RESUMO
A new method for evaluating the patency of a ventriculoatrial shunt is described, and early experience with it is reported. Transesophageal echocardiography can demonstrate a cerebrospinal fluid leak in the right atrium through the atrial tip of a shunting device. This capability was an incidental discovery, and since then the accuracy of the technique in evaluating the patency of a ventriculoatrial shunt has been prospectively studied in 20 observations of 16 patients. The method proved to be accurate in 90% to 100% of cases. It is concluded that transesophageal echocardiography offers a rapid and accurate assessment of ventriculoatrial shunt function, is well tolerated, and is easy to perform.
Assuntos
Derivações do Líquido Cefalorraquidiano , Ecocardiografia/métodos , Adolescente , Adulto , Idoso , Neoplasias Encefálicas/cirurgia , Fossa Craniana Posterior , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Estudos Prospectivos , Siringomielia/cirurgiaRESUMO
We report a 27-year-old woman presenting with chronic fatigue and depressive symptoms. Aspecific neurologic symptoms and biochemical indices of inflammation and anaemia triggered an MRI, revealing a tumor with compression of the medulla oblongata. After neurosurgical resection, anatomopathologic examination showed a chordoid meningioma. All complaints disappeared and inflammatory parameters normalized, suggesting an association with Castleman syndrome. This case demonstrates the importance of a systematic diagnostic approach in patients presenting with unexplained chronic fatigue.
Assuntos
Cordoma/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Adulto , Cordoma/complicações , Cordoma/cirurgia , Depressão/etiologia , Diagnóstico Diferencial , Fadiga/etiologia , Feminino , Humanos , Inflamação/etiologia , Meningioma/complicações , Meningioma/cirurgia , Procedimentos Neurocirúrgicos , Resultado do TratamentoRESUMO
Tumour recurrence and the high mortality and morbidity associated with malignant brain tumours may be attributed to the failure of current therapeutic modalities (surgery, radiation and chemotherapy) to control the invasion of malignant brain tumour cells into healthy brain tissue. Several in vitro and in vivo models have been developed and used to study brain tumour invasion and cell motility. Here, we review some of the traditional in vitro models of brain tumour invasion and the latest adaptations to the widely used spheroid model. Several research groups studying the mechanisms mediating brain tumour invasion have made important contributions to the field by improving in vitro models of tumour migration and invasion. Sharing these advances will hopefully accelerate experimental discovery and the development of novel anti-invasion brain tumour therapies.
Assuntos
Neoplasias Encefálicas , Técnicas de Cocultura , Esferoides Celulares , Células Tumorais Cultivadas , Movimento Celular , Humanos , Invasividade NeoplásicaRESUMO
La desorganisation et le sous-equipement qui caracterisent notre societe font que la prise en charge des traumatises du rachis est souvent aleatoire. Dans cet article sont revues les notions elementaires liees au traumatisme cervical: les mecanismes et types de lesions; les differentes atteintes neurologiques; la clinique; le bilan radiologique; le traitement conservatif et chirurgical y sont discutes. Cette approche tient compte des conditions locales de travail