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1.
World Neurosurg ; 131: 356-363, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31658578

RESUMO

The aim of this study was to introduce resting-state functional magnetic resonance imaging (rest-fMRI) capability for brain tumor surgical planning. rest-fMRI is an emerging functional neuroimaging technique potentially able to provide new insights into brain physiology and to provide useful information regarding brain tumors in preoperative and postoperative settings. rest-fMRI evaluates low-frequency fluctuations in the blood oxygen level-dependent signal while the subject is at rest during magnetic resonance imaging examination. Multiple resting-state networks have been identified, including the somatosensory, language, and visual networks, which are of primary importance for surgical planning. We discuss the feasibility of rest-fMRI examination before and after surgical resection of brain tumors in routine clinical practice and the usefulness of the information obtained for surgical planning in brain tumor resection. rest-fMRI is particularly useful for patients who are unable to cooperate with the task-based paradigm, such as children or patients who are sedated, paretic, or aphasic. Although standardization and validation of rest-fMRI are still ongoing, this technique is feasible and valuable and can be implemented for routine clinical surgical planning.


Assuntos
Neoplasias Encefálicas/cirurgia , Neoplasias Encefálicas/patologia , Craniotomia/métodos , Estudos de Viabilidade , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , Planejamento de Assistência ao Paciente , Cuidados Pré-Operatórios/métodos , Lobo Temporal/patologia , Lobo Temporal/cirurgia
2.
BMC Neurol ; 19(1): 230, 2019 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-31558152

RESUMO

BACKGROUND: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe and most common autoimmune encephalitis in patients under 40 years old. Anti-NMDAR encephalitis has various clinical and neuroimaging findings. Here we report a special case of an anti-NMDAR encephalitis who had diffuse lesions in bilateral hemispheres with mild mass effects in left basal ganglia area. CASE PRESENTATIONS: A 28-year-old female anti-NMDAR encephalitis patient mainly presented with headache and fever. Brain magnetic resonance image (MRI) showed slightly contrasted diffuse lesions, involving the left temporal and frontal lobes, left basal ganglia area and splenium of corpus callosum, as well as the right frontal lobe, with mild edema surrounded in the left basal ganglia area. Cerebrospinal fluid (CSF) revealed a moderate pleocytosis with normal protein and glucose levels. Anti-NMDAR antibodies were identified in CSF. Transvaginal ovarian ultrasound did not reveal an ovarian teratoma. The patient was treated with immunoglobulin and steroid, and had a good recovery. CONCLUSIONS: Anti-NMDAR encephalitis has no special clinical manifestations and brain MRI is highly variable, which could be unremarkable or abnormal involving white and grey matters. The extensive lesions in frontal and temporal lobes, and basal ganglia area, with mild mass effects, have not been described previously. Recognition of various changes in brain MRI will enable the early detection of anti-NMDAR antibody and then effective treatments.


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico , Encefalite Antirreceptor de N-Metil-D-Aspartato/patologia , Gânglios da Base/patologia , Lobo Frontal/patologia , Lobo Temporal/patologia , Adulto , Gânglios da Base/diagnóstico por imagem , Feminino , Lobo Frontal/diagnóstico por imagem , Humanos , Lobo Temporal/diagnóstico por imagem
3.
World Neurosurg ; 132: 403-407, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31493601

RESUMO

BACKGROUND: Choroid plexus papillomas (CPPs) are benign World Health Organization grade I tumors that comprise 2%-4% of all brain tumors among children and less than 1% of brain tumors in adults. Most adult cases occur in the fourth ventricle, with only 1 previous report describing an adult patient with a temporal horn CPP. CASE DESCRIPTION: We report a rare case of a temporal horn CPP presenting in an adult with seizures. We performed a minimally invasive subtemporal approach for gross total resection of the lesion. CONCLUSIONS: CPP presenting in the temporal horn is rare among adults. We discuss the surgical nuances of the subtemporal approach for resection and review the literature regarding adult presentation of CPP and the treatment strategies for adult CPP.


