Clinical Neuroscience

[Simultaneous occurrence of cavernous angioma and developental venous anomaly]

KUNCZ Ádám1, VÖRÖS Erika2, BODOSI Mihály3

MARCH 20, 1996

Clinical Neuroscience - 1996;49(03-04)

[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.]

AFFILIATIONS

  1. Szent-Györgyi Albert Orvostudományi Egyetem Idegsebészeti Klinika,
  2. Szent-Györgyi Albert Orvostudományi Egyetem Radiológiai Klinika
  3. Szent-Györgyi Albert Orvostudományi Egyetem Idegsebészeti Klinika

COMMENTS

0 comments

Further articles in this publication

Clinical Neuroscience

Clinical perspectives of the new, reversible and selective MAO-A inhibitors

VOLZ H P, GLEITER C H, MÖLLER H J

The classical monoamine oxidase inhibitors are used with great care due to their potency to induce severe side effects caused by tyramine interactions from food. With the advent of reversible and selective inhibitors of monoamine oxidase type A their interaction potential was considerably reduced. The first compounds are brofaromine and moclobemide, the latter already, registered for five years in Europe. The paper reviews the essential pharmacological properties of both compounds and gives a survey of the relevant clinical trials. Their efficacy in major depression is established. Regarding therapy resistant depressions, a certain advantage of brofaromine seems to exist. Promising trials in social phobia and panic attacks have been performed with both drugs.

Clinical Neuroscience

[Use of subdural stips in presurgical evaluation of epileptic patients]

HALÁSZ Péter, PAPP László, VAJDA János, SÓLYOM András, CZIRJÁK Sándor

[The subdural strip-electrode technique was introduced in the eighties in the USA. An account is given here of the first Hungarian experience with this method using implantates developed by us. The properties of the electrodes and the use of the technique are described under chronic and intraoperative conditions. In 8 patients the strips were used to localize the pacemaker zone of the seizures in those cases where the scalp EEG and neuroimaging data were discordant. Two temporal, 4 frontal and 2 parietal lobe epileptic patients were studied. Sixty-six seizures were recorded and on 15 occasions the strips were used for intraoperative corticography. The chronically implanted electrodes provided safe conditions for recording and by means of these we obtained additional information in all the cases studied thereby contributing to the indication of surgery or in the rejection of a surgical solution. The mobility and flexibility of the strips make them an ideal tool for corticography. With the strips the invasivity of presurgical evaluation was reduced.]

Clinical Neuroscience

[Dysfunctional personality attitudes and depression amng adolescents suffering from migraine-type headache]

CSORBA János, FARKAS Viktor, MIHÁDÁK Katalin

[Authors compared a clinical sample of adolescent migraine patients (n=28) aequal in age mean sex ratio with a group of healthy control adolescents (n=68) to demonstrate some differential psychological characteristics of adolescents suffering from migraine. The Dysfunctional Attitude Scale (Burns) and Beck's Depression Inventory were used. The patient sample achieved an increased scores on Approval, Entitlement and Omnipotence scales as well as the group showed a greater total means of the DAS scale, but an unexpectedly lower level of Depressivity has been proved in the clinical sample. Both DAS variables and BDI characterize the two groups better, than clinical features, but besides sufficient sensitivity only moderate specificity was managed to achieve on classification by means of discriminant analysis. Migraneous adolescents do not suffer from depressivity, only gradual differences between the two samples have been found.]

Clinical Neuroscience

[Multiple aspects study of short term memory performance in two diagnostic groups of epileptic patients]

BARCS Gábor, VITRAI József, HALÁSZ Péter

[The short term verbal and the visuo-spatial memory performance of 37 temporal lobe, 30 idiopathic generalized epileptic patients, and 24 normal control individuals were studied by interactive computerized tests. The short term visuo-spatial memory performance of epileptic patients was basically determined by the Raven IQ and strongly influenced by the seizure frequency and sustained attention while the verbal memory performance seemed to be independent of these parameters. The verbal memory performance of temporal lobe epileptic patients on carbamazepine monotherapy was lower compared to the idiopathic generalized epileptic patients on valproate monotherapy and to the normal controls. The difference between the performance of temporal lobe epileptic patients and normal controls was statistically significant. The memory performance in the group of temporal lobe epileptics proved to be independent of the laterality of the affected side. Concerning the short term visuo-spatial memory, after the factors having influence on the memory were ruled out, there was no difference between the controls and patients. Memory performance was not influenced by the duration of the illness nor by the type of antiepileptics used. In a treatment resistant group of idiopathic generalized epileptic patients, without considering other factors having influences on the memory, the visuo-spatial memory performance was even lower than the performance of the temporal lobe epileptic patients.]

