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At least 397 records · Page 22Linked to original sources
PubMed1983

Auditory evoked cortical responses to frequency glides in subjects with retrocochlear hearing impairment.

Auditory cortical responses evoked by stimulation with frequency glides of a continuous tone have been recorded from 44 subjects with intracranial tumours affecting auditory function. Response latencies obtained when stimulating the ear on the side of the tumour were different from the non-tumour ear as well as from groups with cochlear impairment and normal hearing. Tumours caused a reduction of a specific sensitivity to the frequency glide stimulation, affecting further processing of the dynamic change in tone frequency. The test appears to have diagnostic potential.

Adolescent↗
PubMed1991

Extracranial metastases of medulloblastoma in adults: literature review.

A consecutive series of 30 cases of extracranial medulloblastoma metastases in adults is analysed. The majority of the patients were males with a 3:1 male/female ratio. Bone was the most frequent site of metastases in adults (77%) and children (78%), followed by lymph nodes (33%) in both children and adults. Lung metastases were more common in adults (17%), but liver metastases occurred more frequently in children (15%). Possible routes of spread and development of metastases are discussed, with special emphasis on the role of shunts in tumour seeding. Distant extracranial metastatic spread of medulloblastoma occurs at the rate of 7.1%. Mean interval between operation of the primary tumour and the discovery of metastases was shorter in children (20 months) than in adults (36 months). Survival after the discovery of metastases was also shorter in children (5 months) than in adults (9.5 months). Shunts were associated with an earlier appearance of metastases and with a poorer prognosis. A detailed review of the literature of 119 cases of medulloblastoma with extracranial metastases is provided.

Adult↗
PubMed1994

Saccadic dysmetria and "intact" smooth pursuit eye movements after bilateral deep cerebellar nuclei lesions.

Two patients with well defined lesions of midline cerebellar structures including the fastigial nuclei on both sides presented with saccadic hypermetria but well preserved smooth pursuit eye movements. This is a remarkable finding as the oculomotor vermis (lobules VI, VII) and the fastigial nucleus are known to play a part in the control of smooth pursuit eye movements and unilateral fastigial lesions lead to a smooth pursuit deficit to the contralateral side (besides saccadic dysmetria). The results are discussed with regard to related deficits seen in patients with Wallenberg's syndrome and after lesions of the pontine reticular formation.

Adult↗
PubMed1975

An approach to contrast enhancement in computed tomography of the brain.

A total of 450 brain examinations were performed using computed tomography before and after intravenous infusion of methylglucamine diatrizoate 30%. In 110 cases involving a documented intracranial lesion, the scans were analyzed to determine the degree and usefulness of contrast enhancement. Enhancement was achieved in a wide variety of neoplastic and non-neoplastic lesions and was found to be of considerable help in detection of abnormality as well as in defining tumor morphology.

Adenoma, Chromophobe↗
PubMed1977

Coronal computed tomography of the skull and brain in infants and children. Part II. Clinical value.

Coronal computed tomography is an important adjunct to the routine axial view in the evaluation of lesions of the skull and brain in infants and children. Of 400 axial scans performed over a four-mounth period, 50 were supplemented by coronal scans. Intracranial or cranial abnormalities were present in 39 (78%). Although the disadvantages of the coronal projection make it impractical as the only modality, when used as an adjunct to the axial view certain lesions of the skull and brain are diagnosed and delineated better.

Astrocytoma↗
PubMed1987

Cerebellopontine angle-petromastoid mass lesions: comparative study of diagnosis with MR imaging and CT.

Capabilities of computed tomography (CT) and magnetic resonance (MR) imaging in the diagnosis of cerebellopontine angle-petromastoid (CPA-PM) lesions were compared in 75 patients. CT and MR demonstrated 95.8% and 98.7% of the lesions, respectively. MR was often more helpful for characterization of neuromas, epidermoid cysts, exophytic gliomas, and vascular lesions, while CT was usually more informative for meningiomas, metastases, and tympanomastoid cholesteatomas. A specific diagnosis could be made with MR for most types of lesions through use of relaxation parameters and characteristic morphologic changes. Size, shape, location, and contour of the lesions, however, were generally more helpful for differential diagnosis than relaxation times. With the exception of metastatic lesions, cholesteatomas, and some meningiomas, MR was usually more helpful than CT in defining the full extent of the lesions and their relationships to contiguous structures. MR, because of its high accuracy in lesion detection, characterization, and localization, is a suitable primary diagnostic modality for evaluating patients with suspected CPA-PM lesions.