Assuntos
Neoplasias do Plexo Corióideo/complicações , Neoplasias do Plexo Corióideo/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Procedimentos Neurocirúrgicos/métodos , Papiloma do Plexo Corióideo/complicações , Papiloma do Plexo Corióideo/cirurgia , Convulsões/etiologia , Lobo Temporal/cirurgia , Adulto , Neoplasias do Plexo Corióideo/patologia , Epilepsias Parciais/etiologia , Feminino , Quarto Ventrículo/patologia , Humanos , Imagem por Ressonância Magnética , Papiloma do Plexo Corióideo/patologia , Lobo Temporal/patologia , Resultado do Tratamento
4.
J Craniofac Surg ; 30(8): 2439-2440, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31261333

RESUMO

The authors report a very rare patient with ectopic odontogenic keratocyst (OKC) in the temporal region that is distant form the mandible. Based on the interesting report, they discuss about the possible origin and illustrate the development of the ectopic OKC. It shows that the OKC could distally relapse with the help of temporal muscle. The surgeon should be more proactive to deal with the peripheral muscle of lesion.


Assuntos
Cistos Odontogênicos/diagnóstico por imagem , Lobo Temporal/diagnóstico por imagem , Cabeça/patologia , Humanos , Masculino , Mandíbula/patologia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Cistos Odontogênicos/patologia , Cistos Odontogênicos/cirurgia , Lobo Temporal/patologia , Lobo Temporal/cirurgia , Músculo Temporal/diagnóstico por imagem , Músculo Temporal/patologia , Músculo Temporal/cirurgia
5.
Mol Med Rep ; 20(2): 1837-1845, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31257533

RESUMO

Hypoxic preconditioning (HPC) is neuroprotective against ischaemic brain injury; however, the roles of potential anti­apoptotic signals in this process have not been assessed. To elucidate the molecular mechanisms involved in HPC­induced neuroprotection, the effects of HPC on the cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA)/cAMP response element­binding protein (CREB) signalling pathway and apoptosis in Sprague­Dawley pups (postnatal day 7) treated with propofol were investigated. Western blot and histological analyses demonstrated that HPC exerts multiple effects on the hippocampus, including the upregulation of cAMP and phosphorylation of CREB. These effects were partially blocked by intracerebroventricular injection of the protein kinase antagonist H89 (5 µmol/5 µl). Notably, the level of cleaved caspase­3 was significantly downregulated by treatment with the cAMP agonist Sp­cAMP (20 nmol/5 µl). The results indicate that propofol increased the level of cleaved caspase­3 and Bax by suppressing the activity of cAMP­dependent proteins and Bcl­2; thus, HPC prevents propofol from triggering apoptosis via the cAMP/PKA/CREB signalling pathway.


Assuntos
Lesões Encefálicas/terapia , Precondicionamento Isquêmico/métodos , Neurônios/metabolismo , Neuroproteção/genética , Animais , Animais Recém-Nascidos , Apoptose/genética , Lesões Encefálicas/genética , Lesões Encefálicas/patologia , Lesões Encefálicas/prevenção & controle , AMP Cíclico , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/genética , Proteínas Quinases Dependentes de AMP Cíclico/genética , Hipocampo/metabolismo , Hipocampo/patologia , Humanos , Neurônios/patologia , Fosforilação/genética , Propofol/toxicidade , Ratos , Transdução de Sinais/genética , Lobo Temporal/metabolismo , Lobo Temporal/patologia
6.
J Am Podiatr Med Assoc ; 109(3): 241-245, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31268784

RESUMO

Polyarteritis nodosa is a progressive, often life-threatening, vasculitis affecting multiple organs, including the skin and peripheral nerves. We report a patient presenting with systemic features of the disease and with characteristic lesions in the feet 3 weeks after vaccination against hepatitis B virus infection.


