Polymorphous Low-Grade Neuroepithelial Tumor of the Young as a Partially Calcified Intra-Axial Mass in an Adult.

Polymorphous low-grade neuroepithelial tumors of the young (PLNTYs) are recently described CNS tumors. Classically, PLNTYs are epileptogenic and are a subtype of a heterogeneous group of low-grade neuroepithelial tumors that cause refractory epilepsy, such as angiocentric gliomas, oligodendrogliomas, gangliogliomas, and pleomorphic xanthoastrocytomas. Although they are a relatively new entity, a number of imaging and histologic characteristics of PLNTYs are already known. We present the imaging and pathologic findings of such a tumor as well as the surgical approach and clinical management.

Mixed Solid and Cystic Mass in an Infant.

Desmoplastic infantile tumors are rare supratentorial brain tumors that occur in pediatric patients. Desmoplastic infantile tumors are made up of 2 subtypes: desmoplastic infantile gangliogliomas and desmoplastic infantile astrocytomas. Desmoplastic infantile tumors are often identifiable on imaging on the basis of multiple characteristics. Nevertheless, pathologic analysis is required to confirm the diagnosis, particularly when the imaging features are atypical. Here, the radiology findings, surgical approach and subsequent management, and pathology of a desmoplastic infantile ganglioglioma are described.

Primum non nocere. The case for a critical approach to global mental health.

The Movement for Global Mental Health (MGMH) argues that there is a moral imperative that psychiatric treatments should be made available to all communities across the world. But psychiatric theories, categories and interventions emerged in the Western world are based on a set of assumptions about the nature of the self and society, nature and the supernatural, health and healing that are not universally accepted. In this paper we argue that there is a stronger moral case for caution with regard to the export of psychiatric thinking. Without a critical interrogation of such thinking the MGMH is at risk of doing a great deal of harm to the diverse, and sometimes fragile, systems of care that already exist across the world.

Transformed occupational prospects for HIV-associated brain syndromes.

We report a case of a full-time worker with late undiagnosed HIV disease presenting as encephalopathy with motor features and a manic-like picture. HIV encephalopathy was a terminal condition before the advent of combination highly active anti-retroviral therapy (HAART). Treatment with HAART, with follow-up in a neuropsychiatric service and rehabilitation involving the occupational health department of his employer, produced a successful return to work. This case demonstrates a remarkable transformation in occupational and other outcomes of HIV-related brain disease in the era of HAART.

A critique of seven assumptions behind psychological trauma programmes in war-affected areas.

Programmes costing millions of dollars to address 'posttraumatic stress' in war zones have been increasingly prominent in humanitarian aid operations, backed by UNICEF, WHO, European Community Humanitarian Office and many nongovernmental organisations. The assumptions underpinning this work, which this paper critiques with particular reference to Bosnia and Rwanda, reflect a globalisation of Western cultural trends towards the medicalisation of distress and the rise of psychological therapies. This paper argues that for the vast majority of survivors posttraumatic stress is a pseudocondition, a reframing of the understandable suffering of war as a technical problem to which short-term technical solutions like counselling are applicable. These concepts aggrandise the Western agencies and their 'experts' who from afar define the condition and bring the cure. There is no evidence that war-affected populations are seeking these imported approaches, which appear to ignore their own traditions, meaning systems, and active priorities. One basic question in humanitarian operations is: whose knowledge is privileged and who has the power to define the problem? What is fundamental is the role of a social world, invariably targeted in today's 'total' war and yet still embodying the collective capacity of survivor populations to mourn, endure and rebuild.