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"CEPHALIC VEIN ANATOMY IN ANTECUBITAL FOSSA DURING THE CONSTRUCTION OF ARTERIOVENOUS FISTULA"  

Directory of Open Access Journals (Sweden)

Full Text Available In order to create an effective arteriovenous fistula (AVF) in patients with sustained chronic renal failure (CRF), surgeons need to become familiar with various anatomical variations of venous structures in the operating field. Because of variety and different types of cubital venous anatomies, there is more than a 90% possibility of creating suitable AVFs in the cubital fossa , but in the wrist and forearm, due to old injections and thrombophlebitis, there is less chance to do so. Since cephalic vein is the main venous conduit for constructing an AVF in the antecubital region, this study focuses on the various anatomical variations of cephalic vein and its communicating branches. We studied the cubital cephalic anatomy of 103 patients with CRF during construction of an AVF from July 1999 to June 2001. Five types of cephalic vein anatomy were seen: type A (44.66%), type B (30.1%), type C (18.44%), type D (3.88%) and type E (2.29%) in 39 right and 64 left arms. Seventy-six anastomoses were performed to brachial trunk, 25 to the radial and 2 to the ulnar artery. Eleven cases with progressive swelling after AVF were uneventfully cured by hand elevation. No infection, false aneurysm, venous hypertension or steal syndrome was detected. In order to obtain the best results and select appropriate operative technique for reliable vascular access in CRF, it is necessary to understand the anatomical variety of cephalic vein.

S. M. Alamshah

2004-01-01

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Physiologically based pharmacokinetic modeling of arterial – antecubital vein concentration difference  

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Full Text Available Abstract Background Modeling of pharmacokinetic parameters and pharmacodynamic actions requires knowledge of the arterial blood concentration. In most cases, experimental measurements are only available for a peripheral vein (usually antecubital) whose concentration may differ significantly from both arterial and central vein concentration. Methods A physiologically based pharmacokinetic (PBPK) model for the tissues drained by the antecubital vein (referred to as "arm") is developed. It is assumed that the "arm" is composed of tissues with identical properties (partition coefficient, blood flow/gm) as the whole body tissues plus a new "tissue" representing skin arteriovenous shunts. The antecubital vein concentration depends on the following parameters: the fraction of "arm" blood flow contributed by muscle, skin, adipose, connective tissue and arteriovenous shunts, and the flow per gram of the arteriovenous shunt. The value of these parameters was investigated using simultaneous experimental measurements of arterial and antecubital concentrations for eight solutes: ethanol, thiopental, 99Tcm-diethylene triamine pentaacetate (DTPA), ketamine, D2O, acetone, methylene chloride and toluene. A new procedure is described that can be used to determine the arterial concentration for an arbitrary solute by deconvolution of the antecubital concentration. These procedures are implemented in PKQuest, a general PBPK program that is freely distributed http://www.pkquest.com. Results One set of "standard arm" parameters provides an adequate description of the arterial/antecubital vein concentration for ethanol, DTPA, thiopental and ketamine. A significantly different set of "arm" parameters was required to describe the data for D2O, acetone, methylene chloride and toluene – probably because the "arm" is in a different physiological state. Conclusions Using the set of "standard arm" parameters, the antecubital vein concentration can be used to determine the whole body PBPK model parameters for an arbitrary solute without any additional adjustable parameters. Also, the antecubital vein concentration can be used to estimate the arterial concentration for an arbitrary input for solutes for which no arterial concentration data is available.

Levitt David G

2004-01-01

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Olmesartan: induced maculopapular rash.  

UK PubMed Central (United Kingdom)

Olmesartan medoxomil is an angiotensin receptor blocker (ARB) which is shown to be effective and well tolerated in hypertensive patients. It is a frequently prescribed antihypertensive as it is considered safe. Here, we report the case of a patient who developed maculopapular rash during the course of the treatment with olmesartan medoxomil.

Bhushan A; Ved Bhushan ST

2013-03-01

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Hot Tub Rash (Pseudomonas Folliculitis)  

Science.gov (United States)

newsletter | contact Share | Hot Tub Rash ( Pseudomonas Folliculitis) Information for adults A A A This image displays follicular elevations of the skin and small pus-filled lesions. Overview Hot tub rash ( Pseudomonas folliculitis) is an infection of ...

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A Desert Rash  

Directory of Open Access Journals (Sweden)

Full Text Available A 29-year-old man presented to the emergency department (ED) with a rash across his chest and abdomen. The rash began 2 hours before his arrival and was initially pruritic, but subsequently became painful. The patient also complained of acute onset of aching pain in both hips and his left arm. He denied associated chest pain or dyspnea, and had no paresthesias or disequilibrium. Routine laboratory studies and chest radiograph were normal. Earlier in the day, the patient had completed a dive to 235 feet in depth in Lake Mead, Nevada, but reported a very controlled ascent with appropriate decompression stops. Two days earlier, he had completed a dive to 315 feet in Lake Mead without any problems. [West J Emerg Med. 2011;12(4):563–564.

Bryan E Bledsoe; Matt Loptien; Ross P. Berkeley

2011-01-01

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Rash associated with dabigatran etexilate.  

UK PubMed Central (United Kingdom)

Patients experiencing atrial fibrillation are at an increased risk for thromboembolic events. Therefore, anticoagulation therapy is imperative to prevent thrombus formation and stroke. Dabigatran etexilate was approved by the Food and Drug Administration in 2010 as anticoagulant prophylaxis for patients with nonvalvular atrial fibrillation. The frequency of dermatologic reactions to dabigatran etexilate is estimated in the product labeling to be less than 0.1%. To date, five cases of dabigatran etexilate-associated rash have reported, including three published cases. We describe the sixth reported case of dabigatran etexilate-associated rash, in a 59-year-old man with a history of atrial fibrillation who received dabigatran etexilate 150 mg twice/day for atrial flutter before cardioversion. The patient had taken dabigatran etexilate for 5 days before the rash was noted on hospital admission. He had no known previous drug allergies, and his platelet count, serum creatinine concentration, and hepatic function were normal. The rash resolved 7 days after the discontinuation of dabigatran etexilate, and the patient was stabilized on warfarin therapy. Use of the Naranjo Adverse Drug Reaction Probability Scale indicated a probable relationship (score of 5) between the patient's development of the rash and dabigatran etexilate therapy. Clinicians should be aware of this adverse effect of dabigatran etexilate and monitor for dermatologic reactions during follow-up visits.

To K; Reynolds C; Spinler SA

2013-03-01

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Vena cava filter placement via the antecubital access: a report of 6 cases  

International Nuclear Information System (INIS)

[en] Objective: To study the methods and skill of vena cava filter placement via the antecubital access. Methods: Six patients with DVT (4 males and 2 females, mean age of 62) underwent vena cava filter placement via the antecubital access in Huashan Hospital from Oct. 2004 to May. 2006. The right basilic vein was punctured with the use of micropuncture technique. SNF(Simon nitinol filter, Bard)was inserted through its carrier into the 90-cm-long sheath. The filter was then deployed with a standard fashion in the IVC, 5 cm inferior to the renal vein. Results: The filter was once placed successfully in all six patients within average time of 25 min without complications, but with good healing, exclusion of bleeding and no phlebitis. The position of filter was accurate without deviation and no occurrence of pulmonary embolism. Conclusions: vena cava filter placement via antecubital access is easy, minimal invasive, no need of lying in bed postoperatively. It is beneficial for DVT patients as an alternative for the contra-indication to femoral venous access. (authors)

2008-01-01

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[A neonate with vesicopustular rash].  

UK PubMed Central (United Kingdom)

We present a neonate with transient neonatal pustular melanosis, a benign skin rash seen in 0.2-2.2% of white neonates and in 4-5% of black neonates. Vesicopustular lesions are present at birth, the lesions rupture in 24-48 hours leaving hyperpigmented macules. These slowly fade in 3-10 weeks.

van Delft R; Rosias PR

2012-01-01

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Posterior fossa epidural hematoma  

International Nuclear Information System (INIS)

[en] CT demonstrated posterior fossa epidural hematoma in three patients with head trauma in whom this diagnosis was not clinically apparent. No patient was in stupor or coma and no patient experienced a lucid interval. Only one patient had signs referable to the posterior fossa. Two patients had occipital skull fracture disclosed by plain radiographs. CT revealed a unilateral biconvex hematoma in two cases, and a bilateral hematoma with supratentorial extension in the third. All patients underwent suboccipital craniectomy and recovered. Therapeutic success in these cases was facilitated by early CT and the rapid disclosure of the unsuspected posterior fossa lesions. CT showing contiguous hematoma below and above the tentorium cerebelli after posterior head trauma is highly suggestive of epidural hematoma arising from the posterior fossa. (orig.)

1983-01-01

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Limb preservation and tumor control in the treatment of popliteal and antecubital soft tissue sarcomas.  

Science.gov (United States)

Soft tissue sarcomas of the antecubital and popliteal space often involve the neurovascular bundle and are prone to recurrence after surgical resection. Amputation has frequently been performed for control of these tumors. A multimodality treatment program consisting of limb-sparing resection, tumor-bed radiation using temporary iridium 192 implants, and adjuvant chemotherapy for high-grade lesions, has yielded satisfactory preservation of limb function and no local tumor recurrence in ten patients after a median follow-up time of 5 years. Eight of the ten patients are still alive, five of whom beyond 5 years; six of the eight survivors had high-grade tumors. These results are superior to those of 14 patients with similar tumors treated earlier by surgery alone: seven by amputation and seven by soft part resection; four of the latter resulted in local recurrence and all of the seven who had high-grade sarcoma died of disease. Multimodality treatment including limb-sparing resection merits consideration in the management of antecubital and popliteal soft tissue sarcomas. PMID:3948134

Shiu, M H; Collin, C; Hilaris, B S; Nori, D; Manolatos, S; Anderson, L L; Hajdu, S I; Lane, J M; Hopfan, S; Brennan, M F

1986-04-15

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[Comparison of the degree of right atrial opacification seen on intracardiac echocardiography following femoral or antecubital injection of saline contrast].  

UK PubMed Central (United Kingdom)

It is thought that femoral injection of agitated saline contrast is better for detecting patent foramen ovale than antecubital injection mainly because of the nature of intraatrial flow where the venae cavae enter the heart. Our aim was to investigate the effect of the contrast injection site on the degree of right atrial opacification seen on intracardiac echocardiography. The degree of right atrial opacification after each femoral or antecubital injection of saline contrast was scored from 0-4 in 21 patients. It was shown that the degree of right atrial opacification was greater after femoral than antecubital injection (3.76 vs. 1.62; P<.001). Future studies comparing the two routes of saline contrast injection should control for the degree of right atrial opacification.

Saura D; García-Alberola A; Florenciano R; de la Morena G; Sánchez-Muñoz JJ; Soria F; Redondo-Bermejo B; Valdés-Chávarri M

2007-06-01

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Tick bites and skin rashes.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: Fever and a rash following a tick bite can signify a true medical emergency. Ticks are important vectors of disease worldwide, including Rocky Mountain spotted fever, Lyme disease, and Congo-Crimean hemorrhagic fever. This paper will review the major ticks of medical importance and the diseases they transmit, including important emerging pathogens. RECENT FINDINGS: Rocky Mountain spotted fever continues to be the most lethal tick-borne illness in the United States and is emerging as an important disease in South America. Other important emerging diseases include human anaplasmosis, southern tick associated rash illness, human monocytic ehrlichiosis, and a variety of rickettsial fevers including those caused by Rickettsia parkeri and Rickettsia amblyommii. SUMMARY: Most tick-borne illnesses respond readily to doxycycline therapy. In the case of Rocky Mountain spotted fever, therapy should be started when the disease is suspected and should never be delayed for confirmatory tests. Accurate identification of tick vectors can help establish a diagnosis and can help guide preventive measures to reduce the burden of disease.

Elston DM

2010-04-01

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Drug Rash (Unclassified Drug Eruption) in Adults  

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newsletter | contact Share | Drug Eruption, Unclassified Information for adults A A A Acute drug eruption with numerous red, raised lesions. Overview A drug rash (drug eruption), also known as a drug ...

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Approach to the Diseases with Rash  

Directory of Open Access Journals (Sweden)

Full Text Available The differential diagnosis for febrile patients with a rash is extensive. Diseases that present with fever and rash are usually classified according to the morphology of the primary lesion. Rashes can be categorized as maculopapular and diffusely erythematous, vesiculobullous, purpuric, or petechial. A thorough history and a careful physical examination are essential to making a correct diagnosis. Certain exanthemas have fairly characteristic morphology, but in many cases an accurate diagnosis cannot be made on the basis of morphology alone. Historical factors may be helpful when evaluating these patients, specifically their disease contacts, immunization record, previous exanthematous illnesses, and associated prodromal symptoms. Although laboratory studies can be useful in confirming the diagnosis, test results often are not available immediately. Because the severity of these illnesses can vary from minor (roseola infantum) to life-threatening (meningococcemia), the physician must make prompt management decisions regarding empiric therapy.

Gönül Tan?r

2009-01-01

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Hematomas na fossa craniana posterior Haematomata in the posterior fossa  

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Full Text Available São relatados 6 casos de hematomas sub-tentorias (um de hematoma subdural crônico, quatro de hematomas intra-cerebelares, um de hematoma extra-dural). Salientando a pequena freqüência dos hematomas da fossa craniana posterior, o autor mostra a necessidade de vários exames complementares para o diagnóstico exato, indispensável para a aplicação de terapêutica cirúrgica adequada.Six cases of sub-tentorial haematomata (one chronic sub-dural, four intra-cerebellar, one extra-dural) are reported. Emphasizing the relative rarity of haematomata in the posterior cranial fossa, the author claims the necessity of complementary examinations for proper diagnosis, indispensable for adequate surgical treatment.

Mário S. Cademartori

1969-01-01

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Glioblastoma Located In Posterior Fossa  

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Full Text Available A 63-year-old woman operated eight months ago for glioblastoma (GB) located in posterior fossa was admitted to emergency room for stuporous, nausea, vomiting and headache. CT and MR showed recurrence of posterior fossa cysticnecrotic tumour without any other intracranial contrast enhancing lesion. Tumour was removed near totally. Perseverative cerebrospinal fluid (CSF) fistula from the incision was occurred and  contaminated by multidrug resistant Acinetobacter baumannii. Two months after the tumour removal she was expired because of the septicaemia. GB located in posterior fossa is uncommon in both adults and children;and it appears as two different subsets: de novo (primary type) and secondary  glioblastomas. Although our patient’s immunohistochemical findings werenot enough to demonstrate the tumour subset, we have thought that her tumour wasde novo because of no other brain involvement, staining with GFAP, vimentin, and  nearly absent p53 mutation.

Bulent Bakar

2013-01-01

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Shedding light on a painful rash.  

UK PubMed Central (United Kingdom)

We present a case of a rare inherited disorder--erythropoietic protoporphyria--with typical clinical manifestations. The diagnosis was suspected on the basis of a history of a light-sensitive rash and characteristic liver biopsy, and confirmed with genetic testing. The patient was followed up for more than 20 years, and ultimately developed the uncommon associated complication of liver cirrhosis. The clinical features, pathogenesis and management of erythropoietic protoporphyria are discussed herein.

Al-Judaibi B; Chakrabarti S; Chandok N

2013-06-01

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[Two cases of adult Still's disease with atypical rash  

UK PubMed Central (United Kingdom)

Adult Still's disease is a febrile disorder of unknown etiology, characterized by spiking fever, arthralgia, leukocytosis and a typical rash. However, most of these clinical findings, except for the typical rash, are not specific to this disease: therefore, the typical rash is the most important clinical finding for diagnosing this disease and physicians often have difficulty in making a definite diagnosis without the typical rash. In our department and related institutions, we have encountered 10 patients with Adult Still's disease who fulfilled the preliminary criteria for classification as Adult Still's disease, proposed by the Adult Still's Research Committee in Japan. The three major criteria are fever, arthralgia and typical rash, and 8 of 10 patients had an atypical rash; one satisfied two major criteria, and had an atypical rash and the other satisfied three major criteria and had an atypical rash on her eyelids. Here, we present the two cases of Adult Still's disease with atypical rash. The first patient was a 36-year-old male with an itchy annular erythema chronicum migrans, frequently seen inpatients with Lyme's disease, on his back. His clinical symptoms improved and the erythema disappeared after treatment with corticosteroids. The second patient, a 17-year-old female, had three major findings. In addition to the typical rash on her face, she had a heliotrope rash, usually seen in patients with dermatomyositis, on her eyelids. The typical rash on her face was related to her other clinical manifestations, and improved after treatment with corticosteroids. However, the rash on her eyelids showed no improvement after steroid therapy, suggesting that the erythema was probably not related to Adult Still's disease. Typical rash in Adult Still's disease, defined as a macular or maculopapular nonpruritic salmon pink eruption, was demonstrated to have the highest relative value associated with relatively high sensitivity and specificity for the diagnosis of Adult Still's disease. However, we have to be aware that some patients with Adult Still's disease could also have an atypical rash.

Saito A; Sato Y; Miyata M; Nishimaki T; Kasukawa R

1998-06-01

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Methylenetetrahydrofolate reductase (MTHFR) deficiency presenting as a rash.  

Science.gov (United States)

We report on the case of a 2-year-old girl recently diagnosed with Methylenetetrahydrofolate reductase (MTHFR) deficiency who originally presented in the neonatal period with a distinctive rash. At 11 weeks of age she developed seizures, she had acquired microcephaly and developmental delay. The rash deteriorated dramatically following commencement of phenobarbitone; both rash and seizures abated following empiric introduction of pyridoxine and folinic acid as treatment of possible vitamin responsive seizures. We postulate that phenobarbitone in combination with MTHFR deficiency may have caused her rash to deteriorate and subsequent folinic acid was helpful in treating the rash and preventing further acute neurological decline as commonly associated with this condition. PMID:22848014

Crushell, Ellen; O'Leary, Daire; Irvine, Alan D; O'Shea, Anne; Mayne, Philip D; Reardon, William

2012-07-27

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Methylenetetrahydrofolate reductase (MTHFR) deficiency presenting as a rash.  

UK PubMed Central (United Kingdom)

We report on the case of a 2-year-old girl recently diagnosed with Methylenetetrahydrofolate reductase (MTHFR) deficiency who originally presented in the neonatal period with a distinctive rash. At 11 weeks of age she developed seizures, she had acquired microcephaly and developmental delay. The rash deteriorated dramatically following commencement of phenobarbitone; both rash and seizures abated following empiric introduction of pyridoxine and folinic acid as treatment of possible vitamin responsive seizures. We postulate that phenobarbitone in combination with MTHFR deficiency may have caused her rash to deteriorate and subsequent folinic acid was helpful in treating the rash and preventing further acute neurological decline as commonly associated with this condition.

Crushell E; O'Leary D; Irvine AD; O'Shea A; Mayne PD; Reardon W

2012-09-01

 
 
 
 
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Leflunomide Induced Drug Rash And Hepatotoxicity  

Directory of Open Access Journals (Sweden)

Full Text Available A 57 year old female presented with generalized erythematous scay plaques of 11/2 months duration and jaundice since 1 month. She was on leflunomide since 3 months for chronic rheumatoid arthritis. Investigations revealed positive ANA, rheumatoid factor and negative anti-DsDNA. Bilirubin and liver enzymes were markedly raised. Viral markers were negative. Direct immunoflourescence did not show lupus band. A diagnosis of drug induced hepatitis and skin rash was made. She was treated with cholestyramine but she died after ten days of hospitalization.

Uppal Monica; Rai Reena; Srinivas C R

2004-01-01

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Pathology Case Study: Skin Rash and Proteinuria  

Science.gov (United States)

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 8-year-old boy has a history of skin rash with concurrent hematuria and proteinuria. Visitors are given the microscopic and gross descriptions, immunoflourescent and electron microscopy findings, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in renal pathology.

Horn, Kevin D.; Dickman, Paul S.

2007-09-19

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Hematomas na fossa craniana posterior/ Haematomata in the posterior fossa  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese São relatados 6 casos de hematomas sub-tentorias (um de hematoma subdural crônico, quatro de hematomas intra-cerebelares, um de hematoma extra-dural). Salientando a pequena freqüência dos hematomas da fossa craniana posterior, o autor mostra a necessidade de vários exames complementares para o diagnóstico exato, indispensável para a aplicação de terapêutica cirúrgica adequada. Abstract in english Six cases of sub-tentorial haematomata (one chronic sub-dural, four intra-cerebellar, one extra-dural) are reported. Emphasizing the relative rarity of haematomata in the posterior cranial fossa, the author claims the necessity of complementary examinations for proper diagnosis, indispensable for adequate surgical treatment.

Cademartori, Mário S.

1969-09-01

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Management of a widely disseminated skin rash.  

Science.gov (United States)

T.J.'s case was interesting from the standpoint of both diagnosis and management. The recommended treatment for this drug reaction was prednisone: however, the use of a steroid in a patient who is neutropenic and has a fever is risky because the because the steroid can mask the symptoms of infection (e.g., fever). Administration of prednisone did help, and the patient experienced a rapid resolution of the skin rash. T.J. will need to avoid the use of these antibiotic agents in the future. Because it is unknown which antibiotic, vancomycin or ceftazidime, caused the allergic reaction, both medicines should be avoided. The decision to rechallenge a patient with a specific drug must be made on an individual basis. Rechallenging of a drug in patients who have had urticarial, bullous, or erythema multiforme-like eruptions can be very dangerous (Padial et al., 2000). Pinpointing the cause of a skin rash can be puzzling. Always ask the patient "Do you take any medicine for any condition (including aspirin, laxatives, vitamins, etc.)? Have you received any shots any shots in the last month?" Keep in mind that any chemical that is ingested can cause a cutaneous drug eruption. PMID:11899630

Gallagher, E

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[Rash in primary Epstein-Barr virus infection].  

UK PubMed Central (United Kingdom)

INTRODUCTION: Rash can be one of the symptoms in acute infectious mononucleosis. According to the classical literature sources, drug-induced rash can be associated with synthetic penicillin and Epstein-Barr virus itself Nowadays, a lot of case reports point to the development of rash after the administration of other groups of antimicrobials. Clinical and laboratory signs and the administration of antimicrobials in acute Epstein-Barr virus infection have been correlaed with the development of rash. MATERIAL AND METHODS: This retrospective-prospective study (2007-2010) included 243 patients hospitalized for acute infectious mononucleosis at the Department for Infectious Diseases, Clinical Center of Vojvodina, of whom 51 had rash and 192 were without it. Epstein-Barr virus infection was confirmed by ELISA IgM EBV VCA in all patients. RESULTS: Student's t-test did not show a significant difference between the age, gender, duration of symptoms, leucocytes count, absolute lymphocytes count, alanine aminotransferase, aspartate aminotransferase among patients with or without rash. Chi2 test did not show a significant difference among the patients treated by synthetic or pure penicillin, macrolids and 1st and 2nd generation cephalosporins. However, if we compare all these antimicrobials, there is a significant difference between them and 3rd generation cephalosporins. Only two patients developed rash without antimicrobials. CONCLUSION: According to our results, rash developed independently of the clinical course of disease. Previous conclusion that synthetic penicillin produces rash seems to be not true, because there are many patients who were treated with them but did not develop rash. All antimicrobials can be associated with rash, but 3rd generation cephalosporins seem to produce rash less frequently than the others.

Lendak D; Mihajlovi? D; Turkulov V; Stefan Miki? S; Tomiç S

2012-03-01

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Rash in primary Epstein?Barr virus infection  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. Rash can be one of the symptoms in acute infectious mononucleosis. According to the classical literature sources, drug-induced rash can be associated with synthetic penicillin and Epstein-Barr virus itself. Nowadays, a lot of case reports point to the development of rash after the administration of other groups of antimicrobials. Clinical and laboratory signs and the administration of antimicrobials in acute Epstein-Barr virus infection have been correlaed with the development of rash. Material and Methods. This retrospective-prospective study (2007-2010) included 243 patients hospitalized for acute infectious mononucleosis at the Department for Infectious Diseases, Clinical Center of Vojvodina, of whom 51 had rash and 192 were without it. Epstein-Barr virus infection was confirmed by ELISA IgM EBVVCA in all patients. Results. Student’s t-test did not show a significant difference between the age, gender, duration of symptoms, leucocytes count, absolute lymphocytes count, alanine aminotransferase, aspartate aminotransferase among patients with or without rash. ?2 test did not show a significant difference among the patients treated by synthetic or pure penicillin, macrolids and 1st and 2nd generation cephalosporins. However, if we compare all these antimicrobials, there is a significant difference between them and 3rd generation cephalosporins. Only two patients developed rash without antimicrobials. Conclusion. According to our results, rash developed independently of the clinical course of disease. Previous conclusion that synthetic penicillin produces rash seems to be not true, because there are many patients who were treated with them but did not develop rash. All antimicrobials can be associated with rash, but 3rd generation cephalosporins seem to produce rash less frequently than the others.

Lendak Dajana; Mihajlovi? Dunja; Turkulov Vesna; Miki? Stefan Sandra; Tomi? Slavica

2012-01-01

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Late presentation of sorafenib-associated rash: a case report  

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Full Text Available Abstract Introduction Sorafenib, an oral multitargeted tyrosine kinase inhibitor, is licensed for the treatment of hepatocellular carcinoma. Rash is one of the most common side effects of its use, generally appearing within days to a few weeks of commencing treatment. We report the first case of rash appearing nine months after starting treatment with sorafenib. Case presentation A 75-year-old Caucasian man initially presented with asymptomatic transient jaundice. He was diagnosed with Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma after extensive investigation. He tolerated sorafenib 400 mg twice a day before presenting nine months later with a rash, confirmed to be drug-induced. Conclusions Sorafenib is a drug of choice in Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma. It can cause protracted rash quite late into treatment. Successful management of the rash could contribute to achieving stable disease in hepatocellular carcinoma over a significant period of time.

Sarkodie Thomas; Ross Paul

2010-01-01

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Internal antecubital fold line: A new useful anatomical repair to identify the medial epicondyle and avoid iatrogenic ulnar nerve injury in patients with supracondylar fracture of the humerus Línea del pliegue antecubital interno: Un nuevo reparo anatómico útil para identificar la epitróclea y evitar lesiones iatrogénicas del nervio ulnar en pacientes con fractura supracondílea del humero  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: The supracondylar fracture of the distal humerus is the most common pediatric fracture around the elbow. The currently accepted techniques of fixation are two lateral parallel wires , crosswiring technique from the lateral side, two divergent wires laterally and two retrograde crossed wires. The retrograde crossed wires provide the best mechanical stability. Many children with this fracture have swelling around the elbow, making difficult the feeling of the anatomic landmarks for percutaneous pinning, increasing the risk of ulnar nerve injury. Objective: To evaluate the correspondence of the internal antecubital fold line with the internal epicondyle in patients with supracondylar fracture and the incidence of iatrogenic ulnar nerve injuries . Methods: We conducted a series of clinical cases. In the first group we included 56 children with supracondylar fracture Gartland type III, from August 2000 to September 2007, who underwent closed reduction and crossed retrograde nail fixation. In the second group we included 241 (481 elbows) outpatients with no anatomic abnormality. We used the extension of antecubital fold line to find the internal epicondyle in both groups. Results: The prolongation of the antecubital fold line intersected the medial epicondyle in all participants of the first group. In 96.3% of the participants in the second group, the extension of antecubital fold line intersected the internal epicondyle. None patient had iatrogenic ulnar nerve injury. Conclusions: The use of the antecubital internal fold line may be useful to identify the internal epicondyle and thus avoid iatrogenic ulnar nerve injury. Salud UIS 2012; 44 (2): 9-14La fractura supracondílea del húmero distal es la más común alrededor del codo en niños. Las técnicas actualmente aceptadas de fijación son dos clavos laterales paralelos, dos clavos cruzados laterales, dos clavos laterales divergentes y dos clavos retrógrados cruzados. Los clavos retrógrados cruzados, proporcionan la mejor estabilidad mecánica. La mayoría de los niños con fractura supracondílea presentan inflamación alrededor del codo, haciendo difícil la palpación de la epítroclea, aumentando el riesgo de lesión del nervio cubital. Objetivo: evaluar la correspondencia de la línea del pliegue antecubital interno con la epitróclea en pacientes con fractura supracondílea y la incidencia de las lesiones iatrogénicas del nervio cubital. Metodología: Realizamos una serie de casos clínicos. El primer grupo incluyó 56 niños con fractura supracondílea tipo III de Gartland, entre agosto de 2000 a septiembre de 2007, tratados con reducción cerrada y fijación con clavos cruzados retrógrados. El segundo grupo incluyó 241 (481 codos) pacientes de consulta externa. En ambos grupos utilizamos la línea antecubital interna para identificar la epitróclea. Resultados: La prolongación de la línea del pliegue antecubital intersecó la epitróclea en todos los participantes del primer grupo. No hubo lesión iatrogénica del nervio cubital. En el segundo grupo la línea del pliegue antecubital intersecó la epitróclea en el 96.3% de los pacientes. Ningún paciente presentó lesión del nervio cubital. Conclusiones: La extensión de la línea de pliegue antecubital interno puede ser útil para la identificación de la epitróclea y así evitar lesiones iatrogénicas del nervio cubital. Salud UIS 2012; 44 (2): 9-14

Luis José Cespedes; Camilo Turriago; Jairo Goyeneche

2012-01-01

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Skin conditions: common skin rashes in infants.  

Science.gov (United States)

Infants exhibit many skin rashes. Erythema toxicum neonatorum presents as erythematous macules, papules, and pustules on the face, trunk, and extremities; it typically resolves spontaneously within 1 week. Neonatal acne presents as comedones or erythematous papules on the face, scalp, chest, and back. Infantile acne is similar but starts after the neonatal period. Both conditions typically resolve spontaneously; failure to resolve within 1 year warrants evaluation for androgen excess. Neonatal cephalic pustulosis is an acne variant caused by hypersensitivity to Malassezia furfur. It is typically self-limited, but severe cases are managed with topical ketoconazole. Miliaria and milia are caused by sweat retention and present as tiny vesicles or papules; they resolve spontaneously. Contact diaper dermatitis is managed by keeping the diaper area clean and with open air exposure. Diaper dermatitis due to Candida albicans is managed with topical antifungals. Seborrheic dermatitis causes scaling on the scalp. Management involves shampooing and removing scales with a soft brush after applying mineral oil or petrolatum; severe cases are managed with tar or ketoconazole shampoo. Atopic dermatitis is related to food allergy in approximately one-third of children. Food allergy can be confirmed with oral food challenges or skin prick tests. Management includes elimination of irritants and triggers and use of low-potency topical steroids. PMID:23600337

Zuniga, Ramiro; Nguyen, Tam

2013-04-01

30

Skin conditions: common skin rashes in infants.  

UK PubMed Central (United Kingdom)

Infants exhibit many skin rashes. Erythema toxicum neonatorum presents as erythematous macules, papules, and pustules on the face, trunk, and extremities; it typically resolves spontaneously within 1 week. Neonatal acne presents as comedones or erythematous papules on the face, scalp, chest, and back. Infantile acne is similar but starts after the neonatal period. Both conditions typically resolve spontaneously; failure to resolve within 1 year warrants evaluation for androgen excess. Neonatal cephalic pustulosis is an acne variant caused by hypersensitivity to Malassezia furfur. It is typically self-limited, but severe cases are managed with topical ketoconazole. Miliaria and milia are caused by sweat retention and present as tiny vesicles or papules; they resolve spontaneously. Contact diaper dermatitis is managed by keeping the diaper area clean and with open air exposure. Diaper dermatitis due to Candida albicans is managed with topical antifungals. Seborrheic dermatitis causes scaling on the scalp. Management involves shampooing and removing scales with a soft brush after applying mineral oil or petrolatum; severe cases are managed with tar or ketoconazole shampoo. Atopic dermatitis is related to food allergy in approximately one-third of children. Food allergy can be confirmed with oral food challenges or skin prick tests. Management includes elimination of irritants and triggers and use of low-potency topical steroids.

Zuniga R; Nguyen T

2013-04-01

31

[Effectiveness of steroids for the rash side effect of pemetrexed].  

UK PubMed Central (United Kingdom)

Rash is a common side effect of pemetrexed(PEM). In clinical trials overseas, patients were prescribed with dexamethasone(DEX), as a prevention against skin rash. Four mg of DEX was orally administered twice daily on the day prior to, day of,and day after the infusion of pemetrexed. The results showed suppression of the incidence and severity of rash. However, the dosage and period of medication was not fully verified. A recent survey was conducted retrospectively, with 81 patients who started PEM monotherapy from May 2009 to August 2010, to study the effectiveness of steroid rash prevention. The patients were classified into the non-administered group(47 patients), who were not given DEX, and the prophylaxis group(34 patients), who were given a median dose of DEX(2mg×3 days). The incidence of rash in the non-administered group was 36.2%, and 23.5% for the prophylaxis group. The severity of rash for the non-administered group was G1: 27.7%, G2: 8.5%; and for the prophylaxis group it was G1: 20.6%, G2: 2.9%. The incidence and severity of rash of the prophylaxis group was statistically and significantly lower than that of the non-administered group. This study shows that a small dosage of steroid is a possible precautionary or preventive measure for rash. Therefore, in order to reduce the incidence and severity of rash, a study with higher doses of medication similar to the clinical trials overseas should be conducted.

Ishikawa H; Onishi T; Kobayashi R; Ohashi Y; Suzuki K; Yamamoto N; Shino M

2013-01-01

32

Rash y anemia aplásica inducidos por fenitoína: caso clínico/ Phenytoin-induced rash and aplastic anemia: case report  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish El rash es un efecto secundario común asociado al uso de fármacos antiepilépticos. La frecuencia de rash con fenitoína se ha estimado en un 5,9% y asciende a un 25% en pacientes que han presentado rash con otro fármaco antiepiléptico. La anemia aplásica es una anomalía adquirida de las células madre hematopoyéticas caracterizada por pancitopenia de la sangre periférica y médula ósea hipocelular. Los pacientes tratados con fenitoína presentan un riesgo 3,5 ve (more) ces mayor de desarrollar anemia aplásica. Presentamos el caso de una mujer de 70 años que desarrolló dos reacciones adversas severas y simultáneas a la fenitoína: un exantema maculopapular pruriginoso con compromiso de mucosas y una anemia aplásica. Ambas condiciones se resolvieron completamente con la suspensión del fármaco. Abstract in english Rash is a common side effect associated with antiepileptic drugs. The rate of a phenytoin rash is 5.9% and increases to 25% in those with another antiepileptic drug rash. Aplastic anemia is an adquired hematopoietic stem-cell disorder characterized by pancytopenia of the peripheral blood and hypocellular bone marrow. The use of phenytoin is associated with a 3.5 fold increased risk of aplastic anemia. We report a case of a 70-year-old woman who developed two severe advers (more) e reactions simultaneously with phenytoin: a maculopapular pruritic rash with involvement of mucous and an aplastic anemia. Both conditions normalized after phenytoin withdrawal.

Soto V, Álvaro; Lavados M, Manuel; Araya D, Fernando

2011-01-01

33

Red, Itchy Rash? Get the Skinny on Dermatitis  

Science.gov (United States)

... review our exit disclaimer . Subscribe Red, Itchy Rash? Get the Skinny on Dermatitis You’ve probably had ... condition, the water-tight barrier between skin cells gets weak, which lets moisture out and other things ...

34

Are Homo sapiens nonsupranuchal fossa and neanderthal suprainiac fossa convergent traits?  

UK PubMed Central (United Kingdom)

The autapomorphic status of the Neanderthal suprainiac fossa was recently confirmed. This was a result of a detailed analysis of the internal bone composition in the area of the suprainiac depression on Neanderthal and Homo sapiens specimens. However, while anatomical differences between Neanderthal suprainiac fossa and the depression in the inion region of the occipital bone of fossil and recent Homo sapiens have been discussed in detail, the etiology of these structures has not been resolved. In this article, the hypothesis that the Homo sapiens non-supranuchal fossa and the Neanderthal suprainiac fossa both formed to maintain the optimal shape of the occipital plane (to minimize strain on the posterior cranial vault) is tested. First, the variation in the expression of the fossa above inion in the crania of recent Homo sapiens from European, African, and Australian samples was examined, and the degree of structural similarity between these depressions and the Neanderthal suprainiac fossa was assessed. Next, the relationship between the shape of the occipital squama in the midsagittal plane and two particular features (the degree of the occipital torus development and the occurrence of a depression in the inion region that is not the supranuchal fossa) were analyzed. Based on the results, it is suggested that the Homo sapiens non-supranuchal fossa and Neanderthal suprainiac fossa are convergent traits. Am J Phys Anthropol,2011. © 2010 Wiley-Liss, Inc.

Nowaczewska W

2010-12-01

35

Are Homo sapiens nonsupranuchal fossa and Neanderthal suprainiac fossa convergent traits?  

Science.gov (United States)

The autapomorphic status of the Neanderthal suprainiac fossa was recently confirmed. This was a result of a detailed analysis of the internal bone composition in the area of the suprainiac depression on Neanderthal and Homo sapiens specimens. However, while anatomical differences between Neanderthal suprainiac fossa and the depression in the inion region of the occipital bone of fossil and recent Homo sapiens have been discussed in detail, the etiology of these structures has not been resolved. In this article, the hypothesis that the Homo sapiens non-supranuchal fossa and the Neanderthal suprainiac fossa both formed to maintain the optimal shape of the occipital plane (to minimize strain on the posterior cranial vault) is tested. First, the variation in the expression of the fossa above inion in the crania of recent Homo sapiens from European, African, and Australian samples was examined, and the degree of structural similarity between these depressions and the Neanderthal suprainiac fossa was assessed. Next, the relationship between the shape of the occipital squama in the midsagittal plane and two particular features (the degree of the occipital torus development and the occurrence of a depression in the inion region that is not the supranuchal fossa) were analyzed. Based on the results, it is suggested that the Homo sapiens non-supranuchal fossa and Neanderthal suprainiac fossa are convergent traits. PMID:21404232

Nowaczewska, Wioletta

2010-12-23

36

Are Homo sapiens nonsupranuchal fossa and Neanderthal suprainiac fossa convergent traits?  

UK PubMed Central (United Kingdom)

The autapomorphic status of the Neanderthal suprainiac fossa was recently confirmed. This was a result of a detailed analysis of the internal bone composition in the area of the suprainiac depression on Neanderthal and Homo sapiens specimens. However, while anatomical differences between Neanderthal suprainiac fossa and the depression in the inion region of the occipital bone of fossil and recent Homo sapiens have been discussed in detail, the etiology of these structures has not been resolved. In this article, the hypothesis that the Homo sapiens non-supranuchal fossa and the Neanderthal suprainiac fossa both formed to maintain the optimal shape of the occipital plane (to minimize strain on the posterior cranial vault) is tested. First, the variation in the expression of the fossa above inion in the crania of recent Homo sapiens from European, African, and Australian samples was examined, and the degree of structural similarity between these depressions and the Neanderthal suprainiac fossa was assessed. Next, the relationship between the shape of the occipital squama in the midsagittal plane and two particular features (the degree of the occipital torus development and the occurrence of a depression in the inion region that is not the supranuchal fossa) were analyzed. Based on the results, it is suggested that the Homo sapiens non-supranuchal fossa and Neanderthal suprainiac fossa are convergent traits.

Nowaczewska W

2011-04-01

37

Cerebellar mutism following posterior fossa tumour surgery.  

Science.gov (United States)

Two cases of transient mutism following operative removal of cerebellar medulloblastoma are reported. These add to the few cases reported in the literature of this rare complication of posterior fossa tumour surgery in children. PMID:8861318

Jones, S; Kirollos, R W; Van Hille, P T

1996-04-01

38

Cerebellar mutism following posterior fossa tumour surgery.  

UK PubMed Central (United Kingdom)

Two cases of transient mutism following operative removal of cerebellar medulloblastoma are reported. These add to the few cases reported in the literature of this rare complication of posterior fossa tumour surgery in children.

Jones S; Kirollos RW; Van Hille PT

1996-04-01

39

Tuberculosis, fever and skin rash: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Hypersensitivity syndrome (HSS) reflects a serious hypersensitivity reaction to drugs, characterized by skin rash, fever, lymphadenopathy, and internal organ involvement. The pathogenesis of HSS is not known, but an immune mechanism is suspected. So far, numerous drugs such as sulfonamides, Phenobarbital, sulfasalazine, carbamazepine, and phenytoin have been reported to cause this syndrome. We report a case in a 12-year-old female patient who diagnosed HSS depend on anti-tuberculosis drugs. She developed fever, rash, and eosinophilia 15 days after antituberculosis treatment with isoniazid, rifampin, pyrazinamide, and ethambutol was initiated. The patient had significant resolution of her fevers and rash with steroid therapy and did not relapse after steroid was tapered. This experience illustrates the potential of anti-tuberculosis treatment to cause hypersensitivity syndrome, a situation that could be misdiagnosed as an infectious process.

Emre Dincer; Nazan Dalg?ç; Leyla Telhan; Yasemin Ceylan; Sarper ?ahin; Betül Diler

2009-01-01

40

Erlotinib-induced rash spares previously irradiated skin  

International Nuclear Information System (INIS)

[en] Erlotinib is an epidermal growth factor receptor inhibitor prescribed to patients with locally advanced or metastasized non-small cell lung carcinoma after failure of at least one earlier chemotherapy treatment. Approximately 75% of the patients treated with erlotinib develop acneiform skin rashes. A patient treated with erlotinib 3 months after finishing concomitant treatment with chemotherapy and radiotherapy for non-small cell lung cancer is presented. Unexpectedly, the part of the skin that had been included in his previously radiotherapy field was completely spared from the erlotinib-induced acneiform skin rash. The exact mechanism of erlotinib-induced rash sparing in previously irradiated skin is unclear. The underlying mechanism of this phenomenon needs to be explored further, because the number of patients being treated with a combination of both therapeutic modalities is increasing. The therapeutic effect of erlotinib in the area of the previously irradiated lesion should be assessed. (orig.)

2011-01-01

 
 
 
 
41

Outcome of resection of infratemporal fossa tumors.  

Science.gov (United States)

BACKGROUND: A variety of tumors arise in or extend to the infratemporal fossa. We investigated the outcome of surgical management of these tumors. METHODS: We conducted a retrospective review of a craniofacial approach to resection of infratemporal fossa tumors from 1992 to 2008 in a cancer center. RESULTS: Forty-three patients underwent resection of a infratemporal fossa tumors (68% men). Median age was 46 years (range, 1-81 years). The most common pathology was sarcoma (13; 30%). Twenty-two tumors (51%) were recurrent. Twenty patients (46%) underwent resection of tumors from the infratemporal fossa, 5 (12%) required resection of the anterior skull base, and 18 (42%) required orbital exenteration, additionally. Thirty-one patients (72%) required reconstruction with free tissue transfer. Twenty-seven patients (62.8%) required further treatment with radiation and/or chemotherapy. Complications occurred in 9 patients (21%). Six patients (14%) underwent salvage operations. Median follow-up was 24 months. Median overall survival and 3-year survival were 40 months and 59.6%. CONCLUSION: Tumors involving the infratemporal fossa can be resected with acceptable morbidity and long-term survival. © 2013 Wiley Periodicals, Inc. Head Neck, 2013. PMID:23322409

Givi, Babak; Liu, Jeffrey; Bilsky, Mark; Mehrara, Babak; Disa, Joseph; Pusic, Andrea; Cordeiro, Peter; Shah, Jatin P; Kraus, Dennis H

2013-01-16

42

Skin rash as early presentation of Guillain-Barré syndrome.  

Science.gov (United States)

We report an unusual case of Guillain-Barre syndrome in a 36-year old gentleman, diagnosed based on clinical presentation, CSF analysis and nerve study tests findings, who presented to our department for elective cystoscopy and discovered at the day of surgery to have macular skin rash over the trunk and upper limbs, surgery was postponed. Then and after 12 hours he started to develop the classical manifestations of Guillain-Barre syndrome. Asymptomatic skin rash should carefully be investigated as it could be an early presentation of a serious condition. PMID:23327042

Rabadi, Daher; Baker, Ahmad Abu; Greize, Ayman

2012-02-01

43

Skin rash as early presentation of Guillain-Barre syndrome.  

UK PubMed Central (United Kingdom)

We report an unusual case of Guillain-Barre syndrome in a 36-year old gentleman, diagnosed based on clinical presentation, CSF analysis and nerve study tests findings, who presented to our department for elective cystoscopy and discovered at the day of surgery to have macular skin rash over the trunk and upper limbs, surgery was postponed. Then and after 12 hours he started to develop the classical manifestations of Guillain-Barre syndrome. Asymptomatic skin rash should carefully be investigated as it could be an early presentation of a serious condition.

Rabadi D; Baker AA; Greize A

2012-02-01

44

Trochanteric fossa or piriform fossa of the femur: time for standardised terminology?  

UK PubMed Central (United Kingdom)

Piriform fossa, trochanteric fossa and greater trochanteric tip have each been described as entry points for antegrade femoral nailing. However, the terminology used for these entry points is confusing. The accuracy of the entry point nomenclature in published text and illustrations was recorded in this review study. The trochanteric fossa, a deep depression at the base of the femoral neck is indicated as 'piriform fossa' in the vast majority of the publications. Other publications indicate the insertion site of the tendon of the piriformis muscle on the greater trochanteric tip as 'piriform fossa'. As a result of recurrent terminology error and consistent reproductions of it, the recommended entry point in literature is confusing and seems to need standardisation. The piriform fossa does not appear to exist in the femoral region. The trochanteric fossa is the standard entry point which most surgeons recommend for facilitating a standard straight intramedullary nail, as is in line with the medullary canal. The greater trochanteric tip is the lateral entry point for intramedullary nails with a proximal lateral bend.

Ansari Moein CM; Gerrits PD; ten Duis HJ

2013-06-01

45

Trochanteric fossa or piriform fossa of the femur: time for standardised terminology?  

Science.gov (United States)

Piriform fossa, trochanteric fossa and greater trochanteric tip have each been described as entry points for antegrade femoral nailing. However, the terminology used for these entry points is confusing. The accuracy of the entry point nomenclature in published text and illustrations was recorded in this review study. The trochanteric fossa, a deep depression at the base of the femoral neck is indicated as 'piriform fossa' in the vast majority of the publications. Other publications indicate the insertion site of the tendon of the piriformis muscle on the greater trochanteric tip as 'piriform fossa'. As a result of recurrent terminology error and consistent reproductions of it, the recommended entry point in literature is confusing and seems to need standardisation. The piriform fossa does not appear to exist in the femoral region. The trochanteric fossa is the standard entry point which most surgeons recommend for facilitating a standard straight intramedullary nail, as is in line with the medullary canal. The greater trochanteric tip is the lateral entry point for intramedullary nails with a proximal lateral bend. PMID:23026115

Ansari Moein, C M S; Gerrits, P D; ten Duis, H J

2012-09-29

46

Decompressive Craniectomy in Posterior Fossa Ischemic Stroke  

Directory of Open Access Journals (Sweden)

Full Text Available Ischemic damage produced in the posterior cerebral territory causes significant morbidity and urgently must be considered if the patient need a surgical attitude. Surgical decompression by suboccipital craniectomy seams to be effective to treat secondary edema due to cerebellar damage or in posterior fossa, when medical treatment is not able to control side effects. We report a clinical case of a patient with a subacute ischemic infarction in the vertebro-basilar territory, with perilesional edema, and a posterior fossa decompressive craniectomy (DC) was carried out.

Luciano Santana-Cabrera; Guillermo Pérez-Acosta; Cristina Rodríguez-Escot; Rosa Lorenzo-Torrent; Manuel Sánchez-Palacios

2012-01-01

47

[Posterior fossa extradural and extracranial hydatid cyst].  

UK PubMed Central (United Kingdom)

Hydatidosis is an endemic disease in Morocco. Cerebral echinococcosis is a relatively rare entity accounting for only 1-2% of all hydatid cysts in humans. Extradural hydatid cyst of the posterior fossa is a very uncommon site for the disease: only four cases have been reported in the literature. We report the case of a 37-year-old admitted for high intracranial pressure. Brain MRI showed an extradural and extracranial posterior fossa cyst without enhancement after contrast medium injection. Multiple hydatid cysts were removed and the histological examination of the tissue sample confirmed the diagnosis. The patient was given albendazole postoperatively with good follow-up 6 months later.

Lakhdar F; Arkha Y; Bougrine M; Derraz S; El Ouahabi A; El Khamlichi A

2010-10-01

48

[Posterior fossa extradural and extracranial hydatid cyst].  

Science.gov (United States)

Hydatidosis is an endemic disease in Morocco. Cerebral echinococcosis is a relatively rare entity accounting for only 1-2% of all hydatid cysts in humans. Extradural hydatid cyst of the posterior fossa is a very uncommon site for the disease: only four cases have been reported in the literature. We report the case of a 37-year-old admitted for high intracranial pressure. Brain MRI showed an extradural and extracranial posterior fossa cyst without enhancement after contrast medium injection. Multiple hydatid cysts were removed and the histological examination of the tissue sample confirmed the diagnosis. The patient was given albendazole postoperatively with good follow-up 6 months later. PMID:20138319

Lakhdar, F; Arkha, Y; Bougrine, M; Derraz, S; El Ouahabi, A; El Khamlichi, A

2010-02-06

49

Cefditoren pivoxil associated rash and arthralgia in a child  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Cefditoren pivoxil is an oral antimicrobial used increasingly in pediatric bacterial infections. We report a case of rash and arthralgia following administration of cefditoren pivoxil for lower respiratory tract infection in a four-year-old female child. On discontinuation of the antibiotic, the chi...

Nandy, Manab; Mandal, Ananya; Tripathi, Santanu K.; Chakrabarti, Abhiram

50

Reduction in Incidence of Ampicillin Rash by Purification of Ampicillin  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Purification of ampicillin (Penbritin) with respect to protein impurities has been found significantly to reduce the incidence of rashes in treated patients. This may be related to findings in animals that injections of the isolated protein impurity can induce the formation of circulating IgG antibo...

Knudsen, E. T.; Dewdney, Janet M.; Trafford, J. A. P.

51

[Epidural hydatid cyst of the posterior fossa  

UK PubMed Central (United Kingdom)

We report a case of epidural hydatid cyst in the posterior fossa in a 5-year-old child. The disease was revealed by raised intracranial pressure with torticollis. The diagnosis was based on the brain CT scan and MRI, and confirmed surgically. The course was uneventful. Cranial epidural hydatid cysts are very rare: only 18 cases have been reported previously in the literature.

Gazzaz M; Bouyaakoub FA; Akhaddar A; Derraz S; Elkhamlichi A

2000-09-01

52

[Proliferating trichilemmal tumor of the ischiorectal fossa].  

UK PubMed Central (United Kingdom)

Proliferating trichilemmal tumor (PTT) is rare and follows a protracted course, almost always benign. Nevertheless an adverse outcome may occur. Usually PTT presents as an indolent mass in the scalp of elderly women. We report a case of PTT localized in the ischiorectal fossa, which might have been diagnosed as an epidermoid carcinoma.

Makhlouf Z; Verola O; Senejoux A; Duval A; Terris B; Balaton A; Molinie V

2011-08-01

53

[A woman with an itchy skin rash on her buttock].  

UK PubMed Central (United Kingdom)

A 24-year-old pregnant woman presented with a severely itchy skin rash on her left buttock after a journey to Thailand. The erythematous lesion appeared as 'cutaneous larva migrans', a skin disease in humans, caused by the larvae of various nematode parasites of the hookworm family (Ancylostomatidae). Due to her pregnancy, the patient was treated with local application of liquid nitrogen instead of oral anthelmintic therapy.

Grootjans-Geerts I; Arensman R

2012-01-01

54

Vermian agenesis without posterior fossa cyst  

Energy Technology Data Exchange (ETDEWEB)

We report 11 cases of vermian partial agenesis without posterior fossa cyst or hemispheric abnormalities. Characteristic MR signs were: absence of the posterior lobe, hypoplasia of the anterior lobe, a narrow sagittal cleft separating the hemispheres (``buttocks sign``) and fourth ventricle deformity. The main clinical signs were complex oculomotor dysfunction and developmental delay. None of the patients had respiratory symptoms. Consideration is given to the relationship between Joubert syndrome and this entity as well as to embroyological data. (orig.)

Adamsbaum, C. [Dept. of Pediatric Radiology, Saint Vincent de Paul Hospital, 75 Paris (France); Moreau, V. [Dept. of Pediatric Radiology, Saint Vincent de Paul Hospital, 75 Paris (France); Bulteau, C. [Dept. of Pediatric Neurology, Saint Vincent de Paul Hospital, 75 Paris (France); Burstyn, J. [Dept. of Pediatric Ophthalmology, Saint Vincent de Paul Hospital, 75 Paris (France); Lair Milan, F. [Dept. of Pediatric Radiology, Saint Vincent de Paul Hospital, 75 Paris (France); Kalifa, G. [Dept. of Pediatric Radiology, Saint Vincent de Paul Hospital, 75 Paris (France)

1994-12-01

55

[Epidural hydatid cyst of the posterior fossa].  

Science.gov (United States)

We report a case of epidural hydatid cyst in the posterior fossa in a 5-year-old child. The disease was revealed by raised intracranial pressure with torticollis. The diagnosis was based on the brain CT scan and MRI, and confirmed surgically. The course was uneventful. Cranial epidural hydatid cysts are very rare: only 18 cases have been reported previously in the literature. PMID:11015677

Gazzaz, M; Bouyaakoub, F A; Akhaddar, A; Derraz, S; Elkhamlichi, A

2000-09-01

56

Computed tomography of lacrimal fossa tumors  

Energy Technology Data Exchange (ETDEWEB)

The lacrimal fossa can be involved by a wide spectrum of orbital pathology. The correct diagnosis is important to avoid unnecessary procedure and to do appropriate management. 14 patients with mass lesions in the lacrimal fossa were evaluated with computed tomography (CT) and clinical findings. The results were as follows: 1. Final diagnosis of 14 cases with lacrimal fossa tumors was pleomorphic adenoma in 3 cases, adenoid cystic carcinoma in 1 case, pseudotumor in 5 cases, lymphoma in 2 cases, neurofibroma in 1 case, chloroma in 1 case and metastatic adenocarcinoma in 1 case. 2. The duration of symptoms of pleomorphic adenoma was more than 1 year and characteristic CT findings were globular masses with pressure erosion of the adjacent bone. Patient with adenoid cystic carcinoma had a short history of symptoms. CT showed a fusiform mass but intracranial extension with frank destruction of sphenoid bone. 3. Patients with pseudotumor and lymphoma had symptoms for less than 1 year. The CT findings were ill-defined infiltrative patterns with scleral thickening and the differential diagnosis of them was difficult. 4. The margins of neurofibroma and chloroma were well defined while that of the metastic adenocarcinoma was ill-defined. 5. The degree and the extent of the contrast enhancement gave no benefit in the differential diagnosis of each disease entities and even of the benign and malignant lesions.

Park, Chan Sup; Kim, Young Goo; Chang, Kee Hyun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1985-12-15

57

[Cochlear implantation through the middle fossa approach.  

UK PubMed Central (United Kingdom)

The inner part of cochlear implant is inserted into inner ear during surgery through mastoid and middle ear. It is a classical method, used in the majority cochlear centers in the world. This is not a suitable method in case of chronic otitis media and middle ear malformation. In these cases Colletti proposed the middle fossa approach and cochlear implant insertion omitting middle ear structures. In patient with bilateral chronic otitis media underwent a few ears operations without obtaining dry postoperative cavity. Cochlear implantation through the middle fossa approach was performed in this patient. The bone fenster was cut, temporal lobe was bent and petrosus pyramid upper surface was exposed. When the superficial petrosal greater nerve, facial nerve and arcuate eminence were localised, the cochlear was open in the basal turn and electrode were inserted. The patient achieves good results in the postoperative speech rehabilitation. It confirmed Colletti tesis that deeper electrode insertion in the cochlear implantation through the middle fossa approach enable use of low and middle frequencies, which are very important in speech understanding.

Szyfter W; Colletti V; Pruszewicz A; Kope? T; Szymiec E; Kawczy?ski M; Karlik M

2001-01-01

58

[Cochlear implantation through the middle fossa approach].  

Science.gov (United States)

The inner part of cochlear implant is inserted into inner ear during surgery through mastoid and middle ear. It is a classical method, used in the majority cochlear centers in the world. This is not a suitable method in case of chronic otitis media and middle ear malformation. In these cases Colletti proposed the middle fossa approach and cochlear implant insertion omitting middle ear structures. In patient with bilateral chronic otitis media underwent a few ears operations without obtaining dry postoperative cavity. Cochlear implantation through the middle fossa approach was performed in this patient. The bone fenster was cut, temporal lobe was bent and petrosus pyramid upper surface was exposed. When the superficial petrosal greater nerve, facial nerve and arcuate eminence were localised, the cochlear was open in the basal turn and electrode were inserted. The patient achieves good results in the postoperative speech rehabilitation. It confirmed Colletti tesis that deeper electrode insertion in the cochlear implantation through the middle fossa approach enable use of low and middle frequencies, which are very important in speech understanding. PMID:11766315

Szyfter, W; Colletti, V; Pruszewicz, A; Kope?, T; Szymiec, E; Kawczy?ski, M; Karlik, M

2001-01-01

59

Benign neurilemmoma in the infratemporal fossa involving maxillary sinus and pterygopalatine fossa  

International Nuclear Information System (INIS)

Neurilemmoma is a benign tumor of the nerve sheath that arises on cranial and spinal nerve roots as well as along the course of peripheral nerves. A case of a neurilemmoma that arose in the left infratemporal fossa of a 29- year-old male was presented. Plain radiographs, enhanced computed tomography scan, and magnetic resonance imaging demonstrated a large, well-circumscribed, heterogeneously enhanced mass with extension into the pterygopalatine fossa. Displaced by the large mass, bowing-in of the posterior maxillary antral wall was noted and a provisional diagnosis of a benign soft tissue tumor was made. The mass was completely excised and a diagnosis of neurilemmoma was confirmed.

2004-01-01

60

Nevirapine-induced rash with eosinophilia and systemic symptoms (DRESS).  

