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Biomedical subjects

A Marchel

Publications and source records attributed to A Marchel.

At least 19 recordsLinked to original sources
PubMed2001

Pedunculated subependymomas of lateral ventricle.

The authors describe two cases of extremely rare, pedunculated subependymomas of lateral ventricle. One patient presented with symptoms of intracranial hypertension (case 2); CT scan revealed evidence of intraventricular mass, but in second patient (case 1) coexisting symptomatic anaplastic astrocytoma masked on CT-scan the presence of asymptomatic intraventricular tumour, which was found no earlier than at autopsy. The cellular origin of this rare intracranial neoplasm is discussed.

Adult↗
PubMed2000

Intrasellar neuronal hamartoma associated with pituitary adenoma. Case report.

46-year-old acromegalic women presenting high level of growth hormone (32 ng/ml) in the serum underwent surgery. The intrasellar tumor, 16 mm in diameter, has been removed. The biopsy material consisted of two types of closely adjacent and intermingled tissues, one of which was growth hormone positive acidophilic adenoma, the second component were haphazardly oriented ganglion cells of various size and shape, also multinuclear, with bundles of unmyelinated fibers. The cytoplasm and processes of ganglion cells were immunopositive for neurofilaments and for synaptophysin on cellular membranes and processes. There were none glial fibrillary acidic protein positive cellular elements. The authors discuss commonly used name of choristoma for this type of tumor and the problem of possible neurosecretory stimulation of pituitary adenoma by neuronal hamartoma.

Adenoma↗
PubMed2000

Epithelioid schwannomas of the acoustic nerve.

Epithelioid schwannomas occur predominantly in relation to peripheral nerves and are associated with histological and clinical malignancy. However, a variant of the epithelioid schwannoma involving cranial nerves is extremely rare. In this study we report three cases of epithelioid schwannomas originating from the acoustic nerves and located in the cerebello-pontine angles. In the first case, the tumor was histopathologically entirely solid and demonstrated biphasic pattern with both spindle-shaped cells and a population of round or polygonal epithelioid cells. The second one consisted of the smaller part exhibiting typical Antoni B and A tissue and large areas containing clusters and bundles of epithelioid cells. Purely epithelioid schwannoma composed predominantly of cords or nests of round and polygonal epithelioid cells were observed in the third case. All schwannomas revealed marked polymorphism and nuclear hyperchromasia. Immunohistochemical studies showed a diffuse, strong positivity for S-100 protein in the cytoplasm of the spindle and epithelioid tumor cells. These two populations of cells were positively stained for vimentin, but were negative for EMA, cytokeratin and HMB45. Patchy GFAP-immunoreactivity was also noticed at the peripheral parts of the tumors. The authors discuss differential diagnosis of this unusual variant of schwannoma in relation to malignant transformation of the epithelioid component.

Adult↗
PubMed2000

[Surgical outcome of temporal lobe epilepsy].

Results of the surgical treatment of temporal lobe epilepsy--Authors present their own experience in the surgical treatment of temporal lobe epilepsy. 403 patients were operated upon. The age of the patients was not limited. The beginning of the epilepsy was in most cases in early childhood, however the conservative treatment was continued for a very long time, usually over 10 years. The modern diagnostic tools, especially MRI, make it possible to diagnose the temporal epileptic focus more often, than previously, especially in cases with morphological substrate. Temporal lobectomy with amygdalo-hippocampectomy was performed. The follow-up was at least 3 years after surgery. Outs of 343 patients examined in this period 175 were cured, without seizures after surgery. Next 61 patients had no more than 2 small attacks a year. So in 69% of patients the result was very good or satisfactory. The neuropsychological investigation revealed that in most patients the IQ improved. Their quality of life improved markedly according to their own opinion.

Adult↗
PubMed1994

Reanimation of the face after facial nerve palsy resulting from resection of a cerebellopontine angle tumour.

Twenty-three patients with facial nerve paralysis following surgery for a cerebellopontine angle tumour had a facial-hypoglossal anastomosis and simultaneous anastomosis of the cervical ansa with the distal stump of the hypoglossal nerve. In 18 patients, simultaneously with the neural anastomoses, additional transpositions of the temporalis and masseter muscles were performed. At follow-up examination 3-87 months after reconstructive surgery, eight patients had House grade II, ten grade III and five grade IV outcome. The EMG evidence of reinnervation was observed 5-11 months after anastomosis. Combination of the facial-hypoglossal anastomosis with simultaneous myoplasty and with anastomosis of the distal hypoglossal nerve stump to the ansa cervicalis provides the advantage of immediate protection against ophthalmic complications, prevents hemiatrophy of the tongue and gives good functional results when reinnervation of the facial muscles takes place.

Adult↗
PubMed1992

Risk of epilepsy after aneurysm operations.

