Clinical Neuroscience

[Extra., intracranialis localised cavernosus haemangioma]

PÁSZTOR Emil1, SZABÓ Gyula1, SLOWIK Felicia1, ZOLTÁN János1

OCTOBER 01, 1963

Clinical Neuroscience - 1963;16(10)

[ In a 36-year-old female patient, multiple cavernous haemangiomas were detected and histologically verified in the right cheek, right os parietalera and right skull base. The case cannot be classified as a multiple haemangiomatous syndrome (Willis), the lesions are localized to the right external carotid artery system. Two years previously, plastic surgery of the right facial skin was performed and currently a large non-bony tumour extending from the base of the skull into the intracranial space has been removed. We discuss the pathological, angiographic and surgical indicative aspects of cavernous haemangiomas of the skull bone in our case. ]

AFFILIATIONS

  1. Országos Idegsebészeti Tudományos Intézet és Központi Honvéd Kórház

COMMENTS

0 comments

Further articles in this publication

Clinical Neuroscience

[Extracranial electrostimulation I. Effect of electrostimulation on the eeg]

HASZNOS Tivadar, FENYŐ Egon, ANTAL János

[The authors used electrodes placed on the scalp to stimulate the scalp partly locally and partly bitemporally with rectangular current pulses. Local stimulation was also performed with bipolar electrode placement. The frequency of stimulation was varied between 2/sec and 10 000/sec and the duration between 0.03 msec and 100 msec. The applied voltage was usually 30 V. The stimulation lasted for 30 or 60 seconds. EEG recording was performed immediately after the end of stimulation. The tests were performed on 18 patients. In patients with tumours, an increase in slow activity and focal excitatory signals were observed in response to local stimulation. In temporal epilepsy an increase in focal symptoms and in post-traumatic patients an increase in slow focal activation were observed. In patients with centrencephalic epilepsy with bitemporal stimulation, centrencephalic paroxysms were seen, and in temporal epilepsy, local slow and excitatory activation of signs. The authors hypothesize that local stimulation is primarily used to stimulate cortical and cortical proximal structures, whereas bitemporal electrostimulation seems to be a suitable technique for stimulation of the mesodiencephalon. ]

Clinical Neuroscience

[Relationships between EEG and motor responses in Evipan anaesthesia]

KAJTOR Ferenc, HALÁSZ Péter

[In humans, the more profound the anaesthesia, the more the "pure synchronisation" of the EEG responses to different peripheral stimuli becomes apparent. Biological signs of reduced sleep depth and pupil dilation are associated with a more sustained synchronisatio, which therefore corresponds to an "inverse" electrical manifestation of a coarse, limited arousal. However, as anaesthesia wears off, there is an increasing proportion of more rapid frequencies in the EEG responses. At first, desynchronised sleep stages appear in which the spontaneous EEG, bioelectrical and motor responses resemble the 1st (IV) stage of human spontaneous sleep and the "paradoxical" ("rhombencephalic") sleep stages of animals. The development of such "paradoxical" stages in humans is often facilitated by peripheral stimulus influx. Later on, bipartite (desynchronisatio + post-synchronisatio) responses are formed; the biological meaning and origin of "pure synchronisatio" and "post-synchronisatio" are not identical. The return of alert wakefulness occurs in the company of "pure desynchronisatio" responses. The generation of these response types is determined by states of functional disinhibition and restitution induced by anaesthesia, which reflect the relations of superiority and inferiority of dependence between reticular systems. The pupillomotor reactivity during barbiturate action is poor compared to the morphological sensitivity of the EEG; the synchronization induced by peripheral stimuli is accompanied by mydriasis, whereas the "paradoxical" phase is accompanied by miosis. The EDG is hyperactive during moderate barbiturate exposure but is rapidly extinguished by deepening anaesthesia; its return and increased excitability are linked to orientational responsiveness, minimal verbal contact ability and a phase of dual EEG responses.]

Clinical Neuroscience

[Constitution and Rules of the World Federation of Neurology (Fédération Mondiale de Neurologie). 1963. ]

[The author reports on the Constitution and Rules of the World Federation of Neurology (Fédération Mondiale de Neurologie). ]

All articles in the issue

Related contents

Clinical Neuroscience

How to manage MuSK antibody-positive myasthenic crisis during pregnancy?

ÇETİNER Mustafa , AKDAĞ Gönül , AKKOYUN ARIKAN Fatma, CANBAZ KABAY Sibel

Myasthenia gravis (MG) is an autoimmune disease that is characterised by the formation of antibodies against acetylcholine receptors in the postsynaptic membrane of the neuromuscular junction. The course of the disease cannot be predicted during pregnancy. A subtype of MG with positive muscle-specific receptor tyrosine kinase (anti-MuSK) antibodies exhibits more localised clinical characteristics and a poor response to treatment compared with the disease subtype that involves positivity for acetylcholine receptor antibodies. Myasthenic crisis is more frequently observed in anti-MuSK-positive myasthenia patients. Anti-MuSK-positive myasthenic crisis management is very difficult and a risky situation during pregnancy. The reported case was 30 years old, female, 9 weeks pregnant and musk antibody positive. She stopped her treatment without asking her doctor because she was planning pregnancy in the 6-month period before her hospitalization. She was intubated for a long time in the intensive care unit due to myasthenic crisis and was very resistant to treatment. During this period, her pregnancy was terminated due to fetal anomaly. Plasmapheresis, IVIg and immunosuppressive treatments were applied. Our patient was discharged after a period of about 10 weeks. We share our treatment management.

