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Colgajo de perforantes de la arteria colateral cubital inferior para defectos por quemadura eléctrica en fosa cubital / Inferior ulnar collateral perforators flap to cover defects on antecubital fossa after electrical burn  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Las quemaduras eléctricas producen lesiones profundas, especialmente las debidas a la entrada y salida de la corriente y al arco voltaico, que pueden dejar expuestas estructuras nobles y afectar áreas de flexo-extensión, como la fosa antecubital. Los defectos resultantes pueden cubrirse mediante col [...] gajos libres o pediculados de brazo y antebrazo. Entre las distintas opciones quirúrgicas, el colgajo medial del brazo evita la interrupción de los ejes vasculares mayores y la secuela en la zona donante es discreta. Sin embargo, su uso está poco extendido por considerarse un colgajo de difícil disección debido a la variabilidad anatómica de las arterias colaterales cubitales superior e inferior que lo irrigan. Presentamos la cobertura para un defecto secundario a quemadura eléctrica en la fosa antecubital mediante un colgajo medial del brazo basado en las ramas perforantes de la arteria colateral cubital inferior. Aunque confirmamos en este caso la variabilidad vascular, la disección resultó sencilla y el resultado estético y funcional fue excelente. Abstract in english Electrical burns result in deep injury to tissues, especially those lesions produced by entrance and exit of electric flow and voltaic arc, that expose structures such as tendons, nerves or vessels when it happens at the antecubital fossa. Defects produced by electrical burns can be covered using fr [...] ee flaps or local pedicled flaps from arm and forearm. Among different surgical procedures, medial arm flap is a useful one, as it avoids interruption of main vascular axis of the arm and donor site sequelae are minimal. Never the less, its use is not extended due to its difficult dissection, as because the pedicle of the flap has a highly variable anatomical vascularity (superior and inferior ulnar collateral artery). We present a defect produced by electrical burn and its coverage using a local flap based on perforator branches from inferior ulnar collateral artery. Although vascular variability was confirmed, dissection was easy and an aesthetical and functional outcome was achieved.

I., González-Alaña; J.V., Torrero-López; M., Llop-Adrián; P., Martín-Playá; F.J., Gabilondo Zubizarreta.

2014-09-01

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Physiologically based pharmacokinetic modeling of arterial – antecubital vein concentration difference  

Directory of Open Access Journals (Sweden)

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

2004-02-01

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Preventing Diaper Rash  

Science.gov (United States)

... features on this page, please enable JavaScript. Preventing Diaper Rash Dermatologist shares tips for protecting your baby's ... Care Rashes WEDNESDAY, Dec. 31, 2014 (HealthDay News) -- Diaper rash is a common problem for babies, but ...

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Babies and heat rashes  

Science.gov (United States)

Heat rashes and babies; Prickly heat rash; Red miliaria ... To avoid heat rash , keep your baby cool and dry during warm weather. Some helpful suggestions: During the hot season, dress your baby in lightweight, soft, cotton clothing. Cotton ...

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ANSWER: A characteristic rash.  

OpenAIRE

Answer: Dengue fever with Herman’srash.Dengue presents as classic dengue fever orhaemorrhagic dengue. It is caused byFlavivirus, transmitted to humans by theAedes aegypti mosquito.Dengue rash or also known as Herman’srash (Panel A) appears as a maculopapularerythematous rash with islands ofnormal skin sparing or scarlatiniform (likeScarlet fever rash: it blanches upon pressure,Panel B). The clinical feature of denguerash is classically described as “Islands ofwhite in a sea of red”. T...

Chong, Vui Heng; Misli, Hartini

2011-01-01

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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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Hot Tub Rash (Pseudomonas Dermatitis/Folliculitis)  

Science.gov (United States)

... How Do I Protect Myself and My Family? "Hot Tub Rash" ( Pseudomonas Dermatitis / Folliculitis) Below are answers ... hot tub rash and healthy swimming. What is Hot Tub Rash? Hot tub rash, or dermatitis, is ...

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Posterior fossa malformations.  

Science.gov (United States)

Understanding embryologic development of the cerebellum and the 4th ventricle is essential for understanding posterior fossa malformations. Posterior fossa malformations can be conveniently classified into those that have a large posterior fossa and those with normal or small posterior fossa. Disorders associated with a large posterior fossa include classic Dandy-Walker malformation, Blake's pouch cyst, mega cisterna magna, and posterior fossa arachnoid cyst. Disorders associated with normal or small posterior fossa include Dandy-Walker variant, Joubert syndrome, tecto-cerebellar dysraphia, rhombencephalosynapsis, the neocerebellar hypoplasias, and cerebellar atrophy. Neuro-imaging features should enable the imager to provide the referring physician a logical approach to these complex posterior fossa malformations. PMID:21596278

Shekdar, Karuna

2011-06-01

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Pediatric Patient with a Rash  

Directory of Open Access Journals (Sweden)

Full Text Available A 2 year old fully immunized male with no personal history of chicken pox presented to the emergency department with a chief complaint of a rash for one week after returning from a hiking trip in a remote island in Canada. After initially being diagnosed with contact dermatitis, a diagnosis of herpes zoster was made by confirmatory viral polymerase chain reaction testing. The purpose of this case report is to examine the literature for the incidence and etiology of shingles in children without a prior history of a primary varicella rash outbreak.

Jared Sutton

2014-07-01

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Rash after treatment with anistreplase.  

OpenAIRE

A palpable purpura developed on the legs and lower abdomen of a woman of 54 five days after she was treated with anistreplase anisoylated plasminogen streptokinase activator complex (APSAC) for an acute myocardial infarction. Histological examination of a skin biopsy specimen taken 6 days after treatment showed leucocytoclastic vasculitis. The rash resolved within two weeks and there were no other complications.

Burrows, N.; Jones, R. R.

1990-01-01

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Posterior fossa tumor  

Science.gov (United States)

... look at the posterior fossa is with an MRI scan. CT scans are usually not helpful to see that area of the brain. The following procedures may be used to remove a piece of tissue from the tumor to help with diagnosis: Open ...

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Rash  

Science.gov (United States)

... you ate a new food, tried a new skin care product or took a new medication? Location and pattern. ... common. Allergic reactions. Avoid the specific food, medicine, skin care products or cosmetics that you had a reaction to. ...

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Rashes  

Science.gov (United States)

... ed. Wilderness Medicine . 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 57. Cydulka RK, Garber B. Dermatologic ... and Clinical Practice . 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 118. Armstrong CA. Examination of the ...

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Rash associated with Pregabalin: A case report  

OpenAIRE

A 48-year-old man with erythematous, maculopapularrash localized to his extremities and lumbar region thathe had been receiving oral pregabalin 300 mg per day for2 months to treat his neuropathy was applied. The Naranjoprobability scale indicates a probable relationship betweenthe development of rash and use of pregabalin byour patient. Pregabalin was discontinued and antihistaminictreatment, oral methyprednisolone and topical steroidcream were given to treat the rash. The rash almostcomplete...

Burak Uz; Ali Alkan; Hakan Göker; Nilgün Atakan; Osman ?lhami Özcebe

2013-01-01

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Approach to the Diseases with Rash  

OpenAIRE

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 diagno...

Gönül Tan?r

2009-01-01

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"Hot Tub Rash" and "Swimmer's Ear" (Pseudomonas)  

Science.gov (United States)

Facts About “Hot Tub Rash” and “Swimmer’s Ear” (Pseudomonas) What is Pseudomonas and how can it affect me? Pseudomonas (sue-doh- ... a major cause of infections commonly known as “hot tub rash” and “swimmer’s ear.” This germ is ...

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Image of Interest: A characteristic rash.  

OpenAIRE

A 15-year-old girl was admitted to the hospital with a four day history of fever (between 38 to39oC) and sore throat. There was also recent history of flooding in her town area. On examination,she had bleeding gums, blanching maculopapular rash all over her trunk and petechiae onher arms and legs. Her full blood count on admission showed pancytopenia. Panel A shows atypical rash over her back and Panel B was taken after placing fingers over the rash for a fewseconds.What is the diagnosis?Refe...

Misli, Hartini; Chong, Vui Heng

2011-01-01

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Variations in the cubital fossa  

Directory of Open Access Journals (Sweden)

Full Text Available The median nerve crosses in front of the brachial artery at the middle of the arm from lateral to medial side, and passes along its medial side. They appear in cubital fossa beneath bicipital aponeurosis and rest on brachialis muscle. In cubital fossa, structures lying from lateral to medial are tendon of biceps brachii, brachial artery and median nerve (TAN. No literature is available stating median nerve to be lateral to the brachial artery in the cubital fossa. In the present case, we found bilateral variations in the course of median nerve and brachial artery in the cubital fossa. The nerve was lateral to the artery. Both the structures passed deep to an accessory slip of brachialis muscle in the lower arm. It is a rare variation. Compression neuropathy of median nerve, vascular compression and injury to the median nerve during brachial catheterization can occur in such a case.

Biswas S

2010-08-01

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Posterior fossa craniotomy: technical report  

OpenAIRE

The use of craniotomy to approach supratentorial lesions is quite well established in the literature. The use of craniotomy for posterior fossa approaches, however, is not well described. The aim of this article is to describe the technical aspects of this approach and to delineate the important landmarks. In our cases, posterior fossa craniotomies have been utilized for treat different pathologies. Additionally, the technique has not added any additional risk, and the cosmetic results have b...

LANDEIRO JOSÉ ALBERTO; CASTRO IGOR DE; FLORES MARLO STEINER; MAIA JÚNIOR ORLANDO TEIXEIRA

2000-01-01

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Posterior Fossa Meningioma: Surgical Strategy  

OpenAIRE

Posterior fossa meningioma is the second most common tumor in the cerebellopontine angle. It has a higher rate of postoperative morbidity and mortality compared to acoustic neuroma. Forty posterior fossa meningioma patients managed in our centers were reviewed. Thirty-nine patients were managed surgically with 42 surgical procedures. The approaches used were the translabyrinthine approach in 18 patients (43%), the modified transcochlear in 11 cases (26%), the petro-occipital transsigmoid in 5...

Saleh, Essam A.; Taibah, Abdel Kader; Achilli, Vittorio; Aristegui, Miguel; Mazzoni, Antonio; Sanna, Mario

1994-01-01

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New Itchy Skin Rashes in Adults  

Science.gov (United States)

... dermatitis is an inflammatory rash caused by direct chemical injury to the skin. Unlike allergic contact dermatitis, which appears 48–72 hours after exposure to an allergen, the symptoms… Poison Ivy, Oak, and Sumac Poison ...

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Clay at Nili Fossae  

Science.gov (United States)

This image of the Nili Fossae region of Mars was compiled from separate images taken by the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) and the High-Resolution Imaging Science Experiment (HiRISE), two instruments on NASA's Mars Reconnaissance Orbiter. The images were taken at 0730 UTC (2:30 a.m. EDT) on Oct. 4, 2006, near 20.4 degrees north latitude, 78.5 degrees east longitude. CRISM's image was taken in 544 colors covering 0.36 to 3.92 micrometers, and shows features as small as 18 meters (60 feet) across. HiRISE's image was taken in three colors, but its much higher resolution shows features as small as 30 centimeters (1 foot) across. CRISM's sister instrument on the Mars Express spacecraft, OMEGA, discovered that some of the most ancient regions of Mars are rich in clay minerals, formed when water altered the planet's volcanic rocks. From the OMEGA data it was unclear whether the clays formed at the surface during Mars' earliest history of if they formed at depth and were later exposed by impact craters or erosion of the overlying rocks. Clays are an indicator of wet, benign environments possibly suitable for biological processes, making Nili Fossae and comparable regions important targets for both CRISM and HiRISE. In this visualization of the combined data from the two instruments, the CRISM data were used to calculate the strengths of spectral absorption bands due to minerals present in the scene. The two major minerals detected by the instrument are olivine, a mineral characteristic of primitive igneous rocks, and clay. Areas rich in olivine are shown in red, and minerals rich in clay are shown in green. The derived colors were then overlayed on the HiRISE image. The area where the CRISM and HiRISE data overlap is shown at the upper left, and is about 5 kilometers (3 miles) across. The three boxes outlined in blue are enlarged to show how the different minerals in the scene match up with different landforms. In the image at the upper right, the small mesa -- a flat-topped hill -- at the center of the image is a remnant of an overlying rock layer that was eroded away. The greenish clay areas at the base of the hill were exposed by erosion of the overlying rock. The images at the upper right and lower left both show that the reddish-toned olivine occurs as sand dunes on top of the greenish clay deposits. The image at the lower right shows details of the clay-rich rock, including that they are extensively fractured into small, polygonal blocks just a few meters in size. Taken together, the CRISM and HiRISE data show that the clay-rich rocks are the oldest at the site, that they are exposed where overlying rock has been eroded away, and that the olivine is not part of the clay-rich rock. Rather it occurs in sand dunes blowing across the clay. Many more images of Nili Fossae and other clay-rich areas will be taken over the next two years. They will be used to try to understand the earliest climate of Mars that is recorded in the planet's rocks. The Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) is one of six science instruments on NASA's Mars Reconnaissance Orbiter. Led by The Johns Hopkins University Applied Physics Laboratory, the CRISM team includes expertise from universities, government agencies and small businesses in the United States and abroad. CRISM's mission: Find the spectral fingerprints of aqueous and hydrothermal deposits and map the geology, composition and stratigraphy of surface features. The instrument will also watch the seasonal variations in Martian dust and ice aerosols, and water content in surface materials o leading to new understanding of the climate. NASA's Jet Propulsion Laboratory, a division of the Califonia Institute of Technology, Pasadena, manages the Mars Reconnaissance Orbiter for the NASA Science Mission Directorate, Washington. Lockheed Martin Space Systems, Denver, is the prime contractor and built the spacecraft.

2006-01-01

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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

2009-05-01

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Side Effects of HIV Medicines: HIV and Rash  

Science.gov (United States)

Key Points A rash is an irritated area of the skin that is sometimes itchy, red, and painful. Possible causes of rash in people with HIV include HIV infection itself, other infections, HIV medicines, and other medicines. Rash is among the most ...

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Traumatic posterior fossa epidural hematoma  

International Nuclear Information System (INIS)

In this paper three acute cases and two subacute cases are reported. CT findings in acute cases show two different types. ''Type I'' shows crescent or lenticular high density area which is not enhanced after contrast infusion. ''Type II'' shows lenticular low density area with membranous high density region in its medial side after contrast infusion. In subacute cases plain CT scan shows lenticular iso or low density area with membranous high density region in its medial side. Forty five cases of posterior fossa epidural hematoma in the review of literature of this country are discussed. Disturbances of the consciousness are the most predominant symptoms in acute cases, while in subacute cases cerebellar signs, vomiting, headache and choked disc are noted. Angiographical examinations may not always be valuable in collecting the direct information of the existence of the epidural hematoma. Liquor cavity in the posterior fossa which is thought to serve as a buffer action of hematoma is about 20 ml, so we discuss about the volume of hematoma, especially of 20 ml, associated with clinical course and prognosis. Volume of epidural hematoma is one of the most important factors affecting clinical course and prognosis. In summary of these our experiences, we again emphasize the value of CT scan as the rapid, noninvasive, accurate radiological examination in the diagnosis of traumatic posterior fossa epidural hematoma. (author)

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Methylenetetrahydrofolate reductase (MTHFR) deficiency presenting as a rash.  

LENUS (Irish Health Repository)

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, Ellen

2012-09-01

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Leflunomide Induced Drug Rash And Hepatotoxicity  

OpenAIRE

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 chole...

Uppal Monica; Rai Reena; Srinivas C.R

2004-01-01

28

Seizure-induced periorbital petechial rash  

OpenAIRE

A 58-year-old man was admitted after a generalized tonic-clonic seizure. The neurological examination was normal, except for bilateral periorbital, enoral and superior thoracic petechiae, which had only occurred after the seizure. The blood pressure, CT scan of the brain and routine laboratory were unremarkable. Seizure-related petechial rash is a rare finding that might be helpful for the diagnosis of an epileptic event in the absence of other objective signs [1, 2] . It ma...

Roth, P.; Zumsteg, D.

2009-01-01

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Clonazepam induced maculopapular rash: a case report  

OpenAIRE

Clonazepam is a benzodiazepine with prominent anticonvulsant action than other members of the group at equisedating doses. It especially blocks pentylenetetrazole-induced seizures. Other important actions include anxiolysis. Common adverse effects to Clonazepam include drowsiness and lethargy. In this submission we report a case of Clonazepam induced maculopapular rash in a 30 year old female treated for panic disorder. [Int J Basic Clin Pharmacol 2013; 2(5.000): 647-649

Mabu Shareef, S.; Sai Krishna, P.; Tadvi, Naser A.; Naidu, C. Dinesh M.

2013-01-01

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NATACIÓN (1915. SANTIAGO MESTRES FOSSAS (SWIMMING - 1915 - SANTIAGO MESTRES FOSSAS  

Directory of Open Access Journals (Sweden)

Full Text Available Resumen: Este artículo resume el libro de Santiago Mestres Fossas titulado “Natación”, escrito en 1915, apenas ocho años después del comienzo de la historia de la natación en España. Con este texto el autor no pretende enseñar a nadar, sino servir como soporte teórico y metodológico a aquellos que quieran acompañar a los que no saben nadar y a los nadadores más experimentados en su camino de aprendizaje y perfeccionamiento. Las cualidades esenciales de la natación, los estilos, los concursos, los juegos en el agua y una introducción al salvamento acuático son los temas que aborda el autor en este libro pionero en la natación española.Abstract: This article is a review of Santiago Mestres Fossas’ book intitled “Natación“ , published in1915, just eigth years after the beginning of Spanish swimming History. The book was notoriented to teach those who do not swim, but to support their teachers, as well as the proficience swimmers. The main focuses are: essential swimming qualities, stiles, competitions, water games and introduction to lifesaving.

María Cuesta Salvador

2010-04-01

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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

2004-01-01

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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

2012-12-01

33

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  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: English Abstract in spanish La 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 cruzad [...] os, 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 Abstract in english 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): 9-14

Luis José, Cespedes; Camilo, Turriago; Jairo, Goyeneche.

2012-12-01

34

Computed tomography of posterior fossa tumor  

Energy Technology Data Exchange (ETDEWEB)

58 case of proven primary posterior fossa tumor examined by CT scanner were analyzed. The CT appearance in acoustic neurinoma, trigeminal neurinoma, meningioma, dermoid, astrocytoma, hemangioblastoma, medulloblastoma, and ependymoma are described and the differential diagnosis are discussed.

Suh, J. H.; Suh, C. O.; Park, C. Y. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

1980-06-15

35

Computed tomography of posterior fossa tumor  

International Nuclear Information System (INIS)

58 case of proven primary posterior fossa tumor examined by CT scanner were analyzed. The CT appearance in acoustic neurinoma, trigeminal neurinoma, meningioma, dermoid, astrocytoma, hemangioblastoma, medulloblastoma, and ependymoma are described and the differential diagnosis are discussed.

36

Geometric morphometrics of hominoid infraspinous fossa shape.  

Science.gov (United States)

Recent discoveries of early hominin scapulae from Ethiopia (Dikika, Woranso-Mille) and South Africa (Malapa) have motivated new examinations of the relationship between scapular morphology and locomotor function. In particular, infraspinous fossa shape has been shown to significantly differ among hominoids. However, this region presents relatively few homologous landmarks, such that traditional distance and angle-based methods may oversimplify this three-dimensional structure. To more thoroughly assess infraspinous fossa shape variation as it relates to function among adult hominoid representatives, we considered two geometric morphometric (GM) approaches-one employing five homologous landmarks ("wireframe") and another with 83 sliding semilandmarks along the border of the infraspinous fossa. We identified several differences in infraspinous fossa shape with traditional approaches, particularly in superoinferior fossa breadth and scapular spine orientation. The wireframe analysis reliably captured the range of shape variation in the sample, which reflects the relatively straightforward geometry of the infraspinous fossa. Building on the traditional approach, the GM results highlighted how the orientation of the medial portion of the infraspinous fossa differed relative to both the axillary border and spine. These features distinguished Pan from Gorilla in a way that traditional analyses had not been able to discern. Relative to the wireframe method, the semilandmark approach further distinguished Pongo from Homo, highlighting aspects of infraspinous fossa morphology that may be associated with climbing behaviors in hominoid taxa. These results highlight the ways that GM methods can enhance our ability to evaluate complex aspects of shape for refining and testing hypotheses about functional morphology. Anat Rec, 298:180-194, 2015. © 2014 Wiley Periodicals, Inc. PMID:25339150

Green, David J; Serrins, Jesse D; Seitelman, Brielle; Martiny, Amy R; Gunz, Philipp

2015-01-01

37

Not all that rashes is measles:  

International Nuclear Information System (INIS)

Measles is a major cause of infant mortality in third world countries, leading to approximately one million deaths each year. The WHO aims to globally eradicate measles virus at the beginning of the next century, which will need a major effort in particular in countries like Sudan. To achieve goal epidemiological studies I am needed to estimate the magnitude of the problem for which accurate diagnostic test are needed. We therefore conducted a study in El hag Yousif area (population 500 000) in Khartoum North where measles is prevalent despite vaccination effort by EPI. We studied the accuracy of the WHO criteria for clinical diagnosis in comparison with laboratory diagnosis during a one-year period. A total of 145 under five suspected measles cases were identified by active, case finding and examined. 111 cases fully complied with the WHO criteria for diagnosis of clinical measles. Out of 103 clinical measles cases, tested using prototype rapid measles test IgM Elisa and Pcr, 77(75%) were measles positive. A battery of virus test was run on 21 sera out of the 26(25%) measles negatives: Herpes virus-6, Epstein-Bar and Dengue viruses were detected in five, one and one case, respectively. It was concluded that one out of every four cases diagnosed by the clinical as measles rash is probably caused by other viruses. (Author)

38

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 SciELO Chile | Language: Spanish 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 veces 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 hypocel [...] lular 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 adverse reactions simultaneously with phenytoin: a maculopapular pruritic rash with involvement of mucous and an aplastic anemia. Both conditions normalized after phenytoin withdrawal.

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

39

Setting the Record Straight on Diaper Rash and Disposable Diapers.  

Science.gov (United States)

Skin in the diapered area is continuously threatened by exposure to changes in pH levels, overhydration, mechanical friction, and fecal enzymes, making diaper rash a common occurrence among babies. Up to one third of infants may exhibit clinical symptoms of diaper rash at any time, and more than half of babies between the ages of 4 and 15 months develop diaper rash at least once in a 2-month period. Despite misperceptions that disposable diapers are related to an increase in diaper rash, the incidence of diaper dermatitis is on the decline, largely due to significant improvements in disposable diaper construction and materials. Modern-day disposable diapers are specifically designed to limit exposure to irritants in the diaper area, reduce overhydration, inhibit skin barrier compromise, and help maintain normal skin pH levels and have been thoroughly evaluated for safety and skin compatibility. PMID:24961777

Clark-Greuel, Jocelyn N; Helmes, C Tucker; Lawrence, Ann; Odio, Mauricio; White, Jeffrey C

2014-06-24

40

Red, Itchy Rash? Get the Skinny on Dermatitis  

Science.gov (United States)

... more allergic to things.” A skin allergy, or allergic contact dermatitis, produces a red, itchy rash that sometimes comes ... of dermatitis that is seen anywhere is an allergic contact dermatitis to nickel,” says Katz. “Why? Because of ear ...

41

Arachnoid cyst of the middle cranial fossa  

International Nuclear Information System (INIS)

The middle cranial fossa is the most common site for intracranial arachnoid cysts. Galassi and his associates have provided a useful classification of middle fossa arachnoid cysts based on their computed tomographic appearances. The Type I cyst is a small lenticular lesion. The Type II cyst is quadrangular in shape, reflecting a completely open insula. The Type III cyst appears as a large area of smoothly rounded lucency, with a significant compression of the brain. We report a 2-year-old boy with a middle fossa arachnoid cyst. This cyst differed from the type of Galassi's classification in its extension. Computerized tomograms showed low-density lesions of the bilateral middle cranial fossa and suprasellar area, which was not enhanced with contrast medium. Magnetic Resonance Imaging (MRI) showed a CSF-like pattern (Kjos) and revealed delicate anatomical structures in the surrounding brain. Arachnoid cysts are usually single lesions. However, not infrequently these cystic cavities may be divided by membranous septa into two or more compartments. Bilateral, more or less symmetrical arachnoid cysts in the middle cranial fossa as seen in this patient, however, seem to be very rare. Only a few such cases have been reported previously. MRI was superior to X-ray CT in characterizing intracranial cystic lesions because of its ability to categorize cysts into Kjos's three groups on the basis of the intensity pattern of the cyst contents, thereby improving diagnostic specificits, thereby improving diagnostic specificity and patient management. (author)

42

Radiographic imaging of the canine intercondylar fossa  

International Nuclear Information System (INIS)

The intercondylar fossa is believed to play an important role in the pathology of cranial cruciate ligament rupture and therefore has received considerable attention in the last decade. Accurate radiographic imaging of the intercondylar fossa requires that the central x-ray beam pass through the center of the intercondylar “tunnel”. The anatomy of the canine intercondylar fossa is similar to humans, however, the orientations of the intercondylar fossa's differ. Consequently, the positioning techniques described for humans are not appropriate for the dog. To pass through the center of the dog, intercondylar fossa, the central x-ray beam should be 12° (S.D. 1.7°) caudal from the femoral diaphysis in the sagittal plane and obliqued caudolateral to craniomedial 7° (S.D. 0.60°) (caudo78°proximo7° lateralcraniodistomedial oblique). Cross table positioning was used with the hip flexed and the radiograph cassette placed on the cranial surface of the stifle. However, superimposition of the tuber ischii and soft tissues caudal to the femur made 15° to 20° the best angle obtainable. There was not a significant difference (p = 0.17) in the notch width index between a 12° versus 20° angle of the central x-ray beam caudal to the femoral diaphysis, both with 7° of external rotation of the stifle. The notch width index of 0.252 obtained from radiographic measurements was not significantly different from measurements obtained grossly of 0.254 (n = 26; p = 0.69). Failure to oblique the central x-ray beam caused a significant (p = 0.0008) decrease in the apparent fossa width radiographically

43

[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

2010-10-01

44

[Hydatid cyst of the posterior fossa].  

Science.gov (United States)

Hydatidosis is an endemic affection in Tunisia. 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. We report the case of a four-year-old child admitted for high intracranial pressure. Brain CT scan showed an extradural posterior fossa cyst without enhancement after contrast medium injection. Operative finding revealed a hydatid cyst. The histological examination of the tissue sample confirmed the diagnosis. The patient was given albendazole post operatively. She feels well six months later. PMID:17434701

Braham, E; Bellil, S; Bellil, K; Chelly, I; Mekni, A; Haouet, S; Kchir, N; Khaldi, M; Zitouna, M

2007-05-01

45

Proximal dentatothalamocortical tract involvement in posterior fossa syndrome  

OpenAIRE

Posterior fossa syndrome is characterized by cerebellar dysfunction, oromotor/oculomotor apraxia, emotional lability and mutism in patients after infratentorial injury. The underlying neuroanatomical substrates of posterior fossa syndrome are unknown, but dentatothalamocortical tracts have been implicated. We used pre- and postoperative neuroimaging to investigate proximal dentatothalamocortical tract involvement in childhood embryonal brain tumour patients who developed posterior fossa syndr...

Morris, E. Brannon; Phillips, Nicholas S.; Laningham, Fred H.; Patay, Zoltan; Gajjar, Amar; Wallace, Dana; Boop, Frederick; Sanford, Robert; Ness, Kirsten K.; Ogg, Robert J.

