Neurologia medico-chirurgica
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Neurol. Med. Chir. (Tokyo) · Sep 2009
Involvement of hypoxia-inducible factor-1alpha and vascular endothelial growth factor in the mechanism of development of chronic subdural hematoma.
Vascular endothelial growth factor (VEGF), a potent inducer of angiogenesis and vascular permeability in diverse physiological and pathological conditions, may be involved in the pathophysiology of chronic subdural hematoma (CSDH). The present study investigated the source and mechanisms for the induction of VEGF in CSDH by measuring the concentration of VEGF in the hematoma of 102 patients (122 hematomas) using the enzyme-linked immunosorbent assay technique. The relationship between the VEGF concentration in hematoma and the intrahematoma membranous structure confirmed by preoperative T(2)(*)-weighted magnetic resonance image was examined in 46 of these patients. ⋯ VEGF concentration in layered hematomas, which have intrahematoma membranous structure, was significantly higher than in non-layered hematomas (p < 0.01). Although MVDs of the outer membranes were comparable to those described in tumors, there was no significant relationship with VEGF expression. The present study suggests that VEGF in CSDH, which may be induced in the neomembrane by HIF-1 release, may give rise to the excessive development of fragile microvessels and hyperpermeability, resulting in the enlargement of CSDH.
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Neurol. Med. Chir. (Tokyo) · Sep 2009
Case ReportsProton magnetic resonance spectroscopy and diffusion-weighted imaging of tumefactive demyelinating plaque.
Proton magnetic resonance spectroscopy, diffusion-weighted axonography, and diffusion tensor tractography in a patient with tumefactive demyelination plaque (TDP) were evaluated for differential diagnosis from glioblastoma. The findings of glutamate and glutamine elevations on magnetic resonance spectroscopy and apparent tracts within the lesion on axonography and tractography were unlikely to represent glioblastoma, and were thus useful for the preoperative diagnosis of TDP.
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Neurol. Med. Chir. (Tokyo) · Sep 2009
Case ReportsSymptomatic syringomyelia associated with a dermoid tumor in the posterior fossa.
A 28-year-old female presented with a dermoid tumor in the posterior fossa associated with symptomatic syringomyelia. Magnetic resonance (MR) imaging revealed cervical syringomyelia and tonsillar herniation concomitant with an intradural posterior fossa tumor which was totally removed. ⋯ Benign congenital intracranial tumor may cause tonsillar herniation resulting in symptomatic cervical syringomyelia. However, both tonsillar herniation and cervical syrinx may clinically and radiologically resolve following removal of the intracranial lesion and posterior fossa decompression.