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Simian virus 40-related DNA sequences in a human brain tumor.

Papovaviruses can induce experimental brain neoplasms in animals, and some papovaviruses have been implicated in the formation of various human tumors. We examined a series of seven human brain tumors removed at craniotomy for the presence of viral DNA sequences by the technique of DNA-DNA hybridization. Simian virus 40 (SV40) DNA was labeled in vitro and used as a "probe" for detecting related DNA sequences in cellular DNA extracted from brain tumors. SV40-related DNA sequences were found in DNA extracted from one tumor, a glioblastoma multiforme. It was calculated that approximately 1.2 viral genome equivalents per diploid cell were present in the tumor. Since the rate of reassociation of the probe deviated from ideal second-order kinetics, it is surmised that either only a portion of the SV40 genome was present in tumor cells or, alternatively, that the probe detected a related human papovavirus.

Animals

Posterior fossa intra-axial tumors: a comparison of computed tomography with other imaging methods.

Fifty patients with posterior fossa intra-axial tumors were evaluated by computed tomography and the results compared with routine skull films, radionuclide brain scanning vertebral angiography, and cerebral air studies. The routine skull series was found to be of little benefit. Computed tomography was more sensitive than the radionuclide brain scan in detecting all of the lesions except astrocytoma, for which sensitivity was comparable. Angiography was the most sensitive means of detecting hemangioblastoma, and was the only reliable radiographic method of differentiating hemangioblastoma from astrocytoma. Cerebral air studies were the most sensitive and specific means of evaluating brainstem gliomas.

Adult

[Angiographic findings in 86 confirmed tumours of the posterior cranial fossa (author's transl)].

The accuracy of vertebral angiography in the diagnosis of tumours was reviewed on the basis 368 selective angiograms. The greatest accuracy was achieved with space-occupying lesions situated centrally in the cerebellum in the region of the fourth ventricle or in the vermis. However, tumours growing eccentrically, but arising in this region, were occasionally missed. Least reliable is the angiographic diagnosis of tumours is the cerebellar hemispheres. Of these, only about two-thirds could be demonstrated. Only 60% of cerebello-pontine tumours were diagnosed from displacement of various structures, another 10% by the presence of pathological vessels or tumour staining. The classic angiographic picture of pontine tumours is rare. Brain stem tumours are frequently eccentric and may simulate cerebello-pontine angle tumours. The demonstration or exclusion of brain stem involvement can be difficult. In view of the implications for treatment, this should, however, always be attempted.

Adolescent

Intracranial epidermoid tumor: discussion of four cases.

Four cases of intracranial epidermoid tumor are presented. These are uncommon tumors with no specific signs or symptoms, and their diagnosis depends upon a high index of suspicion. Computerized axial tomography (CAT scan) was helpful in diagnosing one of the cases described and undoubtedly will be instrumental in identifying future cases. Epidermoid tumors are biologically benign. They are often amenable to resection, and therefore tissue diagnosis before starting any therapy is important.

Adult

The tentorium in axial section. II. Lesion localization.

Most juxtatentorial lesions may be localized accurately on contrast-enhanced axial section CT scans by use of the opacified tentorial bands. Lesions that lie lateral edge of the diverging bands are supratentorial. Lesions that lie medial to the V-shaped tentorial bands are infratentorial and/or incisural. Flattening of the tentorial border of a lesion helps to identify its location. Use of the tentorial bands identifies transincisural extension of meningioma reliably, but does distinguish well between true transtentorial growth of meningioma and marked upward bulging of the tentorium from purely infratentorial meningioma.

Brain Neoplasms

Computerized axial tomography in the preoperative evaluation of posterior fossa tumors in children.

22 cases of pediatric posterior fossa tumors that underwent preoperative evaluation by computerized tomography are presented. 8 of the cases, in the latter part of the series, were successfully operated upon on the basis of computerized tomography alone. In 14 other cases, additional angiographic investigation was carried out. In only 1 case of multiple hemangioblastoma did angiography provide further significant information. On the basis of this experience, it is suggested that computerized tomography is usually sufficient and further contrast studies are unnecessary in the preoperative evaluation of pediatric posterior fossa tumors.

Adolescent

Brain tumor in newborn babies.

5 cases of brain tumor in newborn babies under 2 months are presented. 4 of them were supratentorial teratoma and originated from the midline, and 1 was a glioma at the cerebelloponitine angle. 2 cases died before surgery and 2 cases after surgery. In our 5th case a benign teratoma of 150 g was removed from the third ventricle. He was discharged and enjoyed rather good health for 2 years and 1 month before dying of recurrence of tumor. Internal hydrocephalus associated with the huge tumor was responsible for the sudden deterioration of general condition. Therefore, shunting procedures should be performed as the first aid. However, in our experiences, the conditions at admission were the critical and/or too late to be beneficial. Thus early diagnosis is absolutely necessary for surgical treatment. A summary and discussion of the data of 103 previously reported cases are included.

Brain Neoplasms

The results of operating upon cerebral aneurysms and angiomas in children and adolescents. II. Cerebral angiomas.

Symptomatic angiomas of the brain, brain stem or cerebellum are uncommon in all age groups. They usually present by subarachnoid and intraparenchymatous hemorrhage, but they may act as expanding mass lesions, as causes of ingavescent neurological deficit (?'steal phenomenon'), as epilepticogenic foci, or as a source of relentless headache. We have operated upon 20 patients, 18 years of age of less, with symptomatic angiomas. There has been no surgical mortality, and no patient has been made worse by operation.

Adolescent

Facial myokymia.

Facial myokymia is an uncommon form of dyskinesia, usually resulting from a lesion in the brain stem. The electromyogram is typical. A case is reported. The condition was due to an astrocytoma of the brain stem.

Adult

[Angiographic diagnosis of expanding processes in the posterior cranial fossa using a new topographic line].

The authors proposed a new rentgenometrie method allowing objective determination of the site of expanding lesions in the posterior cranial fossa. On the lateral angiograms of the vertebral arteries they determined the position of the choroid point of the posterior inferior cerebellar artery in relation to the line joining internal occipital protuberance with the upper ridge of acetabulum of the mandibular articulation. On the material of 50 subjects with expanding lesions of the posterior cranial fossa the authors determined interrelationship between the shift of the choroid point and the site of the lesion. They pointed out that the presented method can be of a considerable diagnostic value. In the presented material it allowed for the precise determination of localisation of the tumour in 86% of the cases.

Brain Neoplasms

[Clinico-angiographic diagnosis of space-occupying lesions of the posterior cranial fossa in children].

Superior cerebellar arteries raised above Lisholm's line is the most constant sign of a volume process in the posterior cerebral fossa. In tumors of the brain stem, the angiograms demonstrate hypertrophied arteries of the pons and changes in the position of initial segments of the upper cerebellar arteries. Tumors of the fourth ventricle in most cases cause displacement of the basilar artery to the front and the tonsillar segments of the inferior posterior cerebellar artery to the back and downward. In a lesion of the vermis of the cerebellum the artery and vein of the inferior vermis are considerably displaced to the back toward the occipital squama. Tumors of the cerebellar hemisphere may cause no changes in the position of the basilar artery in relation to Blumenbach's clivus. Displacement of the inferior posterior cerebellar artery beyond the midline indicates the side of the lesion. Demonstration of the vascular network of the tumor itself is the most important sign in topical diagnosis.

Angiography