Assuntos
Vacinas contra Hepatite B/efeitos adversos , Hepatite B/prevenção & controle , Poliarterite Nodosa/etiologia , Lobo Temporal/diagnóstico por imagem , Adulto , Humanos , Imagem por Ressonância Magnética , Masculino , Poliarterite Nodosa/diagnóstico , Poliarterite Nodosa/patologia , Lobo Temporal/patologia , Dedos do Pé/patologia
8.
Anticancer Res ; 39(6): 3067-3070, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31177150

RESUMO

We report a rare case of primary intracranial alveolar rhabdomyosarcoma (ARMS) in the right temporal lobe of a 51-year-old male. ARMS is one of 3 histological subtypes of rhabdomyosarcoma that most commonly presents in older children and younger adults. To our knowledge, there have been no prior published reports of primary intracranial ARMS in adults. Known cases of intracranial ARMS in adults are due to central nervous system (CNS) metastases from the head and neck and extremities. Diagnostic workup did not reveal any primary source outside the CNS. Given that risk factors for ARMS have not been studied in adults, it is difficult to ascertain what aspects of this patient's clinical history may have contributed to his diagnosis. Interestingly, he had prior history of traumatic brain injury requiring evacuation of a right fronto-temporal intraparenchymal hematoma.


Assuntos
Neoplasias Encefálicas/patologia , Rabdomiossarcoma Alveolar/patologia , Lobo Temporal/patologia , Biomarcadores Tumorais/análise , Lesões Encefálicas Traumáticas/complicações , Neoplasias Encefálicas/química , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/etiologia , Progressão da Doença , Evolução Fatal , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Rabdomiossarcoma Alveolar/química , Rabdomiossarcoma Alveolar/diagnóstico por imagem , Rabdomiossarcoma Alveolar/etiologia , Fatores de Risco , Lobo Temporal/química , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/efeitos da radiação , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento
9.
Mol Med Rep ; 20(1): 332-340, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31115535

RESUMO

Saikosaponin­D (SSD), which is the main bioactive component in the traditional Chinese medicine Chai Hu (Bupleurum falcatum L), possesses estrogen­like properties and is widely used in treating estrogen­related neurological disorders. The current study aimed to investigate the protective effects of SSD on the fear memory deficit in ovariectomized (OVX) rats and the potential underlying mechanism. SSD treatment significantly prolonged freezing time in OVX rats in a manner similar to that of estradiol (E2), whereas this effect was markedly suppressed by co­administration of ICI182780, a non­selective estrogen receptor (ER) inhibitor. The expression of ERα in the hippocampus of OVX rats was significantly elevated by SSD; however, Erß expression and E2 synthesis were not markedly affected by SSD treatment. Collectively, this study demonstrated that SSD­mediated fear memory improvement in OVX rats may be attributed not to E2 levels or ERß activity, but to ERα activation in the hippocampus.


Assuntos
Receptor alfa de Estrogênio/genética , Receptor beta de Estrogênio/genética , Medo/efeitos dos fármacos , Transtornos da Memória/tratamento farmacológico , Ácido Oleanólico/análogos & derivados , Saponinas/farmacologia , Animais , Bupleurum/química , Estradiol/metabolismo , Receptor alfa de Estrogênio/antagonistas & inibidores , Receptor beta de Estrogênio/antagonistas & inibidores , Medo/fisiologia , Feminino , Fulvestranto/farmacologia , Regulação da Expressão Gênica/efeitos dos fármacos , Hipocampo/efeitos dos fármacos , Hipocampo/patologia , Medicina Tradicional Chinesa , Transtornos da Memória/genética , Transtornos da Memória/patologia , Ácido Oleanólico/farmacologia , Ovariectomia , Ratos , Lobo Temporal/efeitos dos fármacos , Lobo Temporal/patologia
10.
Folia Neuropathol ; 57(1): 72-79, 2019.
Artigo em Polonês | MEDLINE | ID: mdl-31038190

RESUMO

Glioblastoma, the most malignant astrocytic tumour, is associated with limited survival and thus rare metastases. We analysed a particularly interesting case - a 51-year-old male diagnosed within 2 years with primary and recurrent glioblastoma, isocitrate dehydrogenase (IDH)-wild type, as well as with numerous extra-central nervous system (CNS) metastatic foci. Genetic material obtained from primary and recurrent tumours, as well as from pulmonary metastasis was analysed and compared at a molecular level. Next generation sequencing (NGS) analysis revealed BRAFV600E mutation, detected only in 2-5% of glioblastomas, in both the primary tumour and pulmonary metastases. Importantly, this mutation provides a possible therapeutic option as it constitutes a target for clinically approved inhibitors. This case study not only demonstrates a molecular comparison of primary, recurrent and metastatic glioblastoma, but also emphasizes the need for precise molecular diagnostics, which may facilitate treatment choice, especially in tumours currently lacking efficient treatment.