Clinical Neuroscience

[Prognostic significance of invasion in glioblastoma]

SZIVÓS László, VIRGA József, HORTOBÁGYI Tibor, ZAHUCZKY Gábor, URAY Iván, JENEI Adrienn, BOGNÁR László, ÁRKOSY Péter, KLEKNER Álmos

[Glioblastoma is the most common malignant CNS tumor, its surgical removal is hindered by the tumors invasive nature, while current anti-tumor therapies show limited effectiveness – mean overall survival is 16-24 months. Some patients show minimal response towards standard oncotherapy, however there are no routinely available prognostic and predictive markers in clinical practice to identify the background of mentioned differences in prognosis. This research aims to identify the prognostic significance of invasion-related extracellular (ECM) components. Patient groups with different prognoses were created (OS: group A <16 months, group B > 16 months), and internationally recognized prognostic markers (IDH1 mutation and MGMT promoter hyper-methylation) were tested in the flash-frozen tumor samples. Furthermore, the mRNA levels of 46 invasion-related ECM molecules were measured. Clinical data of the patients who have been operated on at the University of Debrecen Clinical Center Department of Neurosurgery and treated at the Department of Clinical Oncology showed no significant differences except for survival data (OS and PFS), and reoperation rate. All samples were IDH wild type. MGMT promoter hypermethylation rate showed significant differences (28.6% vs 68.8%). The expressional pattern of the invasion-related ECM molecules, i.e. the invasion spectrum also showed major differences, integrin β2, cadherin-12, FLT4/VEGFR-3 and versican molecules having signficantly different mRNA levels. The accuracy of the inivasion spectrum was tested by statistical classifier, 83.3% of the samples was sorted correctly, PPV was 0.93. The difference found in the reoperation rate when comparing different prognostic groups aligns with literature data. MGMG promoter region methylation data in Hungarian samples has not been published yet, and further confirming current knowledge urges the implementation of MGMT promoter analysis in clinical practice. Studying the invasion spectrum provides extra information on tumors, as a prognostic marker it helps recognizing more aggressive tumors, and calls attention to the necessity of using anti-invasive agents in GBM therapies in the future.]

Hypertension and nephrology

[Hypertension, cognitive function and dementia – Significance of antihypertensive therapy]

GAJDÁN Nikolett, ÁBRAHÁM György

[The significance of hypertension as one of the major cardiovascular risk factor is unquestionable. By achieving target blood pressure values differentiated by age and comorbidities, the risk of cardiovascular events can be significantly reduced. However, it is essential to the quality of life the patient spends the extra years of life thus gained. This is a really complex issue affecting many co-disciplines, but one of the most important of these is the mental health, maintaining cognitive functions, and avoiding dementia. High blood pressure impairs the blood supply to the target organs, including the brain, by damaging the smooth muscle of the arteries and accelerating atherosclerosis, which increases the risk, the frequency and the severity of mental decline in proportion to the degree of tension. This means serious implications not only for the individual, but for the family and the society, as well. A particular contradiction is that treating blood pressure to the target range does not automatically means preserving cognitive functions and avoiding the risk of dementia. Meta-analyzes of large studies have shown differences between the individual antihypertensive groups have been confirmed in this respect as well. Inhibitors of the renin-angiotensin system and calcium antagonists – mainly dihydropyridines – appear to be a priority in this regard. The authors provide an overview of the relationship between hypertension and mental abilities, with a review of the literature on the effects of antihypertensive therapy, with particular reference to the effects on cognitive function and dementia. ]

Clinical Neuroscience

[LADA type diabetes, celiac diasease, cerebellar ataxia and stiff person syndrome. A rare association of autoimmune disorders]

SOÓS Zsuzsanna, SALAMON Mónika, ERDEI Katalin, KASZÁS Nóra, FOLYOVICH András, SZŰCS Anna, BARCS Gábor, ARÁNYI Zsuzsanna, SKALICZKI József, VADASDI Károly, WINKLER Gábor

[Celiac disease - in its typical form - is a chronic immunemediated enteropathy with typical clinical symptoms that develops against gliadin content of cereal grains, and is often associated with other autoimmune diseases. In cases of atypical manifestation classic symptoms may be absent or mild, and extra-intestinal symptoms or associated syndromes dominate clinical picture. The authors present a longitudinal follow-up of such a case. A 63-years old woman was diagnosed with epilepsy at the age of 19, and with progressive limb ataxia at the age of 36, which was initially thought to be caused by cerebellar atrophy, later probably by stiff person syndrome. At the age 59, her diabetes mellitus manifested with type 2 diabetic phenotype, but based on GAD positivity later was reclassified as type 1 diabetes. Only the last check-up discovered the celiac disease, retrospectively explaining the entire disease course and neurological symptoms. By presenting this case, the authors would like to draw attention to the fact that one should think of the possibility of celiac disease when cerebellar ataxia, progressive neurological symptoms and diabetes are present at the same time. An early diagnosis may help to delay the progression of disease and help better treatment.]

Clinical Neuroscience

[Simultaneous occurrence of cavernous angioma and developental venous anomaly]

KUNCZ Ádám, VÖRÖS Erika, BODOSI Mihály

[The significance of the simultaneous occurrence of cavernous angioma and developmental venous anomaly, the diagnostic possibilities and the surgical treatment are discussed based upon three cases. Angiography and magnetic resonance imaging together are necessary to get an accurate diagnosis. According to the literature and to the fact that it is the cavernous angioma that mainly causes the symptoms, the cavernosus angioma should be resected, while the developmental venous anomaly should be spared.]