2009-01-01

46

Posterior fossa craniotomy: technical report Craniotomia na fossa posterior: relato técnico  

Directory of Open Access Journals (Sweden)

Full Text Available The use of craniotomy to approach supratentorial lesions is quite well established in the literature. The use of craniotomy for posterior fossa approaches, however, is not well described. The aim of this article is to describe the technical aspects of this approach and to delineate the important landmarks. In our cases, posterior fossa craniotomies have been utilized for treat different pathologies. Additionally, the technique has not added any additional risk, and the cosmetic results have been excellent.O uso de craniotomia para tratamento de lesões supratentoriais se encontra consagrado na literatura. Entretanto, o uso de craniotomia na fossa posterior é pouco descrito. O objetivo deste estudo é descrever os aspectos técnicos dessa abordagem e delinear algumas importantes referências anatômicas. Em nossos casos, as craniotomias na fossa posterior foram utilizadas para tratar patologias diferentes O procedimento provou ser seguro, não trazendo qualquer risco adicional aos pacientes e os resultados estéticos foram excelentes.

JOSÉ ALBERTO LANDEIRO

2000-03-01

47

Posterior fossa craniotomy: technical report Craniotomia na fossa posterior: relato técnico  

OpenAIRE

The use of craniotomy to approach supratentorial lesions is quite well established in the literature. The use of craniotomy for posterior fossa approaches, however, is not well described. The aim of this article is to describe the technical aspects of this approach and to delineate the important landmarks. In our cases, posterior fossa craniotomies have been utilized for treat different pathologies. Additionally, the technique has not added any additional risk, and the cosmetic results have b...

JOSÉ ALBERTO LANDEIRO; IGOR DE CASTRO; MARLO STEINER FLORES; ORLANDO TEIXEIRA MAIA JÚNIOR

2000-01-01

48

Herpes zoster meningitis with multidermatomal rash in an immunocompetent patient.  

Science.gov (United States)

A case of herpetic rash in an immunocompetent patient is described, which was present in multiple dermatomes at the same time. First, patient was thought to have immunodeficiency, but further workup turned out to be negative for it. Patient also had pleocytic lymphocytosis in cerebrospinal fluid, which was suggestive of viral meningitis. Later, the patient responded well to the acyclovir therapy and was discharged home without any sequel. This case illustrates the need for emergency physicians to be extra vigilant for involvement of other dermatomes in case a patient presents with herpetic rash in 1 dermatome because patients with multidermatomal/disseminated herpetic rash need to be started on airborne isolation in addition to contact precautions to prevent the transmission of disease in health care settings. PMID:23891595

Goyal, Hemant; Thakkar, Nirav; Bagheri, Farshad; Srivastava, Sneha

2013-11-01

49

Dermoid cyst of the posterior fossa.  

Science.gov (United States)

Intracranial dermoid tumors represent a rare clinical entity accounting for 0.1-0.7% of all intracranial tumors. Their location in the posterior fossa is uncommon. We report a 16-year-old male patient who presented with clinical signs of increased intracranial pressure and cerebellar symptoms. The CT scan revealed a median cystic lesion of the fourth ventricle causing an active triventicular hydrocephalus. The MRI showed a median well shaped cystic lesion, of low signal intensity compared to the CSF, with capsular contrast enhancement. He underwent endoscopic third ventriculostomy before subtotal removal of the lesion. The postoperative course was uneventful, and the histological diagnosis was a dermoid cyst. Through this observation, we aim to discuss the clinical, and radiological aspects of the posterior fossa dermoid cyst, and to review the therapeutic strategies. PMID:21427666

Benzagmout, Mohammed; Agharbi, Sanae; Chakour, Khalid; Chaoui, Mohammed E

2011-04-01

50

Petrous apex and subarcuate fossa maturation.  

Science.gov (United States)

During the first year of life, the bone of the petrous apex grows rapidly. At birth, only 5 mm of bone separates the cochlea from Dorello's canal as compared to 2 cm in the adult. More than half this growth occurs during the first year of life. The subarcuate fossa is a cavity within the superior semicircular canal which reaches from the posterior fossa to the future mastoid in fetuses and nearly to the mastoid antrum in newborns. During the second year of left it is nearly obliterated to form a shallow depression or slit on the posterior aspect of the temporal bone and the variable petromastoid canal which contains the subarcuate artery and vein. Clinical petrositis of infants less that 1 year of age is rare, and provides a challenge for surgery. A case is reported and discussed. PMID:3657358

Hilding, D A

1987-10-01

51

Choroid plexus papilloma in the posterior fossa.  

Science.gov (United States)

Choroid plexus papillomas in the posterior fossa can present with different clinical signs and symptoms. The tumors in the patients we discuss in this article originated from different sites of the choroid plexus. One patient, who had a fourth ventricle papilloma, experienced unsteady gait and episodes of dizziness over many years. The tumor was cystic an calcified, and adherent to the brain-stem. The second patient had only signs of increased intracranial pressure. A soft tumor was located in the cerebellomedullary cistern. The third patient, with a papilloma in the cerebellopontine angle, complained of hearing loss. This tumor was firmly adherent to the dura mater and looked exactly like a meningioma. The appearance on computed tomography scan, the macroscopic aspect, and the vascular supply of a papilloma in the posterior fossa can vary considerably. PMID:3496674

van Swieten, J C; Thomeer, R T; Vielvoye, G J; Bots, G T

1987-08-01

52

SURGICAL TREATMENT OF POSTERIOR CEREBRAL FOSSA MENINGIOMA  

OpenAIRE

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 ten...

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

2010-01-01

53

[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

54

Extensive VZV Encephalomyelitis without Rash in an Elderly Man  

Science.gov (United States)

Introduction. Varicella zoster virus (VZV) encephalomyelitis with cranial nerve involvement is rare. Characteristically it is preceded by a rash and primarily presents in the immunocompromised. The spectrum of VZV neurologic disease is extensive and it is not uncommon to present without rash. We report the case of an elderly otherwise immunocompetent patient who presented with diverse manifestations of VZV CNS infection all occurring without rash. Case Report. A 78-year-old man presented with 1 week of progressive paraparesis and sensory loss, malaise, and fevers. MRI of the neuraxis demonstrated numerous enhancing lesions: intramedullary, leptomeningeal, pachymeningeal, and cranial nerves. Cerebrospinal fluid (CSF) showed a white blood cell count of 420/?L with elevated protein (385?mg/dL). CSF VZV qualitative PCR was positive and CSF VZV immunofluorescence assay detected IgM antibody, confirming the diagnosis of VZV encephalomyelitis. Clinical and radiological improvement was observed after intravenous acyclovir treatment. Conclusion. This is a rare report of an immunocompetent patient with extensive VZV encephalomyelitis. We highlight the importance of considering this diagnosis even in the absence of the characteristic rash, and the potential risk of premature discontinuation of antiviral therapy once HSV has been excluded. Prompt recognition and treatment can dramatically reduce morbidity and mortality in patients. PMID:24864218

Agarwal, Prakhar

2014-01-01

55

[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

56

Diagnostic imaging of posterior fossa anomalies in the fetus and neonate: part 2, posterior fossa disorders.  

Science.gov (United States)

This second portion of a two-part review illustrates examples of posterior fossa disorders detectable on prenatal ultrasound and MRI, with postnatal or pathology correlation where available. These disorders are discussed in the context of an anatomic classification scheme described in Part 1 of this posterior fossa anomaly review. Assessment of the size and formation of the cerebellar hemispheres and vermis is critical. Diagnoses discussed here include arachnoid cyst, Blake's pouch cyst, Dandy-Walker malformation, vermian agenesis, Joubert syndrome, rhombencephalosynapsis, Chiari II malformation, ischemia, and tumors. PMID:25457569

Chapman, Teresa; Mahalingam, Sowmya; Ishak, Gisele E; Nixon, Jason N; Siebert, Joseph; Dighe, Manjiri K

2014-10-22

57

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

Energy Technology Data Exchange (ETDEWEB)

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.

Choi, Jin Woo; Heo, Min Suk; Lee, Jin Koo; Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of); An, Chang Hyeon [Kyungpook National University College of Medicine, Daegu (Korea, Republic of)

2004-12-15

58

Cerebellopontine angle facial schwannoma relapsing towards middle cranial fossa  

OpenAIRE

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. ...

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

2011-01-01

59

[The jugular fossa--observations in a Norwegian medieval population].  

Science.gov (United States)

A high jugular bulb and fossa has been observed in cases of bleeding complications in neur-otologic surgery, conductive and sensori-neural hearing loss, tinnitus and vertigo. Comparison of 311 skulls from the Oslo mediaeval material with data from other studies showed good agreement regarding the frequency of high fossae, dehiscences, and side and sex differences. The correlation (Pearson's r) of fossa size between the two sides, with the right as the independent variable, and also the correlation between foramen size and fossa depth was less than expected from descriptions in anatomical texts based on visual observations. PMID:10228416

Ongre, A

1999-03-20

60

Posterior fossa craniotomy: technical report / Craniotomia na fossa posterior: relato técnico  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese O uso de craniotomia para tratamento de lesões supratentoriais se encontra consagrado na literatura. Entretanto, o uso de craniotomia na fossa posterior é pouco descrito. O objetivo deste estudo é descrever os aspectos técnicos dessa abordagem e delinear algumas importantes referências anatômicas. E [...] m nossos casos, as craniotomias na fossa posterior foram utilizadas para tratar patologias diferentes O procedimento provou ser seguro, não trazendo qualquer risco adicional aos pacientes e os resultados estéticos foram excelentes. Abstract in english The use of craniotomy to approach supratentorial lesions is quite well established in the literature. The use of craniotomy for posterior fossa approaches, however, is not well described. The aim of this article is to describe the technical aspects of this approach and to delineate the important lan [...] dmarks. In our cases, posterior fossa craniotomies have been utilized for treat different pathologies. Additionally, the technique has not added any additional risk, and the cosmetic results have been excellent.

JOSÉ ALBERTO, LANDEIRO; IGOR DE, CASTRO; MARLO STEINER, FLORES; ORLANDO TEIXEIRA, MAIA JÚNIOR.

2000-03-01

61

Poison Ivy Taking the Itch Out of the Rash  

Science.gov (United States)

A longstanding belief that has it roots in Native American folklore is that the crushed leaves of jewelweed (Impatiens capensis) relieve the skin's allergic reaction to the toxin of poison ivy (Toxicodendron radicans). This case was developed for an introductory majors or non-majors biology or plant class. It first examines students' conceptions about the rash of poison ivy, what in the plant causes the rash, and how the body responds to the toxin. Then students in small groups plan an experiment using the scientific method to test the ability of jewelweed to reduce the reaction. Following a comparison of experimental designs from different groups, data from a scientific paper is presented for interpretation and analysis. An important outcome of this case is that students recognize the need for evaluating myths and misconceptions using scientific evidence.

Ford, Rosemary H.

2011-01-01

62

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

2010-11-01

63

Respuesta anómala de anticuerpos de infecciones virales productoras de rash  

OpenAIRE

Se estudiaron 20 pares de sueros provenientes del Sistema de Vigilancia Seroepidemiológica Nacional de la vacuna triple viral que llegaron al laboratorio con el diagnóstico de rash febril. Mediante la técnica de inhibición de la hemaglutinación se observó una respuesta anormal de nticuerpos, tanto a rubeola como a sarampión, manifiesta por una caída del título de anticuerpos a una o ambas entidades o a una de ellas con seroconversión a la otra. Con el objetivo de definir la respuest...

SONIA RESIK AGUIRRE; Sariol Curbelo, Carlos A.; MARITZA ALVAREZ VEGA; MIGUEL MARRERO SUAREZ

1996-01-01

64

Extended Middle Cranial Fossa Approach for Acoustic Neuroma Surgery  

OpenAIRE

The enlarged middle cranial fossa approach was used for removal of acoustic neuromas in 209 cases. Complete tumor removal was accomplished in 96% of cases. Hearing was preserved in 51% of cases, with better results in smaller tumors. Our experience with the enlarged middle fossa approach has led us to discard the translabyrinthine approach for removal of acoustic neuromas.

Wigand, Malte E.; Haid, Toni; Berg, Michael; Schuster, Bernd; Goertzen, Winfried

1991-01-01

65

MRI diagnosis of posterior fossa tumors  

International Nuclear Information System (INIS)

Magnetic resonance images (MRI) of 58 patients with posterior fossa tumors were compared with computed tomography (CT). Spin echo (SE) technique and inversion recovery (IR) technique were obtained using 0.22 tesla resistive magnetic resonance unit. MRI was superior to CT in detecting the lesions and showing internal archtecture, hemorrhage, edema of the tumor and displacement of the normal brain. CT was superior to MRI in demonstrating calcification. MRI and CT were comparable in detecting erosions of the skull base, while MRI was superior to CT in showing erosions of the clivus. Most tumors showed hypointensity on T1 weighted images and hyperintensity on T2 weighted images. Meningioma showed equal or almost equal intensity to cerebral gray matter on both SE images. The boundary of intra-axial tumors was unclear in many cases without contrast enhancement using Gd-DTPA, while most extra-axial tumors showed clear margin surrounded by a thin band (rim). In 81.8 % of acoustic neurinomas, signal void rims were demonstrated on both SE images, and they were considered to be vessels around the tumor. The rims of meningioma, on the other hand, were hypointense on T1 weighted images and hyperintense on T2 weighted images. They were considered to be cerebrospinal fluid or capsule around the tumor. It has been concluded that MRI is the most important technique for diagnosis of posterior fossa tumors. (author)

66

MRI diagnosis of posterior fossa tumors  

Energy Technology Data Exchange (ETDEWEB)

Magnetic resonance images (MRI) of 58 patients with posterior fossa tumors were compared with computed tomography (CT). Spin echo (SE) technique and inversion recovery (IR) technique were obtained using 0.22 tesla resistive magnetic resonance unit. MRI was superior to CT in detecting the lesions and showing internal archtecture, hemorrhage, edema of the tumor and displacement of the normal brain. CT was superior to MRI in demonstrating calcification. MRI and CT were comparable in detecting erosions of the skull base, while MRI was superior to CT in showing erosions of the clivus. Most tumors showed hypointensity on T1 weighted images and hyperintensity on T2 weighted images. Meningioma showed equal or almost equal intensity to cerebral gray matter on both SE images. The boundary of intra-axial tumors was unclear in many cases without contrast enhancement using Gd-DTPA, while most extra-axial tumors showed clear margin surrounded by a thin band (rim). In 81.8 % of acoustic neurinomas, signal void rims were demonstrated on both SE images, and they were considered to be vessels around the tumor. The rims of meningioma, on the other hand, were hypointense on T1 weighted images and hyperintense on T2 weighted images. They were considered to be cerebrospinal fluid or capsule around the tumor. It has been concluded that MRI is the most important technique for diagnosis of posterior fossa tumors.

Yamashita, Yasuyuki; Takahashi, Mutsumasa; Sakamoto, Yuuji; Kojima, Ryutarou; Bussaka, Hiromasa; Korogi, Yukunori

1988-02-01

67

Acute Spontaneous Posterior Fossa Subdural Hematoma  

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Full Text Available Acute posterior fossa subdural hematomas are rare and most of them are trauma-related. Non-traumatic ones have been reported in patients who had idiopathic thrombocytopenic purpura or those who had been receiving anticoagulant therapy. We report on the case of 57-year-old Iranian man who developed sudden severe occipital headache, drowsiness, repeated vomiting, and instability of stance and gait. He was neither hypertensive nor diabetic. No history of head trauma was obtained and he denied illicit drug or alcohol ingestion. A preliminary diagnosis of acute intra-cerebellar hemorrhage was made. His CT brain scan revealed an acute right-sided, extra-axial, crescent-shaped hyperdense area at the posterior fossa. His routine blood tests, platelets count, bleeding time, and coagulation profile were unremarkable. The patient had spontaneous acute infratentorial subdural hematoma. He was treated conservatively and discharged home well after 5 days. Since then, we could not follow-up him, clinically and radiologically because he went back to Iran. Our patient?s presentation, clinical course, and imaging study have called for conservative management, as the overall presentation was relatively benign. Unless the diagnosis is entertained and the CT brain scan is well-interpreted, the diagnosis may easily escape detection.

Osama Shukir Muhammed Amin

2014-02-01

68

Respuesta anómala de anticuerpos de infecciones virales productoras de rash  

Directory of Open Access Journals (Sweden)

Full Text Available Se estudiaron 20 pares de sueros provenientes del Sistema de Vigilancia Seroepidemiológica Nacional de la vacuna triple viral que llegaron al laboratorio con el diagnóstico de rash febril. Mediante la técnica de inhibición de la hemaglutinación se observó una respuesta anormal de nticuerpos, tanto a rubeola como a sarampión, manifiesta por una caída del título de anticuerpos a una o ambas entidades o a una de ellas con seroconversión a la otra. Con el objetivo de definir la respuesta de anticuerpos a la familia Herpesviridae (HSV, EBV, CMV, VZV, se encontró el 80 % de la respuesta a estos virus. Los resultados se presentan y se iscuten.

SONIA RESIK AGUIRRE

1996-04-01

69

Role of cerebrospinal fluid diversion in posterior fossa tumor surgery  

International Nuclear Information System (INIS)

Objective: To assess the role of cerebrospinal fluid diversion in posterior fossa tumor surgery. Results: There were 48 patients who were operated for posterior fossa tumors. Mean age was 23 years. Male to female ratio was 1.2:1. VPS was done in 14 patients (29%) pre-operatively, in one patient (2%) per-operatively and in 2 patients (4%) postoperatively. EVD was done in 33 patients out of whom 2 patients were shunted post-operatively. Sixty-five percent of the patients remained shunt-free. Conclusion: Although management of hydrocephalus secondary to posterior fossa tumors is controversial, majority of the patients need temporary cerebrospinal fluid diversion. (author)

70

Pyriform fossa carcinoma in South African Negro patients.  

Science.gov (United States)

Seven patients with pyriform fossa carcinoma who presented at Baragwanath Hospital during the period 1973-1976 are discussed. The value of positive contrast studies with special reference to laryngography is emphasized and the results are reviewed. PMID:918795

Fernandes, C M; Solomon, A

1977-09-17

71

Microsurgical Posterior Fossa Vestibular Neurectomy: An Evolution in Technique  

OpenAIRE

Between 1925 and 1945, Walter Dandy and Kenneth McKenzie performed more than 700 posterior fossa eighth nerve sections and vestibular neurectomies, treating the intractable vertigo accompanying Meniere's disease. During the past 10 years, using microsurgical techniques and reaching the posterior fossa through the temporal bone, vestibular neurectomy has enjoyed a resurgence of popularity. When hearing is to be preserved, vestibular neurectomy is the surgical treatment of choice, if the patien...

Silverstein, Herbert; Norrell, Horace; Wanamaker, Hayes; Flanzer, John

1991-01-01

72

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

Science.gov (United States)

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. PMID:22030172

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

2012-02-01

73

Solitary fibrous tumor of the infratemporal fossa: A case report  

OpenAIRE

First described as a pleural neoplasm, the solitary fibrous tumor (fibrous mesothelioma) has been reported in a number of extrapulmonary sites, including the Head-Neck region. In the Head-Neck region, it has been described in the sinonasal tract, epiglottis, parapharyngeal, retropharyngeal spaces, parotid and infratemporal fossa. We present the second case of solitary fibrous tumor of infratemporal fossa described in world literature. A complete excision was achieved by transmaxillary approach.

Naresh, K. Panda; Parida Pradipta, K.; Mahesha, V.; Ashim, Das

2007-01-01

74

Functional morphology of the neandertal scapular glenoid fossa.  

Science.gov (United States)

Neandertals and Homo sapiens are known to differ in scapular glenoid fossa morphology. Functional explanations may be appropriate for certain aspects of glenoid fossa morphology; however, other factors-e.g., allometry, evolutionary development-must be addressed before functional morphology is considered. Using three-dimensional geometric morphometrics, shape of the scapular glenoid fossa was compared among Neandertals, early and recent modern humans, chimpanzees, orangutans, Australopithecus afarensis, and Au. sediba. Permutation analysis revealed that side, sex, and lifestyle did not correlate with shape. Of the features we found to differ between groups, anterior glenoid rim morphology and fossa curvature did not correlate with the aforementioned shape variables; thus, a functional explanation is appropriate for these components of glenoid fossa shape. Shared morphology among recent humans and chimpanzees (to the exclusion of Neandertals and orangutans) suggests independent forces contributing to these morphological configurations. Potential explanations include adaptations to habitual behavior and locomotor adaptations in the scapulae of recent humans and chimpanzees; these explanations are supported by clinical and experimental literature. The absence of these morphological features in Neandertals may support the lack of these selective forces on their scapular glenoid fossa morphology. Anat Rec, 298:168-179, 2015. © 2014 Wiley Periodicals, Inc. PMID:25339238

Macias, Marisa E; Churchill, Steven E

2015-01-01

75

Estudo eletrencefalográfico das afecções cirúrgicas da fossa posterior / Electroencephalography in posterior fossa lesions  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Os resultados eletrencefalográficos em 22 casos verificados de afecção cirúrgica da fossa posterior, obtidos com uma rotina de exame detalhado como preconiza Bagchi, são relatados de modo sintético, em quadros comparativos entre dados eletrencefalográficos e neurocirúrgicos. Dessa análise podem-se d [...] eduzir as seguintes idéias conclusivas: 1. Dos 22 casos estudados, 9 foram normais e 13 anormais. Entre as anormalidades eletrencefalográficas destacamos: a) surtos de ondas bilaterais e síncronas, substituindo o ritmo de base, de potencial ligeiramente superior ao de base e de freqüência 4 a 7 c/s (ritmo ?) : b) ondas lentas e irregulares, difusas ou localizadas (ondas ?), mas sempre com sensível dispersão temporal em relação às áreas de predominante projeção. 2. As alterações eletrencefalográficas não diferiram em casos de tumores das de lesão de tipo inflamatorio (quadro 1). 3. Os surtos de ritmo 4 a 7 c/s bilateral síncrono não diferençaram afecções da linha mediana das paramedianas (quadro 4). 4. Os casos de EEG normal apareceram preferentemente entre afecções extraparenquimatosas, comparativamente com as de lesão intraparen-quimatosa (quadro 3). 5. Nos casos em que houve nítida lateralização das ondas ?;, o processo era contralateral na fossa posterior (quadro 2). 6. Os surtos de ondas ? difusas apareceram mais freqüentemente nos casos de afecção mediana da fossa posterior (quadro 4). Abstract in english The authors have analysed 22 cases of verified infratentorial surgical lesions and found: 1. In 9 cases the EEG was normal and in 13 abnormal. The predominant EEG modifications were: outbursts of bilateral synchronous waves, 4 to 7 c/s. (? rhythm) and ? waves, diffuse or localized, with temporal dis [...] persion in relation to predominant projection areas. 2. The EEG changes did not differentiate the inflammatory lesions from the tumors. 3. The outbursts of 4 to 7 c/s. bilateral synchronous waves did not differentiate the midline lesions from the lateral lesions. 4. The normal EEG was dominant in the cases of extraencephalic lesions in relation to the intraparenchymatous lesions. 5. In the cases of definite localized ? waves the lesions were contralateral in the posterior fossa. 6. The outburst of diffuse ? waves were more frequent in the midline lesions.

Aloysio Mattos, Pimenta; Paulo Pinto, Pupo; Eliova, Zukerman.

1954-09-01

76

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

2012-01-01

77

Respuesta anómala de anticuerpos de infecciones virales productoras de rash  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se estudiaron 20 pares de sueros provenientes del Sistema de Vigilancia Seroepidemiológica Nacional de la vacuna triple viral que llegaron al laboratorio con el diagnóstico de rash febril. Mediante la técnica de inhibición de la hemaglutinación se observó una respuesta anormal de nticuerpos, tanto a [...] rubeola como a sarampión, manifiesta por una caída del título de anticuerpos a una o ambas entidades o a una de ellas con seroconversión a la otra. Con el objetivo de definir la respuesta de anticuerpos a la familia Herpesviridae (HSV, EBV, CMV, VZV), se encontró el 80 % de la respuesta a estos virus. Los resultados se presentan y se iscuten.

SONIA, RESIK AGUIRRE; CARLOS A, SARIOL CURBELO; MARITZA, ALVAREZ VEGA; MIGUEL, MARRERO SUAREZ.

1996-04-01

78

Facial rash with scarring due to granulomatous vasculitis in rheumatoid disease.  

OpenAIRE

A 60-year-old man with destructive rheumatoid disease, multiple nodules, and vasculitis developed a facial rash with ulceration and scarring. Histology showed granulomatous vasculitis. The rash was rapidly controlled with oral corticosteroids. Granulomatous vasculitis has not previously been reported as causing this clinical picture in the absence of concomitant necrobiosis and palisading.

White, R; Wegman, A.; Bulpitt, P.; Wood, G.; Fleming, A.

1986-01-01

79

CT findings of posterior fossa venous angiomas  

International Nuclear Information System (INIS)

Three cases of posterior fossa venous angiomas were reported, with some comments on the CT findings. Case 1: A 53-year-old woman was admitted for the further examination of a viral meningitis which had appeared three months before. Neurological examination revealed no abnormality. Vertebral angiography, however, demonstrated numerous fine medullary veins, with an enlarged intraparenchymal draining vein, in the right cerebellum; they drained into the petrosal vein, which was characteristic of venous angioma. On the plain CT, part of the draining vein was identified as a slightly high-density node. A curvilinear draining vein was demonstrated by the enhanced CT. Case 2: A 29-year-old man was admitted complaining of headache, vomiting, and atxia. Neurological examination disclosed truncal ataxia. The enhanced CT demonstrated two distinct nodules on the anterior border of the hematoma in the deep median cerebellum, probably corresponding to the draining veins. On the angiogram, a venous angioma was found in the bilateral cerebellum; it drained into the precentral cerebellar veins and ultimately joined the straight sinus via the precentro-vermo-rectal vein. Case 3: A 4-year-old boy was admitted suffering from headache, vomiting, and ataxia. Neurological examination disclosed a co-ordination disturbance of the left side. The enhanced CT demonstrated a curvilinear structure inside the hematoma. Angiography showed a venous angioma in the left cerebellum which drained into thethe left cerebellum which drained into the petrosal vein. Computerized angiotomography delineated the characteristic venous structure on the angiogram as many fine, high-density lines (medullary veins) converging to a large intraparenchymal linear structure (central medullary vein) and then to a superficial cortical vein. In all cases, large intraparenchymal draining veins were identified by the conventional CT. (J.P.N.)

80

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

81

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.

Masaru Abiko

2011-05-01

82

Ganglion cyst in the supraspinous fossa: arthroscopically undetectable cases.  

Science.gov (United States)

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. PMID:23925157

Shimokobe, Hisao; Gotoh, Masafumi; Mitsui, Yasuhiro; Yoshikawa, Eiichiro; Kume, Shinichiro; Okawa, Takahiro; Higuchi, Fujio; Nagata, Kensei; Shiba, Naoto

2013-01-01

83

Extrapineal mature teratoma of the posterior fossa in a child  

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Full Text Available Introduction: teratomas are non-malignantgerm cell tumors commonly composed of cell types derived from all of the three germ layers. Intracerebral teratomas typically are midline or paraxial lesions located in the pituitary stalk or the pineal region. We report our experience with mature teratomas of the posterior fossa. Case report: we present the case of an 11-year-old caucasian female with progressive headache that caused interrupted sleep. Cerebral magnetic resonance imaging showed a midline lesion in the posterior fossa with mass effect and without contrast enhancement. Anatomic pathology revealed a mature teratoma. Conclusion: differential diagnosis of midline lesions in pediatric patients must include teratomas in spite of being posterior fossa lesions.