Assuntos
Neoplasias Encefálicas/genética , Neoplasias Encefálicas/patologia , Glioblastoma/genética , Glioblastoma/patologia , Metástase Neoplásica/patologia , Proteínas Proto-Oncogênicas B-raf/genética , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Lobo Temporal/patologia
11.
Brain Cogn ; 134: 1-8, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31054405

RESUMO

Recent evidence has suggested that the hippocampus supports learning and retrieval of arithmetic facts during childhood and adolescence. Whether the hippocampus is also involved in retrieving overlearned arithmetic facts (such as 3 × 5 = 15) during adult age is open for investigation. In this study, we assessed whether patients with hippocampal atrophy due to Alzheimer's disease (AD) are still able to retrieve overlearned arithmetic facts from memory. Sixteen patients (n = 13 with AD, n = 3 with Mild Cognitive Impairment - MCI) were evaluated using standard radiological, neurological, and neuropsychological test procedures. We adopted a multiple single-case analysis in order to acknowledge possible dissociations between hippocampal degeneration and intact arithmetic fact retrieval. All patients performed a neuropsychological screening battery assessing episodic memory as well as arithmetic processing, and underwent a 3-Tesla MRI procedure. A morphometric analysis comprising estimation of both cortical thickness and hippocampal volume, which also included a subfield analysis, was conducted. All patients had marked hippocampal atrophy (bilateral n = 15, unilateral n = 1) in comparison to healthy matched controls and showed deficits in episodic memory (delayed recall). However, 13 out of 16 patients performed in the average range of standardised norms during retrieval of overlearned arithmetic facts (i.e. multiplication tables). Our results suggest that intact retrieval of consolidated arithmetic facts from memory does not depend on the integrity of the hippocampus. This is in line with the view that the hippocampus plays a dynamic and time-limited role in arithmetic processing. While the hippocampus seems to be necessary for learning and consolidating new arithmetic facts in memory, it might not be critically involved in retrieving arithmetic facts when these are well consolidated in memory.


Assuntos
Doença de Alzheimer/patologia , Hipocampo/patologia , Memória Episódica , Lobo Temporal/patologia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Disfunção Cognitiva/patologia , Disfunção Cognitiva/psicologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Rememoração Mental , Testes Neuropsicológicos
12.
Mol Med Rep ; 19(6): 4852-4862, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31059068

RESUMO

Cerebrovascular disease (CVD) is one of the leading causes of mortality worldwide. The role of cytochrome c oxidase subunit 6B1 (COX6B1) in the central nervous system remains unclear. The present study aimed to analyze the role of COX6B1 in rat hippocampal neurons extracted from fetal rats. The subcellular localization of the neuron­specific marker microtubule­associated protein 2 was detected by immunofluorescence assay. Cell viability was assessed using a cell counting kit, and the levels of apoptosis and cytosolic Ca2+ were analyzed by flow cytometry. The expression levels of the molecular factors downstream to COX6B1 were determined using reverse transcription­quantitative polymerase chain reaction and western blotting. Reoxygenation following oxygen­glucose deprivation (OGD) decreased cell viability and the expression levels of COX6B1 in a time­dependent manner, and 60 min of reoxygenation was identified as the optimal time period for establishing an ischemia/reperfusion (I/R) model. Overexpression of COX6B1 was demonstrated to reverse the viability of hippocampal neurons following I/R treatment. Specifically, COX6B1 overexpression decreased the cytosolic concentration of Ca2+ and suppressed neuronal apoptosis, which were increased following I/R treatment. Furthermore, overexpression of COX6B1 increased the protein expression levels of apoptosis regulator BCL­2 and mitochondrial cytochrome c (cyt c), and decreased the protein expression levels of apoptosis regulator BCL2­associated X and cytosolic cyt c in I/R model cells. Collectively, the present study results suggested that COX6B1 overexpression may reverse I/R­induced neuronal damage by increasing the viability of neurons, by decreasing the cytosolic levels of Ca2+ and by suppressing apoptosis. These results may facilitate the development of novel strategies for the prevention and treatment of CVD.


