No abstract available.
Neurosurgery

No abstract available.
Agranulocytosis* ; Granulocytes* ; Humans

Thallium-201 brain SPECT is utilized in the diagnosis of brain tumor especially in cases where CT or MRI findings alone cannot differentiate malignant lesion from benign. Recently we came across two cases of positive T1-201 brain SPECT in clinically suspected brain tumor patients that turned out to be hemorrhagic cerebral infarction instead on biopsy. The findings in these cases demonstrate that thallium-201 accumulation may occur by the breakdown of the blood-brain barrier and phagocytic cell infiltration in the liquefaction stage of infarction.
Biopsy ; Blood-Brain Barrier ; Brain ; Brain Neoplasms ; Cerebral Infarction* ; Diagnosis ; Humans ; Infarction ; Magnetic Resonance Imaging ; Phagocytes ; Tomography, Emission-Computed, Single-Photon

An asymptomatic 26-year-old man was initially admitted with a suspicious mediastinal mass. On the basis of the contrast-enhanced chest CT findings, aneurysm formation involving the left cervical aortic arch associated with subaortic left innominate vein was diagnosed. The aneurysm was confirmed by MR angiography and DSA. The arch aneurysm was surgically removed. We describe this case, and review the literature.
Adult ; Aneurysm* ; Angiography ; Aorta, Thoracic* ; Brachiocephalic Veins* ; Humans ; Tomography, X-Ray Computed

The optimal management of uveal melanoma is still a matter of controversy. To determine the effect of Gamma Knife surgery on patients with uveal melanoma, the authors reviewed the outcome of five operations performed between September 1993 and August 1996. The mean age of the patients was 60.7(range 42 to 76) years; the median follow-up period was 10 months, and four patients were followed up for more than 6 months. The mean tumor volume was 3442mm3(mean diameter 15.3mm) and all patients were irradiated with a mean maximum dose of 74Gy (range 60-80Gy), using a 50% isodose on the tumor margin. In one patient, the tumor disappeared completely 32 months after Gamma Knife surgery; because the tumor did not regress, one patient subsequently required enucleation, and two remained stable. During a mean follow-up period of 10 months, vision was preserved in two patients, but one went blind; in one, enucleation was performed because the tumor did not regress. These results suggest that in cases of uveal melanoma Gamma Knife surgery can effectively control local tumors, can spare the eyeball, and may prevent loss of vision.
Follow-Up Studies ; Humans ; Melanoma* ; Tumor Burden

The incidence of metastasis to the spinal cord in patients with systemic carcinoma has been extimated to be 0.9 to 8.5%. Attempts to aggressively remove intramedullary spinal cord tumor may cause increased neurologic deficits and a worsend outcome. The authors present the case of a multiple intramedullary meetastatic spinal cord tumor which had metastasized from the lung to the thoracic spinal level. Pathologic diagnosis of the small cell carcinoma was made from the tumor specimen obtained by stereotaxic-guided neddle biopsy after which the patient was treated with radiotherapy and chemotherapy.
Biopsy ; Carcinoma, Small Cell* ; Diagnosis ; Drug Therapy ; Humans ; Incidence ; Lung ; Neoplasm Metastasis ; Neurologic Manifestations ; Radiotherapy ; Spinal Cord ; Spinal Cord Neoplasms

Thirty-two cases of surgically removed astrocytoma were evaluated for the expression of androgen receptors(ARs) immunohistochemically and the relationships between androgen receptors, DNA ploidy pattern, and survival of patients were studied. The cases included 18 grade I/II astrocytomas, 4 anaplastic astrocytomas, and 10 glioblastoma multiforme(GBM). Positive AR was present in 12 out of 32 cases(38%), which consisted of 5 cases in grade I/II(28%), 3 cases in anaplastic astrocytoma(75%), and 4 cases in GBM(40%). For both low and high grade astrocytomas, sex and ploidy pattern were not correlated with expression of the androgen receptors. Androgen receptor expression did not significantly affect the survival time. This study confirms previous reports of a low incidence of androgen receptors in astrocytomas. In addition, it shows that expression of androgen receptors is not correlated with DNA ploidy pattern and survival of patients in astrocytoma.
Adolescent ; Adult ; Aged ; Astrocytoma/*metabolism/pathology ; Brain Neoplasms/*metabolism/pathology ; Child ; Female ; Flow Cytometry ; Glioma/metabolism/pathology ; Human ; Male ; Middle Age ; Ploidies ; Receptors, Androgen/*biosynthesis/genetics ; Support, Non-U.S. Gov't ; Survival Analysis

Thirty-two cases of surgically removed astrocytoma were evaluated for the expression of androgen receptors(ARs) immunohistochemically and the relationships between androgen receptors, DNA ploidy pattern, and survival of patients were studied. The cases included 18 grade I/II astrocytomas, 4 anaplastic astrocytomas, and 10 glioblastoma multiforme(GBM). Positive AR was present in 12 out of 32 cases(38%), which consisted of 5 cases in grade I/II(28%), 3 cases in anaplastic astrocytoma(75%), and 4 cases in GBM(40%). For both low and high grade astrocytomas, sex and ploidy pattern were not correlated with expression of the androgen receptors. Androgen receptor expression did not significantly affect the survival time. This study confirms previous reports of a low incidence of androgen receptors in astrocytomas. In addition, it shows that expression of androgen receptors is not correlated with DNA ploidy pattern and survival of patients in astrocytoma.
Adolescent ; Adult ; Aged ; Astrocytoma/*metabolism/pathology ; Brain Neoplasms/*metabolism/pathology ; Child ; Female ; Flow Cytometry ; Glioma/metabolism/pathology ; Human ; Male ; Middle Age ; Ploidies ; Receptors, Androgen/*biosynthesis/genetics ; Support, Non-U.S. Gov't ; Survival Analysis

Due to the low response rate of antidepressant treatment in late-life depression, brain stimulation techniques should be considered when treating elderly patients. Electroconvulsive therapy (ECT) is one of the most frequently used brain stimulation techniques, and shows favorable outcome and acceptable tolerability in the treatment of late-life depression. Hemodynamic change and cognitive impairment are common side effects of ECT, which are transient in most cases. Since cognitive impairment can lead to treatment non-compliance, it should be minimized by controlling electrode position, pulse-width, treatment frequency, etc. Because ECT is followed by rapid cardiovascular change, risk factors should be evaluated and managed properly. Transcranial magnetic stimulation (TMS) and magnetic seizure therapy (MST) are also shown to be effective in treating depression, with less cognitive impairment. However, further research is needed to establish their efficacy in late-life depression.
Aged ; Brain* ; Depression* ; Electroconvulsive Therapy ; Electrodes ; Hemodynamics ; Humans ; Risk Factors ; Seizures ; Transcranial Magnetic Stimulation

Spontaneous regression of an intracranial lesion, as seen in sequential CT or MRI images, does not necessarily indicate a self-limiting process such as trauma or vascular disease. This report describes two cases of intracranial enhancing lesions which, on follow-up, showed complete resolution of the changes seen on MRI, without any treatment other than the administration of corticosteroid for a short period. We review several reports of "disappearing CT lesions", and discuss the possible mechanism of disappearance of intracranial lesions.
Follow-Up Studies ; Magnetic Resonance Imaging ; Vascular Diseases