Science.gov (United States)

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is an adverse reaction commonly occurring with antiepileptic agents. It was earlier referred to by various names such as dilantin hypersensitivity syndrome and anticonvulsant hypersensitivity syndrome. It is characterized by the triad of fever, skin eruption, and systemic involvement. DRESS syndrome has also been reported with a number of other drugs including allopurinol, minocycline, terbinafine, sulfonamides, azathioprine, dapsone, and antiretroviral agents such as abacavir and nevirapine. We describe a rare case of nevirapine-induced hypersensitivity syndrome that was successfully treated with oral steroids. PMID:24014920

Gill, Shaman; Sagar, Amitabh; Shankar, S; Nair, Velu

2013-07-01

 
 
 
 
61

Nevirapine-induced rash with eosinophilia and systemic symptoms (DRESS).  

UK PubMed Central (United Kingdom)

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is an adverse reaction commonly occurring with antiepileptic agents. It was earlier referred to by various names such as dilantin hypersensitivity syndrome and anticonvulsant hypersensitivity syndrome. It is characterized by the triad of fever, skin eruption, and systemic involvement. DRESS syndrome has also been reported with a number of other drugs including allopurinol, minocycline, terbinafine, sulfonamides, azathioprine, dapsone, and antiretroviral agents such as abacavir and nevirapine. We describe a rare case of nevirapine-induced hypersensitivity syndrome that was successfully treated with oral steroids.

Gill S; Sagar A; Shankar S; Nair V

2013-07-01

62

Cerebellar mutism after posterior fossa surgery.  

UK PubMed Central (United Kingdom)

A large midline posterior fossa medulluloblastoma and a cerebellar arteriovenous malformation with associated clot were moved with postoperative mutism. Mutism was immediate and resolved into an ataxic dysarthria with residual mild dysarthria at 3 months. The literature is reviewed, and the clinicopathological and neurophysiological data of cerebellar function in speech are discussed. Acute injury to the midportion of the cerebellum with or without dentate nuclear involvement can cause a spectrum of speech disturbances. The more widespread the injury to the midportion of the cerebellum with dentate nuclei involvement the greater the risk of developing postoperative mutism.

Dietze DD Jr; Mickle JP

1991-01-01

63

SURGICAL TREATMENT OF POSTERIOR CEREBRAL FOSSA MENINGIOMA  

Directory of Open Access Journals (Sweden)

Full Text Available Difficulties of the treatment of posterior fossa meningioma are due to anatomical and physiological characteristics of these expansive intracranial processes. Location of the tumor dictates the neurological sacrifice for a proper approach and resection. Because the meningiomas are benign and have a slowly growth rate, the emergency surgery is not required. The treatment plan depends on age, on the general condition of the patient, on the size of tumor and neurological deficits. The actual tendency is to combine different therapeutic methods in order to obtain the best prognosis with minimum side effects.

M. A. El Husseini; N. Ianovici; M. Dabija

2010-01-01

64

[Candidiasis in children with diaper rash. Study of 140 cases  

UK PubMed Central (United Kingdom)

The frequency of genito-crural candidiasis in infants presenting diaper rash, as well as the possible influence of bacterial flora in this region on the pathogenicity of Candida was studied. Skin scraping were made with sterile swabs and processed by bacteriological and mycological methods in 140 children whose ages ranged between 0 and 20 months. The most commonly found microbiological flora were Candida spp (65.7%), non hemolytic Streptococcus (18.5%), Staphylococus epidermidis (19.2%); beta hemolytic Streptococcus (12.8%) and alfa-hemolytic Streptococcus (9.2%). Of the 140 cases, 76 (54.3%) showed candidiasis associated with diaper rash and 16 (11.4%) had Candida as normal flora. C. albicans was most frequently found (66.3%) followed by C. tropicalis (19.6%). Candidiasis was more frequent in those infants that had no other associated of pathogenic flora. Factors significantly influencing the increase in the frequency of candidiasis were: A) Evolution time, which was directly proportional; B) Use of cotton diapers covered with plastic pants; C) Feeding with cow's as opposed to maternal milk; and D) Malnutrition associated with poor hygiene.

López Martínez R; Ruiz-Maldonado R

1982-01-01

65

Allergic skin rash with lamotrigine and concomitant valproate therapy: evidence for an increased risk Rash cutâneo com lamotrigina e concomitante uso de valproato: evidências de maior risco  

Directory of Open Access Journals (Sweden)

Full Text Available Cutaneous rash is one of the commonest adverse events associated with lamotrigine. We assessed whether the risk is increased in patients receiving concomitant valproate therapy in a population of 103 adult patients with intractable epilepsy, who had lamotrigine added to their treatment. Of the 33 patients taking valproate, 10 (30%) developed a rash, whilst of the 70 not taking valproate, only 6 (8%) developed a rash. This suggests a significantly higher risk of cutaneous rash when starting lamotrigine in patients already taking valproate (pRash cutâneo é um dos efeitos adversos mais comuns associados ao início de tratamento com lamotrigina, uma nova medicação antiepiléptica. Avaliamos se esse risco é maior em pacientes medicados concomitantemente com valproato em 103 pacientes adultos com epilepsia refratária, que tiveram lamotrigina adicionada a seu tratamento. Dez dos 33 pacientes (30%) que faziam uso de valproato e 6 (8%) dos 70 pacientes que não usaram valproato desenvolveram rash. Isto sugere que existe maior risco de desenvolver rash cutâneo quando se adiciona lamotrigina em pacientes em uso de valproato (p<0,02).

L. M. Li; M. Russo; M. F. O'Donoghue; J. S. Duncan; J. W. A. S. Sander

1996-01-01

66

Allergic skin rash with lamotrigine and concomitant valproate therapy: evidence for an increased risk/ Rash cutâneo com lamotrigina e concomitante uso de valproato: evidências de maior risco  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Rash cutâneo é um dos efeitos adversos mais comuns associados ao início de tratamento com lamotrigina, uma nova medicação antiepiléptica. Avaliamos se esse risco é maior em pacientes medicados concomitantemente com valproato em 103 pacientes adultos com epilepsia refratária, que tiveram lamotrigina adicionada a seu tratamento. Dez dos 33 pacientes (30%) que faziam uso de valproato e 6 (8%) dos 70 pacientes que não usaram valproato desenvolveram rash. Isto sugere (more) que existe maior risco de desenvolver rash cutâneo quando se adiciona lamotrigina em pacientes em uso de valproato (p Abstract in english Cutaneous rash is one of the commonest adverse events associated with lamotrigine. We assessed whether the risk is increased in patients receiving concomitant valproate therapy in a population of 103 adult patients with intractable epilepsy, who had lamotrigine added to their treatment. Of the 33 patients taking valproate, 10 (30%) developed a rash, whilst of the 70 not taking valproate, only 6 (8%) developed a rash. This suggests a significantly higher risk of cutaneous rash when starting lamotrigine in patients already taking valproate (p

Li, L. M.; Russo, M.; O'Donoghue, M. F.; Duncan, J. S.; Sander, J. W. A. S.

1996-03-01

67

Posterior fossa involvement in a recurrent gliosarcoma.  

UK PubMed Central (United Kingdom)

Gliosarcoma (GSM) is a WHO grade 4 tumor and a variant of glioblastoma multiforme with predilection for the temporal lobe. We record, perhaps the first case in literature, of a temporal lobe GSM with recurrence involving the posterior fossa. A 50-year-old man presented to us with headache, vomiting, and lethargy of relatively recent onset. Magnetic resonance imaging revealed a well-circumscribed lesion in the left temporal lobe for which left temporal craniotomy with radical excision of the tumor was performed. Histopathology was suggestive of GSM. He presented to us within a month of the first surgery with a large recurrence involving the temporal lobe. He underwent a second surgery with radical excision of the tumor. Histopathology was confirmatory of GSM. He was administered concomitant chemotherapy and radiotherapy. Within a fortnight of starting adjuvant therapy, the bone flap started bulging and a repeat computed tomography scan revealed a large recurrence extending into the posterior fossa. The patient's relatives refused consent for third surgery and he finally succumbed on postoperative day 21. GSMs are aggressive tumors that have a temporal lobe predilection, but they may present anywhere in the brain. Detailed studies on larger cohort of cases are needed to understand the true nature of these biphasic tumors.

Balasubramaniam S; Tyagi DK; Sawant HV; Epari S

2012-01-01

68

Cerebellopontine angle facial schwannoma relapsing towards middle cranial fossa  

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Facial nerve schwannomas involving posterior and middle fossas are quite rare. Here, we report an unusual case of cerebellopontine angle facial schwannoma that involved the middle cranial fossa, two years after the first operation. A 53-year-old woman presented with a 3-year history of a progressive...

Takafumi Nishizaki; Norio Ikeda; Shigeki Nakano; Takanori Sakakura; Masaru Abiko; Tomomi Okamura

69

MANAGEMENT OF HYDROCEPHALUS IN POSTERIOR CRANIAL FOSSA TUMORS  

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Treatment of hydrocephalus in posterior fossa tumors in children is still a matter of controversy and different centers have their own routines. In this regard, hospital records of all children with posterior fossa tumors treated in our center during the interval of 1985-1995 were reviewed. Patients...

S. M. Abdollahzadeh-Hosseini; H. Rezaishiraz F. Allahdini

70

Tratamento cirúrgico da cisticircose da fossa craniana posterior/ Surgical treatment of cysticercosis in posterior cranial fossa  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A cisticercose, um dos mais sérios problemas parasitológicos do sistema nervoso, apresenta, quando localizada na fossa posterior, um quadro clínico dramático, no qual predomina a hipertensão intracraniana. Foram estudados neste trabalho, 70 pacientes com cisticercose de fossa craniana posterior, atendidos no Serviço de Neurocirurgia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo de 1945 a 1968. Considerando-se a grande diversidade e (more) xistente em torno das técnicas de tratamento cirúrgico, foi objetivo deste trabalho o estudo dos resultados obtidos nestes pacientes, nos quais várias técnicas foram empregadas. As cirurgias paliativas que derivam o trânsito do líquido cefalorraqueano para regiões extracranianas, quando comparadas aos outros tipos de cirurgias utilizados, foram as que proporcionaram maior índice de recuperação, exigiram menos reoperações, além de terem sido acompanhadas de menor número de complicações, bem como de menor mortalidade pós-operatória. Por outro lado, a neurocisticercose geralmente é um processo difuso, encontrando-se parasitas em várias regiões do encéfalo e/ou aracnoidite, conforme comprovou-se, também, entre os casos ora reunidos e que vieram a falecer. Baseando-se nestes fatos, não se justificam as derivações intracranianas e, a não ser eventualmente, a abordagem direta do parasita. Os casos estudados permitem cone- tatar, portanto, que as derivações extracranianas, por sua simplicidade e eficácia, apresentam-se, atualmente, como a terapêutica cirúrgica mais propriada à cisticercose de fossa craniana posterior. Abstract in english Cysticercosis is one of the most severe parasitic diseases of the nervous system. When located in the posterior fossa, it presents a dramatic picture of intracranial hypertension. Seventy patients of cysticercosis in posterior cranial fossa have been studied, all of them attended at the Neurosurgery Service of the University of São Paulo Medical School, from 1945 to 1968. Owing to the great differences in surgical procedures, it has been the objective of this work to stu (more) dy the results according to the technique employed. The palliative surgeries that deviate the flow of the cerebrospinal fluid to extracranial regions were the kind of surgery that gave a better rate of recovery, demanded less re-operations and caused not only a less amount of trouble, but also of pos-operative deaths. Neurocysticercosis is usually a spreading process, parasites being found in several regions of the brain. So, intracranial shunts cannot be justified, unless, sometimes, for the direct removal of the parasite. The cases studied allow us to state that extracranial shunts, by their simplicity and effectivenss are at present the most convenient surgical procedure in the treatment of cysticercosis of the posterior cranial fossa.

Lopes, Pedro Garcia

1971-03-01

71

Rash decisions-dermatological manifestations preceding a progressive neurological syndrome.  

Science.gov (United States)

We describe the case of a 72 year old woman who presented with sequential cranial nerve palsies preceded by irritation, pain and a vesicular rash in the sensory distributions of the affected nerves. She had signs and symptoms suggestive of aphagia and Ramsey-Hunt syndrome. Further vesicular eruptions roughly obeying dermatomal boundaries on the limbs and trunk were observed. She was initially thought to have disseminated VZV/HZV infection and was commenced on IV aciclovir. Investigations seeking evidence for viral particles in skin lesions and CSF, and for evidence of immunosuppression or malignancy, were all negative. Between days 35 and 40 she developed hypertension, seizures, a left facial nerve palsy and encephalopathy. This was complicated by a pneumonia requiring invasive ventilation on intensive care. She developed an itchy maculopapular rash with vesiculation of all four limbs. On day 66 she developed truncal and limb rigidity, which became extreme over two weeks, and was associated with pyramidal weakness. The rash was biopsied demonstrating a leucocytoclastic vasculitis. At the nadir of her illness she was encephalopathic, tracheostomy-and NG feeding-dependent, quadriparetic and bedbound due to severe rigidity (leading rapidly to Achilles tendon contractures). She was found to be glycine receptor (GlyR) antibody positive, without antibodies against amphiphysin or GAD65. She was initially treated with a combination of corticosteroids and intravenous immunoglobulin (IVIG), resulting in resolution of her cranial nerve palsies, and a reduction in her rigidity and rash. Imaging using CT, PET, USS and mammography was undertaken to exclude malignancy-associated antibody production. MRI imaging of the brain and spinal cord was essentially normal. CSF analysis demonstrated only the presence of intrathecal IgG synthesis. Her treatment and rehabilitation continues. This case adds to the small number of reports in the literature of a Stiff Person Syndrome (SPS) plus syndrome considered to be caused by antibodies directed against the extracellular GlyR target on the synaptic neuronal surface.(1 2) Our case demonstrates further clinical variability within this unusual disorder. The GlyR is expressed in skin, and the presence of zoster-like dermatological lesions may provide a clinical clue as to the underlying aetiology in similar cases. Many of the features seen in this case have been previously described, however in this case the features emerged sequentially with rigidity, the cardinal feature of this group of diseases, emerging last. The clinical manifestations of the cases of GlyR antibody associated SPS plus disease described, closely resemble the clinical manifestations of genetic mutations of GlyR subunits and associated proteins, and of poisoning with the GlyR antagonist strychnine. This adds to the evidence that these antibodies play a direct role in the pathogenesis of disease, and that the use of immunosuppressive treatment is justified. Indeed our patient has made a substantial recovery with aggressive immunotherapy. To date no associated malignancy has been associated with GlyR antibody-mediated SPS plus disease, and our case supports these findings. PMID:24109022

Doherty, Gary; Vincent, Angela; Cox, Amanda

2013-11-01

72

Endoscopic third ventriculostomy and posterior fossa tumors.  

UK PubMed Central (United Kingdom)

BACKGROUND: The management of hydrocephalus associated with a posterior fossa tumor is debated. Some authors emphasize the advantages of an immediate tumor removal that may normalize the cerebrospinal fluid (CSF) dynamics. However, in clinical practice, the mere excision of the lesion has been demonstrated to be accompanied by a persisting hydrocephalus in about one third of the cases. Preoperative endoscopic third ventriculostomy (ETV) offers several advantages. It may control the intracranial pressure (ICP), avoid the necessity of an emergency procedure, allow appropriate scheduling of the operation for tumor removal, and eliminate the risks related to the presence of an external drainage. The procedure also reduces the incidence of postoperative hydrocephalus. A final advantage, more difficult to weight, but obvious to the neurosurgeon, is the possibility to remove the lesion with a relaxed brain and normal ICP. In the postoperative phase, ETV can be used in case of persisting hydrocephalus, both in patients who underwent only the excision of the tumor and in those whose preoperative ETV failed as a consequence of intraventricular bleeding with secondary closure of the stoma (redoETV). The main advantage of postoperative ETV is that the procedure is carried out only in case of persisting hydrocephalus; its use is consequently more selective than preoperative ETV. The disadvantage consists in the common use of an external CSF drainage in the first few postoperative days, which is necessary to control the pressure and for ruling out those cases that reach a spontaneous cure of the hydrocephalus. METHODS: The authors review the criteria for patient selection and the results of ETV performed in case of hydrocephalus secondary to a posterior fossa tumor. RESULTS AND CONCLUSIONS: Preoperative ETV constitutes an effective procedure for controlling the hydrocephalus associated with posterior fossa tumors. It might lower the rate of persistent postoperative hydrocephalus and result in a short hospital stay. Low rates of patients requiring an extrathecal-CSF shunt device are also reported by authors who utilize ETV postoperatively. As, however, the assessment of the persistent hydrocephalus in these children is based on prolonged ICP monitoring through an external CSF drainage, their results are weighted by a major risk of infective complications and longer hospital stay.

Di Rocco F; Jucá CE; Zerah M; Sainte-Rose C

2013-02-01

73

Cerebellar mutism after posterior cranial fossa surgery.  

Science.gov (United States)

Mutism is a rare sequel of PCF tumor removal. Three patients aged 5 to 20 years old with mutism after posterior fossa surgery are presented. Suboccipital craniectomy was performed in all patients with grossly total removal of a medulloblastoma. The mutism that may occur after an operation for a PCF lesion has been explained in functional and/or organic terms. To date, 24 similar cases of mutism following cerebellar operations have been reported in the literature. We review the features of the syndrome in the light of the published cases and speculate on the underlying physiopathology. The absence of long tract or other brain stem signs, together with a presence of dysarthria during the recovery of speech, suggested a organic cerebellar cause of the mutism. PMID:8913962

Salvati, M; Cervoni, L; Santoro, A

1996-03-01

74

Cerebellar mutism after posterior cranial fossa surgery.  

UK PubMed Central (United Kingdom)

Mutism is a rare sequel of PCF tumor removal. Three patients aged 5 to 20 years old with mutism after posterior fossa surgery are presented. Suboccipital craniectomy was performed in all patients with grossly total removal of a medulloblastoma. The mutism that may occur after an operation for a PCF lesion has been explained in functional and/or organic terms. To date, 24 similar cases of mutism following cerebellar operations have been reported in the literature. We review the features of the syndrome in the light of the published cases and speculate on the underlying physiopathology. The absence of long tract or other brain stem signs, together with a presence of dysarthria during the recovery of speech, suggested a organic cerebellar cause of the mutism.

Salvati M; Cervoni L; Santoro A

1996-03-01

75

CT scanning in middle fossa arachnoid malformations.  

UK PubMed Central (United Kingdom)

The typical appearances of middle foss arachnoid malformations as seen by computed tomography, are presented in six cases out of 3700 unselected CT scans performed in the last two years. These lesions have well-defined borders, the anterior border often conforming to the configuration of the greater sphenoid wing, and the posterior border merging into the Sylvian fissure medially. They exhibit the same attenuation coefficients as cerebrospinal fluid (CSF), in the range of 0 to +8 EMI units. Their size is variable. They produce less mass effect than might be expected, even when their size is considerable. Their appearance does not change after infusion of contrast material. Although arachnoid malformations occur in many intracranial sites, the site of predilection appears to be the middle cranial fossa. The clinical presentation and subsequent management of the six cases is briefly described. The pathogenesis and common clincial presentation associated with these lesions is discussed.

Smith RJ; Zacks DJ

1978-03-01

76

Comparative results of infratemporal fossa approach with or without facial nerve rerouting in jugular fossa tumors.  

UK PubMed Central (United Kingdom)

Jugular fossa tumors are uncommon diseases. During the surgery and due to the interposition of the facial nerve in the tumor approach, the facial nerve must be elevated from the fallopian canal and placed permanently into an anterior position. Although this maneuver provides a wide exposure, most of the patients suffer a long-term total or partial facial palsy. The purpose of this article is to check whether the infratemporal fossa approach without transposition of the facial nerve is equivalent to the approach with rerouting of the facial nerve regarding postsurgical morbidity. The clinical records of 52 patients who underwent an infratemporal fossa approach were reviewed in which 34 patients were segregated into two comparable groups regarding the presence or absence of transposition of the facial nerve. There were 19 women and 15 males. The majority of the patients (73 %) had jugular paragangliomas. The mean follow-up of the full series was 66 months. It was statistically significant that the worst facial nerve function at hospital discharge was in the patients who underwent facial nerve transposition (p = 0.001). Equally the facial nerve function in the no-rerouting group 1 year after the surgery was significantly much better than in the rerouting group (p = 0.003). Regarding to survival, recurrence or complications no significant differences were observed between both groups. Our study suggests that most of cases avoiding facial nerve transposition allow significant better functional results thereof without affecting other parameters such as recurrence, complications or survival.

Llorente JL; Obeso S; López F; Rial JC; Coca A; Suárez C

2013-07-01

77

Rare giant epidermal cyst in the infratemporal fossa and middle cranial fossa.  

UK PubMed Central (United Kingdom)

A 50-year-old man presented with a rare giant crossing cranium-temporal combined epidermal cyst. Physical examination found left facial numbness and temple severely numbness with light pressure. Horizontalis craniocerebral computed tomography demonstrated a mass lesion of 3.0 × 2.0 cm in the middle cranial fossa area; sagittal craniocerebral magnetic resonance scanning demonstrated a mass consisting of 2 leaves (the upper one, 4.0 × 3.0 cm; the lower one, 2.0 × 1.5 cm). Computed tomography angiography showed that the blood supply of the lesion came from superficial temporal artery and middle cranial fossa artery. The clinical diagnosis was neurilemmoma. Surgery revealed a pearly cyst consisting of 2 leaves (connected by a narrowed bridge located at the articular fossa of temporal bone) was 6 × 3 × 3 cm. Histologic examination disclosed disintegrated keratinizing epithelium layer, keratinizing epithelium layer, and stratified squamous epithelium layer from inner to outer and found no hair follicles or sebaceous gland with the diagnosis of epidermoid cyst. Surgery was successfully performed, and the patient was discharged home with severer left facial numbness relatively and left jaw slight opening. The present case suggests that epidermoid cysts can be seen in any location, even giant crossing cranium-temporal combined lesion, and the blood supply should be considered as a factor judging its pathogenesis.

Yang T; Zhang L; Bao H; Hua Z

2012-07-01

78

Management of EGFR-inhibitor associated rash: a retrospective study in 49 patients.  

UK PubMed Central (United Kingdom)

BACKGROUND: In recent years inhibitors directed against the epidermal growth factor receptor (EGFR) have evolved as effective targeting cancer drugs. Characteristic papulopustular exanthemas, often described as acneiform rashes, are the most frequent adverse effect associated with this class of novel cancer drugs and develop in > 90% of patients. Notably, the rash may significantly compromise the patients' quality of life, thereby potentially leading to incompliance as well as dose reduction or even termination of the anti-EGFR therapy. Yet, an effective dermatologic management of cutaneous adverse effects can be achieved. Whereas various case reports, case series or expert opinions on the management of EGFR-inhibitor (EGFRI) induced rashes have been published, data on systematic management studies are sparse. METHODS: Here, we present a retrospective, uncontrolled, comparative study in 49 patients on three established regimens for the management of EGFRI-associated rashes. RESULTS: Strikingly, patients' rash severity improved significantly over three weeks of treatment with topical mometason furoate cream, topical prednicarbate cream plus nadifloxacin cream, as well as topical prednicarbate cream plus nadifloxacin cream plus systemic isotretinoin. CONCLUSIONS: In summary our results demonstrate that EGFRI-associated rashes can be effectively managed by specific dermatologic interventions. Whereas mild to moderate rashes should be treated with basic measures in combination with topical glucocorticosteroids or combined regiments using glucocorticosteroids and antiseptics/antibiotics, more severe or therapy-resistant rashes are likely to respond with the addition of systemic retinoids.

Gerber PA; Meller S; Eames T; Buhren BA; Schrumpf H; Hetzer S; Ehmann LM; Budach W; Bölke E; Matuschek C; Wollenberg A; Homey B

2012-01-01

79

Management of EGFR-inhibitor associated rash: a retrospective study in 49 patients  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background In recent years inhibitors directed against the epidermal growth factor receptor (EGFR) have evolved as effective targeting cancer drugs. Characteristic papulopustular exanthemas, often described as acneiform rashes, are the most frequent adverse effect associated with this class of novel cancer drugs and develop in > 90% of patients. Notably, the rash may significantly compromise the patients' quality of life, thereby potentially leading to incompliance as well as dose reduction or even termination of the anti-EGFR therapy. Yet, an effective dermatologic management of cutaneous adverse effects can be achieved. Whereas various case reports, case series or expert opinions on the management of EGFR-inhibitor (EGFRI) induced rashes have been published, data on systematic management studies are sparse. Methods Here, we present a retrospective, uncontrolled, comparative study in 49 patients on three established regimens for the management of EGFRI-associated rashes. Results Strikingly, patients' rash severity improved significantly over three weeks of treatment with topical mometason furoate cream, topical prednicarbate cream plus nadifloxacin cream, as well as topical prednicarbate cream plus nadifloxacin cream plus systemic isotretinoin. Conclusions In summary our results demonstrate that EGFRI-associated rashes can be effectively managed by specific dermatologic interventions. Whereas mild to moderate rashes should be treated with basic measures in combination with topical glucocorticosteroids or combined regiments using glucocorticosteroids and antiseptics/antibiotics, more severe or therapy-resistant rashes are likely to respond with the addition of systemic retinoids.

Gerber Peter; Meller Stephan; Eames Tatiana; Buhren Bettina; Schrumpf Holger; Hetzer Sonja; Ehmann Laura; Budach Wilfried; Bölke Edwin; Matuschek Christiane; Wollenberg Andreas; Homey Bernhard

2012-01-01

80

Rash to the mTOR Inhibitor Everolimus: Systematic Review and Meta-Analysis.  

Science.gov (United States)

BACKGROUND:: Everolimus is a mammalian target of rapamycin (mTOR) inhibitor approved for treatment of renal cell carcinoma, subependymal giant cell astrocytoma, breast cancer, and progressive neuroendocrine tumors of pancreatic origin. Its use may be hindered because of adverse events, including rash. The reported incidence and risk of a rash to everolimus varies widely and has not been closely investigated. Therefore, we conducted a systematic review and meta-analysis of the literature to determine the incidence and risk of developing a rash. METHODS:: We searched PubMed and Web of Science databases and abstracts presented at the American Society of Clinical Oncology from 1998 to December 2011 using the keyword "everolimus" to identify relevant clinical trials. Eligible studies included prospective phase II and III clinical trials of cancer patients on 10 mg of everolimus daily with available data on incidence of rash. The summary incidence and relative risk (RR) of rash were calculated using either the random-effects or fixed-effects model, depending on the heterogeneity of the constituent studies. RESULTS:: A total of 2242 patients with various malignancies from 13 clinical trials were included in the analysis. The summary incidences of all-grade and high-grade rash in patients on everolimus were 28.6% [95% confidence interval (CI), 20.8-38.0] and 1.0% (95% CI, 0.6-1.8), respectively. Everolimus was associated with a statistically significant increased risk of all-grade rash (RR=3.853, 95% CI, 2.470-6.013, P=0.000), but the RR for high-grade rash (RR=2.997, 95% CI, 0.633-14.185) was not statistically significant, with a P value of 0.166. CONCLUSIONS:: Everolimus is associated with a significant risk of developing a rash. Management of rash to everolimus is critical to prevent dose modifications and decreased quality of life, both of which can negatively affect overall clinical outcomes. PMID:23241507

Ramirez-Fort, Marigdalia K; Case, Emily C; Rosen, Alyx C; Cerci, Felipe B; Wu, Shenhong; Lacouture, Mario E

2012-12-13

 
 
 
 
81

Rash to the mTOR Inhibitor Everolimus: Systematic Review and Meta-Analysis.  

UK PubMed Central (United Kingdom)

BACKGROUND:: Everolimus is a mammalian target of rapamycin (mTOR) inhibitor approved for treatment of renal cell carcinoma, subependymal giant cell astrocytoma, breast cancer, and progressive neuroendocrine tumors of pancreatic origin. Its use may be hindered because of adverse events, including rash. The reported incidence and risk of a rash to everolimus varies widely and has not been closely investigated. Therefore, we conducted a systematic review and meta-analysis of the literature to determine the incidence and risk of developing a rash. METHODS:: We searched PubMed and Web of Science databases and abstracts presented at the American Society of Clinical Oncology from 1998 to December 2011 using the keyword "everolimus" to identify relevant clinical trials. Eligible studies included prospective phase II and III clinical trials of cancer patients on 10 mg of everolimus daily with available data on incidence of rash. The summary incidence and relative risk (RR) of rash were calculated using either the random-effects or fixed-effects model, depending on the heterogeneity of the constituent studies. RESULTS:: A total of 2242 patients with various malignancies from 13 clinical trials were included in the analysis. The summary incidences of all-grade and high-grade rash in patients on everolimus were 28.6% [95% confidence interval (CI), 20.8-38.0] and 1.0% (95% CI, 0.6-1.8), respectively. Everolimus was associated with a statistically significant increased risk of all-grade rash (RR=3.853, 95% CI, 2.470-6.013, P=0.000), but the RR for high-grade rash (RR=2.997, 95% CI, 0.633-14.185) was not statistically significant, with a P value of 0.166. CONCLUSIONS:: Everolimus is associated with a significant risk of developing a rash. Management of rash to everolimus is critical to prevent dose modifications and decreased quality of life, both of which can negatively affect overall clinical outcomes.

Ramirez-Fort MK; Case EC; Rosen AC; Cerci FB; Wu S; Lacouture ME

2012-12-01

82

Severe chronic diarrhea and maculopapular rash: A case report  

Directory of Open Access Journals (Sweden)

Full Text Available Systemic mastocytosis (SM) is a heterogeneous disease of the bone marrow characterized by abnormal growth, accumulation and activation of clonal mast cells (MCs). We report a case of SM with multi-organ involvement. A 30-year-old man presented with diarrhea, flushing, maculopapular rash with itching and weight loss. The upper and lower gastrointestinal endoscopies showed macroscopic involvement of stomach and duodenum; mucosal samples from stomach, duodenum, colon and distal ileum showed mucosal infiltration by large, spindle-shaped MCs with abnormal surface molecule expression (CD2 and CD25), a picture fully consistent with SM, according to the World Health Organization diagnostic criteria. A computed tomography scan showed diffuse lymphadenopathy, hepatosplenomegaly and diffuse small bowel involvement. Bone marrow aspirate and biopsy were diagnostic for SM; serum tryptase levels were increased (209 ng/mL, normal values < 20 ng/mL). The conclusive diagnosis was smouldering SM. There were no therapeutic indications except for treatment of symptoms. The patient was strictly followed up because of the risk of aggressive evolution.

Alessandra Elvevi; Federica Grifoni; Federica Branchi; Umberto Gianelli; Dario Conte

2011-01-01

83

Mature posterior fossa teratoma mimicking infratentorial meningioma: a case report.  

UK PubMed Central (United Kingdom)

Intracranial teratomas are congenital neoplasms mostly diagnosed in the pediatric hood and usually involve supratentorial midline structures. These teratomas, especially those involving the posterior fossa are an uncommon and representing less than 0.5% of all intracranial tumors. We report a case of mature posterior fossa teratoma in an adult patient diagnosed in the 4th decade of life. This lesion was taken for a huge infratentorial meningioma.

Coulibaly O; El Kacemi I; Fatemi N; Gana R; Saïdi A; Maaqili R; Jiddane M; Bellakhdar F

2012-02-01

84

Skin rash during erlotinib for advanced non-small cell lung cancer: is age a clinical predictor?  

Science.gov (United States)

The aim of this study was to evaluate the intensity and the duration of acneiform skin rash in young and elderly patients, to define a possible relationship between age and skin rash. We retrospectively analyzed all consecutive patients with advanced NSCLC who developed acneiform skin rash during erlotinib treatment at our Clinical Oncology Unit from June 2006 to May 2011. We divided the general case study into two subgroups: young and elderly patients (?65 years) and we compared clinical, pathological and therapeutical characteristics of both subgroups. Among 25 patients affected by advanced NSCLC treated with erlotinib during the reference period, 19 patients (76.0 %) developed acneiform skin rash. Fourteen (73.7 %) of 19 patients were elderly. The majority of elderly patients has developed acneiform skin rash (82.4 vs 62.5 %). In addition, in elderly patients, acneiform skin rash has a higher intensity (for mild rash 7.1 vs 20.0 %, for moderate rash 57.1 vs 60.0 %, for severe rash 35.7 vs 20.0 %) and longer duration, especially for mild and moderate rash (for mild rash 154 vs 40 days, for moderate rash 120 vs 76 days, for severe rash 31 vs 85 days). The univariate analysis showed no statistical significant difference in OS between young and elderly patients (p = 0.191), such as age, does not seem to influence the appearance (p = 0.386), duration (p = 0.455) and grade of acneiform skin rash (p = 0.765). In conclusion, we can affirm that age is an insufficient predictor of acneiform skin rash during erlotinib treatment in advanced NSCLC and does not seem to statistically influence the appearance, duration and grade of skin rash. PMID:23536039

Giuliani, Jacopo; Marzola, Marina

2013-03-28

85

Development of Acneiform Rash Does Not Predict Response to Lapatinib Treatment in Patients with Breast Cancer.  

UK PubMed Central (United Kingdom)

STUDY OBJECTIVE: To determine if development of acneiform rash is a predictor of objective response rate with lapatinib. DESIGN: Subanalysis of data from a prospective, phase II study. SETTING: Academic breast care clinic. PATIENTS: Forty-nine treatment-naïve patients with human epidermal growth factor receptor-2 (HER2)-positive locally advanced breast cancer, who were treated with neoadjuvant lapatinib monotherapy for 6 weeks; 47 patients were included in the final analysis. MEASUREMENTS AND MAIN RESULTS: Of the 49 patients enrolled, 33 (67%) developed a rash of any type, and 26 (55%) had acneiform rash. Of the 26 evaluable patients with acneiform rash (55%), 19 (73%) responded to lapatinib and 7 (27%) did not. Of the 21 evaluable patients without acneiform rash, 11 (67%) responded to treatment and 7 (33%) did not. Thus, no association was found between the occurrence of acneiform rash and response to lapatinib monotherapy. CONCLUSION: This study does not support the development of the acneiform rash as a predictor of clinical efficacy of lapatinib in the treatment of breast cancer.

Parma J; Pavlick A; Schiff R; Osborne CK; Chang JC; Rimawi M; Trivedi MV

2013-06-01

86

Robotic surgery of the infratemporal fossa utilizing novel suprahyoid port.  

UK PubMed Central (United Kingdom)

OBJECTIVES/HYPOTHESIS: To develop a minimally invasive technique for robotic access to the infratemporal fossa and describe use of a novel suprahyoid port placement. STUDY DESIGN: A cadaveric study to assess feasibility of robotic dissection of the infratemporal fossa using a novel, midline suprahyoid port placement. METHODS: Six complete and two partial dissections of the infratemporal fossa were carried out on one fixed and three fresh cadaveric heads using the da Vinci surgical robot (Intuitive Surgical, Inc., Sunnyvale, CA). The suprahyoid port site was utilized to place one robotic arm into the vallecula. The second arm and 30 degrees camera were placed transorally, and dissections were performed through the lateral pharyngeal wall and into the infratemporal fossa with identification and preservation of the lingual nerve, inferior alveolar nerve, internal and external carotid arteries, jugular vein, and cranial nerves IX-XII. Surgical clips were placed at the extent of dissection, and computed tomography (CT) imaging was obtained after dissections. RESULTS: The transoral and midline suprahyoid port sites provide excellent access to the infratemporal fossa. The midline port site has excellent utility for accessing wide areas of the skull base bilaterally. CT imaging shows surgical clips placed successfully at the skull base foramina of major neurovascular structures. CONCLUSIONS: Robotic surgery offers several advantages over traditional endoscopic surgery with the addition of tremor-free, two-handed technique and microscopic three-dimensional visualization. A midline suprahyoid port placement provides minimally invasive access for excellent exposure of the infratemporal fossa bilaterally.

McCool RR; Warren FM; Wiggins RH 3rd; Hunt JP

2010-09-01

87

Parapharyngeal space tumors: the infratemporal fossa approach.  

UK PubMed Central (United Kingdom)

Tumors of the parapharyngeal space, although mostly benign in their histopathology, present a challenge to the surgeon due to the limited access. Multiple approaches have been described in the literature for the extirpation of these tumors. The usual anatomic division of the parapharyngeal space into prestyloid and poststyloid spaces does not help the clinician determine which approach to use for a specific tumor. We have reviewed our 10-year experience at the University of Zurich. The usual presentation of the patients and the histopathologic characteristics of their tumors are compared. The radiological evaluation of these patients, their perioperative course, and complications are analyzed. The different surgical techniques used to treat the 72 patients in our series are described, with a special emphasis on the infratemporal fossa approach. Furthermore, a clinical division of the parapharyngeal space in the superior-inferior axis is established. The usefulness of this classification in helping the surgeon to decide which surgical approach is the most suitable for a particular lesion is discussed.

Shahinian H; Dornier C; Fisch U

1995-01-01

88

Malignant Fibrous Histiocytoma in the Infratemporal Fossa  

International Nuclear Information System (INIS)

Malignant fibrous histiocytoma is one of the most common soft tissue sarcomas in late adult life, but its incidence in oral and maxillofacial region is extremely rare. We report a case of malignant fibrous histiocytoma which occurred in the infratemporal fossa. Conventional radiograph of this case showed an ill-defined radiolucent lesion in the alveolar bone of the right maxillary first molar area, the lateral wall of the maxillary sinus, and the ascending ramus of mandible. MRI demonstrated well defined mass of intermediate signal intensity in T1 weighted images but T2 weighted images showed two distinctive regions of different characteristics. Infratemporal portion of the lesion was of hyperintense signal but under that region, the signal intensity decreased clearly, which might mean this case composed of two different subtypes, though it couldn't be confirmed by histopathological examination. Biopsy was taken in the only soft tissue of the maxillary posterior alveolar region and confirmed the lesion as the storiform-pleomorphic type of malignant fibrous histiocytoma. Histopathological subtype was well consistent with the relatively aggressive imaging findings of that region. We expect more detailed analysis of the nature of malignant fibrous histiocytoma with improvement of the imaging modality and the identification of the relationship between diagnostic imaging and histopathologic findings.

1999-01-01

89

Malignant Fibrous Histiocytoma in the Infratemporal Fossa  

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Malignant fibrous histiocytoma is one of the most common soft tissue sarcomas in late adult life, but its incidence in oral and maxillofacial region is extremely rare. We report a case of malignant fibrous histiocytoma which occurred in the infratemporal fossa. Conventional radiograph of this case showed an ill-defined radiolucent lesion in the alveolar bone of the right maxillary first molar area, the lateral wall of the maxillary sinus, and the ascending ramus of mandible. MRI demonstrated well defined mass of intermediate signal intensity in T1 weighted images but T2 weighted images showed two distinctive regions of different characteristics. Infratemporal portion of the lesion was of hyperintense signal but under that region, the signal intensity decreased clearly, which might mean this case composed of two different subtypes, though it couldn't be confirmed by histopathological examination. Biopsy was taken in the only soft tissue of the maxillary posterior alveolar region and confirmed the lesion as the storiform-pleomorphic type of malignant fibrous histiocytoma. Histopathological subtype was well consistent with the relatively aggressive imaging findings of that region. We expect more detailed analysis of the nature of malignant fibrous histiocytoma with improvement of the imaging modality and the identification of the relationship between diagnostic imaging and histopathologic findings.

Lee, Kyung Hee; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1999-08-15

90

A rare posterior cranial fossa tumor.  

Science.gov (United States)

Among tumors of the central nervous system, tumors of the mixed glioneuronal type form an important recognized subset. Some of the examples for mixed glioneuronal tumors include gangliocytoma, dysembryoplastic neuroepithelial tumor (DNT), ganglioglioma, anaplastic ganglioglioma, and central neurocytoma. The rosette-forming glioneuronal tumor (RGNT) of the fourth ventricle is a new entity that has only slowly emerged in the literature due to its prior classification with other low-grade mixed glial and neuronal tumors. These tumors are relatively infrequent lesions, and therefore, they can be challenging to diagnose for the practicing pathologist. This is a rare biphasic tumor with clearly defined neurocytic and glial components. The tumor is found exclusively in the posterior fossa, where it arises in the midline, usually occupying a substantial fraction of the fourth ventricle, and it is observed by magnetic resonance imaging (MRI) as a circumscribed, solid mass with heterogeneous contrast enhancement. We describe here a case of RGNT occurring in a 22-year-old male. PMID:23361291

Nandeesh, Bevinahalli N; Chabra, Manmeet Singh; Babu, Manjaly K; Chand, Ashish K

91

A rare posterior cranial fossa tumor.  

UK PubMed Central (United Kingdom)

Among tumors of the central nervous system, tumors of the mixed glioneuronal type form an important recognized subset. Some of the examples for mixed glioneuronal tumors include gangliocytoma, dysembryoplastic neuroepithelial tumor (DNT), ganglioglioma, anaplastic ganglioglioma, and central neurocytoma. The rosette-forming glioneuronal tumor (RGNT) of the fourth ventricle is a new entity that has only slowly emerged in the literature due to its prior classification with other low-grade mixed glial and neuronal tumors. These tumors are relatively infrequent lesions, and therefore, they can be challenging to diagnose for the practicing pathologist. This is a rare biphasic tumor with clearly defined neurocytic and glial components. The tumor is found exclusively in the posterior fossa, where it arises in the midline, usually occupying a substantial fraction of the fourth ventricle, and it is observed by magnetic resonance imaging (MRI) as a circumscribed, solid mass with heterogeneous contrast enhancement. We describe here a case of RGNT occurring in a 22-year-old male.

Nandeesh BN; Chabra MS; Babu MK; Chand AK

2012-10-01

92

A MEDICINAL ANTI DIAPER RASH CREAM INCORPORATING A BIOPOLYMER AND A PROCESS TO MAKE IT  

UK PubMed Central (United Kingdom)

The present invention is directed to a composition for treating diaper rashes, along with skin rejuvenation containing a) a biopolymer in the form of Chitosan, b) a combination of active pharmaceutical ingredients (APIs), Benzalkonium Chloride & Cetrimide used in treating diaper rashes, c) a cream base containing primary and secondary emulsifiers, waxy materials, co-solvents, acids, preservatives, buffering agents, anti oxidants, chelating agents, and humectants, and d) water. The active ingredients, namely chitosan, Benzalkonium Chloride & Cetrimide are incorporated in cream base for use in treating diaper rashes due to allergy & itching, & wounds on human skin involving contacting human skin with the above identified composition.

VANANGAMUDI SULUR SUBRAMANIAM; SRINIVASAN MADHAVAN; CHULLIEL NEELAKANDAN NARAYANAN; GHOSH KAUSIK

93

Management of EGFR-inhibitor associated rash: a retrospective study in 49 patients  

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Abstract Background In recent years inhibitors directed against the epidermal growth factor receptor (EGFR) have evolved as effective targeting cancer drugs. Characteristic papulopustular exanthemas, often described as acneiform rashes, are the most frequent adverse effect associate...

Gerber Peter; Meller Stephan; Eames Tatiana; Buhren Bettina; Schrumpf Holger; Hetzer Sonja; Ehmann Laura; Budach Wilfried

94

Posterior fossa syndrome after cerebellar stroke.  

UK PubMed Central (United Kingdom)

Posterior fossa syndrome (PFS) due to vascular etiology is rare in children and adults. To the best of our knowledge, PFS due to cerebellar stroke has only been reported in patients who also underwent surgical treatment of the underlying vascular cause. We report longitudinal clinical, neurocognitive and neuroradiological findings in a 71-year-old right-handed patient who developed PFS following a right cerebellar haemorrhage that was not surgically evacuated. During follow-up, functional neuroimaging was conducted by means of quantified Tc-99m-ECD SPECT studies. After a 10-day period of akinetic mutism, the clinical picture developed into cerebellar cognitive affective syndrome (CCAS) with reversion to a previously learnt accent, consistent with neurogenic foreign accent syndrome (FAS). No psychometric evidence for dementia was found. Quantified Tc-99m-ECD SPECT studies consistently disclosed perfusional deficits in the anatomoclinically suspected but structurally intact bilateral prefrontal brain regions. Since no surgical treatment of the cerebellar haematoma was performed, this case report is presumably the first description of pure, "non-surgical vascular PFS". In addition, reversion to a previously learnt accent which represents a subtype of FAS has never been reported after cerebellar damage. The combination of this unique constellation of poststroke neurobehavioural changes reflected on SPECT shows that the cerebellum is crucially implicated in the modulation of neurocognitive and affective processes. A decrease of excitatory impulses from the lesioned cerebellum to the structurally intact supratentorial network subserving cognitive, behavioural and affective processes constitutes the likely pathophysiological mechanism underlying PFS and CCAS in this patient.

Mariën P; Verslegers L; Moens M; Dua G; Herregods P; Verhoeven J

2013-10-01

95

Magnetic resonance imaging in posterior fossa lesions  

International Nuclear Information System (INIS)

Magnetic resonance imaging (MRI) using 0.15 Tesla was performed on more than 240 patients with suspected diseases of the brain and the spinal cord over a two-year period. Among them, 27 patients with various disorders of the CNS in the posterior fossa were selected for evaluation by means of comparing the MRI results with those of X-ray CT (CT). The subjects consisted of 16 patients with ischemic infarctions, 4 with demyelinating diseases, and 7 with craniovertebral junction anomalies in whom abnormalities could be detected only by MRI, while the CT was normal or equivocal. (1) Ischemic infarctions. In 10 cases of midbrain or pontine infarct, MRI was able to locate lesions compatible with the signs and symptoms. In 4 cases of the lateral medullary syndrome, MRI showed the lesions in two cases, but in the others only a lack of symmetry in the medullar was noted. In cases of cerebellar infarct, MRI was obviously superior to CT for detecting not only clinically responsible lesions, but also silent ones. (2) Demyelinating diseases. In 4 cases of multiple sclerosis, MRI successfully detected demyelinating plaques, regardless of the stage, while none were detected by CT alone. Spin-echo images seemed superior over inversion recovery in detection sensitivity. (3) Craniovertebral junction pathology. In this category, 5 cases of Arnold-Chiari malformations and two others were included. A sagittal section of MRI was found most useful for detecting these anomalies and was considered the first choice for tests because of its non-invasive and accurate characteristics. (author)

1986-01-01

96

Posterior fossa syndrome after cerebellar stroke.  

Science.gov (United States)

Posterior fossa syndrome (PFS) due to vascular etiology is rare in children and adults. To the best of our knowledge, PFS due to cerebellar stroke has only been reported in patients who also underwent surgical treatment of the underlying vascular cause. We report longitudinal clinical, neurocognitive and neuroradiological findings in a 71-year-old right-handed patient who developed PFS following a right cerebellar haemorrhage that was not surgically evacuated. During follow-up, functional neuroimaging was conducted by means of quantified Tc-99m-ECD SPECT studies. After a 10-day period of akinetic mutism, the clinical picture developed into cerebellar cognitive affective syndrome (CCAS) with reversion to a previously learnt accent, consistent with neurogenic foreign accent syndrome (FAS). No psychometric evidence for dementia was found. Quantified Tc-99m-ECD SPECT studies consistently disclosed perfusional deficits in the anatomoclinically suspected but structurally intact bilateral prefrontal brain regions. Since no surgical treatment of the cerebellar haematoma was performed, this case report is presumably the first description of pure, "non-surgical vascular PFS". In addition, reversion to a previously learnt accent which represents a subtype of FAS has never been reported after cerebellar damage. The combination of this unique constellation of poststroke neurobehavioural changes reflected on SPECT shows that the cerebellum is crucially implicated in the modulation of neurocognitive and affective processes. A decrease of excitatory impulses from the lesioned cerebellum to the structurally intact supratentorial network subserving cognitive, behavioural and affective processes constitutes the likely pathophysiological mechanism underlying PFS and CCAS in this patient. PMID:23575947

Mariën, Peter; Verslegers, Lieven; Moens, Maarten; Dua, Guido; Herregods, Piet; Verhoeven, Jo

2013-10-01

97

Risk of rash in cancer patients treated with vandetanib: systematic review and meta-analysis.  

UK PubMed Central (United Kingdom)

BACKGROUND: Vandetanib is an oral inhibitor of vascular endothelial growth factor receptor, epidermal growth factor receptor, and rearranged during transfection tyrosine kinases. It is approved for the treatment of unresectable or metastatic medullary thyroid cancer. Its use may be hindered due to adverse events, including rash. The reported incidence and risk of rash to vandetanib varies widely and has not been more closely investigated. Therefore, we conducted a systematic review and meta-analysis of the literature to determine the incidence and risk of developing a rash. DATA SOURCES: Databases from PubMed from 1996 through July 2011 and abstracts presented at the American Society of Clinical Oncology annual meetings from 2004 through July 2011 were searched for relevant studies. STUDY SELECTION: Eligible studies were prospective trials that described side effects of all-grade or high-grade rash for patients who received vandetanib 300 mg as a single agent. The incidence of all-grade and high-grade rash and relative risk were calculated using random-effects or fixed-effects models. RESULTS: Of 63 studies initially identified, nine met the selection criteria and were included for the study. A total of 2961 patients were included for analysis. The summary incidences of all-grade and high-grade rash were 46.1% [95% confidence interval (CI), 40.6-51.8%] and 3.5% (95% CI, 2.5-4.7%), respectively. From randomized controlled trials, patients who received vandetanib 300 mg had a significantly increased risk of developing all-grade rash in comparison with controls, with a relative risk of 2.43 (95% CI, 1.37-4.29; P = 0.002). CONCLUSION: There is a significant risk of developing rash in cancer patients receiving vandetanib. Awareness and treatment of this adverse event is critical to ensure adherence and maximize dosing, guaranteeing the best possible clinical benefit.

Rosen AC; Wu S; Damse A; Sherman E; Lacouture ME

2012-04-01

98

Cerebellopontine angle facial schwannoma relapsing towards middle cranial fossa  

Directory of Open Access Journals (Sweden)

Full Text Available Facial nerve schwannomas involving posterior and middle fossas are quite rare. Here, we report an unusual case of cerebellopontine angle facial schwannoma that involved the middle cranial fossa, two years after the first operation. A 53-year-old woman presented with a 3-year history of a progressive left side hearing loss and 6-month history of a left facial spasm and palsy. Magnetic resonance imaging (MRI) revealed 4.5 cm diameter of left cerebellopontine angle and small middle fossa tumor. The tumor was subtotally removed via a suboccipital retrosigmoid approach. The tumor relapsed towards middle cranial fossa within a two-year period. By subtemporal approach with zygomatic arch osteotomy, the tumor was subtotally removed except that in the petrous bone involving the facial nerve. In both surgical procedures, intraoperative monitoring identified the facial nerve, resulting in preserved facial function. The tumor in the present case arose from broad segment of facial nerve encompassing cerebellopontine angle, meatus, geniculate/labyrinthine and possibly great petrosal nerve, in view of variable symptoms. Preservation of anatomic continuity of the facial nerve should be attempted, and the staged operation via retrosigmoid and middle fossa approaches using intraoperative facial monitoring, may result in preservation of the facial nerve.

Takafumi Nishizaki; Norio Ikeda; Shigeki Nakano; Takanori Sakakura; Masaru Abiko; Tomomi Okamura

2011-01-01

99

Ganglion Cyst in the Supraspinous Fossa: Arthroscopically Undetectable Cases.  

UK PubMed Central (United Kingdom)

Studies have demonstrated favorable outcomes of arthroscopic decompression for ganglion cyst in the supraspinous fossa; however, little attention has been paid to the difficulty in detecting these cysts during arthroscopy. In this report, we present 2 cases in which ganglion cysts in the supraspinous fossa were undetectable during arthroscopy. The ganglion cysts were not identified in these cases during surgery despite arthroscopic decompression being performed through the area in which the cyst was expected until the suprascapular nerve was entirely exposed. After surgery, magnetic resonance imaging (MRI) confirmed the disappearance of the ganglion cyst and external rotation strength was fully improved, without shoulder pain. We emphasize here that surgeons should be aware of this difficulty when performing arthroscopic decompression of ganglion cysts in the supraspinous fossa.

Shimokobe H; Gotoh M; Mitsui Y; Yoshikawa E; Kume S; Okawa T; Higuchi F; Nagata K; Shiba N

2013-08-01

100

Skin rash during cetuximab treatment in advanced colorectal cancer: is age a clinical predictor?  

UK PubMed Central (United Kingdom)

PURPOSE: The aim of this study is to evaluate the intensity and the duration of skin rash in young and elderly patients treated with cetuximab for advanced colorectal cancer, in order to define a possible relationship between age and skin toxicity. METHODS: We retrospectively analyzed all consecutive patients with advanced colorectal cancer who developed skin rash during cetuximab treatment at the Clinical Oncology Unit from June 2006 to May 2011. We divided the general case study into two subgroups: young and elderly patients (? 65 years old), and we compared clinical, pathological, and therapeutical characteristics of both subgroups. RESULTS: Among the 31 patients affected by advanced colorectal cancer (64.5 % with colon cancer and 35.5 % with rectal cancer) treated with cetuximab, 19 patients (61.3 %) developed skin toxicities: seven patients (36.8 %) had grade 1 skin rash, nine patients (47.4 %) had grade 2, three patients (15.8 %) had grade 3, and no grade 4 was found. Ten (52.6 %) out of 19 patients were elderly (>65 years). Concerning skin rash, grading was substantially comparable between the two subgroups, but median duration of skin rash was higher in the first subgroup for all grades. The univariate analysis showed no statistical significant difference in overall survival between young and elderly patients (p = 0.171), such as age that does not seem to statistically influence the appearance (p = 0.386), duration (p = 0.455), and grade of skin rash (p = 0.765). CONCLUSIONS: Age is an insufficient predictor of skin toxicity during cetuximab treatment in advanced colorectal cancer and does not seem to statistically influence the appearance, duration, and grade of skin rash.

Giuliani J; Marzola M

2013-06-01

 
 
 
 
101

Fatal hemorrhagic infarction of posterior fossa meningioma during cardiopulmonary bypass.  

UK PubMed Central (United Kingdom)

Few publications address cardiac surgery in the presence of meningioma. Individual complications include transient visual loss from a suprasellar meningioma, hemiparesis after mitral valve replacement with recovery after resection, and non-fatal hemorrhage into a posterior fossa meningioma. The largest report of 16 patients with known meningiomas over 11 years suggested a benign course, with no new neurologic symptoms and no required resection of a meningioma over an average follow-up of 31 months. In 2 cases we report a presumed posterior fossa meningioma led to fatal outcome after cardiac surgery performed on bypass. Possible causes and future considerations are discussed.

Sun H; Ross DA

2012-02-01

102

A Case of Cerebellar Mutism after Posterior Fossa Surgery  

Directory of Open Access Journals (Sweden)

Full Text Available Cerebellar mutism consisting of disruption speech output, hypotonia, ataxia, and emotional lability occurs after surgery for posterior fossa tumors. Although the mutism is transient, speech rarely normalizes and this condition is associated with adverse neurological, cognitive and psychiatric abnormalities. Possible mechanisms for its etiology include direct injury from surgical trauma, vasospasm, edema and hydrocephalus causing delayed injury to the cerebellar vermis, brainstem and dentate nuclei. In this study, the case of an adolescent patient, who had an astrocytoma and showed symptoms of cerebellar mutism, apathy, ataxi, hemiparesis and visual impairment after posterior fossa surgery, is presented. (Archives of Neuropsychiatry 2012; 49: 320-322)

I??k GÖRKER; Sabahattin ÇOBANO?LU; Volkan ?AN

2012-01-01

103

[Postoperative mutism in children with the posterior fossa tumors  

UK PubMed Central (United Kingdom)

Over 10 years (1990-1999), the Pediatric Department, Ukrainian Institute of Neurosurgery named after Academician A. P. Romodanov, operated on 376 children with posterior fossa tumors. Thirty two 8.7% children developed a posterior fossa syndrome and cerebellar mutism syndrome postoperatively. This paper gives a detailed analysis of the date available in the world literature on the incidence and causes of mutism, and mechanisms of its development. Many factors predisposing to mutism were identified, but no anatomic structures responsible for its formation were found. In the authors' opinion, mutism may not result from anatomic structures, but from the functioning of afferent or efferent connections to this brain region bilaterally.

Orlov IuA; Zentani S

2001-01-01

104

[Postoperative mutism in children with the posterior fossa tumors].  

Science.gov (United States)

Over 10 years (1990-1999), the Pediatric Department, Ukrainian Institute of Neurosurgery named after Academician A. P. Romodanov, operated on 376 children with posterior fossa tumors. Thirty two 8.7% children developed a posterior fossa syndrome and cerebellar mutism syndrome postoperatively. This paper gives a detailed analysis of the date available in the world literature on the incidence and causes of mutism, and mechanisms of its development. Many factors predisposing to mutism were identified, but no anatomic structures responsible for its formation were found. In the authors' opinion, mutism may not result from anatomic structures, but from the functioning of afferent or efferent connections to this brain region bilaterally. PMID:11544744

Orlov, Iu A; Zentani, S

105

Clinical characteristics of children with viral single- and co-infections and a petechial rash.  

UK PubMed Central (United Kingdom)

BACKGROUND: Children with petechial rash are more likely to undergo invasive diagnostics, to be treated with antibiotics for potential bacterial infection and to be hospitalized. However, viruses have also been associated with petechial rash. Nonetheless, a systematic analysis of viral infections with modern available techniques as quantitative real-time polymerase chain reaction in the context of petechial rash is lacking. The purpose of this pediatric study was to prospectively uncover viral pathogens that may promote the emergence of petechiae and to analyze the correlation with the clinical characteristics and course. METHODS: We conducted a prospective study in children (0 to 18 years) presenting with petechiae and signs or symptoms of infection at the emergency department between November 2009 and March 2012. In nasopharyngeal aspirates the following viruses were analyzed by quantitative real-time polymerase chain reaction: cytomegalovirus, Epstein-Barr virus, parvovirus B19, influenza A and B, parainfluenza viruses, human respiratory syncytial virus A and B, human metapneumovirus, rhinovirus, enterovirus, adenovirus, human coronavirus OC43, 229E, NL63 and human bocavirus. RESULTS: A viral pathogen was identified in 67% of the analyzed 58 cases with petechial rash. Virus positive patients showed a significantly higher incidence of lower respiratory tract infections. Forty-one percent were viral coinfections, which were significantly younger than virus negative patients, had a higher leukocyte count and were hospitalized for a longer time. CONCLUSIONS: A petechial rash is frequently associated viral single- and coinfections and can rapidly be identified via quantitative real-time polymerase chain reaction.