Brain↗
PubMed1993

Tumor vascularity in the brain: evaluation with dynamic susceptibility-contrast MR imaging.

PURPOSE: To evaluate the efficacy of dynamic susceptibility-contrast magnetic resonance (MR) imaging for diagnosis of intraaxial brain tumors. MATERIALS AND METHODS: Ten patients with such tumors (two hemangioblastomas, five low-grade astrocytomas, and three glioblastomas) underwent examination at 1.5 T. After bolus injection of 0.15 mmol/kg gadopentetate dimeglumine, gradient-echo MR images were obtained every 3.6 seconds for 90 seconds. Region-of-interest analyses were performed in all tumors. RESULTS: The greatest loss in signal intensity during the first pass of the contrast agent was seen in hemangioblastomas; low-grade astrocytomas had the least loss. The differences in integration of change in the T2* relaxation rate were significant among the three types of tumor (hemangioblastomas vs low-grade astrocytomas, P < .001; hemangioblastomas vs glioblastomas, P < .005; and glioblastomas vs low-grade astrocytomas, P < .02) and indicated differences in vascularity. CONCLUSION: Dynamic susceptibility-contrast MR imaging can provide useful hemodynamic information about intraaxial brain tumors that is not provided by standard MR imaging and therefore contributes to the differential diagnosis.

Adolescent↗
PubMed1996

Patterns of contrast enhancement in the pediatric spine at MR imaging with single- and triple-dose gadolinium.

PURPOSE: To assess patterns of nerve root and spinal cord contrast enhancement in the pediatric spine at magnetic resonance (MR) imaging with single- and triple-dose gadolinium. MATERIALS AND METHODS: In three control patients with no suspected pathologic spinal condition and 19 patients with a suspected condition, spinal cords were evaluated prospectively for potential spread of tumor to cerebrospinal fluid ("drop metastases") (n = 18) or Guillain-Barré syndrome (n = 1). After enhancement with 0.1 mmol/kg gadolinium, patients without definite drop metastases (n = 8) received a booster of 0.2 mmol/kg gadolinium 30-40 minutes later; clinical follow-up was obtained 12 1/2 to 19 months later. RESULTS: Drop metastases appeared as nodular areas of enhancement in 11 patients. Vascular enhancement related to the spinal cord surface and emerging nerve roots was observed in images obtained in all control patients, as well as in patients with negative findings at lumbar puncture and at clinical or MR imaging follow-up examination (n = 6). Vascular and nerve root enhancement increased with triple-dose gadolinium and was greater in patients after radiation therapy (n = 17) than in control patients (n = 3). CONCLUSION: Use of triple-dose gadolinium did not result in detection of additional cases of drop metastases.

Adolescent↗
PubMed2001

Malignant glioma as a secondary malignant neoplasm after radiation therapy for craniopharyngioma: report of a case and review of reported cases.

BACKGROUND: The development of a secondary neoplasm in childhood cancer survivors attains growing importance due to the reported excellent survival and therefore the long exposure to potentially carcinogenic effects of treatment. CASE REPORT: We report a 14-year-old girl in whom a large craniopharyngioma (CP) was diagnosed. After surgery, radiation therapy (RT) was given for residual tumour. Discrete progression necessitated further surgery, resulting in permanent tumour control. Soon after the second surgery hypothalamic-pituitary dysfunction developed together with obesity. Supportive hormone therapy was initiated. Growth hormone (GH) therapy was also given for 15 months. Four years after the diagnosis, a cerebropontine anaplastic astrocytoma WHO grade III was detected, with the main lesion being at the dorsal edge of the irradiated area. The girl died 1 month later from this secondary presumably radiation-induced tumour. Only recently a second child with RT for a CP was diagnosed with malignant glioma in our hospital. CASE REPORTS IN THE LITERATURE: 12 other cases of malignant glioma have been reported after RT for CP. Including our present cases, the mean latency period was 10.7 years (median 9.6 years). However, the shortest latency periods were found in patients who had received GH therapy. In numerous cases, the secondary tumour was seen at the edge of the irradiated volume, and not in the region with the highest absorbed dose. CONCLUSIONS: Therapy-induced secondary gliomas after treatment of CP or other intracranial tumours are rare but dramatic late events with a very poor prognosis. Including our own 2 patients, we reviewed 14 cases of CP with occurrence of a secondary, probably radiation-induced malignant glioma. The short latency periods for patients treated with GH is remarkable. We therefore suspect that GH therapy may accelerate the development of a secondary brain tumour. We are reluctant to recommend GH therapy in conventionally irradiated CP patients. In order to seriously answer the questions about therapy-induced secondary neoplasms, a life-long follow-up is mandatory for all patients who are survivors of childhood cancer.