Mónica Rivero-Garvía

2012-09-01

84

The rasH2 mouse model for assessing carcinogenic potential of pharmaceuticals.  

Science.gov (United States)

A factor limiting widespread use of the transgenic rasH2 mouse model for carcinogenicity testing of pharmaceuticals is the paucity of published data on actual drug candidates in rasH2 mice. This report addresses this gap by highlighting rasH2 mouse study data for 10 pharmaceutical candidates. These results were compared with findings in the 2-year studies in Sprague-Dawley rats for the same 10 compounds. In the 6-month rasH2 studies, only 2 of the 10 compounds tested positive for carcinogenicity and these correlated with positive findings in the companion 2-year rat studies. One compound, sunitinib, produced gastroduodenal carcinoma in both sexes and increased hemangiosarcoma in spleen and uterus in female rasH2 mice; in rats it produced gastroduodenal carcinoma and increased pheochromocytoma (males only). The second compound, bazedoxifene, produced ovarian granulosa cell neoplasms in rasH2 mice and rats, and renal tubular neoplasms associated with increased chronic progressive nephropathy only in rats. The higher percentage of carcinogenicity positive rat bioassays could be attributed to rat-specific phenomena with little or low relevance to man. Thus, this article confirms previous reports that rasH2 mice develop rodent-specific neoplasms less frequently than rats and positive findings, when present, are accompanied by similar positive results in the rat. PMID:23423820

Nambiar, Prashant R; Morton, Daniel

2013-01-01

85

Fatal hemorrhagic infarction of posterior fossa meningioma during cardiopulmonary bypass.  

Science.gov (United States)

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. PMID:22269734

Sun, Hai; Ross, Donald A

2012-02-01

86

BILATERAL ANOMALOUS MUSCLE IN THE POPLITEAL FOSSA & ITS CLINICAL SIGNIFICANCE  

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Full Text Available Muscle variation may occur due to genetic or developmental causes. Some variations may compromise the vascular, muscular or nervous system in the region. Bilateral muscle variation in popliteal fossa is very rare. In present study an instance of bilateral muscle variation in popliteal fossa, arising from different muscles like gastrocnemius and from biceps femoris is recorded. There is no report of such variations. These observations are rare of its kind because of bilateral asymmetrical presence and difference in the origins in different legs. This is the first report as for the literatures available. Clinical and functional importance of such variation is discussed with the morphological aspects of this anomalous muscle.

Sowmya S

2014-10-01

87

A Case of Cerebellar Mutism after Posterior Fossa Surgery  

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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

2012-12-01

88

Microsurgical Localization of the Cochlea in the Extended Middle Fossa Approach  

OpenAIRE

Objective?In the extended middle fossa approach, a portion of the petrous bone known as Kawase's rhomboid can be drilled to expose the posterior fossa through a middle fossa corridor. During this bony resection, the cochlea is placed at risk. The objective of this study was to objectively detail the position of the cochlea in relation to reliable surgical landmarks.

Forbes, Jonathan A.; Rivas, Alejandro; Tsai, Betty; Ehtesham, Moneeb; Zuckerman, Scott; Wanna, George; Weaver, Kyle

2012-01-01

89

Dermoid Cyst of the Infratemporal Fossa: Case Report and Review of the Literature  

OpenAIRE

Background?Intracranial dermoid cysts are rare tumors of congenital origin. We report a case of a large dermoid tumor arising in the infratemporal fossa (ITF) with erosion into the middle cranial fossa. After reviewing the literature, we believe this represents the first reported dermoid tumor of the ITF with extension into the middle cranial fossa.

Triplett, Thomas M.; Griffith, Adam; Hatanpaa, Kimmo J.; Barnett, Samuel L.

2013-01-01

90

Drug-mediated rash: erythema multiforme versus Stevens-Johnson syndrome.  

Science.gov (United States)

A 92-year-old woman presented with an acute onset generalised maculopapular rash with associated mucosal involvement, on a background of recent start of griseofulvin. The rash progressed rapidly over 2 days to involve most of her body, however, mucosal involvement was limited to her oral mucosa. Characteristic target lesions appeared at 72 h, and a diagnosis of erythema multiforme secondary to griseofulvin was made after further investigation and skin biopsy. The patient was monitored closely for progression of the rash and other indicators of more severe dermatological conditions such as Stevens-Johnson syndrome. She was managed symptomatically, with resolution of the rash in 4 weeks and full recovery to her premorbid level of functioning. This case details the diagnostic and management approach to erythema multiforme, a condition that warrants thorough consideration for the differential of Stevens-Johnson syndrome. PMID:25246464

Hidajat, Cassandra; Loi, Duncan

2014-01-01

91

Bone marrow aplasia and severe skin rash after a single low dose of methotrexate.  

Science.gov (United States)

A 64 year old man with recurrent metastatic squamous cell carcinoma of the head and neck developed severe skin rash and bone marrow aplasia 4 and 7 days, respectively, following a single dose of 40 mg/m2 methotrexate (MTX). Skin rash involved regions of the face, lower abdomen, back, buttocks and both upper thighs. Biopsy of the skin rash demonstrated superficial perivascular lymphocytic infiltrate and was consistent with a drug reaction. Peripheral blood count revealed pancytopenia and a bone marrow biopsy was consistent with aplasia. Blood counts returned to normal 6 days after institution of granulocyte colony stimulating factor therapy. In the absence of mucositis or diarrhea, severe dermatologic toxicity following a single low dose of the drug suggests an 'allergic' or acute hypersensitivity reaction to MTX in this patient. Development of an extensive skin rash following a single dose of MTX may be an early warning sign for life-threatening bone marrow aplasia. PMID:7538828

Copur, S; Dahut, W; Chu, E; Allegra, C J

1995-02-01

92

Polymorphous low-grade adenocarcinoma of the nasal fossa.  

Science.gov (United States)

An unusual case of a T4N2CMx polymorphous low grade adenocarcinoma located in the nasal fossae and extending to the pterygoid area is presented. The primary tumor was excised through a Lefort I maxillotomy and the neck was managed with a supraomohyoid neck dissection. Adjuntive postoperative radiotherapy was also administered to the patient. PMID:16056192

González-Lagunas, Javier; Alasà-Caparrós, Cristian; Vendrell-Escofet, Gerard; Huguet-Redecilla, Pere; Raspall-Martin, Guillermo

2005-01-01

93

Transpterygoid Approach to a Dermoid Cyst in Pterygopalatine Fossa  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english Objective? To describe a case of dermoid cyst arising from the pterygopalatine fossa and review the literature. Methods? We report a case of a 23-year-old man who suffered a car accident 2 years before otolaryngologic attendance. He had one episode of generalized tonic-clonic seizure and develope [...] d a reduction of visual acuity of the left side after the accident. Neurologic investigation was performed and magnetic resonance imaging revealed an incidental finding of a heterogeneous ovoid lesion in the pterygopalatine fossa, hyperintense on T2-weighted imaging. Results? Endoscopic sinus surgery with transpterygoid approach was performed. The ovoid lesion was noted in the pterygopalatine fossa. Puncture for intraoperative evaluation showed a transparent thick fluid. Surprisingly, hair and sebaceous glands were found inside the cyst capsule. The cyst was excised completely. Histologic examination revealed a dermoid cyst. The patient currently has no evidence of recurrence at 1?year postoperatively. Conclusion? This unique case is a rare report of a dermoid cyst incidentally diagnosed. An endoscopic transnasal transpterygoid approach may be performed to treat successfully this kind of lesion. Although rare, it should be considered in the differential diagnosis of expansive lesions in the pterygopalatine fossa, including schwannoma, angiofibroma, esthesioneuroblastoma, osteochondroma, cholesterol granuloma, hemangioma, lymphoma, and osteoma.

Alexandre Beraldo, Ordones; Marco Aurélio, Fornazieri; Fábio de Rezende, Pinna; Thiago Freire Pinto, Bezerra; Richard Louis, Voegels; Luiz Ubirajara, Sennes.

2014-01-01

94

Mandibular fossa morphology in the Ngandong and Sambungmacan fossil hominids.  

Science.gov (United States)

There has been debate in recent years concerning the significance of the mandibular fossa morphology in the Ngandong and Sambungmacan hominids. These fossils lack a postglenoid process and their squamotympanic fissure runs along the apex of the fossa for its entire length. This configuration differs from that seen in other fossil and modern humans, which have a prominent postglenoid process and a squamotympanic fissure that takes a more posterior course that does not lie in the apex of the fossa. Some recent studies have suggested that the Ngandong and Sambungmacan hominids are not unique in their expression of these characteristics, and that they can also be found in other fossil crania from Africa and Indonesia. The present study reexamines these morphologies in an effort to better understand their distribution in the hominid fossil record. The results confirm that the lack of a prominent postglenoid process in combination with a squamotympanic fissure that lies wholly in the apex of the mandibular fossa along its entire length is indeed autapomorphic for the Ngandong and Sambungmacan fossils. This finding, in conjunction with work on other nonmetric features in these hominids, suggests that at least two hominid morphs, possibly representing separate species, were present on Java during the Pleistocene. In addition, if this apparent autapomorphy is confirmed, then it is also unlikely that the Ngandong hominids contributed to the gene pool of modern humans. PMID:18521904

Durband, Arthur C

2008-10-01

95

Prenatal diagnosis of posterior fossa anomalies: An overview  

Directory of Open Access Journals (Sweden)

Full Text Available Ultrasonography of the central nervous system is an integral part of a prenatal scan, and the development of imaging technologies has led to better diagnostic possibilities. Posterior fossa anomalies have traditionally been divided into Dandy Walke malformation, Dandy Walker variation and megacisterna magna, but this approach, due to diversity of the extensive number of possible disorders covered by this classification, unables accurate prognosis and therefore adequate counselling. An alternative approach to the classification of posterior fossa anomalies is to divide them into agenesis of the vermis, which could be partial or complete, cerebellar hypoplasia, pontocerebellar hypoplasia and cerebellar atrophy. Different ultrasonographic and magnetic resonance imagining of appearances of the posterior fossa anomalies in prenatal period are discussed in the article, as well as possible syndromes and prognosis of different entities. Diversity of anomalies of the central nervous system, and in particular, subtle differences in prenatal appearances of posterior fossa anomalies, which may have major impact on the prognosis, demand a multidisciplinary approach that encompasses two-dimensional and three-dimensional ultrasound scan, magnetic resonance imaging, infectious diseases and metabolic disorders work-ups as well as individual approach to every case involving of a team of experts in the field of perinatology, radiology, paediatrics, neurology and genetics.

Novakov-Miki? Aleksandra

2009-01-01

96

Prenatal diagnosis of posterior fossa anomalies--an overview.  

Science.gov (United States)

Ultrasonography of the central nervous system is an integral part of a prenatal scan, and the development of imaging technologies has led to better diagnostic possibilities. Posterior fossa anomalies have traditionally been divided into Dandy Walke malformation, Dandy Walker variation and megacisterna magna, but this approach, due to diversity of the extensive number of possible disorders covered by this classification, unables accurate prognosis and therefore adequate counselling. An alternative approach to the classification of posterior fossa anomalies is to divide them into agenesis of the vermis, which could be partial or complete, cerebellar hypoplasia, pontocerebellar hypoplasia and cerebellar atrophy. Different ultrasonographic and magnetic resonance imagining of appearances of the posterior fossa anomalies in prenatal period are discussed in the article, as well as possible syndromes and prognosis of different entities. Diversity of anomalies of the central nervous system, and in particular, subtle differences in prenatal appearances of posterior fossa anomalies, which may have major impact on the prognosis, demand a multidisciplinary approach that encompasses two-dimensional and three-dimensional ultrasound scan, magnetic resonance imaging, infectious diseases and metabolic disorders work-ups as well as individual approach to every case involving of a team of experts in the field of perinatology, radiology, paediatrics, neurology and genetics. PMID:19623847

Novakov-Miki?, Aleksandra; Koprivsek, Katarina; Luci?, Milos; Belopavlovi?, Zoran; Stoji?, Sinisa; Sekuli?, Slobodan

2009-01-01

97

Drug Rash with Eosinophilia and Systemic Symptoms Syndrome Due to Anti-TB Medication  

OpenAIRE

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, idiosyncratic, multi-system reaction characterized by the clinical triad of fever, rash, and internal organ involvement. The mortality rate is estimated to be 8%, especially among patients with liver involvement, so early recognition is imperative. Drugs commonly associated with the development of DRESS syndrome include anticonvulsants, long-acting sulfonamides, and anti-inflammatory medications; however, there ar...

Kaswala, Dharmesh H.

2013-01-01

98

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

OpenAIRE

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 ...

Hassan S.; Wetz R; Zouein E

2011-01-01

99

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

OpenAIRE

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 ...

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

2001-01-01

100

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

OpenAIRE

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 a...

Du?s?u?nsel, R.; Dursun, I?; Poyrazog?lu, M. H.; Gu?ndu?z, Z.; Gu?rgo?ze, M. K.

2006-01-01

101

Severe skin rash with lamivudine in HIV infected patients: Some unusual case reports  

OpenAIRE

Lamivudine (3TC) is a nucleoside reverse transcriptase inhibitor (NRTI) licensed for as a first line drug in Human immunodeficiency virus (HIV) infection and also in the treatment of hepatitis B. It is relatively nontoxic in nature and potentiates the antiviral effects of other NRTIs like zidovudine. Although lamivudine is well-tolerated, certain dermatological side effects like severe skin rash may appear. We report a case series of severe skin rashes in four HIV-infected patients, probably ...

Modak, Dolanchampa; Guha, Subhasish Kamal

2013-01-01

102

Nasal fossa of mouse and dwarf lemurs (primates, cheirogaleidae).  

Science.gov (United States)

Dimensions of the external midface in mammals are sometimes related to olfactory abilities (e.g., "olfactory snouts" of strepsirrhine primates). This association hinges on the largely unexplored relationship between the protruding midface and internal topography of the nasal fossae. Herein, serially sectioned heads of embryonic to adult cheirogaleid primates (mouse and dwarf lemurs) and a comparative sample were studied. To assess the anteroposterior distribution of olfactory epithelium (OE) within the nasal fossa, the surface area of OE and non-OE was measured in two mouse lemurs (one adult, one infant). Prenatally, ethmoturbinal projections appear in an anteroposterior sequence. Fetal mouse lemurs, tenrecs, voles, and flying lemurs have four ethmoturbinals that project toward the nasal septum. Major distinctions among these mammals include the number of turbinals in recesses and the extent of the olfactory recess. Surface area measurements in the adult mouse lemur reveal that 31% of the entire nasal fossa is lined with OE. The majority is sequestered in a posterior recess (70% OE). Anterior to this space, only 28% of the nasal fossa is lined with OE. Ethmoturbinal I is lined with relatively less OE (35%) compared with more posterior ethmoturbinals (46-57%). Age comparisons support the idea that OE increases less than non-OE between ages. Regionally, results suggest that most growth in surface area occurs in turbinals. But in all ethmoturbinals, surface area of non-OE differs between ages more than that of OE. This study shows that the anterior part of the nasal fossa is mostly nonolfactory in Microcebus murinus. PMID:18615700

Smith, Timothy D; Rossie, James B

2008-08-01

103

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

Science.gov (United States)

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. PMID:23200749

Corpa, J M; García-Quirós, A; Casares, M; Gerique, A C; Carbonell, M D; Gómez-Muñoz, M T; Uzal, F A; Ortega, J

2013-03-31

104

Children's vomiting following posterior fossa surgery: A retrospective study  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Nausea and vomiting is a problem for children after neurosurgery and those requiring posterior fossa procedures appear to have a high incidence. This clinical observation has not been quantified nor have risk factors unique to this group of children been elucidated. Methods A six year retrospective chart audit at two Canadian children's hospitals was conducted. The incidence of nausea and vomiting was extracted. Hierarchical multivariable logistic regression was used to quantify risk and protective factors at 120 hours after surgery and early vs. late vomiting. Results The incidence of vomiting over a ten day postoperative period was 76.7%. Documented vomiting ranged from single events to greater than 20 over the same period. In the final multivariable model: adolescents (age 12 to Conclusion The incidence of vomiting in children after posterior fossa surgery is sufficient to consider all children requiring these procedures to be at high risk for POV. Nausea requires better assessment and documentation.

Dundon Belinda

2009-07-01

105

Extensive Supratentorial Hemorrhages Following Posterior Fossa Meningioma Surgery  

OpenAIRE

Remote supratentorial hematoma soon after posterior fossa surgery for the removal of a space-occupying lesion is a rare but dramatic and dreaded complication, carrying significant morbidity and mortality. A 47-year-old woman presented with headache of 1-year duration that worsened over last 2 months, progressive ataxia of 2 months’ duration, blurring and diminution of vision of 2 months’ duration and forgetfulness of 2 months’ duration. Fundus showed bilateral papille dema, and visual a...

Agrawal, Amit; Kakani, Anand; Ray, Kaushik

2010-01-01

106

Spinal Drop Metastasis from a Posterior Fossa Choroid Plexus Papilloma  

OpenAIRE

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. Magnetic resonance imaging revealed mass lesions in the lumbosacral subarachnoid space and recurrent intracranial tumor. The lesions were resected and histologically diagnosed was CPP. We consider...

Ahn, Soon-seob; Cho, Young-dae

2007-01-01

107

Endoscopic Removal of a Bullet Penetrating the Middle Cranial Fossa  

OpenAIRE

Reports of intracranial retained foreign bodies are relatively rare in the literature. Such objects can cause numerous complications requiring removal, such as infection, persistent cerebrospinal fluid (CSF) leak, or new-onset seizures. The transnasal endoscopic approach provides an excellent alternative to craniotomy for repairing middle cranial fossa (MCF) defects. We describe a case of a 57-year-old woman with a self-inflicted bullet piercing the MCF, creating a persistent CSF leak. The de...

Hatch, Neal U.; Riley, Kristen O.; Woodworth, Bradford A.

2011-01-01

108

CT and MRI diagnosis of posterior fossa atypical ependymoma  

International Nuclear Information System (INIS)

Objective: To analyse the CT and MRI features of posterior fossa atypical ependymoma. Methods: Sixteen cases of posterior fossa atypical ependymoma proved by surgery and pathology had CT and (or) MRI scanning. There were 11 males and 5 females. The age ranged from 17 to 46 (mean, 31.2). Twelve cases ranged from 20 to 40 years old. the main symptoms of all cases were dizziness, unsteady walking and vomiting. Results: The locations of all cases were cerebellum (12 cases), vermis (3 cases) and cerebellopontile angle (1 cases). Fifteen cases were solid with multiple cystic changes and 1 case in the cerebellopontile angle was cystic. The tumor was usually close to the surface of cerebellum with rather extensive connection with dura mater or tentorium. Calcifications were shown in 3 cases. The tumors revealed inhomogeneous density on CT scan and inhomogeneous intensity on MRI. Mild inhomogeneous enhancement was shown in most cases, while intense irregular enhancement in the others. Conclusions: The characteristic findings of the posterior fossa atypical ependymoma ependymoma were cerebellar intraparenchymatous multiple small cystic changes within solid tumor in most cases and inhomogeneous density and intensity on CT and MRI. The differential diagnosis is meningioma, metastasis and acoustic schwannoma

109

[Acute subdural hygroma in the posterior fossa (author's transl)].  

Science.gov (United States)

A 2-year-old girl was admitted to Chugoku Rosai Hospital one hour after a car accident on July 16, 1978. On admission she was conscious and no physical or neurologic abnormality was found. However, 2 hours and a half after the accident, she was attacked suddenly by generalized convulsion, and then became comatose with apnea. Bilateral horizontal nystagmus to the left, rhythmic constriction and dilation of the pupils reacting to light, and flaccid tetraplegia were recognized. Plain skull films revealed a linear fracture in the right posterior fossa, which crossed the transverse this region. A burr hole was made in the left posterior fossa, and slightly xanthochromic fluid, 30 to 40 microliter in volume, under high pressure was evacuated from the subdural space. A burr hole on the right side disclosed no abnormality. Spontaneous respiration returned immediately and consciousness became clear 5 hours after the surgery. No neurologic deficit was detect and postoperative EEG was normal. She was discharged from the hospital on July 27, 1978. Ten cases of acute subdural hygroma in the posterior fossa, including the present case, were analyzed. This lesion is able to be cured completely by a simple operation even in coma with apnea, if diagnosis made promptly and the surgery is carried out without delay. In cases of acute head injury, it is quite important to have a possibility of the infratentorial lesion in mind and to find it with the aids of plain skull film of Towne's view, CT scan, and VAG if necessary. PMID:7242836

Andoh, S; Ishikawa, S; Miyazaki, M; Ishihara, H

1981-03-01

110

Posterior fossa cysts: clinical, neuroradiological and surgical features.  

Science.gov (United States)

Various types of neuroimaging investigations were performed in 26 patients with posterior fossa cysts. The results were retrospectively analyzed to facilitate differential diagnosis and clarify indications for surgery. Four major findings were obtained in this study. First, posterior fossa intra-arachnoid cysts were encountered more frequently than expected and were found to be surgically treatable. Second, although IV ventricular cysts were categorized as Dandy-Walker malformation, Dandy-Walker variant, and persistent Blake's pouch in this study, the distinctions of neuroimaging findings between these three types are uncertain. Third, the diagnostic criteria for mega cisterna magna were established, and it was found to be a surgically untreatable condition. Finally, in cases with the following neuroimaging findings, surgery appears to be indicated: (1) occipital bossing or petrosal scalloping with distortion or obliteration of cerebrospinal fluid (CSF) cisterns of the posterior fossa; (2) compression and deformity of the brain surrounding the cyst; (3) radioisotope and/or computed tomography cisternographic findings suggestive of disturbance of intracystic CSF circulation; (4) a non-communicating cyst. PMID:1878871

Arai, H; Sato, K

1991-06-01

111

MRI diagnosis of muscle denervation from herpes zoster with discordant distribution of the skin rash  

Energy Technology Data Exchange (ETDEWEB)

Herpes zoster is a common disorder characterized by a painful rash along a dermatome caused by reactivation of the varicella zoster virus (VZV). Muscle denervation injury from motor involvement is an uncommon phenomenon. Discordant distribution of the skin rash and motor nerve involvement, presenting as a skin rash in one body part and muscle weakness or pain from nerve involvement in another body part is an even more uncommonly reported finding. We present an unusual case of muscle denervation injury resulting from motor involvement of a peripheral nerve by VZV diagnosed by magnetic resonance imaging with cutaneous manifestations in a different dermatomal distribution. To the best of our knowledge, there has been no similar case reported in the English radiology literature. We suggest that whenever a radiologist notices MRI findings suggesting denervation injury and a cause not readily identified, VZV-related denervation injury should be included in the differential diagnosis, especially in an older immunocompromised patient. (orig.)

Gupta, Amit; Sundaram, Murali [Cleveland Clinic, Section of Musculoskeletal Radiology, Imaging Institute, Cleveland, OH (United States); Winalski, Carl S. [Cleveland Clinic, Section of Musculoskeletal Radiology, Imaging Institute, Cleveland, OH (United States); Cleveland Clinic, Department of Biomedical Engineering, Lerner Research Institute, Cleveland, OH (United States)

2014-10-15

112

MRI diagnosis of muscle denervation from herpes zoster with discordant distribution of the skin rash.  

Science.gov (United States)

Herpes zoster is a common disorder characterized by a painful rash along a dermatome caused by reactivation of the varicella zoster virus (VZV). Muscle denervation injury from motor involvement is an uncommon phenomenon. Discordant distribution of the skin rash and motor nerve involvement, presenting as a skin rash in one body part and muscle weakness or pain from nerve involvement in another body part is an even more uncommonly reported finding. We present an unusual case of muscle denervation injury resulting from motor involvement of a peripheral nerve by VZV diagnosed by magnetic resonance imaging with cutaneous manifestations in a different dermatomal distribution. To the best of our knowledge, there has been no similar case reported in the English radiology literature. We suggest that whenever a radiologist notices MRI findings suggesting denervation injury and a cause not readily identified, VZV-related denervation injury should be included in the differential diagnosis, especially in an older immunocompromised patient. PMID:24880713

Gupta, Amit; Sundaram, Murali; Winalski, Carl S

2014-10-01

113

MRI diagnosis of muscle denervation from herpes zoster with discordant distribution of the skin rash  

International Nuclear Information System (INIS)

Herpes zoster is a common disorder characterized by a painful rash along a dermatome caused by reactivation of the varicella zoster virus (VZV). Muscle denervation injury from motor involvement is an uncommon phenomenon. Discordant distribution of the skin rash and motor nerve involvement, presenting as a skin rash in one body part and muscle weakness or pain from nerve involvement in another body part is an even more uncommonly reported finding. We present an unusual case of muscle denervation injury resulting from motor involvement of a peripheral nerve by VZV diagnosed by magnetic resonance imaging with cutaneous manifestations in a different dermatomal distribution. To the best of our knowledge, there has been no similar case reported in the English radiology literature. We suggest that whenever a radiologist notices MRI findings suggesting denervation injury and a cause not readily identified, VZV-related denervation injury should be included in the differential diagnosis, especially in an older immunocompromised patient. (orig.)

114

Geology of the Bellona Fossae (V15) Region of Venus  

Science.gov (United States)

A preliminary geologic map of the the Bellona Fossae (V15) quadrangle on Venus was produced as part of the NASA-funded planetary mapping program. Geologic interpretations are based primarily on the basis of morphology, texture, radar reflectance, and relative stratigraphy derived from Magellan Synthetic Aperture Radar (SAR) images, based on FMAP mosaics showing SAR data at 75 m/pixel resolution, and compiled on a digital base map at 1:5M scale produced by the U.S. Geological Survey. This quadrangle covers approximately 5 million square kilometers of the northern lowlands of Venus, and it includes the Bellona Fossae and Fee Fossae fracture systems of western Kawelu Planitia and northern Ulfrun Regio, along with an arcuate chain of volcano-tectonic centers called coronae (e.g., Ki and Tituba Coronae). Exposed materials are dominated by relatively featureless regional plains and several centers of lobate plains (e.g., Uzume Fluctus) interpreted to be lava flow fields emplaced by effusion from separate vents. Based on stratigraphic relationships at unit contacts, the oldest exposed material units are isolated patches of complex-faulted tessera terrain, restricted to the eastern and southwestern margins of the quadrangle. Relatively small exposures of lineated plains, mountain belt, ridged plains, and dark plains materials are scattered throughout the quadrangle, with only a few impact craters and their associated ejecta and impact-induced flows (e.g., Mumtaz-Mahal crater) representing the latest materials. The tectonism associated with the coronae appears to predate the regional plains for the most part, but individual coronae are the source for lobate plains volcanism which implies that activity at these structural features encompasses much of the time span portrayed in the regional stratigraphy. Northeast-southwest-oriented lineaments exposed in Bellona Fossae not only are generally coincident with the coronae structures, but also cut patches of the stratigraphically late lobate plains units. Extensional tectonism evident in the north-south-oriented graben and lineaments of Fea Fossae cut both regional and lobate plains, and is associated with some of the greatest relief in the quadrangle. The general history portrayed in this quadrangle is consistent with published maps and reports of adjacent portions of the northern lowlands of Venus.

Zimbelman, J. R.

2002-05-01

115

Case series: acute mood symptoms associated with posterior fossa lesions in children.  