Schneider H; Adams O; Weiss C; Merz U; Schroten H; Tenenbaum T

2013-05-01

106

Nevirapine-Associated Hepatotoxicity and Rash among HIV-Infected Pregnant Women in Kenya.  

UK PubMed Central (United Kingdom)

UNLABELLED: Background: Few studies have evaluated the risk of nevirapine (NVP)-associated hepatotoxicity among HIV-infected pregnant women with a CD4 count ?250 cells/mm(3). METHODS: We enrolled HIV-infected pregnant Kenyan women who initiated triple antiretroviral therapy (ART) at 34 weeks gestation. We compared the rates of severe hepatotoxicity (grades 3-4 hepatotoxicity) and rash-associated hepatotoxicity (rash with ?grade 2 hepatotoxicity) with NVP and nelfinavir (NFV), respectively. RESULTS: We initiated triple ART in 522 pregnant women; severe hepatotoxicity and rash-associated hepatotoxicity occurred in 14 (3%) and 9 (2%) women, respectively. Women who initiated NVP had higher rates of severe hepatotoxicity (5% vs 1%; P = .03) and rash-associated hepatotoxicity (4% vs 0%; P = .003) when compared with NFV. Among women who initiated NVP (n = 254), a baseline CD4 count ?250 cells/mm(3) was not associated with severe hepatotoxicity (5% vs 3%; P = .52) or rash-associated hepatotoxicity (4% vs 3%; P = .69). CONCLUSION: Nevirapine use but not CD4 count ?250 cells/mm(3) was associated with hepatotoxicity.

Peters PJ; Polle N; Zeh C; Masaba R; Borkowf CB; Oyaro B; Omolo P; Ogindo P; Ndivo R; Angira F; Lando R; Fowler MG; Weidle PJ; Thomas TK

2012-03-01

107

Allopurinol causing drug rash with eosinophilia and systemic symptoms syndrome: a challenging diagnosis  

Directory of Open Access Journals (Sweden)

Full Text Available Samer Hassan, Robert Wetz, Elie ZoueinStaten Island University Hospital, New York, NY, USABackground: Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is characterized by cutaneous drug eruption, eosinophilia, and systemic symptoms. The syndrome is difficult to diagnose due to its clinical heterogeneity and long latency period(2–6 weeks).Case report: This paper describes a 73-year-old man who presented with a rash that started 1 week prior to his presentation. The rash was associated with fever, dyspnea, and cough. He was admitted for pneumonia and started on intravenous antibiotics. After 3 days, he became confused and developed multiorgan dysfunction. Work-up for possible hematologic disorders, autoimmune diseases, and pneumonia was negative. One month prior to the onset of the rash, allopurinol had been prescribed for asymptomatic hyperuricemia. The allopurinol was stopped and corticosteroids were started; 2 days later, the patient became afebrile and the dyspnea resolved. He was diagnosed with DRESS syndrome, which is associated with high mortality.Conclusion: The recent introduction of a drug followed by a rash, multiorgan dysfunction, and eosinophilia should raise the suspicion of DRESS syndrome. Early cessation of the introduced drug is key to survival. Clinicians should be aware of this potential adverse reaction when prescribing any new drug, including allopurinol.Keywords: DRESS syndrome, eosinophilia, drug reaction, allopurinol, multiorgan failure, hyperuricemia

Hassan S; Wetz R; Zouein E

2011-01-01

108

Spinal Drop Metastasis from a Posterior Fossa Choroid Plexus Papilloma  

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Choroid plexus papillomas (CPPs) are typically considered as benign tumors, with a favorable long-term prognosis. Drop metastasis of CPP into the spinal subarachnoid space is rare. We report a 42-year-old woman who presented with headache and back pain 6 years after removal of a posterior fossa CPP....

Ahn, Soon-Seob; Cho, Young-Dae

109

[Oncogenic osteomalacia due to phosphaturic mesenchymal tumour in infratemporal fossa].  

Science.gov (United States)

Oncogenic osteomalacia is an uncommon syndrome characterized by phosphaturic tumours that produce mineral metabolism abnormalities. Head and neck is the second most frequent location of these tumours. We describe a case of a phosphaturic mesenchymal tumour in the infratemporal fossa that caused oncogenic osteomalacia, resolved by means of surgical excision. PMID:20172500

Viscasillas, Guillem; Maiz, Javier; Lao, Xavier; Zschaeck, Christiane; Sanz, Juan José

2010-02-20

110

[Oncogenic osteomalacia due to phosphaturic mesenchymal tumour in infratemporal fossa].  

UK PubMed Central (United Kingdom)

Oncogenic osteomalacia is an uncommon syndrome characterized by phosphaturic tumours that produce mineral metabolism abnormalities. Head and neck is the second most frequent location of these tumours. We describe a case of a phosphaturic mesenchymal tumour in the infratemporal fossa that caused oncogenic osteomalacia, resolved by means of surgical excision.

Viscasillas G; Maiz J; Lao X; Zschaeck C; Sanz JJ

2010-09-01

111

Gliosarcoma of the posterior cranial fossa: MRI findings  

International Nuclear Information System (INIS)

[en] We report the MR findings of a biopsy-proven gliosarcoma of the posterior cranial fossa. Multiple homogeneously enhancing lesions had shaggy margins and broad-based dural attachments, which may reflect the gliomatous and sarcomatous element of this tumour. (orig.)

1993-01-01

112

Sunitinib-induced reversible purpuric rash in a patient with gastrointestinal stromal tumor.  

UK PubMed Central (United Kingdom)

Sunitinib which is used in the treatment of kidney cancer, gastrointestinal stromal tumor, and advanced pancreatic neuroendocrine tumor is a multi-targeted tyrosine kinase inhibitor. Although sunitinib is associated with some side effects, it is generally well tolerated. In the present case, the diagnosis of gastrointestinal stromal tumor was four years ago. The patient had multiple liver metastases at the time of diagnosis. Sunitinib was initiated with a dose of 50?mg daily for four weeks and two weeks off, because of resistance of imatinib. The patient was admitted to the hospital with purpuric rash on her arms and body in the eighth week of treatment. No other disorders or drugs which may cause purpuric rash were detected in the patient. Purpuric rash disappeared two weeks after sunitinib discontinuation without any further intervention.

Mutlu H; Büyükçelik A; Akça Z; Kaya N

2013-08-01

113

Method for treating diaper rash using superhydrated bacteriostatic topical preparation with stable acid pH  

UK PubMed Central (United Kingdom)

A method for treating diaper rash, leg ulcers and bed sores using super hydrated bacteriostatic topical preparation with a stable acid pH 5.82, by applying this topical application, which is a mixture of anhydrous lanolin (USP), water, boric acid powder (USP), edible corn starch, white petrolatum, cosmetic grade, and zinc oxide ointment (USP 20% zinc oxide) mixed in a paddle mixer at a temperature of about 100 DEG F. to 107 DEG F. then applying topically, the super hydrated bacteriostatic preparation, at room temperature, on the rash, leg ulcers, or bed sores.

SHONG WALLACE W

114

A case of mercury intoxication presenting with hypertension, tachycardia and skin rash  

Directory of Open Access Journals (Sweden)

Full Text Available A 5-year-old-girl with erythematous skin rash, hypertension and tachycardia due to mercury intoxication was presented. Initial clinical and biochemical investigations suggested a diagnosis of vasculitis (atypical Kawasaki’s disease), but subsequently a history of exposure to mercury was discovered. Urine and blood mercury levels were consistent with mercury intoxication. Mercury intoxication should be considered in any child with signs and symptoms of hypertension, erythematous skin rash and tachycardia. Parents and school administrators, as well as paediatricians, should be aware of potential risks of the mercury and should be encouraged to avoid mercury-containing devices in schools and households.

Gürgöze, M. K.; Gündüz, Z.; Poyrazo?lu, M. H.; Dursun, ?.; Dü?ünsel, R.

2006-01-01

115

Decreased Sudomotor Function is Involved in the Formation of Atopic Eczema in the Cubital Fossa.  

UK PubMed Central (United Kingdom)

Background: Eczema in the cubital fossa, which is susceptible to sweat, is frequently observed in atopic dermatitis (AD). However, there has been no direct evidence that sweating causes eczema in the cubital fossa. Methods: To investigate this issue, axon reflex-mediated sweating volume (AXR) and skin barrier function in the cubital fossa were measured in subjects with AD and in healthy volunteers, and were applied to clinical feature of the cubital fossa. Results: AXR in the cubital fossa decreased in AD subjects; it positively correlated only with water-holding capacity in healthy subjects but not in patients with in AD. Furthermore, AD subjects with lichenoid eczema and either prurigo or papules over the cubital fossa showed extremely decreased AXR. Conclusions: These results suggest that decreased sweating is a major source of water in the stratum corneum, and decreased sudomotor function may be involved in both the cause and aggravation of representative atopic eczema in the cubital fossa.

Takahashi A; Murota H; Matsui S; Kijima A; Kitaba S; Lee JB; Katayama I

2013-09-01

116

Penicillin V-induced drug rash with eosinophilia and systemic symptoms.  

Science.gov (United States)

DRESS syndrome (drug reaction with eosinophilia and systemic symptoms), previously named "drug hypersensitivity syndrome", is a severe adverse drug reaction characterized by skin rash, fever lymph node enlargement and internal organ involvement. We report on a 7-year old girl who developed DRESS syndrome caused by penicillin V treatment. PMID:21702250

Orbak, Z; Sepetcigil, O; Karakelleo?lu, C; Gülses, S

2010-12-01

117

Penicillin V-induced drug rash with eosinophilia and systemic symptoms.  

UK PubMed Central (United Kingdom)

DRESS syndrome (drug reaction with eosinophilia and systemic symptoms), previously named "drug hypersensitivity syndrome", is a severe adverse drug reaction characterized by skin rash, fever lymph node enlargement and internal organ involvement. We report on a 7-year old girl who developed DRESS syndrome caused by penicillin V treatment.

Orbak Z; Sepetcigil O; Karakelleo?lu C; Gülses S

2010-12-01

118

Jaundice and rash associated with the use of phenobarbital and hydrochlorothiazide.  

UK PubMed Central (United Kingdom)

Rash, lymphadenopaty, splenomegaly, periorbital edema, and hepatitis occurred in an 18-year-old woman who was taking phenobarbital and hydrochlorothiazide. Tests for fluorescent antinuclear antibody and hepatitis-associated antigen and antibody were negative. Liver biopsy was not characteristic of viral hepatitis. Clinical recovery occurred within two weeks. Treatment consisted of withdrawal of the above drugs plus the administration of methylprednisolone and diphenhydramine.

Weisburst M; Self T; Peace R; Cooper J

1976-01-01

119

Self-reported skin rash or irritation symptoms among World Trade Center Health Registry participants.  

UK PubMed Central (United Kingdom)

OBJECTIVES: We described self-reported skin rash 2 to 3 and 5 to 6 years after 9/11 and examined its association with exposures to 9/11 dust/debris. METHODS: We analyzed a longitudinal study of New York City World Trade Center Health Registry participants who resided or worked in Lower Manhattan or worked in rescue/recovery in two surveys (W1 and W2). RESULTS: Among 42,025 participants, 12% reported post-9/11 skin rash at W1, 6% both times, 16% at W2. Among participants without posttraumatic stress disorder or psychological distress, W1 self-reported post-9/11 skin rash was associated with intense dust cloud exposure (adjusted odds ratio [OR] = 1.6; 95% confidence interval [CI] = 1.3 to 1.9), home/workplace damage (adjusted OR = 1.8; 95% CI, 1.4 to 2.3), and working more than 90 days (adjusted OR = 1.7; 95% CI, 1.3 to 2.2) or 31 to 90 days (adjusted OR = 1.6; 95% CI, 1.3 to 2.1) at the World Trade Center site. CONCLUSIONS: Post-9/11 skin rash may be related to acute and long-term exposure to dust, though subjectivity of skin symptoms may bias findings.

Huang MJ; Li J; Liff JM; Cohen DE; Cone J

2012-04-01

120

A Case of Erythema Nodosumleprosum in a 23-Year-Old Marshallese Man Presenting with Rash  

Science.gov (United States)

Learning Objectives Lepromatous leprosy is a rare disease affecting the skin and peripheral nerves that should be considered in patients from endemic areas who present with a rash. Rarely, leprosy may present with erythema nodosum. Early recognition of this disease is important as early leprosy treatment is essential to avoid complications. Case Presentation A 23-year-old man presented to the emergency department with evolving rash over two weeks. The rash was non-pruritic and started on his lower limbs and gradually spread upwards to the rest of his body, including his face and ears. One week after the rash appeared, he developed fever and generalized pain in his hand and foot joints. The patient had no allergies and no family history of skin disease. He was born in the Marshall Islands but had been living in the United States for the past five years. He had no known history of STDs. He had no recent history of international travel and none of his close contacts had had a similar rash. Physical examination revealed multiple erythematous nodules and papules on the head and neck, disseminated brown and erythematous macules and papules on trunk and limbs, including hands. Palpable purpura and hyperpigmented patches were present on his lower anterior legs. Mild synovitis of his finger joints and bilateral inguinal lymphadenopathy were present. There was no mucosal involvement. Diagnostic testing revealed a white blood cell count of 3.0×109/L and erythrocyte sedimentation rate of 80mm/hr. A skin biopsy was performed and was histologically diagnostic of lepromatous leprosy. Cytology also demonstrated neutrophilic infiltrate and karyorrhectic debris consistent with erythema nodosumleprosum. Fite stain demonstrated numerous intracellular acid-fast bacilli. Amodified treatment protocol consisting of dapsone, rifampin, and moxifloxacin was initiated. In addition, the patient was treated with prednisone for inflammatory symptoms. Discussion This case describes erythema nodosum with systemic symptoms as an atypical presentation of lepromatous leprosy. It illustrates the importance of maintaining a high clinical suspicion for leprosy in a patient who presents with a disseminated erythematous nodular and maculopapular rash. Although it is rare, it should be included in the differential for an unexplained rash in a patient from an endemic area.

Lin, Chunrong; Lian, Kuo-Chiang

2013-01-01

 
 
 
 
121

Symptoms before and after posterior fossa surgery in pediatric patients.  

UK PubMed Central (United Kingdom)

UNLABELLED: The posterior fossa syndrome (PFS) is common after cerebellar tumor resection in pediatric patients. It is characterized by postoperative mutism and ataxia and associated with persistent abnormalities in mood and cognition. METHOD: A 2-year prospective study of children and adolescents with cerebellar tumors identified by neuroimaging was performed at the Children's Hospital Los Angeles. RESULTS: There were 8 girls and 14 boys in the study, aged 14 months to 17 years. The tumor sizes ranged from 2 to 6.5 cm in diameter. The patients presented with ataxia, headache, vomiting, depressed or irritable mood and inattention. Symptoms of PFS were present postoperatively in all except for the 2 patients with lateral tumors. The symptoms began before resection, were most prominent immediately after surgery, and improved over time. Neuropsychological assessment of 10 patients documented a persistent cognitive decrement. CONCLUSION: This small, descriptive study provides information on the natural history of pediatric posterior fossa tumors from before surgery through the postoperative period.

Beckwitt Turkel S; Krieger MD; O'Neil S; Jubran R; Tavaré CJ

2012-01-01

122

Transient cerebellar mutism after posterior fossa surgery in children.  

UK PubMed Central (United Kingdom)

Cerebellar mutism has been reported after surgery for posterior fossa tumors in children and, rarely, in adults. The pathogenesis of this syndrome remains unclear, and controversy exists regarding whether it is a purely psychogenic disorder or an organic syndrome. The anatomical substrate for the mutism also remains unknown. We encountered five cases of postoperative transient cerebellar mutism in a consecutive series of 63 children with posterior fossa tumors. These cases were analyzed and compared with the patients without mutism to find predictive factors for the occurrence of mutism, with the hope of elucidating further the pathophysiological mechanism. The most significant finding was the presence in all cases of a period of cerebellar dysarthria after resolution of the muteness. We, therefore, believe that cerebellar mutism is an extreme form of dysarthria, rather than a real cognitive deficit or a psychological disturbance.

Van Calenbergh F; Van de Laar A; Plets C; Goffin J; Casaer P

1995-11-01

123

Cerebellar mutism after posterior fossa surgery--two case reports.  

Science.gov (United States)

Two adults (aged 71 and 74 years) developed cerebellar mutism after posterior fossa surgery for a mass lesion in the superior cerebellar hemisphere or upper vermis. Histological examination showed one was a hemangioblastoma, the other a metastatic brain tumor. The tumors were totally removed via the occipital transtentorial approach. Both patients developed mutism on the 2nd postoperative day, which persisted for 3-4 weeks and was followed within 2-4 months by cerebellar dysarthria. Thereafter, their condition improved. Transient cerebellar mutism usually occurs in pediatric patients after the removal of a mass lesion in the upper vermis. Cerebellar mutism in adults is rare. The predominance of cerebellar mutism in children may be attributable to the predilection for vermian tumor and their tendency to experience personality and behavioral changes after posterior fossa surgery. PMID:9465594

Kai, Y; Kuratsu, J; Suginohara, K; Marubayashi, T; Ushio, Y

1997-12-01

124

Cerebellar mutism after posterior fossa surgery--two case reports.  

UK PubMed Central (United Kingdom)

Two adults (aged 71 and 74 years) developed cerebellar mutism after posterior fossa surgery for a mass lesion in the superior cerebellar hemisphere or upper vermis. Histological examination showed one was a hemangioblastoma, the other a metastatic brain tumor. The tumors were totally removed via the occipital transtentorial approach. Both patients developed mutism on the 2nd postoperative day, which persisted for 3-4 weeks and was followed within 2-4 months by cerebellar dysarthria. Thereafter, their condition improved. Transient cerebellar mutism usually occurs in pediatric patients after the removal of a mass lesion in the upper vermis. Cerebellar mutism in adults is rare. The predominance of cerebellar mutism in children may be attributable to the predilection for vermian tumor and their tendency to experience personality and behavioral changes after posterior fossa surgery.

Kai Y; Kuratsu J; Suginohara K; Marubayashi T; Ushio Y

1997-12-01

125

Canine fossa approaches in endoscopic sinus surgery - our experience.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To define the role of canine fossa approach when standard endoscopic endonasal sinus surgery technique fails. STUDY DESIGN: Retrospective review of all endoscopic sinus surgeries performed from 1992 to 2007. RESULT: Out of 1612 endoscopic sinus surgeries for various indications, CFA was used in 80 patients (4.96%) and among this 15 had bilateral procedure.The various diseases which required CFA were allergic fungal sinusitis (AFS), Fungal ball, Chronic invasive aspergillosis,antro choanal polyp, inflammatory polyp, Mucocoele and Maxillary cyst,inverted papilloma and Juvenile Nasopharyngeal Angiofibroma (JNA). Eight patients had minor complications (cheek swelling-6, facial pain-2 ) which resolved in 5 days. CONCLUSION: Canine fossa approach offers an ancillary approach to failed standard endoscopic endonasal technique thereby avoiding other more invasive procedures.

Anand V; Santosh S; Aishwarya A

2008-09-01

126

Encephalomyelitis by Toxoplasma gondii in a captive fossa (Cryptoprocta ferox).  

UK PubMed Central (United Kingdom)

Encephalomyelitis due to Toxoplasma gondii was diagnosed in a fossa (Cryptoprocta ferox). The animal had ataxia, atrophy of hind limb muscles and progressive wasting before dying 12 months after the onset of clinical signs. Toxoplasmosis was suspected antemortem based on clinical signs and the detection of T. gondii DNA by PCR on EDTA-blood from live animal. Necropsy revealed necrotizing gastritis and severe emaciation. The main histological lesions included non-suppurative encephalomyelitis, with dilation of myelin sheaths and swollen axons in the spinal cord, and multifocal gliosis in the brain with intralesional protozoan cysts that stained positive for T. gondii immunohistochemistry. To the authors' knowledge, this is the first report of toxoplasmosis in a fossa, and a new host record.

Corpa JM; García-Quirós A; Casares M; Gerique AC; Carbonell MD; Gómez-Muñoz MT; Uzal FA; Ortega J

2013-03-01

127

Imaging in infections of the left iliac fossa.  

UK PubMed Central (United Kingdom)

The main organs in the left iliac fossa are the descending colon, sigmoid colon and, in women, internal reproductive organs. An infection of the left iliac fossa must lead the clinician firstly to suspect diverticulitis of the sigmoid colon in older patients and salpingitis in women of childbearing age. Other less common aetiologies are possible (inflammatory or infectious colitis, epiploic appendagitis, abscess of the psoas, pyelonephritis, renal abscess, etc.). Sonography as a first-line investigation may lead to diagnosis (especially in gynaecological disease), but a CT scan with intravenous injection of an iodine-containing contrast medium will allow for a full assessment of disease spread, and complications of sigmoid colitis or its differential diagnoses (abscess, fistula, perforation) to be investigated. It can also be used to guide percutaneous drainage or fine-needle aspiration for microbiology investigations.

Le Pennec V; Hourna E; Schmutz G; Pelage JP

2012-06-01

128

Imaging in infections of the left iliac fossa.  

Science.gov (United States)

The main organs in the left iliac fossa are the descending colon, sigmoid colon and, in women, internal reproductive organs. An infection of the left iliac fossa must lead the clinician firstly to suspect diverticulitis of the sigmoid colon in older patients and salpingitis in women of childbearing age. Other less common aetiologies are possible (inflammatory or infectious colitis, epiploic appendagitis, abscess of the psoas, pyelonephritis, renal abscess, etc.). Sonography as a first-line investigation may lead to diagnosis (especially in gynaecological disease), but a CT scan with intravenous injection of an iodine-containing contrast medium will allow for a full assessment of disease spread, and complications of sigmoid colitis or its differential diagnoses (abscess, fistula, perforation) to be investigated. It can also be used to guide percutaneous drainage or fine-needle aspiration for microbiology investigations. PMID:22521776

Le Pennec, V; Hourna, E; Schmutz, G; Pelage, J-P

2012-04-20

129

Associations between dispositions to rash action and internalizing and externalizing symptoms in children.  

UK PubMed Central (United Kingdom)

Impulsivity is not a unitary construct; instead, dispositions to rash action can be divided into five moderately-correlated dimensions. However, the associations between these dimensions and symptoms of psychopathology among youth remain unclear. The goal of this study was to examine associations between different dispositions to rash action and psychopathology in a community sample of middle school youth. One hundred forty-four youth (M age = 11.9; 65% Hispanic, 30% African American; 50% male; 81% qualifying for free school lunches) participated in this study. Self-reported questionnaire measures of dispositions to rash action (lack of planning, lack of perseverance, sensation seeking, negative urgency, and positive urgency) and psychopathology symptoms (conduct disorder [CD], alcohol use, depression, overall anxiety, panic, generalized anxiety, social anxiety, and separation anxiety, as well as teacher reports of attention deficit/hyperactivity disorder [ADHD] inattentive and hyperactive symptoms) were used. Negative and positive urgency were positively associated with all symptom types examined except certain anxiety subtypes (and positive urgency was not associated with ADHD symptoms). Lack of planning was positively associated with externalizing and depressive symptoms. Lack of perseverance was positively associated with CD. Sensation seeking was positively associated with both CD and alcohol use. When other dispositions were adjusted for, negative urgency remained a positive predictor of CD, whereas positive urgency remained a positive predictor of depressive and panic symptoms. Sensation seeking was negatively associated with separation anxiety. Psychopathology symptoms are differentially related to dispositions to rash action in children; emotion-based dispositions to rash action may be particularly important targets for future research.

Marmorstein NR

2013-01-01

130

Posterior fossa syndrome: identifiable risk factors and irreversible complications.  

Science.gov (United States)

Cerebellar mutism was first described by Rekate et al. in 1985 as a transient condition which occurs after posterior fossa operations in children. Posterior fossa syndrome (PFS) and cerebellar mutism are often used interchangeably in the literature. In our experience, we found cerebellar mutism to be a reversible component of a persistent neurologic syndrome. The cause and identifiable risk factors have not been clearly elucidated in the literature. To further characterize PFS, we reviewed 253 children with posterior fossa tumors who underwent surgical resection. We documented 20 cases of PFS (8%), 12 males and 8 females. Age ranged from 1.5 to 13 years (mean = 6.5). Of the 20, 16 were medulloblastoma, 3 ependymoma and 1 astrocytoma. There was a 21 % incidence (16/76) of PFS in medulloblastoma of the posterior fossa. The incidence for ependymoma was 13% (3/24) and 1% (1/102) for astrocytoma. All 20 cases (100%) had brainstem involvement by the tumor. The most frequent postoperative findings included mutism, ataxia, 6th and 7th nerve palsies and hemiparesis. Mutism had a latency range of 1-7 days (mean = 1.7) and a duration of 6-365 days (mean = 69.2, median = 35). Although mutism resolved in all cases, the remaining neurologic complications which characterized our findings of PFS were rarely reversible. We describe potential risk factors for developing PFS after surgery with hopes of making neurosurgeons more aware of potential problems following the removal of lesions in this area. Early recognition of PFS would further promote patient and family understanding and coping with this syndrome. PMID:10708354

Doxey, D; Bruce, D; Sklar, F; Swift, D; Shapiro, K

1999-09-01

131

Posterior fossa syndrome: identifiable risk factors and irreversible complications.  

UK PubMed Central (United Kingdom)

Cerebellar mutism was first described by Rekate et al. in 1985 as a transient condition which occurs after posterior fossa operations in children. Posterior fossa syndrome (PFS) and cerebellar mutism are often used interchangeably in the literature. In our experience, we found cerebellar mutism to be a reversible component of a persistent neurologic syndrome. The cause and identifiable risk factors have not been clearly elucidated in the literature. To further characterize PFS, we reviewed 253 children with posterior fossa tumors who underwent surgical resection. We documented 20 cases of PFS (8%), 12 males and 8 females. Age ranged from 1.5 to 13 years (mean = 6.5). Of the 20, 16 were medulloblastoma, 3 ependymoma and 1 astrocytoma. There was a 21 % incidence (16/76) of PFS in medulloblastoma of the posterior fossa. The incidence for ependymoma was 13% (3/24) and 1% (1/102) for astrocytoma. All 20 cases (100%) had brainstem involvement by the tumor. The most frequent postoperative findings included mutism, ataxia, 6th and 7th nerve palsies and hemiparesis. Mutism had a latency range of 1-7 days (mean = 1.7) and a duration of 6-365 days (mean = 69.2, median = 35). Although mutism resolved in all cases, the remaining neurologic complications which characterized our findings of PFS were rarely reversible. We describe potential risk factors for developing PFS after surgery with hopes of making neurosurgeons more aware of potential problems following the removal of lesions in this area. Early recognition of PFS would further promote patient and family understanding and coping with this syndrome.

Doxey D; Bruce D; Sklar F; Swift D; Shapiro K

1999-09-01

132

Petergopalatine Fossa A Key Area In Rhinocerebral Mucormycosis Extension  

Directory of Open Access Journals (Sweden)

Full Text Available Rhinocerebral mucormycosis is a rapidly progressive fungal infection that spreads from nose and sinuses to brain in short time. Cunent hypothesis about brain involvement explains that infection initiates in nose and progresses into orbit through ethmoidat sinuses via erosion of lamina papyranea. Then infection spreads from orbit apex to cavernous sinus and brain. Therefore, in addition to medical therapy surgical debridement of the sinuses plays a major role in treatment of these patients. The aim of this study is introduction of a new point of view about extension of mucor from the nose to orbit and brain. Also we discuss clinical implication of this perspective on surgery."nMaterials and Methods: Since 1997-2002 nine patients with mucormycosis involving nose. Sinuses and orbit were admitted in ENT ward of Imam Khomeini general hospital. 8 patients with positive pathology entered the study. Variable such as age, underlying diseases, symptoms, site of involvement, extent of debridement and its times, and outcome were studied."nResults: After review of the history, surgical reports and pathological results, we found these findings in almost all patients: 1) facial pain, facial anesthesia, paralysis of buccal branch of facial nerve, paralysis of extrocular muscles, chemosis, periorbital edema 2) involvement of cheek subcutaneous tissue, buccal fat pad, IOF, SOF, orbital apex, infraorbital and maxillary nerves 3) involvement of pterygoid fossa with or without infratemporal fossa extension. Three patients have survived. Causes of death in other five patients were pneumonia, hypokalemia, and arrythmis during anesthesia. Mucormycosis was under control in most of these patients."nConclusion: Pterygopalatine fossa is the main source for replication and extension of mucor. After entrance to the nose, mucor reaches this site and after involvement of IOF and SOF rapidly extends to retrobulbar portion of the orbit. Paranasal sinuses, buccal space, cheek, palate and infratemporal fossa may be secondarily involved. Exploration and debridment of this area has beneficial effect on surviving of these patients."n"n"n"n"n 

Sadr-Hoseini S M; Saedi B

2003-01-01

133

A bullet in the maxillary antrum and infratemporal fossa.  

UK PubMed Central (United Kingdom)

A young male patient was shot from a revolver on his left temple from a close range, but surprisingly he survived. On imaging, a complete bullet was found occupying his left maxillary sinus and infratemporal fossa. The bullet, after hitting and breaking the neck of the mandible on the left side, ricocheted and entered the left maxillary sinus through its posterior wall. It was removed safely by a combination of sublabial antrotomy and endoscopic approach.

Goswami S

2013-01-01

134

Posterior fossa extraaxial cyst: diagnosis with metrizamide CT cisternography.  

UK PubMed Central (United Kingdom)

This study describes a new technique for the study of posterior fossa extraaxial cysts. Using metrizamide (Amipaque) CT cisternography, a rapid, simple, low morbidity method is now available which gives both anatomic and physiologic information that may obviate the need for pneumoencephalography and angiography. Two cases are reported; in a third the diagnosis was definitively excluded. By doing serial CT scans following the intrathecal introduction of metrizamide, data concerning the diffusion characteristics of these cysts as well as the accompanying hydrocephalus are obtained.

Drayer BP; Rosenbaum AE; Maroon JC; Bank WO; Woodford JE

1977-03-01

135

Pseudoaneurysm in gall bladder fossa following laparoscopic cholecystectomy.  

UK PubMed Central (United Kingdom)

A 32-year-old lady presented with severe hematemesis and melena after laparoscopic cholecystectomy. Initial ultrasonography and spiral CT suggested a vascular lesion in the gall bladder fossa. Selective hepatic angiography confirmed the presence of a pseudoaneurysm close to the surgical clip and filling through the right hepatic artery. This was treated with coil embolization, resulting in cessation of hematemesis and amelioration of symptoms.

Halbe S; Ahmed NI; Sundar K; Sathyakumar C

1999-07-01

136

Posterior fossa meningioma "our experience" in 64 cases.  

UK PubMed Central (United Kingdom)

BACKGROUND: Posterior fossa meningiomas are 20% of all intracranial meningiomas. These are slow-growing tumors thus become large before presentation. Microsurgical resection is the treatment of choice for the majority of these lesions, but variable locations, large size at diagnosis, frequent encroachment of neural and vascular structures, and their potentially invasive behavior are some of the features of these tumors that make their resection challenging. MATERIALS AND METHODS: We studied 64 cases of posterior fossa meningioma operated in last 6 years, and analysed the technical difficulties encountered during excision of these tumors. Postoperative complications and outcomes of these patients were also analysed. RESULTS: Gross total excision was achieved in 72% cases. Partial excision or subtotal excision was more in petroclival, jugular foramen with extra cranial extension, tentorial with intrasinus extension and ventral foramen magnum. Postoperative complication in form of new or aggravation of existing neurological deficit was found in 33% cases and CSF leak in 12.5% cases. We encountered the recurrence of total 10 cases (16%) over mean follow-up of 4 years. Most of the recurrent cases were seen in petroclival and tentorial subgroups with partial or subtotal excision. CONCLUSION: Posterior fossa meningiomas are difficult to excise due to close relation to cranial nerves and vessels. Use of microscope, CUSA, intraoperative nerve monitor help in removal and preserving surrounding important anatomical structures. Although neurological deterioration is common postoperatively, recovery does occur completely after total removal thus increasing the recurrence free period and improving the outcome.

Velho V; Agarwal V; Mally R; Palande DA

2012-07-01

137

Gamma Knife surgery for posterior fossa arteriovenous malformations  

International Nuclear Information System (INIS)

The long-term outcomes after Gamma Knife surgery (GKS) were retrospectively analyzed in patients with posterior fossa arteriovenous malformations (AVMs) to evaluate the efficacy, safety, and indications for this procedure. The medical records were reviewed of 75 patients who underwent GKS between 1992 and 2005 in our institution. The rate of complete AVM obliteration was 57.3% at 3 years and 80.2% at 5 years after GKS. Multivariate analysis showed that the significant factors for higher obliteration rates were younger patient age, smaller nidus volume, and smaller nidus maximum/minimum diameter. Two patients suffered hemorrhages during the latency interval. Clinical deterioration was observed in 10 patients with radiation-induced edema after the GKS. Larger nidus volume and AVM located adjacent to eloquent areas were significantly associated with the risk of neuropathy after GKS. One patient developed radiation-induced necrosis 4 years after confirmation of complete AVM obliteration. GKS is an effective and safe modality for the treatment of posterior fossa AVMs, resulting in high AVM obliteration rate with low complication rates based on neuroimaging and neurological symptoms. Posterior fossa AVMs tend to occur adjacent to eloquent areas, so we recommend preparing a conformed dose plan that considers both obliteration of the AVM nidus and preservation of neurological function. (author)

2011-01-01

138

MANAGEMENT OF HYDROCEPHALUS IN POSTERIOR CRANIAL FOSSA TUMORS  

Directory of Open Access Journals (Sweden)

Full Text Available Treatment of hydrocephalus in posterior fossa tumors in children is still a matter of controversy and different centers have their own routines. In this regard, hospital records of all children with posterior fossa tumors treated in our center during the interval of 1985-1995 were reviewed. Patients’ demographic and diagnostic data were analyzed and the frequencies of shunting procedures were determined. Fisher exact test was employed to compare the frequency of postoperative complications in different groups. A total of 108 patients with age ranging from 3 months to 18 years and a male to female ratio of 1.5 comprised the study population. Ninety-nine cases had hydrocephalus at the time of diagnosis and 81 patients underwent preoperative shunting. Of the remaining 18 patients, 13 underwent external ventricular drainage at tumor operation session plus preoperative corticosteroid therapy. The rest of the patients got no primary treatment for hydrocephalus. Three of these 5 patients had postoperative shunting after tumor removal, but the other 2 remained shunt free. The rate of postoperative complications including cerebrospinal fluid leakage and septic meningitis were significantly lower in patients with preoperative shunting. The results of this study are in favor of those that approve the effect of preoperative shunting in decreasing postoperative complications. This is well established when the tumor size is big or when the diagnosis of posterior fossa tumor is made in later stages or when hydrocephalus is severe. It could be concluded that preoperative shunting can decrease the rate of postoperative complications.

S. M. Abdollahzadeh-Hosseini; H. Rezaishiraz F. Allahdini

2006-01-01

139

Inflammatory orbital pseudotumor with infratemporal fossa extension mimicking temporomandibular joint dysfunction.  

UK PubMed Central (United Kingdom)

Inflammatory orbital pseudotumor is a benign space-occupying lesion of unknown origin that involves all or part of the fatty tissue within the orbit. Occasionally the disease may extend into the middle cranial, the pterygopalatine, and the infratemporal fossa through the various foramina of the orbit, although extension into the infratemporal fossa is very rare. We present a case which extends into the infratemporal fossa through the inferior orbital fissure, resulting in presenting symptoms mimicking temporomandibular joint dysfunction.

Lee JY; Kim KD; Hwang EH; Park HS; Park CS

2002-03-01

140

Association between Rash and a Positive Drug Response Associated with Vinorelbine in a Patient with Primary Peritoneal Carcinoma.  

Science.gov (United States)

Vinorelbine (Navelbine, VRL) is commonly used for platinum-resistant ovarian cancer and has been shown to be effective in patients with recurrent primary peritoneal carcinoma. Of VRL's major side effects, skin rash is uncommon, and, if it does occur, it is usually localized to site of injection. In this case report, a 71-year-old Hispanic female with primary peritoneal carcinoma received single agent VRL as fourth-line regimen, which she tolerated very well except for a skin rash related to VRL. The rash continued to progress throughout 6 cycles of VRL, and follow-up CT/PET scan demonstrated complete metabolic and radiological responses. We, therefore, believe that this rash was linked to VRL administration and correlated with response to therapy. Rash has been recognized as a useful surrogate marker with targeted agents such as cetuximab and erlotinib; to the best of our knowledge, this case report describes the first patient with a possible drug rash and its association with a positive outcome. This case report incites interest in further investigation of similar cases to support this observation, since there is a lack of reports of skin rash with VRL therapy. PMID:24073344

Mohammad, Mustafa M; Syrigos, Kostas N; Saif, M Wasif

2013-09-01

 
 
 
 
141

Association between Rash and a Positive Drug Response Associated with Vinorelbine in a Patient with Primary Peritoneal Carcinoma.  

UK PubMed Central (United Kingdom)

Vinorelbine (Navelbine, VRL) is commonly used for platinum-resistant ovarian cancer and has been shown to be effective in patients with recurrent primary peritoneal carcinoma. Of VRL's major side effects, skin rash is uncommon, and, if it does occur, it is usually localized to site of injection. In this case report, a 71-year-old Hispanic female with primary peritoneal carcinoma received single agent VRL as fourth-line regimen, which she tolerated very well except for a skin rash related to VRL. The rash continued to progress throughout 6 cycles of VRL, and follow-up CT/PET scan demonstrated complete metabolic and radiological responses. We, therefore, believe that this rash was linked to VRL administration and correlated with response to therapy. Rash has been recognized as a useful surrogate marker with targeted agents such as cetuximab and erlotinib; to the best of our knowledge, this case report describes the first patient with a possible drug rash and its association with a positive outcome. This case report incites interest in further investigation of similar cases to support this observation, since there is a lack of reports of skin rash with VRL therapy.

Mohammad MM; Syrigos KN; Saif MW

2013-01-01

142

Skin rash by gefitinib is a sign of favorable outcomes for patients of advanced lung adenocarcinoma in Japanese patients.  

Science.gov (United States)

Skin rash is one of the notorious adverse events of gefitinib as well as other epidermal growth factor receptor tyrosine kinase inhibitors. The differences of response rate and frequency of adverse events between ethnic groups are well known. Some reports demonstrated the correlation between development of rash and efficacy in Caucasian patients treated with erlotinib, gefitinib or cetuximab. We analyzed clinical course of Japanese patients of lung adenocarcinoma in order to assess the relation between adverse events and efficacy of gefitinib. Between January 2008 and June 2012, 24 Japanese patients administered gefitinib 250 mg daily. The adverse events were evaluated in accordance with Common Terminology Criteria For Adverse Events v4.0 (CTCAE). Objective response to gefitinib was evaluated with using computed tomography every 1-2 months. The relationship between each adverse event and objective response was examined by chi-square test. The Log-rank Test was used to assess the relationship between the presence of skin rash and overall survival. Twenty four patients with a median age of 67 years (range 55-89) entered were 16 female and 8 male patients; the pathological diagnosis of all patients was adenocarcinoma. Skin rash in CTCAE occurred in 10. The objective response and overall survival among the patients with skin rash was significantly superior to the patients without skin rash. Skin rash by gefitinib correlates with improved clinical outcomes among advanced lung adenocarcinoma patients. PMID:23420789

Sugiura, Yasoo; Nemoto, Etsuo; Kawai, Osamu; Ohkubo, Yasuyuki; Fusegawa, Hisae; Kaseda, Shizuka

2013-01-23

143

Association between Rash and a Positive Drug Response Associated with Vinorelbine in a Patient with Primary Peritoneal Carcinoma  

Science.gov (United States)

Vinorelbine (Navelbine, VRL) is commonly used for platinum-resistant ovarian cancer and has been shown to be effective in patients with recurrent primary peritoneal carcinoma. Of VRL's major side effects, skin rash is uncommon, and, if it does occur, it is usually localized to site of injection. In this case report, a 71-year-old Hispanic female with primary peritoneal carcinoma received single agent VRL as fourth-line regimen, which she tolerated very well except for a skin rash related to VRL. The rash continued to progress throughout 6 cycles of VRL, and follow-up CT/PET scan demonstrated complete metabolic and radiological responses. We, therefore, believe that this rash was linked to VRL administration and correlated with response to therapy. Rash has been recognized as a useful surrogate marker with targeted agents such as cetuximab and erlotinib; to the best of our knowledge, this case report describes the first patient with a possible drug rash and its association with a positive outcome. This case report incites interest in further investigation of similar cases to support this observation, since there is a lack of reports of skin rash with VRL therapy.

Mohammad, Mustafa M.; Syrigos, Kostas N.; Saif, M. Wasif

2013-01-01

144

Herpes Zoster Ophthalmicus Presenting as Acute Orbital Myositis Preceding a Skin Rash: A Case Report  

International Nuclear Information System (INIS)

Herpes zoster ophthalmicus, in which orbital symptoms and signs appear before the onset of a skin rash, is very rare. We experienced such a case and therefore report on it via magnetic resonance imaging. A 48-year-old man with pain and swelling of left eye and headache presented 2 days before onset of a zoster skin rash. On orbit-al MRI, edematous thickening of the left lateral rectus muscle with high signal intensity was revealed. After contrast injection, the lateral rectus muscle demonstrated heterogenous enhancement. Also, diffuse contrast enhancement was noted at left preseptal space, lacrimal gland and periorbital soft tissue. The man was treated with antiviral agents and prednisolone. Two weeks later, he recovered from the skin manifestations and most of the orbital manifestations except for the diplopia and restricted lateral movement.

2012-01-01

145

Maculopapular rash in the convalescent phase of Kawasaki disease: case series and literature review.  

UK PubMed Central (United Kingdom)

UNLABELLED: Intravenous immunoglobulin (IVIG) is currently the standard treatment for Kawasaki disease (KD). Although IVIG therapy is generally well tolerated, several minor adverse reactions have been reported. We report a patient with KD treated with IVIG, who developed a cutaneous reaction in the convalescent phase (approximately 10 days after therapy). We identified seven additional KD cases with a similar presentation, accounting for 9.3 % of KD patients at our hospital. We performed a literature review and found that a maculopapular rash could be observed approximately 10 days after IVIG treatment, in patients with and those without KD. CONCLUSION: Maculopapular rash can occur in nearly 10 % of IVIG-treated children with KD in our cohort, approximately 10 days after treatment. A delayed-onset adverse event of IVIG could be a causative etiology of this unrecognized eruption.

Takeuchi M; Oda Y; Suzuki I

2013-03-01

146

Cushingoid Syndrome Following of Local Steroid Administration for Diaper Rash; A Case Report  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: Prolonged exogenous administration of ACTH or hydrocortisone or its analogs results in a clinical pattern identical to the spontaneous disorder and is frequently referred to as Cushingoid syndrome. This syndrome is generally reported as a result of oral or parenteral steroids administration. Case Report: Our report presents a five-month old baby with typical Cushingoid changes following local steroid application due to diaper rash. Clobetasol was used for diaper rash, but had not used systemic corticosteroid. Serum Cortical and ACTH was very low and no detectable. After discontinuation of local steroid, Skin complication recovered gradually and after 5 months, completely. Conclusion: Local corticosteroids may be high absorption and cause systemic complication such as Adrenal insufficiency and cushingoid syndrome.

Kh Daneshjou; Z Haghshenas

2006-01-01

147

Herpes Zoster Ophthalmicus Presenting as Acute Orbital Myositis Preceding a Skin Rash: A Case Report  

Energy Technology Data Exchange (ETDEWEB)

Herpes zoster ophthalmicus, in which orbital symptoms and signs appear before the onset of a skin rash, is very rare. We experienced such a case and therefore report on it via magnetic resonance imaging. A 48-year-old man with pain and swelling of left eye and headache presented 2 days before onset of a zoster skin rash. On orbit-al MRI, edematous thickening of the left lateral rectus muscle with high signal intensity was revealed. After contrast injection, the lateral rectus muscle demonstrated heterogenous enhancement. Also, diffuse contrast enhancement was noted at left preseptal space, lacrimal gland and periorbital soft tissue. The man was treated with antiviral agents and prednisolone. Two weeks later, he recovered from the skin manifestations and most of the orbital manifestations except for the diplopia and restricted lateral movement.

Oh, Ha Yeun; Cho, Seong Whi [Dept. of Radiology, Kangwon National University Hospital, Chuncheon (Korea, Republic of); Kim, Sung Hun [Dept. of Neurology, Kangwon National University Hospital, Chuncheon (Korea, Republic of)

2012-03-15

148

Facial heliotrope rash as the initial manifestation of acute myelomonocytic leukemia.  

Science.gov (United States)

The association of leukocytoclastic vasculitis or dermatomyositis with malignancies has been reported. We describe a patient who developed a skin rash, histologically compatible with dermatomyositis, which during the course of the disease switched to leukocytoclastic vasculitis, which was accompanied with peripheral blood pancytopenia in the absence of any specific pathological manifestation from the bone marrow three years prior to the diagnosis of acute myelomonocytic leukemia (AMML). PMID:9168450

Tzavara, V; Stamoulis, K; Aroni, K G; Kordossis, T; Boki, K A

1997-04-01

149

Fatal clindamycin-induced drug rash with eosinophilia and systemic symptoms (DRESS) syndrome.  

UK PubMed Central (United Kingdom)

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare, complex, idiosyncratic drug reaction that can be fatal. Systemic symptoms include lymphadenopathy, hepatic failure, and possibly renal failure. The syndrome has been primarily associated with anticonvulsants, whereas antimicrobials are less commonly associated. We describe a 63-year-old woman who initially presented with rash and acute kidney injury secondary to treatment with clindamycin for a methicillin-susceptible Staphylococcus aureus prosthetic hip infection. Her rash progressed to desquamation of over 90% of her body surface area. Her renal function progressively declined during her hospital stay, and continuous renal replacement therapy was started. Peripheral eosinophilia was present, and urine studies were consistent with intrinsic renal failure. The patient also developed pancreatitis, hepatic failure with elevated liver enzyme levels and coagulopathy, respiratory failure necessitating mechanical ventilation, and hypotension. After a 16-day hospitalization, life-sustaining measures were withdrawn, and the patient died. Use of a cutaneous adverse drug reaction scale indicated that clindamycin was the definite cause of this patient's DRESS syndrome. To our knowledge, this is the first case report of fatal clindamycin-induced DRESS syndrome and only the second case report of DRESS attributable to clindamycin therapy. Although commonly linked with anticonvulsants, clinicians should consider the possibility of this reaction with antimicrobials, including clindamycin.

Miller Quidley A; Bookstaver PB; Gainey AB; Gainey MD

2012-12-01

150

Fatal clindamycin-induced drug rash with eosinophilia and systemic symptoms (DRESS) syndrome.  

Science.gov (United States)

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare, complex, idiosyncratic drug reaction that can be fatal. Systemic symptoms include lymphadenopathy, hepatic failure, and possibly renal failure. The syndrome has been primarily associated with anticonvulsants, whereas antimicrobials are less commonly associated. We describe a 63-year-old woman who initially presented with rash and acute kidney injury secondary to treatment with clindamycin for a methicillin-susceptible Staphylococcus aureus prosthetic hip infection. Her rash progressed to desquamation of over 90% of her body surface area. Her renal function progressively declined during her hospital stay, and continuous renal replacement therapy was started. Peripheral eosinophilia was present, and urine studies were consistent with intrinsic renal failure. The patient also developed pancreatitis, hepatic failure with elevated liver enzyme levels and coagulopathy, respiratory failure necessitating mechanical ventilation, and hypotension. After a 16-day hospitalization, life-sustaining measures were withdrawn, and the patient died. Use of a cutaneous adverse drug reaction scale indicated that clindamycin was the definite cause of this patient's DRESS syndrome. To our knowledge, this is the first case report of fatal clindamycin-induced DRESS syndrome and only the second case report of DRESS attributable to clindamycin therapy. Although commonly linked with anticonvulsants, clinicians should consider the possibility of this reaction with antimicrobials, including clindamycin. PMID:23165860

Miller Quidley, April; Bookstaver, P Brandon; Gainey, Andrew B; Gainey, Matthew D

2012-11-16

151

Two family members with a syndrome of headache and rash caused by human parvovirus B19  

Directory of Open Access Journals (Sweden)

Full Text Available Human parvovirus B19 infection can cause erythema infectiosum (EI) and several other clinical presentations. Central nervous system (CNS) involvement is rare, and only a few reports of encephalitis and aseptic meningitis have been published. Here, we describe 2 cases of B19 infection in a family presenting different clinical features. A 30 year old female with a 7-day history of headache, malaise, myalgias, joint pains, and rash was seen. Physical examination revealed a maculopapular rash on the patient's body, and arthritis of the hands. She completely recovered in 1 week. Two days before, her 6 year old son had been admitted to a clinic with a 1-day history of fever, headache, abdominal pain and vomiting. On admission, he was alert, and physical examination revealed neck stiffness, Kerning and Brudzinski signs, and a petechial rash on his trunk and extremities. Cerebrospinal fluid analysis was normal. He completely recovered in 5 days. Acute and convalescent sera of both patients were positive for specific IgM antibody to B19. Human parvovirus B19 should be considered in the differential diagnosis of aseptic meningitis, particularly during outbreaks of erythema infectiosum. The disease may mimic meningococcemia and bacterial meningitis.

Antonio Carlos M. Pereira; Roberto Alexandre Q. Barros; Jussara Pereira do Nascimento; Solange Artimos de Oliveira

2001-01-01

152

Endoscopic evaluation of pterygopalatine fossa in adult Iranian cadavers  

Directory of Open Access Journals (Sweden)

Full Text Available   Background : Our aim in this study was to recognize the endoscopic anatomy of the Pterygopalatine fossa (PPF) and the anatomic variations of the related neurovascular structures, to define the endoscopic endonasal approach to this region.   Methods: In a case series study 17 fresh adult cadavers were studied by endoscopic endonasal approach. To reach the pterygopalatine fossa endonasally, we performed the antrostomy and uncinectomy in all cadavers. The medial and posterior walls of the maxillary sinus were defined and studied. The internal maxillary artery and pterygopalatine ganglion and the other nerves were exposed. The posterior wall of maxillary sinus was opened to expose the pterygopalatine fossa and its neurovascular contents, which were studied and documented . Mean, median, range, standard deviation, frequency and frequency percentage were determined using statistical software SPSS V.19 and using descriptive analyses. For comparison of qualitative averages, independent t test was used after the normal distribution of data was tested to determine whether it is followed by 1-sample KS; and -Chi square statistical test was used for the comparison of qualitative ratios. In all tests, significance level was considered as two tails and p value less than 0.05.   Results: The PPF was easily approached by endoscopic transnasal transmaxillary approach. The PPF region was best exposed by the middle meatus tranasal approach. In the PPF infraorbital nerve, vidian nerve, greater palatine nerve, the infraorbital artery, internal maxillary artery, sphenopalatine artery, descending palatine artery, posterior superior alveolar artery and buccal artery were exposed.   Conclusion: During the endoscopic transnasal transmaxillary approach to the PPF, it is possible to face wide range of variations in every phase of the approach but they are similarities at the base. Understanding the anatomy of this region and the neurovascular relations from the endoscopic view by cadaver dissections, will help us to perform more controlled and safe surgery.

Alireza Mohebbi; Maryam Etemadi; Kaveh Mousavi Kani

2013-01-01

153

Intensity-Modulated Arc Therapy for Pediatric Posterior Fossa Tumors  

International Nuclear Information System (INIS)

Purpose: To compare intensity-modulated arc therapy (IMAT) to noncoplanar intensity-modulated radiation therapy (IMRT) in the treatment of pediatric posterior fossa tumors. Methods and Materials: Nine pediatric patients with posterior fossa tumors, mean age 9 years (range, 6–15 years), treated using IMRT were chosen for this comparative planning study because of their tumor location. Each patient’s treatment was replanned to receive 54 Gy to the planning target volume (PTV) using five different methods: eight-field noncoplanar IMRT, single coplanar IMAT, double coplanar IMAT, single noncoplanar IMAT, and double noncoplanar IMAT. For each method, the dose to 95% of the PTV was held constant, and the doses to surrounding critical structures were minimized. The different plans were compared based on conformity, total linear accelerator dose monitor units, and dose to surrounding normal tissues, including the entire body, whole brain, temporal lobes, brainstem, and cochleae. Results: The doses to the target and critical structures for the various IMAT methods were not statistically different in comparison with the noncoplanar IMRT plan, with the following exceptions: the cochlear doses were higher and whole brain dose was lower for coplanar IMAT plans; the cochleae and temporal lobe doses were lower and conformity increased for noncoplanar IMAT plans. The advantage of the noncoplanar IMAT plan was enhanced by doubling the treatment arc. Conclusion: Noncoplanar IMAT results in superior treatment plans when compared to noncoplanar IMRT for the treatment of posterior fossa tumors. IMAT should be considered alongside IMRT when treatment of this site is indicated.

2012-02-01

154

Posterior cranial fossa arteriovenous fistula with presenting as caroticocavernous fistula  

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We report cases of posterior cranial fossa arteriovenous fistula (AVF) with presenting with exophthalmos, chemosis and tinnitus in 26- and 66-year-old men. The final diagnoses was vertebral artery AVF and AVF of the marginal sinus, respectively. The dominant venous drainage was the cause of the unusual presentation: both drained from the jugular bulb or marginal sinus, via the inferior petrosal and cavernous sinuses and superior ophthalmic vein. We used endovascular techniques, with coils and liquid adhesives to occlude the fistulae, with resolution of the symptoms and signs. (orig.)

Liu, H.M.; Shih, H.C.; Huang, Y.C.; Wang, Y.H. [Dept. of Medical Imaging, National Taiwan University Hospital, Taipei (Taiwan)

2001-05-01

155

Posterior cranial fossa arteriovenous fistula with presenting as caroticocavernous fistula  

International Nuclear Information System (INIS)

We report cases of posterior cranial fossa arteriovenous fistula (AVF) with presenting with exophthalmos, chemosis and tinnitus in 26- and 66-year-old men. The final diagnoses was vertebral artery AVF and AVF of the marginal sinus, respectively. The dominant venous drainage was the cause of the unusual presentation: both drained from the jugular bulb or marginal sinus, via the inferior petrosal and cavernous sinuses and superior ophthalmic vein. We used endovascular techniques, with coils and liquid adhesives to occlude the fistulae, with resolution of the symptoms and signs. (orig.)

2001-01-01

156

A dental implant in the infratemporal fossa: case report.  

UK PubMed Central (United Kingdom)

This case report describes a rare displacement of a dental implant in the infratemporal fossa, which occurred during placement of the implant into the pterygoid process with computer-assisted technology. The implant was immediately removed by means of an intraoral approach to prevent any neurologic complications. Although computer-aided systems in implant surgery represent a reliable and effective tool, the surgeon should always instruct the patient on the necessary behavior during implant placement and the risks associated with a lack of adherence to these recommendations.

Nocini PF; De Santis D; Morandini B; Procacci P

2013-07-01

157

[Abscess of the posterior cranial fossa. Apropos of 10 cases  

UK PubMed Central (United Kingdom)

In this study, a series of 10 cases of abscess of the posterior cerebral fossa is analysed. In our department, the incidence of this condition is 2 cases per year. These predominantly occur in juvenile male and are frequently caused by adjacent ENT disease. Numerous therapeutic approaches are possible. In our series, 3 patients underwent emergency surgery with simultaneous treatment of the abscess of the ear. A second series of 6 patients underwent delayed treatment of the ENT infection (over 2 weeks) after the emergency puncture of the abscess. The rapid and good recovery of the 3 patients who underwent simultaneous petromastiodectomy and puncture of the abscess during surgery should be emphasized.

Ouboukhlik A; el-Kamar A; el-Azhari A; Boucetta M; Benchekroun Y

1993-01-01

158

Computed tomography of the nasopharynx and fossa pterygopalatina  

Energy Technology Data Exchange (ETDEWEB)

CT is -especially since the introduction of thin slice technique - the method of choice for the diagnosis of nasopharyngeal tumors. This method provides better results than the conventional film tomography in determining intracranial tumor extension, osseous destruction of the base of the skull, and involvement of the orbit. Tumor infiltration into the pterygoid fossa is also well seen by the third generation of CT. In particular CT scans are superior to conventional tomography in delineating tumor extension to the parapharyngeal and retromaxillary space as well as in recognition of cervical lymph node involvement.

Moedder, U.; Bertram, G.

1982-06-01

159

Recurrent ameloblastoma in temporal fossa: A diagnostic dilemma.  

Science.gov (United States)

Ameloblastoma is a unique, histologically benign but aggressive neoplasm of the jaws, arising from odontogenic epithelium with potency to cause extensive destruction of jaw bones and infiltration into the surrounding tissues. Recurrences are common after incomplete treatment. Recurrences can occur at difficult sites such as temporal and infratemporal fossa, orbit, anterior cranial base, paranasal sinuses etc. Fine needle aspiration cytology or core biopsy of these recurrent lesions may be misleading. Clinical course and radiological features help immensely in these situations. Good communication between surgeon, radiologist, and pathologist is of paramount importance. PMID:24015013

Vaishampayan, Sagar S; Nair, Deepa; Patil, Asawari; Chaturvedi, Pankaj

2013-04-01

160

Recurrent ameloblastoma in temporal fossa: A diagnostic dilemma.  

UK PubMed Central (United Kingdom)

Ameloblastoma is a unique, histologically benign but aggressive neoplasm of the jaws, arising from odontogenic epithelium with potency to cause extensive destruction of jaw bones and infiltration into the surrounding tissues. Recurrences are common after incomplete treatment. Recurrences can occur at difficult sites such as temporal and infratemporal fossa, orbit, anterior cranial base, paranasal sinuses etc. Fine needle aspiration cytology or core biopsy of these recurrent lesions may be misleading. Clinical course and radiological features help immensely in these situations. Good communication between surgeon, radiologist, and pathologist is of paramount importance.