Assuntos
Complexo IV da Cadeia de Transporte de Elétrons/metabolismo , Complexo IV da Cadeia de Transporte de Elétrons/farmacologia , Neurônios/metabolismo , Traumatismo por Reperfusão/prevenção & controle , Lobo Temporal/metabolismo , Animais , Apoptose/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Transtornos Cerebrovasculares/prevenção & controle , Citocromos c/metabolismo , Complexo IV da Cadeia de Transporte de Elétrons/genética , Feminino , Glucose/metabolismo , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Neurônios/patologia , Oxigênio/metabolismo , Substâncias Protetoras/metabolismo , Substâncias Protetoras/farmacologia , Ratos , Ratos Sprague-Dawley , Lobo Temporal/patologia , Proteína bcl-X/metabolismo
13.
Brain Struct Funct ; 224(6): 1999-2008, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31104120

RESUMO

Several studies have begun to demonstrate that contextual memories constitute an important mechanism to guide our attention. Although there is general consensus that the hippocampus is involved in the encoding of contextual memories, it is controversial whether this structure can support implicit forms of contextual memory. Here, we combine automated segmentation of structural MRI with neurobehavioral assessment of implicit contextual memory-guided attention to test the hypothesis that hippocampal volume would predict the magnitude of implicit contextual learning. Forty healthy subjects underwent 3T magnetic resonance imaging brain scanning with subsequent automatic measurement of the total brain and hippocampal (right and left) volumes. Implicit learning of contextual information was measured using the contextual cueing task. We found that both left and right hippocampal volumes positively predicted the magnitude of implicit contextual learning. Larger hippocampal volume was associated with superior implicit contextual memory performance. This study provides compelling evidence that implicit contextual memory-guided attention is hippocampus-dependent.


Assuntos
Atenção/fisiologia , Hipocampo/patologia , Aprendizagem/fisiologia , Memória/fisiologia , Adulto , Sinais (Psicologia) , Feminino , Hipocampo/fisiologia , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Tempo de Reação , Lobo Temporal/patologia , Lobo Temporal/fisiologia , Adulto Jovem
14.
J Affect Disord ; 252: 152-159, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-30986730

RESUMO

BACKGROUND: Smaller hippocampus volume represents a consistent finding in major depression (MDD). Hippocampal neuroplasticity due to chronic stress might have differential effect on hippocampal subfields. We investigated the effects of the rs1360780 polymorphism of the hypothalamic-pituitary-axis related gene FKBP5 in combination with early life stress (ELA) on the structure of hippocampal subfields in MDD. METHODS: We assessed the hippocampal subfields volumes in 85/67 MDD/healthy controls. We investigated the effects of diagnosis, FKBP5 allelic status and their interaction as predictors of hippocampal subfield volumes as well as the effect of ELA and its interaction with FKBP5. RESULTS: MDD patients had smaller hippocampal volumes, in particular within the cornu ammonis (CA) and dentate gyrus (DG) regions. Patients exposed to ELA had larger hippocampi, in particular within the CA and DG. Among the patients exposed to ELA, the T allele carriers displayed lower volumes within the hippocampus-amygdala-transition-area (HATA) as those subjects homozygous for the C allele. LIMITATIONS: We pooled the subjects from 2 centers in order to increase the sample size. We did not include the cumulative lifetime exposure to medication. CONCLUSIONS: Hippocampal volume reductions in MDD were present particularly in the CA and DG. MDD with ELA display differential volume changes compared to MDD without ELA. The significant interaction between ELA and the rs1360780 polymorphism in HATA suggests a role of FKBP5 in the pathophysiology of structural alterations in depression.