Science.gov (United States)

Nineteen children were acutely dysphoric, inattentive, irritable, and sometimes mute following midline posterior fossa neoplasm resection and arteriovenous malformation hemorrhage. These symptoms represent an acute manifestation of the cerebellar cognitive affective syndrome. The authors aimed to describe the acute psychiatric changes in mood and behavior in children with posterior fossa lesions and to evaluate the relationship of posterior fossa syndrome to cerebellar cognitive affective syndrome. PMID:15616170

Turkel, Susan Beckwitt; Shu Chen, Lan; Nelson, Marvin D; Hyder, Douglas; Gilles, Floyd H; Woodall, Linda; Braslow, Kenneth; Tavaré, C Jane

2004-01-01

116

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.

Dü?ünsel, R.

2006-01-01

117

A case of Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) related to rufinamide.  

Science.gov (United States)

Drug Rash (or Reaction) with Eosinophilia and Systemic Symptoms (DRESS) is a potentially life-threatening hypersensitivity reaction to drugs characterized by rash, fever, lymphadenopathy, hematologic abnormalities, and involvement of internal organs. Initially coined in 1996, the term is used to refer to an idiosyncratic reaction to several drugs, the most common of which are carbamazepine, allopurinol, sulfasalazine, and phenobarbital. We report the first case of DRESS related to rufinamide in a ten year old boy with a history of a complex seizure disorder. PMID:24021364

Shahbaz, S; Sivamani, R K; Konia, T; Burrall, B

2013-01-01

118

A 50-year-old man presenting with rash after exposure to sunlight  

Science.gov (United States)

Photodermatoses is a condition characterized by development of a skin rash following exposure to sunlight. Here we present the case of a patient who presented with pigmented, pruritic, blistering rash that developed shortly after exposure to sunlight. Careful history revealed that the patient was on suppressive therapy with doxycycline for osteomyelitis. Following stopping of doxycycline, and symptomatic treatment, the patient had significant improvement in symptoms. The case illustrates that clinicians should be cognizant of drug induced photodermatoses particularly in individuals exposed to high doses of ultraviolet radiation. PMID:25333025

2014-01-01

119

Multidimensional analysis of fetal posterior fossa in health and disease.  

Science.gov (United States)

Fetal magnetic resonance imaging (MRI) is now routinely used to further investigate cerebellar malformations detected with ultrasound. However, the lack of 2D and 3D biometrics in the current literature hinders the detailed characterisation and classification of cerebellar anomalies. The main objectives of this fetal neuroimaging study were to provide normal posterior fossa growth trajectories during the second and third trimesters of pregnancy via semi-automatic segmentation of reconstructed fetal brain MR images and to assess common cerebellar malformations in comparison with the reference data. Using a 1.5-T MRI scanner, 143 MR images were obtained from 79 normal control and 53 fetuses with posterior fossa abnormalities that were grouped according to the severity of diagnosis on visual MRI inspections. All quantifications were performed on volumetric datasets, and supplemental outcome information was collected from the surviving infants. Normal growth trajectories of total brain, cerebellar, vermis, pons and fourth ventricle volumes showed significant correlations with 2D measurements and increased in second-order polynomial trends across gestation (Pearson r, p?fossa biometrics enhance the delineation of normal and abnormal cerebellar phenotypes on fetal MRI and confirm the advantages of utilizing advanced neuroimaging tools in clinical fetal research. PMID:23553467

Vatansever, Deniz; Kyriakopoulou, Vanessa; Allsop, Joanna M; Fox, Matthew; Chew, Andrew; Hajnal, Joseph V; Rutherford, Mary A

2013-10-01

120

Intensity-Modulated Arc Therapy for Pediatric Posterior Fossa Tumors  

Energy Technology Data Exchange (ETDEWEB)

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.

Beltran, Chris, E-mail: chris.beltran@stjude.org [Department of Radiological Sciences, St. Jude Children' s Research Hospital, Memphis, TN (United States); Gray, Jonathan; Merchant, Thomas E. [Department of Radiological Sciences, St. Jude Children' s Research Hospital, Memphis, TN (United States)

2012-02-01

121

Posterior fossa cystic lesions--magnetic resonance imaging manifestations.  

Science.gov (United States)

Cystic lesions of the posterior fossa remain a controversial subject as to clinical classification and diagnosis, especially for those in combination with other intracranial abnormalities. During the period of November 1985 to June 1991, 16 patients with cystic lesions of the posterior fossa were retrospectively reviewed on neuroradiological evaluation with MR images. The patients were 9 males and 7 females aged from 5 days to 15 years old (medium 1 year old). They were classified into three groups as Dandy-Walker cyst (group A, 5 patients), mega cisterna magna (group B, 4) and retrocerebellar pouch or cyst (group C, 7). Nine patients had associated intracranial anomalies, holoprosencephaly in 3 (group A, 3), dysgenesis of the corpus callosum in 4 (group A, 2; group C, 2), and occipital meningoceles in 2 (group C, 2). Hydrocephalus or ventricular enlargement was found in 10 patients (group A, 5; group B, 2; group C, 3). Surgical treatment (cyst-peritoneal shunt or cystectomy) was performed for 10 patients with clinical symptoms due to cyst. Postoperatively, clinical symptoms due to increased intracranial pressure or hydrocephalus improved in 7 patients. For long-term results, the cyst was reduced in 1 of 5 patients of group A and 2 of 5 of group C. Most of our patients have a poor prognosis because of the associated intracranial anomalies or atrophy of the cerebellum. Multiplanar MR images may provide sufficient evidence for the diagnosis of posterior fossa cysts, especially in the case of rotation or upward displacement of the cerebellar vermis. However, the cyst membrane, and the communication of fluid between the cyst and the cistern, cannot be demonstrated on MR images. Further investigation on these subjects and indications for surgical intervention is highly necessary. PMID:8747420

Tan, E C; Takagi, T; Karasawa, K

1995-01-01

122

Varicella Zoster Virus Meningitis in a Young Immunocompetent Adult without Rash: A Misleading Clinical Presentation.  

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Meningitis caused by varicella zoster virus (VZV) is rare in healthy population. Predominantly immunocompromised patients are affected by reactivation of this virus with primary clinical features of rash and neurological symptoms. Here we report a young otherwise healthy man diagnosed with a VZV meningitis without rash. He complained of acute headache, nausea, and vomiting. The clinical examination did not show any neurological deficits or rash. Cerebrospinal fluid (CSF) analysis revealed a high leukocyte cell count of 1720?cells/µL and an elevated total protein of 1460?mg/L misleadingly indicating a bacterial infection. Further CSF analyses, including polymerase chain reaction (PCR) and detection of intrathecal synthesis of antibodies, showed a VZV infection. Clinical and CSF follow-up examinations proved the successful antiviral treatment. In conclusion, even young immunocompetent patients without rash might present with VZV meningitis. CSF examination is a key procedure in the diagnosis of CNS infections but in rare cases the standard values cell count and total protein might misleadingly indicate a bacterial infection. Thus, virological analyses should be considered even when a bacterial infection is suspected. PMID:25614843

Pasedag, Thomas; Weissenborn, Karin; Wurster, Ulrich; Ganzenmueller, Tina; Stangel, Martin; Skripuletz, Thomas

2014-01-01

123

Isolated horizontal positional nystagmus from a posterior fossa lesion.  

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Isolated vertigo with horizontal positional nystagmus as an impending sign of a central lesion has rarely been reported. Here we present neuro-otologic findings of patients with these clinical signs. Lesion overlays from 6 patients with ageotropic positional nystagmus revealed that the nodulus and vermis are common areas of injury. In contrast, 2 patients with geotropic positional nystagmus had cerebellar peduncle and lateral medullary lesions. These clinical findings suggest that vertigo with horizontal positional nystagmus, even in the absence of other initial neurological signs, may indicate a posterior fossa lesion, including that in the nodulus, vermis, and deep cerebellar structures. PMID:25362860

Lee, Hyo-Jeong; Kim, Eun Soo; Kim, Minbum; Chu, Hosuk; Ma, Hyeo-Il; Lee, Joong Seob; Koo, Ja-Won; Kim, Hyung-Jong; Hong, Sung Kwang

2014-12-01

124

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

125

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.)

126

Computed tomography of the nasopharynx and fossa pterygopalatina  

International Nuclear Information System (INIS)

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 conventionaltomography in delineating tumor extension to the parapharyngeal and retromaxillary space as well as in recognition of cervical lymph node in volvement. (orig.)

127

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

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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

128

HLA-Cw*04 allele associated with nevirapine-induced rash in HIV-infected Thai patients  

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Full Text Available Abstract Background A high incidence of rash has been reported in HIV-1 patients who received the anti-retroviral drug nevirapine. In addition, several studies have suggested that polymorphisms of human leukocyte antigen (HLA genes may play important roles in nevirapine-induced rash. The aim of the present study was to evaluate the effects of different HLA-C alleles on rash associated with nevirapine in patients who started highly active anti-retroviral therapy (HAART containing nevirapine in Thailand. Results A case-control study was carried out involving HIV-1 patients under treatment at Bamrasnaradura Infectious Diseases Institute, Nonthaburi, Thailand between March 2007 and March 2008. The study included all HIV/AIDS patients being treated with nevirapine-containing regimens. The study population comprised 287 HIV/AIDS patients of whom 248 were nevirapine-tolerant and 39 developed rash after nevirapine treatment. From the nevirapine-tolerant patients, 60 were selected as the control group on the basis of age, sex, and therapy history matched for nevirapine-induced rash cases. We observed significantly more HLA-Cw*04 alleles in nevirapine-induced rash cases than in nevirapine-tolerant group, with frequencies of 20.51% and 7.50%, respectively (P = 0.009. There were no significant differences between the rash and tolerant groups for other HLA-C alleles except for HLA-Cw*03 (P = 0.015. Conclusion This study suggests that HLA-Cw*04 is associated with rash in nevirapine treated Thais. Future screening of patients' HLA may reduce the number of nevirapine-induced rash cases, and patients with alleles associated with nevirapine-induced rash should be started on anti-retroviral therapy without nevirapine.

Tunthanathip Preecha

2009-10-01

129

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

130

The subarcuate fossa and cerebellum of extant primates: comparative study of a skull-brain interface.  

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The subarcuate fossa of the petrosal bone houses the petrosal lobule of the cerebellar paraflocculus. Although the subarcuate fossa can be extensive, little is known about its relative size and distribution in primates. Studies indicate parafloccular involvement with cerebellar areas coordinating vestibular, visual, auditory, and locomotor systems. Hypotheses have proposed a role for the paraflocculus in vestibular-oculomotor integration, caudal muscle control, autonomic function, and visual-manual predation. This study examines the morphology and relative extent of the subarcuate fossa/petrosal lobule in a range of living primates. Methods include study of postmortem specimens representing nine mammalian orders, and qualification of the volume of the subarcuate fossa and endocranial cavity in 155 dry primate crania of 36 genera. Results show that, in mammals, the size and morphology of the petrosal lobule is directly related to that of the subarcuate fossa. Craniometric analysis shows that the ratio of subarcuate fossa volume to endocranial volume is largest in lemuriforms. The largest ratio is in Microcebus and Hapalemur. Lorisids show a significant reduction in the size of the subarcuate fossa to almost 50% below the lemuriform mean. Tarsius is near the lemuriform mean. Among platyrrhines, the ratio is high, but significantly reduced compared to lemuiforms. The highest platyrrhine ratio is seen in Ateles, the lowest in Saimiri and Alouatta. Atelids are significantly elevated compared to cebids. In cercopithecids, the fossa is significantly reduced compared to platyrrhines. The trend toward reduction of the cercopithecid fossa is most pronounced in Theropithecus and least evident in Presbytis. In hominoids, the fossa is present only in Hylobates. In great apes and humans, other than Gorilla, the petromastoid canal occupies a similar location to the subarcuate fossa of other primates, but is not homologous to it. Neither the subarcuate fossa nor the petromastoid canal are present in Gorilla. A graded reduction of the subarcuate fossa/petrosal lobule is evident among primates which evolved later in time. The relative size of this cerebellar lobule within primates may reflect size-related factors and/or degree of neocortical evolution as these relate to usage of a specific sensory-mediated locomotor behavior. The subarcuate fossa may serve as an indicator to the differentiation of the petrosal lobule of the paraflocculus in fossil forms. PMID:3207165

Gannon, P J; Eden, A R; Laitman, J T

1988-10-01

131

Extensive supratentorial hemorrhages following posterior fossa meningioma surgery.  

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Remote supratentorial hematoma soon after posterior fossa surgery for the removal of a space-occupying lesion is a rare but dramatic and dreaded complication, carrying significant morbidity and mortality. A 47-year-old woman presented with headache of 1-year duration that worsened over last 2 months, progressive ataxia of 2 months' duration, blurring and diminution of vision of 2 months' duration and forgetfulness of 2 months' duration. Fundus showed bilateral papille dema, and visual acuity was 6/9 in both eyes. She had left-sided cerebellar signs. There were no focal motor or sensory neurological deficits. MRI brain with contrast showed a large posterior fossa tumor with obstructive hydrocephalus. The patient underwent left paramedian suboccipital craniectomy in prone position with left side up. In the immediate postoperative period, the patient did no recover from anesthesia and was persistently drowsy. Immediate repeat CT scan showed diffuse subarachnoid hemorrhage spread all over the bilateral cerebral hemispheres with diffuse cerebral edema. The patient recovered with conservative management without deficits. This case stresses the importance of early postoperative CT scan and optimal management of the hemorrhage for good outcome. PMID:22091344

Agrawal, Amit; Kakani, Anand; Ray, Kaushik

2010-07-01

132

Extracranial propagation of glioblastoma with extension to pterygomaxillar fossa  

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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.

Grahovac Gordan

2011-05-01

133

Neurobehavioral alterations in an adolescent following posterior fossa tumor resection.  

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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

134

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

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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

135

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.

136

A purple rash: a case study of Henoch-Schönlein purpura.  

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Rashes are one of the most common presenting symptoms in the emergency department setting; they may be a primary diagnosis or a symptom of systemic disease. Accurate diagnosis of a rash may be challenging and requires clinical acumen, systematic history and physical examination, and judicious use of diagnostic testing. This case study reviews Henoch-Schönlein purpura (HSP) or IgA vasculitis, a common vasculitis of childhood. Although typically a self-limited disease, HSP may cause serious complications in a small subset of patients and requires monitoring. In addition, there are several differential diagnoses that may mimic HSP that are more serious. This article reviews the case of a 6-year-old boy who presented to a community emergency department and had a nontypical clinical course. PMID:25076400

Contino, Christopher; Bradbury-Golas, Kathleen

2014-01-01

137

An unusual presentation of acute brucellosis with thrombocytopenia and maculopapular rash  

OpenAIRE

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 ...

O Alici, B. Kasapoglu

2007-01-01

138

A case of cyst hydatid rupture presented with rashes to the emergency department  

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Hydatid cyst is a disease caused by Echinococcus Granulosus. The cystic form of Echinoccocus granulosus (Cyst Hydatid) is usually seen in the liver (60%). Hydatid cyst rupture may cause with a wide range of allergic reactions, from urticaria to anaphylactic shock. Erythema, puffiness and pruritus may be the only findings of cyst hydatid rupture in some cases. In the present study, we report a case of 22 year old man presented with skin rashes and diagnosed as cyst hydatid rupture. And we als...

Kandis, Hayati; Katirci, Yavuz

2009-01-01

139

Association between gold induced skin rash and remission in patients with rheumatoid arthritis.  

OpenAIRE

The coincidence of skin eruption and remission induced by gold has not previously been reported. In 50 out of 247 patients with rheumatoid arthritis treated with gold salts (Solganal) between 1977 and 1987 treatment was stopped owing to adverse reactions. Skin rashes were present in 31 patients, 10 had nephropathy, and nine patients had aphthous stomatitis. All 31 patients who developed skin eruption entered a concomitant clinical and laboratory remission. The remission satisfied the American...

Caspi, D.; Tishler, M.; Yaron, M.

1990-01-01

140

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.)

141

Fractures of the nasolacrimal fossa and canal: CT findings and clinical significance  

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This study was aimed to determine the CT findings of nasolacrimal fossa and their clinical significance. Twenty-nine of 116 patients who underwent facial CT scanning after trauma showed evidence of nasolacrimal fracture. We retrospectively analyzed CT findings to evaluate fracture patterns of the nasolacrimal fossa and canal and associated facial fractures. To determine the frequency of associated complications, clinical records were reviewed were reviewed. Three types of fracture were identified: avulsion, comminuted,and linear. Forty-one nasolacrimal fractures, 20 of which involved the nasolacrimal fossa and 21 the nasolacrimal canal, were found in the 29 patients. Of the 20 fractures involving the nasolacrimal fossa, ten were avulsion, eight were linear, and two were comminuted. Seventeen of 21 fractures involving the nasolacrimal canal were comminuted and four were linear;all nasolacrimal fractures were associated with other facial fractures. Twenty-five of 29 fractures were the complex midfacial-type (naso-ethmoid);the remaining four were simple and unilateral. Nasolacrimal sac and duct-related complications were documented in only two patients; they experienced epiphora associated with avulsion fracture of the nasolacrimal fossa, though the probvlem was resolvced by conservative treatment without surgery. Fractures of the nasolacrimal fossa and canal were accompanied by simple or complex facial fractures. Injury-associated complications were rare, and all were associated with avulsion fractures of the nasolacrimal fossa.=20.

Lee, Chae Kyung; Lee, Hyeon Kyeong; Lee, Jong Hwa; Ku, Kwan Min; Choi, Dae Seob; Oh, Yeon Hee; Kim, Seung Hyeon; Lee, Sung Woo; Han, Jae Sik; Kim, Mi Woon [Dongguk Univ., College of Medicine, Seoul (Korea, Republic of)

1998-09-01

142

Fractures of the nasolacrimal fossa and canal: CT findings and clinical significance  

International Nuclear Information System (INIS)

This study was aimed to determine the CT findings of nasolacrimal fossa and their clinical significance. Twenty-nine of 116 patients who underwent facial CT scanning after trauma showed evidence of nasolacrimal fracture. We retrospectively analyzed CT findings to evaluate fracture patterns of the nasolacrimal fossa and canal and associated facial fractures. To determine the frequency of associated complications, clinical records were reviewed were reviewed. Three types of fracture were identified: avulsion, comminuted,and linear. Forty-one nasolacrimal fractures, 20 of which involved the nasolacrimal fossa and 21 the nasolacrimal canal, were found in the 29 patients. Of the 20 fractures involving the nasolacrimal fossa, ten were avulsion, eight were linear, and two were comminuted. Seventeen of 21 fractures involving the nasolacrimal canal were comminuted and four were linear;all nasolacrimal fractures were associated with other facial fractures. Twenty-five of 29 fractures were the complex midfacial-type (naso-ethmoid);the remaining four were simple and unilateral. Nasolacrimal sac and duct-related complications were documented in only two patients; they experienced epiphora associated with avulsion fracture of the nasolacrimal fossa, though the probvlem was resolvced by conservative treatment without surgery. Fractures of the nasolacrimal fossa and canal were accompanied by simple or complex facial fractures. Injury-associated complications were rare, and all were aed complications were rare, and all were associated with avulsion fractures of the nasolacrimal fossa.=20

143

MR imaging of the floor of the middle cranial fossa  

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The intracranial extension of nasopharyngeal and paranasal sinus neoplasms poses difficult imaging problems. MR images were obtained of five healthy volunteers and 15 patients with pathologic conditions of the paranasal sinuses and nasopharynx affecting the skull base. MR images were acquired with a 0.3-T permanent magnet imaging system using 3-mm-thick sections and various two-dimensional Fourier transform spin-echo pulse sequences. MR imaging findings were compared with clinical records, plain film findings, and CT and pathologic findings. The normal MR images were correlated with thin cryosection specimens of fresh human cadavers. MR images provided excellent spatial and contrast resolution of the floor of the middle cranial fossa and related structures. Neoplastic invasion could be demonstrated as well as or better than with CT

144

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

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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.

Pereira Antonio Carlos M.

2001-01-01

145

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

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Full Text Available SciELO Brazil | Language: English Abstract in english 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 pre [...] senting 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.

2001-02-01

146

Magnetic resonance properties of hydrogen: imaging the posterior fossa  

International Nuclear Information System (INIS)

Posterior fossa scans were performed on five healthy volunteers using a nuclear magnetic resonance (NMR) machine constructed by Thorn-EMI Ltd. Three different NMR scanning sequences were used. In the first, a type of saturation-recovery technique was used to produce images strongly dependent on the density of hydrogen nuclei, but with some dependence on the spin-lattice relaxation time (T1). In the second, an inversion-recovery technique was used to produce images with a stronger dependence on the spin-lattice relaxation time. In the third, a spin-echo technique was used to obtain images with a dependence on the spin-spin relaxation time (T2). All three types of NMR image were unaffected by bone artifact. Visualization of brain adjacent to the skull base was obtained without loss of detail due to partial-volume effect from bone. The saturation-recovery images highlighted arteries and veins that were clearly visible without the use of contrast agents. The inversion-recovery images showed remarkable gray-white matter differentiation enabling internal structure to be seen within the brainstem and cerebellum. The trigeminal nerve and ganglion were also seen outside the brain. Experience with the spin-echo technique is limited, but the images at the base of the brain show considerable soft-tissue detail. The NMR images of the posterior fossa in this study were comparable in quality to those obtained from a new rotate-rotate x-ray computed tomography m rotate-rotate x-ray computed tomography machine and were superior in several respects

147

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.

Ivanovi? S.

2004-01-01

148

Infratemporal Fossa Fasciae: Anatomical and Clinical-Surgical Study.  

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Full Text Available The lack of thoroughness that characterizes the anatomical description of pterygo-temporo-mandibular and interpterygoid fasciae is indisputable; this shortcoming is not only found in classical but also in contemporary bibliography. Likewise, these are not contemplated in International Anatomical Terminology. This paper aims to provide a detailed description of the aforementioned fasciae and the ligaments that depend of them, thus as the bony bridges. Similarly, a correlation among these anatomical structures and trigeminal neuralgia will be developed, placing particular emphasis on its role as the possible etiological agents. In the process of performing this task, skulls (n=200, cadavers without previous fixing (n=10 and cadavers fixed in a 5% aqueous formaldehyde solution (n=20 were used. Following a standardized procedure, using appropriate instrumental and magnifying devices, the dissections were performed. It should be stressed that both, conventional and unconventional approaches, were executed. During each stage of this research pertinent photographic recording was taken. The distinctive anatomical characteristics of these fasciae have been precisely exhibited, detailing its shapes, limits, insertions and relations within infratemporal fossa. A meticulous description of pterygoalar and pterygospinosous ligament was attained and its relations with the colateral branches of mandibular nerve bear special highlighting. Indeed, the role played by these ligaments in the constitution of bony bridges surrounding the oval foramen was widely analyzed. After profound reflexion on the obtained results, a thorough description of pterygo-temporo-mandibular and interpterygoid fasciae and its ligaments was achieved allowing to drawing a parallel between its disposition in the infratemporal fossa and its possible ossification and the compression the nervous branches might undergo so that a trigeminal neuralgia befalls.

Menéndez, José María

2012-12-01

149

Geomorphology and structural geology of Saturnalia Fossae and adjacent structures in the northern hemisphere of Vesta  

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Vesta is a unique, intermediate class of rocky body in the Solar System, between terrestrial planets and small asteroids, because of its size (average radius of ?263 km) and differentiation, with a crust, mantle and core. Vesta's low surface gravity (0.25 m/s2) has led to the continual absence of a protective atmosphere and consequently impact cratering and impact-related processes are prevalent. Previous work has shown that the formation of the Rheasilvia impact basin induced the equatorial Divalia Fossae, whereas the formation of the Veneneia impact basin induced the northern Saturnalia Fossae. Expanding upon this earlier work, we conducted photogeologic mapping of the Saturnalia Fossae, adjacent structures and geomorphic units in two of Vesta's northern quadrangles: Caparronia and Domitia. Our work indicates that impact processes created and/or modified all mapped structures and geomorphic units. The mapped units, ordered from oldest to youngest age based mainly on cross-cutting relationships, are: (1) Vestalia Terra unit, (2) cratered highlands unit, (3) Saturnalia Fossae trough unit, (4) Saturnalia Fossae cratered unit, (5) undifferentiated ejecta unit, (6) dark lobate unit, (7) dark crater ray unit and (8) lobate crater unit. The Saturnalia Fossae consist of five separate structures: Saturnalia Fossa A is the largest (maximum width of ?43 km) and is interpreted as a graben, whereas Saturnalia Fossa B-E are smaller (maximum width of ?15 km) and are interpreted as half grabens formed by synthetic faults. Smaller, second-order structures (maximum width of structure, by the use of the general descriptive term 'adjacent structures', which encompasses minor ridges, grooves and crater chains. For classification purposes, the general descriptive term 'minor ridges' characterizes ridges that are not part of the Saturnalia Fossae and are an order of magnitude smaller (maximum width of structural features on Vesta by presenting findings of a photogeologic, structural mapping study which highlights how impact cratering and impact-related processes are expressed on this unique, intermediate Solar System body.

Scully, Jennifer E. C.; Yin, A.; Russell, C. T.; Buczkowski, D. L.; Williams, D. A.; Blewett, D. T.; Ruesch, O.; Hiesinger, H.; Le Corre, L.; Mercer, C.; Yingst, R. A.; Garry, W. B.; Jaumann, R.; Roatsch, T.; Preusker, F.; Gaskell, R. W.; Schröder, S. E.; Ammannito, E.; Pieters, C. M.; Raymond, C. A.

2014-12-01

150

Diaper Rash  

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... brands of disposable diapers or baby wipes. Plastic pants that fit over diapers raise the temperature and ... your baby's skin from moisture. Avoid using plastic pants or diapers with plastic edges. After bathing, pat ...

151

Middle cranial fossa tumors of rare and a typical CT features  

International Nuclear Information System (INIS)

Six different brain tumors in middle cranial fossa are presented which are studied by CT and proved pathologically. The authors experienced rare tumors in middle cranial fossa such as cavernous hemangioma, cystic meningioma, Schwannoma, Masson's vegetant intravascular hemangioendothelioma and other tumors (arteriovenous malformation and metastatic adenoid cystic carcinoma) whose CT findings were atypical. The results are as follows; 1. In case of tumors in middle cranial fossa, basal and coronal sections are necessary for further evaluation of the relations with dura and adjancent bone change. 2. In suspicion of metastasis, bone setting should be done to find out bone involvement. 3. Internal carotid angiography gave little help in the differential diagnosis of tumors in middle cranial fossa

152

The Radiological Spectrum of Orbital Pathologies that Involve the Lacrimal Gland and the Lacrimal Fossa  

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CT and MRI are utilized to differentiate between different types of masses and to determine the extent of lesions involving the lacrimal gland and the fossa. Although many diseases that affect the lacrimal gland and fossa are specifically diagnosed by imaging, it is frequently very difficult to differentiate each specific disease on the basis of image characteristics alone due to intrinsic similarities. In lacrimal gland epithelial tumors, benign pleomorphic adenomas are seen most commonly wi...

Jung, Won Sang; Ahn, Kook Jin; Park, Mi Ra; Kim, Ji Young; Choi, Jae Jeong; Kim, Bum Soo; Hahn, Seong Tai

2007-01-01

153

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

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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 we...