Vaishampayan SS; Nair D; Patil A; Chaturvedi P

2013-04-01

 
 
 
 
161

Recurrent ameloblastoma in temporal fossa: A diagnostic dilemma  

Science.gov (United States)

Ameloblastoma is a unique, histologically benign but aggressive neoplasm of the jaws, arising from odontogenic epithelium with potency to cause extensive destruction of jaw bones and infiltration into the surrounding tissues. Recurrences are common after incomplete treatment. Recurrences can occur at difficult sites such as temporal and infratemporal fossa, orbit, anterior cranial base, paranasal sinuses etc. Fine needle aspiration cytology or core biopsy of these recurrent lesions may be misleading. Clinical course and radiological features help immensely in these situations. Good communication between surgeon, radiologist, and pathologist is of paramount importance.

Vaishampayan, Sagar S.; Nair, Deepa; Patil, Asawari; Chaturvedi, Pankaj

2013-01-01

162

Hesperian age for western Medusae Fossae Formation, Mars.  

UK PubMed Central (United Kingdom)

The Medusae Fossae Formation (MFF) on Mars is an intensely eroded deposit north of the cratered highlands. It is widely thought that MFF materials were emplaced through ignimbrite eruptions. Recent geologic mapping of western MFF identified outliers of MFF materials well beyond the previously mapped western extent for the deposit, including outliers close to Gale crater. We report counts of impact craters on the MFF units that have implications for our understanding of the general history of MFF and the uppermost layered materials on the Gale crater mound.

Zimbelman JR; Scheidt SP

2012-06-01

163

Rhinolith in the fossa of Rosenmuller--a hidden stone.  

Science.gov (United States)

This is a case report of an 80-year-old woman who presented to the ENT services with multiple non-specific upper aerodigestive tract symptoms. Despite extensive investigation and treatment, her symptoms remained unalleviated with significant impact on the psychological morbidity. During a routine flexible nasoendoscopy for worsening globus pharnygis, a mass was noted in the right Rosenmüller's fossa, where the Eustachian tube leaves the lateral wall of the nasopharynx. A CT scan showed this to be a 10 mm calcified entity within the right Eustachian tube. It was subsequently removed under local anaesthesia providing much relief to the patient. Histology showed this mass to be a rhinolith. PMID:22715230

Shilston, J; Foo, S H; Oko, M

2011-01-11

164

Drug rash with eosinophilia and systemic symptoms (DRESS) in patients receiving strontium ranelate.  

UK PubMed Central (United Kingdom)

UNLABELLED: We have reviewed 47 drug rash with eosinophilia and systemic symptoms (DRESS) cases associated to strontium ranelate reported up to March 2011 to the Marketing Holder. The main signs were skin rash, fever, face oedema hypereosinophilia and liver involvement. For ten patients, persistence of DRESS symptoms was reported at the latest news obtained, and DRESS was identified as the direct cause of death in one case. The maximum incidence of DRESS associated with strontium ranelate was 1/24,112 [95 % CI (1/14,859; 1/42,194)] newly treated patients in France. Because DRESS is a severe drug reaction, the occurrence of a rash in a patient treated with strontium ranelate should lead to prompt and permanent treatment discontinuation. INTRODUCTION: This study aims to describe cases of DRESS reported to the Marketing Authorisation Holder worldwide for patients receiving strontium ranelate by practitioner or by regulatory authorities. METHODS: Spontaneously reported hypersensitivity events from the strontium ranelate pharmacovigilance database since marketing authorisation (2004) to March 2011 were reviewed by an expert committee. Cases of DRESS were classified as established, probable, possible or no DRESS according to expert judgement. National incidences of DRESS were estimated in relation to the number of newly treated patients. RESULTS: Up to March 2011, 325 cases of strontium ranelate-induced hypersensitivity events were assessed from which 47 DRESS cases were confirmed. Mean age was 68.7 years and besides skin rash, the main signs and symptoms were hypereosinophilia, liver involvement, fever and face oedema. Median time to skin reaction was 33.5 days after treatment start. Most patients (62 %) recovered at the time of reporting or were recovering. For ten patients, persistence of DRESS symptoms was reported at the latest news obtained. Relapses were observed in a single case. The mortality rate was 8.5 %. The maximum incidence of DRESS associated with strontium ranelate was 1/24,112 [95 % CI (1/14,859; 1/42,194)] newly treated patients in France. CONCLUSION: DRESS is a well-identified and characterised adverse reaction to strontium ranelate. This risk should be integrated in the risk-benefit balance evaluation of patient treatment, and the occurrence of a rash should lead to prompt and permanent treatment discontinuation with careful follow-up.

Cacoub P; Descamps V; Meyer O; Speirs C; Belissa-Mathiot P; Musette P

2013-05-01

165

Depression in patients with newly diagnosed epilepsy predicts lamotrigine-induced rash: a short-term observational study.  

Science.gov (United States)

Lamotrigine (LTG) has a good efficacy and tolerability as initial monotherapy for patients with newly diagnosed epilepsy (NDE). However, the occurrence of skin rash is one of the main reasons to discontinue LTG. On the basis of a high frequency of adverse effects associated with antiepileptic drugs in depressed patients, this study investigated whether depression is a likely predictor of LTG-induced rash in patients with NDE. Eligible patients received LTG monotherapy and were observed for 12 weeks. Twenty (27%) of 74 enrolled patients had depression. Ten patients (13.5%) developed a skin rash within 5 weeks. Depression was a sole predictor of LTG-induced rash (OR=9.154, 95% CI 2.077-40.344, p=0.003). PMID:23673289

Park, Sung-Pa

2013-05-11

166

Depression in patients with newly diagnosed epilepsy predicts lamotrigine-induced rash: a short-term observational study.  

UK PubMed Central (United Kingdom)

Lamotrigine (LTG) has a good efficacy and tolerability as initial monotherapy for patients with newly diagnosed epilepsy (NDE). However, the occurrence of skin rash is one of the main reasons to discontinue LTG. On the basis of a high frequency of adverse effects associated with antiepileptic drugs in depressed patients, this study investigated whether depression is a likely predictor of LTG-induced rash in patients with NDE. Eligible patients received LTG monotherapy and were observed for 12 weeks. Twenty (27%) of 74 enrolled patients had depression. Ten patients (13.5%) developed a skin rash within 5 weeks. Depression was a sole predictor of LTG-induced rash (OR=9.154, 95% CI 2.077-40.344, p=0.003).

Park SP

2013-07-01

167

Right-sided infective endocarditis presenting with purpuric skin rash and cardiac failure in a patient without fever.  

UK PubMed Central (United Kingdom)

We describe the case of a 70-year-old woman who presented with symptoms of cardiac failure, and was found on clinical examination to have a purpuric rash over her lower extremities. Further evaluation of cardiac failure revealed tricuspid regurgitation with two large tricuspid valve vegetations. Blood cultures yielded a growth of Streptococcus viridans. She was treated with an intravenous ceftriaxone and gentamicin and made a complete recovery with resolution of the rash.

Shetty RK; Vivek G; Naha K; Bekkam S

2013-01-01

168

Right-sided infective endocarditis presenting with purpuric skin rash and cardiac failure in a patient without fever.  

Science.gov (United States)

We describe the case of a 70-year-old woman who presented with symptoms of cardiac failure, and was found on clinical examination to have a purpuric rash over her lower extremities. Further evaluation of cardiac failure revealed tricuspid regurgitation with two large tricuspid valve vegetations. Blood cultures yielded a growth of Streptococcus viridans. She was treated with an intravenous ceftriaxone and gentamicin and made a complete recovery with resolution of the rash. PMID:23355575

Shetty, Ranjan K; Vivek, G; Naha, Kushal; Bekkam, Sreedivya

2013-01-25

169

Cerebellar mutism following posterior fossa tumor resection in children.  

UK PubMed Central (United Kingdom)

AIM: Cerebellar mutism is a documented complication of posterior fossa surgery in pediatric ages. Risk factors such as the type of tumor, size, and location of tumor, hyrdrocephalus, postoperative cerebellar swelling for cerebellar mutism were investigated in this study. MATERIAL AND METHODS: A consecutive series of 32 children with a cerebellar tumor were operated on at the Haseki Educational and Research Hospital, Department of Neurosurgery, between 1990 and 2005. Their speech and neuroradiological studies were systematically analysed both preoperatively and postoperatively RESULTS: Cerebellar mutism developed in ten children (32%) in the early postoperative period. The type of tumor, midline localization, and vermian incision were significant single independent risk factors. In addition, an interdependency of possible risk factors (tumor > 5 cm, medulloblastoma) was found. The latency for the development of mutism ranged from 0 to 90 days (mean 15.6 d). The speech returned to normal in eight patients. All cases were accompanied by cerebellar ataxia. CONCLUSION: Mutism after posterior fossa tumor resection is also associated with ataxia. Cerebellar mutism usually has a self-limiting course and a favorable prognosis.

Kotil K; Eras M; Akçetin M; Bilge T

2008-01-01

170

Neurobehavioral alterations in an adolescent following posterior fossa tumor resection.  

UK PubMed Central (United Kingdom)

The posterior fossa syndrome (PFS) consists of a variety of symptoms, including cerebellar mutism, behavioral disturbances and personality changes. We report longitudinal clinical, neuroradiological and neurobehavioral findings in a 19-year-old left-handed patient, diagnosed with attentional deficit hyperactivity disorder (ADHD) at the age of 12, who underwent posterior fossa tumor resection. Although the patient did not develop cerebellar mutism after surgery, marked apathy and emotional indifference, urinary retention, eye-lid apraxia and visual hallucinosis became apparent after a brief interval of normal functioning. Based on these findings it is argued that the PFS might be considered a semiological heterogeneous condition with variable clinical expressions. Long-term follow-up investigations revealed subtle, but significant cognitive and affective deficits, resembling the cerebellar cognitive affective syndrome in adults. As demonstrated by functional neuroimaging studies with SPECT, symptoms were associated with perfusional deficits in the anatomoclinically suspected supratentorial regions, reflecting the distant impact of the cerebellum on cognitive and affective functions.

Baillieux H; De Smet HJ; Lesage G; Paquier P; De Deyn PP; Mariën P

2006-01-01

171

Neurobehavioral alterations in an adolescent following posterior fossa tumor resection.  

Science.gov (United States)

The posterior fossa syndrome (PFS) consists of a variety of symptoms, including cerebellar mutism, behavioral disturbances and personality changes. We report longitudinal clinical, neuroradiological and neurobehavioral findings in a 19-year-old left-handed patient, diagnosed with attentional deficit hyperactivity disorder (ADHD) at the age of 12, who underwent posterior fossa tumor resection. Although the patient did not develop cerebellar mutism after surgery, marked apathy and emotional indifference, urinary retention, eye-lid apraxia and visual hallucinosis became apparent after a brief interval of normal functioning. Based on these findings it is argued that the PFS might be considered a semiological heterogeneous condition with variable clinical expressions. Long-term follow-up investigations revealed subtle, but significant cognitive and affective deficits, resembling the cerebellar cognitive affective syndrome in adults. As demonstrated by functional neuroimaging studies with SPECT, symptoms were associated with perfusional deficits in the anatomoclinically suspected supratentorial regions, reflecting the distant impact of the cerebellum on cognitive and affective functions. PMID:17134992

Baillieux, Hanne; De Smet, Hyo Jung; Lesage, Geoffrey; Paquier, Philippe; De Deyn, Peter P; Mariën, Peter

2006-01-01

172

Chondrosarcoma of the posterior fossa--case report.  

UK PubMed Central (United Kingdom)

The authors describe a case of well differentiated (grade I) chondrosarcoma in a 52-year-old male. The tumor originated in the posteromedial wall of the left petrous bone and extended into the posterior fossa and cervical spine. He showed impaired functions of the left VII to XII cranial nerves. Plain skull x-rays demonstrated erosion of the left petrous and occipital bones, with speckled calcifications. Computed tomography showed a huge mass of slightly high density with mushroom-like calcifications, which was poorly enhanced by contrast medium. Inversion recovery magnetic resonance imaging clearly defined the low-intensity lesion, while the long spin-echo image depicted the tumor as mixed-intensity. On electron microscopic examination, the tumor cells were rich in Golgi apparatus, endoplasmic reticulum, glycogen granules and mitochondria in the cytoplasm, and formed many vacuoles crossing the cell membrane. These vacuoles were suggested to play an important role in matrix formation. Thirty nine other reported cases of chondrosarcoma are reviewed, and the two reported posterior fossa chondrosarcomas are compared with that of ours.

Oguro K; Nakahara N; Yamaguchi Y; Shimabukuro H; Masuzawa T

1989-11-01

173

Man with posterior fossa tumors 15 years apart.  

Science.gov (United States)

A 48-year-old man with a history of hypertension, peripheral vascular disease and a 50-pack-year history of smoking presented with new onset vertigo, tinnitus, diplopia and ataxia in January 1978. CT scan showed a radiolucent defect in the left cerebellar hemisphere with a possible mural nodule. In ensuing months, he experienced worsening symptoms with a corresponding increase in lesion size on re-imaging. Months later, a left posterior fossa craniotomy was performed and revealed a single cystic lesion containing copious amounts of straw-colored fluid and a single mural nodule in the inferior portion of the cyst. Following resection, he was followed clinically until 1985 at which time follow-up was discontinued. He did well until January 1993 when he presented with progressively worsening episodic headaches and retro-orbital pressure. Subsequent MRIs of the brain and spine (February 1993, March 1993) showed multiple lesions along the neuraxis involving the superficial brain parenchyma, leptomeninges, and dura. Despite therapy, his condition progressively declined until he succumbed. A brain-only autopsy revealed numerous small tumor nodules involving the base of the brain over both frontal and temporal lobes, midbrain, pons, right optic nerve, pituitary fossa, and the base of the skull. Pathologic evaluation revealed metastatic hemangioblastoma. Metastatic hemangioblastoma is a rare entity, with only a few reported cases in the literature to date. PMID:22150927

Gorman, Emily F; Bag, Asim K; Palmer, Cheryl Ann

2012-01-01

174

Man with posterior fossa tumors 15 years apart.  

UK PubMed Central (United Kingdom)

A 48-year-old man with a history of hypertension, peripheral vascular disease and a 50-pack-year history of smoking presented with new onset vertigo, tinnitus, diplopia and ataxia in January 1978. CT scan showed a radiolucent defect in the left cerebellar hemisphere with a possible mural nodule. In ensuing months, he experienced worsening symptoms with a corresponding increase in lesion size on re-imaging. Months later, a left posterior fossa craniotomy was performed and revealed a single cystic lesion containing copious amounts of straw-colored fluid and a single mural nodule in the inferior portion of the cyst. Following resection, he was followed clinically until 1985 at which time follow-up was discontinued. He did well until January 1993 when he presented with progressively worsening episodic headaches and retro-orbital pressure. Subsequent MRIs of the brain and spine (February 1993, March 1993) showed multiple lesions along the neuraxis involving the superficial brain parenchyma, leptomeninges, and dura. Despite therapy, his condition progressively declined until he succumbed. A brain-only autopsy revealed numerous small tumor nodules involving the base of the brain over both frontal and temporal lobes, midbrain, pons, right optic nerve, pituitary fossa, and the base of the skull. Pathologic evaluation revealed metastatic hemangioblastoma. Metastatic hemangioblastoma is a rare entity, with only a few reported cases in the literature to date.

Gorman EF; Bag AK; Palmer CA

2012-01-01

175

Extracranial propagation of glioblastoma with extension to pterygomaxillar fossa  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Glioblastoma multiforme is a highly malignant primary brain tumor that shows marked local aggressiveness, but extracranial spread is not a common occurrence. We present an unusual case of recurrent glioblastoma in 54-year old male that spread through the scull base to the ethmoid and sphenoid sinuses, to the orbita, pterygomaxillar fossa, and to the neck. Methods A 54-year old male underwent left temporal resection because of brain tumor of his left temporal lobe. Operation was followed by external beam radiation combined with temozolomide. The tumor recurred eight months after first surgery. The patient developed swelling of left temporal region, difficult swallowing and headache. MRI of head showed recurrent tumor, which invaded orbita, ethmoid and sphenoid sinuses, nasal cavity, pterygomaxillar fossa. Results The patient died ten months after initial diagnosis of glioblastoma multiforme, and two months after his second operation. Conclusions The aggressive surgical operation helped to downsize the tumor mass as much as possible, but did not prolonged significantly the life or improved the life quality of the patient. The current literature is reviewed, and the diagnostic approaches as well as therapeutic options are discussed.

Tomac Damir; Chudy Darko; Lambaša Smiljka; Topi? Iva; Grahovac Gordan; Zoric Arijana

2011-01-01

176

Apparent paradoxical vault changes with middle cranial fossa arachnoid cysts--implication for aetiology.  

Science.gov (United States)

Three cases of middle cranial fossa arachnoid cyst with paradoxical bone changes in the adjacent vault are described, namely, a small middle cranial fossa and pneumosinus dilatans. This association is unusual and unique. The existing literature is reviewed and the probable aetiological factors discussed. PMID:11895303

Redla, S; Husami, Y; Colquhoun, I R

2001-10-01

177

Apparent paradoxical vault changes with middle cranial fossa arachnoid cysts--implication for aetiology.  

UK PubMed Central (United Kingdom)

Three cases of middle cranial fossa arachnoid cyst with paradoxical bone changes in the adjacent vault are described, namely, a small middle cranial fossa and pneumosinus dilatans. This association is unusual and unique. The existing literature is reviewed and the probable aetiological factors discussed.

Redla S; Husami Y; Colquhoun IR

2001-10-01

178

Apparent paradoxical vault changes with middle cranial fossa arachnoid cysts - Implication for aetiology  

International Nuclear Information System (INIS)

Three cases of middle cranial fossa arachnoid cyst with paradoxical bone changes in the adjacent vault are described, namely, a small middle cranial fossa and pneumosinus dilatans. This association is unusual and unique. The existing literature is reviewed and the probable aetiological factors discussed. Redla, S., Husani, Y. and Colquhoun, I.R. (2001)

2001-01-01

179

Apparent paradoxical vault changes with middle cranial fossa arachnoid cysts - Implication for aetiology  

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Three cases of middle cranial fossa arachnoid cyst with paradoxical bone changes in the adjacent vault are described, namely, a small middle cranial fossa and pneumosinus dilatans. This association is unusual and unique. The existing literature is reviewed and the probable aetiological factors discussed. Redla, S., Husani, Y. and Colquhoun, I.R. (2001)

Redla, Sridhar; Husami, Yahya; Colquhoun, Iain R

2001-10-01

180

Posterior fossa dermoid in association with Klippel-Feil syndrome--a short report.  

Directory of Open Access Journals (Sweden)

Full Text Available A posterior fossa dermoid cyst in association with the Klippel-Feil syndrome, in a 4 year old child is reported. Early diagnosis to prevent complications like neural compression, cyst rupture and staphylococcal meningitis justifies investigation for posterior fossa dermoids in cases of Klippel-Feil syndrome. Their embryological basis is discussed.

Sharma M; Sharma B; Yadav A; Khosla V

2001-01-01

 
 
 
 
181

Detection of Serpentine on Mars by MRO-CRISM and Possible Relationship with Olivine and Magnesium Carbonate in Nili Fossae  

Science.gov (United States)

Reports the first orbital detection of serpentine on Mars’ surface, made by CRISM in the Thaumasia and Nili Fossae regions. Evidence for serpentinization of an olivine-magnesium carbonate-serpentine bearing rock unit in Nili Fossae is discussed.

Ehlmann, B. L.; Mustard, J. F.; Murchie, S. L.

2009-03-01

182

Endonasal transpterygoid approach to the infratemporal fossa: correlation of endoscopic and multiplanar CT anatomy.  

UK PubMed Central (United Kingdom)

BACKGROUND: The infratemporal fossa anatomy, from an endoscopic standpoint, is poorly understood. Our purpose was to design an anatomic model that illustrates the anatomy of the infratemporal fossa from the endoscopic standpoint and serves as a training model for surgeons interested in pursuing this endeavor. METHODS: Red and blue silicone dyes were respectively injected into the great vessels of the neck. Digital data acquired from a high resolution CT scan was imported to a navigational system. An endoscopic endonasal dissection of the infratemporal fossa was completed under conditions that mimicked our operating suite. RESULTS: A detailed anatomic dissection of the infratemporal fossa was correlated to the image guidance (navigation) system. This provided a surgical map highlighting critical neurovascular structures and illustrating the potential surgical corridors. CONCLUSION: A thorough understanding of the anatomy of infratemporal fossa from the endoscopic perspective allows the surgeon to plan an adequate corridor.

Hosseini SM; Razfar A; Carrau RL; Prevedello DM; Fernandez-Miranda J; Zanation A; Kassam AB

2012-03-01

183

Epidermoid cyst of the posterior fossa: a case report/ Cisto epidermoide da fossa posterior: relato de caso  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Os cistos epidermoides do sistema nervoso central (SNC) são condições incomuns, estando localizados mais frequentemente no ângulo pontocerebelar e ao redor da ponte. Eles são revestidos por epitélio escamoso queratinizado e lamelas de queratina, tornando seu conteúdo branco-perolado e pastoso. Os cistos epidermoides são, na maioria das vezes, originados de malformações, possivelmente associados ao entremeio de elementos superficiais do ectoderma do SNC durante o (more) fechamento da placa neural, ou formação das vesículas cerebrais secundárias. Os autores descrevem um caso de cisto epidermoide da fossa posterior determinando hidrocefalia e revisam critérios morfológicos e diagnósticos dessa lesão. Abstract in english Epidermoid cysts of the central nervous system are uncommon conditions, which are frequently located in the cerebellopontine angle and around the pons. They are covered with keratinized squamous epithelium and keratin lamella, which give its contents a soft, white-pearly appearance. Epidermoid cysts are mostly originated from malformations, presumably associated with surface elements of the nervous system ectoderm during the closure of the neural groove or formation of se (more) condary cerebral vesicles. The authors describe a case of epidermoid cyst in the posterior fossa causing hydrocephalus and review morphologic and diagnostic criteria of this lesion.

Cambruzzi, Eduardo; Presa, Karinelli; Silveira, Luciano Carvalho; Perondi, Gerson Evandro

2011-02-01

184

Cephalhematoma and petechial rashes associated with acute parvovirus B19 infection: a case report.  

UK PubMed Central (United Kingdom)

BACKGROUND: Parvovirus B19 can cause petechial rashes in the acute phase of illness as well as erythema infectiosum (fifth disease) during convalescence. This petechial rash is often called "gloves and socks" syndrome because of the typical distribution of the eruption. However, involvement of other sites (e.g., intertriginous area) and generalized involvement have been recently recognized. We report here a patient with parvovirus-associated petechiae and cephalhematoma. CASE PRESENTATION: The patient was a previously healthy 10-year-old boy. There was a family history of fatal bleeding; his sister died of intracranial bleeding with an uncertain cause at the age of 5 months. The patient was admitted to our hospital because of sudden onset of cephalhematoma associated with fever. He reported that he had no recent head trauma but that he massaged his scalp on the day before admission. On admission, his temperature was 38.8[degree sign]C; otherwise, he was in a stable condition. Besides cephalhematoma, petechial rashes were present on his trunk and limbs. The initial laboratory tests were essentially normal, including platelet count and coagulation tests. Expanded laboratory tests were repeated to explore the etiology of his skin hemorrhage, all of which indicated that hematological disorders were unlikely. His symptoms subsided spontaneously over the next few days and he was discharged uneventfully. Anti-parvovirus IgM titer was elevated during hospitalization and typical erythema infectiosum was seen approximately 1 week after discharge. During 6 months follow-up, he remained stable without recurrence of a hemorrhagic episode. Finally, we concluded that his cephalhematoma was responsible for acute parvoviral infection. CONCLUSIONS: This is believed to be the first report describing a possible association between parvovirus B19 infection and cephalhematoma. Parvovirus B19 infection should be considered in the differential diagnosis of children who present with unexplained hemorrhage such as cephalhematoma or petechiae.

Takeuchi M; Shiozawa R; Hangai M; Takita J; Kitanaka S

2013-10-01

185

"Blueberry muffin" rash and large right thigh mass: a unique presentation of Langerhans cell histiocytosis.  

Science.gov (United States)

Langerhans cell histiocytosis (LCH) is a clonal proliferation of bone marrow derived antigen-presenting cells that can involve a spectrum of cutaneous findings, with or without internal organ involvement. Neonatal LCH almost always presents with skin findings, usually petechial papules and/or erosions in a seborrheic distribution, with or without extracutaneous involvement. Previously described as varying entities, LCH is now considered a single disease process demonstrating a spectrum of clinical findings. We report a unique case of neonatal LCH presenting with a "blueberry muffin" rash in conjunction with a large soft tissue tumor. PMID:24011317

Lau, Erica G; Stepenaskie, Shelly; Moran, Rebecca; Quinn, Robert; Matthew, Prasad; Smidt, Aimee C

2013-06-15

186

"Blueberry muffin" rash and large right thigh mass: a unique presentation of Langerhans cell histiocytosis.  

UK PubMed Central (United Kingdom)

Langerhans cell histiocytosis (LCH) is a clonal proliferation of bone marrow derived antigen-presenting cells that can involve a spectrum of cutaneous findings, with or without internal organ involvement. Neonatal LCH almost always presents with skin findings, usually petechial papules and/or erosions in a seborrheic distribution, with or without extracutaneous involvement. Previously described as varying entities, LCH is now considered a single disease process demonstrating a spectrum of clinical findings. We report a unique case of neonatal LCH presenting with a "blueberry muffin" rash in conjunction with a large soft tissue tumor.

Lau EG; Stepenaskie S; Moran R; Quinn R; Matthew P; Smidt AC

2013-01-01

187

A 6-year-old boy with fever, rash and severe pneumonia.  

UK PubMed Central (United Kingdom)

The authors report a 6-year-old boy with fever, rash and cough. He was diagnosed with severe measles pneumonia and admitted to the paediatric intensive care unit with severe dyspnoea 8 days after symptom onset. He received intravenous antibiotics and high dose vitamin A. Three days later, he had recovered and was discharged home. He had not been vaccinated for measles, mumps and rubella according to the schedule. This case highlights the need for rapid diagnosis, appropriate treatment and determination of vaccination status of children with measles in order to prevent complications.

Kongthavonsakul K; Washington CH; Oberdorfer P

2012-01-01

188

Mutism after posterior fossa surgery. Review of the literature.  

UK PubMed Central (United Kingdom)

Mutism is an infrequent and transitory complication observed following posterior fossa surgery. Patients become mute in the immediate postoperative period, with restoration of speech within a few weeks. A review of the literature disclosed 157 patients with this condition. The anatomical structures thought to be involved are the connections between the cerebella dentate nucleous, the ventrolateral nucleous of the contalateral thalamus and the supplementary motor area. We reviewed 157 of cerebellar mutism; however several reports did not give sufficient information about the patients and 134 cases were selected for this study. The ages of the patients ranged from 2 to 61 years and the vermisat was the site of the tumour in 89% of the cases. All tumours were considered to be large or very large. The mutism lasted from 4 days to 52 months and was transient in all cases.

Gelabert-González M; Fernández-Villa J

2001-07-01

189

Mutism after posterior fossa surgery. Review of the literature.  

Science.gov (United States)

Mutism is an infrequent and transitory complication observed following posterior fossa surgery. Patients become mute in the immediate postoperative period, with restoration of speech within a few weeks. A review of the literature disclosed 157 patients with this condition. The anatomical structures thought to be involved are the connections between the cerebella dentate nucleous, the ventrolateral nucleous of the contalateral thalamus and the supplementary motor area. We reviewed 157 of cerebellar mutism; however several reports did not give sufficient information about the patients and 134 cases were selected for this study. The ages of the patients ranged from 2 to 61 years and the vermisat was the site of the tumour in 89% of the cases. All tumours were considered to be large or very large. The mutism lasted from 4 days to 52 months and was transient in all cases. PMID:11516555

Gelabert-González, M; Fernández-Villa, J

2001-07-01

190

[Abscess of the posterior cranial fossa. Apropos of 10 cases].  

Science.gov (United States)

In this study, a series of 10 cases of abscess of the posterior cerebral fossa is analysed. In our department, the incidence of this condition is 2 cases per year. These predominantly occur in juvenile male and are frequently caused by adjacent ENT disease. Numerous therapeutic approaches are possible. In our series, 3 patients underwent emergency surgery with simultaneous treatment of the abscess of the ear. A second series of 6 patients underwent delayed treatment of the ENT infection (over 2 weeks) after the emergency puncture of the abscess. The rapid and good recovery of the 3 patients who underwent simultaneous petromastiodectomy and puncture of the abscess during surgery should be emphasized. PMID:8377885

Ouboukhlik, A; el-Kamar, A; el-Azhari, A; Boucetta, M; Benchekroun, Y

1993-01-01

191

Supratentorial Neurometabolic Alterations in Pediatric Survivors of Posterior Fossa Tumors  

International Nuclear Information System (INIS)

Purpose: Therapy and tumor-related effects such as hypoperfusion, internal hydrocephalus, chemotherapy, and irradiation lead to significant motor and cognitive sequelae in pediatric posterior fossa tumor survivors. A distinct proportion of those factors related to the resulting late effects is hitherto poorly understood. This study aimed at separating the effects of neurotoxic factors on central nervous system metabolism by using H-1 MR spectroscopy to quantify cerebral metabolite concentrations in these patients in comparison to those in age-matched healthy peers. Methods and Materials: Fifteen patients with World Health Organization (WHO) I pilocytic astrocytoma (PA) treated by resection only, 24 patients with WHO IV medulloblastoma (MB), who additionally received chemotherapy and craniospinal irradiation, and 43 healthy peers were investigated using single-volume H-1 MR spectroscopy of parietal white matter and gray matter. Results: Concentrations of N-acetylaspartate (NAA) were significantly decreased in white matter (p

2012-03-01

192

Transnasal endoscopic closure of anterior fossa cerebrospinal fluid fistula.  

UK PubMed Central (United Kingdom)

The anterior skull base can be approached intranasally, and the development of endoscopes and accompanying endoscopic instruments in recent years makes possible extremely precise and defined work along the ethmoid and sphenoid sinus roof. Since these areas are the most frequent locations of anterior skull base CSF rhinorrhea, it follows that the localization and subsequent closure of these defects theoretically can be accomplished in this manner. Our report and others show that closure of CSF leaks can be accomplished successfully using this procedure, with minimal morbidity and at a fraction of the cost of frontal craniotomy. In our opinion, this should become the initial procedure of choice for closure of anterior fossa CSF leaks in amenable cases.

Handley GH; Goodson MA; Real TH

1993-02-01

193

Posterior fossa meningiomas. A report of 30 cases.  

UK PubMed Central (United Kingdom)

The clinical symptoms of thirty patients with surgically treated posterior fossa meningiomas were reviewed. These included 16 cerebellopontine (CPA), 7 cerebellar, 4 carrefour-falco-tentorial (CFT), 2 foramen magnum, and 1 clivus meningiomas. Careful attention to clinical findings is necessary in diagnosing these tumors. With rare exception they have an insidious onset and even after having reached considerable size, the ensuing neurological abnormalities might not be revealing. On occasion there are false localizing neurological findings. Neuroradiological localization is essential to obtain accurate diagnosis and to plan the best operative approach. Radioactive brain scanning offers the best screening method. Although air studies remain useful, angiography of vessels of the posterior foss is assuming a dominant role in diagnosis and surgical planning.

Grand W; Bakay L

1975-01-01

194

[Sciatic nerve block at the popliteal fossa for foot surgery  

UK PubMed Central (United Kingdom)

We review the results of 312 cases of sciatic nerve blockade in the poplitea fossa for surgery of the dorsal foot. An atraumatic, insulated needle connected to a neurostimulator was used to make a single puncture using a posterior approach. The anesthetic was 1% mepivacaine (4-5 mg/kg-1). Mean latency was 12.4 min. Efficacy was very high (86% excellent, 10% adequate, 4% failed). Time of analgesia was 6 h 15 min (range 3-16 h). No complications or sequelae were recorded. We conclude that the technique is highly effective and comfortable for patients, as it requires only one puncture and gives good postoperative analgesia with no major side effects.

Monsó A; Santaliestra J; Barbal F; Fitó F; Riudeubás J

1996-01-01

195

Quantitative analysis of endoscopic endonasal approaches to the infratemporal fossa.  

UK PubMed Central (United Kingdom)

OBJECTIVES/HYPOTHESIS: The operative management of infratemporal skull base lesions is challenging. Expanded endonasal approaches to this area can decrease surgical morbidity. Access lateral to the natural nasal corridor can be achieved via a middle meatal antrostomy, medial maxillectomy complemented by a septotomy, or anteromedial maxillotomy (i.e., Denker's approach). We sought to compare the access to the infratemporal fossa offered by these endoscopic endonasal approaches. STUDY DESIGN: Software-enabled CT scan measurements. METHODS: Axial CT scans obtained with submillimeter cuts through the skull base were examined. All calculations were performed on axial images obtained at the level of the sphenoid floor using Kodak Carestream Image Software (Rochester, NY) measuring tools. RESULTS: Fifty sides were examined. A medial maxillectomy increased the exposure on average by 18.5 degrees (SD = 4.28), when compared to maxillary antrostomy. When we augmented the access with an ipsilateral Denker's approach, an additional 33.5 degrees (SD = 4.81) of exposure were obtained (P < .0001). The addition of a 1-cm anteromedial maxillotomy accessed the entire posterior maxillary wall in 54% of cases. Equivalent access was obtained via a contralateral approach with a septotomy at 1.56 cm from the columella. To access the entire posterior maxillary wall the average anterior maxillotomy should be 1.1 cm (SD = 0.42). In contrast, to access the entire posterior maxillary wall using a contralateral approach the average septotomy position should be 1.52 cm (SD = 0.39) from the columella. CONCLUSIONS: This radioanatomic study provides objective support for the use of an ipsilateral Denker's approach to augment an endoscopic endonasal approach to the infratemporal fossa.

Prosser JD; Figueroa R; Carrau RI; Ong YK; Solares CA

2011-08-01

196

Neuralgies of the lower cranial nerves: Microsurgical posterior fossa exploration  

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Full Text Available Neuralgias of the lower cranial nerves are trigeminal neuralgia (TN), glossopharingeal neuralgia (GphN), and geniculate neuralgia (GN). Microsurgical posterior fossa exploration with its variations microvascular decompression (MVD), partial sensory rhisotomy (PSR), and total sensory rhisotomy (TSR) is one of the most efficient ways of treating these neuralgias. It was performed 130 operations in 125 patients with TN, 3 in GphN patients, 1 in GN patient, 1 in GN/TN patients, 1 in GphN/GN patient, and 2 in GN/hemifacial spasm patients. Of total of 125 patients with TN, MVD was performed in 63, PSR in 18, and MVD+PSR in 44 cases. In 5 patients with recidivate TN PSR was performed. Of total 3 patients with GphN MVD was performed in 2 cases, and extirpation of a small meningeoma in 1 case (it was not seen on CT). In the patients with GN TSR of intermediate nerve was performed, in GN/TN patients TSR of intermediate nerve and PSR of trigeminal nerve was performed, in the GN/GphN patients MVD of glossopharingeal and TSR of intermediate nerve were performed, and in the GN/hemifacial spasm patients TSR of intermediate and MVD of facial nerve were performed. The results of TN patients are: excellent in 82,4%, good in 12%, and poor in 5,6% of patients. There is no difference in complete pain relief, rate of recurrence, and complications between MVD, MVD+PSR and PSR operative groups (p>0,05). Among patients with other neuralgias the following results are noted: excellent in 4, good in 3, and poor in 1 patient. Microsurgical posterior fossa exploration is the method of choice in the treatment of the neuralgias of the lower cranial nerves.

Anti? Branislav; Peri? Predrag; Ivanovi? S.; Spai? M.

2004-01-01

197

Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear  

International Nuclear Information System (INIS)

From a series of patients undergoing routine radiographic examination, 112 temporal bones with a high jugular fossa were selected. Among these, 43 jugular bulb diverticula were found. The structures affected by a high fossa or diverticulum were recorded and correlated to the clinical symptoms of the patient. The vestibule was suspected to be affected in five patients. Two of these patients had tinnitus and vertigo, and three had hearing loss. In one of the latter the hearing loss was most marked in the supine position. The cochlea was close to the fossa in three patients, all of whom had tinnitus. Four patients had a defect of the posterior semicircular canal. One of them lost his hearing after a severe fit of coughing, became unsteady and showed signs of a fistula. The internal acoustic meatus and the mastoid portion of the facial canal were affected in two and four patients, respectively, who had no recorded symptoms. Twelve of 34 patients with Meniere's disease and a high jugular fossa on the side of the diseased ear had a dehiscence of the vestibular aqueduct caused by the fossa or diverticulum, compared with nine of 58 patients in the unselected material. For comparison and demonstration of topographic relationships, 58 casts of unselected radiograhed temporal bone specimens with high jugular fossae or diverticula were investigated. In patients with a high jugular fossa or jugular bulb diverticulum, tomographic assessment may be of value. (orig.)

1986-01-01

198

Simian varicella virus infection of Chinese rhesus macaques produces ganglionic infection in the absence of rash.  

UK PubMed Central (United Kingdom)

Varicella-zoster virus (VZV) causes varicella (chickenpox), becomes latent in ganglia along the entire neuraxis, and may reactivate to cause herpes zoster (shingles). VZV may infect ganglia via retrograde axonal transport from infected skin or through hematogenous spread. Simian varicella virus (SVV) infection of rhesus macaques provides a useful model system to study the pathogenesis of human VZV infection. To dissect the virus and host immune factors during acute SVV infection, we analyzed four SVV-seronegative Chinese rhesus macaques infected intratracheally with cell-associated 5?×?10³ plaque-forming units (pfu) of SVV-expressing green fluorescent protein (n?=?2) or 5?×?10? pfu of wild-type SVV (n?=?2). All monkeys developed viremia and SVV-specific adaptive B- and T-cell immune responses, but none developed skin rash. At necropsy 21 days postinfection, SVV DNA was found in ganglia along the entire neuraxis and in viscera, and SVV RNA was found in ganglia, but not in viscera. The amount of SVV inoculum was associated with the extent of viremia and the immune response to virus. Our findings demonstrate that acute SVV infection of Chinese rhesus macaques leads to ganglionic infection by the hematogenous route and the induction of a virus-specific adaptive memory response in the absence of skin rash.

Ouwendijk WJ; Mahalingam R; Traina-Dorge V; van Amerongen G; Wellish M; Osterhaus AD; Gilden D; Verjans GM

2012-04-01

199

Facial herpes zoster infection precipitated by surgical manipulation of the trigeminal nerve during exploration of the posterior fossa: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction We present a case of herpes zoster infection (shingles) precipitated by surgical manipulation of the trigeminal nerve root during an attempted microvascular decompression procedure. The pathogenesis of this phenomenon, as well as the importance and role of prophylactic acyclovir in its management, are discussed. Case presentation A 54-year-old Caucasian man with a classical long-standing left-sided V2 and V3 division primary trigeminal neuralgia refractory to medical management, underwent posterior fossa exploration for microvascular decompression via a standard retromastoid craniectomy. The patient had immediate and complete relief from pain. Three days after the operation, he developed severely painful vesicles with V2 and V3 dermatomal distribution. Rather than the classical paroxysmal, lancinating type of trigeminal neuralgia, the pain experienced by the patient was of a constant burning nature. A clinical diagnosis of herpes zoster (shingles) was made after smear confirmation from microbiological testing. The patient was commenced on antiviral treatment with acyclovir. His vesicular rash and pain gradually subsided over the next two weeks. He remains asymptomatic one year later. Conclusions Postoperative shingles precipitated by trigeminal nerve manipulation during surgery for trigeminal neuralgia can be a distressing and demoralizing experience for the patient. A careful preoperative history, early recognition, and prompt antiviral therapy is necessary.

Mansour Nassir; Kaliaperumal Chandrasekaran; Choudhari Kishor A

2009-01-01

200

Dislocation of the mandibular condyle into the middle cranial fossa: a case report.  

UK PubMed Central (United Kingdom)

INTRODUCTION: A 32-year-old woman was admitted to our hospital following a motor vehicle accident. Her chief complaint was severe limited mouth opening and unilateral open bite on the left. METHODS: Axial and coronal CT scans showed penetration of right condyle into the middle cranium through the fractured roof of glenoid fossa. A craniotomy exactly above the glenoid fossa was done. RESULTS: The condyle was reduced and the glenoid fossa was reconstructed. CONCLUSION: On postoperative follow-up at 6 months, the patient had no complaint, but there was a small deviation to the affected side on opening.

Vaezi T; Rajaei SA; Hosseini Abrishami M; Erfanian Taghvaei M

2013-02-01

 
 
 
 
201

Superior eyelid crease approach for transobital neuroendoscopic surgery of the anterior cranial fossa.  

Science.gov (United States)

Access to the anterior cranial fossa has traditionally required a large exposure of the surgical field, which can be a source of aesthetic and neurologic morbidity. Minimally invasive surgery approaches have been developed to overcome these adverse effects and was, for a long time, represented by endonasal endoscopic surgery. The superior eyelid crease approach of the anterior cranial fossa with supraorbital osteotomy was described in the early 80s as an interesting alternative to the endonasal approach. This keyhole endoscopic approach allows safe and efficient surgery of the orbit, the anterior cranial fossa, and the mesiotemporal lobe. We successfully treated 10 patients with benign tumors of the anterior cranial fossa, with excellent cosmetic results and no complications. This study presents the surgical technique and its potential indication and limits throughout our experience as well as a review of the literature. PMID:24036738

Koppe, Matthieu; Gleizal, Arnaud; Orset, Emmanuelle; Bachelet, Jean Thomas; Jouanneau, Emmanuel; Rougeot, Amélie

2013-09-01

202

Transient selective downward gaze paralysis complicating posterior fossa tumor resection in children. Report of 2 cases.  

UK PubMed Central (United Kingdom)

Selective downward gaze paralysis has not previously been described as a complication after posterior fossa operations in children. The authors found downgaze palsy to be a transient complication after resection of large pediatric posterior fossa midline tumors reaching the aqueduct of Sylvius. They reviewed the cases of 2 children with large posterior fossa midline tumors who underwent resection via an inferior transventricular approach. They developed a hypothetical scheme to account for downward gaze paralysis based on anatomy and insight gained from experimental studies. The authors describe potential risk factors for developing transient selective downward gaze paralysis with the hope of making more pediatric neurosurgeons aware of this complication following removal of lesions around the mesencephalic periaqueductal gray matter. Recognition and understanding of downward gaze palsy after posterior fossa surgery should improve preoperative counseling and promote postoperative family coping.

Chern JJ; Relyea K; Edmond JC; Whitehead WE; Curry DJ; Luerssen TG; Jea A

2009-06-01

203

Spectral Evidence for the Carbonation of Serpentine in Nili Fossae, Mars  

Science.gov (United States)

Spectral analysis of Nili Fossae phyllosilicates reveals evidence for the presence of talc (not saponite) and mixed-layer clay. These findings provide further evidence that carbonation of serpentine is the formation mechanism for carbonates on Mars.

Viviano, C. E.; Moersch, J. E.; McSween, H. Y.

2012-03-01

204

High-resolution CT of the pterygopalatine fossa and its communications  

International Nuclear Information System (INIS)

The pterygopalatine fossa is an important space because it communicates with the middle cranial fossa, orbit, nasal cavity, oral cavity, pharynx, foramen lacerum, and the infratemporal fossa via eight foramina and canals. We studied the pterygopalatine fossa, foramen rotundum, inferior orbital fissure, sphenopalatine foramen, pterygoid canal, greater and lesser palatine foramen, palatinovaginal canal, and the pterygomaxillary fissure with high-resolution CT to characterise the anatomy and variants of these structures. These structures were evaluated using axial and coronal planes. In the morphometric study, the distance between the foramina rotunda did not show statistically significant differences between the anterior and posterior segments. The pterygoid canal was slightly narrower in the anterior segment (23.9 mm) than in the posterior segment (25.2 mm). The pterygoid canal narrowed in the anterior (1.8 mm) to posterior (1.2 mm) direction (P

1996-01-01

205

Endoscopic transnasal resection of anterior cranial fossa meningiomas.  

UK PubMed Central (United Kingdom)

OBJECT: The extended transnasal approach, a recent surgical advancements for the ventral skull base, allows excellent midline access to and visibility of the anterior cranial fossa, which was previously thought to be approachable only via a transcranial route. The extended transnasal approach allows early decompression of the optic canals, obviates the need for brain retraction, and reduces neurovascular manipulation. METHODS: Between 2004 and 2007, 11 consecutive patients underwent transnasal resection of anterior cranial fossa meningiomas--4 olfactory groove (OGM) and 7 tuberculum sellae (TSM) meningiomas. Age at surgery, sex, symptoms, and imaging studies were reviewed. Tumor size and tumor extension were estimated, and the anteroposterior, vertical, and horizontal diameters were measred on MR images. Medical records, surgical complications, and outcomes of the patients were collected. RESULTS: A gross-total removal of the lesion was achieved in 10 patients (91%), and in 1 patient with a TSM only a near-total (> 90%) resection was possible. Four patients with preoperative visual function defect had a complete recovery, whereas 3 patients experienced a transient worsening of vision, fully recovered within few days. In 3 patients (2 with TSMs and 1 with an OGM), a postoperative CSF leak occurred, requiring a endoscopic surgery for skull base defect repair. Another patient (a case involving a TSM) developed transient diabetes insipidus. The operative time ranged from 6 to 10 hours in the OGM group and from 4.5 to 9 hours in the TSM group. The mean duration of the hospital stay was 13.5 and 10 days in the OGM and TSM groups, respectively. Six patients (3 with OGMs and 3 with TSMs) required a blood transfusion. Surgery-related death occurred in 1 patient with TSM, in whom the tumor was successfully removed. CONCLUSIONS: The technique offers a minimally invasive route to the midline anterior skull base, allowing the surgeon to avoid using brain retraction and reducing manipulation of the large vessels and optic apparatus; hastens postoperative recovery; and improves patient compliance. Further assessment and refinement are required, particularly because of the potential risk of CSF leakage. Other studies and longer follow-up periods are necessary to ascertain the benefits of the technique.

de Divitiis E; Esposito F; Cappabianca P; Cavallo LM; de Divitiis O; Esposito I

2008-01-01

206

Facial nerve neurinoma presenting as middle cranial fossa and cerebellopontine angle mass : a case report.  

Directory of Open Access Journals (Sweden)

Full Text Available Facial nerve neurinomas are rare. The tumours arising from the geniculate ganglion may grow anteriorly and superiorly and present as a mass in the middle cranial fossa. Only a few cases of facial nerve neurinomas presenting as middle cranial fossa mass have so far been reported. These tumours present with either long standing or intermittent facial palsy along with cerebellopontine angle syndrome.

Devi B; Panigrahi M; Jaiswal V; Bhat D; Das S; Das B

2000-01-01

207

[Acute subdural hematoma of the posterior fossa in the child. Case report  

UK PubMed Central (United Kingdom)

Acute subdural hematoma (ASDH) of the posterior fossa is very rare in childhood. It represent 0.52% of all subdural hematomas. We report a case of post-traumatic acute subdural hematoma of the posterior fossa in a 4-year-old child who was drowsy, without a neurologic defect. The CT scan revealed a simple ASDH, with a good recovery after surgical treatment. The literature is reviewed, clinical and therapeutic aspects are discussed.

Hilmani S; Bertal A; El Malki M; Sami A; Achouri M; Ouboukhlik A; El Kamar A; El Azhari A

2003-03-01

208

[Acute subdural hematoma of the posterior fossa in the child. Case report].  

Science.gov (United States)

Acute subdural hematoma (ASDH) of the posterior fossa is very rare in childhood. It represent 0.52% of all subdural hematomas. We report a case of post-traumatic acute subdural hematoma of the posterior fossa in a 4-year-old child who was drowsy, without a neurologic defect. The CT scan revealed a simple ASDH, with a good recovery after surgical treatment. The literature is reviewed, clinical and therapeutic aspects are discussed. PMID:12736580

Hilmani, S; Bertal, A; El Malki, M; Sami, A; Achouri, M; Ouboukhlik, A; El Kamar, A; El Azhari, A

2003-03-01

209

Endoscopic third ventriculostomy in the treatment of hydrocephalus in posterior fossa tumors in children.  

UK PubMed Central (United Kingdom)

OBJECT: The purpose of the present study is to assess the effectiveness of endoscopic third ventriculostomy (ETV) in children with hydrocephalus related to posterior fossa tumors. METHODS: Between September 1999 and December 2002, 63 children with posterior fossa tumors were treated at Santobono Hospital in Naples, Italy. Twenty-six patients had severe hydrocephalus. In order to relieve intracranial hypertension before tumor removal, 20 were treated with ETV, and 6 with ventriculo-peritoneal (VP) shunts. Twenty patients with mild hydrocephalus were treated with diuretics, corticosteroid agents, and early posterior fossa surgery, and 17 patients who did not have hydrocephalus were treated by elective posterior fossa surgery. Another 4 ETV were performed in the management of postoperative hydrocephalus. RESULTS: Preoperative ETV procedures were technically successful. One was complicated by intraventricular bleeding. The successful 19 preoperative ETV resolved intracranial hypertension before posterior fossa surgery in all cases. Three of these 19 patients developed postoperative hydrocephalus and were treated by VP shunt insertion after posterior fossa surgery. Out of the 4 ETV performed after posterior fossa surgery, only 2 were successful, both when the shunt malfunctioned. CONCLUSIONS: Endoscopic third ventriculostomy should be considered as an alternative procedure to ventriculo-peritoneal shunting and external ventricular draining for the emergency control of severe hydrocephalus caused by posterior fossa tumors, since it can quickly eliminate symptoms, and hence, can delay surgery scheduling if required. Even though ETV does not prevent postoperative hydrocephalus in all cases, it does protect against acute postoperative hydrocephalus due to cerebellar swelling. In addition, it eliminates the risks of cerebrospinal fluid (CSF) infection related to external drainage and minimizes the risk of overdrainage because it provides more physiological CSF drainage than the other procedures. Since postoperative hydrocephalus is very often physically obstructive, ETV should always be considered a possible treatment procedure.

Ruggiero C; Cinalli G; Spennato P; Aliberti F; Cianciulli E; Trischitta V; Maggi G

2004-11-01

210

[Psychic disorders. An unknown complication of surgery of the posterior cranial fossa  

UK PubMed Central (United Kingdom)

Psychic trouble is not generally recognised as a possible complication of posterior fossa surgery. Reviewing a series of 63 pediatric patients operated on for posterior fossa intraxial tumors, the Authors found 21 cases of psychic troubles in the post-operative period. The incidence was higher in: a) medulloblastoma; b) rostral vermis location; c) supracerebellar infratentorial and transvermian approach. The neuropathophysiological basis of the phenomenon is discussed.

Punzo A; De Marinis P; Ruggiero C; D'Arienzo G; Ambrosio G; Graziano DV

1992-04-01

211

Mudez após cirurgia para tumor da fossa posterior relato de dois casos/ Mutism after posterior fossa tumor surgery: report of two cases  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Os autores descrevem episódios de mutismo após cirurgia para tumores da fossa posterior em pacientes jovens. São apresentados dois casos e é feita análise da ausência de expressão verbal que estabeleceu após a cirurgia. Também é feita análise do mutismo do ponto de vista de suas conotações neurológicas e psicológicas, ao mesmo tempo em que é revista a literatura sobre o assunto. Abstract in english The authors present two cases of mutism after posterior fossa surgery. Two patients aged 16 and 5 years old respectively with astrocytoma and medulloblastoma, developed mutism after the operation. Topographic aspects of the condition are discussed and its neurological expression.

Wagner, Roberto da Cunha; Gallo, Pasquale; Oppitz, Paulo P.

1995-03-01

212

Susceptibility to infectious rash illness in pregnant women from diverse geographical regions.  

Science.gov (United States)

Varicella-zoster (VZV), rubella (RV) and parvovirus B19 (B19V) infections are important causes of rash illness in pregnancy, due to their potential adverse impact on both mother and fetus. We determined susceptibility to these infections in pregnant women attending our hospital in 2002. Age and nationality were recorded. Sera were tested for VZV, RV, and B19V antibody by enzyme immunoassay. Of 7,980 women screened for VZV IgG, 11.3% were seronegative and therefore susceptible to infection. Across different worldwide regions, 6.9% of Irish and other Western European women were susceptible to VZV, compared to 19.7% of other women tested (p 79804

Knowles, S J; Grundy, K; Cahill, I; Cafferkey, M T

2004-12-01

213

Glenoid fossa position in Class III malocclusion associated with mandibular protrusion.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Our aim in this study was to investigate the position of the glenoid fossa in subjects with Class III malocclusion associated with mandibular protrusion to better clarify the role of this craniofacial component in Class III skeletal disharmony. METHODS: A sample of 30 subjects, aged 8 years +/- 6 months, with skeletal and dental Class III malocclusion associated with mandibular protrusion, normal skeletal vertical relationships, and normal mandibular dimensions, was compared with a control group of 33 subjects with skeletal and dental Class I relationships. The comparisons between the Class III group and the control group on the cephalometric measures for the assessment of glenoid fossa position were performed with the Mann-Whitney U test at P <0.05. RESULTS: Subjects with Class III malocclusion had a significantly more mesial position of the glenoid fossa, when compared with the control group as measured with 3 parameters. CONCLUSIONS: An anterior position of the glenoid fossa is a possible diagnostic anatomic feature of Class III malocclusion associated with mandibular protrusion. An effective measurement to evaluate glenoid fossa position in craniofacial relationships is the cephalometric distance from the glenoid fossa to the frontomaxillary-nasal suture.

Innocenti C; Giuntini V; Defraia E; Baccetti T

2009-04-01

214

MRI tight posterior fossa sign for prenatal diagnosis of Chiari type II malformation  

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Chiari type II malformation (CMII) is one of three hindbrain malformations that display hydrocephalus. We have observed that cerebrospinal fluid (CSF) signal in the posterior fossa, which is always apparent on normal fetal MR images, is not visible in a fetus with CMII. We use the term 'tight posterior fossa' for this MR imaging finding, and evaluate the diagnostic value of this finding on fetal MR images. Included in the study were 21 fetuses which underwent brain MR imaging at 1.5 T using two-dimensional balanced turbo-field-echo (2-D balanced-TFE) in the axial and sagittal planes. Postnatal diagnoses were CMII (n=5), CNS abnormalities other than CMII (n=8), and no abnormality (n=8). A tight posterior fossa was defined as an absent or slit-like water signal space around the hindbrain in the posterior fossa on both sagittal and axial MR images. All CMII fetuses displayed a tight posterior fossa on MR images. Hydrocephalus was visualized in all CMII fetuses and myelomeningocele in four fetuses, but hindbrain herniation was visualized only in two of five fetuses. The CSF signal surrounding the hindbrain was clearly visible in all the other 16 fetuses, including five with hydrocephalus not associated with CMII, although it was slightly narrower in a fetus with a cloverleaf skull than in the normal fetuses. Tight posterior fossa in the presence of hydrocephalus is a useful and characteristic finding of CMII on fetal MRI. (orig.)

Ando, Kumiko; Ishikura, Reiichi; Ogawa, Masayo; Takada, Yoshihiro; Yamamoto, Satoshi; Fujiwara, Masayuki; Hirota, Shozo [Hyogo College of Medicine, Department of Radiology, Nishinomiya, Hyogo (Japan); Shakudo, Miyuki [Osaka City General Hospital, Department of Radiology, Osaka (Japan); Tanaka, Hiroyuki [Hyogo College of Medicine, Department of Gynecology, Nishinomiya (Japan); Minagawa, Kyoko [Hyogo College of Medicine, Department of Pediatrics, Nishinomiya (Japan)

2007-12-15

215

'There are no significant side-effects from a bone scan injection' - a rash statement  

International Nuclear Information System (INIS)

[en] Full text: Adverse reactions to radiopharmaceuticals are very uncommon, mild and generally occur a few hours post-injection. For these reasons they are poorly documented and rarely seen in nuclear medicine departments. Diphosphonates produce the most reports and the annual incidence is reputed to be between 0.3 and 33 events per 100,000 administrations. Very few of these require medical intervention and appear to resolve quickly. We report a case of a 78-year-old retired medical practitioner who underwent a staging whole body bone scan for renal cell carcinoma. 880 MBq of Tc-HDP was injected intravenously without extravasation and routine whole body images obtained 2 hours later. He awoke next morning with a macular rash and intense pruritis involving his chest, which over one week spread to involve his whole trunk, arms and then legs. The rash remained symptomatic for three months requiring continuous topical therapy. The patient was already on regular anti-histamine tablets. Dermatological review confirmed a drug reaction. There is a history of chronic renal failure requiring peritoneal dialysis. While multiple medications were being ingested, including phenergan for pruritus, there were no changes to his usual regime around this time and no other obvious causal agents. A previous bone scan 5 years ago passed uneventfully. Review of the literature provides scanty information as therapy is seldom required and when indicated is purely symptomatic. There are no reports of a prolonged adverse event. This case almost certainly represents a hypersensitivity reaction to a common bone radio-pharmaceutical and reminds us that very rarely these may be quite severe and prolonged. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

2002-01-01

216

Human parvovirus B19 surveillance in patients with rash and fever from Belarus.  

UK PubMed Central (United Kingdom)

Human parvovirus B19 (B19V) infection in immunocompetent patients usually has a mild clinical course, but during pregnancy it can cause serious and even fatal complications in the fetus. The most common clinical presentation of B19V infection is erythema infectiosum and in this case laboratory confirmation is required for differentiation from other exanthematous diseases. Measles and rubella negative sera collected in Belarus between 2005 and 2008 from 906 patients with a rash and fever were screened for B19V infection by ELISA. More than 35% of the samples (322/906) were positive for B19V. The proportion ranged from 10.1% in 2008 to 53.2% in 2006 when an outbreak took place in Minsk city. All B19V outbreaks and cluster cases occurred during the winter-spring period, but sporadic cases were recorded basically throughout the year. The majority of the cases (56.5%) occurred among the 2 till 10 year old children, and 27.3% of the cases were observed in adults between 19 and 53 years. All 104 B19V strains sequenced in the NS1/VP1u region belonged to genotype 1 with a maximal genetic distance of 1.75%. The two phylogenetic clusters reflected the geographic origins of the viruses within the country. Forty-two unique nucleotide mutations as compared to sequences downloaded from GenBank were found in the VP1u and NS1 regions; most of these changes were nonsynonymous. This report highlights the importance of B19V infection in patients with a rash and fever in Belarus.