Assuntos
Transtorno Depressivo Maior/genética , Transtorno Depressivo Maior/patologia , Hipocampo/patologia , Estresse Psicológico/genética , Proteínas de Ligação a Tacrolimo/genética , Adulto , Tonsila do Cerebelo/patologia , Giro Denteado/patologia , Feminino , Genótipo , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Plasticidade Neuronal/genética , Tamanho do Órgão , Lobo Temporal/patologia
15.
Dev Period Med ; 23(1): 15-20, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30954976

RESUMO

OBJECTIVE: Introduction: Epileptic spasms are seizures usually associated with a severe developmental epilepsy syndrome with onset in the first year of life, peaking between 3 and 10 months of age [12]. A variety of disorders can cause epileptic spasms, with the etiology driving management, prognosis, and overall outcome. Preexisting brain damage has been demonstrated in 60% to 90% of the cases reflecting pre-, peri-, or postnatal brain injury that may usually be determined by history and clinical neurologic examination. Cerebral malformations may account for up to 30% of the cases [2]. Prenatal alcohol exposure can permanently damage the brain, affecting important structures, such as the cerebellum, corpus callosum as well as specific cell populations in many other regions of the brain. No one knows what a "safe" amount of alcohol consumption during pregnancy may be[3]. Objective: The aim of this article is to present a clinical case of a large brain temporal lobe malformation which was recognized after a very early onset of spasms registered on video EEG-monitoring followed by MRI findings and to put forward the assumption that regular consumption of light alcoholic drinks even in low doses could contribute to irreversible brain damage in the fetus. PATIENTS AND METHODS: Material and methods: All patient data were collected from the NICU and Newborn Pathology Department of Lviv City Children's Clinical Hospital Health Record Department, and included the hospital and clinic records by the staff neurologist, neurophysiologist, and pediatrician, as well as EEG records in the postneonatal period. The mother was interviewed to clarify the pregnancy course data. The mother's consent was obtained for publication. RESULTS: Results: Asymmetric spasms, which were recognized as seizures on the 4th day of the child's life while recording video EEG, urged the physicians towards further diagnostic investigations. Primarily the child was diagnosed with neonatal abstinence syndrome on the 2nd day of life based on clinical and patient history data, but on the following day episodes of myoclonic jerks and jitteriness were noticed and video EEG monitoring started. Upon analysis of video- EEG, myoclonic seizures and spasms were reported showing asymmetry in the amplitude of ictal EEG. MRI was recommended and performed to explain focal EEG findings, and a large brain left temporal lobe malformation was seen. CONCLUSION: Conclusions: Spasms in the form of seizures are rarely reported in the neonatal period. Their recognition has to lead to urgent brain imaging study to look for the underlying cause and to implement timely, appropriate corrections in the treatment strategy. Although brain malformations can have many causes, taking careful antenatal, perinatal and family history has ruled out many usual etiologies. Maternal alcohol consumption during pregnancy may potentially have contributed to the condition.


Assuntos
Epilepsia do Lobo Temporal/etiologia , Efeitos Tardios da Exposição Pré-Natal/diagnóstico , Espasmos Infantis/etiologia , Lobo Temporal/patologia , Eletroencefalografia , Epilepsia do Lobo Temporal/diagnóstico , Epilepsia do Lobo Temporal/patologia , Etanol , Feminino , Humanos , Recém-Nascido , Imagem por Ressonância Magnética , Gravidez , Efeitos Tardios da Exposição Pré-Natal/diagnóstico por imagem , Efeitos Tardios da Exposição Pré-Natal/patologia , Espasmos Infantis/diagnóstico , Espasmos Infantis/patologia , Lobo Temporal/diagnóstico por imagem
16.
World Neurosurg ; 126: 216-222, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30877004

RESUMO

BACKGROUND: Ectopic recurrent craniopharyngioma is rare. We present a case of a temporal ectopic recurrent tumor after a trans-eyebrow supraorbital keyhole approach and provide a review of the reported data with basic statistics. METHODS: We retrospectively reviewed 57 cases of craniopharyngiomas surgically treated at our institution. A temporal ectopic recurrent tumor with 10% high Ki-67 proliferation index expression was identified. The lesion underwent gross total resection without any complications. We also reviewed the related data and performed a basic statistical analysis. RESULTS: Our review found 64 cases of ectopic recurrent craniopharyngioma that had been reported (including the present case). The median interval until ectopic recurrence was 4.0 years (interquartile range, 2.0-10.0). Of the 64 lesions, 48 (75%) were adamantinous, 6 (9%) were papillary, and 10 (16%) were unknown. Also, 34 tumors (53%) were located in the previous surgical tract, and 30 (47%) had disseminated along the cerebrospinal fluid pathway. Of the 64 ectopic tumors, 50 (78%) could be resected in total without complications. CONCLUSIONS: Ectopic recurrent craniopharyngioma is a rare phenomenon. Meticulous protection of the entire surgical field and careful manipulation of the tumor during resection are required to prevent possible ectopic recurrence. Regular follow-up examinations are strongly recommended to detect any further recurrences. Gross total resection is the treatment of choice for ectopic recurrence.