Chen, Duo; Wei, Xiangtai; Yin, Qiang

2009-01-01

154

Microanatomy and Surgical Approaches to the Infratemporal Fossa: An Anaglyphic Three-Dimensional Stereoscopic Printing Study  

OpenAIRE

Objective: The infratemporal fossa (ITF) is a continuation of the temporal fossa between the internal surface of the zygoma and the external surface of the temporal bone and greater wing of the sphenoid bone that is sitting deep to the ramus of the mandible. The principal structure to understanding its relationships is the lateral pterygoid muscle. Other important structures are the medial pterygoid muscle, the maxillary artery, the pterygoid venous plexus, the otic ganglion, the chorda tympa...

Isolan, Gustavo Rassier; Rowe, Richard; Al-mefty, Ossama

2007-01-01

155

CT and MRI diagnosis of tumor originating in the pterygopalatine fossa  

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Objective: To investigate the CT and MRI findings of tumors originating in the pterygopalatine fossa so as to promote the diagnostic accuracy. Methods: All 11 patients with tumors arising from the pterygopalatine fossa were confirmed by pathology and surgery. CT and MRI appearances were analyzed retrospectively. Results: The tumors included 3 neurilemmomas, 2 neurofibromas, 3 angiofibromas, 2 adenoid cystic carcinomas, and 1 melanoma, and they all extended through communicating pathways of the pterygopalatine fossa. On HRCT, neurogenic tumors caused enlargement of the pterygopalatine fossa with thinning of their bony walls, while MRI demonstrated isointense signal to brain on T1WI and hyperintense signal on T2WI. Two neurofibromas showed homogeneous enhancement after administration of contrast medium while 3 neurilemmomas showed heterogeneous enhancement. On HRCT scans, angiofibroma caused enlargement of the pterygopalatine fossa, eroding their bony walls. On MR imaging, the lesions were isointense compared to muscle on T1WI, hyperintense on T2WI with marked postcontrast enhancement. One case of angiofibroma showed scattered stippling or stria-shaped signal voids and inhomogeneous postcontrast enhancement. On CT scans, adenoid cystic carcinoma revealed moth-eaten bony wall of the pterygopalatine fossa with poorly defined margins and irregular shapes. Adenoid cystic carcinoma showed hypointense signal compared to muscle on T1WI, inhomogeneous hyperintense signal on T2WI and heterogeneous postcontrast enhancement. One case of melanoma showed enlargement of pterygopalatine fossa and destruction of the bony walls except for the anterior wall by invading adjacent structures with well-defined border and irregular shape. On MR imaging, the lesion showed isointense signal compared to muscle on T1WI and hyperintense signal on T2WI with discrete mottled or linear signal voids and inhomogeneous postcontrast enhancement. Conclusion: HRCT can depict bony changes clearly and MRI can demonstrate optimally the extent of the lesion in pterygopalatine fossa. Both imaging modalities can contribute to the diagnosis of neurogenic tumor and angiofibroma and can provide information for therapeutic procedure and surgical planning

156

Exploration of Saturnalia Fossa and Associated Structures in Vesta’s Northern Hemisphere  

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Since its arrival at Vesta on July 16th 2011, NASA’s Dawn spacecraft has collected spectacular imaging, compositional and geophysical data. Dawn is scheduled to depart Vesta on August 26th and during this eventful year many unexpected discoveries have been made about this diverse asteroid. One such discovery is the Saturnalia Fossa trough in Vesta’s northern hemisphere. Saturnalia Fossa is the chief structure of at least 5 parallel troughs, many of which partly coalesce into one another at various locations. The sizeable Saturnalia Fossa dominates Vesta’s northern hemisphere and lends its name to the Saturnalia Ridge and Trough Terrain. Saturnalia Fossa has a maximum width of 39 km, making it almost twice the width of the 22 km wide Divalia Fossa equatorial trough. Currently Saturnalia Fossa ( 366 km long) is shorter than Divalia Fossa ( 465 km long) (Buczkowski et al., 2012, submitted to GRL). But, Saturnalia Fossa extends into the currently shadowed northern region and its length will increase as Dawn gains coverage in this enigmatic area. The northern troughs are covered in an obscuring layer of regolith, which makes identifying their specific form challenging. Comparative planetology, along with the analysis of Dawn data, helps to indicate whether the troughs are graben or another structure. The orientation of the troughs makes it likely that their formation is linked to that of the southern Veneneia basin (Buczkowski et al., 2011, AGU). There are many smaller structures, which include grooves, pit crater chains and small ridges that are preferentially oriented sub-parallel or sub-perpendicular to the troughs. This suggests that they have a related formation mechanism. An initial analysis of the distribution of the troughs and smaller structures indicates that they are oriented as if they were formed by large-scale shearing. This shear is possibly a result of the Veneneia-forming impact.

Scully, Jennifer; Russell, C. T.; Yin, A.; Buczkowski, D. L.; Williams, D. A.; Hiesinger, H.; Garry, W. B.; Yingst, R. A.; Blewett, D. T.; Roatsch, T.; Gaskell, R. W.; Preusker, F.; Le Corre, L.; Ammannito, E.; Jaumann, R.; Pieters, C. M.; Raymond, C. A.

2012-10-01

157

Dermoid cyst of the infratemporal fossa: case report and review of the literature.  

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Background?Intracranial dermoid cysts are rare tumors of congenital origin. We report a case of a large dermoid tumor arising in the infratemporal fossa (ITF) with erosion into the middle cranial fossa. After reviewing the literature, we believe this represents the first reported dermoid tumor of the ITF with extension into the middle cranial fossa. Results?A 21-year-old women presented with a large cystic mass involving the left infratemporal fossa and middle cranial fossa that was discovered following a motor vehicle collision. Neurologic examination was normal. The mass was resected through a frontotemporal extradural approach with endoscopic assistance. Imaging studies, gross findings, and histopathology were consistent with a dermoid tumor. Conclusion?This is the first report of a dermoid cyst arising in the ITF with extension into the middle cranial fossa. We suggest including dermoid tumor in the differential diagnosis of cystic abnormalities in this region. Complete resection of the cyst remains the preferred treatment with surgical approach guided by preoperative imaging. PMID:25083385

Triplett, Thomas M; Griffith, Adam; Hatanpaa, Kimmo J; Barnett, Samuel L

2014-08-01

158

Supratentorial Neurometabolic Alterations in Pediatric Survivors of Posterior Fossa Tumors  

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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 < 0.0001) and gray matter (p < 0.0001) of MB patients and in gray matter (p = 0.005) of PA patients, compared to healthy peers. Decreased creatine concentrations in parietal gray matter correlated significantly with older age at diagnosis in both patient groups (MB patients, p = 0.009, r = 0.52; PA patients, p = 0.006, r = 0.7). Longer time periods since diagnosis were associated with lower NAA levels in white matter of PA patients (p = 0.008, r = 0.66). Conclusions: Differently decreased NAA concentrations were observed in both PA and MB groups of posterior fossa tumor patients. We conclude that this reflects a disturbance of the neurometabolic steady state of normal-appearing brain tissue due to the tumor itself and to the impact of surgery in both patient groups. Further incremental decreases of metabolite concentrations in MB patients may point to additional harm caused by irradiation and chemotherapy. The stronger decrease of NAA in MB patients may correspond to the additional damage of combined irradiation and chemotherapy on neuroaxonal cell viability and number.

Rueckriegel, Stefan M., E-mail: rueckriegel.s@nch.uni-wuerzburg.de [Pediatric Neurooncology Program, Department of Pediatric Oncology and Hematology, Charite-Universitaetsmedizin Berlin, Berlin (Germany); Driever, Pablo Hernaiz [Pediatric Neurooncology Program, Department of Pediatric Oncology and Hematology, Charite-Universitaetsmedizin Berlin, Berlin (Germany); Bruhn, Harald [Department of Radiology, Charite-Universitaetsmedizin Berlin, Berlin (Germany); Department of Radiology, Klinikum der Friedrich-Schiller-Universitaet, Erlanger (Germany)

2012-03-01

159

Polygonal Dike Networks in the Medusae Fossae Formation  

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1. Introduction 1.1 The Medusae Fossae Formation The Medusae Fossae Formation (MFF) is a widespread and voluminous formation which covers 2.1 x 106 km2 between 130-230ºE and 12ºS-12ºN [1-3]. As a fine-grained, friable deposit, its surface is dominated by aeolian features such as yardangs [3-5] and a large number of both fresh and indurated transverse aeolian ridges [TARs] [5]. The deposition of the MFF began at the latest in the Hesperian [6], and over time it has been recognized that, by virtue of its fine-grained nature, the MFF may preserve an important record of Martian history, most directly as a result of the burial and exhumation of channels found in the Zephyria region of the formation [7]. In order to better document the occurrence of smallscale features of interest within the MFF, we examined 427 High Resolution Imaging Science Experiment (HiRISE) images spread across the formation, during which the occurrence of features of interest were mapped [8]. HiRISE images were supplemented by Mars Reconnaissance Orbiter Context Imager (CTX), Mars Express High Resolution Stereo Camera (HRSC) and Mars Global Surveyor Mars Orbiter Camera (MOC) images where needed. Here we describe the occurrence and characteristics of several polygonal networks of rectilinear ridges. 1.2 Rectilinear Ridges on Mars Rectilinear ridges have been recognized in several different areas on Mars. Long, linear to slightly curving or en echelon ridges hypothesized to be exhumed magmatic dikes have been found in a variety of environments on Mars [9-13], particularly in formerly glaciated terrains where magma may have been emplaced into an icy substrate. A network of rectilinear ridges was described in detail in an unnamed crater on the dichotomy boundary [14]. These chaotic, intersecting ridges, forming irregular polygons ~1 km across, are hypothesized to be brecciated dikes emplaced during the process of crater formation [14]. A group of intersecting rectilinear ridges, informally known as "Inca City" and seen to be eroding out of the south polar layered deposits, was observed in early MOC images and hypothesized to be lithified duneforms, clastic dikes, or magmatic dikes [15]. More recently, smaller networks of linear ridges (polygons ~25 m across) have been identified in Gale Crater, where they have been attributed to preferential cementation of material due to the circulation of fluids through fracture networks [16].

Kerber, L.; Dickson, J. L.; Forget, F.; Head, J. W.; Grosfils, E. B.

2013-09-01

160

Drug Rash with Eosinophilia and Systemic Symptoms Syndrome Due to Anti-TB Medication.  

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Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, idiosyncratic, multi-system reaction characterized by the clinical triad of fever, rash, and internal organ involvement. The mortality rate is estimated to be 8%, especially among patients with liver involvement, so early recognition is imperative. Drugs commonly associated with the development of DRESS syndrome include anticonvulsants, long-acting sulfonamides, and anti-inflammatory medications; however, there are no reported cases implicating anti-tuberculosis (anti-TB) medications. We report a case of DRESS syndrome from anti-TB therapy. A 68-year-old male with pulmonary TB presented with pruritic skin eruption and sore throat, 8 weeks after starting Rifampin, Isoniazid, Pyrazinamide, and Ethambutol (RIPE) therapy. He takes metformin and glyburide for diabetes. Physical exam was significant for diffuse, exfoliative erythematous macules with target lesions involving the entire skin surface, without mucosal involvement. Laboratory data was significant for mild transaminitis and new onset eosinophilia. Given suspicion of drug eruption, RIPE therapy was discontinued. Skin biopsy confirmed erythema multiforme. Despite discontinuation of the implicated medications, eosinophilia and transaminitis continued to worsen, and so systemic corticosteroids were started. After 4 weeks of discontinuation of RIPE therapy, the cutaneous eruption resolved and laboratory data returned to normal. The patient is finishing course of anti-TB with cycloserine and moxifloxacin. Upon follow up as outpatient, the rash was resolving and disappeared in 1 month. DRESS syndrome is always considered when there is high eosinophil counts and multisystem involvement with skin eruptions. It can be potentially life threatening with certain drugs and infectious agents in predisposed individuals. It is imperative to discontinue the causative medication and avoid re-exposure. PMID:24479051

Kaswala, Dharmesh H

2013-01-01

161

Histopathological characterization of the skeletal myopathy in rasH2 mice carrying human prototype c-Ha-ras gene.  

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A skeletal myopathy is found in approximately 100% of rasH2 mice. To confirm detailed features of the rasH2 skeletal myopathy, the biceps femoris, diaphragm, triceps brachii, gastrocnemial (types I and II fiber-mixed muscles) and soleus muscle (type I fiber-dominant muscle) obtained from male rasH2 and non-transgenic littermates aged 10-13 and 34 weeks were examined. Variations in the muscle fiber size, early-scattered degeneration/necrosis and regeneration of muscle fibers were detected in 10-13-week-old rasH2 mice. The severity of the above muscular lesions was more prominent in older rasH2 mice. These lesions were noted in the type II myofiber dominant muscles (biceps femoris, triceps brachii and gastrocnemial). NADH-TR stain clearly demonstrated a disorganized intermyofibrillar network and necrotic change in muscle fibers. No specific morphological changes, like rod structure or tubular aggregation seen in some types of myopathy, were noted in Gomori trichrome and NADH-TR stains in the rasH2 mouse like in many types of muscular dystrophy. Electronmicroscopically, occasional muscle fiber degeneration/regeneration, invaded phagocytic cells, indistinct Z-band suggesting excessive contraction and dilatation of the sarcoplasmic reticulum were observed. In summary, the skeletal myopathy occurring in rasH2 mice is consistent with muscular dystrophy characterized morphologically by progressive degeneration and regeneration of myofibers. The myopathy is confined to the type II myofiber predominant muscles and is not associated with any pathognomonic lesions. These characteristics will provide us with a useful model for research in muscular dystrophy of diverse myofibers. PMID:15942132

Tsuchiya, Takayuki; Okada, Miyoko; Sakairi, Tetsuya; Sano, Fumiko; Sugimoto, Jiro; Takagi, Shirou

2005-05-01

162

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

OpenAIRE

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 ...

Guzma?n, Mari?a G.; DELFINA ROSARIO; Rodri?guez, Mari?a E.; MAYLING ÁLVAREZ; ROSMARI RODRÍGUEZ; SUSET OROPESA; JOSÉ LAFERTÉ; SONIA RESIK

1997-01-01

163

A case of cyst hydatid rupture presented with rashes to the emergency department  

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Full Text Available Hydatid cyst is a disease caused by Echinococcus Granulosus. The cystic form of Echinoccocus granulosus (Cyst Hydatid is usually seen in the liver (60%. Hydatid cyst rupture may cause with a wide range of allergic reactions, from urticaria to anaphylactic shock. Erythema, puffiness and pruritus may be the only findings of cyst hydatid rupture in some cases. In the present study, we report a case of 22 year old man presented with skin rashes and diagnosed as cyst hydatid rupture. And we also discussed the cyst hydatid rupture in the light of the medical literature.

Hayati KANDIS

2009-01-01

164

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

OpenAIRE

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. Clinica...

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

165

Synovial sarcoma of the infratemporal fossa: A case report.  

Science.gov (United States)

Synovial sarcomas (SS) are high-grade soft-tissue sarcomas, predominantly found in the deep soft tissues of the lower extremities, with only 3-5% occurring in the head and neck region. Primary SS of the infratemporal fossa (ITF) is exceptionally uncommon. The present study reports the case of a 23-year-old female with an SS arising in the ITF. To the best of our knowledge, this case is only the second patient with intracranial involvement recorded in the literature. The patient was treated primarily with surgery, followed by a total of 60 Gy adjuvant radiotherapy and chemotherapy, consisting of cisplatin (25 mg/m(2) intravenously on days one to three), epirubicin (25 mg/m(2) intravenously on days one and two) and ifosfamide (1.8 g/m(2) intravenously on days one to five) for three cycles. At present, two years after this multimodal therapy, the patient exhibits no signs of loco-regional recurrence or distant metastases. This study highlights the importance of a multidisciplinary approach in the diagnosis and treatment of this extremely rare entity with intracranial extension. In addition, the study reviews the English literature with regard to SS of ITF and discusses the clinicopathological features, management and outcome. PMID:25295104

Wushou, Alimujiang; Zhao, Ya-Jun; Shao, Zhi-Ming

2014-11-01

166

Diagnostic imaging of posterior fossa anomalies in the fetus and neonate: part 1, normal anatomy and classification of anomalies.  

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This article is the first portion of a two-part review that illustrates the normal appearance of the cerebellum and posterior fossa on prenatal ultrasound and MRI and on postnatal diagnostic imaging studies. Classification and terminology of posterior fossa abnormalities in the literature are confusing due to evolution of concepts and sometimes lack of consensus. Accurate classification of posterior fossa anomalies is important for predicting fetal outcome and for appropriate counseling. In Part 1 of this review, prenatal and postnatal imaging techniques for assessing the posterior fossa will be discussed, followed by a discussion of how cerebellar malformations may be classified. PMID:25457573

Chapman, Teresa; Mahalingam, Sowmya; Ishak, Gisele E; Nixon, Jason N; Siebert, Joseph; Dighe, Manjiri K

2015-01-01

167

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  

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Full Text Available 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 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.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 days 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.

André Luis Selmi

2012-01-01

168

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 'unrese high risk patients, as well as in 'unresectable' meningiomas, it is an obvious alternative to microsurgery. (authors)

169

Medusae Fossae Formation, Mars: A Mars Global Surveyor Perspective  

Science.gov (United States)

Massive deposits of the Medusae Fossae Formation (MFF) in the Elysium-Amazonis region of Mars (12S to 18N lat., 125 to 220W long.) are superposed on both the heavily cratered terrain of the southern highlands and the moderately cratered lowlands north of the dichotomy boundary. The origin of MFF materials has been controversial since Viking images first showed its complex texture and extensive distribution. New imaging and topographic data from instruments on the Mars Global Surveyor (MGS) spacecraft have clarified our knowledge of some of the details of MFF, but they have thus far failed to provide unambiguous evidence of the most likely origin for these materials. Here we will summarize the attributes of MFF derived from an abundance of both Mars Orbiter Camera (MOC) and Mars Orbiter Laser Altimeter (MOLA) data, and how this information fits with the many proposed hypotheses of origin for MFF. Recent releases of both MOC and MOLA data have clarified both the geomorphic and topographic attributes of MFF deposits, particularly with regard to the massive nature of most exposures and the unconformable contact relations between MFF and both old and (relatively) young terrains underlying MFF throughout the region. The MGS data do not seem to provide unequivocal evidence of a single origin, raising the possibility that the extensive MFF deposits represent a mixture of origins. As more MGS data are released, these analyses will continue to be evaluated as part of an on-going collaborative effort in an effort to at least reduce the number of the most viable hypotheses of origin.

Zimbelman, J. R.

2001-12-01

170

Defining the superior border of posterior fossa radiation treatment fields  

International Nuclear Information System (INIS)

Purpose: Lateral posterior fossa treatment fields are usually defined on traditional simulation films based on bony landmarks. The superior field border, intended to include the apex of the tentorium cerebelli, is frequently difficult to define. While sagittal magnetic resonance imaging (MRI) images or three-dimensional treatment planning tools are good means to locate the tentorial apex, these are not always available. We herein describe a method for locating the tentorial apex based on bony landmarks. Methods and Materials: Midsagittal magnetic resonance images of 53 patients were reviewed. Using a Cartesian grid, the geometric relationship between the tentorial apex and several bony landmarks was assessed. Two lines were defined: the first connected the posterior clinoid and the internal occipital protuberance (AB). The second was perpendicular to the first, included the tentorial apex, and extended from the base of the skull inferiorly to the 'crown' of the skull superiorly (DE). Relationships between measurements were made using linear regression and least square fits. Results: Line DE was within 5 mm of the perpendicular bisector of line AB in 83% (44/53) of patients. The tentorial apex was located within 10 mm of the midpoint of DE in 91% (48/53) of patients. Conclusion: In the majority of patients, the location of the tentorial apex can be estimated based on bony landmarks, to within approximately 10 mm. The technique described is a useful means of estimating described is a useful means of estimating the location of the tentorial apex in patients where sagittal MRI imaging or three-dimensional treatment planning tools are not available

171

Congenital cholesteatoma of the infratemporal fossa with congenital aural atresia and mastoiditis: a case report  

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Full Text Available Abstract Background Congenital cholesteatoma may be expected in abnormally developed ear, it may cause bony erosion of the middle ear cleft and extend to the infratemporal fossa. We present the first case of congenital cholesteatoma of the infratemporal fossa in a patient with congenital aural atresia that has been complicated with acute mastoiditis. Case presentation A sixteen year old Egyptian male patient presented with congenital cholesteatoma of the infratemporal fossa with congenital aural atresia complicated with acute mastoiditis. Two weeks earlier, the patient suffered pain necessitating hospital admission, magnetic resonance imaging revealed a soft tissue mass in the right infratemporal fossa. On presentation to our institute, Computerized tomography was done as a routine, it proved the diagnosis of mastoiditis, pure tone audiometry showed an air-bone gap of 60 dB. Cortical mastoidectomy was done for treatment of mastoiditis, removal of congenital cholesteatoma was carried out with reconstruction of external auditory canal. Follow-up of the patient for 2 years and 3 months showed a patent, infection free external auditory canal with an air-bone gap has been reduced to 35db. One year after the operation; MRI was done and it showed no residual or recurrent cholesteatoma. Conclusions Congenital cholesteatoma of the infratemporal fossa in cases of congenital aural atresia can be managed safely even if it was associated with mastoiditis. It is an original case report of interest to the speciality of otolaryngology.

Abdel-Aziz Mosaad

2012-06-01

172

Cystic malformations of the posterior cranial fossa, current state of classification, CT and MR appearance  

International Nuclear Information System (INIS)

The cerebellum has the longest development in comparison with other large structures of the brain, and this may be the cause of many developmental abnormalities.They are divided into two groups: cystic malformations and disturbances of cerebellar histiogenesis process. The paper focuses on the former of the two large groups mentioned above. Cystic malformations leading to hypoplasia of the vermis and cerebellar hemispheres often cause enlargement of the posterior cranial fossa. The aim of this study is to summarize and systematize the contemporary knowledge of cystic lesions of the posterior fossa, especially their imaging. Imaging of posterior fossa malformations is practically based on computed tomography (CT) and magnetic resonance imaging (MRI). On CT studies, the posterior fossa is imaged with 5 mm or 2- 3 mm slices to gain more precise visualization. However, CT is often followed by MRI, mainly in T1-weighted, sagittal and axial images, which allow for the best evaluation of the posterior fossa structures. 2D-FISP imaging technique may be also useful. Thorough analysis of the literature allowed to put forward the following conclusions: classification of these cystic malformations is frequently changed; it is necessary to evaluate disorders both in CT and MRI; one should use the descriptive term - retrocerebellar cyst, if an image is not clear-cut; the radiologist's goals include finding a lesion, evaluation of its topography and effect on the brain, but not neceaphy and effect on the brain, but not necessarily establishing its particular type. (author)

173

A case of recurrent rash and leg numbness mimicking systemic rheumatic disease: the occurrence of leprosy in a nonendemic area.  

Science.gov (United States)

Leprosy, a rare chronic granulomatous communicable disease caused by Mycobacterium leprae, is classically known to have cutaneous and neurologic sequelae. As a result of immigration, the disease, endemic in Brazil, India, Nepal, Madagascar, Myanmar, and Indonesia, has been recognized to be present in North America and the Caribbean. We describe a case of a woman presenting with a long history of a recurrent rash and leg numbness, initially diagnosed with systemic lupus, who was later proven to have lepromatous leprosy. It is a reminder that this underappreciated disease should still be considered in the differential diagnosis of skin rash and neuropathy, even in nonendemic regions. PMID:17551381

Flower, Cindy; Gaskin, David; Marquez, Sean

2007-06-01

174

Cerebral Venous Thrombosis Causing Posterior Fossa Lesions: Description of a Case Series and Assessment of Safety of Anticoagulation.  

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Background: Isolated posterior fossa parenchymal lesions associated with cerebral venous thrombosis (CVT) are rare. Posterior fossa lesions are an independent predictor of death in CVT. We aim to describe the characteristics and outcome of patients with CVT and isolated posterior fossa lesions and assess the safety of anticoagulation in patients with posterior fossa lesions associated with CVT. Methods: We retrieved data from all patients with posterior fossa parenchymal lesions in the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) cohort related to clinical features, therapy and outcome. Fisher's exact test was used to evaluate associations. To assess the safety of anticoagulation in CVT patients with posterior fossa lesions we considered all patients with a lesion in this topography, either isolated or with concomitant supratentorial lesions, and compared the rate of new intracranial haemorrhages on repeated imaging with the remaining cohort. Results: Out of 624 patients, 12 had isolated posterior fossa lesions and 14 had posterior fossa lesion with accompanying supratentorial lesions. The lateral sinus was most frequently occluded (n = 11). Involvement of the superior sagittal sinus was significantly less frequent compared to the remaining patients of the cohort (p = 0.013). None of the patients with isolated posterior fossa lesion died but 3 remained dependent on follow-up. Poor outcome (modified Rankin Scale ?3) was more frequent in patients with any posterior fossa lesion, even when on anticoagulation (29.2% vs. 11.9%; OR 3.04; 95% CI 1.2-7.6; p = 0.018). Of the 24 anticoagulated patients with a posterior fossa lesion, 3 (12.5%) had new haemorrhages on repeated imaging, compared with 30 out of 495 anticoagulated patients (6.1%) without posterior fossa lesions (p = 0.19). Conclusions: We describe the largest series of CVT patients with associated posterior fossa lesions. When compared to anticoagulated CVT patients without posterior fossa lesions, CVT patients with posterior fossa lesions on full anticoagulation did not have a significant increase in the rate of new intracranial haemorrhages. © 2014 S. Karger AG, Basel. PMID:25428134

Aguiar de Sousa, Diana; Ferro, José M; Canhão, Patrícia; Barinagarrementeria, Fernando; Bousser, Marie-Germaine; Stam, Jan; Nogueira Pinto, Amélia; Viana Baptista, Miguel; Béjot, Yannick; Dequatre-Ponchelle, Nelly

2014-11-25

175

Endoscopic Endonasal Approach to the Middle Cranial Fossa through the Cavernous Sinus Triangles: Anatomical Considerations.  

Science.gov (United States)

The lateral limit of endoscopic endonasal surgery has yet to be defined. The aim of this study was to investigate the lateral limit of endoscopic endonasal surgery at the level of the sphenoid sinus. Access from the sphenoid sinus to the middle cranial fossa through the cavernous sinus triangles was evaluated by cadaver dissection. Anatomical analysis demonstrated that the medial temporal dura mater was exposed through the anterior area of the clinoidal triangle, anteromedial triangle, and superior area of the anterolateral triangle, indicating potential corridors to the middle cranial fossa. This study suggests that the cavernous sinus triangles are applicable in selected cases to manage middle cranial fossa lesions by endoscopic endonasal surgery. PMID:25446385

Komatsu, Fuminari; Oda, Shinri; Shimoda, Masami; Imai, Masaaki; Shigematsu, Hideaki; Komatsu, Mika; Tschabitscher, Manfred; Matsumae, Mitsunori

2014-12-15

176

DEMOGRAPHIC DATA COMPARISON OF PREVALENCE OF MASS IN RIGHT ILIAC FOSSA: A PROSPECTIVE HOSPITAL BASED STUDY  

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Full Text Available Mass in the right iliac fossa is one of the commonest problems faced in surgical practice. The present study was conducted to find the incidence of mass in patients attending surgery department. A total of 50 cases were included in the study. Their demographic data was collected and analysed to find the incidence of mass in right iliac fossa. The results showed a high incidence of appendicular mass (44% with male preponderance; followed by ileocaecal tuberculosis and carcinoma of caecum. The incidence of appendicular mass was highest in the age of 21-30 years. Appendicular abscess and ileocaecal tuberculosis showed highest incidence in the age group of 31-40 years. In the age group of 51-60 years carcinoma of caecum was observed the most. Several factors like age, gender, food habits and occupation caused the development of mass in the abdomen. Coolies and agriculturists were more prone to development of mass in the right iliac fossa.

