RESUMEN
Compressive optic neuropathy with acute or chronic vision loss has been associated with various skull base tumors, aneurysms, Graves disease, trauma, and, less commonly, fibrous dysplasia and osteopetrosis. The authors present a case of acute visual deterioration in a 25-year-old woman who had massive calvarial hypertrophy with optic canal stenosis secondary to renal osteodystrophy (uremic leontiasis ossea [ULO]: bighead disease). Significant visual field restoration was achieved with high-dose corticosteroids followed by optic nerve decompression. This is the first case report of cranial neuropathy associated with ULO.
Asunto(s)
Trastorno Mineral y Óseo Asociado a la Enfermedad Renal Crónica/complicaciones , Enfermedades del Nervio Óptico/etiología , Cráneo/patología , Adulto , Trastorno Mineral y Óseo Asociado a la Enfermedad Renal Crónica/diagnóstico , Trastorno Mineral y Óseo Asociado a la Enfermedad Renal Crónica/diagnóstico por imagen , Trastorno Mineral y Óseo Asociado a la Enfermedad Renal Crónica/tratamiento farmacológico , Descompresión Quirúrgica , Femenino , Estudios de Seguimiento , Glucocorticoides/uso terapéutico , Humanos , Imagen por Resonancia Magnética , Metilprednisolona/uso terapéutico , Enfermedades del Nervio Óptico/fisiopatología , Enfermedades del Nervio Óptico/cirugía , Escotoma/etiología , Escotoma/fisiopatología , Cráneo/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Campos VisualesRESUMEN
We report four cases of the use of peroperative cortical mapping during craniotomy under local anaesthesia to define the relationship between the glioma and speech and somatosensory cortex. This enabled a radical subtotal (two cases) or an apparent total (two cases) excision of the tumour close to the somatosensory and speech cortex with no permanent neurological deficit. Use of this technique allows radical excision of intrinsic low and intermediate grade gliomas that would otherwise be considered unexcisable and may lead to an improved survival.
Asunto(s)
Anestesia Local , Astrocitoma/cirugía , Mapeo Encefálico/instrumentación , Neoplasias Encefálicas/cirugía , Electroencefalografía/instrumentación , Lóbulo Frontal/cirugía , Glioblastoma/cirugía , Oligodendroglioma/cirugía , Lóbulo Parietal/cirugía , Adulto , Astrocitoma/patología , Astrocitoma/fisiopatología , Biopsia , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/fisiopatología , Craneotomía/instrumentación , Estimulación Eléctrica , Femenino , Lóbulo Frontal/patología , Lóbulo Frontal/fisiopatología , Glioblastoma/patología , Glioblastoma/fisiopatología , Humanos , Masculino , Oligodendroglioma/patología , Oligodendroglioma/fisiopatología , Lóbulo Parietal/patología , Lóbulo Parietal/fisiopatología , Técnicas Estereotáxicas/instrumentaciónRESUMEN
We report four cases of the use of per-operative cortical mapping during craniotomy under local anaesthesia to define the relationship between the glioma and speech and somatosensory cortex. This enabled a radical subtotal (two cases) or an apparent total (two cases) excision of the tumour close to somatosensory and speech cortex with no permanent neurological deficit. Use of this technique allows radical excision of intrinsic low and intermediate grade gliomas that would otherwise be considered unexcisable and may lead to an improved survival.
Asunto(s)
Mapeo Encefálico/métodos , Neoplasias Encefálicas/cirugía , Corteza Cerebral , Craneotomía/métodos , Glioma/cirugía , Adulto , Anestesia Local , Astrocitoma/fisiopatología , Astrocitoma/cirugía , Neoplasias Encefálicas/fisiopatología , Femenino , Glioblastoma/fisiopatología , Glioblastoma/cirugía , Glioma/fisiopatología , Humanos , MasculinoRESUMEN
The use of a chloroform-ethanol-water solvent system for the direct extraction of retinyl palmitate isomers from fortified food products was previously shown to be unsuitable because significant isomerization of all-trans-retinyl palmitate occurred during the extraction. This study investigated the extent of isomerization of retinyl palmitate in various extraction solvents when subjected to gold fluorescent laboratory light. Purified solutions of all-trans-retinyl palmitate in hexane were diluted with methyl t-butyl ether, hexane, methylene chloride, and stabilized chloroform and subjected to gold fluorescent laboratory light for 2, 4, and 6.5 h. Similar solutions were subjected to light or kept in the dark for 3.5 h. All-trans-, 9-cis-, and 13-cis-retinyl palmitate esters in the solutions were determined by using normal phase high performance liquid chromatography with fluorometric detection. Results demonstrated a noticeable increase in the 9-cis-retinyl palmitate concentration and a corresponding decrease in all-trans-retinyl palmitate concentration with time, in chloroform and methylene chloride compared with hexane. Chlorinated solvents in the absence of light did not promote isomerization of retinyl palmitate. Use of chlorinated solvents for the extraction of vitamin A esters should be avoided because they promote isomerization of retinyl palmitate when subjected to light, including gold fluorescent laboratory light.