Assuntos
Neoplasias Encefálicas/patologia , Craniofaringioma/patologia , Recidiva Local de Neoplasia/patologia , Lobo Temporal/patologia , Adulto , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Craniofaringioma/diagnóstico por imagem , Craniofaringioma/cirurgia , Craniotomia , Humanos , Masculino , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/cirurgia , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/cirurgia , Resultado do Tratamento
17.
Cogn Behav Neurol ; 32(1): 46-53, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30896577

RESUMO

Four patients with primary progressive aphasia displayed a greater deficit in understanding words they heard than words they read, and a further deficiency in naming objects orally rather than in writing. All four had frontotemporal lobar degeneration-transactive response DNA binding protein Type A neuropathology, three determined postmortem and one surmised on the basis of granulin gene (GRN) mutation. These features of language impairment are not characteristic of any currently recognized primary progressive aphasia variant. They can be operationalized as manifestations of dysfunction centered on a putative auditory word-form area located in the superior temporal gyrus of the left hemisphere. The small size of our sample makes the conclusions related to underlying pathology and auditory word-form area dysfunction tentative. Nonetheless, a deeper assessment of such patients may clarify the nature of pathways that link modality-specific word-form information to the associations that mediate their recognition as concepts. From a practical point of view, the identification of these features in patients with primary progressive aphasia should help in the design of therapeutic interventions where written communication modalities are promoted to circumvent some of the oral communication deficits.


Assuntos
Afasia Primária Progressiva/fisiopatologia , Percepção de Forma/fisiologia , Degeneração Lobar Frontotemporal/patologia , Percepção da Fala/fisiologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lobo Temporal/patologia
18.
JAMA Netw Open ; 2(3): e190261, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30924889

RESUMO

Importance: Criminal and socially inappropriate behavior is encountered among patients with dementia, and it is sometimes the first sign of a dementing disorder. This behavior constitutes a significant burden to society, patients' relatives, and patients themselves. Objectives: To investigate and compare the prevalence and type of criminal and socially inappropriate behavior, as well as recurrence of criminal behavior, associated with Alzheimer disease (AD) and frontotemporal dementia (FTD) neuropathologically verified post mortem, and to assess whether there is a specific type of protein pathology more closely associated with criminal behavior in patients with FTD. Design, Setting, and Participants: Cohort study using medical record review of 220 Swedish patients with a postmortem neuropathologic diagnosis of AD (n = 101) or frontotemporal lobar degeneration (n = 119) (hereinafter referred to as FTD) diagnosed between January 1, 1967, and December 31, 2017. Main Outcomes and Measures: Patient notes containing reports of criminal and socially inappropriate behavior, as well as data on dominant protein pathology for patients with FTD, were duly reviewed and recorded. The Fisher exact test or logistic regression was used to assess possible differences between groups. Results: Of the 220 patients studied, 128 (58.2%) were female, the median (range) age at disease onset was 63 (30-88) years and at death was 72 (34-96) years, and the median (range) disease duration was 9 (1-28) years. Instances of criminal behavior were found in 65 of the 220 patients (29.5%): in 15 of the 101 patients (14.9%) with AD and 50 of the 119 patients (42.0%) with FTD (P < .001). Recurrence of criminal behavior was significantly higher in the FTD group (89.0%) than in the AD group (53.3%) (P = .04). Instances of socially inappropriate behavior were found in 57 patients (56.4%) with AD and 89 (74.8%) with FTD (P = .004). An expression of non-tau pathology increased the odds for criminal behavior by a factor of 9.0 (95% CI, 3.4-24.0) among patients with FTD. Conclusions and Relevance: These results suggest that criminal and socially inappropriate behaviors may be more prevalent and criminal behaviors may be more recurrent in patients with FTD than in those with AD. Non-tau pathology, but not tau pathology, appears to be associated with criminal behavior. These findings may help with the clinical diagnostic process.