Clinical Neuroscience

[Intracranial respiratory epithelial cysts: report of two cases]

VARGA Zs, VAJTAI I, BODOSI M, VÖRÖS E

[The authors report two cases of leptomeningeal cysts with unusual histologic features. Both cysts originated in the subarachnoid space of the left Sylvian fissure, being solitary in one case and multiocular in the other. Symptoms in both cases were referable to intracranial space occupation. Both lesions were resected surgically. Microscopically, the cyst walls were predominantly lined with pseudostratified and ciliated columnar or non-keratinizing squamous epithelium reminiscent of various segments of the respiratory mucosa. Ependymal covering was present only focally. The cellular elements displayed a characteristic immunophenotype and there was evidence for mucin production. Intracranial respiratory epithelial cysts are distinctly rare. While a dysontogenic origin is presumed for such cysts are distinctly rare. While a dysontogenic origin is persumed for such cysts along the spinal cord, intracranial occurrences are most plausibly interpreted as a result of metaplastic transformation of the meningeal anlage induced by cyst expansion. ]

All articles in the issue

Related contents

Clinical Neuroscience

[The role of MRI in measuring the effectivity of disease modifying treatments II]

KINCSES Zsigmond Tamás, TÓTH Eszter, FRICSKA-NAGY Zsanett, FÜVESI Judit, RAJDA Cecília, BENCSIK Krisztina, VÖRÖS Erika, CSOMOR Angéla, PALKÓ András, VÉCSEI László

[The paraclinical examinations, principally the MRI have an increasing significance in the diagnosis of multiple sclerosis. However, MRI markers also have a prominent role in monitoring of the disease-course and activity, and also in the planning of possible therapeutic changes. In accordance with previously published international guidelines, in this article we propose a protocol for the monitoring the treatment efficacy in multiple sclerosis. This could be the basis of a consensus based guideline to be implemented in Hungary.]

Clinical Neuroscience

Long-term follow-up results of concomitant chemoradiotherapy followed by adjuvant temozolomide therapy for glioblastoma multiforme patients. The importance of MRI information in survival: Single-center experience

LUKÁCS Gábor, TÓTH Zoltán, SIPOS Dávid, CSIMA Melinda, HADJIEV Janaki, BAJZIK Gábor, CSELIK Zsolt, SEMJÉN Dávid, REPA Imre, KOVÁCS Árpád

Introduction - Glioblastoma multiforme (GBM) is the most common malignant primary anomaly of central nervous system. The GBM infiltrates the nearly sturctures from the initial tumor and its metastatic attribution is well known. The aim of our single-centered retrospective study was to introduce the importance of postoperative medical imaging confirmation of total tumor resection for patient with GBM combined concomitant and adjuvant chemoradiotherapy on a 10 year long patient follow up. Methods - From January 2006 to April 2015 we registered 59 patients with newly diagnosed GBM at the University of Kaposvár Health Center Institute of Diagnostic Imaging and Radiation Oncology. The histological diagnosis was confirmed by a proficient neuropathologist (World Health Organisation WHO; grade IV astrocytoma). According to histological status if the ECOG performance status of patients allowed it the mutidisciplinary oncoteam recommended adjuvant chemoradiotherapy all features strictly by Stupp protocol. (60 Gy dose on the gross tumor volume and 2-3 cm margin for the clinical target volume with parallel 75 mg/m2 TMZ. Four weeks after monotherapial phase patients had to recieve 6 cycles of TMZ first cycle with 150 mg/m2 up to 200 mg/m2). The irradiation was carried out by a conformal three dimensional planning system. Results - 59 patients with the median age of 63 (range 17-84) year. Our sample counted 34 male patients and 25 woman patients. 14 patients underwent gross total tumor resection while, 39 patients underwent partial resection and the rest from our sample 6 patients passed through biopsy. Statistical analysis showed a lengthier survival among males than females, with a median survival of 13 months for males and females, the OS of 26.209 for males, meanwhile 15.625 for females. However, the difference is not considerable (log-rank p=0.203). Our study found that the estimated survival of patients at least 50 years old is significantly shorter at a median survival of 12 months (log rank p=0.027) than that of patients below 50 years of age at a median survival of 23 months. The longest estimated median survival was calculated with patients of ECOG '0' condition (16 months). However, no significant difference was found in the estimated survival of patients of different ECOG conditions (log-rank p=0.146). Based on the extent of surgery, complete resection resulted in the longest average survival of 36.4 months, followed by 21.5 months among patients with biopsy, and 15.8 months among patients with partial resection. Different surgical procedures, however, did not result in significant differences in survival (log-rank p=0.059). The overal survival of patients who had complete resection confirmed by MRI compared with the overal survival of patients with residual tumor confirmed by MRI as well we can estimate that there is significant difference between these two groups (p=0,004). Conclusion - Despite complex and intense treatment, recurrence is inevitable and causes relatively rapid death. In our analysis complete resection, as defined from the neurosurgeon’s report and postoperative MRI, resulted in an independently significant improvement in OS. Our results are the evidences that the treatment of patients with glioblastoma multiforme in Hungary is at least on the same level as any other developed European countries.