Yermalovich MA; Hübschen JM; Semeiko GV; Samoilovich EO; Muller CP

2012-06-01

217

Skin rash and arthritis a simplified appraisal of less common associations.  

UK PubMed Central (United Kingdom)

Skin and joint manifestations are part of the clinical spectrum of many disorders. Well-known associations include psoriatic arthritis and arthritis associated with autoimmune connective tissue diseases. This review focuses on less common associations where skin lesions can provide easily accessible and valuable diagnostic clues, and directly lead to the specific diagnosis or limit the list of possibilities. This may also affect health care resources as diagnostic tests are often low-specific, highly expensive and poorly available. This group of diseases can be divided into two subsets, based on the presence/absence of fever, and then further classified according to elementary skin lesions (macular, urticarial, maculo-papular, vesico-bullous, pustular, petechial and nodular). In most instances joint involvement occurs as peripheral migrating polyarthritis. Erythematosus macular or urticarial rashes occur in most febrile disorders such as monogenic autoinflammatory syndromes, Schnitzler's syndrome, Still's disease and rheumatic fever and afebrile diseases as urticarial vasculitis. Pustular rash may be observed in chronic recurrent multifocal osteomyelitis (CRMO) and pyogenic arthritis with pyoderma gangrenosum and acne (PAPA) syndrome (both febrile) as well as in Behcet's disease and Synovitis, acne, pustulosis, hyperostosis and osteitis syndrome (both non-febrile). Papular lesions are typical of secondary syphilis, sarcoidosis, interstitial granulomatous dermatitis, papular petechial of cutaneous small-vessel vasculitis and nodular lesions of polyarteritis nodosa and multicentric reticulohistiocytosis all of which are afebrile. Differential diagnosis includes infections and drug reactions which may mimic several of these conditions. To biopsy the right skin lesion at the right time it is essential to obtain relevant histological information.

Cozzi A; Doria A; Gisondi P; Girolomoni G

2013-08-01

218

CT findings of dural arteriovenous malformation in the posterior fossa  

Energy Technology Data Exchange (ETDEWEB)

CT findings in eight cases of dural arteriovenous malformation, mainly involving the dura mater and the tentorium cerebelli of the posterior fossa, are reported. The main findings observed on CT scans may be summarized as follows: 1) patchy and vermiform enhancement after the intravenous injection of the contrast medium; 2) abnormal low-density area; 3) local mass effect; 4) hydrocephalus; 5) distention and aneurysmal dilatation of the major venous sinus system, and 6) dilated meningeal grooves of the skull inner table. These findings were commonly noted in the patients with Types II, III and IV in Djinjian's classification. The abnormal low density with or without patchy and vermiform enhancement and/or hydrocephalus are most likely caused by a disturbed venous return of the cerebral parenchyma and an impaired absorption of the cerebrospinal fluid due to the increased pressure of the venous sinus system. These findings were improved following artificial embolization or surgical excision of the dural arteriovenous malformation. (author).

Mabuchi, Shohji; Nakagawa, Yoku; Abe, Hiroshi; Miyasaka, Kazuo; Takei, Hidetoshi; Abe, Satoru

1984-12-01

219

[Severe cerebellar mutism after posterior fossa tumor resection].  

Science.gov (United States)

Cerebellar mutism is an infrequent but important complication after posterior fossa surgery in children. Dysarthria, irritability and ataxia are among the signs and symptoms of this disorder, which are usually mild and self-limiting. However, in severe cases, there can be impairment of higher-level cognitive functions, affecting the child's future personal and social relations. This disorder has been described in many other situations and consequently pediatricians should be familiar with its symptoms, physiopathology, diagnosis, degrees of severity, treatment, and prognosis, since a multidisciplinary approach is required. We present the case of a 5-year-old boy who underwent surgery for a low-grade ependymoma in the fourth ventricle; 48 hours after surgical resection, the boy developed irritability, cranial nerve involvement and stereotyped movements in the context of active hydrocephalus. His symptoms progressively improved 6 weeks after the intervention. We review the literature on cerebellar mutism and discuss the physiopathology of this disorder, which seems to confirm that the cerebellum not only acts as a simple coordinator of motor function, but also plays an important role in higher-level cognitive functions, such as language. PMID:17266856

García Conde, M; Martín Viota, L; Febles García, P; Ravina Cabrera, J; López Almaraz, R

2007-01-01

220

[Severe cerebellar mutism after posterior fossa tumor resection  

UK PubMed Central (United Kingdom)

Cerebellar mutism is an infrequent but important complication after posterior fossa surgery in children. Dysarthria, irritability and ataxia are among the signs and symptoms of this disorder, which are usually mild and self-limiting. However, in severe cases, there can be impairment of higher-level cognitive functions, affecting the child's future personal and social relations. This disorder has been described in many other situations and consequently pediatricians should be familiar with its symptoms, physiopathology, diagnosis, degrees of severity, treatment, and prognosis, since a multidisciplinary approach is required. We present the case of a 5-year-old boy who underwent surgery for a low-grade ependymoma in the fourth ventricle; 48 hours after surgical resection, the boy developed irritability, cranial nerve involvement and stereotyped movements in the context of active hydrocephalus. His symptoms progressively improved 6 weeks after the intervention. We review the literature on cerebellar mutism and discuss the physiopathology of this disorder, which seems to confirm that the cerebellum not only acts as a simple coordinator of motor function, but also plays an important role in higher-level cognitive functions, such as language.

García Conde M; Martín Viota L; Febles García P; Ravina Cabrera J; López Almaraz R

2007-01-01

 
 
 
 
221

Augmentation of temporal fossa hollowing with Mersilene mesh.  

UK PubMed Central (United Kingdom)

PURPOSE: Temporal fossa hollowing can represent a serious cosmetic concern to patients', whether congenital; part of a post-traumatic deformity; following oncological resection; or following orbital decompression procedures. Various methods have been described to augment the defect including high density polyethylene (HDPE) implants, methyl methylmethacrolate and lipotransfer, but all have their relative drawbacks. METHODS: We describe 13 temporal defects in 10 patients whose defects have been reconstructed with Mersilene mesh (Ethicon, Livingstone UK). When the temporalis muscle is still adequately suspended; folded mesh can be placed in a submuscular/subperiosteal plane. The mesh can be folded as many times as necessary to recreate the appropriate volume, thereby allowing fine control of temple width. If the temporalis is attenuated or displaced inferiorly by previous surgery, its insertion can be recreated using titanium screws to attach the mesh superiorly to the appropriate site on the cranium; the temporalis resuspended and the fascia sutured to the mesh. RESULTS: We report very pleasing cosmetic results with no associated complications such as implant, extrusion or exposure. One patient was complicated by infection requiring removal of the mesh as well as titanium cranioplasty, screws and plates. CONCLUSION: Mersilene mesh is easy to use, contours naturally to the defect and is considerably cheaper than alternatives like HDPE implants.

Atherton DD; Joshi N; Kirkpatrick N

2010-10-01

222

The results of radiosurgical management of 72 middle fossa meningiomas  

International Nuclear Information System (INIS)

Of 812 patients with intracranial tumours treated by radiosurgery during the period 1984-1990, 129 had meningiomas. Of these latter, 72 had middle fossa meningiomas. Patients with meningiomas treated by us since March 1990 are not included in this report since we established the investigative principle of a minimum of 30 months follow-up. Seventeen of the 72 patients were treated after incomplete surgical resection, and 21 for tumour regrowth. In 34 patients, radiosurgery was the primary treatment. The tumour was calculated by the ellipsoid method. It ranged from 0.588-76.346ml. Radiosurgery was performed using the non-invasive stereotactic fixation head device (Greitz-Bergstroem) adapted to the Fixster frame, and dynamic irradiation performed with the linear accelerator, using especially designed collimators. The total tumour dose for each patient ranged from 15-45Gy. The minimum follow-up was 2.5 years and the maximum 8 years. In 50 patients there was tumour shrinkage ranging from 24-91% of the initial tumour volume. Shrinkage was associated with central tumour necrosis in 11 of these 50 patients. In 18 patients the tumour volume remained stable. In 2 patients there was tumour progression and in 2 there was regrowth after initial reduction of tumour volume. There were no significant treatment complications. Radiosurgery is preferable to re-operation in recurrent meningiomas and indicated after incomplete surgical removal. In high risk patients, as well as in 'unresectable' meningiomas, it is an obvious alternative to microsurgery. (authors).

1993-01-01

223

Rash and hepatitis within days of starting a new antiretroviral regimen: Nevirapine hypersensitivity, secondary syphilis or both?  

UK PubMed Central (United Kingdom)

We report a case in which an HIV-positive man developed general malaise, skin rash and biochemical hepatitis within days of starting a nevirapine-based antiretroviral treatment regimen. At the same time, his syphilis serology proved positive. We discuss the diagnostic dilemma: was this a nevirapine hypersensitivity reaction, secondary syphilis or both?

Saxon CJ; Helbert MR; Komolafe AJ; Higgins SP

2013-08-01

224

Drug rash with eosinophilia and systemic symptoms syndrome associated with use of phenytoin, divalproex sodium, and phenobarbital.  

UK PubMed Central (United Kingdom)

PURPOSE: A probable case of drug reaction with eosinophilia and systemic symptoms (DRESS) associated with consecutive use of three medications for seizure control is reported. SUMMARY: A 36-year-old woman was treated at a community hospital for a mild fever (37.9°C) and diffuse raised maculopapular rash with erythema. Three weeks previously, she had been diagnosed with a seizure disorder and initiated on phenytoin (dose unknown) at that time; about two weeks later, she developed a rash, prompting a switch from phenytoin to extended-release divalproex sodium 250 mg orally twice daily. During the week after discontinuation of phenytoin, the rash was improving, but about five days after the initiation of divalproex therapy, she had worsening rash and pruritus requiring urgent treatment; the divalproex was discontinued, and phenobarbital 30 mg three times daily was initiated for continued seizure control. Despite the discontinuation of phenytoin and divalproex, the patient's hepatic function worsened over five days, and phenobarbital therapy was discontinued. With continued deterioration of the patient's condition to fulminant hepatic failure, a transfer to a liver transplant facility was arranged. The use of the adverse reaction probability scale of Naranjo et al. in this case yielded a score of 8, indicating a probable relationship between DRESS and the serial use of phenytoin, divalproex, and phenobarbital. CONCLUSION: After receiving phenytoin for treatment of seizure disorder, a 36-year-old woman developed a fever and maculopapular rash with erythema. This reaction continued even after drug therapy was switched to extended-release divalproex and then phenobarbital. The patient's liver function deteriorated despite discontinuation of all seizure medications.

Brizendine CE; Naik PJ

2013-03-01

225

Chronic subdural hematoma of the posterior fossa associated with cerebellar hemorrhage: report of rare disease with MRI findings  

Directory of Open Access Journals (Sweden)

Full Text Available Chronic subdural hematoma of the posterior fossa is an uncommon entity, and spontaneous lesions are very rarely described, occurring mostly during anticoagulation therapy. The association of the posterior fossa chronic subdural hematoma with spontaneous parenchymal hemorrhage without anticoagulation therapy was never related in the literature, to our knowledge. We describe a case of a 64 year-old woman who suffered a spontaneous cerebellar hemorrhage, treated conservatively, and presented 1 month later with a chronic subdural posterior fossa hematoma.

Costa Jr Leodante B.; Andrade Agustinho de; Valadão Gustavo Fonseca

2004-01-01

226

Malignant melanoma of nasal fossae, a propos of a case  

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Full Text Available Introduction: The melanoma of the nasal fossae represents a 4% of all sinonasal malignant tumors. The symptoms are unspecific, thus delaying diagnosis. We present a case of a woman of 80 years of age. She has hypertension and a degenerative heart disease, and presents nasal respiratory insufficiency, left otalgia and epistaxis of 8 months of evolution. Examination revealed a dark, polypoidal, fleshy mass. The CT revealed a mass that occupied that space, without bone erosion. A biopsy of the mass revealed that it was an amelanotic melanoma. Due to the age of the patient and her general pathology, endoscopic sinonasal surgery was applied. The pathological anatomic analysis confirmed that it was a malignant round cell melanoma with the following phenotype: positive for Vimentin, positive for nuclear S-100, focal positive for HMB-45, negative, melan A+ negative for HMB-45 with heterogeneous intensity, and negative for ENE and ALC. The patient did not present symptoms until a year later, when she discovered a small laterocervical adenopathy. A FNAP confirmed that the melanoma had metastatized. The patient underwent a radical neck dissection and remained 15 months without symptoms. She is currently going through monthly revisions. Discussion: The treatment of choice is surgery. Selective neck dissection is not justified. This tumor is radioresistant. Active immunotherapy (a combination of Interferon and Cimetidine) and targeted chemotherapy have also been used, mainly in inoperable cases. Five-year survival ranges between 6.5% and 34%.Conclusion: We propose endoscopic surgery for non-infiltrating tumors or for patients who cannot undergo very aggressive surgery due to their general condition.

Santos-Gorjón P; Gil-Melcón M; Franco-Calvo F; Guardado-Sánchez LA; Rey-Marcos M; Gómez-González JL

2012-01-01

227

Klippel-Feil syndrome in association with posterior fossa dermoid tumour.  

UK PubMed Central (United Kingdom)

BACKGROUND: Klippel-Feil syndrome (KFS) is characterized by specific congenital anomalies of segmentation of the cervical spine. On the other hand, dermoid tumour is a rare entity accounting for 0.04-0.7% of all intracranial tumours and the most common location is in the posterior fossa, at or near the midline. CASE DESCRIPTION: A new case with the association of KFS and the posterior fossa dermoid tumour is presented with complaints of progressive headache, occipital lump, and short neck. Plain radiography and 3D computed tomography (CT) of the craniovertebral region revealed a central occipital hole as well as fusion of the C4-7 vertebrae. CT and magnetic resonance imaging (MRI) of the brain demonstrated a well circumscribed midline cystic mass without contrast enhancement in the posterior fossa compressing the vermis and cerebellum. A suboccipital craniectomy was done and dermoid tumour with dermal sinus was removed totally after the opening of the dura mater. Pathological examination confirmed that the mass was a dermoid tumour consisting of stratified squamous epithelium, hair, keratin and sebaceous glands. Control MRI showed no evidence of recurrence and the patient was asymptomatic. CONCLUSION: The experience prompted me to review reports in the literature since 1936 of posterior fossa dermoid tumour associated with KFS. From my analysis, I highlight early diagnosis and an appropriate surgery to prevent complications such as neural compression and bacterial or aseptic meningitis through the rupture site or dermal sinus in cases of KFS associated with for dermoid tumours of the posterior fossa.

Turgut M

2009-03-01

228

Evaluation of CSF flow patterns of posterior fossa cystic malformations using CSF flow MR imaging  

International Nuclear Information System (INIS)

Differential radiologic diagnosis of cystic malformations of the posterior fossa is often difficult with conventional imaging techniques because of overlapping features of these entities. Posterior fossa cystic malformations occupy the cerebrospinal fluid (CSF) spaces. They may create secondary dynamic effects on the movements of CSF. The aim of this study was to investigate CSF flow alterations in posterior fossa cystic malformations with CSF flow MR imaging. The study included 40 patients with cystic malformations of the posterior fossa. The patients underwent cardiac-gated phase-contrast cine MR imaging. CSF flow was qualitatively evaluated using an in-plane phase-contrast sequence in the midsagittal plane. The MR images were displayed in a closed-loop cine format. Twelve of the patients had communicating arachnoid cyst, seven had non-communicating arachnoid cyst, ten had mega cisterna magna, six had Dandy-Walker malformation, two had Dandy-Walker variant, and three had Blake's pouch cyst. CSF flow MR imaging indicated the regions of no, slow or higher flow, direction of flow, and abnormal cystic fluid motion. Each malformation displayed a distinct CSF flow pattern. Phase-contrast cine MR imaging for CSF flow evaluation may be a useful adjunct to routine MR imaging in the evaluation of the cystic malformations of the posterior fossa because it can improve the specificity in differentiating such malformations. (orig.)

2006-01-01

229

Evaluation of CSF flow patterns of posterior fossa cystic malformations using CSF flow MR imaging  

Energy Technology Data Exchange (ETDEWEB)

Differential radiologic diagnosis of cystic malformations of the posterior fossa is often difficult with conventional imaging techniques because of overlapping features of these entities. Posterior fossa cystic malformations occupy the cerebrospinal fluid (CSF) spaces. They may create secondary dynamic effects on the movements of CSF. The aim of this study was to investigate CSF flow alterations in posterior fossa cystic malformations with CSF flow MR imaging. The study included 40 patients with cystic malformations of the posterior fossa. The patients underwent cardiac-gated phase-contrast cine MR imaging. CSF flow was qualitatively evaluated using an in-plane phase-contrast sequence in the midsagittal plane. The MR images were displayed in a closed-loop cine format. Twelve of the patients had communicating arachnoid cyst, seven had non-communicating arachnoid cyst, ten had mega cisterna magna, six had Dandy-Walker malformation, two had Dandy-Walker variant, and three had Blake's pouch cyst. CSF flow MR imaging indicated the regions of no, slow or higher flow, direction of flow, and abnormal cystic fluid motion. Each malformation displayed a distinct CSF flow pattern. Phase-contrast cine MR imaging for CSF flow evaluation may be a useful adjunct to routine MR imaging in the evaluation of the cystic malformations of the posterior fossa because it can improve the specificity in differentiating such malformations. (orig.)

Yildiz, Harun; Yazici, Zeynep; Hakyemez, Bahattin; Erdogan, Cuneyt; Parlak, Mufit [University of Uludag, Department of Radiology, School of Medicine, Bursa (Turkey)

2006-09-15

230

Diagnóstico virológico de un brote de fiebre y rash producido por Parvovirus B19, Cuba, 1995  

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Full Text Available Se reportan los resultados obtenidos en el estudio de un brote de fiebre y rash ocurrido en Ciudad de La Habana en marzo de 1995. En las muestras de 35 pacientes se descartaron dengue, sarampión, rubéola, herpes simple y Epstein Barr como agentes causales del brote. Mediante la detección de anticuerpos IgM y la técnica de reacción en cadena de la polimerasa (RCP) se identificó al Parvovirus B19 como agente causal del brote. En 14/18 muestras (77,7 %) se comprobó la infección por este agente por alguna de las técnicas empleadas. Este estudio se refiere al primer brote confirmado de Parvovirus B19 en Cuba.The results obtained in the study of an aoutbreak of fever and reash ocurred in Havana City in March, 1995, are reported. Dengue, measles, rubella, herpes simplex, and Epstein Barr were discarded as causal agents of the outbreak in the samples of 35 patients. Parvovirus B19 was identified as the causing agent of the outbreak by the detection of IgM antibodies and the polymerase chain reaction technique (PCR). The infection produced by this agent was confirmed in 14/18 samples (77,7 %) by some of the techniques used. This study makes reference to the first outbreak of Parvovirus B19 that was proved in Cuba.

MARÍA G GUZMÁN; DELFINA ROSARIO; MARÍA E. RODRÍGUEZ; MAYLING ÁLVAREZ; ROSMARI RODRÍGUEZ; SUSET OROPESA; JOSÉ LAFERTÉ; SONIA RESIK

1997-01-01

231

Genetic linkage of familial granulomatous inflammatory arthritis, skin rash, and uveitis to chromosome 16  

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Blau syndrome (MIM 186580), first described in a large, three-generation kindred, is an autosomal, dominantly inherited disease characterized by multiorgan, tissue-specific inflammation. Its clinical phenotype includes granulomatous arthritis, skin rash, and uveitis and probably represents a subtype of a group of clinical entities referred to as {open_quotes}familial granulomatosis.{close_quotes} It is the sole human model with recognizably Mendelian inheritance for a variety of multisystem inflammatory diseases affecting a significant percentage of the population. A genomewide search for the Blau susceptibility locus was undertaken after karyotypic analysis revealed no abnormalities. Sixty-two of the 74-member pedigree were genotyped with dinucleotide-repeat markers. Linkage analysis was performed under dominant model of inheritance with reduced penetrance. The marker D16S298 gave a maximum LOD score of 3.75 at {theta} = .04, with two-point analysis. LOD scores for flanking markers were consistent and placed the Blau susceptibility locus within the 16p12-q21 interval. 46 refs., 3 figs., 3 tabs.

Tromp, G.; Kuivaniemi, H.; Ala-Kokko, L. [Thomas Jefferson Univ., Philadelphia, PA (United States)] [and others

1996-11-01

232

Case report of drug rash with eosinophilia and systemic symptoms demonstrating human herpesvirus-6 reactivation.  

Science.gov (United States)

Drug rash with eosinophilia and systemic symptoms (DRESS) is a severe drug-induced hypersensitivity syndrome that presents with diffuse cutaneous eruptions, fever, and multiorgan involvement. Here we present a pediatric case of DRESS complicated by human herpesvirus (HHV)-6 reactivation. After 1 week of sulfasalazine, our patient developed a diffuse morbilliform eruption. Sulfasalazine was discontinued. The patient presented to the emergency department soon thereafter with worsening eruption, fever, rigors, facial edema, and lymphadenopathy. Methylprednisolone was initiated. Peripheral smear did not demonstrate eosinophilia but showed toxic granulation with atypical lymphocytes. Transaminase levels and white blood cell count quickly became elevated, with increased eosinophils, suggesting DRESS. During the methylprednisolone taper, our patient experienced symptom exacerbation, acute hepatitis, and HHV-6 seroconversion, indicating HHV-6 reactivation as the cause. As demonstrated by our patient, a decelerated methylprednisone taper is important because of potential symptom flaring during taper. Additionally, in the care of individuals with DRESS, HHV-6 is often tested for upon admission and not repeated. Delay in the rise of titers necessitates repeat testing. PMID:24016284

Ferrero, Natalie A; Pearson, Kelly C; Zedek, Daniel C; Morrell, Dean S

2013-09-01

233

A 6-year-old girl with fever, rash, and increased intracranial pressure.  

UK PubMed Central (United Kingdom)

BACKGROUND: Rocky Mountain spotted fever (RMSF) is a well-described, potentially lethal, tick-borne zoonotic infection and has very effective therapy. However, the diagnosis might not be made early enough, often leading to worse outcomes. OBJECTIVE: Our aim was to discuss the diagnostic dilemmas facing the physician when evaluating patients with suspected RMSF. METHODS: We report a case of RMSF in a 6-year-old girl who presented to our hospital with a 7-day history of fever, headache, and a petechial rash. After blood cultures were obtained, the patient was treated empirically with doxycycline, vancomycin, and ceftriaxone. During the next 24 h, her clinical status worsened, with acute onset of altered mental status, posturing, and fixed and dilated pupils. A computed tomography scan of the brain demonstrated diffuse cerebral edema with evidence of tonsillar herniation. She died 24 h after admission. A serum specimen tested positive for immunoglobulin G to Rickettsia rickettsii at a titer of 128 dilutions, confirming recent infection. CONCLUSIONS: We present this case to raise awareness of RMSF in patients who present with a nonspecific febrile illness in tick-endemic areas in the United States. Early diagnosis and treatment with doxycycline before day 5 of illness is essential and can prevent morbidity and mortality.

Ravish ME; Krowchuk DP; Zapadka M; Shetty AK

2013-08-01

234

An unusual presentation of acute brucellosis with thrombocytopenia and maculopapular rash  

Directory of Open Access Journals (Sweden)

Full Text Available Human brucellosis is common in developing countries and a multi-system disease with a broad spectrum of clinical manifestations. Cutaneous lesions associated with brucellosis have been rarely reported in the world literature. Here we present the case of a 69-year-old woman with history of consumption of cheese made from raw milk seen with occurrence of thrombocytopenia and diffuse maculopapular rash during the course of Brucella infection. Physical examination showed a pruritic maculopapular exanthema over the trunk, arms and legs. Laboratory tests revealed severe thrombocytopenia with platelet count of 15x109/L. Body temperature was normal. Parasitic examinations and serologic tests for syphilis, salmonellosis, rickettsiae, toxoplasma, Epstein-Barr virus, human immunodeficiency virus, and hepatitis B and C viruses were negative. The Brucella agglutination test titer was 1/2.560 and the skin lesions were interpreted as brucellar dermatitis. The patient was subsequently treated with oral doxycycline and rifampicin and was discharged in good health. If there is suspicion of exposure to infected food products, brucellosis should be included in the differential diagnosis of thrombocytopenia in Brucella-endemic areas; there may be skin lesions other than purpura that can accompany thrombocytopenia.

O. Alici,1 B. Kasapoglu,2 R. Alkan,2 E. Sarifakioglu,3 R. Akgedik,4 R. Bozalan,2 A. Kosar,5 H. Sahin6

2007-01-01

235

Clinical and Laboratory evaluation of measleslike rash in children and young adults  

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Full Text Available A clinical and laboratory evaluation of 11 children and young adults with measleslike rash was done during the measles outbreak in the Greater São Paulo Metropolitan area at the end of 1996 and spread over the country during 1997. Measles was laboratory confirmed in 07 patients by specific IgM detection in acute serum specimens using an IgM-capture EIA, by specific IgG seroconversion in serum pairs, and by reverse transcription PCR and virus isolation in peripheral blood lymphocytes. Clinical presentations were not always classic; one of the 07 cases had received measles vaccine and corresponded to modified clinical case of measles. The 4 remaining cases were negative for measles and were diagnosed as exanthem subitum (2 cases), scarlet fever and Kawasaki disease. The present study reinforces the view that clinical features alone are not sufficient for establishing an accurate diagnosis in the post-vaccine era, and a surveillance system based on sensitive laboratory results is needed so that it can confirm IgM-negative measles cases.

Stewien Klaus Eberhard; Lima Lourdes Rehder de Andrade Vaz de; Botosso Viviane Fongaro; Oliveira Maria Isabel de; Fagundes Simone N.; Nogueira Meri B.; Ragazzi Selma Lopes Betta; Costa Maria Tereza Zuluni da; Ejzenberg Bernardo; Durigon Edison Luiz

2000-01-01

236

Case report of drug rash with eosinophilia and systemic symptoms demonstrating human herpesvirus-6 reactivation.  

UK PubMed Central (United Kingdom)

Drug rash with eosinophilia and systemic symptoms (DRESS) is a severe drug-induced hypersensitivity syndrome that presents with diffuse cutaneous eruptions, fever, and multiorgan involvement. Here we present a pediatric case of DRESS complicated by human herpesvirus (HHV)-6 reactivation. After 1 week of sulfasalazine, our patient developed a diffuse morbilliform eruption. Sulfasalazine was discontinued. The patient presented to the emergency department soon thereafter with worsening eruption, fever, rigors, facial edema, and lymphadenopathy. Methylprednisolone was initiated. Peripheral smear did not demonstrate eosinophilia but showed toxic granulation with atypical lymphocytes. Transaminase levels and white blood cell count quickly became elevated, with increased eosinophils, suggesting DRESS. During the methylprednisolone taper, our patient experienced symptom exacerbation, acute hepatitis, and HHV-6 seroconversion, indicating HHV-6 reactivation as the cause. As demonstrated by our patient, a decelerated methylprednisone taper is important because of potential symptom flaring during taper. Additionally, in the care of individuals with DRESS, HHV-6 is often tested for upon admission and not repeated. Delay in the rise of titers necessitates repeat testing.

Ferrero NA; Pearson KC; Zedek DC; Morrell DS

2013-09-01

237

Incisive Fossa Case Report Fosa Incisiva - Reporte de un Caso  

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Full Text Available The importance of the radiographic anatomy knowledge in the interpretation of the pathologies is undeniable. The base of this knowledge is a great familiarity with the anatomy of the region that is going to be evaluated. Thus, it is important to recognize what is considered normal, as well as the anatomical variations, so that one can identify what is pathologic. In this case report we describe a radiographic finding in leucoderm patient, 13 years old and one month, submitted to a panoramic radiography in a private clinic in São Paulo - Brazil, for evaluation of the third molars. During the radiographic reading, a bilateral radiolucid area with an inverted tear shape could be observed in the region between the roots of the lateral incisive teeth and upper canines. Although it was an image that suggested bone rarefaction, the integrity of the hard lamina was evident in both sides. During the patient's clinical examination, a bilateral asymmetry was not observed, as well as any kind of sintomatology. In our case report, according to the clinical and radiographic findings, we conclude that the diagnosis was bilateral incisive fossa.La importancia de los conocimientos de anatomía radiográfica en la interpretación de las patologías es innegable. La base de este conocimiento es familiarizarse con la anatomía de la región que va a ser evaluada. Por tanto, es importante reconocer lo que se considera normal, así como las variaciones anatómicas y, de esta manera, identificar lo que es patológico. En este caso clínico, se describe un hallazgo radiológico en un paciente leucodérmico, de 13 años y un mes de edad, quiense realizó, para la evaluación de los terceros molares, una radiografía panorámica en una clínica privada en São Paulo - Brasil. Durante la lectura radiológica, se pudo observar en la región entre las raíces de los dientes incisivos laterales y caninos superiores una zona radiolúcida bilateral con una forma de lágrima invertida. Aunque era una imagen que sugería rarefacción ósea, la integridad de la lámina dura se hizo evidente en ambos lados. Durante la exploración clínica del paciente, no se observó una asimetría bilateral, así como cualquier tipo de sintomatología. En este caso, de acuerdo con los hallazgos clínicos y radiográficos, se concluye que el diagnóstico es la presencia de una fosa incisiva bilateral.

Nilton Alves

2010-01-01

238

Posterior fossa imaging in 158 children with ataxia.  

UK PubMed Central (United Kingdom)

UNLABELLED: OBJECTIFS: To propose a MRI cerebellar algorithm that may be applied to guide genetic/malformative or biochemical investigations for patients with cerebellar ataxia. PATIENTS AND METHODS: Cerebral MRI of 158 patients with cerebellar ataxia and no supratentorial abnormality were examined according to a new categorization system based on posterior fossa imaging. The clinical and radiological findings were confronted to biochemical and/or genetic results using the MR cerebellar algorithm. Seven groups of cerebellar MRI pattern were described: vermian dysgenesis (n=27), cerebellar hypoplasia (n=15), hemispheric cerebellar dysgenesis (n=6), unilateral hemispheric atrophy (n=5), global cerebellar atrophy (n=84), signal abnormalities (n=11) and normal MRI (n=10). Cerebellar hypoplasia, vermian dysgenesis and hemispheric cerebellar dysgenesis groups were classified as malformative disorders. Global atrophy and signal abnormality groups were classified as metabolic disorders. RESULTS: In the vermian dysgenesis group, a specific genetic diagnosis was obtained in eight children (8/27) and all of the mutated genes (AHI1 (JBS3), CEP290 (JBS5), TMEM67 (JBS6), and RPGRIP1L (JBS7)) are involved in primary cilia function. In the group of pontocerebellar hypoplasia specific genetic diagnosis was obtained in one patient (PCH2) (1/15). Thus, nine of 42 children classified as malformative disorder had a molecular diagnosis. Global atrophy and signal abnormality groups were classified as metabolic disorders, specific biochemical was obtained in 46/95 children. In global atrophy group, respiratory chain deficiency was diagnosed in 18 children (18/84). In 21 children a congenital disorders of glycosylation type 1a (CDG Ia) was diagnosed (21/84) and infantile neuroaxonale dystrophy (INAD) was diagnosed in one child. In signal abnormalities group, specific biochemical diagnosis was obtained in six out of 11 children, five children with respiratory chain deficiency and one child with sulphite oxidase deficiency. In hemispheric cerebellar dysgenesis and normal MRI groups, no biological diagnosis was found for any of the patients. In the group of unilateral hemispheric atrophy, we hypothesized a clastic prenatal injury. CONCLUSION: The proposed MR cerebellar algorithm was useful to guide genetic/malformative or biochemical investigations, allowing an etiological diagnosis in 55 children.

Boddaert N; Desguerre I; Bahi-Buisson N; Romano S; Valayannopoulos V; Saillour Y; Seidenwurm D; Grevent D; Berteloot L; Lebre AS; Zilbovicius M; Puget S; Salomon R; Attie-Bitach T; Munnich A; Brunelle F; de Lonlay P

2010-10-01

239

Venous hemodynamics of arteriovenous meningeal fistulas in the posterior cranial fossa  

International Nuclear Information System (INIS)

The etiology of arteriovenous meningeal fistulas (AVMFs) of the posterior fossa often remains unclear. Analyses of three personal cases, however, suggest a change in venous hemodynamics due to a primary lesion, the cases being of sinus thrombosis, intracerebral abcess with oedema and arteriovenous malformation. It is suggested that increase of venous pressure in the posterior fossa leads to increased drainage and, consequently, to dilatation of infratentorial veins and of meningeal branches of the external carotid and vertebral artery. Clinical findings and anatomical facts underlying AVMF lesions tend to confirm the view that the concept of a congenital malformation decompensating with age cannot be upheld for all AVMFs, especially when located in the posterior fossa and when clinical symptoms arise in middle age. It is proposed that a pressure activated mechanism of growth results in widening of normally insignificantly small dural vessels. (orig.)

1983-01-01

240

Ultrasound detection of posterior fossa abnormalities in full-term neonates.  

UK PubMed Central (United Kingdom)

Routine cranial ultrasonography, using the anterior fontanelle as acoustic window enables visualization of the supratentorial brain structures in neonates and young infants. The mastoid fontanelle enables a better view of the infratentorial structures, especially cerebellar hemorrhage in preterm infants. Reports on the usefulness and reliability of cranial ultrasonography using the mastoid fontanelle approach for the detection of posterior fossa abnormalities, focusing only on full-term neonates are limited. This article describes the technique of mastoid fontanelle ultrasonography in full-term neonates and the features of posterior fossa abnormalities that may be encountered in various neonatal disorders and conditions, combined with subsequent MRI in the same patients. Cranial ultrasound through the mastoid fontanelle plays a pivotal role in the early detection of posterior fossa pathology and selection of neonates with an indication for MRI.

Steggerda SJ; de Bruïne FT; Smits-Wintjens VE; Walther FJ; van Wezel-Meijler G

2012-04-01

 
 
 
 
241

Intradural spinal metastases in patients with posterior fossa brain metastases from various primary cancers.  

UK PubMed Central (United Kingdom)

Intradural spinal metastases (ISM) are rare and primarily found associated with certain types of brain tumors like medulloblastoma. Their association with metastases to the brain has been recently described and seems to occur more frequently in posterior fossa lesions. We reviewed patients treated at Massachusetts General Hospital for posterior fossa brain metastases from various primary cancers, and evaluated the risk of concomitant or subsequent ISM. Of 104 patients, 10 developed ISM, with a 1-year actuarial risk of 25%. The risk was not significantly related to age, sex, histology, site of primary tumor or previous therapy. The study suggests that in patients with posterior fossa metastasis, particular attention should be paid to seeding via cerebrospinal fluid and drop metastases to the spinal cord.

Mirimanoff RO; Choi NC

1987-01-01

242

Liver transplantation in a child with acute liver failure resulting from drug rash with eosinophilia and systemic symptoms syndrome  

Science.gov (United States)

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is characterized by a severe idiosyncratic reaction including rash and fever, often with associated hepatitis, arthralgias, lymph node enlargement, or hematologic abnormalities. The mortality rate is approximately 10%, primarily owing to liver failure with massive or multiple disseminated focal necrosis. Here, we report a case of a 14-year-old girl treated with vancomycin because of a wound infection by methicillin-resistant Staphylococcus aureus, who presented with non-specific symptoms, which progressed to acute liver failure, displaying the hallmarks of DRESS syndrome. With the presence of aggravated hepatic encephalopathy and azotemia, the patient was refractory to medical treatments, she received a living-donor liver transplantation, and a cure was achieved without any sign of recurrence. Vancomycin can be a cause of DRESS syndrome. A high index of suspicion and rapid diagnosis are necessary not to miss this potentially lethal disease.

Song, Seung Min; Cho, Min Sung; Oh, Seak Hee; Park, Young Seo; Kim, Dae Yeon; Lee, Sung Gyu

2013-01-01

243

Removal of a Maxillary Third Molar Displaced into Pterygopalatine Fossa via Intraoral Approach.  

UK PubMed Central (United Kingdom)

The removal of impacted maxillary third molars is one of the most common procedures performed in oral and maxillofacial surgery units with low rates of complications and morbidity. A few cases of accidental displacement of third molars into adjacent anatomical spaces, such as the infratemporal fossa, the pterygomandibular space, the maxillary sinus, buccal space, or the lateral pharyngeal space, during surgical interventions have been reported. In this paper, a case of a maxillary third molar accidentally displaced into the pterygopalatine fossa is presented, and the removal of the tooth via intraoral approach is described.

Ozer N; Uçem F; Saruhano?lu A; Yilmaz S; Tanyeri H

2013-01-01

244

Evaluation of peritumoral area associated with brain tumor in posterior cranial fossa using three dimensional SPECT  

International Nuclear Information System (INIS)

We measured peritumoral hypoperfusion volume associated with brain tumor in posterior cranial fossa using SPECT and compared the result with volumes of tumor and peritumoral edema on MRI. Seventeen patients with brain tumor in posterior cranial fossa, who underwent 123 I-IMP SPECT and MRI before operation, were studied. The SPECT images were performed in three dimension using a panning visualization software (application visualization system medical viewer: AVS-MV). The peritumoral hypoperfusion area on three dimensional SPECT was larger than the volume of edema on MRI with a statistical different (p

2002-01-01

245

Arachnoid cyst of the middle fossa and subdural hygroma: an uncommon association  

International Nuclear Information System (INIS)

[en] The middle fossa is the most common site for arachnoid cysts and the presence of subdural hematomas has been well-established. Occasionally, as a consequence of mild cranial trauma, or even spontaneously, the capsule of the cyst can be damaged, allowing part of the contents to empty into the extra cerebral compartment. We present two cases of congenital arachnoid cysts of middle fossa media complicated by subdural hygroma and intracranial hypertension, and we discuss the possible mechanisms involved in this uncommon association. 9 refs

1995-01-01

246

Spinal subdural haematoma mimicking tethered cord after posterior fossa open surgery  

International Nuclear Information System (INIS)

[en] We report the MRI findings in a girl aged 3 years and 10 months who developed a spinal subdural haematoma after posterior fossa open surgery for cerebellar malignant rhabdoid tumour. Emergency surgery was performed immediately because of increased intracranial pressure. Control MRI 48 h after surgery showed a spinal subdural haematoma without clinical signs of paresis or bladder dysfunction. Spinal subdural haematoma is rare, and only few cases have been reported, especially in children. This report suggests that ''silent'' (without clinical symptoms) postoperative spinal acute subdural haemorrhage can occur after posterior fossa surgery. (orig.)

2002-01-01

247

Spinal subdural haematoma mimicking tethered cord after posterior fossa open surgery  

Energy Technology Data Exchange (ETDEWEB)

We report the MRI findings in a girl aged 3 years and 10 months who developed a spinal subdural haematoma after posterior fossa open surgery for cerebellar malignant rhabdoid tumour. Emergency surgery was performed immediately because of increased intracranial pressure. Control MRI 48 h after surgery showed a spinal subdural haematoma without clinical signs of paresis or bladder dysfunction. Spinal subdural haematoma is rare, and only few cases have been reported, especially in children. This report suggests that ''silent'' (without clinical symptoms) postoperative spinal acute subdural haemorrhage can occur after posterior fossa surgery. (orig.)

Porto, L.; Turowski, B.; Lanfermann, H.; Zanella, F.E. [Institut fuer Neuroradiologie, Klinikum der Johann Wolfgang Goethe-Universitaet, Frankfurt am Main (Germany); Kieslich, M. [Neuropediatric Department, Klinikum der Johann Wolfgang Goethe-Universitaet, Frankfurt am Main (Germany)

2002-05-01

248

Circumscribed changes in the cranial vault in extracerebral accumulations of fluid in the middle cranial fossa  

Energy Technology Data Exchange (ETDEWEB)

On the basis of 26 cases with extracerebral fluid accumulation in the middle cranial fossa the bony changes occurring in this connection are described and discussed in respect of their aetiology. If there are bony accompanying reactions, two entities can be observed on principle: One group shows thinning and protrusion of the temporal squama, raising of the lesser wing of the sphenoid bone and protrusion of the greater wing of the sphenoid bone. The second group is associated with thickening of the temporal squama and of the lesser and greater wing of the sphenoid bone without showing any change in volume of the middle cranial fossa. (orig./GDG).

Trittmacher, S.; Purmann, H.; Hunsdiek, F.; Schmid, A.; Traupe, H.

1988-11-01

249

Chololesterol granuloma in the middle cranial fossa: report of two cases  

Energy Technology Data Exchange (ETDEWEB)

We report two cases of cholesterol granuloma in the middle cranial fossa. On CT the lesions appeared as a nonspecific, nonenhancing soft-tissue mass with bone erosion. On MRI they were seen as areas of high signal intensity surrounded by a low-intensity peripheral zone on both T1- and T2-weighted images. Cholesterol granuloma is thought to occur when pneumatised cells in the temporal bone become obstructed. Although this lesion usually occurs in the petrous bone, it can extend to the middle cranial fossa. The diagnosis and surgical management are discussed. (orig.)

Morioka, T. [Dept. of Neurosurgery, Neurological Institute, Kyushu Univ., Fukuoka (Japan); Fujii, K. [Dept. of Neurosurgery, Neurological Institute, Kyushu Univ., Fukuoka (Japan); Nishio, S. [Dept. of Neurosurgery, Neurological Institute, Kyushu Univ., Fukuoka (Japan); Hasuo, K. [Dept. of Radiology, Faculty of Medicine, Kyushu Univ., Fukuoka (Japan); Hisashi, K. [Dept. of Otolaryngology, Kyushu Univ., Fukuoka (Japan); Miyagi, Y. [Dept. of Neurosurgery, Neurological Institute, Kyushu Univ., Fukuoka (Japan); Nagata, S. [Dept. of Neurosurgery, Neurological Institute, Kyushu Univ., Fukuoka (Japan); Fukui, M. [Dept. of Neurosurgery, Neurological Institute, Kyushu Univ., Fukuoka (Japan)

1995-10-01

250

Chololesterol granuloma in the middle cranial fossa: report of two cases  

International Nuclear Information System (INIS)

[en] We report two cases of cholesterol granuloma in the middle cranial fossa. On CT the lesions appeared as a nonspecific, nonenhancing soft-tissue mass with bone erosion. On MRI they were seen as areas of high signal intensity surrounded by a low-intensity peripheral zone on both T1- and T2-weighted images. Cholesterol granuloma is thought to occur when pneumatised cells in the temporal bone become obstructed. Although this lesion usually occurs in the petrous bone, it can extend to the middle cranial fossa. The diagnosis and surgical management are discussed. (orig.)

1995-01-01

251

Assessment of cognitive function before and after surgery for posterior cranial fossa lesions using computerized and conventional tests.  

UK PubMed Central (United Kingdom)

Cognitive function has not been well studied after neurosurgery for posterior fossa lesions despite its potential importance in determining surgical indications and approaches. The present study evaluated changes in cognitive functions after posterior fossa surgery to detect any differences between the middle cranial fossa and lateral suboccipital approaches in 50 patients with posterior fossa lesions such as tumors and vascular diseases. Twenty-five patients underwent surgery via the middle fossa and 25 via the lateral suboccipital approaches. Computerized test battery (CogState) and conventional neuropsychological tests (serial seven-word learning test and mini-mental state examination) were examined before, 1 month after, and 3 months after surgery. All scores of the neuropsychological tests remained within normal limits after surgery. However, the scores of one computerized test battery and serial seven-word learning tests decreased significantly 1 month after surgery and recovered within 3 months, indicating temporary deterioration of short-term memory in the middle fossa group. The computerized tests detected significantly larger numbers of patients with worsened results than the conventional tests. The middle fossa approach and operation time showed correlations with the postoperative neuropsychological declines. The computerized tests could be performed easily and were beneficial for detecting subtle changes of the cognitive function after surgery. Cognitive function, especially short-term memory, may decline temporarily with the middle fossa approach and long operation time.

Ichimura S; Ohira T; Kobayashi M; Kano T; Akiyama T; Orii M; Fukunaga A; Kawase T

2010-01-01

252

Assessment of cognitive function before and after surgery for posterior cranial fossa lesions using computerized and conventional tests.  

Science.gov (United States)

Cognitive function has not been well studied after neurosurgery for posterior fossa lesions despite its potential importance in determining surgical indications and approaches. The present study evaluated changes in cognitive functions after posterior fossa surgery to detect any differences between the middle cranial fossa and lateral suboccipital approaches in 50 patients with posterior fossa lesions such as tumors and vascular diseases. Twenty-five patients underwent surgery via the middle fossa and 25 via the lateral suboccipital approaches. Computerized test battery (CogState) and conventional neuropsychological tests (serial seven-word learning test and mini-mental state examination) were examined before, 1 month after, and 3 months after surgery. All scores of the neuropsychological tests remained within normal limits after surgery. However, the scores of one computerized test battery and serial seven-word learning tests decreased significantly 1 month after surgery and recovered within 3 months, indicating temporary deterioration of short-term memory in the middle fossa group. The computerized tests detected significantly larger numbers of patients with worsened results than the conventional tests. The middle fossa approach and operation time showed correlations with the postoperative neuropsychological declines. The computerized tests could be performed easily and were beneficial for detecting subtle changes of the cognitive function after surgery. Cognitive function, especially short-term memory, may decline temporarily with the middle fossa approach and long operation time. PMID:20587966

Ichimura, Shinya; Ohira, Takayuki; Kobayashi, Masahito; Kano, Tadashige; Akiyama, Takekazu; Orii, Maaya; Fukunaga, Atsushi; Kawase, Takeshi

2010-01-01

253

Extremely weak tumor-promoting effect of troglitazone on splenic hemangiosarcomas in rasH2 mice induced by urethane  

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To examine the tumor-promoting effect of troglitazone (TRG), a novel thiazolidinedione insulin-sensitizing agent, on splenic hemangiosarcomas in rasH2 mice, histopathological and molecular analyses were performed in the spleen of female rasH2 mice fed a diet containing 6,000 or 0 ppm TRG for 16 weeks after 1,000 or 0 mg/kg urethane (UR) initiation. Histopathologically, splenic hemangiosarcomas were observed in the UR-alone and UR+TRG groups, but there was no significant difference in the incidence of splenic hemangiosarcomas between the UR-alone and UR+TRG groups. There were increasing tendencies in the number of positive cells for anti-PCNA antibody and gene expression in the UR+TRG group, but such a change was not statistically significant as compared to that in the UR-alone group. The gene expressions of VEGF, VEGFR1, VEGFC, VEGFR2 and Tie2 related to angiogenesis; c-fos related to MAPK cascade activation; and cyclin D1 related to cell cycle in the UR-alone and UR+TRG groups were significantly higher than those in the untreated control group. However, only the Tie2 gene in the UR+TRG group was significantly increased as compared to that in the UR-alone group. These results suggest that the vascular tumor-promoting activity of TRG in rasH2 mice is extremely low in the present experimental condition and a part of the gene related to angiogenesis probably contributes to the promotion of splenic hemangiosarcomas in rasH2 mice given TRG. (orig.)

Jin, Meilan [Tokyo University of Agriculture and Technology, Laboratory of Veterinary Pathology, Tokyo (Japan); Tokyo University of Agriculture and Technology, Department of Applied Biological Science, United Graduate School of Agricultural Sciences, Tokyo (Japan); Matsumoto, Sayaka; Saekusa, Yukie; Mitsumori, Kunitoshi [Tokyo University of Agriculture and Technology, Laboratory of Veterinary Pathology, Tokyo (Japan); Dewa, Yasuaki; Nishimura, Jihei [Tokyo University of Agriculture and Technology, Laboratory of Veterinary Pathology, Tokyo (Japan); Gifu University, Pathogenetic Veterinary Science, United Graduate School of Veterinary Sciences, Gifu (Japan); Hasumi, Keiji [Tokyo University of Agriculture and Technology, Department of Applied Biological Science, United Graduate School of Agricultural Sciences, Tokyo (Japan)

2008-10-15

254

Does cooling the tonsillar fossae during thermal welding tonsillectomy have an effect on postoperative pain and healing?  

UK PubMed Central (United Kingdom)

The objective of this study was to evaluate the effect of cooling the tonsillar fossa during thermal welding tonsillectomy on pain and wound healing. Prospective, blinded, clinical study was conducted. 30 patients who underwent tonsillectomy by thermal welding were evaluated. When one of the tonsillar fossa was cooled by isotonic fluid, the other has left untreated. Postoperative pain and mucosal healing pattern were assessed. Data were recorded and statistically analyzed. Healing process of the cooled down tonsillar fossae were significantly better on the 7th and 14th postoperative day (p < 0.01). Control tonsillar fossae had significantly higher pain scores on the 3rd, 7th and 14th postoperative day (p < 0.05). Administration of isotonic fluid, during thermal welding tonsillectomy for cooling tonsillar fossae, accelerates wound-healing process significantly and decreases tonsillectomy related pain complaints post-operatively.

Tepe Karaca C; Celebi S; Oysu C; Celik O

2013-01-01

255

Edema agudo de pulmão secundário a tumor de fossa posterior: registro de um caso Pulmonary edema secondary to posterior fossa tumor: a case report  

Directory of Open Access Journals (Sweden)

Full Text Available É relatada a observação de uma paciente de 44 anos de idade com quadro clínico de edema de pulmão secundário a meningioma situado na fossa posterior. São feitos comentários sobre a importância da gasometria arterial realizada no período pré e pós-operatório e especialmente sobre o gradiente alvéolo-arterial de oxigênio que serve de guia na avaliação clínica do paciente neurocirúrgico, particularmente nos casos de edema pulmonar não cardiogênico.A case of a 44-year-old woman presenting pulmonary edema secondary to posterior fossa meningioma is reported. The authors have tried to demonstrate the relationship between a lesion occupying space in the posterior fossa and important pulmonary abnormality such as interstitial edema based on increasing A-aD02 (oxygen alveolar arterial gradient) in this peculiar case. A-aD02 is easily measured and represents a good guide for evaluating the efficiency of medical and neurosurgical management when it is done in the serial way, particularly in those cases of non cardiogenic pulmonary edema.

Antonio Cesar G. Borges; Gastão Duval-Neto; Rodinei R. Festugato; Alfredo D. Zauk; Mauro Aquini

1982-01-01

256

Itch and skin rash from chocolate during fluoxetine and sertraline treatment: Case report  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background The skin contains a system for producing serotonin as well as serotonin receptors. Serotonin can also cause pruritus when injected into the skin. SSRI-drugs increase serotonin concentrations and are known to have pruritus and other dermal side effects. Case presentation A 46-year-old man consulted his doctor due to symptoms of depression. He did not suffer from any allergy but drinking red wine caused vasomotor rhinitis. Antidepressive treatment with fluoxetine 20 mg daily was initiated which was successful. After three weeks of treatment an itching rash appeared. An adverse drug reaction (ADR) induced by fluoxetine was suspected and fluoxetine treatment was discontinued. The symptoms disappeared with clemastine and betametasone treatment. Since the depressive symptoms returned sertraline medication was initiated. After approximately two weeks of sertraline treatment he noted an intense itching sensation in his scalp after eating a piece of chocolate cake. The itch spread to the arms, abdomen and legs and the patient treated himself with clemastine and the itch disappeared. He now realised that he had eaten a chocolate cake before this episode and remembered that before the first episode he had had a chocolate mousse dessert. He had never had any reaction from eating chocolate before and therefore reported this observation to his doctor. Conclusions This case report suggests that there may be individuals that are very sensitive to increases in serotonin concentrations. Dermal side reactions to SSRI-drugs in these patients may be due to high activity in the serotonergic system at the dermal and epidermo-dermal junctional area rather than a hypersensitivity to the drug molecule itself.

Cederberg Jonas; Knight Stefan; Svenson Svante; Melhus Håkan

2004-01-01

257

Estenose da fossa intercondilar após estabilização articular com retalho de fáscia lata em cães/ Intercondylar fossa stenosis after joint stabilization using a fascial strip in dogs  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Determinaram-se os índices de largura da fossa intercondilar (FI), após transecção do ligamento cruzado cranial em nove cães adultos submetidos à estabilização articular com retalho de fáscia lata. Os joelhos foram alocados em dois grupos, sendo o joelho direito (GI) submetido à incisuroplastia troclear (ITR) e posterior estabilização articular, e o joelho esquerdo submetido somente à substituição ligamentar (GC). Cada grupo foi dividido em três subgrupos (more) correspondentes aos momentos de eutanásia aos 30, 90 e 180 dias de pós-operatório. Os índices de largura da FI foram determinados, macroscópica e radiograficamente, pela mensuração da abertura cranial da FI nos terços cranial, médio e caudal, e indexados em relação à largura epicondilar. Observou-se aumento significativo dos índices macroscópicos e radiográficos nas articulações do GI, sendo estes estatisticamente diferentes daqueles das articulações de GC. Não foi observada estenose intercondilar nos joelhos de GC após a estabilização articular. Conclui-se que a estabilização articular com retalho de fáscia lata preveniu a estenose da fossa intercondilar, e que a ITR promoveu o alargamento permanente dessa estrutura. Abstract in english Intercondylar fossa width indexes (IFWI) were determined in nine adult dogs submitted to intercondylar notchplasty (IN) after transection of the cranial cruciate ligament (CCL) followed by a fascial strip stabilization. The right stifle was submitted to IN followed by fascial strip reconstruction of the CCL (GI) while in the left stifle IN was not performed (GC). Each group was then divided into three subgroups which corresponded to time of euthanasia at 30, 90 and 180 da (more) ys after surgery. IFWI were determined, both macroscopically and radiographically, by measuring the cranial outlet of the intercondylar fossa in relation to the epicondylar width. A significant increase was observed in indexes of GI following IN, and these differed from indexes of GC throughout the evaluation period. It was concluded that articular repair using a fascia strip prevented stenosis of the intercondylar fossa, and that IN caused a permanent widening of it.

Selmi, André Luis; Padilha Filho, João Guilherme; Lins, Bruno Testoni; De Nardi, Andrigo Barboza; Penteado, Bianca Mota

2012-01-01

258

Reduced CYP2D6 function is associated with gefitinib-induced rash in patients with non-small cell lung cancer  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Rash, liver dysfunction, and diarrhea are known major adverse events associated with erlotinib and gefitinib. However, clinical trials with gefitinib have reported different proportions of adverse events compared to trials with erlotinib. In an in vitro ...

Suzumura Tomohiro; Kimura Tatsuo; Kudoh Shinzoh; Umekawa Kanako; Nagata Misato; Matsuura Kuniomi; Tanaka Hidenori

259

Temporal fossa arachnoid cyst presenting with bilateral subdural hematoma following trauma: two case reports  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Introduction Intracranial arachnoid cysts are considered to be congenital malformations with a predilection for the temporal fossa. They are often asymptomatic but can sometimes be symptomatic due to enlargement or hemorrhage. There are multiple case reports of arachnoid cysts becoming symptomatic with hemorrhagic complications following head trauma. In such cases, the bleeding is often confined to the side ipsilateral to the arachnoid cyst. Occurrence of contralateral subdural hematomas in patients with temporal fossa arachnoid cysts has rarely been observed and is reported less frequently in the medical literature. Case presentation We report two cases of people (a 23-year-old man and a 41-year-old man) with temporal fossa arachnoid cysts complicated by a subdural hematoma following head injury. Both patients developed a subdural hematoma contralateral to the side of a temporal fossa arachnoid cyst. It is likely that lack of adequate intracranial cushioning in the presence of an intracranial arachnoid cyst may result in injury not only to ipsilateral but also to contralateral bridging veins, following head trauma. Conclusion It is important to identify and report such rare complications with intracranial arachnoid cysts, so that asymptomatic patients with an intracranial arachnoid cyst can be counseled about such possibilities following head trauma.

Pillai Promod; Menon Sajesh K; Manjooran Raju P; Kariyattil Rajiv; Pillai Ashok B; Panikar Dilip

2009-01-01

260

[Questionnaire on the anaesthesiology treatment of patients subjected to posterior fossa neurosurgery].  

UK PubMed Central (United Kingdom)

OBJECTIVES: To find out, by means of a questionnaire, the procedures used by Spanish anaesthetists in peri-operative management of patients subjected to neurosurgery of the posterior cranial fossa. MATERIAL AND METHODS: A closed-question type questionnaire was sent to Anaesthesiology Departments with a Neurosurgery Department on the participation of anaesthetists in the peri-operative treatment of patients subjected posterior fossa surgery. RESULTS: The questionnaire was completed by 42 (57.5%) of the 73 national public hospitals with a Neurosurgery Department. The posterior fossa surgery was performed in the sitting position in 36 hospitals, although it was less frequently used than the lateral decubitus or prone decubitus position. There was little specific neurological monitoring, as well as little use of precordial and/or transcranial Doppler for detecting vascular air embolism. Nitrous oxide was used in less than 10% of the centres, and 15% avoided neuromuscular block when neurophysiological monitoring was used during the surgery. Cardiovascular problems were mentioned as being the most frequent in 29% of the centres, while in the post-operative period the most common complications were, cranial nerve déficit, airway oedema (23%), and post-operative vomiting (47%). CONCLUSIONS: The results obtained from the questionnaire showed that the sitting position was less used than the prone position in posterior fossa surgery, and that neurophysiological monitoring is during surgery is hardly used.

Ingelmo II; Juliá NF; Rama-Maceiras P; Romero RR; Quiles RB; Sola LV; Krauchi OR; Honorato C; Palazón JH; Ledesma MJ

2012-03-01

 
 
 
 
261

A Rare Case of Metastatic Renal Cell Carcinoma in Posterior Fossa  

Directory of Open Access Journals (Sweden)

Full Text Available Renal cell carcinoma (RCC) is a tumor with high degree of potentiality for distant metastasis. Intracranial metastasis is a very rare location for this tumor. Here is presented a 47-year-old female with history of RCC and cerebellar metastasis. Key Words: Renal Cell Carcinoma, Metastasis, Posterior Fossa

H Moin; P Mohagheghzadeh

2005-01-01

262

Comparison of CT and angiographic findings about tumors of the posterior cranial fossa  

International Nuclear Information System (INIS)

[en] The CT and angiographic criteria of localisation and classification of tumors of the posterior cranial fossa are explained on the basis of 44 histologically verified cases. (orig.)[de] Anhand von 44 histologisch verifizierten Faellen von Tumoren der hinteren Schaedelgrube wurden die computertomographischen und die angiographischen Kriterien der Lokalisations- und der Artdiagnose aufgestellt. (orig.)