Sunil Kumar M*, Mohan, Sarath Babu K, Deepak Hongaiah, Pradeep Kumar T and Balakrishna MA

2014-03-01

177

A rare tentorial mesenchymal chondrosarcoma in posterior cranial fossa: case report.  

Science.gov (United States)

Intracranial extraskeletal mesenchymal chondrosarcoma is a very rare malignant tumor with predilection site of frontoparietal falx cerebri. Only few cases of mesenchymal chondrosarcoma in posterior cranial fossa are reported. Here, we report a 23-year-old young man with a dura-attached mass in left posterior cranial fossa misdiagnosed as a tentorial meningioma preoperatively. According to the following operation, the lesion was confirmed as mesenchymal chondrosarcoma surgically and pathologically. On MRI, the tumor was characterized by lobulated soft-tissue mass with dura-attached base, patchy calcifications and heterogeneous signal intensities. On contrast-enhanced MRI, it was well-defined, with marked enhancement. We consider that these imaging features above might remind us to consider the diagnosis of mesenchymal chondrosarcoma in posterior cranial fossa. The postoperative treatment of radiotherapy is still controversial. As for our case, according to the 24 months follow-up after postoperative ?-knife, our patient shows an optimistic prognosis so far. PMID:25168329

Xiao, Anqi; Li, Zhenlin; He, Xin; You, Chao

2014-01-01

178

Atypical transformation in sacral drop metastasis from posterior fossa choroid plexus papilloma.  

Science.gov (United States)

Choroid plexus papillomas (CPP) are rare tumours and spinal metastases of CPP are even less common. We report a 50-year-old woman with spinal drop metastases at Th9 and S1-2 6 years after total resection of a posterior fossa CPP. The metastasis at S1-2 was resected and histological examination showed transformation to an atypical CPP. Atypical transformation in a metastasis years after resection of a benign posterior fossa CPP has been described once. We would like to advocate craniospinal MRI at the time of initial diagnosis as well as periodic follow-up after total and subtotal resection of a posterior fossa CPP in adults at least once in 1 or 2 years, depending on the histological grading of the primary CPP. In our case report, this could have resulted in earlier diagnosis of the locoregional recurrence or of the spinal drop metastasis. PMID:22922909

Stuivenvolt, Mischa; Mandl, Ellen; Verheul, Jeroen; Fleischeuer, Ruth; Tijssen, Cees C

2012-01-01

179

Hydrothermal formation of Clay-Carbonate alteration assemblages in the Nili Fossae region of Mars  

CERN Document Server

The Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) has returned observations of the Nili Fossae region indicating the presence of Mg- carbonate in small (<10km sq2), relatively bright rock units that are commonly fractured (Ehlmann et al., 2008b). We have analyzed spectra from CRISM images and used co-located HiRISE images in order to further characterize these carbonate-bearing units. We applied absorption band mapping techniques to investigate a range of possible phyllosilicate and carbonate minerals that could be present in the Nili Fossae region. We also describe a clay-carbonate hydrothermal alteration mineral assemblage in the Archean Warrawoona Group of Western Australia that is a potential Earth analog to the Nili Fossae carbonate-bearing rock units. We discuss the geological and biological implications for hydrothermal processes on Noachian Mars.

Brown, Adrian J; Baldridge, Alice M; Crowley, James K; Bridges, Nathan T; Thomson, Bradley J; Marion, Giles M; Filho, Carlos R de Souza; Bishop, Janice L

2014-01-01

180

Acute infection with the human immunodeficiency virus (HIV) associated with acute brachial neuritis and exanthematous rash.  

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Clinical descriptions of acute or primary infection with the human immunodeficiency virus (HIV) are rare. Among cases previously reported, most describe an acute illness resembling infectious mononucleosis. We describe the case of a 32-year-old homosexual man with an acute illness associated with strong serologic evidence of a primary infection with HIV. This case illustrates two new clinical features: an acute, bilateral brachial neuritis, and a vesicular, pustular exanthematous and enanthematous rash. Studies of HIV-related serologic results show differential sensitivities for enzyme-linked immunosorbent assay, Western blot, immunofluorescence, and viral antigen techniques in the acute phase of HIV infection. There appears to be significant clinical heterogeneity of the acute phase of HIV infection. PMID:3688679

Calabrese, L H; Proffitt, M R; Levin, K H; Yen-Lieberman, B; Starkey, C

1987-12-01

181

The Radiological Spectrum of Orbital Pathologies that Involve the Lacrimal Gland and the Lacrimal Fossa  

International Nuclear Information System (INIS)

CT and MRI are utilized to differentiate between different types of masses and to determine the extent of lesions involving the lacrimal gland and the fossa. In lacrimal gland epithelial tumors, benign pleomorphic adenomas are seen most commonly with a well defined benign appearance, and a malignant adenoid cystic carcinoma is seen with a typical invasive malignant appearance. However, a malignant myoepithelial carcinoma is seen with a benign looking appearance. Lymphomatous lesions of the lacrimal gland include a broad spectrum ranging from reactive hyperplasia to malignant lymphoma. These lesions can be very difficult to differentiate both radiologically and pathologically. Generally, lymphomas tend to occur in older patients. The developmental cystic lesions found in the lacrimal fossa such as dermoid and epidermoid cysts can be diagnosed when the cyst involves the superior temporal quadrant of the orbit and manifests as a nonenhancing cystic mass and, in case of a lipoma, it is diagnosed as a total fatty mass. However, masses of granulocytic sarcoma and xanthogranuloma, as well as vascular masses, such as a hemangiopericytoma, are difficult to diagnose correctly on the basis of preoperative imaging findings alone. Clinically, the lesions of the lacrimal gland and fossa are found as palpable masses in the superior lateral aspect of the orbit, and these lesions constitute about 5-13% of all of the orbital masses confirmed by biopsy. Many different pathological entit biopsy. Many different pathological entities arise from the lacrimal gland and fossa, and as each of them requires a different therapeutic approach, the radiological characterization of each lesion is important. Approximately, half of the lacrimal gland masses are tumors of epithelial origin and the rest are lesions that arise from lymphoid or inflammatory diseases. Pseudotumors, metastatic masses and developmental cysts may also occur in the lacrimal fossa. This paper aims to discuss the radiologic findings of the lesions that are found in the lacrimal gland and fossa, and to aid physicians in the differential diagnoses of these various diseases

182

The Radiological Spectrum of Orbital Pathologies that Involve the Lacrimal Gland and the Lacrimal Fossa  

Energy Technology Data Exchange (ETDEWEB)

CT and MRI are utilized to differentiate between different types of masses and to determine the extent of lesions involving the lacrimal gland and the fossa. In lacrimal gland epithelial tumors, benign pleomorphic adenomas are seen most commonly with a well defined benign appearance, and a malignant adenoid cystic carcinoma is seen with a typical invasive malignant appearance. However, a malignant myoepithelial carcinoma is seen with a benign looking appearance. Lymphomatous lesions of the lacrimal gland include a broad spectrum ranging from reactive hyperplasia to malignant lymphoma. These lesions can be very difficult to differentiate both radiologically and pathologically. Generally, lymphomas tend to occur in older patients. The developmental cystic lesions found in the lacrimal fossa such as dermoid and epidermoid cysts can be diagnosed when the cyst involves the superior temporal quadrant of the orbit and manifests as a nonenhancing cystic mass and, in case of a lipoma, it is diagnosed as a total fatty mass. However, masses of granulocytic sarcoma and xanthogranuloma, as well as vascular masses, such as a hemangiopericytoma, are difficult to diagnose correctly on the basis of preoperative imaging findings alone. Clinically, the lesions of the lacrimal gland and fossa are found as palpable masses in the superior lateral aspect of the orbit, and these lesions constitute about 5-13% of all of the orbital masses confirmed by biopsy. Many different pathological entities arise from the lacrimal gland and fossa, and as each of them requires a different therapeutic approach, the radiological characterization of each lesion is important. Approximately, half of the lacrimal gland masses are tumors of epithelial origin and the rest are lesions that arise from lymphoid or inflammatory diseases. Pseudotumors, metastatic masses and developmental cysts may also occur in the lacrimal fossa. This paper aims to discuss the radiologic findings of the lesions that are found in the lacrimal gland and fossa, and to aid physicians in the differential diagnoses of these various diseases.

Jung, Won Sang; Ahn, Kook Jin; Park, Mi Ra; Kim, Ji Young; Choi, Jae Jeong; Kim, Bum Soo; Hahn, Seong Tai [Catholic University College of Medicine, Seoul (Korea, Republic of)

2007-08-15

183

Concomitant boost radiotherapy for squamous carcinoma of the tonsillar fossa  

International Nuclear Information System (INIS)

Purpose: To assess the efficacy of a concomitant boost fractionation schedule of radiotherapy for treating patients with squamous carcinoma of the tonsillar fossa. Patients and Methods: Between December 1983 and November 1992, 83 patients with squamous carcinoma of the tonsil were treated with concomitant boost fractionation. The distribution of American Joint Committee on Cancer T stages was TX-4, T1-5, T2-29, T3-41, T4-4; N stages were NX-1, N0-26, N1-13, N2-31, N3-12. Patients were treated with standard large fields to 54 Gy in 6 weeks. The boost treatment consisted of a second daily 1.5 Gy fraction for 10-12 fractions, usually delivered during the final phase of treatment. The tumor dose was 69-72 Gy, given over 6 weeks. Twenty-one patients, who all had N2 or N3 regional disease, underwent neck dissections, either before (13 patients) or 6 weeks after radiotherapy (8 patients); the other patients were treated with radiotherapy alone. Results: The 5-year actuarial disease-specific survival and overall survival rates were 71 and 60%, respectively. Patients with T2 and T3 primary tumors had 5-year actuarial local control rates of 96 and 78%, respectively. Patients with T3 disease who received the final-phase boost had a 5-year actuarial local control rate of 82%. Actuarial 5-year regional disease control rates were N0, 92%; N1, 76%; N2, 89%; and N3, 89%. The 21 patients who had neck dissections all had their disease regionally controlled. Patients presenting with nody controlled. Patients presenting with nodal disease or after a node excision who were treated with radiation alone had a 5-year actuarial regional disease control rate of 79%. All but five patients had confluent Grade 4 mucositis during treatment. Severe late complications attributable to radiation included mandibular necrosis, in-field osteosarcoma, and chronic dysphagia for solid foods. Conclusions: High rates of local and regional disease control were achieved with the concomitant boost fractionation schedule, with few cases of severe late morbidity. Patients with N2 and N3 neck disease were effectively treated with radiation and the selective use of neck dissections. The concomitant boost schedule is our preferred fractionation approach for treating patients with intermediate stage tonsil cancer who are not participating in our current research protocols

184

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

International Nuclear Information System (INIS)

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 reportss 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

185

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

Science.gov (United States)

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. PMID:23980929

Cozzi, A; Doria, A; Gisondi, P; Girolomoni, G

2014-06-01

186

Hemangiopericytoma of the posterior fossa: a case report and review of the literature.  

Science.gov (United States)

Intracranial hemangiopericytoma is unusual, and those occurring in the posterior fossa is extremely rare; we report such a rare case of hemangiopericytoma of the posterior fossa. The radiologic findings and gross characteristics of hemangiopericytomas are sometimes quite similar to those of meningiomas. Although extremely rare, the operator should be aware of the existence of this disorder to dexterously manage the aggressive nature and high vascular tendency of hemangiopericytomas. The radiological features and histological findings in this case are discussed in this study. PMID:24904899

Seo, Il; Kim, Yun-Suk; Kim, Ho-Sang; Kim, Jeong-Ho; Lee, Myung-Ki

2013-10-01

187

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

International Nuclear Information System (INIS)

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.)

188

Dermoid cysts of the posterior fossa--morbid associations of a benign lesion.  

Science.gov (United States)

Dermoid cysts of posterior fossa are uncommon benign lesions. They differ from other lesions found in the infra tentorial compartment by virtue of their associated conditions. Due to their association with dermal sinus tracts, intracranial infection is a potential threat following infection of the cyst. Due to their embryologic origin, these cysts may also be associated with other congenital anomalies. In this article we detail our eleven-year-experience with posterior fossa dermoid cysts in fifteen patients. Despite the morbid presentation with severe life-threatening complications, the overall outcome was excellent. Implications of the various associations are discussed. PMID:23530667

Raghunath, Avanali; Indira Devi, Bhagavatula; Bhat, Dhananjaya Ishwar; Somanna, Sampath

2013-12-01

189

Sudden cochlear hearing loss as presenting symptom of arachnoid cyst of the posterior fossa.  

Science.gov (United States)

Arachnoid cysts account for almost 1% of neoformations located in the cerebellopontine angle. The aetiopathogenesis is unknown. Arachnoid cysts of the cranial posterior fossa may produce symptoms typical of a tumour such as headache, dizziness, tinnitus and progressive sensorineural hearing loss. Management of these lesions is still controversial; if the arachnoid cyst is symptomatic, surgical treatment is usually recommended. The case is described of an adult female with sudden unilateral cochlear hearing loss as presenting symptom of an arachnoid cyst in the cranial posterior fossa. PMID:16886854

Cadoni, G; Agostino, S; Volante, M; Scipione, M S

2006-04-01

190

Magnetic resonance imaging textural evaluation of posterior cranial fossa tumors in childhood; Avaliacao textural por ressonancia magnetica dos tumores da fossa posterior em criancas  

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Objective: To distinguish healthy from pathological tissues in pediatric patients with posterior cranial fossa tumors using calculated textural parameters from magnetic resonance images. Materials And Methods: We evaluated 14 pediatric patients with posterior cranial fossa tumors using the software MaZda to define the texture parameters in selected regions of interest representing healthy and pathological tissues based on T2-weighted magnetic resonance images. Results: There was a statistically significant difference between normal and tumoral tissues as well as between supposedly normal tissues adjacent and distant from the tumoral lesion. Conclusion: Magnetic resonance textural evaluation is an useful tool for determining differences among various tissues, including tissues that appear apparently normal on visual analysis. (author)

Santos, Joelson Alves dos; Costa, Maria Olivia Rodrigues da; Otaduy, Maria Concepcion Garcia; Lacerda, Maria Teresa Carvalho de; Leite, Claudia da Costa [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Radiologia]. E-mail: joelson_alves@ig.com.br; Matsushita, Hamilton [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Neurologia

2004-08-01

191

Thalidomide-Induced Hemorrhagic Rash in a Patient With Myelofibrosis and Delta-Granule Storage Pool Disease.  

Science.gov (United States)

Thalidomide is one of the immunomodulating agents used in current oncology practice. We present a case of hemorrhagic rash induced by thalidomide in a patient with delta granule storage pool disease. The patient was getting thalidomide for underlying myelofibrosis. PMID:24105355

Taj, Asma; Abbi, Kamal; Skeel, Roland T

2013-10-01

192

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

OpenAIRE

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...

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

1982-01-01

193

Revised classification of posterior fossa cysts and cystlike malformations based on the results of multiplanar MR imaging.  

Science.gov (United States)

MR and clinical data on 31 patients with posterior fossa CSF collections were analyzed. A clear separation of these patients into classical categories was not possible because of new information obtained from the MR images. We present a new classification of these disorders. The Dandy-Walker malformation, Dandy-Walker variant, and mega-cisterna magna seem to represent a continuum of developmental anomalies of the posterior fossa. A possible embryologic basis for this continuum is suggested. Discrete posterior fossa CSF collections that are clearly separate from the fourth ventricle and vallecula are classified as posterior fossa cysts. Posterior fossa CSF collections that communicate with the fourth ventricle and are associated with cerebellar atrophy are classified as prominent cisterna magna. Both the Dandy-Walker complex and posterior fossa cysts can cause enlargement of the posterior fossa and scalloping of the inner table of the occipital bone. The Dandy-Walker complex presents with seizures, developmental delay, and enlarging head size; it requires CSF diversion when associated with hydrocephalus. Posterior fossa cysts present with symptoms of a posterior fossa mass; they generally require surgical resection. Prominent cisterna magna is a result of degenerative disorders and requires no surgical therapy. This new classification facilitates both diagnosis and therapy of these disorders. MR revealed that disorders previously referred to as the Dandy-Walker malformation, the Dandy-Walker variant, and the mega-cisterna magna actually are not separate entities, but appear to represent steps on a continuum of developmental anomalies of the posterior fossa. Because of this, we suggest a new term, the Dandy-Walker complex, be used to describe this continuum. PMID:2816648

Barkovich, A J; Kjos, B O; Norman, D; Edwards, M S

1989-12-01

194

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

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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

1982-06-01

195

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

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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. Abstract in english 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 increas [...] ing 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.

1982-06-01

196

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  

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Full Text Available SciELO Brazil | Language: Portuguese 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 troc [...] lear (ITR) e posterior estabilização articular, e o joelho esquerdo submetido somente à substituição ligamentar (GC). Cada grupo foi dividido em três subgrupos 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 days 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.

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

197

Stasis of 111In-DTPA in the posterior fossa in patients with cerebellar degeneration  

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Prolonged stasis of 111In-DTPA was noted in the posterior fossa in two patients during cisternography. Both patients had clinical signs of cerebellar dysfunction and pneumoencephalographic evidence of marked cerebellar degeneration. Cisternography may be a useful adjunct in evaluating patients with suspected cerebellar atrophy

198

Hypopharynx and larynx defect repair after resection for pyriform fossa cancer with a platysma skin flap.  

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We used a platysma skin flap to repair larynx and hypopharynx defects to improve postoperative laryngeal function in patients with pyriform fossa cancer. Larynx-sparing surgery and postoperative radiotherapy were used in 10 patients with pyriform fossa cancer. The surgical approaches of lymph node dissection of the neck, vertical partial laryngectomy, and pyriform fossa resection were adopted, and a platysma skin flap was used to repair the resulting defects. In this group, the overall 3-year survival rate was 75% according to the Kaplan-Meier analysis, and the local control rate was 90%. Additionally, all patients were able to speak fluently with mild-to-moderate hoarseness. The tracheal tube was removed in all cases. Laryngeal fistulas were observed in 1 patient during radiotherapy. In conclusion, a platysma skin flap can be used to rebuild the larynx and hypopharynx in larynx-sparing resection for pyriform fossa cancer. These patients can obtain good postoperative function in swallowing, breathing, and pronunciation. PMID:25428776

Cai, Qian; Liang, Faya; Huang, Xiaoming; Han, Ping; Pan, Yong; Zheng, Yiqing

2015-02-01

199

A Cognitive and Affective Pattern in Posterior Fossa Strokes in Children: A Case Series  

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Aim: Posterior fossa strokes account for about 10% of ischaemic strokes in children. Although motor and dysautonomic symptoms are common, to our knowledge cognitive and affective deficits have not been described in the paediatric literature. Our aim, therefore, was to describe these symptoms and deficits. Method: In a retrospective study, we…

Kossorotoff, Manoelle; Gonin-Flambois, Coralie; Gitiaux, Cyril; Quijano, Susana; Boddaert, Nathalie; Bahi-Buisson, Nadia; Barnerias, Christine; Dulac, Olivier; Brunelle, Francis; Desguerre, Isabelle

2010-01-01

200

The intercondylar fossa of the normal canine stifle: an anatomic and radiographic study  

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The intercondylar fossa (ICF) in dogs consists of a cranial outlet, intercondylar shelf, caudal arch, caudal outlet, a medial wall, and a lateral wall. The normal cranial outlet is bell-shape and, in mixed-breed dogs (mean body weight 19.2 kg, N = 21), measured 5.8 mm cranially, 8.1 mm centrally, and 10.3 mm caudally. The ICF is oriented 12 degree from the dorsal plane of the femoral diaphysis and obliqued 7 degree , proximolateral to distomedial, in the sagittal plane. To adjust for dog size, a fossa width index (FWI) was calculated by dividing the cranial outlet width by the distance between epicondyles. The normal FWI as determined in this study was 0.18 cranially, 0.25 centrally, and 0.32 caudally. The fossa height index was 0.31. Contact between the ICF and the cranial cruciate ligament began at about 115 degree of extension. The contact area moved cranially in the intercondylar fossa as the stifle was extended. Evaluation of the ICF can be performed radiographically but positioning is critical

201

The role of scintiangiography in suspected acute cholecystitis: The hyperemic gallbladder fossa  

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Gallbladder hyperemia in acute cholecystitis (AC) has been described pathologically and angiographically. The authors' purpose is to evaluate the use of scintiangiography for the detection of this hypernia as a supporting sign of AC. Ten mCi of Tc 99m disofenin were injected by bolus technique in 64 patients with suspected AC. Sequential 3 second images were obtained with a 500K blood pool image at one minute. Routine images to 60 minutes were performed followed by delayed views. The scintiangiogram was positive if there was focal increased activity in the gallbladder fossa greater than liver and separate from right kidney during the preportal arterial phase. The location of the gallbladder fossa was determined by superimposition with the early hepatocyte phase. AC was confirmed surgically and normals confirmed clinically. Increased flow to the gallbladder fossa was demonstrated in 23/32 cases of AC and in 2/33 normals (72% sensitivity, 94% specificity). Accuracy is 54/65 (83%). Positive predictive value is 23/25 (92%). All patients with both a positive scintiangiogram and cholescintigram had AC, while 3 with pericholecystic abscess and false negative cholescintigram had positive scintiangiograms. Increased perfusion to the gallbladder fossa during scintiangiography is a sign of AC. This along with gallbladder nonvisualization by cholescintigraphy was able to predict AC in 100% of cases where both findings occurred. Scintiangiography may help select our patients with a very high likelihood of AC and may potentially shorten chole-scintigraphy examinations

202

The value of cranial computed tomography in posterior fossa epidermoids and dermoids  

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Report on posterior fossa epidermoids and dermoids (3 in the cerebellopontine angle, 1 in the region of the fourth ventricle). Computed tomographic aspects are related with other neuroradiological findings. Differential diagnosis of these mass lesions is discussed in detail, especially of low density and (rarely occuring) high density epidermoids. (orig.)

203

Role of squamosal suture as a consistent landmark for middle fossa approach craniotomy: an anatomical study.  

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Objective?To establish a consistent surface bony landmark for a middle fossa approach (MFA) lateral craniotomy represented by the squamosal suture (SS). Methods?In 60 dried skulls, we assessed the relation between the SS and the external auditory canal (EAC). The lateral portion of the middle cranial fossa floor was also assessed for a possible relation with the anteroposterior diameter (APD) of the squama temporalis (ST). Clinically, we applied our findings on the SS in MFA for different lesions. Results?A vertical line at the EAC divided the ST into the anterior part constituting 61% of the APD (i.e., two thirds) and the posterior part forming 39% (i.e., one third). The average ST height was 35.92 mm. The SS posterior limit at the supramastoid crest was located just anterior to the external projection of the petrous ridge in 35 skulls (58%) and exactly corresponded to it in 25 skulls (42%). The APD of the ST equals on average 97% of the APD of the lateral middle cranial fossa. Optimum exposure of the middle fossa was obtained without any further craniotomy extension. Conclusion?The SS serves as a consistent natural surface bony landmark for MFA. Optimum craniotomy, two thirds anterior to the EAC and one third posterior, is obtained following SS as a landmark. PMID:25685647

Alkhalili, Kenan; Tantawy, Mohammed; Nageeb, Mohab M; Ragaee, Mohamed A; Alshyal, Gasser H; Alcindor, Dunbar S; Chen, Douglas A; Aziz, Khaled M Abdel

2015-02-01

204

Posterior fossa cystic arachnoiditis : an uncommon presentation of neuro-tuberculosis  

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Thirty cases of posterior fossa cystic arachnoiditis were studied over a period of three years. Out of these, nine cases showed evidence of tuberculous pathology. It is these nine cases, where neurotuberculosis presented in form of a pseudocyst, which form the basis of this presentation. Their clinical profile and clinico-radio-pathological correlation is being presented.

Srivastava, V. K.; Reddy, G. N.

1982-01-01

205

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 treatment by direct exploration and shunt surgery was emphasised.

Rongxun, Zhang

1982-01-01

206

Teratoma of the posterior fossa CT and MR aspects A case  

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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

207

Dislocation of the mandible into the middle cranial fossa. Case report.  

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Dislocation of the mandibular condyle into the middle cranial fossa is a rare event due to anatomical and biomechanical factors. The authors report the case of a 12-year-old girl who presented with this condition after colliding with a classmate. One day after her injury, the patient demonstrated an inability to close her mouth completely, and she had minor tenderness to palpation anterior to the tragus, without neurological deficits. Imaging studies demonstrated a fractured glenoid fossa with intrusion of the mandible into the cranial cavity. Open reduction of the mandibular condyle was performed, and the glenoid fossa was reconstructed with a split-thickness bone graft and titanium screws. Several dural tears noted at the time of surgery were repaired primarily. Mandibular condyle dislocation into the middle cranial fossa is often misdiagnosed initially because of its low incidence and nonspecific symptoms. Computed tomography scanning is the most sensitive diagnostic study for detecting this injury. Closed reduction after induction of general anesthesia has been recommended in recently suffered injuries without neurological deficits, but this approach may overlook damage to intracranial structures. Surgical repair is recommended if neurological injury is suspected. Treatment options should be tailored to the individual factors of each case. PMID:17644926

Magge, Suresh N; Chen, H Isaac; Heuer, Greg G; Carrasco, Lee R; Storm, Phillip B

2007-07-01

208

The significance of the pterygopalatine fossa angiography before endoscopic sinus surgery  

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Full Text Available Objective?To investigate the value of pterygopalatine fossa angiography in fresh cadaveric heads, so as to provide a useful guidance and an individualized operative procedure for endoscopic sinus surgery. Methods?Three fresh cadaveric heads were used in the present study. After injection with 10%, 5% iodine fluorine into carotid artery, 3D vascular structure of the pterygopalatine fossa was constructed. The posterior wall of the maxillary sinus was dissected by gently removing the fat tissue with sinus forceps. All anatomical structures, such as vascular, nerve and muscle structures were then exposed. The anatomical characteristics of vasculature in the pterygopalatine fossa and the imaging data were compared. Results?The pterygopalatine segment at the third portion of the MA was well shown in the imaging system. According to Morton and Khan morphologic classification of the third portion of the internal maxillary artery, the proportion of Y type, M type, and intermediate type was 33.3%, 16.7% and 50.0%, respectively. Using an endoscopic endonasal approach, the PPF was exposed through its anteromedial surface. The first visible structures would be the branches of the MA. It appeared that the anatomical land-markers of the pterygopalatine fossa area was well shown by both intranasal endoscopic view and imaging data. Conclusion?CTA is a useful technique for pterygopalatine fossa imaging before surgical dissection. The terminal segment of MA provides direct anatomical topography features of the PPF. This technique provides useful information for the individual surgery in this area. DOI: 10.11855/j.issn.0577-7402.2013.11.013

Hong-yu XING

2013-11-01

209

Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear. A clinical and radiologic investigation  

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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.

Wadin, K.; Thomander, L.; Wilbrand, H.

210

Cloning differentially expressed genes using rapid subtraction hybridization (RaSH).  