Adolescent↗
PubMed2001

Surgical management of single and multiple brain metastases: results of a retrospective study.

BACKGROUND: Advancement in diagnosis and treatment of various cancer entities led to an increasing incidence of brain metastases in the last decades. Surgical excision of single and multiple brain metastases is one of the central treatment options beside radiotherapy, radiosurgery and chemotherapy. To evaluate the benefit of surgery with/without whole-brain radiation therapy (WBRT) in single brain metastases and the influence of image guidance for brain metastases resection, 104 patients were retrospectively evaluated for post-operative outcome. PATIENTS AND METHODS: Between January 1994 and December 1999 150 patients were surgically treated for brain metastases at the Department of Neurosurgery at the Technical University of Dresden. Outcome could be evaluated in 104 patients with respect to special treatment strategies and survival time (69 patients with single and 35 patients with multiple lesions). RESULTS: Most metastases originated from primary lung and breast tumours. Karnofsky performance score improved on average by 10 after surgery. The extent of the extracerebral tumour burden was the main influence on survival time. Patients' age below 70 years was combined with prolonged survival time (median survival time, MST: 4.5 months vs. 7 months). Patients with solitary cerebral metastasis had a MST of 16 months, whereas patients with singular lesions had a MST of 7 and 4 months, depending on the extent of the extracerebral tumour growth. Additional post-operative WBRT with 30 Gy was combined with an increase in MST in patients with single brain metastasis (surgery + WBRT: MST 13 months; surgery only: MST 8 months). In addition, the rate of recurrent cerebral tumour growth was distinctly higher in the non-WBRT group. Neuronavigation did not significantly improve post-operative survival time. In 80% of patients extracerebral tumour growth limited patients' survival. CONCLUSION: Surgery is an initial treatment option in patients with single and multiple brain metastases especially with large tumours (> 3 cm). Post-operative WBRT seems to prolong survival time in patients with single brain metastasis by decreasing local and distant tumour recurrence. Neuronavigational devices permit a targeted approach. Multiple processes can be extirpated in one session without prolonging the hospitalisation time for the patient. However, neuronavigational devices cannot assure complete tumour resection.

Aged↗
PubMed2006

Hypercalcaemia in relapsed medulloblastoma 8 years post-diagnosis; evidence to support PTHrP production by medulloblastoma cells.

BACKGROUND: A 19-year-old male presented with symptomatic hypercalcaemia as the first manifestation of relapsed metastatic medulloblastoma. Management at the time of the initial presentation 8 years earlier was with surgical excision and craniospinal radiotherapy. His biochemistry at the time of relapse and studies of medulloblastoma cell lines provide an insight into the pathogenesis of his hypercalcaemia. METHODS: Parathyroid hormone-related protein (PTHrP) was measured by immunoradiometric assay in blood, and in conditioned and control media from three medulloblastoma cell lines following 72 h growth. RESULTS: The histology at initial presentation (11 years of age) and at the time of relapse (with bone marrow infiltration and widespread bony metastases) demonstrated medulloblastoma. Ionised calcium concentrations at relapse were 2.89 mmol/l and serum PTHrP levels were increased at the same time (2.7 pmol/l; normal range: 0.7-1.8 pmol/l). There was evidence of PTHrP production by one cell line (MHH-MED-8A) while results for both other lines tested were below the limit of detection. CONCLUSIONS: Relapse 8 years after diagnosis is unusual in medulloblastoma and for this relapse to manifest as hypercalcaemia is also very uncommon. Our investigations suggest that the clinical picture was a reflection of PTHrP production by medulloblastoma cells.

Adolescent↗
PubMed1993

Long-term clinical effects of radiation therapy for primitive gliomas and medulloblastomas: a role for radiosurgery.

The effect of conventional irradiation on primitive gliomas and medulloblastomas was examined for 21 patients and a role for radiosurgery was evaluated. Five patients survived more than 8 years after treatment. However, side effects were recognized not only on neuronal and hormonal functions but also on neurovascular structures in the developing brain. The remaining patients died due to tumor recurrence, dissemination and/or metastases. Although these tumors were radioresponsive, conventional irradiation was inadequate in more than half the cases. A role for Gamma Knife radiosurgery should be considered, especially for young children and recurrences. Radiosurgery could also conceivably contribute to the prevention of tumor dissemination. In all events a multidisciplinary treatment should be considered.

Adolescent↗