Clinical Neuroscience

[The role of MRI in measuring the effectivity of disease modifying treatments I]

TÓTH Eszter, BENCSIK Krisztina, VÖRÖS Erika, FRICSKA-NAGY Zsanett, FÜVESI Judit, RAJDA Cecília, CSOMOR Angéla, PALKÓ András, VÉCSEI László, KINCSES Zsigmond Tamás

[MRI has a significant role in the diagnosis of multiple sclerosis. The newer and newer treatment options of the disease make it necessary to monitor the effectiveness of the therapy. Besides the clinical signs (clinical relapses and progression), the different MRI parameters can also reflect the disease activity. In our current article we summarize those MRI markers, which best predict the long-term disability, based on the international standards.]

Clinical Neuroscience

Cerebral cavernous malformation type 1 with retinal blood vessel tortuosity and KRIT1 gene mutation

KALMÁR Tibor, MARÓTI Zoltán, VADVÁRI Árpád, HALMOSI Ágnes, KÁLOVITS Ferenc, KÁLMÁN Bernadette

Cerebral cavernous malformations (CCMs) represent a relatively rare and heterogeneous clinical entity with mutations identified in three genes. Both sporadic and familial forms have been reported. We present a young female patient with episodic paresthesia and headaches, but without acute neurological deficits. Her mother had a hemorrhaged cavernoma surgically removed 21 years ago. Cranial magnetic resonance imaging revealed multiple cavernous malformations in the size of a few millimeters and the ophthalmologic exam detected retinal blood vessel tortuosity in the proband. Targeted exome sequencing analysis identified a nonsense mutation in exon 16 of the KRIT1 gene, which resulted in a premature stop codon and a truncated protein underlying the abnormal development of cerebral and retinal blood vessels. This mutation with pathogenic significance has been reported before. Our case points to the importance of a thorough clinical and molecular work up despite the uncertain neurological complaints, since life style recommendations, imaging monitoring and genetic counseling may have major significance in the long term health of the patient.

Clinical Neuroscience

[Childhood sporadic type of hemiplegic migraine with arteria cerebri media hypoperfusion]

NAGY Csaba, BAJZIK Gábor, SKOBRÁK Andrea, CSORBA Eszter, LAJTAI Anikó, BALOGH Gábor, NAGY Ferenc, VAJDA Zsolt

[Hemiplegic migraine is a rare subtype of migraine that is associated with reversible motor weakness in the aura phase. This is an uncommon form of migraine usually starting in childhood. The purpose of this case report is to highlight the differential diagnostic difficulty of the first attack. We describe a case, where the fluctuating unilateral motor weakness and aphasia suggested that the patient had ischaemic stroke. Nevertheless the brain MRI and MR angiography, the measured 5-hydroxyindole acetic acid (5-HIAA) concentration changes and the spontaneously improving clinical status proved the diagnosis of hemiplegic migraine. The MRI and MR angiography was very beneficial in establishing the correct diagnosis in this case. To distinguish between the familiar and sporadic type of hemiplegic migraine further genetic tests can be carried out.]