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 authors present a case of cervical syringomyelia associated with cerebellar mixed oligoastrocytoma in an 18-month-old boy who was normally delivered at full-term. The child presented with an increasing incidence of vomiting and irritability, and a poor truncal control. Preoperative magnetic resonance imaging of the brain revealed cerebellar vermian tumor with an obstructive hydrocephalus and a small-sized syringomyelia at the 6th cervical vertebral level. The tumor was completely removed via suboccipital craniectomy. Histologically, the tumor consisted of mixed oligo-astrocytoma. The cervical syringomyelia was conservatively managed with no specific operative treatment. At two months postoperatively, magnetic resonance imaging of the cervical spine showed a remarkable reduction in size of the syringomyelic cavity.
Astrocytoma ; Brain ; Cerebellar Neoplasms ; Child ; Humans ; Hydrocephalus ; Incidence ; Infant ; Magnetic Resonance Imaging ; Male ; Spine ; Syringomyelia* ; Vomiting

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

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

Of the many potential source of free radial generation, the enzyme xanthine oxidase has been shown to be important in ischemia in non-cerebral tissues. Oxygen-derived free radicals have been implicated in various pathological conditions including ischemia. Xanthine oxidase serve as a source of oxidizing agents such as superoxide radical and hydrogen peroxide. It is investigated that the effect of a specific xanthine oxidase inhibitor, allopurinol, on infarct size in a model of continuous partial cerebral ischemia in rats. Infarct volume was measured by triphenyl tetrazolium chloride staining of brains removed 24 hours after middle cerebral arterial occlusion. Cortical tissue was more effectively protected than basal tissue, especially in allopurinol pretreated group. On histological examinations, hemispheric swelling, PMN cell infiltration and endothelial damage were noted irrespective of allopurinol treatment. It was speculated that free radicals are important in infarction secondary to partial continuous cerebral ischemia and that xanthine oxidase may by the primary source of these radicals.
Allopurinol* ; Animals ; Brain Infarction* ; Brain Ischemia ; Brain* ; Free Radicals ; Hydrogen Peroxide ; Infarction ; Infarction, Middle Cerebral Artery* ; Ischemia ; Middle Cerebral Artery* ; Oxidants ; Rats ; Superoxides ; Xanthine Oxidase

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