PubMed · 301241
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M H Savitz, S S Katz, H Nakazawa. Acute cerebellar infarction producing brainstem compression.. https://pubmed.ncbi.nlm.nih.gov/301241/
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The authors report the case of a 14-month-old baby boy with an epidermoid cyst located entirely within the pons and medulla, without an exophytic component. The lesion was examined by computed tomography and magnetic resonance imaging. The child was operated upon three times after two recurrences of the lesion. A suboccipital, subtonsillar approach was used for the first and second procedures and a transtemporal approach for the last one. Excision was thought to be complete the first time, since a solid tumor was found and removed in a large cyst. The cyst wall was not identified. No tumor was found during the second procedure despite recurrence of the cyst, which was drained without an attempt to remove the cyst wall. Finally the cyst recurred with a large tumor in the cyst wall which was again totally removed. Consistent with the high mortality of brain stem epidermoid cysts in the literature, the child eventually died. The therapeutic problems, surgical options, and consequences are discussed.
To evaluate narcotic and nicotine effects on the neonatal auditory system, brain stem auditory evoked responses were recorded in 15 infants prenatally exposed to both narcotics and nicotine (median gestational age 38.4 weeks, median birth weight 2820 g), in 15 nicotine exposed infants (gestational age 40.0 weeks, birth weight 3000 g) and in 24 healthy term infants (gestational age 40.1 weeks, birth weight 3310 g) who served as controls. Whereas nicotine-exposed and control infants were similar in all brain stem auditory evoked response measurements, narcotic/nicotine infants had bilaterally increased wave V latencies (left: p = 0.005; right: p = 0.04) and I-V intervals (left: p = 0.02; right: p = 0.01) when compared to controls. Our findings suggest that prenatal narcotic but not nicotine exposure negatively affects maturation or integrity of the neonatal auditory brain stem tract and that neither narcotic nor nicotine exposure is associated with hearing loss in the neonate.
New radiofrequency lesion dorsal root entry zone (DREZ) electrodes for relief of facial pain were designed based on a neuroanatomic study in man of the trigeminal nucleus caudalis at the cervicomedullary junction. The human brainstems of 3 normal postmortem specimens were sectioned with measurements and relationships of the trigeminal nucleus caudalis, segmental tracts, spinocerebellar tracts and dorsal columns. Two right-angle DREZ electrodes were made by Radionics for producing DREZ lesions in the trigeminal nucleus caudalis to treat deafferentation facial pain.