1981-01-01

263

Ameloblastoma de fossa nasal: revisão bibliográfica e relato de dois casos  

Directory of Open Access Journals (Sweden)

Full Text Available O ameloblastoma é um tumor bastante incomum na cavidade nasal. Surge a partir do epitélio odontogênico, podendo estender-se ao seio maxilar, órbitas e base de crânio. Apresentamos dois casos de ameloblastoma em fossa nasal direita, associados a sintomas nasossinusais e seus principais achados, clínicos e cirúrgicos.

Almeida Washington L. C.; Costa Alex C.; Góis Carlos R. T.; Almeida Marcelo C. C.; Moura Milton P. C.; Bittencourt Achiléa A. L.

2001-01-01

264

Epidermoid tumour of the posterior fossa causing multiple facial pain--a case report.  

Science.gov (United States)

A 53-year-old woman presented with three types of pain. The pains had characteristics of neuralgia of the fifth cranial nerve, ninth cranial nerve, and cluster headache. On further investigation, a tumour in the posterior fossa was observed and histologically shown to be an epidermoid tumour. PMID:2036668

Levyman, C; Dagua Filho, A dos S; Volpato, M M; Settanni, F A; de Lima, W C

1991-02-01

265

Epidermoid tumour of the posterior fossa causing multiple facial pain--a case report.  

UK PubMed Central (United Kingdom)

A 53-year-old woman presented with three types of pain. The pains had characteristics of neuralgia of the fifth cranial nerve, ninth cranial nerve, and cluster headache. On further investigation, a tumour in the posterior fossa was observed and histologically shown to be an epidermoid tumour.

Levyman C; Dagua Filho Ados S; Volpato MM; Settanni FA; de Lima WC

1991-02-01

266

Traumatic Acute Subdural Hematoma Extending from the Posterior Cranial Fossa to the Cerebellopontine Angle  

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Posterior cranial fossa subdural hematomas and extension of the subdural hematoma to the cerebellopontine angle is rarely seen and the concurrent development of acute peripheral facial palsy and the management strategy have not previously been reported in this pathology because of its rarity. We pre...

Gulsen, Salih; Sonmez, Erkin; Yilmaz, Cem; Altinors, Nur

267

Mapping Medusae Fossae Formation materials in the southern highlands of Mars  

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Abstract The Medusae Fossae Formation (MFF) is an extensive deposit (2.2 x 106 km2, Bradley et al., (2002)) of wind-eroded material of widely debated origin, which unconformably overlies a considerable area of the crustal dichotomy boundary on Mars. The MFF shows a variety of layering patter...

268

Emptiness of the left iliac fossa: a new clinical sign of sigmoid volvulus  

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BACKGROUND—Diagnostic difficulties are common in sigmoid volvulus. This diagnostic delay contributes to high morbidity and mortality.?AIM—This paper recognises visible or palpable emptiness of the left iliac fossa as a new clinical sign of sigmoid volvulus. Predictive accuracy of the sign was assess...

Raveenthiran, V

269

Teratoma of the posterior fossa CT and MR aspects A case  

International Nuclear Information System (INIS)

The CT and MR findings are reported for a patient diagnosed as having teratoma of the posterior fossa with onset in the form of intracranial hypertension. The objective of this article is to report the detection of the lesion, as well as its origin in the closure defect of the cranial cavity with the formation of a cutaneous fistula, and review the recent literature

1994-01-01

270

Chronic arachnoiditis in the posterior fossa: a study of 82 cases  

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Arachnoiditis in the posterior fossa is not a rare disorder in China. Eighty-two cases seen in a three year period were studied with reference to symptomatology, aetiology and treatment. The presentation was contrasted with that of increased intracranial pressure caused by tumour. The efficacy of tr...

Rongxun, Zhang

271

Computerized tomography findings of the posterior fossa in children: etiology and clinical correlation.  

UK PubMed Central (United Kingdom)

Of 1105 childhood cases who were evaluated by computerized tomography (CT) in a two-year interval, 93 who had posterior fossa abnormalities are reviewed. The cerebellar atrophies, either alone or accompanied by cerebral atrophy, were the most common morphological diagnoses. The clinical picture, etiology, and developmental state of the cases are discussed in relation to the CT findings.

Renda Y; Erzen C; Anlar B; Uysal S; Kilci E; Alo?lu H

1989-04-01

272

Preoperative endoscopic third ventriculostomy in children with posterior fossa tumors: an institution experience.  

UK PubMed Central (United Kingdom)

AIM: To assess the effectiveness and safety of pre-resection endoscopic third ventriculostomy (ETV) in permanently relieving hydrocephalus in children with posterior fossa tumors. MATERIAL and METHODS: 17 pediatric patients with posterior fossa tumors and associated triventricular obstructive hydrocephalus underwent ETV before definitive tumor resection, and ETV was repeated after tumor resection if hydrocephalus with increased intracranial pressure persisted or recurred. The medical records, operative notes and imaging studies were retrospectively reviewed. RESULTS: 18 ETV procedures were performed in 17 patients, consisting of 11 males and 6 females, age range (1.5 to 13 years; mean 6±3.86). Follow-up periods ranged from 6 to 23 months (mean follow-up 13.9±5.4 months). ETV was successful in relieving hydrocephalus during the follow-up period in 15 out of 17 patients (88.2%). Prior to surgical excision of the posterior fossa tumors, no failures of ETV were detected and all of the 17 patients showed marked clinical improvement and radiological disappearance of signs of active hydrocephalus. CONCLUSION: Preoperative ETV is a highly effective long-term CSF diversion procedure for treatment of hydrocephalus associated with posterior fossa tumors in children. In experienced hands, ETV has a very low complication rate.

Azab W; Al-Sheikh T; Yahia A

2013-01-01

273

High-resolution CT of the pterygopalatine fossa and its communications  

Energy Technology Data Exchange (ETDEWEB)

The pterygopalatine fossa is an important space because it communicates with the middle cranial fossa, orbit, nasal cavity, oral cavity, pharynx, foramen lacerum, and the infratemporal fossa via eight foramina and canals. We studied the pterygopalatine fossa, foramen rotundum, inferior orbital fissure, sphenopalatine foramen, pterygoid canal, greater and lesser palatine foramen, palatinovaginal canal, and the pterygomaxillary fissure with high-resolution CT to characterise the anatomy and variants of these structures. These structures were evaluated using axial and coronal planes. In the morphometric study, the distance between the foramina rotunda did not show statistically significant differences between the anterior and posterior segments. The pterygoid canal was slightly narrower in the anterior segment (23.9 mm) than in the posterior segment (25.2 mm). The pterygoid canal narrowed in the anterior (1.8 mm) to posterior (1.2 mm) direction (P < 0.01). The distance between the pterygoid canal and the lower wall of the sphenoid sinus was 2.2 mm anteriorly and 2.8 mm posteriorly (P < 0.01). The pterygoid canal showed various relationships with the sphenoid and ethmoid sinuses. In addition, a previously unreported situation, where the foramen rotundum was surrounded by the spheroid sinus, was observed. (orig.). With 4 figs., 2 tabs.

Kim, H.S. [Department of Diagnostic Radiology, Severance Hospital, 134 Shinchon-dong, Seodaemun-ku, Seoul, 120-752 (Korea, Republic of); Kim, D.I. [Department of Diagnostic Radiology, Severance Hospital, 134 Shinchon-dong, Seodaemun-ku, Seoul, 120-752 (Korea, Republic of); Chung, I.H. [Department of Anatomy, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, 120-752 (Korea, Republic of)

1996-05-01

274

Facial nerve palsy in posterior fossa arachnoid cysts: report of two cases.  

UK PubMed Central (United Kingdom)

CASE REPORT: Two patients with a posterior fossa arachnoid cyst responsible for isolated facial nerve palsy are reported. DISCUSSION: The relationships between the cyst and the facial nerve and between the facial nerve palsy and the size variation of the cyst are discussed and documented by pre- and postoperative magnetic resonance imaging.

Pirotte B; Morelli D; Alessi G; Lubansu A; Verheulpen D; Fricx C; David P; Brotchi J

2005-07-01

275

Structural characterization of the cerberus fossae and implications for paleodischarge of Athabasca Valles, Mars  

Science.gov (United States)

Mechanically interacting fault systems on Earth are often associated with groundwater flow (e.g. Curewitz and Karson, 1997) by facilitating water storage and flow through fracture conduits before, during, and after seismic events (e.g. Sibson, 1975). Similar associations between interacting fault segments and fluid flow are present on Mars (Davatzes and Gulick, 2007a). The Cerberus Fossae compose a system of elongate topographic lows, a portion of which coincides with the source region of the outflow channel Athabasca Valles. The Cerberus Fossae and source area were mapped using Thermal Emission Imaging System (THEMIS) daytime IR mosaics and Context camera (CTX) images to establish spatial relations of structural features. Mars Orbiter Laser Altimeter (MOLA) elevation data were plotted to construct the depth profiles of the fossae to test the hypothesis that the Cerberus Fossae are normal fault-bounded graben. High Resolution Imaging Science Experiment (HiRISE) images were mapped for fractures within the fault damage zones with the degree of fracture plotted as a function of distance along strike. This plot established the spatial relations between fractures, mechanically interacting fossae segments, and Athabasca Valles. The depth profiles of the Cerberus Fossae are consistent with the displacement distribution of terrestrial normal faults with a surface expression consistent with fault propagation from depth and mechanical interaction among segments. Similarly, regions of interpreted mechanical interaction indicated by slip distribution and segment overlap correspond to increased fracture intensity and density. On Earth, such regions of mechanical interaction tend to have high fracture intensity (e.g. Davatzes et al., 2005), are associated with hydrothermal fluid flow (Curewitz and Karson, 1997), and have evidence of extensive long-term fluid flow as evidenced by diagenetic alterations (Eichhubl et al., 2004). Higher fracture intensities and densities near the head of Athabasca Valles as a proxy for increased permeability provide a potential mechanism and a necessary condition for the localized fluid flux necessary to supply the outflow channel. Thus, I conclude the Cerberus Fossae are mechanically interacting normal fault-bounded graben with highly permeable damage zones that would act to quickly dewater an aquifer resulting in the carving of Athabasca Valles.

Runyon, Kirby D.

276

Management of imatinib-associated skin rash in a patient with metastatic gastrointestinal stromal tumor: a case report.  

UK PubMed Central (United Kingdom)

UNLABELLED: PURPOSE: Long-term continuous imatinib is recommended for adult patients with unresectable and/or metastatic KIT+ gastrointestinal stromal tumors (GIST) as long as the patient continues to benefit. In the adjuvant setting, recent findings indicate that patients at considerable risk of recurrence should receive at least 3 years of imatinib. Because imatinib is often administered for prolonged periods, proper management of imatinib-associated adverse events is crucial. CASE REPORT: We report a 56-year-old man with metastatic KIT+ GIST of the liver who had Grade 3 imatinib intolerance (skin rash) when treatment was started. The rash was managed with antihistamine treatment (Dexchlorpheniramine maleate 4 mg per day) and several temporary (up to 2 weeks) dose interruptions. The patient's skin rash partially improved, and he tolerated gradual reintroduction of imatinib over several months. The patient maintained imatinib 400 mg/d, and tolerated it during the 2 years when he was on antihistamine treatment. After 2 years, the patient continued imatinib therapy without having to take antihistamines. The patient responded according to RECIST 1.1 and Choi to imatinib treatment for his metastatic GIST (partial response). As of September, 2012, the patient has been on imatinib therapy for 131 months and remains progression free. CONCLUSIONS: The results of this case report demonstrated that a patient with metastatic KIT+ GIST who was initially intolerant to imatinib maintained, and responded to imatinib therapy after treatment of an imatinib-associated adverse effect. These results suggest that initial intolerance to imatinib should not necessarily result in treatment discontinuation, as these adverse effects, when managed properly, may be tolerated and may decrease over time.

Blay JY

2012-01-01

277

Supra-orbital keyhole removal of anterior fossa and parasellar meningiomas/ Minicraniotomia supra-orbitária superciliar no tratamento de meningiomas na fossa craniana anterior e para-selares  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A evolução técnica e a introdução de instrumentais cirúrgicos mais delicados proporcionaram o uso de craniotomias menores no tratamento de patologias intracranianas. Avaliamos os aspectos técnicos da minicraniotomia supra-orbitária superciliar, considerando as indicações, limitações e complicações no tratamento de meningiomas na fossa craniana anterior e para-selares. Vinte e quarto pacientes (21 mulheres; idade média, 53±8,6 anos) operados entre 2002 e 20 (more) 06 foram estudados. O diâmetro tumoral máximo variou de 1,6 a 6 cm. Ressecção total foi obtida em 20 (83,3%). Todos os tumores eram histologicamente benignos. Dois pacientes (8%) apresentaram fistula liquórica pós-operatória e outros dois diabetes insipido transitórioa (8%). Um paciente evoluiu com hemiparesia transitória. Houve um caso de meningite e um de evolução fatal. O seguimento variou de 6 a 66 meses (média 31,5±20,1 meses), não houve recidiva. A minicraniotomia supra-orbitária superciliar é uma via de abordagem eficaz para o tratamento de meningiomas da fossa craniana anterior e para-selares selecionados. Abstract in english The improvement of surgical techniques as well as the introduction of new surgical instruments promoted the use of keyhole craniotomies in neurosurgery. We evaluated the technical aspects of the supra-orbital keyhole approach considering the indications, limitations, and complications of this approach to treat anterior cranial fossa and parasellar meningiomas. Twenty-four patients (21 females; mean age, 53±8.6 years) operated on between 2002 and 2006 through a supra-orbi (more) tal eyebrow approach were studied. Maximal tumor diameter ranged from 1.6 to 6 cm. Gross total resection was done in 20 (83.3%). All tumors were histologically benign. Two patients (8%) experienced CSF rinorhea and another two patients suffered transitory diabetes insipidus (8%). One patient experienced transitory hemiparesis. There was one case of meningitis and one mortality. Follow-up ranged between 6 to 66 months (mean 31.5±20.1 months), with no recurrence. The supra-orbital keyhole craniotomy is a useful minimally invasive approach to treat selected anterior fossa and parasellar meningiomas.

Paiva-Neto, Manoel Antonio de; Tella-Jr, Oswaldo Inácio de

2010-06-01

278

Higher rate of skin rash in a phase II trial with weekly nanoparticle albumin-bound paclitaxel and cisplatin combination in Chinese breast cancer patients.  

UK PubMed Central (United Kingdom)

PURPOSE The aim of this phase II study is to explore the incidence of skin rash among advanced breast cancer(ABC) patients treated with weekly nab-paclitaxel and cisplatin combination. METHOD: S Nab-paclitaxel(125 mg/m2) was administered on days 1, 8, 15, followed by cisplatin(75 mg/m2) on day 1 every 28 day cycle until disease progression, intolerable toxicities or the maximum of 6 cycles. Patients who received a least one injection of the study drug were included in this analysis of the incidence of skin rash among Chinese patients. Toxicity was graded using the CTCAE4.0. Statistical analysis was carried out by using SPSS 16.0 (SPSS Inc, Chicago, IL). RESULTS: Seventy-three patients enrolled were qualified to be analyzed, and a total of 384 cycles were administered before the data first collected at Oct 1st, 2011. Rash was presented in 27 patients (37.0%). The most common sites involved were face (14/27), neck (14/27), limbs (18/27) and frictional parts of the trunk (10/27). Macular and papular rash with pruritus commonly occurred 2 (1-7) days after the first day of chemotherapy. Only one patient developed Grade 3 skin toxicity with generalized erythroderma and disfigurement of the face requiring dose reduction. The rash gradually regressed 2 (1-10) days after antihistamines using and pigmentation remained in 13/27 cases. The incidence rate of skin rash was significantly different between Chinese and western patients (P<0.0001). CONCLUSION: A higher rate of maculo-papular rash occurred in Chinese breast cancer patients treated with weekly nab-paclitaxel comparing to western patients. The albumin component of nab-paclitaxel might be the cause of the skin disorder.

Tang LC; Wang BY; Sun S; Zhang J; Jia Z; Lu YH; Di GH; Shao ZM; Hu XC

2013-05-01

279

Chronic subdural hematoma of the posterior fossa associated with cerebellar hemorrhage: report of rare disease with MRI findings Hematoma subdural crônico de fossa posterior associado a hemorragia cerebelar espontânea: relato de doença rara com achados de RNM  

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Full Text Available Chronic subdural hematoma of the posterior fossa is an uncommon entity, and spontaneous lesions are very rarely described, occurring mostly during anticoagulation therapy. The association of the posterior fossa chronic subdural hematoma with spontaneous parenchymal hemorrhage without anticoagulation therapy was never related in the literature, to our knowledge. We describe a case of a 64 year-old woman who suffered a spontaneous cerebellar hemorrhage, treated conservatively, and presented 1 month later with a chronic subdural posterior fossa hematoma.Hematomas subdurais da fossa posterior são lesões raras, mais comumente relacionadas com traumas graves. A ocorrência de hematomas subdurais crônicos na fossa posterior é muito rara, sendo descritos 15 casos até o momento, boa parte relacionada ao uso de anticoagulantes. Em nossa revisão da literatura, não pudemos encontrar nenhum relato da associação entre hematoma subdural crônico da fossa posterior e hemorragia cerebelar espontânea. Relatamos o caso de paciente de 64 anos com hematoma intraparenquimatoso cerebelar tratado conservadoramente e hematoma subdural crônico, tratado cirurgicamente, cerca de 1 mês após o acidente vascular cerebelar.

Leodante B. Costa Jr; Agustinho de Andrade; Gustavo Fonseca Valadão

2004-01-01

280

Chronic subdural hematoma of the posterior fossa associated with cerebellar hemorrhage: report of rare disease with MRI findings/ Hematoma subdural crônico de fossa posterior associado a hemorragia cerebelar espontânea: relato de doença rara com achados de RNM  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Hematomas subdurais da fossa posterior são lesões raras, mais comumente relacionadas com traumas graves. A ocorrência de hematomas subdurais crônicos na fossa posterior é muito rara, sendo descritos 15 casos até o momento, boa parte relacionada ao uso de anticoagulantes. Em nossa revisão da literatura, não pudemos encontrar nenhum relato da associação entre hematoma subdural crônico da fossa posterior e hemorragia cerebelar espontânea. Relatamos o caso de paci (more) ente de 64 anos com hematoma intraparenquimatoso cerebelar tratado conservadoramente e hematoma subdural crônico, tratado cirurgicamente, cerca de 1 mês após o acidente vascular cerebelar. Abstract in english Chronic subdural hematoma of the posterior fossa is an uncommon entity, and spontaneous lesions are very rarely described, occurring mostly during anticoagulation therapy. The association of the posterior fossa chronic subdural hematoma with spontaneous parenchymal hemorrhage without anticoagulation therapy was never related in the literature, to our knowledge. We describe a case of a 64 year-old woman who suffered a spontaneous cerebellar hemorrhage, treated conservatively, and presented 1 month later with a chronic subdural posterior fossa hematoma.

Costa Jr, Leodante B.; Andrade, Agustinho de; Valadão, Gustavo Fonseca

2004-03-01

 
 
 
 
281

Rash impulsiveness and reward sensitivity in relation to risky drinking by university students: potential roles of frontal systems.  

UK PubMed Central (United Kingdom)

BACKGROUND: Two forms of impulsivity, rash impulsiveness and reward sensitivity, have been proposed to reflect aspects of frontal lobe functioning and promote substance use. The present study examined these two forms of impulsivity as well as frontal lobe symptoms in relation to risky drinking by university students. METHODS: University undergraduates aged 18-26years completed the Alcohol Use Disorders Identification Test (AUDIT), Barratt Impulsiveness Scale (BIS-11), Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ), Frontal Systems Behavior Scale (FrSBe), and a demographics questionnaire assessing age, gender, and age of onset of weekly drinking (AOD). RESULTS: AUDIT-defined harmful drinkers reported earlier AOD and scored higher on BIS-11, the Sensitivity to Reward (SR) scale of the SPSRQ, and the Disinhibition and Executive Dysfunction scales of the FrSBe compared to lower risk groups. Differences remained significant after controlling for duration of alcohol exposure. Path analyses indicated that the influence of SR on AUDIT was mediated by FrSBe Disinhibition, whereas the influence of BIS-11 on AUDIT was mediated by both Disinhibition and Executive Dysfunction scales of the FrSBe. CONCLUSIONS: Findings tentatively suggest that the influence of rash impulsiveness on drinking may reflect dysfunction in dorsolateral prefrontal and orbitofrontal systems, whereas the influence of reward sensitivity on drinking may primarily reflect orbitofrontal dysfunction. Irrespective of the underlying functional brain systems involved, results appear to be more consistent with a pre-drinking trait interpretation than effects of alcohol exposure.

Lyvers M; Duff H; Basch V; Edwards MS

2012-08-01

282

Posterior fossa syndrome after a vermian stroke: a new case and review of the literature.  

Science.gov (United States)

The posterior fossa syndrome (PFS) is a well-known clinical consequence of posterior fossa surgery that has only been reported in a limited number of cases with a nontumoral etiology. It consists of transient cerebellar mutism, behavioral abnormalities and personality changes. We describe a 12-year-old child who developed transient cerebellar mutism associated with behavioral and emotional symptoms following rupture of a vermis arteriovenous malformation (AVM). Following the stroke, the girl experienced a 24-hour symptom-free interval. After that, she became mute and her emotional state was characterized by severe anxiety, irritability and withdrawal. After 3 days, mutism resolved and dysarthria became apparent. Two weeks after stroke, the AVM was surgically removed and the postoperative course was uneventful. This case is the first reported in which the PFS occurred after focal nonsurgically induced cerebellar damage. PMID:17786004

Baillieux, Hanne; Weyns, Frank; Paquier, Philippe; De Deyn, Peter P; Mariën, Peter

2007-01-01

283

Discharge management of an adolescent female with posterior fossa syndrome: a case report.  

UK PubMed Central (United Kingdom)

Posterior Fossa Syndrome (PFS) is a constellation of neurological, behavioural and psychological symptoms occurring in pediatric patients following surgical resection of posterior fossa brain tumours. The clinical presentation of PFS typically includes cerebellar mutism, bulbar dysfunction, ataxia, cranial nerve palsies, flaccid hemiparesis and emotional lability. The intent of this paper is to (a) provide an overview of PFS, (b) explore the case of a 16-year-old adolescent who presented with PFS following surgical resection of a fourth ventricle medulloblastoma, (c) reveal the complexity of her discharge, and (d) describe a discharge management framework used by the authors to guide the discharge process from a general pediatric unit in a tertiary care hospital.

Pearlman LS; McVittie A; Hunter K

2008-01-01

284

Posterior fossa syndrome after a vermian stroke: a new case and review of the literature.  

UK PubMed Central (United Kingdom)

The posterior fossa syndrome (PFS) is a well-known clinical consequence of posterior fossa surgery that has only been reported in a limited number of cases with a nontumoral etiology. It consists of transient cerebellar mutism, behavioral abnormalities and personality changes. We describe a 12-year-old child who developed transient cerebellar mutism associated with behavioral and emotional symptoms following rupture of a vermis arteriovenous malformation (AVM). Following the stroke, the girl experienced a 24-hour symptom-free interval. After that, she became mute and her emotional state was characterized by severe anxiety, irritability and withdrawal. After 3 days, mutism resolved and dysarthria became apparent. Two weeks after stroke, the AVM was surgically removed and the postoperative course was uneventful. This case is the first reported in which the PFS occurred after focal nonsurgically induced cerebellar damage.

Baillieux H; Weyns F; Paquier P; De Deyn PP; Mariën P

2007-01-01

285

Posterior fossa syndrome in an adult patient following surgical evacuation of an intracerebellar haematoma.  

Science.gov (United States)

The posterior fossa syndrome (PFS) consists of transient cerebellar mutism, cognitive symptoms and neurobehavioural abnormalities that typically develop in children following posterior fossa tumour resection. Although PFS has been documented in more than 350 paediatric cases, reports of adult patients with a vascular aetiology are extremely rare. In addition, the pathophysiological substrate of the syndrome remains unclear. We report an adult patient with PFS after surgical evacuation of a cerebellar bleeding. After 45 days of (akinetic) mutism, the patient's cognitive and behavioural profile closely resembled the "cerebellar cognitive-affective syndrome". A quantified SPECT study showed perfusional deficits in the anatomoclinically suspected supratentorial areas, subserving language dynamics, executive functioning, spatial cognition and affective regulation. We hypothesize that cerebello-cerebral diaschisis might be an important pathophysiological mechanism underlying akinetic mutism, cognitive deficits and behavioural-affective changes in adult patients with PFS. PMID:22038693

De Smet, Hyo Jung; Mariën, Peter

2012-06-01

286

Discharge management of an adolescent female with posterior fossa syndrome: a case report.  

Science.gov (United States)

Posterior Fossa Syndrome (PFS) is a constellation of neurological, behavioural and psychological symptoms occurring in pediatric patients following surgical resection of posterior fossa brain tumours. The clinical presentation of PFS typically includes cerebellar mutism, bulbar dysfunction, ataxia, cranial nerve palsies, flaccid hemiparesis and emotional lability. The intent of this paper is to (a) provide an overview of PFS, (b) explore the case of a 16-year-old adolescent who presented with PFS following surgical resection of a fourth ventricle medulloblastoma, (c) reveal the complexity of her discharge, and (d) describe a discharge management framework used by the authors to guide the discharge process from a general pediatric unit in a tertiary care hospital. PMID:18856094

Pearlman, Lisa S; McVittie, Alison; Hunter, Kerry

2008-01-01

287

Posterior fossa syndrome in an adult patient following surgical evacuation of an intracerebellar haematoma.  

UK PubMed Central (United Kingdom)

The posterior fossa syndrome (PFS) consists of transient cerebellar mutism, cognitive symptoms and neurobehavioural abnormalities that typically develop in children following posterior fossa tumour resection. Although PFS has been documented in more than 350 paediatric cases, reports of adult patients with a vascular aetiology are extremely rare. In addition, the pathophysiological substrate of the syndrome remains unclear. We report an adult patient with PFS after surgical evacuation of a cerebellar bleeding. After 45 days of (akinetic) mutism, the patient's cognitive and behavioural profile closely resembled the "cerebellar cognitive-affective syndrome". A quantified SPECT study showed perfusional deficits in the anatomoclinically suspected supratentorial areas, subserving language dynamics, executive functioning, spatial cognition and affective regulation. We hypothesize that cerebello-cerebral diaschisis might be an important pathophysiological mechanism underlying akinetic mutism, cognitive deficits and behavioural-affective changes in adult patients with PFS.

De Smet HJ; Mariën P

2012-06-01

288

Arachnoid cyst of the middle fossa with paradoxical changes of the bony structures.  

Science.gov (United States)

Two patients with an arachnoid cyst of the middle fossa showed paradoxical changes of the adjoining bony structures of the skull. There was a diminution of the middle fossa and hyperplasia of the sphenoid sinus (pneumosinus dilatans) as well as a marked bulging of the squamous part of the temporal bone. In one case in which scinticisternography was performed, communication between the cyst and the subarachnoidal space was proven as well as an extremely slow cerebrospinal fluid circulation in the cyst. The pathogenesis of the cyst is discussed, based upon the structural changes of the skull, the angiographic findings and the locally disturbed cerebrospinal fluid circulation. The primary disturbance seems to be a temporal lobe agenesis. PMID:1004704

Seur, N H; Kooman, A

1976-01-01

289

Arachnoid cyst of the middle fossa with paradoxical changes of the bony structures.  

UK PubMed Central (United Kingdom)

Two patients with an arachnoid cyst of the middle fossa showed paradoxical changes of the adjoining bony structures of the skull. There was a diminution of the middle fossa and hyperplasia of the sphenoid sinus (pneumosinus dilatans) as well as a marked bulging of the squamous part of the temporal bone. In one case in which scinticisternography was performed, communication between the cyst and the subarachnoidal space was proven as well as an extremely slow cerebrospinal fluid circulation in the cyst. The pathogenesis of the cyst is discussed, based upon the structural changes of the skull, the angiographic findings and the locally disturbed cerebrospinal fluid circulation. The primary disturbance seems to be a temporal lobe agenesis.

Seur NH; Kooman A

1976-01-01

290

Magnetic resonance imaging findings of true bifid mandibular condyle with duplicated mandibular fossa.  

UK PubMed Central (United Kingdom)

Bifid mandibular condyle (BMC) is a rare asymptomatic morphological alteration with no predilection for age group or gender. Its morphology varies from a shallow groove to two condylar heads with separate necks, oriented mediolaterally or anteroposteriorly. This report describes an unusual case of anteroposterior bifid condyle in a 39-year-old female patient with the main complaint of mouth-opening limitation and a deviation of the mandible to the left side. Magnetic resonance imaging (MRI) findings revealed a bifid condyle on the left side and duplicated mandibular fossa, with the articular disc over the anterior head. The MRI images in the open-mouth position revealed minimal movement of the condyle. Despite the increased number of mediolateral bifid mandibular condyle cases described in the literature, none of previously reported cases of BMC included an anteroposterior bifid condyle case with two distinct mandibular fossa.

Melo SL; Melo DP; Oenning AC; Haiter-Neto F; Almeida SM; Campos PS

2012-07-01

291

O papel do acesso via fossa média no tratamento da paralisia facial traumática The role of the middle fossa approach in the management of traumatic facial paralysis  

Directory of Open Access Journals (Sweden)

Full Text Available Há vários aspectos controversos no tratamento da paralisia facial traumática. Um destes é a natureza precisa da intervenção cirúrgica a ser usada, uma vez que a decisão de ser realizada tenha sido feita. FORMA DE ESTUDO: Clínico retrospectivo. OBJETIVOS E MÉTODOS: Entre o período de junho de 1984 e junho de 1993, 220 casos de paralisia facial traumática com boa função coclear foram tratados na Universidade de São Paulo pela seguinte técnica cirúrgica: descompressão dos segmentos mastóideo e timpânico através do acesso transmastoídeo e descompressão do gânglio geniculado e dos 50% distais do segmento labiríntico, usando-se o acesso pela fossa média. Apresentamos uma revisão de literatura e a discussão e resultados de nosso trabalho.Management of traumatic facial paralysis has several controversial aspects. One of these is the precise nature of surgical intervention to be used once the decision to operate has been made. STUDY DESIGN: chart review. AIMS AND METHODS: Between June 1984 and June 1993, 220 cases of traumatic facial paralysis with good cochlear reserve were treated at the University of São Paulo by the following surgical approach: decompression of the tympanic and mastoid segments by the transmastoid approach and decompression of the geniculate ganglion and the distal 50% of the labyrinthine segment by the middle fossa approach. We present a review of the literature and a discussion and results of our management.

Ricardo Ferreira Bento; Sulene Pirana; Rubens Vuonno de Brito Neto; Tanit Ganz Sanchez; Arthur Menino Castilho; Robert Carl Sweet

2004-01-01

292

Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus  

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Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyoma virus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppressed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa (author)

Goncalves, Fabricio Guimaraes; Lamb, Leslie; Del Carpio-O' Donovan, Raquel, E-mail: goncalves.neuroradio@gmail.com [McGill University Health Center Montreal General Hospital (Canada)

2011-11-15

293

Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus  

International Nuclear Information System (INIS)

[en] Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyoma virus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppressed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa (author)

2011-01-01

294

Multiple systemic metastases of posterior fossa - primitive neuroectodermal tumor (PF-PNET) in adult: case report  

Directory of Open Access Journals (Sweden)

Full Text Available We present the case of a 30-year female patient with multiple systemic metastases of posterior fossa primitive neuroectodermal tumor (PF- PNET) and present a review concerning the usual presentation, sign and symptoms, radiological aspects, pathways of spread, genetic patterns and treatment of PF-PNET. The biological behavior of PF - PNET is analyzed taking into consideration the presence of systemic metastases.

Mattos João Paulo; Bonilha Leonardo; Ferreira Daniele; Borges Wilson; Fernandes Yvens Barbosa; Borges Guilherme

2003-01-01

295

MS Plaque Demonstration in the Posterior Fossa: T2W Imaging is Better Than FLAIR  

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Full Text Available Background/Objective: For imaging diagnosis of multiple sclerosis, axial FLAIR, T2W and Sagittal T2W are commonly obtained and FLAIR is known as the best pulse in showing the plaques. According to our daily observation and corresponding to an investigation, T2W is better for posterior fossa and FLAIR is better for supra-tentorial plaque diagnosis."nMaterials and Methods: Four-hundred patients in a series of brain MRIs were investigated by ROI (region of interest) signal intensity assessment. All images are obtained by a 1.5 tesla machine. Patients were men and women and we used the mean signal intensity of ROI in the MRI machine."nResults: On T2W and FLAIR images, the mean signal intensity of the pontine white matter was measured as 306 and 294; the centrum semiovalae as 295 and 286; the brachium cerebella as 311 and 309; the cerebral penduncle as 247 and 238; the CSF as 820 and 134; the MS plaque in the supratentorial as 616 and 434 and the MS plaque in the posterior fossa as 407 and 344."nConclusion: The background in T2 images is darker than it is in FLAIR. Supra-tentorial background signal intensity suppression is due to the free CSF signal in the FLAIR pulse."nThe amount of CSF is larger in the supratentorial cisternal regions compared to the less gyral pattern in the infratentorial region. These problems and findings in the background and high signal T2 value of MS plaque in T2 show the following mentioned results:"nFor supra-tentorial area plaques, FLAIR is more sensitive and for plaques in the posterior fossa, T2W is better than FLAIR (visual and by ROI signal assessment)."nBy better T2W demonstration of the posterior fossa plaques, their water density was higher than supra-tentorial plaques.

Jalal Jalalshokouhi; Mansour Fatehi; Dariush Etemadi

2010-01-01

296

Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyomavirus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppresed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa.

Gonçalves, Fabrício Guimarães; Lamb, Leslie; Del Carpio-O'Donovan, Raquel

2011-12-01

297

Spontaneous bilateral subdural haematomas in the posterior cranial fossa revealed by MRI  

International Nuclear Information System (INIS)

[en] A 52-year-old woman treated for acute myeloproliferative disease developed progressive stupor. CT showed obstructive hydrocephalus resulting from unexplained mass effect on the fourth ventricle. MRI revealed bilateral extra-axial collections in the posterior cranial fossa, giving high signal on T1- and T2-weighted images, suggesting subacute subdural haematomas. Subdural haematomas can be suspected on CT when there is unexplained mass effect. MRI may be essential to confirm the diagnosis and plan appropriate treatment. (orig.)

2003-01-01

298

Subdural enhancement on postoperative spinal MRI after resection of posterior cranial fossa tumours  

International Nuclear Information System (INIS)

[en] In malignant brain tumours which may disseminate staging, usually by cranial and spinal MRI is necessary. If MRI is performed in the postoperative period pitfalls should be considered. Nonspecific subdural contrast enhancement on spinal staging MRI is rarely reported after resection of posterior fossa tumours, which may be mistaken for dissemination of malignancy. We investigated the frequency of spinal subdural enhancement after posterior cranial fossa neurosurgery in children. We reviewed 53 postoperative spinal MRI studies performed for staging of paediatric malignant brain tumours, mainly infratentorial primitive neuroectodermal tumours 2-40 days after surgery. There was contrast enhancement in the spinal subdural space in seven cases. This was not seen in any of eight patients who had been operated upon for a supratentorial tumour. After resection of 45 posterior cranial fossa tumours the frequency of subdural enhancement was 15.5%. MRI showing subdural enhancement was obtained up to 25 days postoperatively. No patient with subdural enhancement had cerebrospinal fluid (CSF) examinations positive for tumour cells or developed dissemination of disease in the CSF. Because the characteristic appearances of subdural contrast enhancement, appropriate interpretation is possible; diagnosis of neoplastic meningitis should rarely be impeded. Because of the striking similarity to that in patients with a low CSF-pressure syndrome and in view of the fact that only resection of tumours of the posterior cranial fossa, usually associated with obstructive hydrocephalus, was followed by this type of enhancement one might suggest that rapid changes in CSF pressure are implicated, rather the effects of blood introduced into the spinal canal at surgery. (orig.)

2004-01-01

299

Spontaneous bilateral subdural haematomas in the posterior cranial fossa revealed by MRI  

Energy Technology Data Exchange (ETDEWEB)

A 52-year-old woman treated for acute myeloproliferative disease developed progressive stupor. CT showed obstructive hydrocephalus resulting from unexplained mass effect on the fourth ventricle. MRI revealed bilateral extra-axial collections in the posterior cranial fossa, giving high signal on T1- and T2-weighted images, suggesting subacute subdural haematomas. Subdural haematomas can be suspected on CT when there is unexplained mass effect. MRI may be essential to confirm the diagnosis and plan appropriate treatment. (orig.)

Pollo, C.; Porchet, F. [Department of Neurosurgery, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne (Switzerland); Meuli, R. [Department of Radiology, Centre Hospitalier Universitaire Vaudois, 1011, Lausanne (Switzerland)

2003-08-01

300

Subdural enhancement on postoperative spinal MRI after resection of posterior cranial fossa tumours  

Energy Technology Data Exchange (ETDEWEB)

In malignant brain tumours which may disseminate staging, usually by cranial and spinal MRI is necessary. If MRI is performed in the postoperative period pitfalls should be considered. Nonspecific subdural contrast enhancement on spinal staging MRI is rarely reported after resection of posterior fossa tumours, which may be mistaken for dissemination of malignancy. We investigated the frequency of spinal subdural enhancement after posterior cranial fossa neurosurgery in children. We reviewed 53 postoperative spinal MRI studies performed for staging of paediatric malignant brain tumours, mainly infratentorial primitive neuroectodermal tumours 2-40 days after surgery. There was contrast enhancement in the spinal subdural space in seven cases. This was not seen in any of eight patients who had been operated upon for a supratentorial tumour. After resection of 45 posterior cranial fossa tumours the frequency of subdural enhancement was 15.5%. MRI showing subdural enhancement was obtained up to 25 days postoperatively. No patient with subdural enhancement had cerebrospinal fluid (CSF) examinations positive for tumour cells or developed dissemination of disease in the CSF. Because the characteristic appearances of subdural contrast enhancement, appropriate interpretation is possible; diagnosis of neoplastic meningitis should rarely be impeded. Because of the striking similarity to that in patients with a low CSF-pressure syndrome and in view of the fact that only resection of tumours of the posterior cranial fossa, usually associated with obstructive hydrocephalus, was followed by this type of enhancement one might suggest that rapid changes in CSF pressure are implicated, rather the effects of blood introduced into the spinal canal at surgery. (orig.)

Warmuth-Metz, M.; Solymosi, L. [Abteilung fuer Neuroradiologie, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany); Kuehl, J. [Paediatric Oncology, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany); Krauss, J. [Paediatric Neurosurgery, Klinikum der Bayerischen Julius Maximilians Universitaet, Josef-Schneider-Strasse 11, 97080, Wuerzburg (Germany)

2004-03-01

 
 
 
 
301

Posterior fossa dermoid with Klippel-Feil syndrome in a child.  

UK PubMed Central (United Kingdom)

Intracranial dermoid tumors constitute a rare entity. Their association with Klippel-Feil anomaly is all the more rare. These lesions, if associated with dermal sinuses, receive attention when a patient presents with features of central nervous system infection. We describe a 5-year-old girl who presented with purulent discharge from an occipital dermal sinus with an infected posterior fossa dermoid associated with cerebellar abscesses and characteristic Klippel-Feil anomaly.

Ramzan A; Khursheed N; Rumana M; Abrar W; Ashish J

2011-09-01

302

Primary intraosseous meningioma of orbit and anterior cranial fossa: a case report and literature review  

International Nuclear Information System (INIS)

[en] Primary intraosseous meningiomas of the skull base are rare. Extensive involvement of the skull base by the tumour may result rarely in loss of vision. Surgical management requires extensive decompression and reconstruction. A case of primary intraosseous meningioma of orbits and anterior cranial fossa presenting with painless proptosis and loss of vision is presented here and the literature reviewed. Copyright (2001) Blackwell Science Pty Ltd

2001-01-01

303

Unusual presentation of a dermoid cyst in the ischiorectal fossa. Magnetic resonance imaging and ultrasound appearances  

International Nuclear Information System (INIS)

The ischiorectal fossa may give rise to a wide variety of pathological entities, although it is composed of relatively few structures. Developmental cysts are included among the list. Large epidermoid cysts in the ischiorectal fossa have been previously described (Fujimoto et al., Clin Imaging 17:146-148, 1993; Ng et al., Can J Surg 49:435-436, 2006). However, to the best of our knowledge, there is no published case in the English literature of a dermoid cyst within the ischiorectal fossa. Using magnetic resonance (MR) imaging and a subsequent ultrasound-guided biopsy, we were able to offer a focused differential that included a dermoid cyst within the ischiorectal fossa in a 55-year-old man presenting with a painful mass on the buttocks. Hair and fatty components were obtained by targeted ultrasound-guided biopsy. On MR imaging, the mass was seen to be well circumscribed and registered a heterogeneous T1-weighted signal that corresponded to layers of fat and debris on short-tau inversion recovery (STIR) imaging. A well-defined ball of fat was noted centrally within the lesion, with a speckled low T1 and low T2 signal within it. Hair admixed with fat was obtained from it by targeted ultrasound-guided biopsy. There was no enhancement of the lesion after administration of gadolinium. On ultrasound, the lesion was well circumscribed and heterogeneous; the echogenic area corresponded to the fat signal seen on magnetic resonance imaging (MRI). The lower level echoes within the lesion corresponded to the debris seen on MRI. The central rounded area of speckling, registering fine posterior shadowing corresponded to the hairy contents obtained by the targeted ultrasound-guided biopsy. A differential diagnosis of all lipomatous lesions was included in the pre-biopsy report: fat necrosis within a lipoma; well-differentiated liposarcoma; myxoid liposarcoma and dermoid cyst. Histopathological diagnosis following complete surgical resection was that of a dermoid cyst. (orig.)

2009-01-01

304

Progressive multifocal leukoencephalopathy restricted to the posterior fossa in a patient with systemic lupus erythematosus  

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Full Text Available Progressive multifocal leukoencephalopathy is a neurological infectious disease caused by the John Cunningham polyomavirus (JCV), an opportunistic agent with worldwide distribution. This disease is frequently seen in immunosuppresed patients and rarely associated with systemic lupus erythematosus. In the central nervous system PML demyelinating lesions occur in the supratentorial compartment. The authors describe a rare case of PML secondary to SLE treatment with atypical presentation restricted to the posterior fossa.

Fabrício Guimarães Gonçalves; Leslie Lamb; Raquel Del Carpio-O'Donovan

2011-01-01

305

A nomenclature for vertebral fossae in sauropods and other saurischian dinosaurs.  

UK PubMed Central (United Kingdom)

BACKGROUND: The axial skeleton of extinct saurischian dinosaurs (i.e., theropods, sauropodomorphs), like living birds, was pneumatized by epithelial outpocketings of the respiratory system. Pneumatic signatures in the vertebral column of fossil saurischians include complex branching chambers within the bone (internal pneumaticity) and large chambers visible externally that are bounded by neural arch laminae (external pneumaticity). Although general aspects of internal pneumaticity are synapomorphic for saurischian subgroups, the individual internal pneumatic spaces cannot be homologized across species or even along the vertebral column, due to their variability and absence of topographical landmarks. External pneumatic structures, in contrast, are defined by ready topological landmarks (vertebral laminae), but no consistent nomenclatural system exists. This deficiency has fostered confusion and limited their use as character data in phylogenetic analysis. METHODOLOGY/PRINCIPAL FINDINGS: We present a simple system for naming external neural arch fossae that parallels the one developed for the vertebral laminae that bound them. The nomenclatural system identifies fossae by pointing to reference landmarks (e.g., neural spine, centrum, costal articulations, zygapophyses). We standardize the naming process by creating tripartite names from "primary landmarks," which form the zygodiapophyseal table, "secondary landmarks," which orient with respect to that table, and "tertiary landmarks," which further delineate a given fossa. CONCLUSIONS/SIGNIFICANCE: The proposed nomenclatural system for lamina-bounded fossae adds clarity to descriptions of complex vertebrae and allows these structures to be sourced as character data for phylogenetic analyses. These anatomical terms denote potentially homologous pneumatic structures within Saurischia, but they could be applied to any vertebrate with vertebral laminae that enclose spaces, regardless of their developmental origin or phylogenetic distribution.

Wilson JA; D'Emic MD; Ikejiri T; Moacdieh EM; Whitlock JA

2011-01-01

306

Avoiding pitfalls in surgery of the neck, parapharyngeal space, and infratemporal fossa.  

UK PubMed Central (United Kingdom)

The region of the upper neck, parapharyngeal space, and infratemporal fossa contains many vital structures in a confined area. Access is often limited, making surgical treatment challenging. Preoperative assessment is critical in determining the optimal surgical approach. In spite of improvements in preoperative evaluation and surgical techniques, sequelae from surgical therapy are sometimes unavoidable. Awareness of the potential problems is necessary to counsel patients appropriately regarding treatment options and all potential risks.

Sharma PK; Massey BL

2005-08-01

307

Pressure Sore at an Unusual Site- the Bilateral Popliteal Fossa: A Case report  

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Full Text Available Pressure sore is tissue ulceration due to unrelieved pressure, altered sensory perception, and exposure to moisture. Geriatric patients with organic problems and patients with spinal cord injuries are the high-risk groups. Soft tissues over bony prominences are the common sites for ulcer development. About 95% of pressure ulcers occur in the lower part of the body. Ischial tuberosity, greater trochanter, sacrum and heel are common sites. In addition to these, pressure sores at unusual sites like nasal alae, malar eminences, cervical region and medial side of knee have also been described. Only 1.6% of the patients present with sores in areas outside the pelvis and lower extremity. In a paraplegic patient, pressure sores are usually over extensor surface of knee and heel but pressure ulcer over popliteal fossa are extremely rare. We herein report a case of a 36-years-old diabetic and paraplegic male, who presented with multiple bed sores involving the sacral area, heels and bilateral popliteal fossa. Popliteal fossa is an unusual site for pressure sores. Only one similar case has been previously reported in the literature.

Kamal Kataria; Sushma Sagar; Manish Singhal; Rajni Yadav

2012-01-01

308

Cerebellar mutism in adults after posterior fossa surgery: a report of 2 cases.  

UK PubMed Central (United Kingdom)

BACKGROUND: Mutism has been associated with injury to midline cerebellar structures secondary to degenerative disease, tumors, hemorrhage, or surgery. Typically, cerebellar mutism syndrome (CMS) has been seen in children and only rarely described in adults after surgery of the posterior fossa. This syndrome typically arises 48 hours after the initiating event and resolves approximately 7 to 8 weeks later. Characteristics of CMS include complete absence of speech without impaired consciousness, other cranial nerve deficits, or long tract signs. CASE DESCRIPTION: The authors report on 2 patients each of whom developed cerebellar mutism after tumor resection using a posterior fossa approach. The first patient underwent gross total resection of a pineal region tumor via a supracerebellar approach. The second patient underwent posterior fossa decompression for a left cerebellar hemispheric renal cell carcinoma metastasis with adjacent hemorrhage. One patient displayed a variant of cerebellar mutism with severe ataxic dysarthria without complete absence of speech, whereas the other demonstrated frank mutism. After neuroimaging studies confirmed the absence of a surgically treatable postoperative cause for the patients' symptoms, they were managed in a supportive fashion (eg, speech therapy) and improved within 3.5 months and 1 year, respectively. CONCLUSION: It is paramount that neurosurgeons be aware of cerebellar mutism with regard to its very rare occurrence in adults, its time of onset, and typical self-limiting course.

Sherman JH; Sheehan JP; Elias WJ; Jane JA Sr

2005-05-01

309

Reversible cerebral perfusion alterations in children with transient mutism after posterior fossa surgery.  

Science.gov (United States)

Mutism is an infrequent and transitory complication observed following posterior fossa surgery. Patients become mute in the immediate postoperative period, with restoration of speech within a few weeks in the absence of additional neurological alterations. The anatomical structures thought to be involved are the connections between the cerebellar dentate nucleus, the ventrolateral nucleus of the contralateral thalamus and the supplementary motor area. In an attempt to understand the pathophysiology of this syndrome, and to depict the perfusion of different brain areas semiquantitatively, in two children who had become mute after posterior fossa surgery we performed a Tc99M-HM-PAO SPECT study during the period of mutism and again when normal speech had returned. In one patient, who had a left cerebellar astrocytoma, the SPECT study showed a marked reduction of cerebral perfusion in the right fronto-parietal region, and in the other, who had a medulloblastoma, a left fronto-temporo-parietal perfusion alteration was observed. When the patients regained normal speech, the follow-up SPECT studies revealed normalization of the cerebral perfusion. This study demonstrates the occurrence of a focal dysfunction of cerebral perfusion in children with cerebellar mutism after posterior fossa surgery. These observations are useful in extending our understanding of the pathophysiology of this postoperative clinical syndrome. PMID:9579866

Germanò, A; Baldari, S; Caruso, G; Caffo, M; Montemagno, G; Cardia, E; Tomasello, F

1998-03-01

310

Reversible cerebral perfusion alterations in children with transient mutism after posterior fossa surgery.  

UK PubMed Central (United Kingdom)

Mutism is an infrequent and transitory complication observed following posterior fossa surgery. Patients become mute in the immediate postoperative period, with restoration of speech within a few weeks in the absence of additional neurological alterations. The anatomical structures thought to be involved are the connections between the cerebellar dentate nucleus, the ventrolateral nucleus of the contralateral thalamus and the supplementary motor area. In an attempt to understand the pathophysiology of this syndrome, and to depict the perfusion of different brain areas semiquantitatively, in two children who had become mute after posterior fossa surgery we performed a Tc99M-HM-PAO SPECT study during the period of mutism and again when normal speech had returned. In one patient, who had a left cerebellar astrocytoma, the SPECT study showed a marked reduction of cerebral perfusion in the right fronto-parietal region, and in the other, who had a medulloblastoma, a left fronto-temporo-parietal perfusion alteration was observed. When the patients regained normal speech, the follow-up SPECT studies revealed normalization of the cerebral perfusion. This study demonstrates the occurrence of a focal dysfunction of cerebral perfusion in children with cerebellar mutism after posterior fossa surgery. These observations are useful in extending our understanding of the pathophysiology of this postoperative clinical syndrome.

Germanò A; Baldari S; Caruso G; Caffo M; Montemagno G; Cardia E; Tomasello F

1998-03-01

311

Neurinomas of the facial nerve extending to the middle cranial fossa  

International Nuclear Information System (INIS)

[en] Three cases with neurinomas of the facial nerve are reported, especially with regard to the computerized tomographic (CT) findings. All of them had a long history of facial-nerve dysfunction, associated with hearing loss over periods from several to twenty-five years. Intraoperative findings demonstrated that these tumors arose from the intrapetrous portion, the horizontal portion, or the geniculate portion of the facial nerve and that they were located in the middle cranial fossa. The histological diagnoses were neurinomas. CT scans of three cases demonstrated round and low-density masses with marginal high-density areas in the middle cranial fossa, in one associated with diffuse low-density areas in the left temporal and parietal lobes. The low-density areas on CT were thought to be cysts; this was confirmed by surgery. Enhanced CT scans showed irregular enhancement in one case and ring-like enhancement in two cases. High-resolution CT scans of the temporal bone in two cases revealed a soft tissue mass in the middle ear, a well-circumscribed irregular destruction of the anterior aspect of the petrous bone, and calcifications. These findings seemed to be significant features of the neurinomas of the facial nerve extending to the middle cranial fossa. We emphasize that bone-window CT of the temporal bone is most useful in detecting a neurinoma of the facial nerve in its early stage in order to preserve the facial- and acoustic-nerve functions. (author)

1986-01-01

312

[Results in otosurgically treated patients with acoustic neuroma. Part 2: Hearing results after middle fossa approach].  

UK PubMed Central (United Kingdom)

BACKGROUND: The surgical therapy of acoustic neuromas has been seen critically lately. Alternative methods like the gamma-knife treatment open a wide field of discussion. PATIENTS: The results of 392 patients are presented operated on via a middle fossa approach between 1989 and 2004. RESULTS: Hearing preservation according to the 50:50 rule (hearing loss less than 50 dB in pure tone audiogram 500-1000-2000 Hz, speech discrimination>50%) was possible in 59.7% of patients. A hearing impression up to 90 dB was recognized in 83.1%, 16.9% of cases were deaf. There was no difference between tumors confined to the inner ear canal and tumors extending into the cerebello pontine angle. There was also no difference between tumors up to a volume of 100 mm3 and tumors between 100 mm3 and 500 mm3. CONCLUSION: Acoustic neuroma confined to the internal meatus or with little extend into the cerebello pontine angle (i. e. no contact to structures of the brain stem or vessels of the posterior fossa) are feasible for resection via the middle fossa approach. The possibility of hearing preservation and low morbidity makes it the treatment of choice for this group of tumors.

Schwager K; Baier G; Helms J; Hagen R

2008-09-01

313

Elastic Lithosphere Thickness and Heat Flux Estimates from Rift Valley Topography: Coracis Fossae, Mars  

Science.gov (United States)

The Coracis Fossae in the Thaumasia region on Mars are two several hundred kilometer long and ˜50 km wide extensional structures. Their complex morphology, fractured graben floors and segmented border faults, which are arranged in en echelon pattern, suggest that they are Martian analogues to terrestrial rift systems. At Coracis Fossae's NE segment rift flank uplift is most pronounced, the rift shoulders having heights of more than 1000 m with respect to the surrounding planes. We model the uplift by fitting a flexed broken plate to the topography data obtained by the Mars Orbiter Laser Altimeter. Thus, the elastic thickness at the time of rifting is constrained to 10.3 - 12.5 km. Assuming a diabase composition of the crust, this corresponds to a thermal gradient of 27 - 33 K km-1. Investigating the key surface units associated with the rifting, the time of rift formation is determined by measuring their crater size-frequency distribution and comparing the results to an impact cratering chronology model. The time of rifting is thus constrained to 3.5 - 3.9 Gyr b.p. Given the fault block topography and elastic thickness, the stresses acting on the bounding faults which support the topography may be calculated. We estimate that at the Coracis Fossae the faults need not withstand stresses in excess of 5 MPa, a value comparable to terrestrial faults. We take this weakness as an indication that the faults are or have been in contact with liquid water below the surface.

Grott, M.; Hauber, E.; Werner, S. C.; Kronberg, P.; Neukum, G.

2005-08-01

314

BIOGENIC AMINE CONTENT AND CHEMICAL AND PHYSICAL FEATURES OF ITALIAN FORMAGGIO DI FOSSA  

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Full Text Available Formaggio di Fossa is an Italian traditional cheese of the Montefeltro area (Emilia Romagna and Marche regions) characterized by a particular step of ripening that is carried out into pits (infossamento) borne in the sandstone. Since the XIV century, the inhabitants were used to set food, especially cereals and cheese, into pits to preserve them during winter and to protect them from invaders. The aim of the present work is to study physical and chemical features of this product with particular reference to the presence of the most important biogenic amines ( -Phenylethylamine, putrescine, cadaverine, histamine, tyramine, spermine and spermidine), compared with a control cheese fully ripened in factory. Formaggio di Fossa showed higher values of Aw, pH, humidity, proteins, pH 4,6-soluble nitrogen (NCN) and water soluble nitrogen (NPN) and much lower amounts of fat. Much higher amounts of total biogenic amines were detected in Formaggio di Fossa than in control cheese, where their concentration was very low. Cadaverine, putrescine and tyramine were the most concentrated biogenic amines. Nevertheless, thyramine was present at levels suggested as compatible with GMPs. Histamine was detected at low amounts, far from potentially toxic levels.

N. Mascaro; R. Stocchi; M. Ricciutelli; N. Cammertoni; F Renzi; S Cecchini; A.R Loschi; S Rea

2010-01-01

315

BIOGENIC AMINE CONTENT AND CHEMICAL AND PHYSICAL FEATURES OF ITALIAN FORMAGGIO DI FOSSA  

Directory of Open Access Journals (Sweden)

Full Text Available Formaggio di Fossa is an Italian traditional cheese of the Montefeltro area (Emilia Romagna and Marche regions) characterized by a particular step of ripening that is carried out into pits (infossamento) borne in the sandstone. Since the XIV century, the inhabitants were used to set food, especially cereals and cheese, into pits to preserve them during winter and to protect them from invaders. The aim of the present work is to study physical and chemical features of this product with particular reference to the presence of the most important biogenic amines ( -Phenylethylamine, putrescine, cadaverine, histamine, tyramine, spermine and spermidine), compared with a control cheese fully ripened in factory. Formaggio di Fossa showed higher values of Aw, pH, humidity, proteins, pH 4,6-soluble nitrogen (NCN) and water soluble nitrogen (NPN) and much lower amounts of fat. Much higher amounts of total biogenic amines were detected in Formaggio di Fossa than in control cheese, where their concentration was very low. Cadaverine, putrescine and tyramine were the most concentrated biogenic amines. Nevertheless, thyramine was present at levels suggested as compatible with GMPs. Histamine was detected at low amounts, far from potentially toxic levels.

N. Mascaro; R. Stocchi; M. Ricciutelli; N. Cammertoni; F Renzi; S Cecchini; A.R Loschi; S Rea

2013-01-01

316

Large liposarcoma developing in the ischiorectal fossa: Report of a rare case  

Science.gov (United States)

INTRODUCTION We herein report an extremely rare case of a liposarcoma developing in the ischiorectal fossa that was completely resected using a transsacral approach. PRESENTATION OF CASE A 74-year-old man was admitted to our institute because of a large perianal tumor. A pelvic magnetic resonance imaging (MRI) revealed an 8 cm × 7 cm × 5 cm sized encapsulated heterogeneous tumor on the right side of the ischiorectal fossa. Transsacral excision was performed under a diagnosis of liposarcoma. The tumor was partially fixed to the external sphincter and puborectalis. Therefore, the muscles were partially resected to ensure sufficient margins. Histopathological examination revealed a well differentiated liposarcoma and negative surgical margins. DISCUSSION The basic treatment strategy of liposarcoma is surgical resection, whereas the effects of chemotherapy or radiotherapy remain limited. Although no postoperative adjuvant therapy has been performed in our case, no recurrences have occurred for 1 year after surgery. CONCLUSION Although the curative resection of large tumors located in the ischiorectal fossa is usually difficult, the complete resection of liposarcoma is the main potentially curative treatment. A transsacral approach is useful for a complete resection.