Assuntos
Doença de Alzheimer , Efeitos Psicossociais da Doença , Comportamento Criminoso/fisiologia , Lobo Frontal/patologia , Demência Frontotemporal , Lobo Temporal/patologia , Adulto , Idoso , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/patologia , Doença de Alzheimer/psicologia , Diagnóstico , Feminino , Demência Frontotemporal/epidemiologia , Demência Frontotemporal/patologia , Demência Frontotemporal/psicologia , Humanos , Masculino , Registros Médicos/estatística & dados numéricos , Neuropatologia/métodos , Prevalência , Recidiva , Comportamento Social , Suécia/epidemiologia
19.
J Affect Disord ; 250: 410-418, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30878653

RESUMO

BACKGROUND: Depression's relationship with cerebral abnormalities and cognitive decline is temporally dynamic. Despite clear clinical utility, understanding depression's effect on cerebral structures, cognitive impairment and the interaction between these symptoms has had limited consideration. METHODS: This review summarised studies examining a clinical depression diagnosis or validated scales measuring depressive symptoms, data concerning amyloid-beta (Aß) levels, brain structure and function focusing on hippocampal alterations, or white matter hyperintensities (WMH), and at least one validated neuropsychological test. Online database searches of: PsycINFO, EMBASE, MEDLINE, and Scopus were conducted to identify potential articles. RESULTS: While depression was consistently associated with cross-sectionally cognitive decline across multiple domains, the neuropathological basis of this dysfunction remained unclear. Hippocampal, frontal, and limbic dysfunction as well as cortical thinning, WMH, and Aß burden all provide inconsistent findings, likely due to depression subtypes. The consistency of these findings additionally decreases when examining this relationship longitudinally, as these results are further confounded by pre-dementia states. The therapeutic interventions examined were more efficacious in the younger compared with the older samples, who were characterised by greater WMH and Aß burden. LIMITATIONS: The limited number of longitudinal and interventional studies in addition to the heterogeneity of the samples restricts their generalisability. CONCLUSIONS: Symptomatological differences between early-onset and late-onset depression (EOD and LOD) appear crucial in understanding whether late-life depression is the primary or secondary source of cerebral pathology. Though severe cognitive impairments and clearer neuropathological underpinnings are more characteristic of LOD than EOD, the inconsistency of valid biomarkers remains problematic.


Assuntos
Córtex Cerebral/patologia , Disfunção Cognitiva/patologia , Transtorno Depressivo/patologia , Substância Branca/patologia , Idoso , Demência/patologia , Depressão , Feminino , Hipocampo/patologia , Humanos , Imagem por Ressonância Magnética , Masculino , Testes Neuropsicológicos , Índice de Gravidade de Doença , Lobo Temporal/patologia
20.
World Neurosurg ; 126: 310-313, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30885870

RESUMO

BACKGROUND: Stiff neck or nuchal rigidity is a significant clinical sign of neurologic disease. It is commonly associated with meningitis, subarachnoid hemorrhage, and posterior fossa tumors. It may also occur as a result of tonsillar impaction following pressure in the infratentorial compartment from an expanding posterior fossa mass. It is, however, not commonly known to be associated with uncal herniation. CASE DESCRIPTION: We report a recent experience on this association. CONCLUSIONS: In the presence of stiff neck or nuchal rigidity in a patient with clinical signs of uncal herniation from a temporal arachnoid cyst, this unusual association could possibly be owing to the effect of increased pressure in the posterior fossa from massive shift of brain tissue posteriorly following a rapid rise in middle cranial fossa pressure consequent on an acute enlargement of the cyst. A false impression of acute meningeal irritation in such a situation could be quite misleading, resulting in late diagnosis and subsequently a delay in timely intervention.


Assuntos
Cistos Aracnóideos/complicações , Hérnia/complicações , Rigidez Muscular/complicações , Cistos Aracnóideos/patologia , Cistos Aracnóideos/cirurgia , Fossa Craniana Média/patologia , Fossa Craniana Posterior/patologia , Hérnia/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Lobo Temporal/patologia , Resultado do Tratamento
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