Clinical Neuroscience

Epidermoid tumours of the posterior fossa

K. Bálint1, F. Slowik1, M. Kordás1, J. Juhász1, J. Julow2

MAY 20, 1994

Clinical Neuroscience - 1994;47(05-06)

In opposite of the benign biological behaviour of the posterior fossa epidermoids the operation of these tumours a great challenge for the surgeon both theoretical and surgical point of view. We analysed our 14 operated cases clinico pathologically in this retrospective study.

AFFILIATIONS

  1. National Institute of Neurosurgery, Budapest
  2. St. John's Hospital, Budapest

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Transoral and anterolateral surgery of the cervical spine in ventral extradural pathological processes

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This paper is a shortened version of an invited lecture given at the Karolinska Institute, Stockholm, on 17th September, 1993, illustrated with 120 slides.

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Correlation of clinical and molecular genetic findings in malignant brain stem tumors

V. K. Ammon, U. Sure, DN Louis, V. Deimling A.

Brain stem gliomas are rare, predominantly pediatric tumours. Histologically, they are comparable to adult supratentorial astrocytomas. Most of the pediatric brain stem tumours were classified as low-grade astrocytoma (WHO II), anaplastic astrocytoma (WHO III) or glioblastoma multiforme (GBM, WHO IV). Survival of patients with malignant brain stem gliomas as WHO grade III and IV rarely exceeds more than two years. Recently developed molecular genetic techniques gave new insights in tumour biology. Oncogenes and tumour suppressor genes are genetic alterations which can cause tumorous transformation and furthermore malignant progression. Molecular genetic studies of malignant brain stem gliomas have rarely been investigated. Therefore, we set out to study 12 such tumours clinically and 2 by molecular biological methods.

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Simultaneous occurence of unilateral multiplex meningiomas and syringomyelia

BÜKI András, MÉSZÁROS István, KÖVÉR Ferenc, KASÓ Gábor

Long lasting intracranial hypertension is considered to be a major pathogenic factor of syringomyelia in patients with a Chiari malformation or posterior fossa tumor.

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Different autoregulatory responses in the cerebellar cortex, neocortex and subcortical gray matter of the rat to systemic hypo- and hypertension

BALÁZS István, BARZÓ Pál, DÓCZI Tamás, PÓRSZÁSZ Róbert, SZOLCSÁNYI János

Cerebral autoregulation was investigated in the cerebral and cerebellar cortex, and subcortical gray matter (caudate nucleus) of the rat by means of Laser-Doppler flowmetry. As the vascular architecture of the basal ganglia, the cerebral cortex and the cerebellar cortex have substantial geometrical, onto genetical and pathological differences (3), we tested the working hypothesis that autoregulation of the blood supply to these areas may also be different. Laser-Doppler flowmetry has an ideal time resolution, and it enables analysis of flow-pressure curves (1, 2). The dependency of autoregulation on the rate of change in systemic blood pressure (SABP) in all three regions were confirmed. Control of CBF was significantly different in the subcortical gray matter and the neocortex. Interestingly, no autoregulatory capacity of the cerebellar vasculature was found.

Clinical Neuroscience

Cine brain MR examinations and its value in the analysis of pathology of the posterior fossa

BERÉNYI Ervin, MENDLY József, DÓCZI Tamás, KOPA János, REPA Imre

The study of motion of the central nervous system in the one of the most difficult problems in neuroradiology. Visualisation of brain parenchyma motions and cerebrospinal fluid flow is very important in understanding of normal cerebral physiology as well as pathological processes. Magnetic resonance imaging is the most available non-invasive method for investigation these motions taken as a function of heart cycle. In this lecture we would like to presentour resulto in developing sequences and to demonstrate the usefulness of CINE measurements in diagnostic work.

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[A case of destructive cervical spondylarthropathy related to chronic dialysis]

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[A case of a 61-year-old male patient suffered chronic renal failure and dialysed for 23 years with destructive cervical spondylarthropathy is presented. The patient presented with sudden onset of cervical pain radiating into his shoulders without neurological deficits. CT and MRI of the cervical and thoracic spine revealed severe destructive changes and compressive fractures of C6 and C7 vertebrae which caused the narrowing of the nerve root canals at these levels. A 360-degree fixation was performed to treat the unstable fracture and the patient’s pain (C6 and C7 corpectomy, autolog bone graft replacement of the two vertebral bodies, anterior plate fixation and posterior instrumentation with screws and rods). Postoperatively the patient had no significant pain, no neurological deficit and he was able to manage independent life himself. During the immediate follow-up CT of the neck showed the satisfactory position of the bone graft and the metal implantations. The 6 months follow-up CT revealed the anterior migration of the two screws from the Th1 vertebral body and 2 mm ventral elevation of the caudal end of the plate from the anterior surface of the Th1 vertebral body. The 1-year follow-up could not be performed because the patient died due to cardio-pulmonary insufficiency. This is the second Hungarian report of a chronic dialysis related severe spondylarthropathy which may cause pathologic fractures of the vertebral bodies. The typical radiological and histological findings are discussed. This disease affect patients’ quality of life and the conservative treatment alone seems to be ineffective in most cases. Based on the literature and personal experiences, the authors suggest 360-degree fixation of the spine to provide sufficient stability for the vertebrae of ”bad bone quality”, and early mobilisation of the patient can be achieved.]

Clinical Neuroscience

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Clinical Neuroscience

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