Seishima, Ryo; Ishii, Yoshiyuki; Hasegawa, Hirotoshi; Endo, Takashi; Ochiai, Hiroki; Okabayashi, Koji; Mukai, Makio; Kitagawa, Yuko

2012-01-01

317

Large liposarcoma developing in the ischiorectal fossa: Report of a rare case.  

UK PubMed Central (United Kingdom)

INTRODUCTION: We herein report an extremely rare case of a liposarcoma developing in the ischiorectal fossa that was completely resected using a transsacral approach. PRESENTATION OF CASE: A 74-year-old man was admitted to our institute because of a large perianal tumor. A pelvic magnetic resonance imaging (MRI) revealed an 8cm×7cm×5cm sized encapsulated heterogeneous tumor on the right side of the ischiorectal fossa. Transsacral excision was performed under a diagnosis of liposarcoma. The tumor was partially fixed to the external sphincter and puborectalis. Therefore, the muscles were partially resected to ensure sufficient margins. Histopathological examination revealed a well differentiated liposarcoma and negative surgical margins. DISCUSSION: The basic treatment strategy of liposarcoma is surgical resection, whereas the effects of chemotherapy or radiotherapy remain limited. Although no postoperative adjuvant therapy has been performed in our case, no recurrences have occurred for 1 year after surgery. CONCLUSION: Although the curative resection of large tumors located in the ischiorectal fossa is usually difficult, the complete resection of liposarcoma is the main potentially curative treatment. A transsacral approach is useful for a complete resection.

Seishima R; Ishii Y; Hasegawa H; Endo T; Ochiai H; Okabayashi K; Mukai M; Kitagawa Y

2013-01-01

318

External drainage with an Ommaya reservoir for perioperative hydrocephalus in children with posterior fossa tumors.  

UK PubMed Central (United Kingdom)

PURPOSE: This study aims to evaluate an external drainage using an Ommaya reservoir for relieving perioperative hydrocephalus and reducing postoperative complications in children with posterior fossa tumors. METHODS: We retrospectively analyzed the data from 48 children with posterior fossa tumors who underwent tumor resection between May 2006 and June 2012. An Ommaya reservoir was placed in the right lateral ventricle forehead for continuous perioperative drainage of cerebrospinal fluid (CSF). RESULTS: Tumors were successfully removed from all patients. Intracranial infection occurred in nine patients and was controlled by antibiotic treatment. Preoperative obstruction and obstructive hydrocephalus were relieved, and the need for a shunt or endoscopic third ventriculostomy was avoided. One patient who underwent a second surgical procedure had intracranial infection, hydrocephalus, and occipital pseudomeningocele. After continuous drainage and anti-infective treatment, hydrocephalus and intracranial infection were effectively controlled. CONCLUSIONS: Using an Ommaya reservoir for perioperative external ventricular CSF drainage enabled tumors to be wholly and safely removed. Restoring CSF circulation provided an effective means of controlling and preventing hydrocephalus secondary to posterior fossa tumors in children.

Jiang C; Wu X; Lin Z; Wang C; Kang D

2013-08-01

319

Tumor Promotion by 12-O-Tetradecanoylphorbol-13-Acetate in an Ultra-Short-Term Skin Carcinogenesis Bioassay Using rasH2 Mice.  

UK PubMed Central (United Kingdom)

Assessment of the skin tumor-promoting potential of 12-O-tetradecanoylphorbol-13-acetate (TPA) after initiation with 7,12-dimethylbenz[a]anthracene (DMBA) was conducted using rasH2 transgenic (Tg) mice and their nontransgenic (non-Tg) littermates. Mice were treated with DMBA (50 ?g/100 ?L acetone) on clipped back skin at the commencement of the study, and 1 week thereafter, TPA was applied at 8 ?g/200 ?L or 4 ?g/200 ?L acetone, once or twice weekly, for 7 weeks. Skin nodules were observed in the rasH2 Tg mice from week 4, and the incidence reached 100% at weeks 5 and 6. The number of skin nodules (multiplicity) in the 8-?g twice-weekly, 8-?g once-weekly, 4-?g twice-weekly, and 4-?g once-weekly groups was 62.4, 46.2, 62.6, and 36.9, respectively. The non-Tg mice also developed skin nodules, but the sensitivity to induction in the rasH2 Tg mice was higher. No nodules were observed in the acetone groups, but single nodules were apparent in the no-treatment rasH2 Tg and non-Tg groups. In conclusion, skin promotion effects could be detected within only 8 weeks in the rasH2 mice, and the concentration of 4 ?g TPA once weekly was sufficient as a positive control. This short-term skin carcinogenesis bioassay using rasH2 mice could represent a useful tool for the assessment of drug and chemical safety with cutaneous treatment.

Kawabe M; Urano K; Suguro M; Numano T; Taguchi F; Tsutsumi H; Furukawa F

2013-09-01

320

Tumor Promotion by 12-O-Tetradecanoylphorbol-13-Acetate in an Ultra-Short-Term Skin Carcinogenesis Bioassay Using rasH2 Mice.  

Science.gov (United States)

Assessment of the skin tumor-promoting potential of 12-O-tetradecanoylphorbol-13-acetate (TPA) after initiation with 7,12-dimethylbenz[a]anthracene (DMBA) was conducted using rasH2 transgenic (Tg) mice and their nontransgenic (non-Tg) littermates. Mice were treated with DMBA (50 ?g/100 ?L acetone) on clipped back skin at the commencement of the study, and 1 week thereafter, TPA was applied at 8 ?g/200 ?L or 4 ?g/200 ?L acetone, once or twice weekly, for 7 weeks. Skin nodules were observed in the rasH2 Tg mice from week 4, and the incidence reached 100% at weeks 5 and 6. The number of skin nodules (multiplicity) in the 8-?g twice-weekly, 8-?g once-weekly, 4-?g twice-weekly, and 4-?g once-weekly groups was 62.4, 46.2, 62.6, and 36.9, respectively. The non-Tg mice also developed skin nodules, but the sensitivity to induction in the rasH2 Tg mice was higher. No nodules were observed in the acetone groups, but single nodules were apparent in the no-treatment rasH2 Tg and non-Tg groups. In conclusion, skin promotion effects could be detected within only 8 weeks in the rasH2 mice, and the concentration of 4 ?g TPA once weekly was sufficient as a positive control. This short-term skin carcinogenesis bioassay using rasH2 mice could represent a useful tool for the assessment of drug and chemical safety with cutaneous treatment. PMID:23610217

Kawabe, M; Urano, K; Suguro, M; Numano, T; Taguchi, F; Tsutsumi, H; Furukawa, F

2013-04-22

 
 
 
 
321

Higher rate of skin rash in a phase II trial with weekly nanoparticle albumin-bound paclitaxel and cisplatin combination in Chinese breast cancer patients.  

Science.gov (United States)

PURPOSE The aim of this phase II study is to explore the incidence of skin rash among advanced breast cancer(ABC) patients treated with weekly nab-paclitaxel and cisplatin combination. METHOD: S Nab-paclitaxel(125 mg/m2) was administered on days 1, 8, 15, followed by cisplatin(75 mg/m2) on day 1 every 28 day cycle until disease progression, intolerable toxicities or the maximum of 6 cycles. Patients who received a least one injection of the study drug were included in this analysis of the incidence of skin rash among Chinese patients. Toxicity was graded using the CTCAE4.0. Statistical analysis was carried out by using SPSS 16.0 (SPSS Inc, Chicago, IL). RESULTS: Seventy-three patients enrolled were qualified to be analyzed, and a total of 384 cycles were administered before the data first collected at Oct 1st, 2011. Rash was presented in 27 patients (37.0%). The most common sites involved were face (14/27), neck (14/27), limbs (18/27) and frictional parts of the trunk (10/27). Macular and papular rash with pruritus commonly occurred 2 (1-7) days after the first day of chemotherapy. Only one patient developed Grade 3 skin toxicity with generalized erythroderma and disfigurement of the face requiring dose reduction. The rash gradually regressed 2 (1-10) days after antihistamines using and pigmentation remained in 13/27 cases. The incidence rate of skin rash was significantly different between Chinese and western patients (Pnab-paclitaxel comparing to western patients. The albumin component of nab-paclitaxel might be the cause of the skin disorder. PMID:23659317

Tang, Li Chen; Wang, Bi Yun; Sun, Si; Zhang, Jian; Jia, Zhen; Lu, Yun Hua; Di, Gen Hong; Shao, Zhi Ming; Hu, Xi Chun

2013-05-01

322

Inhibitory effect of yogurt on aberrant crypt foci formation in the rat colon and colorectal tumorigenesis in RasH2 mice.  

Science.gov (United States)

The inhibitory effects of yogurt consisting of milk fermented by Lactobacillus delbrueckii subsp. bulgaricus strain 2038 and Streptococcus salivarius subsp. thermophilus strain 1131 on formation of colonic aberrant crypt foci (ACF) in rats and also on development of colorectal tumors in transgenic mice harboring human prototype c-Ha-ras genes (rasH2 mice) were examined. F344 rats and rasH2 mice were fed commercial diet containing freeze-dried yogurt or starter medium (non-fermented milk). Rats were inoculated orally with heterocyclic amine 2-amino-methyl-6-phenylimidazo[4,5-b]pyridine hydrochloride (PhIP) for two weeks. The rats were necropsied 14 days after the PhIP treatment, and ACF in the colon and rectum were counted. RasH2 mice were injected with 1,2-dimethylhydrazine dihydrochloride (DMH) for 20 weeks. Three weeks after the last injection of DMH, rasH2 mice were necropsied to determine the number and the size of colorectal tumors. Yogurt supplementation in diet significantly reduced the number of ACF and aberrant crypts (ACs) in rats fed control diet (P<0.01), but not in rats fed non-fermented milk diet. On the other hand, rasH2 mice receiving the yogurt-supplemented diet had significantly reduced numbers of tumors induced by DMH compared with those fed the non-fermented milk-supplemented diet (P<0.05). These results demonstrate that the yogurt used in this study appears to have tumor-suppressing properties, and rasH2 mice are a useful model for the evaluation of antitumor activities of foods. PMID:20660995

Narushima, Seiko; Sakata, Tadashi; Hioki, Kyoji; Itoh, Toshio; Nomura, Tatsuji; Itoh, Kikuji

2010-01-01

323

Inhibitory effect of yogurt on aberrant crypt foci formation in the rat colon and colorectal tumorigenesis in RasH2 mice.  

UK PubMed Central (United Kingdom)

The inhibitory effects of yogurt consisting of milk fermented by Lactobacillus delbrueckii subsp. bulgaricus strain 2038 and Streptococcus salivarius subsp. thermophilus strain 1131 on formation of colonic aberrant crypt foci (ACF) in rats and also on development of colorectal tumors in transgenic mice harboring human prototype c-Ha-ras genes (rasH2 mice) were examined. F344 rats and rasH2 mice were fed commercial diet containing freeze-dried yogurt or starter medium (non-fermented milk). Rats were inoculated orally with heterocyclic amine 2-amino-methyl-6-phenylimidazo[4,5-b]pyridine hydrochloride (PhIP) for two weeks. The rats were necropsied 14 days after the PhIP treatment, and ACF in the colon and rectum were counted. RasH2 mice were injected with 1,2-dimethylhydrazine dihydrochloride (DMH) for 20 weeks. Three weeks after the last injection of DMH, rasH2 mice were necropsied to determine the number and the size of colorectal tumors. Yogurt supplementation in diet significantly reduced the number of ACF and aberrant crypts (ACs) in rats fed control diet (P<0.01), but not in rats fed non-fermented milk diet. On the other hand, rasH2 mice receiving the yogurt-supplemented diet had significantly reduced numbers of tumors induced by DMH compared with those fed the non-fermented milk-supplemented diet (P<0.05). These results demonstrate that the yogurt used in this study appears to have tumor-suppressing properties, and rasH2 mice are a useful model for the evaluation of antitumor activities of foods.

Narushima S; Sakata T; Hioki K; Itoh T; Nomura T; Itoh K

2010-01-01

324

Cisticercose do quarto ventrículo simulando neoplasia da fossa posterior a cintilografia cerebral: relato de um caso/ Cysticercosis of the fourth ventricle simulating posterior fossa tumor on brain scan: a case report  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese É relatado o caso de uma criança de 12 anos de idade apresentando quadro de hipertensão endocraniana e síndrome cerebelar, cujos exames neurológico e neuroradiológicos foram sugestivos de neoplasia de fossa posterior. A cintilografia cerebral mostrou um quadro compatível com a existência de tumor da fossa posterior, da linha mediana, mais provavelmente meduloblastoma ou astrocitoma. Pela intervenção cirúrgica foi verificado tratar-se de cisticercose, sendo remo (more) vido um cisto do 4ºventrícuio. Os autores sugerem que em áreas geográficas com alta prevalência de neurocisticercose na população infantil a hipótese da forma pseudotumoral seja lembrada, quando da tentativa de caracterização do tipo de lesão da fossa posterior, detectada pela cintilografia cerebral. Abstract in english The case of a twelve year old child with intracerebral hypertension and cerebellar syndrome in whom the neuroradiological and neurological examinations were sugestive of posterior cranial fossa tumor is reported. The brain scan depicted the scintigraphic pattern of midline neoplasms, most likely medullo-blastoma or astrocytoma. At surgery a Cysticercus cellulosae was removed from the fourth the fourth ventricle. The authors suggest that in geographical areas with high pre (more) valence of neurocysticercosis in the infantile population the hypothesis of the pseudotumoral form of the disease be remembered when one attempts to characterize the type of neoplasms of the posterior fossa as detected by brain scan.

Morais-Rego, Sydney F. de; Latue, Nilton L.

1978-12-01

325

Management of hydrocephalus in pediatric patients with posterior fossa tumors: the role of endoscopic third ventriculostomy.  

UK PubMed Central (United Kingdom)

OBJECT: The authors undertook a study to evaluate the effectiveness of endoscopic third ventriculostomy in the management of hydrocephalus before and after surgical intervention for posterior fossa tumors in children. METHODS: Between October 1, 1993, and December 31, 1997, a total of 206 consecutive children with posterior fossa tumors underwent surgery at H?pital Necker-Enfants Malades in Paris. Excluded were 10 patients in whom shunts had been placed at the referring hospital. The medical records and neuroimaging studies of the remaining 196 patients were reviewed and categorized into three groups: Group A, 67 patients with hydrocephalus present on admission in whom endoscopic third ventriculostomy was performed prior to tumor removal; Group B, 82 patients with hydrocephalus who did not undergo preliminary third ventriculostomy but instead received conventional treatment; and Group C, 47 patients in whom no ventricular dilation was present on admission. There were no significant differences between patients in Group A or B with respect to the following variables: age at presentation, evidence of metastatic disease, extent of tumor resection, or follow-up duration. In patients in Group A, however, more severe hydrocephalus was demonstrated (p < 0.01): the patients in Group C were in this respect different from those in the other two groups. Ultimately, there were only four patients (6%) in Group A compared with 22 patients (26.8%) in Group B (p = 0.001) in whom progressive hydrocephalus required treatment following removal of the posterior fossa tumor. Sixteen patients (20%) in Group B underwent insertion of a ventriculoperitoneal shunt, which is similar to the incidence reported in the literature and significantly different from that demonstrated in Group A (p < 0.016). The other six patients (7.3%) were treated by endoscopic third ventriculostomy after tumor resection. In Group C, two patients (4.3%) with postoperative hydrocephalus underwent endoscopic third ventriculostomy. In three patients who required placement of CSF shunts several episodes of shunt malfunction occurred that were ultimately managed by endoscopic third ventriculostomy and definitive removal of the shunt. There were no deaths; however, there were four cases of transient morbidity associated with third ventriculostomy. CONCLUSIONS: Third ventriculostomy is feasible even in the presence of posterior fossa tumors (including brainstem tumors). When performed prior to posterior fossa surgery, it significantly reduces the incidence of postoperative hydrocephalus. The procedure provides a valid alternative to placement of a permanent shunt in cases in which hydrocephalus develops following posterior fossa surgery, and it may negate the need for the shunt in cases in which the shunt malfunctions. Furthermore, in patients in whom CSF has caused spread of the tumor at presentation, third ventriculostomy allows chemotherapy to be undertaken prior to tumor excision by controlling hydrocephalus. Although the authors acknowledge that the routine application of third ventriculostomy in selected patients results in a proportion of patients undergoing an "unnecessary" procedure, they believe that because patients' postoperative courses are less complicated and because the incidence of morbidity is low and the success rate is high in those patients with severe hydrocephalus that further investigation of this protocol is warranted.

Sainte-Rose C; Cinalli G; Roux FE; Maixner R; Chumas PD; Mansour M; Carpentier A; Bourgeois M; Zerah M; Pierre-Kahn A; Renier D

2001-11-01

326

Fronto-cerebellar fiber tractography in pediatric patients following posterior fossa tumor surgery.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Fronto-cerebellar association fibers (FCF) are involved in neurocognitive regulatory circuitry. This may also be relevant for cerebellar mutism syndrome (CMS) as a complication following posterior fossa tumor removal in children. In the present study, we investigated FCF by diffusion tensor imaging in affected children and controls. METHODS: Diffusion-weighted MR imaging at 3 T (GE) allowed tractography of FCF using a fiber tracking algorithm software (Brainlab 2.6) in 29 patients after posterior fossa tumor removal and in 10 healthy peers. Fiber tract volumes were assessed and fiber signals were evaluated in a semiquantitative manner along the anatomical course. RESULTS: Volumes of FCF revealed significant diminished values in pediatric patients with symptoms of CMS (19.3 ± 11.7 cm(3)) when compared with patients without symptoms of CMS (26.9 ± 11.9 cm(3)) and with healthy peers (36.5 ± 13.82 cm(3)). In medulloblastoma patients, the volume of FCF was also significantly reduced in patients with symptoms of CMS despite having the same antitumor therapy. In semiquantitative analysis of the fiber tract signals, differences were observed in the superior cerebellar peduncles and midline cerebellar structures in patients with symptoms of CMS. CONCLUSION: Using DTI, which allows the visualization of fronto-cerebellar fiber tracts, lower FCF tract volumes and diminished fiber signal intensities at the level of the superior cerebellar peduncles and in midline cerebellar structures were identified in patients with postoperative symptoms of CMS. Our study refers to the role of a neural circuitry between frontal lobes and the cerebellum being involved in neurocognitive impairment after posterior fossa tumor treatment in children.

Soelva V; Hernáiz Driever P; Abbushi A; Rueckriegel S; Bruhn H; Eisner W; Thomale UW

2013-04-01

327

Avian cerebellar floccular fossa size is not a proxy for flying ability in birds.  

UK PubMed Central (United Kingdom)

Extinct animal behavior has often been inferred from qualitative assessments of relative brain region size in fossil endocranial casts. For instance, flight capability in pterosaurs and early birds has been inferred from the relative size of the cerebellar flocculus, which in life protrudes from the lateral surface of the cerebellum. A primary role of the flocculus is to integrate sensory information about head rotation and translation to stabilize visual gaze via the vestibulo-occular reflex (VOR). Because gaze stabilization is a critical aspect of flight, some authors have suggested that the flocculus is enlarged in flying species. Whether this can be further extended to a floccular expansion in highly maneuverable flying species or floccular reduction in flightless species is unknown. Here, we used micro computed-tomography to reconstruct "virtual" endocranial casts of 60 extant bird species, to extract the same level of anatomical information offered by fossils. Volumes of the floccular fossa and entire brain cavity were measured and these values correlated with four indices of flying behavior. Although a weak positive relationship was found between floccular fossa size and brachial index, no significant relationship was found between floccular fossa size and any other flight mode classification. These findings could be the result of the bony endocranium inaccurately reflecting the size of the neural flocculus, but might also reflect the importance of the flocculus for all modes of locomotion in birds. We therefore conclude that the relative size of the flocculus of endocranial casts is an unreliable predictor of locomotor behavior in extinct birds, and probably also pterosaurs and non-avian dinosaurs.

Walsh SA; Iwaniuk AN; Knoll MA; Bourdon E; Barrett PM; Milner AC; Nudds RL; Abel RL; Sterpaio PD

2013-01-01

328

Preoperative irradiation of an extracerebral cavernous hemangioma in the middle fossa  

International Nuclear Information System (INIS)

This is a report of case with the extracerebral cavernous hemangioma in the middle fossa in which total removal was carried out after radiotherapy. Follow-up study with computed tomography during and after irradiation are presented. A 44-year-old house-wife complained of a decreased vision of the both eyes and paresis of the left upper and lower limbs. CT scan revealed a slightly high density area in the right middle cranial fossa which was markedly enhanced with contrast media. Right carotid angio-graphy demonstrated a large avascular mass in the right middle fossa and no feeding artery or draining vein was visualized except a faint irregular stain in the venous phase. An attempt to total removal of the tumor had failed to success because of extensive hemorrhage from the tumor. Histological examination revealed a cavernous hemangioma. Irradiation with a total dose of 5000 rads was delivered. After irradiation. CT scan revealed a marked decrease of size and EMI number of the tumor. At this stage, hypervascular mass lesion with feeding arteries was noted in conventional angiography. Tumor stain in prolonged injection angiography was also visualized. In the second operation, removal of the tumor was performed without any difficulty and hemorrhage was controlled easily by electrocoagulation. Histology revealed a marked narrowing of vessels with an increase in the connective tissues. In the central part of specimen, there noted findings of coagulation necrosis, intraluminal thrombus formations and so on, which were attributed to the influence of radiation. It is concluded that in case of a extracerebral cavernous hemangioma with massive hemorrhage, radiation of up to 3000 - 5000 rads was a method of choice. The treatment results in an increase of probability of total removal of the tumor. (author).

1981-01-01

329

Avian cerebellar floccular fossa size is not a proxy for flying ability in birds.  

Science.gov (United States)

Extinct animal behavior has often been inferred from qualitative assessments of relative brain region size in fossil endocranial casts. For instance, flight capability in pterosaurs and early birds has been inferred from the relative size of the cerebellar flocculus, which in life protrudes from the lateral surface of the cerebellum. A primary role of the flocculus is to integrate sensory information about head rotation and translation to stabilize visual gaze via the vestibulo-occular reflex (VOR). Because gaze stabilization is a critical aspect of flight, some authors have suggested that the flocculus is enlarged in flying species. Whether this can be further extended to a floccular expansion in highly maneuverable flying species or floccular reduction in flightless species is unknown. Here, we used micro computed-tomography to reconstruct "virtual" endocranial casts of 60 extant bird species, to extract the same level of anatomical information offered by fossils. Volumes of the floccular fossa and entire brain cavity were measured and these values correlated with four indices of flying behavior. Although a weak positive relationship was found between floccular fossa size and brachial index, no significant relationship was found between floccular fossa size and any other flight mode classification. These findings could be the result of the bony endocranium inaccurately reflecting the size of the neural flocculus, but might also reflect the importance of the flocculus for all modes of locomotion in birds. We therefore conclude that the relative size of the flocculus of endocranial casts is an unreliable predictor of locomotor behavior in extinct birds, and probably also pterosaurs and non-avian dinosaurs. PMID:23825638

Walsh, Stig A; Iwaniuk, Andrew N; Knoll, Monja A; Bourdon, Estelle; Barrett, Paul M; Milner, Angela C; Nudds, Robert L; Abel, Richard L; Sterpaio, Patricia Dello

2013-06-25

330

A 27-year-old man with diplopia, fatiguable ptosis and rash: a rare presentation of angiocentric T cell lymphoma with lymphomatoid vasculitis  

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A 27-year-old man presented with a 36-h history of ptosis and diplopia and a 10-day history of a lower limb rash. Skin biopsy revealed an aggressive angiocentric ??-T cell lymphoma. The patient's symptoms and signs disappeared within 1 week of commencement of chemotherapy and there are plans for all...

Lefter, Stela; Forde, Patrick; Nashat, Hebah; Moylan, Eugene; Yacoob, Yaseen

331

A case of intrauterine diagnosed posterior fossa dermoid presenting in childhood.  

UK PubMed Central (United Kingdom)

Intrauterine intracranial brain tumor is a rare entity. Traditionally, the outcome of this tumor had been dismal. In a large series of congenital brain tumor, the commonest have been teratoma followed by astrocytoma and craniopharyngioma. We report a case of intracranial dermoid in post-fossa diagnosed at 8 months of intrauterine life during routine prenatal ultrasonography. The child's clinical picture, the surgery performed and the final outcome have been discussed. As far as our knowledge goes, this is perhaps the first reported case of intrauterine-diagnosed intracranial dermoid.

Aggarwal A; Tewari MK; Radotra B; Gupta V

2013-07-01

332

Complications of posterior cranial fossa surgery--an institutional experience of 500 patients.  

UK PubMed Central (United Kingdom)

BACKGROUND: The complication of the posterior fossa surgery is seldom described in the literature. The purposes of this retrospective study are to draw attention to the potential complications associated with posterior fossa surgery and to critically review the predisposing factors that might influence the complication rate. METHODS: We undertook a 10-year (1992-2002) retrospective study of all posterior fossa surgery performed at LSUHSC. A total of 500 patients were obtained from the operation database, and they were categorized into 5 groups based on the surgical approaches: (1) cerebellopontine angle lesion, (2) microvascular decompression for facial pain and spasm, (3) cerebellar lesions, (4) Chiari I decompression, and (5) petroclival lesions. Data collected for analysis included patient demographics, pathological characteristics of the lesions, and the postoperative complications that occurred as unexpected and undesirable events that prolonged hospital stay and may require surgical/medical intervention. RESULTS: Of the 500 patients reviewed, 220 (44%) patients had tumor resections at the cerebellopontine angle; 110 (22%) patients had microvascular decompression for trigeminal neuralgia and hemifacial spasm; 86 (17.2%) patients had cerebellar lesions; 60 (12%) patients had Chiari I decompression; and 24 (4.8%) patients required transpetrosal approaches for petroclival lesions. The overall complication rate in our study was 31.8%, affecting 159 patients. Cerebrospinal fluid leaks were the most frequently encountered, presenting in 65 (13%) patients followed by meningitis in 46 (9.2%) patients, wound infection in 35 (7%) patients, and CN palsies in 24 (4.8%) patients. Other complications that were observed to develop almost exclusively in patients undergoing cerebellar parenchymal tumor resection included cerebellar edema in 25 (5%) patients, hydrocephalus in 23 (4.6%) patients, cerebellar hematoma in 15 (3%) patients, and cerebellar mutism in 6 (1.2%) patients. The overall mortality rate related to surgery was 2.6% occurring in 13 patients. CONCLUSION: Posterior fossa surgery involves greater morbidity and mortality and has a wider variety of complications than surgery in the supratentorial compartment. These complications may be avoided by careful perioperative planning, strict adherence to aseptic technique, meticulous microsurgical dissection, proper wound closure, and the judicious use of prophylactic agent. A thorough understanding of the patient's history, neurological findings, imaging studies, operative anatomy, as well as all potential adverse events associated with the procedure is also essential to minimize complications.

Dubey A; Sung WS; Shaya M; Patwardhan R; Willis B; Smith D; Nanda A

2009-10-01

333

Traumatic acute subdural haematomas of the posterior fossa: clinicoradiological analysis of 24 patients  

International Nuclear Information System (INIS)

[en] We report 24 patients with a traumatic acute subdural haematoma of the posterior fossa managed between 1997 and 1999 at 8 Italian neurosurgical centres. Each centre provided data about patients clinico-radiological findings, management, and outcomes, which were retrospectively reviewed. A poor result occurred in 14 patients (58.3 %). Ten patients (41.7 %) had favourable results. Patients were divided into two groups according to their admission Glasgow Coma Scale (GCS) scores. In Group 1 (12/24 cases; GCS score, 8), the outcome was favourable in 75 % of cases. In Group 2 (12/12 cases; GCS score,

2003-01-01

334

Invasive intracranial aspergillosis spread by the pterygopalatine fossa in an immunocompetent patient  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Aspergillosis of the central nervous system (CNS) is an uncommon infection, mainly found in immunocompromised patients but rarely seen among immunocompetent patients. Herein we describe a 57 year-old immunocompetent man who suffered intracranial aspergillosis spread by the pterygopalatine fossa (PPF) following a tooth extraction. Based on magnetic resonance imaging (MRI) characteristics, in this report we focus on the spreading routes of CNS aspergillosis via communicativ (more) e structures of the PPF, the relationship between clinical manifestations and the locations of the lesion, and propose a therapeutic strategy to improve the prognosis.

Xiao, Anqi; Jiang, Shu; Liu, Yi; Deng, Kaihong; You, Chao

2012-04-01

335

The prognostic analysis of whole nervous system and posterior fossa irradiation for patients with cerebellar medulloblastoma  

International Nuclear Information System (INIS)

Objective: To analyze the results of whole nervous system and posterior fossa irradiation for 29 post-oprative patients with cerebellar medulloblastoma. Methods: Long term follow-up is exerted for the pathology-confirmation cerebellar medulloblastoma patients between 1996 and 2005. The results is analyzed. Results: 3 year and 5 year survival rate is 66.2% and 62.1% repectively. Conclusions: The treatment results for the patients is satisfactory with little side-effect. The result of surgery and the dose for the spiral could be prognostic factors. (authors)

336

Magnetic resonance - optimal method of visualization of tumors in the posterior cranial fossa  

International Nuclear Information System (INIS)

Visualization by magnetic resonance is an auxiliary examination method which, of all imaging modalities, provides most information on infratentorial tumors. MR reveals reliably both the extraaxial and intraaxial localization of tumors. Its advantages include optional selection of sections, absence of artifacts from bone structures in the posterior cranial fossa, and absence of X rays. It also provides most information for substrate diagnosis. The advantages of computed tomography, on the other hand, include a low number of contraindications, accurate imaging of bone structures, and lower costs. (author).

1998-01-01

337

Congenital piriform fossa sinus tract presenting as an asymptomatic neck mass in an infant  

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A 5-month-old girl with an asymptomatic left-sided neck mass was demonstrated by ultrasound and upper gastrointestinal series (UGI), and confirmed at surgery, to have a congenital piriform fossa sinus tract (CPFST) that communicated with an intrathyroidal cyst. To demonstrate a case of CPFST presenting as an asymptomatic neck mass. Nearly all cases of CPFST present with infection or pain, making this case unique. Case report and review of the literature. CPFST with an associated cyst should be added to the differential diagnosis of asymptomatic cystic neck masses in infants, especially if the cyst is intrathyroidal by ultrasound. (orig.)

Bloom, David A. [Department of Pediatric Imaging, Children' s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Boulevard, Detroit, MI 48201 (United States); Adler, Brent H. [Department of Radiology, Children' s Radiological Institute, Columbus Children' s Hospital, Columbus, Ohio (United States); Forsythe, Robert C. [Department of Pediatrics, Columbus Children' s Hospital, Ohio State University Medical Center, Columbus, Ohio (United States); Mutabagani, Khaled; Teich, Steven [Department of Surgery, Columbus Children' s Hospital, Ohio State University Medical Center, Columbus, Ohio (United States)

2003-05-01

338

The reverse lateral arm flap, based on the interosseous recurrent artery, for cubital fossa burns.  

UK PubMed Central (United Kingdom)

The reverse lateral arm flap based on the interosseous recurrent artery was used successfully to reconstruct cubital fossa defects caused by high voltage electric burn in two cases. The flap is nourished by the septocutaneous perforators of the posterior radial collateral artery which anastomoses around the lateral epicondyle with the interosseous recurrent artery. The primary benefits of this flap are that it is an easy and rapid one-stage procedure, with no necessity of sacrificing a main artery or local muscle, and it requires no immobilisation of the involved joint.

Lai CS; Lin SD; Chou CK; Tsai CC

1994-07-01

339

The reverse lateral arm flap, based on the interosseous recurrent artery, for cubital fossa burns.  

Science.gov (United States)

The reverse lateral arm flap based on the interosseous recurrent artery was used successfully to reconstruct cubital fossa defects caused by high voltage electric burn in two cases. The flap is nourished by the septocutaneous perforators of the posterior radial collateral artery which anastomoses around the lateral epicondyle with the interosseous recurrent artery. The primary benefits of this flap are that it is an easy and rapid one-stage procedure, with no necessity of sacrificing a main artery or local muscle, and it requires no immobilisation of the involved joint. PMID:8087373

Lai, C S; Lin, S D; Chou, C K; Tsai, C C

1994-07-01

340

Incidental Finding of Anterior Cranial Fossa Meningioma on 18F-Fluoride PET/CT.  

UK PubMed Central (United Kingdom)

The association of breast carcinoma and meningioma has been described. We report a case of anterior cranial fossa meningioma in a woman with breast cancer detected by F-fluoride PET/CT. The whole-body F-fluoride PET images demonstrate an intense intracranial focal radiotracer accumulation in the skull base. Simultaneous CT showed a corresponding calcified space-occupying lesion consistent with meningioma. Follow-up CT image obtained 8 months later demonstrated the persistence and stable appearance of the lesion.

Zacchi SR; Duarte PS; Coura Filho GB; Sapienza MT; Buchpiguel CA

2013-11-01

 
 
 
 
341

Deep soft-tissue leiomyoma of the popliteal fossa in a 14-year-old girl.  

UK PubMed Central (United Kingdom)

This is the first case report of a deep soft-tissue leiomyoma with intraarticular localization within the knee joint. A 14-year-old girl presented with a painless mass in the dorsal aspect of her knee which she had noticed some 9 months earlier. While on plain radiographs no bony lesions were visible, magnetic resonance imaging (MRI) revealed an intraarticularly located tumor with well-defined margins. Intraoperatively, the tumor was found adjacent to the posterior cruciate ligament. The final diagnosis was established immunohistologically. Although this is a very rare tumor, it has to be considered in the differential diagnosis for soft-tissue swellings of the popliteal fossa.

Schmidt-Rohlfing B; Tietze L; Siebert CH; Staatz G

2001-11-01

342

Incidental Finding of Anterior Cranial Fossa Meningioma on 18F-Fluoride PET/CT.  

UK PubMed Central (United Kingdom)

The association of breast carcinoma and meningioma has been described. We report a case of anterior cranial fossa meningioma in a woman with breast cancer detected by F-fluoride PET/CT. The whole-body F-fluoride PET images demonstrate an intense intracranial focal radiotracer accumulation in the skull base. Simultaneous CT showed a corresponding calcified space-occupying lesion consistent with meningioma. Follow-up CT image obtained 8 months later demonstrated the persistence and stable appearance of the lesion.

Zacchi SR; Duarte PS; Coura Filho GB; Sapienza MT; Buchpiguel CA

2013-10-01

343

[Surgical details and complications from retransplantation into the iliac fossa for third and fourth kidney transplants].  

UK PubMed Central (United Kingdom)

OBJECTIVES: To analyze the surgical aspects and complications from retransplantation into the iliac fossa for third and fourth kidney transplants. METHODS: Retrospective study of the 34 third and 5 fourth transplants performed in our department. We analyze patient's characteristics, surgical aspects and complications, and graft outcomes. RESULTS: Mean patient age was 41.6 years. 67% of the first and second transplants had been lost to vascular problems (19%) or chronic rejection (48%). Average time from last transplant in the retransplanted iliac fossa was 9 years (3 days-17 years). There were not significant differences between the groups of first and second transplant and third and fourth in cold ischemia time, number of mismatches, and number of days on hemodialysis after transplantation; there were significant differences in receptor age, number of transfusions, maximum and current antibodies and donor age, all of which were higher in third and fourth transplants. The graft was basically implanted in the right iliac fossa (71%) through a lumbar-iliac iterative incision; vascular anastomosis were equally made to the common and external iliac vessels; ureteral reimplant was performed following an extravesical technique; simultaneous transplant nephrectomy of the previous graft was performed in 33% of the cases. 59% of the cases had immediate diuresis and 49% did not require dialysis within the first 7 postransplant days. Surgical complications were mainly vascular: 4 cases of hemorrhage, 3 venous thrombosis and 2 arterial thrombosis. There were also 4 cases of lymphocele, 1 perirenal hematoma, and 1 enterocutaneous fistula with an abscess of the surgical bed. There were no urologic complications in the series. Globally, there was 1 death (2.5%) secondary to hemorrhage and another 6 grafts (15%) were lost to complications, 5 vascular thrombosis and 1 after surgical bed abscess. 1, 3, 5, and ten-year actuarial graft survival were 65%, 52%, 40% and 28% respectively. CONCLUSIONS: Retransplantation into the iliac fossa for third and fourth transplants is associated with a small increase in the number of surgical complications, mainly vascular complications.

Gutiérrez Baños JL; Rodrigo Calabia E; Rebollo Rodrigo Mdel H; Portillo Martín JA; Correas Gómez MA; Roca Edreira A; del Valle Schaan JI; Ruiz Izquierdo F; Aguilera Tubet C; Arias Rodríguez M; Martín García B

2005-03-01

344

The Microscopic Surgical Treatment for Tumor of Posterior Cranial Fossa in Children  

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Full Text Available OBJECTIVE To analyze and discuss about the clinical characteristics, pathological types, surgical modalities and techniques, and postoperative complications in children with tumor of posterior cranial fossa .METHODS Retrospective study was conducted on 102 cases of pediatric tumor of posterior cranial fossa, admi? ed and treated in our hospital during the period of January 1996 to January 2007. All patients underwent microscopic surgical treatment. Fifty-eight were male and 44 cases were female. The age ranged from 9 months to 14 years old, with an average of 6.1 ± 0.5 of age. Cranial CT or MRI examination was conducted before and after the surgery on all patients.RESULTS The primary manifestations for this group of patients were increased intracranial pressure and/or ataxia. Postoperative pathological diagnoses showed: 46 cases of medulloblastoma, 43 cases of astrocytoma, 11 cases of ependymoma (including 1 case of degenerative ependymoma), 1 case of dermoid cyst, and 1 case of teratoma. In this group of the patients, radical surgery was used in 68 cases and subtotal surgical removal used in 31 cases, while surgical removal of large section was performed on 3 cases. There were no deaths from surgery reported. Ninety-one cases showed significant symptomatic improvement when compared with preoperative conditions, while 11 cases showed either no improvement or more severely affected afterward. For 6 cases, postoperative ventriculoperitoneal shunt was performed within 7 days to 2 months after the surgery. Sixty-three patients gained follow-up for 3 to 60 months in duration. Thirty-nine patients regained normal life and were able to learn well, while there were 7 patients who could not live normally on their own. During the follow-up period, there were 17 cases of recurrence and 7 cases of death. In 23 cases of medulloblastoma in children with age of 3 years old or above, 2 cases who underwent surgical removal of intracranial ependymoma received small dosage of postoperative X-ray radiotherapy on the the brain and spinal cord. Nine cases of medulloblastoma in children under age of 3 and 17 cases of astrocytoma diagnosed after the surgery received chemotherapy of Carmustine.CONCLUSION Medulloblastomas and astrocytomas were the most common types of pediatric tumor of posterior cranial fossa, right followed by ependymoma, and dermoid cysts and teratomas were rare. Early correct diagnosis, proper selection of appropriate surgical modality and the surgical margin, proper treatment of postoperative complications, and the selecting right radiotherapy or chemotherapy were the key factors in infl uencing the prognostic outcome of children with tumor of posterior cranial fossa.

Duo CHEN; Xiangtai WEI; Qiang YIN

2009-01-01

345

Incidental Finding of Anterior Cranial Fossa Meningioma on 18F-Fluoride PET/CT.  

Science.gov (United States)

The association of breast carcinoma and meningioma has been described. We report a case of anterior cranial fossa meningioma in a woman with breast cancer detected by F-fluoride PET/CT. The whole-body F-fluoride PET images demonstrate an intense intracranial focal radiotracer accumulation in the skull base. Simultaneous CT showed a corresponding calcified space-occupying lesion consistent with meningioma. Follow-up CT image obtained 8 months later demonstrated the persistence and stable appearance of the lesion. PMID:24096998

Zacchi, Samara Riguete; Duarte, Paulo Schiavon; Coura Filho, George Barberio; Sapienza, Marcelo Tatit; Buchpiguel, Carlos Alberto

2013-11-01

346

Rhinolith in the fossa of Rosenm?ller - a hidden stone  

Science.gov (United States)

This is a case report of an 80-year-old woman who presented to the ENT services with multiple non-specific upper aerodigestive tract symptoms. Despite extensive investigation and treatment, her symptoms remained unalleviated with significant impact on the psychological morbidity. During a routine flexible nasoendoscopy for worsening globus pharnygis, a mass was noted in the right Rosenmüller's fossa, where the Eustachian tube leaves the lateral wall of the nasopharynx. A CT scan showed this to be a 10 mm calcified entity within the right Eustachian tube. It was subsequently removed under local anaesthesia providing much relief to the patient. Histology showed this mass to be a rhinolith.

Shilston, J; Foo, S H; Oko, M

2011-01-01

347

Parasitic copepods in the nasal fossae of five fish species (Characiformes) from the upper Paraná river floodplain, Paraná, Brazil = Copépodes parasitos de fossas nasais de cinco espécies de peixes (Characiformes) da planície de inundação do alto rio Paraná, Paraná, Brasil  

Directory of Open Access Journals (Sweden)

Full Text Available The present work had the objective to study parasitic copepods in thenasal fossae of fish from the upper Paraná river floodplain. Fish were captured in different locations of the floodplain in March, June and September, 2004. A total of 73 specimens (Characiformes) were collected, belonging to 4 distinct families and 5 species: Acestrorhynchus lacustris (Acestrorhynchidae), Schizodon borellii (Anostomidae), Prochilodus lineatus (Prochilodontidae), Serrasalmus marginatus and Serrasalmus maculatus (Serrasalmidae). Among 73 fishes examined, 53 were parasitized by nasal fossae copepods, varying from 1 to 146 parasites per host. Parasites found belonged to 3 known species: Gamidactylus jaraquensis Thatcher & Boeger, 1984; Gamispatulus schizodontis Thatcher & Boeger, 1984; and Rhinergasilus piranhus Boeger & Thatcher, 1988. There were differences in parasite corporal measurements and in the quantity of parasites per host in relation to copepod parasites from the Amazon region. The present study constitutes one of the few studies of identification of copepod parasites in the nasal fossae of fish from the Southern region of Brazil.O presente trabalho teve como objetivo o estudo de copépodes parasitos de fossas nasais de peixes da planície de inundação do alto Rio Paraná. As coletas foram realizadas em diversos pontos da planície nos meses de março, junho e setembro de 2004. Foram coletados 73 exemplares de peixes da ordem Characiformes, de quatrofamílias distintas, pertencentes a cinco espécies: Acestrorhynchus lacustris, Prochilodus lineatus, Schizodon borellii, Serrasalmus maculatus e Serrasalmus marginatus. Dentre os 73 peixes examinados, 53 encontravam-se parasitados por copépodes de fossas nasais,variando de 1 a 146 parasitos por peixe. Os parasitos encontrados pertenciam a três espécies conhecidas: Gamidactylus jaraquensis Thatcher & Boeger, 1984; Gamispatulus schizodontis Thatcher & Boeger, 1984 e Rhinergasilus piranhus Boeger & Thatcher, 1988. Diferenças foram observadas nas medidas corporais dos parasitos e na quantidade de espécies de parasitos por espécie de peixe em relação aos copépodes encontrados em estudos anteriores na região amazônica. O presente estudo constitui um dos poucos trabalhos de identificação de copépodes parasitos de fossas nasais de peixes da região Sul do Brazil.

Ana Carolina Figueiredo Lacerda; Ricardo Massato Takemoto; Maria de los Angeles Perez Lizama; Gilberto Cezar Pavanelli

2007-01-01

348

[Rash and fever illness caused by herpes simplex virus type 1 needs to be distinguished from hand, foot and mouth disease].  

UK PubMed Central (United Kingdom)

An epidemic of rash and fever illnesses suspected of hand, foot and mouth disease (HFMD) occurred in Gansu Province of China in 2008, laboratory tests were performed in order to identify the pathogen that caused this epidemic. Eight clinical specimens collected from the 4 patients (each patient has throat swab and herpes fluid specimens) with rash and febrile illness, were inoculated onto RD and HEp-2 cells for virus isolation, and the viral nucleic acid was then extracted with the positive virus isolates, the dual-channel real-time reverse transcript-polymerase chain reaction (RT-PCR) was performed to detect the nucleic acid of human enterovirus (HEV) in the viral isolates at the same time. For the viral isolates with the negative results of HEV, a sequence independent single primer amplification technique (SISPA) was used for "unknown pathogen" identification. Totally, 6 viral isolates were identified as herpes simplex virus type 1 (HSV-1). Comprehensive analyses results of the clinical manifestations of the patients, epidemiological findings and laboratory test indicated that this epidemic of rash and febrile illness was caused by HSV-1. The differences among the gG region of 6 HSV-1 isolates at nucleotide level and amino acid level were all small, and the identities were up to 98. 8% and 97.9%, respectively, showing that this outbreak was caused by only one viral transmission chain of HSV-1. HSV-1 and other viruses that cause rash and febrile illnesses need differential diagnosis with HFMD. The etiology of rash and febrile illness is sometimes difficult to distinguish from the clinical symptoms and epidemiological data, the laboratory diagnosis is therefore critical.

Zhu SL; Liu JF; Sun Q; Li J; Li XL; Zhang Y; Chen Y; Wen XY; Yan DM; Huang GH; Zhang BM; Zhang B; An HQ; Li H; Xu WB

2013-06-01

349

Recurrent inverted papilloma with intracranial and temporal fossa involvement: A case report and review of the literature  

International Nuclear Information System (INIS)

Inverted papilloma (I.P.) is a rare naso-sinusal benign tumour, with epithelium surface inversion to inside the stroma. Extension to intracranial temporal fossa and middle ear has been reported in few cases in the literature. This involvement may be derived from either direct extension from sino-nasal cavity via the Eustachian tube or primary middle ear involvement secondary to meta-plastic changes of the middle ear mucosa. Here, we report a case of inverted papilloma in a male patient, with multiple recurrences, middle ear and intracranial involvement into the temporal fossa with posterior development of malignancy. This patient had received multiple surgeries and radiotherapy but despite of that, his disease recurred several times. As a conclusion, inverted papilloma is a benign tumour with an aggressive course, tendency to recurrence and progression to malignancy. Intracranial and temporal fossa involvements are rare and the treatment depends of the symptoms and the severity of the disease. (authors)

2010-01-01

350

Persistent hydrocephalus after early surgical management of posterior fossa tumors in children: is routine preoperative endoscopic third ventriculostomy justified?  

UK PubMed Central (United Kingdom)

OBJECT: The authors evaluate the incidence of persistent hydrocephalus after early surgical management of pediatric posterior fossa tumors and the indicators for routine preoperative endoscopic third ventriculostomy (ETV). METHODS: Between 1989 and 2004, 160 children with a posterior fossa tumor were treated at Erasme Hospital in Brussels, Belgium. Hydrocephalus was present at admission in 114 of the patients. Thirty-one patients had severe hydrocephalus (Evans index [EI] > 0.4). Twenty-four of these and the 83 patients with mild hydrocephalus (EI between 0.3 and 0.4) were treated with early posterior fossa surgery (Group 1; 107 patients). In this group, 93 patients underwent a total or subtotal tumor resection associated with external ventricular drainage (Group 1A), and 14 underwent a stereotactic biopsy associated with an ETV (Group 1B). The 53 remaining patients underwent elective posterior fossa surgery (Group 2). Early tumor resection (Group 1A) resolved hydrocephalus in 85 (91%) of 93 patients, whereas an ETV resolved intracranial hypertension in 11 patients (Group 1B). In Group 1, persistent hydrocephalus affected 11 (10%) of 107 patients, seven of whom had symptoms and were treated (three with shunts and four with ETVs). Persistent hydrocephalus was more frequent in children with severe preoperative hydrocephalus (p = 0.002) and with medulloblastomas (p = 0.0154). A total of 22 technically successful ETV procedures were performed. The ETV success rate for controlling hydrocephalus was 81% (18 of 22) and the rate of severe complications was 9% (two of 22). CONCLUSIONS: An ETV is an efficient procedure for controlling hydrocephalus associated with posterior fossa tumor. The authors confirm that a routine postoperative ETV is indicated for treating persistent hydrocephalus. For preventing it, however, they recommend early posterior fossa surgery whenever possible. The low rate of persistent hydrocephalus does not justify adopting routine preoperative ETVs.

Morelli D; Pirotte B; Lubansu A; Detemmerman D; Aeby A; Fricx C; Berré J; David P; Brotchi J

2005-09-01

351

Late effects of treatment on the intelligence of children with posterior fossa tumors  

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This retrospective pilot study was undertaken to evaluate the late effects of treatment on intelligence in a population of children with posterior fossa tumors. Ten children with posterior fossa tumors treated with radiation and chemotherapy received intellectual evaluations at least one year following diagnosis. Six children had medulloblastomas, one child had a fourth ventricular ependymoma, two children had brainstem gliomas, and one child had a recurrent cerebellar astrocytoma. Children with supratentorial tumors were specifically excluded from the study in order to eliminate the possible influence of the tumor on intellectual functioning. Four children had had intelligence testing in school prior to treatment of their tumor. In each case results following treatment revealed a deterioration of full scale IQ of at least 25 points. Six children did not have prior testing; of these, two had IQ's less than 20. Overall, 50% of the patients had IQ's of less than 80 and 20% had IQ's of greater than 100. Furthermore, four children with normal intelligence (IQ greater than 80) have learning problems requiring special classes. Thus, of the ten children evaluated, all have either dementia, learning disabilities, or evidence of intellectual retardation. This study suggests that aggressive treatment of children with brain tumors may improve survivals but may be associated with significant long-term disabilities

1983-01-15

352

[Congenital arachnoid cysts of the posterior fossa midline. On their anatomoradiological variability (author's transl)  

UK PubMed Central (United Kingdom)

An anatomical and radiological study of seven cases with arachnoid cyst of the midline of the posterior fossa in which there was either necropsic or surgical anatomical diagnosis is reported. A great variation was observed regarding their location, size and extension, which covers all the zone existing between the foramen of Magendie and the quadrigeminal lamina, presenting two cases which rose to the medial fossa, one of them entering in a left lateral ventricle and implanting itself in its' walls. Associated to arachnoid cysts other malformations have been found, such as type I Chiari, partial agenesis of the vermis, cerebellar dismorphies and stenosis of the aqueduct. Neuroradiological examination is fundamental for diagnosis, existing important alterations both in plain skull X-Rays and pneumoencephalography, ventriculography and vertebral and carotid angiographies. There are no strict neuroradiological patterns in the study with air nor in arterial and or venous times of angiography which define assuredly, presence, of the arachnoid cyst, since each case shows different findings. However, the conjugated analysis of all explorations must give correct diagnosis in almost the totality of cases.

Pascual-Castroviejo I; Santolaya JM; López Martín V; Rodríguez Costa T

1977-06-01

353

Late effects of treatment on the intelligence of children with posterior fossa tumors  

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This retrospective pilot study was undertaken to evaluate the late effects of treatment on intelligence in a population of children with posterior fossa tumors. Ten children with posterior fossa tumors treated with radiation and chemotherapy received intellectual evaluations at least one year following diagnosis. Six children had medulloblastomas, one child had a fourth ventricular ependymoma, two children had brainstem gliomas, and one child had a recurrent cerebellar astrocytoma. Children with supratentorial tumors were specifically excluded from the study in order to eliminate the possible influence of the tumor on intellectual functioning. Four children had had intelligence testing in school prior to treatment of their tumor. In each case results following treatment revealed a deterioration of full scale IQ of at least 25 points. Six children did not have prior testing; of these, two had IQ's less than 20. Overall, 50% of the patients had IQ's of less than 80 and 20% had IQ's of greater than 100. Furthermore, four children with normal intelligence (IQ greater than 80) have learning problems requiring special classes. Thus, of the ten children evaluated, all have either dementia, learning disabilities, or evidence of intellectual retardation. This study suggests that aggressive treatment of children with brain tumors may improve survivals but may be associated with significant long-term disabilities.

Duffner, P.K.; Cohen, M.E.; Thomas, P.

1983-01-15

354

Posterior reversible encephalopathy syndrome during posterior fossa tumor resection in a child.  

UK PubMed Central (United Kingdom)

Posterior reversible encephalopathy syndrome (PRES) has been described in the setting of malignant hypertension, renal disease, eclampsia, and immunosuppression. In addition, a single case of intraoperative (posterior fossa craniotomy) PRES has been reported; however, this case occurred in an adult. The authors present a clinically and radiographically documented case of intraoperative PRES complicating the resection of a posterior fossa tumor in a 6-year-old child. During tumor resection, untoward force was used to circumferentially dissect the tumor, and excessive manipulation of the brainstem led to severe hypertension for a 10-minute period. An immediate postoperative MR image was obtained to rule out residual tumor, but instead the image showed findings consistent with PRES. Moreover, the patient's postoperative clinical findings were consistent with PRES. Aggressive postoperative management of blood pressure and the institution of anticonvulsant therapy were undertaken. The patient made a good recovery; however, he required a temporary tracheostomy and tube feedings for prolonged lower cranial nerve dysfunction. Posterior reversible encephalopathy syndrome can occur as a result of severe hypertension during surgery, even among young children. With prompt treatment, the patient in the featured case experienced significant clinical and radiographic recovery.

Patel AJ; Fox BD; Fulkerson DH; Yallampalli S; Illner A; Whitehead WE; Curry DJ; Luerssen TG; Jea A

2010-10-01

355

Eurythmy therapy in the aftercare of pediatric posterior fossa tumour survivors--a pilot study.  

UK PubMed Central (United Kingdom)

BACKGROUND: Pediatric posterior fossa brain tumour survivors are burdened with extensive neurologic, emotional, behavioral and mental impairments. Even long-term common remediation therapies such as conventional physical therapy and occupational therapy do not warrant full recovery. Innovative complementary therapy strategies offer a new option that needs evaluation. EYT is a movement therapy that belongs to the field of mind-body therapies (MBTs). This holistic approach aims to promote self-regulation and self-healing powers e.g. in cancer patients. This pilot study is a first attempt to assess the feasibility, treatment adherence and impact of eurythmy therapy (EYT) in pediatric neurooncology. METHODS: Seven posterior fossa tumour survivors who each participated in 25 EYT interventions over 6 months were followed for an additional 6 months. The outcome parameters cognitive functioning, neuromotor functioning and visuomotor integration were assessed at baseline as well as six and 12 months afterwards. RESULTS: We found good adherence and improvements in cognitive and neuromotor functioning in all children and better visuomotor integration in 5/7 children after 6 months. After 12 months, neuromotor functioning and visuomotor integration diminished again to some extent. CONCLUSION: EYT in pediatric cerebellar tumour survivors is feasible and patients may profit from this new approach.

Kanitz JL; Pretzer K; Calaminus G; Wiener A; Längler A; Henze G; Driever PH; Seifert G

2013-04-01

356

Fractura de cavidad glenoidea: reporte de un caso/ Glenoid fossa fracture: case report  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Las fracturas del componente craneofacial aumentan su frecuencia y severidad día con día en las salas de urgencias. Las disrupciones de la mandíbula pueden clasificarse de acuerdo a su localización anatómica, siendo más frecuentes las del ángulo (36.3%) y el cuerpo (21.2%) y poco comunes las de apófisis coronoides (0.25%).¹ Las fracturas de coronoides, condilares y de arco cigomático, pueden enmascarar un fractura de cavidad glenoidea, ya que clínicamente exist (more) e restricción de la motricidad mandibular. Presentamos el caso de un paciente de 38 años, con fracturas de complejo cigomaticomaxilar, apófisis coronoides y cavidad glenoidea derecho. Abstract in english Emergency rooms have seen a gradual increase of patients afflicted by craniofacial fractures. Mandible fractures can be classified according to their anatomical location. The most frequent fractures are angle fractures (36.3%) and body of the mandible fractures (21.2%). Coronoid process fractures are uncommon (0.25%)¹ Zygomatic arch, condylar or coronoid process fractures can mask a fracture of the glenoid fossa, since, clinically, there is restriction of mandibular move (more) ments. The case here presented is that of a 38 year patient afflicted with fractures of the maxillary-zygomatic complex, coronoid process as well as right glenoid fossa.

Rodríguez Piña, Carlos Alain; Miranda Villasana, José Ernesto

2013-09-01

357

Microvascular decompression for glossopharyngeal neuralgia through the transcondylar fossa (supracondylar transjugular tubercle) approach.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Our surgical results were reviewed to clarify the cause of glossopharyngeal neuralgia (GPN) and the effects of the microvascular decompression (MVD) procedure. METHODS: Fourteen cases of idiopathic GPN were operated on through the transcondylar fossa (supracondylar transjugular tubercle) approach. Their clinical data and operative records were retrospectively reviewed. RESULTS: In every case, vascular compression on the glossopharyngeal nerve was found and MVD was performed without any major complications. In 13 of the 14 cases the neuralgia completely disappeared postoperatively. Recurrence of pain was found in 1 case. Offending vessels were the posterior inferior cerebellar artery (PICA) in 10 cases, the anterior inferior cerebellar artery (AICA) in 2 cases, and both arteries in 2 cases. In 10 of the 14 cases, the high-origin PICA formed an upward loop between the glossopharyngeal and vagus nerves, compressing the glossopharyngeal nerve upward. In those cases, the PICA was transposed and fixed to the dura mater by the stitched sling retraction technique, and MVD was very effective. CONCLUSION: The offending artery was the PICA in most cases. MVD is expected to be very effective, especially when the radiological images show the following 3 findings: 1) high-origin PICA, 2) the PICA making an upward loop, and 3) the PICA coursing the supraolivary fossette. The transcondylar fossa approach is suitable for transposing the PICA by the stitched sling retraction technique, and provides sufficient surgical results.

