Lege Artis Medicinae

[Tumour therapy with the tools of interventional radiology]

ENGLONER László

FEBRUARY 20, 2002

Lege Artis Medicinae - 2002;12(02)

[The author reviews the interventional radiological methods applicable in tumour therapy. The therapy of non-resectable primary and secondary liver tumours is discussed based on literature data and own experience. The possibilities of percutaneous tumour ablation are limited by the size and number of the tumours. Intra-arterial chemotherapy, chemoembolisation and feeding artery occlusion can be successful resulting in longer life and better quality of life in cases with advanced tumours. The results are better if these methods are combined with systemic chemotherapy.]

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[INTRODUCTION - The most common and most important cause of recurrent meningitis is bacterial infection. In the majority of cases, recurrent episodes of bacterial meningitis are associated with certain anatomical abnormalities that enable bacteria to penetrate subarachnoideal space. Nasal liquorrhoea can arise via traumatic or non-traumatic way. Non-traumatic nasal liquorrhoea with normal pressure is either of congenital origin or "idiopathic" and is frequently called spontaneous liquorrhoea. Spontaneous liquorrhoea is a rare entity making up 3-4 % of nasal liquorrhoea. CASE REPORT - The patient presented in this study was initially treated with purulent meningitis. A diagnosis of Streptococcus pneumoniae infection was established by bacterial culture tests. After being discharged, the patient was free from complaints for a considerable period of time. Her recurrent symptoms of a running nose were diagnosed later as allergic rhinitis at an ambulatory examination. A year later the patient was readmitted to hospital with bacterial meningitis. Due to the noticeable rhinorrhea on admission, the initially suspected liquorrhoea was confirmed by an otorhinolaryngological examination. A CT scan of the cranium verified external and internal pneumocephalus. Through a nuclear medicine examination a liquor fistula communicating with the sphenoidal sinus was diagnosed. After recovering from the meningitis caused by ascending bacterial infection the patient successfully underwent a neurosurgical operation for a reconstruction of the cerebral base via frontal craniotomy. CONCLUSION - With this case presentation we wish to bring attention to the rare disorder of spontaneous cerebrospinal fluid rhinorrhea when treating recurrent meningitis.]

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