RESUMO
OBJECTIVE: To investigate the diagnostic method and analyze the result of microneurosurgical treatment for tumors of the fourth cerebral ventricle. METHODS: Tumor of the fourth ventricle was clinically diagnosed in 86 patients basing on the preliminary assessment of symptom and CT or MRI findings. Of these 86 patients treated with micro-neurosurgery, the tumors in 62 were totally removed, subtotally in 19, and partially in 5. Forty-two patients received postoperative radiotherapy. RESULTS: Three patients died postoperatively within ten days, and symptoms in 83 were improved after treatment. The average survival period was over 3 years. The pathology included 32 medulloblastomas, 23 ependymoma, 15 astrocytoma, 10 hemangiblastomas, 2 choroid plexus papillomas, and 4 epidermoid cysts. CONCLUSION: Medulloblastoma, astrocytoma and hemangiblastoma are suggested to be removed totally whenever technically possible according to the site, character and volume of the tumor. For ependymoma, if close to the brain stem, is recommended to be subtotally removed. Postoperative radiotherapy may be beneficial for malignant types.
Assuntos
Neoplasias do Ventrículo Cerebral/diagnóstico , Quarto Ventrículo/patologia , Meduloblastoma/diagnóstico , Microcirurgia/métodos , Adolescente , Adulto , Idoso , Astrocitoma/diagnóstico , Astrocitoma/diagnóstico por imagem , Astrocitoma/cirurgia , Neoplasias do Ventrículo Cerebral/radioterapia , Neoplasias do Ventrículo Cerebral/cirurgia , Criança , Pré-Escolar , Terapia Combinada , Ependimoma/diagnóstico , Ependimoma/diagnóstico por imagem , Ependimoma/cirurgia , Feminino , Seguimentos , Quarto Ventrículo/efeitos da radiação , Quarto Ventrículo/cirurgia , Hemangioblastoma/diagnóstico , Hemangioblastoma/diagnóstico por imagem , Hemangioblastoma/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Meduloblastoma/diagnóstico por imagem , Meduloblastoma/cirurgia , Microcirurgia/mortalidade , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Análise de Sobrevida , Taxa de Sobrevida , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Transcranial magnetic stimulation (TMS) can non-invasively investigate the function of human brain. However, it can induce a focal pain at the stimulated site on the scalp or seizures when applied with high frequency (>1 Hz). Here we report an induction of nausea as a complication of low-frequency repetitive TMS (rTMS) of the cerebellum. SUBJECTS AND METHODS: Eight right-handed normal volunteers underwent low-frequency (0.9 Hz) rTMS of the right cerebellum. The stimulus intensity was set at 90% of the resting motor threshold determined by TMS to motor cortex. RESULTS: Nausea lasted as long as 10 min after the end of rTMS without apparent neurological deficit in two subjects. This symptom was replicated when the same protocol was applied on a different day in the same subjects. CONCLUSIONS: Low-frequency rTMS of cerebellum is still a safe procedure, but the experimenters should keep in mind the possibility of inducing nausea.
Assuntos
Tronco Encefálico/efeitos da radiação , Cerebelo/efeitos da radiação , Campos Eletromagnéticos/efeitos adversos , Náusea/etiologia , Ponte/efeitos da radiação , Adulto , Tronco Encefálico/fisiopatologia , Ângulo Cerebelopontino/fisiopatologia , Ângulo Cerebelopontino/efeitos da radiação , Estimulação Elétrica/instrumentação , Feminino , Quarto Ventrículo/fisiopatologia , Quarto Ventrículo/efeitos da radiação , Humanos , Masculino , Náusea/diagnóstico , Náusea/fisiopatologia , Ponte/fisiopatologia , Valores de Referência , Estimulação Magnética TranscranianaRESUMO
BACKGROUND: This study investigated the relevance of prognostic factors and the impact of histological features in posterior fossa ependymoma. METHODS: The charts of 26 patients (aged 1-59 years, mean 20.6 years; 11 adults) with posterior fossa ependymoma operated on between January 1983 and December 1994 were reviewed and patients followed up (mean: 93 months). RESULTS: Gross total resection was performed in 18 patients (69%), subtotal in seven patients (27%), biopsy in one patient (4%). One patient (3.8%) developed respiratory complications and died. All patients underwent posterior fossa radiotherapy (5000 cGy) after surgery. Four children first received chemotherapy and then radiotherapy only when at least 3 years old. Eleven patients (42%) received radiotherapy and subsequently chemotherapy. The 5-year survival rate was 90% for adults and 40% for children (
