ABSTRACT
El origen subcortical de la epilepsia ha sido tema de profundo debate durante muchísimo tiempo y solo se le otorgaba a las estructural subcorticales un rol en la distribución, modulación y alteración de la actividad cortical. Sin embargo, los estudios neurofisiológicos y de neuroimágenes de las últimas décadas han provisto de la información suficiente como para confirmar que algunas crisis epilépticas pueden iniciarse en estructuras subcorticales. Presentamos 4 pacientes pediátricos con lesiones cerebelosas y epilepsia refractaria, revisamos la bibliografía, analizamos las formas de presentación, los hallazgos neurofisiológicos y resultados a largo plazo con cirugía
The subcortical origin of epilepsy has been a subject of debate and only the subcortical structures were given a role in the distribution, modulation and alteration of cortical activity. However, neurophysiological and neuroimaging studies of recent decades have provided enough information to confirm the onset of some epileptic seizures in subcortical structures. We present 4 pediatric patients with cerebellar lesions and refractory epilepsy, we reviewed the literature, analyzed the forms of presentation, the neurophysiological findings and long-term results with surgery
Subject(s)
Humans , Female , Epilepsy , Seizures , General Surgery , Drug Resistant EpilepsyABSTRACT
Lhermitte-Duclos disease (LDD), or cerebellar dysplastic gangliocytoma, is a rare type of cerebellar tumor, from unknown origin. Patients can be asymptomatic for several years, but there are usually imprecise neurological signs for long periods.
Subject(s)
Humans , Female , Aged , Hamartoma Syndrome, Multiple/diagnosis , Hamartoma Syndrome, Multiple/therapy , Ganglioneuroma/surgery , Ganglioneuroma/diagnosis , Hamartoma Syndrome, Multiple/pathology , Cerebellar Neoplasms/diagnosis , Ganglioneuroma/pathologyABSTRACT
We report a case of acute comitant esotropia in a child with a cerebellar tumor. A 3-year-old boy was referred for management of a 9 month history of acute acquired comitant esotropia. On first presentation, the patient's angle of esodeviation was 50 prism-diopters (PD) at distance and near fixation without any lateral incomitance. The cycloplegic refraction revealed +0.75 diopters in both eyes. Very mild bilateral papilledema was found on the fundus examination, but the neurological examination did not reveal any other pathological findings. Brain MRI showed a 5 cm mass located in the midline of the cerebellum as well as hydrocephalus. The mass was completely excised and histological examination confirmed the diagnosis of pilocytic astrocytoma. Despite neurosurgery, the patient's strabismus remained unresolved. One year after neurosurgery, both medial rectus muscles were surgically recessed by 6 mm, resulting in esotropia of 8PD at distant and near fixation without restoration of bifoveal fusion at follow-up 2 years after the eye muscle surgery. Therefore, acute onset comitant esotropia in a child can be the first sign of a cerebellar tumor, even without any other neurological signs and symptoms.
Subject(s)
Child, Preschool , Humans , Male , Acute Disease , Astrocytoma/complications , Brain/pathology , Cerebellar Neoplasms/complications , Esotropia/etiology , Magnetic Resonance Imaging , Neurosurgical Procedures , Oculomotor Muscles/surgery , Refraction, Ocular , Time FactorsABSTRACT
We report here on a neonate with congenital cerebellar mixed germ cell tumor, and this initially presented as cerebellar hemorrhage. Postnatal cranial ultrasonography revealed an echogenic cerebellar mass that exhibited the signal characteristics of hemorrhage rather than tumor on MR images. The short-term follow-up images also suggested a resolving cerebellar hemorrhage. One month later, the neonate developed vomiting. A second set of MR images demonstrated an enlarged mass that exhibited changed signal intensity at the same site, which suggested a neoplasm. Histological examination after the surgical resection revealed a mixed germ cell tumor.
Subject(s)
Female , Humans , Infant, Newborn , Cerebellar Diseases/etiology , Cerebellar Neoplasms/congenital , Cerebral Hemorrhage/etiology , Magnetic Resonance Imaging , Neoplasms, Germ Cell and Embryonal/congenitalABSTRACT
Authors report a very rare case of primary Hodgkin's lymphoma limited to the cerebellum. A 64-year-old female patient presented with headache, nausea, and vomiting. Magnetic resonance imaging of the brain revealed a nodular enhancing mass in the left cerebellar hemisphere. Tumor was removed totally with retromastoid suboccipital approach. Diagnosis was Hodgkin's lymphoma of mixed cellularity type, consisting of a dense mixed inflammatory infiltrate containing scattered large atypical mononuclear Hodgkin cells and multinucleated Reed-Sternberg cells. Systemic work-up for the Hodgkin's lymphoma was followed with negative result. Postoperative radiation therapy was given and the patient is disease-free at 16 months after the operation.
Subject(s)
Female , Humans , Middle Aged , Brain , Cerebellar Neoplasms , Cerebellum , Diagnosis , Headache , Hodgkin Disease , Magnetic Resonance Imaging , Nausea , Reed-Sternberg Cells , VomitingABSTRACT
The authors present a case of cervical syringomyelia associated with cerebellar mixed oligoastrocytoma in an 18-month-old boy who was normally delivered at full-term. The child presented with an increasing incidence of vomiting and irritability, and a poor truncal control. Preoperative magnetic resonance imaging of the brain revealed cerebellar vermian tumor with an obstructive hydrocephalus and a small-sized syringomyelia at the 6th cervical vertebral level. The tumor was completely removed via suboccipital craniectomy. Histologically, the tumor consisted of mixed oligo-astrocytoma. The cervical syringomyelia was conservatively managed with no specific operative treatment. At two months postoperatively, magnetic resonance imaging of the cervical spine showed a remarkable reduction in size of the syringomyelic cavity.