencialmente curável. Três casos säo relatados, ilustrando o problema
Assuntos
Humanos , Masculino , Feminino , Criança , Pessoa de Meia-Idade , Meningioma , Neoplasias Meníngeas , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Tomografia Computadorizada por Raios XRESUMO
Trata-se do relato do caso de paciente do sexo feminino, com 39 anos, politraumatizada, que desenvolveu quadro de diabetes insipidus. A paciente faleceu onze dias após sua internaçäo, período em que foram realizadas tomografia computadorizada e ressonância magnética, evidenciando lesöes hipotalâmicas características. Estes fatos nos estimularam revisar a literatura e chamar a atençäo para prevençäo de síndromes endócrinas que podem acometer secundária e tardiamente pacientes vítimas de traumatismo crânio-encefálico e que, se diagnosticadas e tratadas de maneira precoce, podem ter sua morbidade diminuída
Assuntos
Humanos , Feminino , Adulto , Lesões Encefálicas/complicações , Diabetes Insípido/etiologia , Lesões Encefálicas/diagnóstico , Espectroscopia de Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
Os autores relatam dois casos de presença de ar livre em hematoma extradural agudo. Trata-se de achado radiológico näo incomúm, mas que tem sido relatado infrequentemente na literatura
Assuntos
Humanos , Masculino , Criança , Adulto , Ar , Encefalopatias , Hematoma , Encefalopatias/etiologia , Hematoma/etiologia , Fraturas Cranianas/complicações , Osso Temporal/lesões , Tomografia Computadorizada por Raios XRESUMO
The purpose of this paper is to report a case of false aneurysm of the middle meningeal artery. The authors emphasize the value of "common" carotid angiography in diagnosis and treatment of this rare lesion.
Assuntos
Aneurisma Intracraniano/diagnóstico por imagem , Artérias Meníngeas/diagnóstico por imagem , Adulto , Hematoma Epidural Craniano/etiologia , Humanos , Aneurisma Intracraniano/complicações , Masculino , RadiografiaRESUMO
Hematomas of the posterior fossa are an uncommon complication of head injury. Almost invariably they occur after trauma of the occiput, and are associated with skull fracture. Their diagnosis and management have been greatly improved by CT scanning. In the present series, the majority of patients had acute evolution indicating the potential hazard of conservative treatment. Our results (29% mortality) are similar to those previously reported in other series.
Assuntos
Lesões Encefálicas/complicações , Hematoma Epidural Craniano/diagnóstico por imagem , Adulto , Lesões Encefálicas/diagnóstico por imagem , Lesões Encefálicas/cirurgia , Criança , Pré-Escolar , Fossa Craniana Posterior , Craniotomia , Feminino , Escala de Coma de Glasgow , Hematoma Epidural Craniano/etiologia , Hematoma Epidural Craniano/cirurgia , Humanos , Masculino , Tomografia Computadorizada por Raios XRESUMO
Multiple intracranial meningiomas (MIM) may be a specific pathological entity. In general these lesions are associated with neurofibromatosis. The classical clinical picture of neurofibromatosis, as described by von Recklinghausen, may not necessarily be associated with MIM. This possibility is a direct result of the variable penetrability of chromosomic aberrations connected with the chromosome 22. Molecular studies of these tumors confirmed this finding. In our series of 108 patients with intracranial meningiomas only three cases were multiple. In only one of them external stigmata of von Recklinghausen's disease were detected. In the absence of skin manifestations of neurofibromatosis in patients with MIM it is very difficult to diagnosis von Recklinghausen's disease, and the so called "true multiple meningiomas". The authors believe that there are no justificative findings to consider MIM as an independent pathological entity.
Assuntos
Neoplasias Meníngeas/patologia , Meningioma/patologia , Neurofibromatoses/patologia , Idoso , Feminino , Humanos , Masculino , Neoplasias Meníngeas/cirurgia , Meningioma/cirurgia , Pessoa de Meia-IdadeRESUMO
The clinical aspects of the meningiomas are well described. However, there is an important number of reports on a variety of other lesions simulating meningioma, including the prostate cancer. The authors describe one additional patient with prostate cancer who at presentation had clinical and radiographic signs suggesting meningioma. The literature on the subject is reviewed and summarized.
Assuntos
Adenocarcinoma/secundário , Neoplasias Encefálicas/secundário , Neoplasias da Próstata/patologia , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/cirurgia , Idoso , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Angiografia Cerebral , Craniotomia , Diagnóstico Diferencial , Humanos , Masculino , Meningioma/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
The clinical aspects of the meningiomas are well described. However, there is an important number of reports on a variety of other lesions simulating meningioma, including the prostate cancer. The authors describe one additional patient with prostate cancer who at presentation had clinical and radiographic signs suggesting meningioma. The literature on the subject is reviewed and summarized.
Assuntos
Humanos , Masculino , Idoso , Adenocarcinoma , Neoplasias Encefálicas , Neoplasias da Próstata/patologia , Adenocarcinoma , Neoplasias Encefálicas , Angiografia Cerebral , Craniotomia , Diagnóstico Diferencial , Meningioma , Tomografia Computadorizada por Raios XRESUMO
Multiple intracranial meningiomas (MIM) may be a specific pathological entity. In general these lesions are associated with neurofibromatosis. The classical clinical picture of neurofibromatosis, as described by von Recklinghausen, may not necessarily be associated with MIM. This possibility is a direct result of the variable penetrability of chromosomic aberrations connected with the chromosome 22. Molecular studies of these tumors confirmed this finding. In our series of 108 patients with intracranial meningiomas only three cases were multiple. In only one of them external stigmata of von Recklinghausen's disease were detected. In the absence of skin manifestations of neurofibromatosis in patients with MIM it is very difficult to diagnosis von Recklinghausen's disease, and the so called "true multiple meningiomas". The authors believe that there are no justificative findings to consider MIM as an independent pathological entity.