This prospective study was undertaken to evaluate the risk of epilepsy after aneurysm operations. The patients were discharged after operation without any anticonvulsant prophylactic treatment and followed-up for 12 months. Out of 128 such patients 121 were submitted for final evaluation. Epilepsy was diagnosed if two or more seizure attacks occurred during that time. Such attacks occurred in 8 patients, so the risk of epilepsy was estimated at 7% for the 12 months after operation in patients without prophylactic treatment. In another 3 patients single seizures occurred during the follow-up, they were not treated with anticonvulsant drugs; seizures did not recur for up to two years. Detailed analysis of the patients with late epilepsy revealed that most of them were pre-operatively in the 3rd clinical group according to WFNS scale. The rationale for the use of prophylactic anticonvulsants after aneurysm surgery seems to be doubtful in view of this study and data from the literature.

Adult↗
PubMed1991

Formation of new aneurysms. Report of five cases.

Among 964 patients diagnosed and treated for intracranial aneurysms in 5 evidence of formation of new aneurysms was found. Repeat angiography, performed after the second SAH, revealed new aneurysms on arteries normal on previous angiograms; there were multiple aneurysms in 3 cases. In 4 cases, the aneurysms were formed within 3 to 6 years. In the authors' opinion, the possibility of formation of new aneurysms after the cure of a demonstrable one, should be considered in all aneurysmal patients, especially in multiple cases. Possible mechanisms of development of new aneurysms are discussed.

Adolescent↗
PubMed1990

Acute surgery in intracranial aneurysms. Experience with 100 cases.

In the last 3.5 years (up to August 1988) out of 450 patients with surgically treated intracranial aneurysms in 100 cases (22%) acute surgery was performed (up to 72 h after SAH). Patients in grade I-III (WFNS scale) were operated upon. In all the cases there were supratentorial aneurysms. CSF drainage during the operation was used routinely and nimodipine topically, in intravenous infusion and orally was applied. In all the cases, but one, the aneurysms was clipped. Follow-up--1 year. Assessment of the results was done using the Glasgow Outcome Scale (GOS). Full recovery was obtained in 78 patients and further 5 patients are independent. There were 14 deaths, in 7 patients due to postoperative vasospasm. Symptomatic ischaemia developed in 25 patients, however, in 15 of them it was fully reversible, due to the possibility of aggressive antivasospastic treatment (hypervolaemia, induced arterial hypertension). The relatively worse results were obtained in patients with chronic arterial hypertension.

Adolescent↗
PubMed1989

[Erdheim's tumors in adults--diagnosis, treatment and therapeutic results].

The authors present a group of 27 adult patients aged over 25 years treated in the Department of Neurosurgery, Medical Academy in Warsaw in the years 1960-1985 for Erdheim's tumours. In most cases the first signs were visual disturbances and signs of raised intracranial pressure, and in only 48% of cases endocrine disturbances were additionally found. The basic diagnostic method in these cases was computerized tomography which indicates precisely the location of the lesion, its consistency and width of ventricles. All patients were treated surgically, the operative surgery was 14.8%. The authors believe that surgical treatment followed by radiotherapy is the best method of management of such tumours in adults.

Adult↗
PubMed1980

[Microsurgical treatment of cerebral arteriovenous aneurysm].

The authors describe a group of 9 patients with arteriovenous malformations of the brain operated upon using the microsurgical technique and controlled arterial hypotension. In all cases the malformations were radically removed. In one patient the neck of a coexistent aneurysm of the pericallosal artery was clamped with a clip. Disability in one patient was the effect of haemorrhage, another patient with hemiparesis is being rehabilitated. The remaining patients are feeling well and in only one of them epileptic seizures remained after the operation, they had, been however, present before the operation. The use of the microsurgical technique makes possible reduction of the surgical trauma to the brain tissue and opens greater possibilities of intraoperative evaluation of radical performance of the operation.

Adolescent↗
PubMedDate not supplied

[A case of congenital fissure of C2 and C3 arches with compression of cervical spinal cord].

A 41-years old male patient is reported who had spastic paresis of all extremities, and evidence of peripheral motor neuron damage. He had been treated with steroids for 10 years after erroneous diagnosis of multiple sclerosis. The final diagnosis was a congenital fissure of C2 and C3 arches with spinal cord compression in cervical part. After operation some improvement of the neurological status was obtained.

Adult↗
PubMedDate not supplied

[Primary brain lymphomas].

In the Department of Neurosurgery of the Medical University of Warsaw 11 patients with primary central nervous system lymphomas were diagnosed and treated between 1990 and 1999. The patients comprised of 6 females and 5 males, aged 23 to 86 years, with most patients presenting in the sixth decade. The time from first symptoms to the diagnosis ranged from a few days to 5 months. In the majority of patients, the leading symptoms were: headaches, motor weakness, aphasia and memory disturbance. Initial diagnosis was based on MR in 3 patients, CT in 7 and on both CT and MR in 1 patient. The frontal lobe was the most common site of involvement. All the patients underwent surgery. The histological diagnosis was confirmed by immunohistochemical analysis using monoclonal antibodies: CD 20, CD3, CKMNF 116. In all cases, a B-cell type lymphoma was diagnosed. Radiotherapy was administered to 4 patients, 2 received chemotherapy and 1 received combined treatment. The median survival time so far is 17.6 months.

Adult↗
PubMedDate not supplied

[Arteriovenous malformations of the dura mater].

The authors present two cases of dural arteriovenous malformations treated in Dept. of Neurosurgery, Warsaw Medical School. The main clinical problems of this type of AVM are discussed.

Adult↗