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Differential gene expression represents the entry point for comprehending complex biological processes. In this context, identification and cloning of differentially expressed genes represent critical elements in this process. Many techniques have been developed to facilitate achieving these objectives. Although effective in many situations, most currently described approaches are not trouble-free and have limitations, including complexity of performance, redundancy of gene identification (reflecting cloning biases) and false-positive gene identification. A detailed methodology to perform a rapid and efficient cloning approach, called rapid subtraction hybridization is described in this chapter. This strategy has been applied successfully to a number of cell culture systems and biological processes, including terminal differentiation and cancer progression in human melanoma cells, resistance or sensitivity to HIV-1 in human T cells and gene expression changes following infection of normal human fetal astrocytes with HIV-1 or treatment with neutrotoxic agents. Based on its simplicity of performance and high frequency of genuine differential gene identification, the rapid subtraction hybridization (RaSH) approach will allow wide applications in diverse systems and biological contexts. PMID:18217676

Boukerche, Habib; Su, Zao-Zhong; Kang, Dong-Chul; Fisher, Paul B

2007-01-01

211

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

1997-04-01

212

Phototherapy rash in newborn infants: does it differ between conventional and light emitting diode phototherapy?  

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Data comparing the cutaneous side effects of light emitting diode (LED) phototherapy (LP) and conventional phototherapy (CP) devices in jaundiced newborn infants are very limited. We investigated the incidence and extent of skin eruptions caused by different phototherapy devices in preterm infants who are more prone to neonatal jaundice. This prospective, randomized controlled trial was conducted in the neonatal intensive care unit (NICU) of Hacettepe University Ihsan Dogramaci Childrens' Hospital in Ankara, Turkey. Preterm infants without skin lesions before and requiring phototherapy in the first week of life were included in the study. The infants were randomly assigned to receive CP or LP and were monitored closely for skin eruptions during phototherapy. Fifty-eight infants were included in the study: 25 (43.1%) received CP while 33 (56.9%) received LP. The duration of phototherapy was similar in the two groups (30.4 ± 9.6 hours and 31.8 ± 15.6 hours, respectively). Baseline and control bilirubin levels were similar for the two groups (p = 0.101 and p = 0.105, respectively). The frequency of skin eruptions was 36% in the CP group and 33% in the LP group (p = 0.83). The skin eruptions were macules in 13 (22.4%), papules in 5 (8.6%), and maculopapular rashes in 2 (3.4%) infants.There were no differences in the incidence and extent of skin eruptions in preterm infants who received CP or LP. PMID:24016282

Surmeli-Onay, Ozge; Korkmaz, Ayse; Yigit, Sule; Yurdakok, Murat

2013-01-01

213

The aftermath of rash action: sleep-interfering counterfactual thoughts and emotions.  

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A consistent body of evidence suggests that excessive cognitive activity at bedtime is a key factor in insomnia. It is generally assumed that sleep-interfering cognitions are affect laden, but still little is known about the precise nature of the affective processes that are involved. The present study sought to explore the role of counterfactual thinking and counterfactual emotions (regret, shame, and guilt) in insomnia as a function of impulsivity. It was hypothesized that when retiring for the night, individuals scoring high on urgency review their rash daytime behavior and are therefore likely to engage in counterfactual thinking and to experience associated feelings of regret, shame, and guilt. A sample of 101 undergraduate students completed three questionnaires: the UPPS Impulsive Behavior Scale, the Bedtime Counterfactual Processing Questionnaire, and the Insomnia Severity Index. Results indicated that both urgency and counterfactual processing were related to insomnia severity and that the effect of urgency on insomnia was mediated by counterfactual processing. These findings reveal for the first time that impulsivity relates to counterfactual cognitive-affective processing and that this type of processing contributes to sleep disturbances. PMID:19653778

Schmidt, Ralph E; Van der Linden, Martial

2009-08-01

214

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish 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 anticuer [...] pos 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. Abstract in english 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 cau [...] sing 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.

1997-04-01

215

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

2000-01-01

216

An unusual presentation of acute brucellosis with thrombocytopenia and maculopapular rash  

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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

2007-10-01

217

[A case of sarcoidosis presenting with high fever and rash progressing to acute respiratory failure].  

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A 66-year-old man who had been given a clinical diagnosis of vasculitis at another hospital after presenting with high fever and rash was admitted to our hospital for further examination following a relapse of fever during steroid reduction. The biopsy specimens of the leg with crusts showed the presence of epithelioid granuloma, and because of a negative tuberculin test, increased serum angiotensin converting enzyme (ACE) and lysozyme levels, and pulmonary Ga uptake, the patient was given a diagnosis of sarcoidosis. Although the patient had been treated on an outpatient basis following resolution of fever with NSAIDs and 5 mg prednisolone (PSL), he suffered acute respiratory failure during follow-up and required emergency admission. Chest CT revealed bilateral ground-glass opacity and pleural effusion, and serum ACE and soluble IL2R levels were significantly elevated. We diagnosed acute exacerbation of sarcoidosis and given high dose steroid therapy. The patient's symptoms, image findings, blood test results, and other findings promptly improved. Here we reported a highly unusual presentation of acute respiratory failure in sarcoidosis. PMID:17929471

Shibata, Seiko; Saito, Kazuhito; Ishiwata, Nobuo; Ieki, Ryuji

2007-09-01

218

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  

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Full Text Available 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-orbital 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.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 2006 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.

Manoel Antonio de Paiva-Neto

2010-06-01

219

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 SciELO Brazil | Language: English 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 n [...] o 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 2006 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 approa [...] ch 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-orbital 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.

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

2010-06-01

220

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

2004-03-01

221

Functional Outcomes of the Retromaxillary-Infratemporal Fossa Dissection for Advanced Head and Neck/Skull Base Lesions  

OpenAIRE

The retromaxillary-infratemporal fossa (RM-ITF) dissection, using a preauricular incision, was initially popularized for the treatment of temporomandibular joint disorders, facial fractures, and orbital tumors. This approach has been expanded for the treatment of advanced head and neck and skull base tumors extending into the infratemporal fossa. We studied prospectively eight consecutive patients requiring a RM-ITF dissection. Pre- and postoperative functional outcomes measured were masticat...

Shibuya, Terry Y.; Doerr, Timothy D.; Mathog, Robert H.; Burgio, Don L.; Meleca, Robert J.; Yoo, George H.; Guthikonda, Murali

2000-01-01

222

Combined Middle Cranial Fossa and Trans-Mastoid Approach for the Management of Post-Mastoidectomy CSF Otorrhoea  

OpenAIRE

Cerebrospinal fluid (CSF) otorrhoea is an uncommon condition arising from defects in the tegmen and middle cranial fossa. 33 year gentleman presented with post-mastoidectomy CSF otorrhoea of 5 year duration. Imaging finding were suggestive of fracture in the tegmen region. A combined middle cranial fossa/transmastoid was used to repair the defect. Defect was identified in the tegmen plate and it was closed with pedicled pericranial graft, laterally based pedicled temporalis muscle graft rei...

Agrawal, Amit; Baisakhiya, Nitish; Deshmukh, P. T.

2011-01-01

223

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

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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.

Svenson Svante

2004-11-01

224

Transarterial embolization of an anterior fossa cranial base dural arteriovenous fistula.  

Science.gov (United States)

Open surgical disconnection has long been the treatment of choice for dural arteriovenous fistulas (dAVFs) of the anterior cranial fossa. However, advanced patient age and the presence of medical comorbidities can substantially increase the risk of craniotomy and favor a less invasive endovascular approach. Optimal positioning within the distal ophthalmic artery, beyond the origin of the central retinal branch, is achievable using current microcatheter technology and embolic materials. Here we present the case of an 88-year-old female with an incidentally discovered dAVF of the anterior cranial fossa. Angiographic cure was achieved with one-stage Onyx embolization. The video can be found here: http://youtu.be/KVE0fUIECQM . PMID:24983725

Lee, Brian; Mehta, Vivek A; Amar, Arun P; Tenser, Matthew S; Mack, William J

2014-07-01

225

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

226

Magnetic resonance imaging textural evaluation of posterior cranial fossa tumors in childhood  

International Nuclear Information System (INIS)

Objective: To distinguish healthy from pathological tissues in pediatric patients with posterior cranial fossa tumors using calculated textural parameters from magnetic resonance images. Materials And Methods: We evaluated 14 pediatric patients with posterior cranial fossa tumors using the software MaZda to define the texture parameters in selected regions of interest representing healthy and pathological tissues based on T2-weighted magnetic resonance images. Results: There was a statistically significant difference between normal and tumoral tissues as well as between supposedly normal tissues adjacent and distant from the tumoral lesion. Conclusion: Magnetic resonance textural evaluation is an useful tool for determining differences among various tissues, including tissues that appear apparently normal on visual analysis. (author)

227

[Enlargement of the fetal posterior fossa--what is the significance?].  

Science.gov (United States)

The posterior fossa may be enlarged due to: mega cisterna magna, arachnoid cyst or Dandy Walker malformation. These anomalies can be identified during routine ultrasound screening performed in the beginning of the second half of pregnancy (22nd week). The outcome of these findings is not clear. Therefore, it is difficult to advise the parents how to manage the pregnancy after the discovery of this anomaly. Most of the studies report a good prognosis in cases of mega cisterna magna or arachnoid cyst, as long as this finding is isolated. A Dandy-Walker malformation or non-isolated enlargement of the posterior fossa entail a guarded prognosis. Further studies are needed in order to enable better counseling. PMID:19264007

Dror, Raheli; Malinger, Gustavo; Ben-Sira, Liat; Lev, Dorit; Pick, Chaim; Lerman-Sagie, Tally

2008-11-01

228

The radiological spectrum of orbital pathologies that involve the lacrimal gland and the lacrimal fossa.  

Science.gov (United States)

CT and MRI are utilized to differentiate between different types of masses and to determine the extent of lesions involving the lacrimal gland and the fossa. Although many diseases that affect the lacrimal gland and fossa are specifically diagnosed by imaging, it is frequently very difficult to differentiate each specific disease on the basis of image characteristics alone due to intrinsic similarities. In lacrimal gland epithelial tumors, benign pleomorphic adenomas are seen most commonly with a well defined benign appearance, and a malignant adenoid cystic carcinoma is seen with a typical invasive malignant appearance. However, a malignant myoepithelial carcinoma is seen with a benign looking appearance. Lymphomatous lesions of the lacrimal gland include a broad spectrum ranging from reactive hyperplasia to malignant lymphoma. These lesions can be very difficult to differentiate both radiologically and pathologically. Generally, lymphomas tend to occur in older patients. The developmental cystic lesions found in the lacrimal fossa such as dermoid and epidermoid cysts can be diagnosed when the cyst involves the superior temporal quadrant of the orbit and manifests as a non-enhancing cystic mass and, in case of a lipoma, it is diagnosed as a total fatty mass. However, masses of granulocytic sarcoma and xanthogranuloma, as well as vascular masses, such as a hemangiopericytoma, are difficult to diagnose correctly on the basis of preoperative imaging findings alone. A careful clinical evaluation and moreover, a pathologic verification, are needed. In this pictorial review, the various imaging spectrums of pathologic masses involving the lacrimal gland and fossa are presented, along with appropriate anatomy and pathology reviews. PMID:17673845

Jung, Won Sang; Ahn, Kook Jin; Park, Mi Ra; Kim, Ji Young; Choi, Jae Jeong; Kim, Bum Soo; Hahn, Seong Tai

2007-01-01

229

Migration of a Kirschner wire from the wrist to the cubital fossa  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english A patient presented with a distal radius and ulna fracture which was treated with closed reduction and Kirschner wires. The patient presented after an extended time period with elbow pain and associated loss of function. Examination revealed that the Kirschner wires migrated to his cubital fossa. Re [...] moval of the Kirschner wire resulted in complete functional recovery.

AH, Botha; AB, du Toit.

230

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

2011-12-01

231

Malignant fibrous histiocytoma of the mandible and the infratemporal fossa—A case report  

OpenAIRE

Malignant fibrous histiocytoma is a sarcoma which commonly occurs in the soft tissues, joints and tendons of the extremities of adults but its occurrence in the oral and maxillofacial region is very rare. We present a rare case of malignant fibrous histiocytoma of the mandible with recurrence in the infratemporal fossa after surgery and radiotherapy. Patient underwent second surgery and complete tumor excision with minimal loss of function was achieved. Patient survived 8 years after surgery ...

Joshi, Himani; Rayappa, Chinna Swamy

2011-01-01

232

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

Energy Technology Data Exchange (ETDEWEB)

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.)

Choudur, H.N. [Hamilton General Hospital, Department of Radiology, Hamilton, ON (Canada); Hamilton General Hospital, McMaster University, Department of Diagnostic Imaging, Hamilton Health Sciences, Hamilton, Ontario (Canada); Hunjan, J.S.; Howey, J.M. [Hamilton General Hospital, McMaster University, Department of Diagnostic Imaging, Hamilton Health Sciences, Hamilton, Ontario (Canada); DeNardi, F. [Henderson General Hospital, McMaster University, Department of Diagnostic Imaging, Hamilton Health Sciences, Hamilton, Ontario (Canada)

2009-09-15

233

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.

Dariush Etemadi

2010-05-01

234

Mapping Medusae Fossae Formation materials in the southern highlands of Mars  

OpenAIRE

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 patterns, erosional styles and channel-like forms and has been mapped into five main outcrops and three geological members according to exposure and stratigraphy (Scott and Tanaka, 1986; 1987; Zimbelm...

Harrison, S. K.; Balme, M. R.; Hagermann, A.; Murray, J. B.; Muller, J-p

2010-01-01

235

Physical and Histologic Properties of Substitutes Used for the Anterior Fossa Region Dural Repair  

OpenAIRE

During the last 10 years, 41 patients with dural tear caused by anterior cranial fossa bone fracture were treated surgically. Those treated conservatively were not included in this series. The patients' mean age was 36 years. The average time of postoperative observation was 15 months. Traffic accidents, as well as wounds caused by missiles (shell fragments or bullets), blows, and falls were the mechanisms of injury. An autogenous graft, followed by homologous (lyodura) and most recently by h...

Vrankovic, Djuro; Mrcela, T.; Mursic, B.; Splavski, B.; Dmitrovic, B.; Mrcela, M.; Blagus, G.

1999-01-01

236

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

Energy Technology Data Exchange (ETDEWEB)

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

237

Effect of Texture, Shape, and Intensity Feature Fusion for Posterior-Fossa Tumor Segmentation in MRI  

OpenAIRE

In this study, we systematically investigate efficacy of using several different image features such as intensity, fractal texture, and level-set shape in segmentation of posterior-fossa (PF) tumor for pediatric patients. We explore effectiveness of using four different feature selection and three different segmentation techniques, respectively, to discriminate tumor regions from normal tissue in multimodal brain MRI. We further study the selective fusion of these features for improved PF tum...

Channu Kokila, K. Ramesh

2013-01-01

238

Clinical studies of photodynamic therapy for malignant brain tumors: facial nerve palsy after temporal fossa photoillumination  

Science.gov (United States)

In two randomized prospective studies of brain tumor PDT more than 180 patients have been accrued. At the Toronto site we recognized two patients who developed a lower motor neuron (LMN) facial paralysis in the week following the PDT treatment. In both cases a temporal lobectomy was undertaken and the residual tumor cavity was photo-illuminated. The surface illuminated included the temporal fossa floor, thus potentially exposing the facial nerve to the effect of PDT. The number of frontal, temporal, parietal, and occipital tumors in this cohort was 39, 24, 12 and 4, respectively. Of the 24 temporal tumors 18 were randomized to Photofrin-PDT. Of these 18 a temporal lobectomy was carried out exposing the middle fossa floor as part of the tumor resection. In two of the 10 patients where the lobectomy was carried out and the fossa floor was exposed to light there occurred a postoperative facial palsy. Both patients recovered facial nerve function in 6 and 12 weeks, respectively. 46 J/cm2 were used in the former and 130 J/cm2 in the latter. We did not encounter a single post-operative LMN facial plasy in the 101 phase 2 patients treated with Photofrin-PDT. Among 688 supratentorial brain tumor operations in the last decade involving all pathologies and all locations no case of early post-operative LMN facial palsy was identified in the absence of PDT. One further patient who had a with post-PDT facial palsy was identified at the Denver site. Although it is possible that these patients had incidental Bell's palsy, we now recommend shielding the temporal fossa floor during PDT.

Muller, Paul J.; Wilson, Brian C.; Lilge, Lothar D.; Varma, Abhay; Bogaards, Arjen; Fullagar, Tim; Fenstermaker, Robert; Selker, Robert; Abrams, Judith

2003-06-01

239

Giant cell tumour of the posterior cranial fossa: a case report.  

Science.gov (United States)

Giant cell tumours (GCTs) of the cranium preferentially affect the sphenoid and temporal bones. We report a 19-year-old patient with GCT involving the left occipital bone and petromastoid portion of the temporal bone. CT and MRI revealed a predominantly expansive soft-tissue mass of the posterior cranial fossa. The patient underwent surgery. Permanent histopathological sections and immunostatins revealed the presence of a GCT. The radiological features and method of surgical intervention of this rare lesion are discussed. PMID:22011823

Lu, Z H; Yao, Z W

2011-11-01

240

Giant cell tumour of the posterior cranial fossa: a case report  

OpenAIRE

Giant cell tumours (GCTs) of the cranium preferentially affect the sphenoid and temporal bones. We report a 19-year-old patient with GCT involving the left occipital bone and petromastoid portion of the temporal bone. CT and MRI revealed a predominantly expansive soft-tissue mass of the posterior cranial fossa. The patient underwent surgery. Permanent histopathological sections and immunostatins revealed the presence of a GCT. The radiological features and method of surgical intervention of t...

Lu, Z. H.; Yao, Z. W.

2011-01-01

241

Total spine and posterior fossa MRI screening in adolescent idiopathic scoliosis (177 cases)  

OpenAIRE

Background: MRI screening for idiopathic scoliosis is controversial. Considering our clinical experiences, the results of MRI in all patients with idiopathic scoliosis were evaluated. Methods: In a prospective clinical study, all neurologically normal patients with idiopathic scoliosis screened by posterior fossa and total spine MRI. Results: After excluding 9 patients for mild neurological findings, in other 177 patients (132 female, 45 male), the average age and curve angle was 15...

MR Etemadifar; Mobini, B.; Behtash, H.; Ameri, E.

2005-01-01

242

Pain relief and pituitary function following injection of alcohol into the pituitary fossa.  

OpenAIRE

Eleven patients were investigated for pituitary function after the injection of alcohol into the pituitary fossa; all had persistent pain and 8 had carcinoma of the breast. Most of the patients showed varying degrees of reduction of pituitary activity; 8 patients obtained significant pain relief and 3 patients exhibited polyuria. These 3 observations could not be completely correlated; the possible mechanisms which may lead to pain suppression by this method are discussed.

Williams, N. E.; Miles, J. B.; Lipton, S.; Hipkin, L. J.; Davis, J. C.

1980-01-01

243

Agenesis of the vermis cerebelli and malformations of the posterior fossa in childhood and adolescence.  

Science.gov (United States)

Three cases of cerebellar vermis agenesis are reported and the relevant literature (19 other cases) is reviewed. Other posterior fossa malformations, such as a mega-cisterna magna, arachnoid cyst and Dandy-Walker syndrome, are discussed both from the pathological and clinical view point. We put forward a hypothesis that agenesis of the cerebellar vermis and Dandy-Walker syndrome could be regarded as two different stages of the same malformation. PMID:503277

Mercuri, S; Curatolo, P; Giuffrè, R; Di Lorenzo, N

1979-09-01

244

Combined Retrolabyrinthine-Retrosigmoid Approach for Improved Exposure of the Posterior Fossa Without Cerebellar Retraction  

OpenAIRE

The combined retrolabyrinthine-retrosigmoid (CRR) approach utilizes anterior retraction of the sigmoid sinus to improve exposure of the posterior fossa without cerebellar retraction. The CRR was initially used for vestibular neurectomy but is now utilized for acoustic neuroma excision with hearing preservation and exposure for clipping of basilar and vertebrobasilar aneurysms. This excellent exposure of the cerebellopontine angle without cerebellar retraction can be used for all posterior fos...

Silverstein, Herbert; Nichols, Mark L.; Rosenberg, Seth; Hoffer, Michael; Norrell, Horace

1995-01-01

245

Imprint cytology facilitating the diagnosis of primary cutaneous anaplastic large cell lymphoma of iliac fossa  

OpenAIRE

Primary cutaneous anaplastic large cell lymphoma (C-ALCL) is a form of cutaneous T-cell lymphoma that is characterized by solitary nodules and plaques. In this report, the authors present an unusual case of a 59-year-old male with a solitary ulcerofungative mass in the left iliac fossa clinically masquerading as sqaumous cell carcinoma. The imprint smears of the lesion had characterstic morphological features which helped in the diagnosis. Subsequently, the imprint cytology correlated well wi...

Singh, Suman; Gupta, Neelam; Tekta, Geeta R.

2012-01-01

246

Imaging techniques in evaluation of juvenile angiofibroma with lateral extension in the pterygopalatine and infratemporal fossa  

International Nuclear Information System (INIS)

Juvenile angiofibroma is a benign tumour arising in the nasopharynx and penetrating laterally into the pterygopalatine fossa, infratemporal fossa and orbit. Precise preoperative evaluation of the presence and extension of its lateral spread is crucial for choosing the best surgical approach and performing radical operation. The aim of the study was to assess usefulness of imaging methods in diagnosis and evaluation of lateral extension of juvenile angiofibroma. In a group of 39 patients operated on from 1973 to 2002 due to juvenile angiofibroma in 21 (54%) cases a lateral extension of the tumor was diagnosed. All patients underwent carotid angiography (CA) and lateral plain skull X-ray. Computed tomography (CT) was performed in 18,and magnetic resonance imaging (MRI) in 4 patients. In all cases the extension of the tumor and its lateral spread was verified during surgery. A widening of the pterygopalatine fossa on lateral plain X-ray was present in 13 (62%) patients. CT and MRI demonstrated the presence of lateral extension in all patients diagnosed with these methods. In 9 cases, lateral CA revealed dislodgement of the internal maxillary artery by the tumor in the pterygopalatine fossa. The presence of big lateral extension of the juvenile angiofibroma is demonstrated on lateral plain X-ray as anterior bowing of the posterior wall of the maxillary sinus (Holman-Miller sign). MRI shows better than CT the extent and margins of the tumor in soft tissues. Lateral CA showthe tumor in soft tissues. Lateral CA shows dislodgement of the internal maxillary artery and its course in relation to the lateral extension of the tumor, which is important for surgical planning. (author)

247

Repair of Spontaneous Cerebrospinal Fluid Otorrhea from Defect of Middle Cranial Fossa  

OpenAIRE

Spontaneous cerebrospinal fluid (CSF) otorrhea is defined as CSF otorrhea where there are no identifiable causes including previous trauma, surgery, infection, neoplasm or congenital anomaly. The condition is rare. The origin of CSF leak is commonly a defect in the tegmen of the middle cranial fossa. The pathophysiology of spontaneous CSF otorrhea is unclear. Two theories of the etiology of bony defects of the temporal bone are the congenital bony defect theory and arachnoid granulation theor...

Boo, Sung Hyun; Goh, Young Bum; Han, Chi-sung

2013-01-01

248

Primary hydatid disease of the infratemporal fossa and the parotid gland  

International Nuclear Information System (INIS)

Hydatid disease should be considered in the differential diagnosis of lesions causing swelling of the parotid area or exophthalmos in patients originating from countries where the incidence of the disease is high. An unusual case of hydatid disease located in the infratemporal fossa and the anterior parotid region is presented. Computed Tomography is a valuable tool for establishment of the diagnosis, before any surgical approach to the lesion is initiated and for postoperative follow-up and evaluation. (orig.)

249

Analysis of mandibular condylar and glenoid fossa fractures with computed tomography  

Energy Technology Data Exchange (ETDEWEB)

The purpose of this study was to investigate the prevalence of glenoid fossa and condylar fractures in patients with mandibular fractures using multidetector computed tomography (MDCT). A prospective study was performed in 227 patients with mandibular fractures who underwent 64-MDCT. Mandibular fractures were classified into four types: median, paramedian, angle and condylar. Statistical analysis of the relationship between prevalence of condylar fractures and mandibular fracture locations was performed using ?{sup 2} test with Fisher's exact test. A P value less than 0.05 was considered statistically significant. The prevalence of condylar fracture was 64.8 % of all patients with mandibular fractures, 66.7 % of median type (P = 0.667), 45.5 % of paramedian type (P = 0.001) and 12.3 % of angle type (P = 0.000), respectively. Furthermore, glenoid fossa fracture was seen in 1.4 % of patients with condylar fractures. The results of the presented study suggest focusing also on incidental findings such as glenoid fossa fractures. (orig.)

Ogura, Ichiro; Sasaki, Yusuke; Kaneda, Takashi [Nihon University School of Dentistry at Matsudo, Department of Radiology, Matsudo, Chiba (Japan)

2014-04-15

250

Delayed effect of radiation therapy on extracerebral cavernous angioma in the middle fossa  

International Nuclear Information System (INIS)

This is a report of a case with extracerebral cavernous angioma in the middle fossa which had received radiation therapy. Follow-up study with serial computed tomography during and after irradiation were presented. A 62-year-old housewife complained of vertigo. CT scan revealed a slightly high density area in the left middle cranial fossa which was markedly enhanced with contrast media. Left carotid angiography demonstrated a large avascular mass in the left middle fossa and no feeding artery or draining vein was visualized except a faint irregular stain in the venous phase. Irradiation with a total dose of 50 Gy was delivered. At the end of radiation, CT scan revealed a slight decrease in size and CT number of the tumor. Follow-up CT scans 5 months later showed 50 % regression of the tumor and 19 months later were negative for tumor. It is concluded that in case of an extracerebral cavernous angioma with massive hemorrhage, radiation of up to 30 - 50 Gy was a method of choice. The treatment results in the possibility of eliminating surgery and the benefit of irradiation may not become evident until the first year. (author)

251

Neurinomas of the facial nerve extending to the middle cranial fossa  

International Nuclear Information System (INIS)

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)-nerve functions. (author)

252

Cystic malformations of the posterior fossa: differential diagnosis clarified through embryologic analysis.  

Science.gov (United States)

Cystic or cyst-like malformations of the posterior fossa represent a spectrum of disorders, including the Dandy-Walker malformation, vermian-cerebellar hypoplasia, mega cisterna magna, and arachnoid cyst. Differentiation of these lesions may be difficult with routine cross-sectional imaging; however, an accurate diagnosis is essential for proper treatment planning and genetic counseling. Dandy-Walker malformation is easily diagnosed on the basis of the classic triad: complete or partial agenesis of the vermis, cystic dilatation of the fourth ventricle, and enlarged posterior fossa. Vermian-cerebellar hypoplasia is a general classification that describes congenital malformations with a normal-sized posterior fossa, varying degrees of vermian and cerebellar hypoplasia, and a prominent retrocerebellar cerebrospinal fluid space that communicates freely with a normal or dilated fourth ventricle. Mega cisterna magna can be asymmetric and can manifest apparent mass effect, simulating the appearance of an arachnoid cyst; therefore, ventriculography or cisternography may be needed to demonstrate communication of the cystic mass with the subarachnoid space. A careful review of the embryologic development is essential in understanding these malformations and in making a more accurate radiologic diagnosis. PMID:8031352

Kollias, S S; Ball, W S; Prenger, E C

1993-11-01

253

[Linear accelerator-based stereotactic radiation treatment of patients with medial middle fossa meningiomas].  

