Neurologia medico-chirurgica
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Case ReportsMalignant transformation 20 years after partial removal of intracranial epidermoid cyst--case report.
A 74-year-old woman presented with malignant progression of remnant epidermoid cyst manifesting as sudden onset of right ptosis and double vision. She had right oculomotor nerve paresis. She had a history of surgery for right cerebellopontine angle epidermoid cyst 20 years previously. ⋯ She has been without tumor recurrence for 17 months. Malignant change of epidermoid cyst is extremely rare, but rapid progress of the symptoms suggests malignant transformation. MR imaging with gadolinium is useful for diagnosis.
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Case ReportsCavernous sinus cavernous hemangioma largely extending into the sella turcica and mimicking pituitary adenoma: case report.
A 77-year-old female presented with a rare cavernous sinus cavernous hemangioma with extension to the sella turcica, neuroradiologically mimicking nonfunctioning pituitary macroadenoma. The lesion was partially removed via transsphenoidal surgery, and the histological diagnosis was cavernous hemangioma. After stereotactic radiosurgery using a cyber knife, the lesion decreased in size. Stereotactic radiosurgery may be a good option for cavernous sinus cavernous hemangioma with high risk of surgical bleeding.
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Case ReportsOperative management of skull base malignant tumors arising from the nasal cavity and paranasal sinus: recent strategies used in 25 cases.
Cancers of the paranasal sinuses and nasal cavity are the most common malignant tumors of the anterior and anterolateral skull base. The treatment of these tumors affecting the skull base is complex due to the significant anatomical features. We examined 25 patients, 17 males and 8 females with mean age 61 +/- 2 years. ⋯ However, potential complications include cerebrospinal fluid leakage, meningitis, abscess formation, pneumocephalus, frontal brain contusion, trismus, and dysphagia as a functional complication. We believe that the optimal management of such malignant tumors involves a multimodal and multidisciplinary team approach. Here we present our recent institutional experience and treatment policy employed during the past 3 years.
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Case ReportsRecurrence of subarachnoid hemorrhage due to the rupture of cerebral aneurysms in a patient with Sjögren's syndrome. Case report.
A 52-year-old woman with Sjögren's syndrome presented with multiple cerebral aneurysms, which resulted in recurrent subarachnoid hemorrhage (SAH) manifesting as severe headache. Computed tomography (CT) showed SAH. Cerebral angiography revealed aneurysms of the anterior communicating artery and the left middle cerebral artery. ⋯ The internal carotid artery aneurysm was successfully treated with endovascular coil embolization. However, she regained no neurological function and died. Patients with Sjögren's syndrome may develop cerebral aneurysm complicated with SAH.
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Neurol. Med. Chir. (Tokyo) · Jan 2010
Case ReportsIntracerebral hemorrhage secondary to ventriculoperitoneal shunt insertion--four case reports.
Four patients presented with intracerebral hemorrhage secondary to ventriculoperitoneal (VP) shunt insertion. VP shunt insertion was performed for idiopathic normal-pressure hydrocephalus (Case 1), hydrocephalus after cerebellar hemorrhage (Case 2), and subarachnoid hemorrhage followed by meningitis (Cases 3 and 4). ⋯ The 7 previous and our 4 patients were divided according to early (within 2 days after shunt placement, n = 6, Group 1) and delayed (5-13 days post-shunting, n = 5, Group 2) hemorrhage. Bleeding was attributable to venous occlusion due to intraoperative manipulation in Group 1, and to the vulnerability of brain tissue induced by a primary brain disease in Group 2.