Kawashima M; Matsushima T; Inoue T; Mineta T; Masuoka J; Hirakawa N

2010-06-01

358

MR cisternography in the posterior fossa: the evaluation of trigeminal neurovascular compression.  

UK PubMed Central (United Kingdom)

AIM: To evaluate the utility of 3D-magnetic resonance cisternography(MRC) of posterior cranial fossa in visualizing trigeminal neurovascular compression in patients with trigeminal neuralgia. MATERIAL AND METHODS: 146 consecutive patients in the period from June 2010 to July 2011 in our institute diagnosed with trigeminal neuralgia underwent MRC on the posterior cranial fossa. MR devices used for MRC included two sets of 3.0 tesla and one set of 1.5 tesla. The hydrography sequences for MRC included 3D-SPACE and 3D-DRIVE. RESULTS: In total, 75 patients (51.4%) were found with trigeminal neurovascular compression on MRC. Among them, 25 patients underwent microvascular decompression. Intraoperatively, 20 patients (80%) had related arteries consistent with imaging manifestations on MRC. Nevertheless, the arterial compression combined with petrosal vein could not be identified on MRC in 3 of the 20 patients. In the inconsistent 5 cases, the involved vessels were confirmed as superior petrosal veins during the surgery. CONCLUSION: 3D-MRC has prominent clinical value in determining the trigeminal neurovascular compression and identifying the related vessels. However, MRC does have certain limitations on identifying petrosal vein compression.

Anqi X; Ding L; Jiahe X; Zhenlin L; Chunchao X; Chao Y

2013-01-01

359

Posterior interhemispheric retrocallosal approach to pineal region and posterior fossa lesions in a pediatric population.  

UK PubMed Central (United Kingdom)

OBJECT: The purpose of this study was to evaluate the posterior interhemispheric retrocallosal approach (PIRA) for its safety and efficacy in the resection of pineal region and posterior fossa lesions in children. METHODS: Twenty-nine PIRAs were performed in 26 children between March 1997 and March 2009, and these cases were retrospectively reviewed. There were 15 girls and 11 boys in the series. The median age at the time of surgery was 7 years (range 7 months-17 years). Twenty-seven cases were treated for tumor, 1 for loculated hydrocephalus, and 1 for an aneurysm. RESULTS: Of the 27 cases treated for tumor, there were 20 (74%) gross-total resections, 5 (19%) subtotal resections, and 2 (7%) biopsies. One bridging vein was sacrificed in 6 cases and 2 bridging veins were divided in 1 case, whereas in 3 cases there was sacrifice of a single deep cerebral vein. No patient developed radiographic evidence of venous infarction. Approach-related complications were low, and included 2 cases of transient homonymous hemianopia. There were no surgery-related deaths. CONCLUSIONS: This approach allows for ample access to pineal region and posterior fossa lesions, with low postoperative morbidity.

Davidson L; Krieger MD; McComb JG

2011-05-01

360

Estudo da anatomia endoscópica da fossa lacrimal guiado por transiluminacão Transillumination-guided study of the endoscopic anatomy of the lacrimal fossa  

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Full Text Available A dacriocistorrinostomia é o tratamento de escolha para a obstrução do aparelho lacrimal. No final do século passado, o desenvolvimento da instrumentação endoscópica em cirurgia nasossinusal tornou viável sua realização por via endonasal. Entretanto, variações anatômicas tornam difícil a reprodutibilidade de uma técnica de abordagem endonasal. OBJETIVO: Estudar a anatomia endoscópica da fossa lacrimal através da transiluminação do canalículo comum. FORMA DE ESTUDO: Experimental. MATERIAL E MÉTODO: Foram dissecadas 40 vias lacrimais de 20 cadáveres humanos, constando três etapas: 1 - identificação e dilatação do canalículo lacrimal. 2 - introdução do feixe de fibra óptica; 3 - dissecção endoscópica do saco lacrimal, descrevendo sua posição. RESULTADOS: A posição mais frequente do saco lacrimal foi entre a borda livre do corneto médio e sua inserção e imediatamente abaixo desta. A linha maxilar foi visualizada em 95% dos casos. A septoplastia foi necessária em 12,5%, uncifectomia em 35% e turbinectomia média em 7,5%. CONCLUSÃO: embora o saco lacrimal tenha mostrado uma localização mais frequente, sua posição variou consideravelmente. A transiluminação do canalículo comum mostrou-se útil, resolvendo o problema da variabilidade anatômica.Dacryocystorhinostomy is the treatment of choice for the obstruction of the lachrymal apparatus. At the end of last century, the development of the endoscopic instruments for nasosinusal surgery has made it possible to do it through the endoscopic pathway. Nonetheless, anatomical variations make it difficult to have reproducibility endonasaly. AIM: study the endoscopic anatomy of the lachrymal fossa through transillumination of the common canaliculus. STUDY DESIGN: experimental. MATERIALS AND METHODS: we dissected 40 lachrymal pathways from 20 human cadavers, in three stages: 1. identification and dilation of the lachrymal canaliculus. 2 - Optic fiber beam introduction; 3 - endoscopic dissection of the lachrymal sac, describing its position. RESULTS: the most frequent position of the lachrymal sac was between the free border of the middle turbinate and its insertion immediately underneath it. The maxillary line was seen in 95% of the cases. Septoplasty was needed in 12.5%, unicifectomy in 35% and middle turbinectomy in 7.5%. CONCLUSION: Although the lachrymal sac has a more frequent location, its position varied considerably. The transillumination of the common canaliculus proved useful, solving the problem of the anatomical variability.

Luiz Artur Costa Ricardo; Marcio Nakanishi; Antonio Sérgio Fava

2010-01-01

 
 
 
 
361

Estudo da anatomia endoscópica da fossa lacrimal guiado por transiluminacão/ Transillumination-guided study of the endoscopic anatomy of the lacrimal fossa  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A dacriocistorrinostomia é o tratamento de escolha para a obstrução do aparelho lacrimal. No final do século passado, o desenvolvimento da instrumentação endoscópica em cirurgia nasossinusal tornou viável sua realização por via endonasal. Entretanto, variações anatômicas tornam difícil a reprodutibilidade de uma técnica de abordagem endonasal. OBJETIVO: Estudar a anatomia endoscópica da fossa lacrimal através da transiluminação do canalículo comum. FOR (more) MA DE ESTUDO: Experimental. MATERIAL E MÉTODO: Foram dissecadas 40 vias lacrimais de 20 cadáveres humanos, constando três etapas: 1 - identificação e dilatação do canalículo lacrimal. 2 - introdução do feixe de fibra óptica; 3 - dissecção endoscópica do saco lacrimal, descrevendo sua posição. RESULTADOS: A posição mais frequente do saco lacrimal foi entre a borda livre do corneto médio e sua inserção e imediatamente abaixo desta. A linha maxilar foi visualizada em 95% dos casos. A septoplastia foi necessária em 12,5%, uncifectomia em 35% e turbinectomia média em 7,5%. CONCLUSÃO: embora o saco lacrimal tenha mostrado uma localização mais frequente, sua posição variou consideravelmente. A transiluminação do canalículo comum mostrou-se útil, resolvendo o problema da variabilidade anatômica. Abstract in english Dacryocystorhinostomy is the treatment of choice for the obstruction of the lachrymal apparatus. At the end of last century, the development of the endoscopic instruments for nasosinusal surgery has made it possible to do it through the endoscopic pathway. Nonetheless, anatomical variations make it difficult to have reproducibility endonasaly. AIM: study the endoscopic anatomy of the lachrymal fossa through transillumination of the common canaliculus. STUDY DESIGN: experi (more) mental. MATERIALS AND METHODS: we dissected 40 lachrymal pathways from 20 human cadavers, in three stages: 1. identification and dilation of the lachrymal canaliculus. 2 - Optic fiber beam introduction; 3 - endoscopic dissection of the lachrymal sac, describing its position. RESULTS: the most frequent position of the lachrymal sac was between the free border of the middle turbinate and its insertion immediately underneath it. The maxillary line was seen in 95% of the cases. Septoplasty was needed in 12.5%, unicifectomy in 35% and middle turbinectomy in 7.5%. CONCLUSION: Although the lachrymal sac has a more frequent location, its position varied considerably. The transillumination of the common canaliculus proved useful, solving the problem of the anatomical variability.

Ricardo, Luiz Artur Costa; Nakanishi, Marcio; Fava, Antonio Sérgio

2010-02-01

362

Titanium Mesh Reconstruction to Maintain Scalp Contour after Temporalis Musculofascial Flap Reconstruction of the Floor of the Middle Cranial Fossa: A Technical Note and Report of Two Cases  

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Objective: Temporalis musculofascial rotational flaps can provide excellent tissue for reconstruction of defects in the floor of the middle cranial fossa. This technique can, however, result in cosmetic deformity of the temporal fossa with an asymmetric contour of the head. We report a technique tha...

Lipira, Angelo; Limbrick, David; Haughey, Bruce; Custer, Phillip; Chicoine, Michael R.

363

Risk factors for sorafenib-induced high-grade skin rash in Japanese patients with advanced renal cell carcinoma.  

UK PubMed Central (United Kingdom)

The aim of this study was to evaluate the clinical factors, drug-related genetic polymorphisms, and human leukocyte antigen (HLA) types to determine the association with sorafenib-induced high-grade skin rash (HGSR) in Japanese patients with advanced renal cell carcinoma (RCC). A total of 55 patients with advanced RCC treated with sorafenib were analyzed retrospectively. Of these, 33 patients were subjected to HLA typing and polymorphism analyses of CYP3A5, ABCB1, ABCC2, and UGT1A1, which are involved in the metabolism and membrane transport of sorafenib. Grade 3 or higher SR developed in 12 (22%), and a higher incidence was observed in female patients than in male patients (40 vs. 15%, P=0.046). The initial dose, initial dose per body weight, and initial dose per body surface area in patients with HGSR were significantly higher than those in patients without HGSR. Patients with the ABCC2 -24CC genotype were at a significantly higher risk of SR than those with the CT genotype (35 vs. 0%, P=0.032). HLA-A*24 was significantly associated with the occurrence of HGSR (P=0.049). Our finding suggested that women, higher initial dose per body weight or body surface area, the ABCC2 -24CC genotype, and HLA-A*24 are associated with the risk of sorafenib-induced HGSR in Japanese RCC patients.

Tsuchiya N; Narita S; Inoue T; Hasunuma N; Numakura K; Horikawa Y; Satoh S; Notoya T; Fujishima N; Hatakeyama S; Ohyama C; Habuchi T

2013-03-01

364

Anatomical aspects of posterior fossa affecting lateral suboccipital approach. Evaluation by bone-window CT  

International Nuclear Information System (INIS)

[en] The high-resolution 1.5 mm-slice bone-window CT images of the posterior fossa in 40 patients with the cerebello-pontine angle tumor were reviewed regarding three anatomical aspects: the internal occipital crest (IOC), the posterior surface of the petrous bone, and the 'petrous angle'. The IOC was sometimes prominent and protruded profoundly into the posterior fossa. The height of IOC from the inner table of the occipital bone was 9.6±3.3 mm. The posterior surface of the petrous bone was convex to the posterior fossa in the most cases; the zenith of the prominence was the porus acusticus. The convexity of the posterior surface in the CT image was objectively evaluated by the 'porus angle' made by two lines of A and B; the line A was the posterior half of the posterior surface of the petrous bone, and the line B was the anterior half of it. The 'porus angle' in 40 cases was 28±14deg in the left side, and 28±12deg in the right side. The 'petrous angle', made by the cranial sagittal line and (the posterior half of ) the posterior surface of the petrous bone, was 61.8±5.8deg and 62.7±7.0deg, respectively. In the patient with a prominent IOC, the lateral suboccipital approach (LSA) with a unilateral suboccipital craniotomy may induce the compression of the cerebellar hemisphere by the brain retractor and the prominent IOC, and develop cerebellar contusion. Such a postoperative cerebellar complication can be avoided by a large suboccipital craniotomy with the resection of the prominent IOC extending contralaterally. The severe convexity of the posterior surface of the petrous bone, i.e. the large 'porus angle', makes it difficult to get the view of the petroclival region in the LSA. The larger is the 'petrous angle', the less cerebellar compression is necessary for the approach to the cerebello-pontine angle by the LSA; the large 'petrous angle' is advantageous to the approach. (H.O.)

1996-01-01

365

Facial Nerve Schwannoma Involving Middle Cranial Fossa: When the Unilateral Sensorineural Hearing Loss Guide to the Correct Diagnosis  

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The Facial Nerve Schwannoma is a rare tumor and it seldom involved the middle cranial fossa. Facial nerve schwannoma has various manifestations, including facial palsy but unfortunately facial nerve is very resistant to compression and often facial nerve paralysis or a facial weakness are not presen...

De Stefano, Alessandro; Dispenza, Francesco; Kulamarva, Gautham

366

Contribution of sup(99m)Tc pertechnetate brain scintigraphy in the diagnosis of tumours of posterior fossa  

International Nuclear Information System (INIS)

The present work concerns 38 posterior cranial fossa tumour cases subjected to sup(99m)Tc pertechnetate brain scintigraphy between May 1974 and June 1976. 33 of these patients have undergone an anatomical check while for the remaining 5, the existence of a posterior fossa tumour is established from the conjunction of clinical signs and other paraclinical examinations. The procedure was the same for all these 38 patients: after a 300 ?C/kg injection of tracer, an immediate angioscintigraphic period, an early set of pictures (half an hour after the tracer injection) then delayed set (4 to 5 hours later) taken from 4 angles: front, back and two profiles. The examination was performed with an OHIO NUCLEAR SIEMENS gamma camera and sometimes a conventional scanner as well (the latter giving no better a diagnosis than the former). In 75% of the cases a hyperfixation of the injected tracer was observed and its site located quite accurately in the posterior fossa tumour. The etiology of the lesion could be diagnosed in 'most probable' or 'least probable' terms. Examination of work by other authors, who obtained similar results, leads to the conclusion that this method is very helpful in the diagnosis of posterior fossa tumours when used as a means of early detection, before the undertaking of more complex neuroradiological explorations

1976-01-01

367

Deliberate soft tissue injection of petrol.  

Science.gov (United States)

We present a case report of self-inflicted injection of petrol into the antecubital fossa and buttocks. The presentation and subsequent management of these difficult and rare injuries is discussed. PMID:21220220

Wiper, Jonathan D; Grant, Ian; Kay, Simon P

2011-01-09

368

Regional variations of cutaneous propionibacteria.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Propionibacterium acnes, P. avidum, and P. granulosum were quantitatively measured in 50 young adults. The scalp, forehead, external auditory canal, alae nasi, anterior nares, groin, rectum, and antecubital and popliteal fossa were sampled. These represent various cutaneous microenvironments, differ...

McGinley, K J; Webster, G F; Leyden, J J

369

Niacin improved rigidity and bradykinesia in a Parkinson's disease patient but also caused unacceptable nightmares and skin rash--a case report.  

UK PubMed Central (United Kingdom)

A patient with Parkinson's disease taking levodopa/carbidopa, selegiline, buproprion, aspirin and niacin had decreased rigidity and bradykinesia when his niacin dose was steadily escalated for treatment of high triglycerides, but ultimately the patient could not tolerate niacin because of severe nightmares and skin rash. If further research can reproduce this patient's initial beneficial experience while avoiding the adverse effects, niacin could be a useful adjunctive agent for Parkinson's disease, either population-wide or in a pharmacogenomically defined set of responders.

Alisky JM

2005-10-01

370

Patterns of failure following treatment for medulloblastoma: is it necessary to treat the entire posterior fossa?  

International Nuclear Information System (INIS)

Purpose: Craniospinal radiation (CSRT) followed by a boost to the entire posterior fossa (PF) is standard post-operative therapy for patients with medulloblastoma. A large proportion of recurrences after treatment are local with approximately 50-70% of recurrences occurring in the PF. It is unclear, however, whether these failures are occurring in the original tumor bed, or outside the tumor bed but still within the PF. With improved diagnostic imaging, better definition of tumor volumes, and the use of 3D conformal therapy, we may be able to restrict the boost volume to the tumor bed plus a margin without compromising local control. This retrospective study analyzes the patterns of failure within the PF of a series of patients treated with radiation therapy (RT). Methods: From (7(86)) through (2(96)), 27 of 114 (24%) patients > 18 mo and

1997-01-01

371

Patterns of failure following treatment for medulloblastoma: is it necessary to treat the entire posterior fossa?  

International Nuclear Information System (INIS)

Purpose: Craniospinal radiation (CSRT) followed by a boost to the entire posterior fossa (PF) is standard postoperative therapy for patients with medulloblastoma. A large proportion of recurrences after treatment are local, with approximately 50-70% of recurrences occurring in the PF. It is unclear, however, whether these failures are occurring in the original tumor bed or outside the tumor bed, but still within the PF. With improved diagnostic imaging, better definition of tumor volumes, and the use of three-dimensional conformal therapy (3D CRT), we may be able to restrict the boost volume to the tumor bed plus a margin without compromising local control. This retrospective study analyzes the patterns of failure within the PF in a series of patients treated with radiation therapy (RT). Methods: From July 1986 through February 1996, 114 patients >18 months and

1998-08-01

372

Assessment of posterior fossa structures with midsagittal MRI: the effects of age.  

UK PubMed Central (United Kingdom)

Midsagittal magnetic resonance (MR) images of 36 normal volunteers, ranging in age from 26 to 79 years, were used to evaluate the effects of age on the size of posterior fossa structures (cerebellar vermis, midbrain, pons, medulla and fourth ventricle). Our results demonstrate a highly statistically significant age-related decline in the cross-sectional area of the midbrain (r = -.44, p less than 0.007), a less prominent decline in the area of the anterior cerebellar vermis (r = -.33, p less than 0.05) and striking intercorrelations between the dimensions of the pons, medulla and cerebellar vermis. To the best of our knowledge, this is the first MRI demonstration of midbrain atrophy during aging in normal adults.

Shah SA; Doraiswamy PM; Husain MM; Figiel GS; Boyko OB; McDonald WM; Ellinwood EH Jr; Krishnan KR

1991-07-01

373

Neuropsychological sequelae and quality of life following treatment of posterior fossa ependymomas in children.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Modern treatment of posterior fossa ependymomas in children has improved the overall survival, but as more children live longer, the neuropsychological problems that they endure as result of the disease and its treatment become more the focus of attention. MATERIAL: Early problems such as cerebellar mutism appear to be related to surgery and do not seem to be influenced in their incidence or outcome by the otherwise beneficial effect of oncological treatment. Indeed, the cause of cerebellar mutism is still elusive. While it was originally believed to be totally reversible, it is increasingly realized that it may be related to more complex delayed neuropsychological problems. Late problems such as the cerebellar cognitive affective syndrome are increasingly being recognized. The deleterious effect of both surgery and radiotherapy that is commonly administered afterwards is now well appreciated. CONCLUSION: Careful neuropsychological assessment of these children and early intervention will maximize chances for recovery and improvement of academic functions and quality of life issues.

Charalambides C; Dinopoulos A; Sgouros S

2009-10-01

374

[Escherichia coli meningitis in a 16-month old infant revealing a posterior fossa epidermoid cyst].  

UK PubMed Central (United Kingdom)

UNLABELLED: Meningitis due to Escherichia coli is rare, and generally observed in very particular circumstances, such as neonatal period, anatomical anomalies or in immune-deficient patients. CASE REPORT: A 16-month-old male infant was admitted for acute meningitis. E coli was detected in the cerebro-spinal fluid (CSF). As appropriate antibiotic treatment proved inefficient, a cerebral computerised tomography (CT) scan was performed, revealing an epidermoid cyst of the posterior fossa. The cyst was resected after CSF sterilisation. Postoperative recovery was satisfactory. CONCLUSION: When an unusual bacterial species such as E coli is detected in CSF, the authors suggest consideration of a cutaneous or ETN focus, or a congenital malformation with communication between cutaneous and meningeal structures.

Baujat G; Le Masne A; Cinalli G; Abadie V

1998-09-01

375

Venous sinus volume in the caudal cranial fossa in Cavalier King Charles spaniels with syringomyelia.  

UK PubMed Central (United Kingdom)

Syringomyelia (SM) in Cavalier King Charles spaniels (CKCS) has a complex pathophysiology. Recent studies support a relationship between altered venous drainage and cerebrospinal fluid flow dynamics. The aim of this study was to evaluate the relationship between venous sinus and parenchymal volume within the caudal cranial fossa (CCF) in CKCS with SM (n=22) and without SM (n=12) using magnetic resonance venography (MRV). MRI and MRV images were used to obtain volumetric calculations of CCF volume, as well as the percentage of this volume occupied by parenchyma (CCFP%) and venous sinuses (CCFV%). In CKCS with SM, CCFP% was significantly higher (P<0.001), whilst CCFV% was significantly lower (P=0.001) than in CKCS without SM. These results support a role for reduced venous drainage and parenchymal 'overcrowding' of the CCF in the pathophysiology of SM.

Fenn J; Schmidt MJ; Simpson H; Driver CJ; Volk HA

2013-06-01

376

Cine-magnetic resonance imaging evaluation of communication between middle cranial fossa arachnoid cysts and cisterns  

International Nuclear Information System (INIS)

Cine-magnetic resonance (MR) imaging examinations were performed in 10 patients with middle cranial fossa arachnoid cysts to evaluate communication between the cysts and the normal cerebrospinal fluid (CSF) space. Eight of 10 patients were evaluated by time of flight cine-MR imaging, and two by phase contrast cine-MR imaging. Two patients underwent membranectomy of the cysts, and were evaluated both pre-and postoperatively. Computed tomography cisternography was used to confirm communication between the cysts and the surrounding cisterns. Pulsatile fluid motion within the cysts was present in all patients. However, marked fluid motion and jet flow between the cysts and the surrounding cisterns were only observed in communicating cysts. In the two patients who underwent membranectomy, postoperative examination found greater fluid motion and jet flow not previously present. Cine-MR imaging demonstration of marked pulsatile fluid motion accompanied by jet flow suggests that a cyst communicates with the normal CSF space. (author).

1996-01-01

377

Bifurcated plantaris with rare relations to the neurovascular bundle in the popliteal fossa.  

Science.gov (United States)

The plantaris muscle (PM) is a vestigial muscle in human. The PM arises as a small muscular belly from the lateral condyle of the femur and then its long tendon inserts into the calcaneum or blends with the tendocalcaneus. There are many reports to describe the variations in the origin, nature of muscle, course of the tendon, and insertion of PM. However, here we report a case of a rare and unreported variation of PM with one common origin and two muscle bellies with peculiar relations with the neurovascular bundle in the popliteal fossa. Although its anatomical functions are insignificant, its tendon is useful as a graft in various reconstructive surgeries and variation in this muscle and its relation to nearby neurovascular bundle may be of clinical interest. Therefore, the present variation is worth considering in predicting uncommon neurovascular entrapment in the leg and may also be useful in various surgical procedures in the region of the knee joint. PMID:23771697

Kotian, Sushma R; Sachin, K S; Bhat, Kumar M R

2013-06-15

378

Posterior Cranial Fossa Crowdedness Is Related to Age and Sex: an Magnetic Resonance Volumetric Study  

International Nuclear Information System (INIS)

[en] Purpose: To measure 3-dimensional (3D) posterior cranial fossa (PCF) crowdedness and to evaluate the effect of age, sex, and body height on PCF. Material and Methods: Fifty-two healthy volunteers (24 M and 28 F; mean age 55.4±17.2 years; range 24-82 years) were recruited. Using a semi-automated magnetic resonance technique, we calculated a PCF crowdedness index (CI) as the ratio of hindbrain (HB) volume to PCF volume x100% and correlated this index with age, sex, body height, and other crowdedness parameters. Results: The mean PCF CI was 93.7±2.7%. Women had a more crowded PCF than men (95.0±1.7% versus 92.1±2.7%; P

2005-01-01

379

Unusual complications of a benign tumour - our experience with midline posterior fossa epidermoids.  

UK PubMed Central (United Kingdom)

Epidermoids of the brain are uncommon benign tumours. Their midline posterior fossa location is exceedingly rare. Fifteen patients with this condition were operated during a 14-year period. Majority of the patients presented in their middle age with mean duration of symptoms of 10 months. Gait imbalance was the commonest symptom observed. Seven patients had features suggestive of raised intracranial tension. Computed tomography scanning showed typical hypodense lesions. On MRI, tumours were hypo-intense on T1 weighted images and hyper-intense on T2 weighted images. All patients underwent microsurgical excision. We encountered certain complications in the post-operative period. This prompted us for a review of our case material and literature and is the basis of the present article. Implications of these findings are discussed.

Raghunath A; Devi BI; Bhat DI; Somanna S

2013-02-01

380

Selected hematologic and biochemical values in subadult and adult captive fossas (Cryptoprocta ferox).  

Science.gov (United States)

Hematologic and serum biochemical values were determined for 26 (16 males and 10 females) clinically healthy captive fossas (Cryptoprocta ferox) living at Zoo Duisburg, Germany. The animals were net-restrained and anesthetized with ketamine and medetomidine for a general examination. A total of 11 animals were classified as subadult (1-3 yr of age) and 15 as adult (aged between 4 and 13 yr). The results include reference intervals and analysis of sex and age differences. Levels of inorganic phosphorus, alkaline phosphatase, glutamate dehydrogenase, creatine kinase, lactate dehydrogenase, and calcium were significantly higher in the subadult group. The white blood cell count and red blood cell count were significantly lower in the adult group than among the subadult group. PMID:24063085

Langer, Sandra; Jurczynski, Kerstin; Widmer, Dimitri

2013-09-01

 
 
 
 
381

Radiological evaluation of mine water discharges from hard coal mining in the Fossa Eugeniana Area, Germany  

International Nuclear Information System (INIS)

[en] Discharges of radium-carrying mine waters from hard coal mining in the area of the Fossa Eugeniana and the Rheinberger Altrhein in Germany have caused elevated radioactivity in sediments and soils. Extensive measurements of the ambient dose rate revealed some small area contaminations as well as a larger one in a nature protection area at the Rheinberger Altrhein. For the evaluation of the potential radiation exposure investigations of the activity concentrations of river sediments, soils, and biological materials were performed. The potential exposure of members of the public was modelled on the basis of the German Guidelines for the Calculation of Radiation Exposure due to Radioactivity from Mining Activities. In the assessment the present situation as well as its possible future development was considered. (orig.)

2008-01-01

382

Single photon emission tomography following posterior fossa surgery in patients with and without mutism.  

UK PubMed Central (United Kingdom)

MATERIALS AND METHODS: We designed a prospective study to investigate single photon emission tomography (SPECT) findings in patients with or without mutism who had undergone posterior fossa surgery. These patients had a (99m)Tc-hexamethylpropyleneamine oxime-SPECT scan postoperatively. SPECT was performed between the 1st and 2nd week after surgery. The patients with cerebellar mutism had a second SPECT scan after regaining their power of speech. The patients were evaluated in terms of age, gender, preoperative and postoperative neurological and radiological findings, tumor size and location, vermian incision and histopathology. RESULTS: Six girls and 5 boys, ranging in age from 3 to 11 years who had undergone posterior fossa tumor surgery were included in this study as controls. Their tumors were located in the vermis and fourth ventricle in 8 patients, in the cerebellar hemisphere in 1, fourth ventricle in 1, and 1 patient had a fourth ventricular tumor extending the cerebello-pontine angle. The histopathology of the tumors was as follows: astrocytoma in 5 patients, ependymoma in 3, medulloblastoma in 1, dermoid tumor in 1, and choroid plexus papilloma in 1 patient. Postoperative cerebellar mutism developed in 2 girls and 1 boy whose ages ranged from 2 to 5 years. Pathological examination revealed 2 medulloblastomas and 1 ependymoma. Mutism developed 2 to 4 days after surgery. All of the patients with cerebellar mutism showed either clinical or radiological signs and symptoms of brain stem involvement. SPECT findings were similar in the patients with cerebellar mutism and in those without. CONCLUSIONS: SPECT findings are not specific enough to explain how cerebellar mutism occurs. Clinical signs of brain stem involvement seem to be a significant risk factor in the development of cerebellar mutism.

Er?ahin Y; Yararbas U; Duman Y; Mutluer S

2002-07-01

383

Cochlear implantation through the middle fossa: an anatomic study for a novel technique.  

UK PubMed Central (United Kingdom)

Abstract Conclusion: The technique proposed is simple, reliable, and provides sufficient exposure of the basal portion of the cochlea while avoiding disabling complications. It enables visualization of the cochlear basal turn and the osseous spiral lamina, facilitating the insertion of the cochlear implant array through the scala tympani. Objectives: To describe a novel approach for exposing the cochlear basal turn for cochlear implantation through the middle cranial fossa. Methods: Fifty temporal bones were dissected and a cochleostomy was performed via a middle fossa approach on the most superficial part of the cochlear basal turn, using the superior petrosal sinus, the skeletonized petrous apex, the lateral surface of the meatal plane trailed on the petrous apex from its most proximal portion, and the great superficial petrosal nerve as landmarks. The distance between the landmarks and the distance between the cochleostomy and the round window were measured. Results: In all temporal bones, only the top portion of the cochlear basal turn was uncovered. The cochleostomy allowed both the scala tympani and the vestibule to be exposed. A computed tomography scan of the temporal bones was performed to document the electrode insertion from the cochlear basal turn until its apex. The mean ± SD minor and major distances between the cochleostomy and the meatal plane were estimated to be 2.48 ± 0.88 mm and 3.11 ± 0.86 mm, respectively. The mean distance from the cochleostomy to the round window was 8.38 ± 1.96 mm, and that to the superior petrosal sinus was 9.19 ± 1.59 mm. The mean minor and major distances between the cochleostomy and the long axis of the meatal plane from its most proximal portion were estimated to be 6.63 ± 1.38 mm and 8.29 ± 1.43 mm, respectively.

Brito Rd; Bittencourt AG; Tsuji RK; Magnan J; Bento RF

2013-09-01

384

Cochlear implantation through the middle fossa: an anatomic study for a novel technique.  

Science.gov (United States)

Abstract Conclusion: The technique proposed is simple, reliable, and provides sufficient exposure of the basal portion of the cochlea while avoiding disabling complications. It enables visualization of the cochlear basal turn and the osseous spiral lamina, facilitating the insertion of the cochlear implant array through the scala tympani. Objectives: To describe a novel approach for exposing the cochlear basal turn for cochlear implantation through the middle cranial fossa. Methods: Fifty temporal bones were dissected and a cochleostomy was performed via a middle fossa approach on the most superficial part of the cochlear basal turn, using the superior petrosal sinus, the skeletonized petrous apex, the lateral surface of the meatal plane trailed on the petrous apex from its most proximal portion, and the great superficial petrosal nerve as landmarks. The distance between the landmarks and the distance between the cochleostomy and the round window were measured. Results: In all temporal bones, only the top portion of the cochlear basal turn was uncovered. The cochleostomy allowed both the scala tympani and the vestibule to be exposed. A computed tomography scan of the temporal bones was performed to document the electrode insertion from the cochlear basal turn until its apex. The mean ± SD minor and major distances between the cochleostomy and the meatal plane were estimated to be 2.48 ± 0.88 mm and 3.11 ± 0.86 mm, respectively. The mean distance from the cochleostomy to the round window was 8.38 ± 1.96 mm, and that to the superior petrosal sinus was 9.19 ± 1.59 mm. The mean minor and major distances between the cochleostomy and the long axis of the meatal plane from its most proximal portion were estimated to be 6.63 ± 1.38 mm and 8.29 ± 1.43 mm, respectively. PMID:23795614

Brito, Rubens de; Bittencourt, Aline Gomes; Tsuji, Robinson Koji; Magnan, Jacques; Bento, Ricardo Ferreira

2013-06-24

385

The management of birth-related posterior fossa hematomas in neonates.  

UK PubMed Central (United Kingdom)

BACKGROUND: Symptomatic posterior fossa hematoma in the term newborn is rare. OBJECTIVE: To report on the management and outcome of posterior fossa subdural hematoma (PFSDH) in neonates. METHODS: A retrospective analysis of the department database and clinical notes of neonates admitted since 1985 with a PFSDH was performed together with a literature review of similar case series. RESULTS: Sixteen patients were included. The median gestational age was 40 weeks with a high proportion of primiparous mothers (n = 9) and forceps delivery (n = 9). Nine neonates had symptoms of brainstem dysfunction within the first 24 hours of life, whereas the other 7 had a delayed presentation (median 4 days) with signs of raised intracranial pressure due to hydrocephalus. Each patient had a cranial ultrasound followed by computed tomography scan that showed the PFSDH. Eleven neonates required surgical evacuation of the PFSDH, whereas hydrocephalus was managed by transient external ventricular drainage in 2 further patients. Eventually, 2 neonates required a permanent ventriculoperitoneal shunt. Five neonates had no operative intervention. With a mean follow-up of 7.8 years, 2 patients had mild developmental delay and 1 had severe developmental delay. The 13 other patients had a normal development. CONCLUSION: In neonates with a PFSDH, surgery can be safely performed in those who have clinical and radiological signs of brainstem compression or hydrocephalus. A small number of neonates require a ventriculoperitoneal shunt in the long term. Initial aggressive resuscitation should be performed even in cases of initial severe brainstem dysfunction because of the good long-term neurological outcome.

Blauwblomme T; Garnett M; Vergnaud E; Boddaert N; Bourgeois M; Dirocco F; Zerah M; Sainte-Rose C; Puget S

2013-05-01

386

Endoscopic reconstruction of anterior and middle cranial fossa defects using acellular dermal allograft.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To report our experience in reconstructing defects of the anterior and middle cranial fossa skull base using endoscopic placement of acellular dermal allograft (AlloDerm, LifeCell Corp., The Woodlands, TX). STUDY DESIGN: Retrospective chart review. METHODS: In all cases, the skull base repair was completed with a similar technique. After identification of the defect boundaries, endoscopic transnasal repair was performed through placement of a layered reconstruction of acellular dermal allograft, septal bone/cartilage, and acellular dermal allograft, which were all placed on the intracranial side of the defect. A mucosal free graft was draped over the reconstruction. Fibrin glue was used to hold the mucosal graft in place, and the reconstruction was supported by both absorbable and nonabsorbable nasal packing. RESULTS: Eight patients with nine skull base defects underwent the procedure for repair of cerebrospinal fluid rhinorrhea. All defects were successfully repaired. One patient underwent successful reconstruction of bilateral ethmoid roof defects that resulted from endoscopic resection of ethmoid adenocarcinoma. Twenty-four patients underwent primary resection of hypophyseal adenomas. Twenty-three patients had macroadenomas, and intraoperative cerebrospinal fluid leaks were noted in 11 patients. Sellar repairs after trans-sphenoidal hypophysectomy were successful in 22 of 24 patients. One patient with hypophysectomy required reoperation (1 of 24 [4%]) for secondary closure of a cerebrospinal fluid leak. Serious complications were avoided in all patients. Patients were followed for a period ranging from 5 to 57 months (mean period, 34 mo). CONCLUSIONS: Acellular dermal allograft can be successfully used for the reconstruction of anterior and middle cranial fossa skull base defects. This allograft, which is easy to manipulate endoscopically, provides an effective seal and barrier in skull base reconstruction and avoids the need for a donor site.

Lorenz RR; Dean RL; Hurley DB; Chuang J; Citardi MJ

2003-03-01

387

Chronic uncal herniation secondary to posterior fossa shunting: case report and literature review.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Chronic herniation syndromes other than tonsillar herniation are not well-recognized. Transtentorial uncal herniation in its chronic form has been reported in only few case reports (Horowitz et al., J Neuroimaging 12:78-79, 2002; Naidich et al., Radiology 158:431-434, 1986; Ng and Valiante, J Clin Neurosci 16:944, 2009; Ng and Valiante, J Clin Neurosci 16:984, 2009). We hereby illustrate a case with this rare finding, including MR imaging, and analyze this phenomenon. CASE REPORT: A 15-year-old girl had a resection of a cerebellar pilocytic astrocytoma at 5 years of age. Two months later, she underwent a cystoperitoneal shunt for persistent headache and pseudomeningocele, secondary to an enlarging cyst at the tumor bed. Subsequently, her shunt was upgraded to a more conservative valve following clinical evidence of over drainage. This was also associated with imaging compatible with bilateral uncal herniation. After the procedure, she had relief of symptoms. CONCLUSION: We conclude that a negative pressure gradient in the posterior fossa, relative to the supratentorial compartment, is the etiology of the chronic uncal herniation in our patient. Comparing the case reports in the literature with our case, we postulate that chronic uncal herniation is a complication of shunting of a posterior fossa fluid cavity in children, many of them with Dandy-Walker syndrome and/or other cerebellar cystic formations. The treatment priority at presentation should be to rule out shunt malfunction. In the event of association with clinical over-drainage syndrome, there may be a role for changing the shunt system into a more conservative drainage combination.

Udayakumaran S; Ben Sira L; Constantini S

2010-02-01

388

Associação singular de síndrome de Kallmann e cisto aracnóide da fossa média: relato de caso Singular association of Kallmann's syndrome and arachnoid cyst of middle fossa: case report  

Directory of Open Access Journals (Sweden)

Full Text Available O hipogonadismo hipogonadotrófico pode resultar de diferentes anomalias do sistema nervoso central, apresentando sinais clínicos que dependem da idade de aparecimento, bem como do grau de deficiência gonadotrófica e de sua associação com outras deficiências hipofisárias. Relatamos o caso de um rapaz de 18 anos com atraso puberal, retardo de crescimento estatural a partir de 10 anos e história de dificuldade de aprendizado escolar. Ao exame apresentava discreto aspecto eunucóide, 162 cm de altura (z score = -2,17), estadiamento puberal GII, PII, testículos de 4 cm³. A avaliação complementar demonstrou níveis pré-puberais de testosterona, megateste com resposta normal, exceto ao teste de estímulo com GnRH agudo e prolongado. CT de crânio mostrou cisto aracnóide da fossa média esquerda com extensão supra-selar. Foi feito o diagnóstico de hipogonadismo hipogonadotrófico provavelmente secundário à compressão pelo cisto aracnóide e por isso, optou-se por derivação cisto-peritoneal. Após a cirurgia não houve retomada do desenvolvimento puberal, sendo então verificada anosmia bilateral e, portanto, diagnosticada Síndrome de Kallmann, que foi confirmada pelos achados da RNM, embora os resultados hormonais não sejam totalmente compatíveis com a referida síndrome. Não encontramos na literatura descrição da associação entre Síndrome de Kallmnann e cisto aracnóide e acreditamos que neste caso os resultados da avaliação hormonal possam ser devidos a tal associação que provocou adicionalmente uma disfunção hipofisária.Hypogonadotrophic hypogonadism can result from different abnormalities in the central nervous system. The clinical picture depends upon the time of onset the deficiency, the magnitude of the gonadotropins deficiency and whether there are other pituitary hormone deficiencies as well. We report on a 18-year-old boy, who was investigated because of pubertal and growth delay. He also had learning disabilities. On physical examination he exhibited mild eunuchoid aspect, 162 cm height (z score = -2,17), pubertal development on stage G II, P II, and 4 cm5 testis. Laboratory investigation revealed pre-pubertal levels of testosterone and normal results of the combined test of anterior pituitary function, except for in GnRH acute and prolonged test. Brain CT showed an arachnoid cyst on left middle fossa with expansion to suprasellar cisterna. He was diagnosed as having hypogonadotrophic hypogonadism secondary to compression by the cyst, and a cyst-peritoneal derivation was performed. After surgery there was no improvement of the pubertal state and bilateral anosmia was discovered, so Kallmann's syndrome was then diagnosed and was confirmed by MRI, even though the hormonal results are not totally matched with the refered syndrome. We did not find in the literature any description of the association between Kallmann's syndrome and arachnoid cyst and we believe that in this case the results of the hormonal measurement may be due to such association that provoked an additional hypophysis dysfunction.

Yvens B. Fernandes; Gil Guerra Jr; Sofia H. V. Lemos; Maria T. Matias; Benito P. Damasceno; Osmi Hamamoto; Ary Marconi Jr; Donizetti C. Honorato; José L. C. Marins

1995-01-01

389

Associação singular de síndrome de Kallmann e cisto aracnóide da fossa média: relato de caso/ Singular association of Kallmann's syndrome and arachnoid cyst of middle fossa: case report  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese O hipogonadismo hipogonadotrófico pode resultar de diferentes anomalias do sistema nervoso central, apresentando sinais clínicos que dependem da idade de aparecimento, bem como do grau de deficiência gonadotrófica e de sua associação com outras deficiências hipofisárias. Relatamos o caso de um rapaz de 18 anos com atraso puberal, retardo de crescimento estatural a partir de 10 anos e história de dificuldade de aprendizado escolar. Ao exame apresentava discreto as (more) pecto eunucóide, 162 cm de altura (z score = -2,17), estadiamento puberal GII, PII, testículos de 4 cm³. A avaliação complementar demonstrou níveis pré-puberais de testosterona, megateste com resposta normal, exceto ao teste de estímulo com GnRH agudo e prolongado. CT de crânio mostrou cisto aracnóide da fossa média esquerda com extensão supra-selar. Foi feito o diagnóstico de hipogonadismo hipogonadotrófico provavelmente secundário à compressão pelo cisto aracnóide e por isso, optou-se por derivação cisto-peritoneal. Após a cirurgia não houve retomada do desenvolvimento puberal, sendo então verificada anosmia bilateral e, portanto, diagnosticada Síndrome de Kallmann, que foi confirmada pelos achados da RNM, embora os resultados hormonais não sejam totalmente compatíveis com a referida síndrome. Não encontramos na literatura descrição da associação entre Síndrome de Kallmnann e cisto aracnóide e acreditamos que neste caso os resultados da avaliação hormonal possam ser devidos a tal associação que provocou adicionalmente uma disfunção hipofisária. Abstract in english Hypogonadotrophic hypogonadism can result from different abnormalities in the central nervous system. The clinical picture depends upon the time of onset the deficiency, the magnitude of the gonadotropins deficiency and whether there are other pituitary hormone deficiencies as well. We report on a 18-year-old boy, who was investigated because of pubertal and growth delay. He also had learning disabilities. On physical examination he exhibited mild eunuchoid aspect, 162 cm (more) height (z score = -2,17), pubertal development on stage G II, P II, and 4 cm5 testis. Laboratory investigation revealed pre-pubertal levels of testosterone and normal results of the combined test of anterior pituitary function, except for in GnRH acute and prolonged test. Brain CT showed an arachnoid cyst on left middle fossa with expansion to suprasellar cisterna. He was diagnosed as having hypogonadotrophic hypogonadism secondary to compression by the cyst, and a cyst-peritoneal derivation was performed. After surgery there was no improvement of the pubertal state and bilateral anosmia was discovered, so Kallmann's syndrome was then diagnosed and was confirmed by MRI, even though the hormonal results are not totally matched with the refered syndrome. We did not find in the literature any description of the association between Kallmann's syndrome and arachnoid cyst and we believe that in this case the results of the hormonal measurement may be due to such association that provoked an additional hypophysis dysfunction.

Fernandes, Yvens B.; Guerra Jr, Gil; Lemos, Sofia H. V.; Matias, Maria T.; Damasceno, Benito P.; Hamamoto, Osmi; Marconi Jr, Ary; Honorato, Donizetti C.; Marins, José L. C.

1995-09-01

390

La Verbena azul en el tratamiento del niño con salpullido The blue Verbena to treat the child with rash  

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Full Text Available Introducción: la miliaria es una enfermedad inflamatoria de la piel, usualmente conocida como salpullido, es muy frecuente en niños pequeños sobre todo en los meses de verano. Objetivo: valorar la eficacia de la infusión de Verbena azul en el control de la miliaria común. Métodos: se realizó un ensayo clínico fase II, a partir de la preparación de una infusión de hojas frescas o secas molidas, que se vertieron en 12 litros de agua hirviente, se tapó y se separó del fuego después de añadirle la planta, se dejó reposar y se coló. Fue aplicada tibia en todo el cuerpo durante 21 días, en dos secciones, al levantarse, y en la tarde luego del baño diario. El estudio se realizó en 30 lactantes de raza blanca, que acudieron con esta patología a la consulta de Medicina Natural y Tradicional, en el consultorio 6 del poblado de Altagracia, en el periodo entre junio del 2004 y junio del 2005, los cuales pertenecían al Policlínico Comunitario Docente "Carlos J. Finlay" de la Ciudad de Camagüey. Los datos se recogieron mediante una encuesta, confeccionada de acuerdo con los objetivos planteados en la investigación. Resultados: el grupo más afectado fue el de 3 a 6 meses, todos los pacientes fueron blancos, no se encontraron diferencias significativas en cuanto al sexo. La variedad clínica más frecuente fue la cristalina, y los meses en que más se presentó fueron entre junio y agosto. Conclusiones: este tratamiento presentó una alta eficacia en el control de la sintomatología de la miliaria común; se curaron 9 de cada 10 pacientes.Introduction: miliaria is an skin inflammatory disease known as rash and is very frequent in small children mainly during summer months. Objective: assessing the efficacy of the infusion of blue Verbena in controlling common heat rash. Methods: a phase II clinical trial was conducted from the preparation of an infusion of fresh leaves or dry grinded poured out in 12 liters of boiling water, was covered and removed from fire after adding the plant, it was doughed and strained. It was applied warm in whole body for 21 days in t wo sessions, to stand up and at evening after daily bath. A study was conducted in 30 white infants presenting with this pathology who came to the Natural and Traditional Medicine Service in the No.6 consulting room of the Altagracia settlement from June, 2004 to June, 2005 of "Carlos J. Finlay" Teaching Community polyclinic of the Camagüey city. Data were collected by survey, designed according to the objectives proposed in research. Results: the more involved group was that aged 3-6 months, all patients were white; there were not significant differences as regards sex. The more frequent clinical variety was the crystalline one and more prevalent months were June and August. Conclusions: present treatment was highly effective in the control of symptomatology of the common miliaria; nine of ten patients were cured.

Roberto Galiano Piquet; Bárbaro Usatorres Rodríguez

2012-01-01

391

La Verbena azul en el tratamiento del niño con salpullido/ The blue Verbena to treat the child with rash  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Introducción: la miliaria es una enfermedad inflamatoria de la piel, usualmente conocida como salpullido, es muy frecuente en niños pequeños sobre todo en los meses de verano. Objetivo: valorar la eficacia de la infusión de Verbena azul en el control de la miliaria común. Métodos: se realizó un ensayo clínico fase II, a partir de la preparación de una infusión de hojas frescas o secas molidas, que se vertieron en 12 litros de agua hirviente, se tapó y se separ? (more) ? del fuego después de añadirle la planta, se dejó reposar y se coló. Fue aplicada tibia en todo el cuerpo durante 21 días, en dos secciones, al levantarse, y en la tarde luego del baño diario. El estudio se realizó en 30 lactantes de raza blanca, que acudieron con esta patología a la consulta de Medicina Natural y Tradicional, en el consultorio 6 del poblado de Altagracia, en el periodo entre junio del 2004 y junio del 2005, los cuales pertenecían al Policlínico Comunitario Docente "Carlos J. Finlay" de la Ciudad de Camagüey. Los datos se recogieron mediante una encuesta, confeccionada de acuerdo con los objetivos planteados en la investigación. Resultados: el grupo más afectado fue el de 3 a 6 meses, todos los pacientes fueron blancos, no se encontraron diferencias significativas en cuanto al sexo. La variedad clínica más frecuente fue la cristalina, y los meses en que más se presentó fueron entre junio y agosto. Conclusiones: este tratamiento presentó una alta eficacia en el control de la sintomatología de la miliaria común; se curaron 9 de cada 10 pacientes. Abstract in english Introduction: miliaria is an skin inflammatory disease known as rash and is very frequent in small children mainly during summer months. Objective: assessing the efficacy of the infusion of blue Verbena in controlling common heat rash. Methods: a phase II clinical trial was conducted from the preparation of an infusion of fresh leaves or dry grinded poured out in 12 liters of boiling water, was covered and removed from fire after adding the plant, it was doughed and strai (more) ned. It was applied warm in whole body for 21 days in t wo sessions, to stand up and at evening after daily bath. A study was conducted in 30 white infants presenting with this pathology who came to the Natural and Traditional Medicine Service in the No.6 consulting room of the Altagracia settlement from June, 2004 to June, 2005 of "Carlos J. Finlay" Teaching Community polyclinic of the Camagüey city. Data were collected by survey, designed according to the objectives proposed in research. Results: the more involved group was that aged 3-6 months, all patients were white; there were not significant differences as regards sex. The more frequent clinical variety was the crystalline one and more prevalent months were June and August. Conclusions: present treatment was highly effective in the control of symptomatology of the common miliaria; nine of ten patients were cured.

Galiano Piquet, Roberto; Usatorres Rodríguez, Bárbaro

2012-03-01

392

Reduced CYP2D6 function is associated with gefitinib-induced rash in patients with non-small cell lung cancer  

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Full Text Available Abstract Background Rash, liver dysfunction, and diarrhea are known major adverse events associated with erlotinib and gefitinib. However, clinical trials with gefitinib have reported different proportions of adverse events compared to trials with erlotinib. In an in vitro study, cytochrome P450 (CYP) 2D6 was shown to be involved in the metabolism of gefitinib but not erlotinib. It has been hypothesized that CYP2D6 phenotypes may be implicated in different adverse events associated with gefitinib and erlotinib therapies. Methods The frequency of each adverse event was evaluated during the period in which the patients received gefitinib or erlotinib therapy. CYP2D6 phenotypes were determined by analysis of CYP2D6 genotypes using real-time polymerase chain reaction techniques, which can detect single-nucleotide polymorphisms. The CYP2D6 phenotypes were categorized into 2 groups according to functional or reduced metabolic levels. In addition, we evaluated the odds ratio (OR) of the adverse events associated with each factor, including CYP2D6 activities and treatment types. Results A total of 232 patients received gefitinib therapy, and 86 received erlotinib therapy. Reduced function of CYP2D6 was associated with an increased risk of rash of grade 2 or more (OR, 0.44; 95% confidence interval [CI], 0.21–0.94; *p = 0.03), but not diarrhea ? grade 2 (OR, 0.49; 95% CI, 0.17–1.51; *p = 0.20) or liver dysfunction ? grade 2 (OR, 1.08; 95% CI, 0.52–2.34; *p = 0.84) in the gefitinib cohort. No associations were observed between any adverse events in the erlotinib cohort and CYP2D6 phenotypes (rash: OR, 1.77; 95% CI, 0.54–6.41; *p = 0.35/diarrhea: OR, 1.08; 95% CI, 0.21–7.43; *p = 0.93/liver dysfunction: OR, 0.93; 95% CI, 0.20–5.07; *p = 0.93). Conclusions The frequency of rash was significantly higher in patients with reduced CYP2D6 activity who treated with gefitinib compared to patients with functional CYP2D6. CYP2D6 phenotypes are a risk factor for the development of rash in response to gefitinib therapy.

Suzumura Tomohiro; Kimura Tatsuo; Kudoh Shinzoh; Umekawa Kanako; Nagata Misato; Matsuura Kuniomi; Tanaka Hidenori; Mitsuoka Shigeki; Yoshimura Naruo; Kira Yukimi; Nakai Toshiyuki; Hirata Kazuto

2012-01-01

393

Implante coclear via fossa craniana média: uma nova técnica para acesso ao giro basal da cóclea Cochlear implantation through the middle cranial fossa: a novel approach to access the basal turn of the cochlea  

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Full Text Available A técnica clássica para o implante coclear é realizada através de mastoidectomia e timpanotomia posterior. A abordagem pela fossa craniana média provou ser uma alternativa valiosa, embora venha sendo usada para o implante coclear apenas esporadicamente e sem normatização. OBJETIVO: Descrever uma nova abordagem para expor o giro basal da cóclea para o implante coclear através da fossa craniana média. MÉTODO: Cinquenta ossos temporais foram dissecados. A cocleostomia foi realizada através de uma abordagem via fossa craniana média, na parte mais superficial do giro basal da cóclea, usando o plano meatal e seio petroso superior como pontos de reparo. A parede lateral do meato acústico interno foi dissecada após o broqueamento e esqueletização do ápice petroso. A parede dissecada do meato acústico interno foi acompanhada longitudinalmente até a cocleostomia. Design: Estudo anatômico de osso temporal. RESULTADOS: Em todos os ossos temporais, apenas a parte superficial do giro basal da cóclea foi aberta. A exposição do giro basal da cóclea permitiu que as escalas timpânica e vestibular fossem visualizadas. Assim, não houve dificuldade na inserção do feixe de eletrodos através da escala timpânica. CONCLUSÃO: A técnica proposta é simples e permite exposição suficiente do giro basal da cóclea.The classic approach for cochlear implant surgery includes mastoidectomy and posterior tympanotomy. The middle cranial fossa approach is a proven alternative, but it has been used only sporadically and inconsistently in cochlear implantation. OBJECTIVE: To describe a new approach to expose the basal turn of the cochlea in cochlear implant surgery through the middle cranial fossa. METHOD: Fifty temporal bones were dissected in this anatomic study of the temporal bone. Cochleostomies were performed through the middle cranial fossa approach in the most superficial portion of the basal turn of the cochlea, using the meatal plane and the superior petrous sinus as landmarks. The lateral wall of the internal acoustic canal was dissected after the petrous apex had been drilled and stripped. The dissected wall of the inner acoustic canal was followed longitudinally to the cochleostomy. RESULTS: Only the superficial portion of the basal turn of the cochlea was opened in the fifty temporal bones included in this study. The exposure of the basal turn of the cochlea allowed the visualization of the scala tympani and the scala vestibuli, which enabled the array to be easily inserted through the scala tympani. CONCLUSION: The proposed approach is simple to use and provides sufficient exposure of the basal turn of the cochlea.

Aline Gomes Bittencourt; Robinson Koji Tsuji; João Paulo Ratto Tempestini; Alfredo Luiz Jacomo; Ricardo Ferreira Bento; Rubens de Brito

2013-01-01

394

Pesquisa de Staphylococcus aureus enterotoxigênico nas fossas nasais de manipuladores de alimentos em hospitais, São Paulo, 1976 Staphylococcus aureus in the anterior portion of nasal fossae of hospital food handlers, São Paulo, Brazil, 1976  

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Full Text Available Foi realizada a verificação da presença de Staphylococcus aureus enterotoxigênico, em manipuladores de alimentos, em cozinhas hospitalares. Foi colhido material da porção anterior das fossas nasais de 34 pessoas que trabalhavam em três hospitais da cidade de São Paulo. Dentre os indivíduos examinados, 12 (35,3%) revelaram-se portadores de S. aureus e, destes 2 (16,7%) foram positivos para cepas produtoras de enterotoxina estafilocócica do tipo C. Das 12 cepas isoladas, 9 (75%) foram fagotipáveis; das duas cepas enterotoxigênicas, uma foi não fagotipável e a outra foi Usada por fagos do grupo III.The presence of enterotoxic S. aureus in the nasal fossae of hospital food handlers was investigated. Material was collected from the anterior portion of fossae of 34 food handlers in the kitchens of three hospitals in the city of S. Paulo, Brazil. Of these 34 persons, 12 (35.3%) were positive for S. aureus, of these same 12, two (16.7%) showed positive for type C staphylococcal enterotoxin producing strains. Of the 12 strains isolated, nine (75%) could be phagetyped; of the enterotoxic strains, one was lysed by Group III phage; the other was non-typeable.

Sebastião Timo laria; Sirdéia M. P. Furlanetto; Maria Lúcia C. Campos

1980-01-01

395

Ultrasound Imaging of the Sciatic Nerve Division in the Popliteal Fossa: A Volunteer Study  

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Full Text Available The Background and Objectives: A sciatic nerve block at the level of the popliteal fossa is frequently administered for post-operative analgesia for surgery below the knee. While ultrasound continues to gain popularity as the technique of choice for guiding needle positioning during peripheral nerve blocks, practitioners can begin to utilize ultrasound to look for patterns of anatomical significance. Recognizing anatomical variations among different demographic populations can help practitioners improve in performing nerve blocks. We aim to determine if predictable variability exists in sciatic nerve bifurcation location and depth at the level of the popliteal fossa. Methods: After IRB approval, eligible subjects were screened for ASA I or II status and demographic data was collected. Fifty subjects were enrolled. The SonoSite MicroMaxx® with 38-mm broadband linear array, 13-6 MHz probe with color Doppler and image capturing capabilities was used for ultrasound measurements. With subject lying prone, the location of the sciatic nerve in relation to the popliteal crease and skin-to-nerve distance were assessed via ultrasound. Two independent investigators confirmed nerve location for measurements. Analyses were performed with SAS version 9.1 using Pearson Correlation Coefficients and regression analysis. Results: Gender stratification revealed that, while males were both taller and heavier, skin-nerve measurements for depth were consistently deeper in females (p-value 0.02). Independent of the right or left leg, male gender and increased height decreases the skin-nerve distance, while increased weight increases the distance. There was no correlation between patient characteristics and crease-nerve distance. In some subjects, variability of crease-nerve distance even existed between their right and left leg. Conclusion: We show that significant variability exists for actual sciatic nerve bifurcation location, or target injection site, with consistently deeper skin depth values for female patients when compared to male patients, accounting for height and weight. These findings suggest visualization techniques such as ultrasound may lead to better localization of ideal injection sites.

Eric P. Chiang; Paul Dangerfield; Daniel Asay; Anita Cucchiaro; Jeffrey S. Berger

2013-01-01

396

Sphenoid sinus mucocele penetrating to the orbit, anterior and middle cranial fossae and parapharyngeal space: a case report.  

UK PubMed Central (United Kingdom)

Mucocele, though is a common lesion, rarely penetrates to the surrounding intra- and extracranial spaces. We describe the case of 45-year-old male with 2 years history of a chronic left nasal obstruction and a concentric visual field deficit in the left eye as the only manifestations. Diagnostic CT and MRI imaging revealed a mucocele originating from the posterior ethmoid and sphenoid sinuses and penetrating intracranially to the anterior and middle cranial fossae and extracranially to the pterygopalatine fossa and the parapharyngeal space. This extensive localization appears to be an extremely rare entity, which, to our knowledge, has not been described in the English literature yet. The clinical features and a literature review are also presented.

Chmielewski R; Paprocki A; Morawski K; Niemczyk K

2010-01-01

397