Science.gov (United States)

Medial middle fossa meningiomas are challenging for neurosurgical treatment. Invasion of cranial nerves and vessels leads to high risk of complications after removal of such meningiomas. Currently methods of conformal stereotactic radiation treatment are applied wider and wider for the discussed lesions. During a 3.5-year period 80 patients with medial middle fossa meningiomas were treated in Burdenko Moscow Neurosurgical Institute using linear accelerator "Novalis". In 31 case radiation treatment was preceded by surgical resection. In majority of patients symptoms included cranial nerve dysfunction: oculomotor disturbances in 62.5%, trigeminal impairment--in 37.5%, visual deficit--in 43.8%, facial nerve palsy--in 1.25%. 74 patients underwent radiotherapy with classical fractioning, 2--in hypofractionated mode and 4 received radiosurgery. In cases of classical fractioning mean marginal dose reached 46.3 Gy during 28-33 fractions, in hypofractioning (7 fractions)--31.5 Gy, in radiosurgery--16.25 Gy. Mean follow-up period was 18.4 months (6-42 months). Control of tumor growth was achieved in 97.5% of cases (78 patients): in 42 (52.5%) lesion shrinked, in 36 (45%) stabilization was observed. Clinical examination revealed improvement of visual function in 15 patients (18%) and deterioration in 2 (2.5%). No new neuropathies were found. Stereotactic radiation treatment is the method of choice for medial anterior and middle fossa meningiomas due to effective control of tumor progression and minimal rate of complications. PMID:20429360

Golanov, A V; Cherekaev, V A; Serova, N K; Pronin, I N; Gorlachev, G E; Kotel'nikova, T M; Podoprigora, A E; Kudriavtseva, P A; Galkin, M V

2010-01-01

254

Johann Christian Rosenmüller (1771-1820): A Historical Perspective on the Man behind the Fossa.  

Science.gov (United States)

Introduction The fossa of Rosenmüller, also known as the lateral pharyngeal recess, is a well-established site of origin of nasopharyngeal carcinoma. It is located in the lateral pharyngeal wall behind the cartilaginous portion of the Eustachian tube, the torus tubarius, and is named after Johann Christian Rosenmüller (JCR). Objective We present a history on the life and extensive works of Johann Christian Rosenmüller, a German physician and anatomist. Results Johann Christian Rosenmüller was a dedicated anatomist. In addition to identifying the fossa of Rosenmüller, his influence extends to various other anatomic subjects, including the Rosenmüller gland, the palpebral portion of the lacrimal gland, and the organ of Rosenmüller (i.e., the caudal remnant of the mesonephric duct). He was also an avid speleologist, studying the composition of caves and their life forms. For his contributions to this field, he had a cave in Germany and an extinct species named after him-Rosenmüllerhöhle and Ursus spelaeus Rosenmüller, respectively. Conclusion The fossa of Rosenmüller plays an important role in the growth and surgical treatment of nasopharyngeal carcinoma. We present a brief glimpse into the life of Johann Christian Rosenmüller, for whom it was named. PMID:24436911

Amene, Chiazo; Cosetti, Maura; Ambekar, Sudheer; Guthikonda, Bharat; Nanda, Anil

2013-08-01

255

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<0.001). Acoustic tumor cases showed a good correlation between the volume of peritumoral hypoperfusion area on three dimensional SPECT and the volume of edema on MRI. These results suggest tumor volume in posterior cranial fossa affects cerebral circulation. It is assumed that pressure exerted by the tumor may contribute to the reduction in cerebral blood flow. The large amount of data provided by three dimensional SPECT images, gives reliable results and furthermore, makes objective evaluation possible because it eliminates the need to set region of interest (ROI) in the analysis. The application of SPECT to assess the extent of hypoperfusion volume, is considered a new and clinically useful tool. (author)

256

Interactive web-based programs to teach functional anatomy: the pterygopalatine fossa.  

Science.gov (United States)

Certain areas of the body contain structures that are difficult to envision in their proper spatial orientations and whose functions are complex and difficult to grasp. This is especially true in the head, where many structures are relatively small and inaccessible. To address this problem, we are designing Web-based programs that consist of high-resolution interactive bitmap illustrations, prepared using Adobe Photoshop, and vector-based animations, prepared via Macromedia Flash. Flash action script language is used for the animations. We have used this approach to prepare a program on the pterygopalatine fossa, an important neurovascular junction in the deep face that is especially difficult to approach by dissection and to depict in static images in an atlas. The program can be viewed online at http://cds.osr.columbia.edu/anatomy/ppfossa/. A table of contents simplifies navigation through the program and a menu enables the user to identify each of the vascular and neuronal components and either to insert or to remove each from its position in the fossa. The functional anatomy of the nerves in the fossa is animated. For example, users can activate and subsequently follow action potentials as they course along axons to their targets. This high degree of interactivity helps promote learning. PMID:15278936

Sinav, Ahmet; Ambron, Richard

2004-07-01

257

Bare spot of the glenoid fossa in children: incidence and MRI features  

International Nuclear Information System (INIS)

The bare spot of the glenoid fossa is a normal cartilage defect seen frequently in adults. It has been used on arthroscopy as a landmark for the center of the glenoid fossa. There are no reports of this variant in children, but we have noted it on some pediatric clinical shoulder MRI studies. Our main purpose is to evaluate the incidence of the bare spot in children and define location and MRI features. Shoulder MRI studies (total 570) from 2004 to 2008 were reviewed. Children were divided into two age groups: group 1, 0-10 years (n=200), group 2, 11-20 years (n=370). A total of 12 bare spots (2.1%) were identified; all were seen in group 2. Eight (67%) were central and four were eccentric in the glenoid fossa. All showed a well-marginated focal cartilage defect containing hyperintense joint fluid or contrast agent. Three also had air. The bare spot is seen in children. The absence in children younger than 10 years and the low incidence in the second decade support the proposed acquired nature. Familiarity with this finding is important so as not to misinterpret it as a pathologic condition. (orig.)

258

The use of wavelet filters for reducing noise in posterior fossa Computed Tomography images  

Science.gov (United States)

Wavelet transform based de-noising like wavelet shrinkage, gives the good results in CT. This procedure affects very little the spatial resolution. Some applications are reconstruction methods, while others are a posteriori de-noising methods. De-noising after reconstruction is very difficult because the noise is non-stationary and has unknown distribution. Therefore, methods which work on the sinogram-space don't have this problem, because they always work over a known noise distribution at this point. On the other hand, the posterior fossa in a head CT is a very complex region for physicians, because it is commonly affected by artifacts and noise which are not eliminated during the reconstruction procedure. This can leads to some false positive evaluations. The purpose of our present work is to compare different wavelet shrinkage de-noising filters to reduce noise, particularly in images of the posterior fossa within CT scans in the sinogram-space. This work describes an experimental search for the best wavelets, to reduce Poisson noise in Computed Tomography (CT) scans. Results showed that de-noising with wavelet filters improved the quality of posterior fossa region in terms of an increased CNR, without noticeable structural distortions.

Pita-Machado, Reinado; Perez-Diaz, Marlen; Lorenzo-Ginori, Juan V.; Bravo-Pino, Rolando

2014-11-01

259

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, intraluminndings 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)

260

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

2013-01-01

261

Interferon-induced remission of rapidly growing aggressive fibromatosis in the temporal fossa.  

Science.gov (United States)

Aggressive fibromatosis is the name for uncommon soft-tissue neoplasms arising within musculoaponeurotic tissue. They show benign histologic features but have an aggressive local behaviour and frequently recur after surgery or radiation. A 48-year-old black woman presented with recurrent aggressive fibromatosis after primary radiotherapy in the left temporal fossa involving the base of the skull. The patient received interferon alpha2a subcutaneously for 6 months. A slow but steady reduction of the tumour was observed, and pre-existing symptoms disappeared. PMID:15308262

Raguse, J-D; Gath, H J; Oettle, H; Bier, J

2004-09-01

262

Subdural hygroma in association with middle fossa arachnoid cyst: acetazolamide therapy.  

Science.gov (United States)

Intracranial arachnoid cysts are cerebrospinal fluid-filled collections between arachnoid layers. While many are silent, arachnoid cysts can become symptomatic if there is sudden expansion, haemorrhage or rupture with the development of subdural hygroma or subdural hematoma. Several studies have demonstrated the association of arachnoid cysts with subdural hygroma and subdural hematoma. We describe a 9-year-old girl with a moderate-sized middle-fossa arachnoid cyst and bilateral frontal subdural hygroma presenting with raised intracranial pressure. She was treated with acetazolamide which resulted in resolution of the subdural hygroma and relief of symptomatology. PMID:9761002

Choong, C T; Lee, S H

1998-08-01

263

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English 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 communicative structures of the PPF, the relationship between clinical manifestations and the locations of the lesion, and propose a therapeutic strategy to improve the prognosis.

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

2012-04-01

264

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 (18)F-fluoride PET/CT. The whole-body (18)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

265

Progressive tumefactive fibroinflammatory lesion of the infratemporal fossa treated by radiation therapy  

OpenAIRE

Tumefactive fibroinflammatory lesion (TFIL) is a rare benign tumor in the head and neck region. We present a case of a 40-year-old female with a benign but progressive lesion of the infratemporal fossa, which was diagnosed as TFIL. Patient responded briefly to a course of steroid treatment but eventually showed progression and was unresponsive to further steroids. She was then treated with external beam radiation to a dose of 60 Gy in 30 fractions. After radiation a slow, gradual decrease in ...

Hoebers, Frank J. P.; Brian O’Sullivan; Eugene Yu; Jon Irish; Bayardo Perez Ordonez; Simpson, Rand E.

2012-01-01

266

Variation d'origine sismique du flux de chaleur convectif dans La Fossa de Vulcano (Italie)Hydrothermal convective flux variation related to a seismo-tectonic crisis in theLa Fossa of Vulcano (Italy).  

Science.gov (United States)

Temperature, composition and extent of fumaroles at La Fossa of Vulcano (Italy) have been measured since 1978. Variations are attributed to changing regional tectonic factors, or to changes in magmatic activity. Hydrothermal heat discharge on a hot zone of La Fossa has been measured since 1997. An important increase in this flux is clearly related to a regional seismo-tectonic crisis that occurred in 1998, which opened the volcano's fracture system. The upper part of the aquifer has since cooled, without any apparent effect on the magmatic system below.

Aubert, Maurice; Alparone, Salvatore

2000-05-01

267

Spontaneous resolution of a flow-related ophthalmic-segment aneurysm after treatment of anterior cranial fossa dural arteriovenous fistula  

Science.gov (United States)

Background: The natural history of proximal, feeding-artery aneurysms after successful obliteration of high-grade, anterior cranial fossa dural arteriovenous fistulas (dAVFs) has not been well documented. Case Description: A 52-year-old Caucasian male presented with an unruptured anterior cranial fossa (dAVF) and an associated aneurysm. Cerebral angiography revealed a large, contralateral, carotid-ophthalmic segment aneurysm, enlarged feeding ophthalmic arteries, as well as cortical venous drainage. Successful surgical obliteration of the dAVF was undertaken to eliminate the risk of hemorrhage. Conclusion: The carotid-ophthalmic aneurysm regressed significantly after surgical obliteration of the dAVF and a follow-up, planned coiling procedure to address the carotid-ophthalmic aneurysm was abandoned. This represents the first reported case of a near complete, spontaneous resolution of an unruptured carotid-ophthalmic aneurysm associated with a high-grade anterior cranial fossa dAVF. PMID:25525558

Reinard, Kevin; Basheer, Azam; Pabaney, Aqueel; Marin, Horia; Malik, Ghaus

2014-01-01

268

Absence of HLA-B*1502 and HLA-A*3101 alleles in 9 Korean patients with antiepileptic drug-induced skin rash: a preliminary study.  

Science.gov (United States)

There have been a number of studies about correlations between HLA genotypes in various ethnic groups and occurrence of various cutaneous adverse drug reactions, ranging in intensity from mild to severe, caused by antiepileptic drugs (AEDs). This is the first report analyzing the HLA genotypes of 9 Korean patients with skin rashes induced by various AEDs. The AEDs that induced skin rash were lamotrigine (n=3), carbamazepine (n=3), oxcarbazepine (n=1), phenobarbital (n=1), and phenytoin (n=1). None of the patients' HLA genotypes was either HLA-B*1502 or HLA-A*3101. Based on these series of cases, AED-induced skin rash can occur independently of HLA-B*1502 or HLA-A*3101 genotypes in the Korean patients. PMID:25187890

Song, Ju Sun; Kang, Eun-Suk; Joo, Eun Yeon; Hong, Seung Bong; Seo, Dae-Won; Lee, Soo-Youn

2014-09-01

269

Pseudolesions around the gallbladder fossa: comparison of frequency and radiological characteristics in multiphasic CT, CTAP, and CTHA  

International Nuclear Information System (INIS)

The purpose of this study is to compare the frequency with which pseudolesions around the gallbladder (GB) fossa are revealed by multiphasic CT, by CT during arterial portography (CTAP), and by CT during hepatic arteriography (CTHA) and to determine their radiological characteristics. Multiphasic CT, CTAP, and CTHA examinations of 81 patients without pathology of the GB and around the GB fossa were evaluated for pseudolesion around the GB fossa. The definition of pseudolesion was as follows: 1) hyperattenuation during the arterial phase and isoattenuation during the delayed phase of multiphasic CT, or perfusion defect on CTAP and hyperattenuation on CTHA; 2) no Lipiodol tagging on Lipiodol CT, 3) all findings observed adjacent to the gallbladder fossa; and 4) no interval change on follow-up CTAP and CTHA. We compared the frequency of pseudolesions around the GB fossa, as seen on multiphasic CT, CTAP, and CTHA, and determined their size, location, and shape, as revealed by CTHA. The frequency of pseudolesion was 2.5% (2/81) on multiphasic CT, while on CTAP or CTHA, the frequency was 53.1% (43/81), and 58 pseudolesions were identified. Of 58 pseudolesions, 56 were revealed by CTAP and 57 by CTHA. Forty-nine of 58 pseudolesions were larger and all pseudolesions showed more contrast to parenchyma on CTHA than on CTAP. The location of pseudolesions was segment V (32 of 58), IV (25 of 58), and VI (1 of 58), and their size ranged from 5 to 30 (mean, 17.5) mm. Pseudolesions wm 5 to 30 (mean, 17.5) mm. Pseudolesions were wedge-shaped (48 of 58), oval (6 of 58), bandlike (3 of 58), or round (1 of 58). CTAP and CTHA frequently revealed pseudolesion around the GB fossa. The radiological characteristics of these modalities help differentiate pseudolesions from true tumoral hepatic lesions. (author)

270

Localization of the Internal Maxillary Artery for Extracranial-to-Intracranial Bypass through the Middle Cranial Fossa: A Cadaveric Study.  

Science.gov (United States)

The internal maxillary artery (IMAX) is a promising arterial pedicle to function as a donor vessel for extracranial-to-intracranial (EC-IC) bypass procedures. The access to the IMAX through the anterior portion of the middle cranial fossa floor allows a much shorter interposition graft to be used to create a bypass to the ipsilateral middle cerebral artery and prevents a second incision in the neck. One of the challenges of this technique, however, is the difficulty to find the IMAX through an intracranial approach. The purpose of this cadaveric study is to establish a reliable method to localize the IMAX through a middle fossa floor approach based on skull base bone landmarks. In this study 5 latex-injected fixated cadaveric specimens were dissected bilaterally (providing a total of 10 IMAX dissections) to determine the precise location of the IMAX in the pterygopalatine fossa in relationship to bone landmarks of the middle fossa floor as seen through an intracranial approach. Drilling of the middle fossa floor was undertaken through both the originally described "anteromedial" approach, and a new "anterolateral" approach. Measurements were taken correlating the position of the IMAX to ipsilateral foramen rotundum, ipsilateral foramen ovale, posterior wall of the maxillary sinus, and distal V2 branches. Median and standard deviation were calculated for each dataset. The IMAX was found, within the pterygopalatine fossa, by drilling the greater wing of the sphenoid bone on average 10 mm anteriorly and 5 mm laterally to foramen rotundum, at an average depth of 8 mm. The IMAX was also found inferiorly to the maxillary nerve and laterally to the pterygoid head of the lateral pterygoid muscle. A more laterally oriented approach, consisting of drilling the greater wing of the sphenoid bone from a point perpendicular to foramen rotundum posteriorly to the sphenotemporal suture anteriorly, allowed for a longer segment of the IMAX to be easily identified and exposed facilitating its use as a donor vessel in bypass procedures. This cadaveric study provides a reliable and reproducible set of measurements to localize the IMAX within the pterygopalatine fossa through an intracranial middle fossa approach. The ability to find the IMAX consistently is an important step in exploring the possibility of using the IMAX as a routine donor vessel for EC-IC bypass procedures. PMID:23372995

Eller, Jorge L; Sasaki-Adams, Deanna; Sweeney, Justin M; Abdulrauf, Saleem I

2012-02-01

271

Pathology, treatment and management of posterior fossa brain tumors in childhood  

International Nuclear Information System (INIS)

Brain tumors are the second most common childhood malignancy. Between 1975 and 1985, 462 newly diagnosed patients were treated at the Children's Hospital of Philadelphia; 207 (45%) tumors arose in the posterior fossa and 255 (55%) appeared supratentorially. A wide variety of histological subtypes were seen, each requiring tumor-specific treatment approaches. These included primitive neuroectodermal tumor (n = 86, 19%), astrocytoma (n = 135, 30%), brainstem glioma (n = 47, 10%), anaplastic astrocytoma (n = 32, 7%), and ependymoma (n = 30, 6%). Because of advances in diagnostic abilities, surgery, radiotherapy, and chemotherapy, between 60% and 70% of these patients are alive today. Diagnostic tools such as computed tomography and magnetic resonance imaging allow for better perioperative management and follow-up, while the operating microscope, CO2 laser, cavitron ultrasonic aspirator and neurosurgical microinstrumentation allow for more extensive and safer surgery. Disease specific treatment protocols, utilizing radiotherapy and adjuvant chemotherapy, have made survival common in tumors such as medulloblastoma. As survival rates increase, cognitive, endocrinologic and psychologic sequelae become increasingly important. The optimal management of children with brain tumors demands a multidisciplinary approach, best facilitated by a neuro-oncology team composed of multiple subspecialists. This article addresses incidence, classification and histology, clinical e, classification and histology, clinical presentation, diagnosis, pre-, intra- and postoperative management, long-term effects and the team approach in posterior fossa tumors in childhood. Management of specific tumor types is included as well. 57 references

272

A case of bilateral ophthalmoplegia caused by focal idiopathic hypertrophic pachymeningitis on the anterior cranial fossa.  

Science.gov (United States)

A previously healthy 63-year-old man presented with a 2-weeks history of diplopia without headache. Neurological examination revealed total external ophthalmoplegia of the left eye and limitation of abduction of the right eye. Initial cranial MRI showed thickening and enhancement of the dura mater only on the anterior cranial fossa but unremarkable on the cavernous sinus. Idiopathic hypertrophic cranial pachymeningitis was diagnosed in the absence of demonstrable underlying infective, neoplastic, or systemic autoimmune disease by his clinical findings, laboratory tests and radiological examinations. Corticosteroid therapy was initiated with methylprednisolone (1,000?mg/day for 3 days), followed by oral prednisolone and tapering off. Eye movements improved with treatment and completely recovered within 4 weeks after starting administration, and cranial MRI at the 15 days after starting treatment showed improvement. We suggest that his ophthalmoplegia was caused by the inflammation of dura on the cavernous sinus beyond the thickening lesion of cranial MRI. In a case of bilateral ophthalmoplegia with or without headache, it is required to examine the dural thickening and enhancement on the anterior cranial fossa by cranial MRI. PMID:25672863

Teramoto, Hiroko; Hara, Makoto; Morita, Akihiko; Kamei, Satoshi

2015-01-01

273

A morphometric CT study of Down's syndrome showing small posterior fossa and calcification of basal ganglia  

International Nuclear Information System (INIS)

We report characteristic and morphometric changes of cranial computed tomography (CT) with increasing age in 56 patients with Down's syndrome aged from 0 month to 37 years. Patients were compared with 142 normal controls aged 0 to 59 years. Width of ventricles, Sylvian fissures, posterior fossa, pons and cisterna magna were measured on CT. The incidences of the cavum septi pellucidi, cavum vergae and cavum veli interpositi and high density in the basal ganglia were examined. There was high incidence (10.7%) of bilateral calcification of basal ganglia in Down's syndrome, although that of pineal body and choroid plexus calcification was similar in Down's syndrome and controls. Basal ganglia calcification is more frequently seen in young Down's syndrome and may be related to the premature aging characteristic of Down's syndrome. The CT in Down's syndrome showed relatively small posterior fossa, small cerebellum, small brain stem and relatively large Sylvian fissures in those under one year of age. There was a high frequency of midline cava and large cisterna magna. There were no significant atrophic changes on CT except after the fifth decade comparing with controls. (orig.)

274

Extensive middle cranial fossa arachnoid cysts and different clinical presentation in two patients.  

Science.gov (United States)

Arachnoid cysts (ACs), particularly suprasellar cysts, cause a wide spectrum of endocrine disorders. Herein, we report two patients diagnosed with an extensive AC in the middle cranial fossa while being investigated for etiologies of precocious puberty and short stature. One of them required surgery due to his pubertal disorders associated with compression effects of cyst. After surgery, his puberty progression was regressed within one year. On the other hand, surgery was not planned for the second patient considering of his cranial imaging findings and the extremely low incidence of growth hormone (GH) deficiency caused by middle fossa AC (MFAC). We started treatment with recombinant human GH and no complication was found during treatment follow-up. Endocrine disorders associated with MFACs are extremely rare. By presenting with these two cases, we aimed to remain our fellow physcians that ACs can be possibly cause of endocrine disorders. Clinicians should be careful evaluating endocrine disorders because real cause may not be cyst itself but masked by it. PMID:25241612

Yüce, Ozge; Dö?er, Esra; Celik, Nurullah; Emeksiz, Hamdi Cihan; Bulduk, Erkut Baha; Camurdan, Mahmut Orhun

2014-09-01

275

Clinical anatomy of the auriculotemporal nerve in the area of the infratemporal fossa.  

Science.gov (United States)

The auriculotemporal nerve is a sensory branch extending from the posterior section of the mandibular nerve trunk. Its nerve roots form a short trunk, which gives off a number of branches, innervating: the temporomandibular joint, the temporal region, structures of the external ear: auricle, and external acoustic meatus, and the parotid gland. It also conducts excretory fibres to the buccal and labial glands. Anatomical relationships between the auriculotemporal nerve and the muscles of mastication, temporomandibular joint, and surrounding vessels in the area of the infratemporal fossa create favourable conditions for entrapment syndromes. Entrapment of the auriculotemporal nerve plays a role in the pathogenesis of temporomandibular joint pain syndromes, headaches, as well as pain symptoms or paraesthesias within the external acoustic meatus and auricle. The current study was performed on 16 specimens containing the infratemporal fossa. Some variations in the nerve roots of the auriculotemporal nerve were found and described as one-, two-, three-, four-, and five-root variants. The topography of the auriculotemporal nerve and its close relationship to the structures of the temporomandibular joint were described. Individually, the variable topography of the nerve course may play a role in the symptomatology of headaches and localisation of pain in the face regions and masticatory system. PMID:22936556

Komarnitki, I; Andrzejczak-Soboci?ska, A; Tomczyk, J; Deszczy?ska, K; Ciszek, B

2012-08-01

276

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

International Nuclear Information System (INIS)

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

277

Three-dimensional Anatomical Analysis of Surgical Landmarks for the Middle Cranial Fossa Approach.  

Science.gov (United States)

This study describes the microsurgical anatomy of the middle cranial fossa approach using temporal bone three-dimensional (3D) computed tomography (CT) reconstruction, which should contribute to determining the drilling point for the internal auditory meatus (IAM) when bony landmarks are absent. Thirty temporal bone CT scans were reviewed retrospectively. We measured the shortest and longest distances to IAM from the petrous ridge, and measured the angle between the facial nerve and various labyrinth structures. Three-dimensional reconstructed images were obtained using high-resolution axial temporal bone CT (0.7-mm-thick slices, FOV 90 × 90, KVp 120, 305 mA, width 2,800, and level 800). The mean shortest and longest distances to IAM from the petrous ridge were 5.22 and 10.1 mm, respectively. The mean distance to the IAM from the cochlea was 9.91 mm. The mean angle between the IAM and superior semicircular canal was 47.21°, which was more acute than previously reported. The mean angle between the IAM and geniculate ganglion (GG) and external auditory canal was 113.8°, and the mean distance from the GG to the IAM was 15.44 mm. Understanding the 3D relationships among the microsurgical structures will help to decide the drilling point for the IAM when bony landmarks are absent. A preoperative evaluation might be useful for preserving important neurovascular structures while approaching the middle fossa. PMID:25032122

Choi, Bong Jin; Kim, Min Ju; Chang, Ki-Hong; Yeo, Sang Won; Jun, Beom Cho

2014-09-01

278

[Endonasal treatment of iatrogenic or spontaneous cerebrospinal rhinorrhea of the anterior cranial fossa].  

Science.gov (United States)

There is a 25% risk of meningitis in case of cerebrospinal fluid rhinorrhea from the anterior cranial fossa. Treatment usually is based on neurosurgery when medical management is unsuccessful. The risk of morbidity and mortality in such operations is important and recurrence is observed in 25% of the cases. The development of endonasal surgery has increased the incidence of iatrogenic breaches but has also allowed the development of new techniques for closing breaches. Certain authors recently published a recent series of patients treated via the endonasal route. We present here six cases of cerebrospinal fluid rhinorrhoea from the anterior cranial fossa treated at the Foch Hospital. Etiology was iatrogenic in 4 cases, trauma in 1 and spontaneous in 1. The operative technique and mid-term results are presented. Cure was achieved in all cases after a mean follow-up of 2 years. One patient with osteopetrosis of the cranial floor who underwent neurosurgical decompression of the optic nerve complained of recurrent rhinorrhoea which could not be confirmed by endoscopy nor by imaging. Early endoscopic treatment of cerebrospinal fluid rhinorrhoea should be the first intention option as it preserves olfactive function, limits operative morbidity and mortality and leaves open the option of neurosurgery in case of failure. PMID:8729399

Coiffier, T; Cabanes, J; Visot, A; Dupuy, M; Freche, C; Chabolle, F

1995-01-01

279

[Malformations of the nasal fossa and paramedian facial clefts. New perspectives].  

Science.gov (United States)

Since choanal atresia may be associated with other cranio-facial malformations, including various degrees of nasal fossa malformation, and be a part of paramedian facial clefts, (as described by Tessier), they can be integrated into the larger group of neurocristopathies. We identified four such cases with combined clinical elements corresponding to Tessier's paramedian facial cleft, including eyelid coloboma, mild to severe choanal and nasal fossa anomalies, ethmoidal hypoplasia and anterior skull base malformation, sometimes with proboscis lateralis. These various malformations are due to abnormality of the olfactive placode and the adjacent mesenchyme. These discoveries incited us to elaborate a conception first of all on the pertinent embryology involved, second, to propose a new classification based on anatomical and pathogenic embryological considerations. And finally, since endonasal laser therapy is particularly dangerous in such cases, to propose the use of transpalatal approach to restore choanal permeability. Pediatric ENT surgeons should pay special attention to any small stigmatism of facial cleft when dealing with children affected by choanal atresia. PMID:9207969

Garabedian, E N; Ducroz, V; Leperchey, F; Roger, G; Denoyelle, F

1996-01-01

280

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Mexico | Language: Spanish 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 apóf [...] isis coronoides (0.25%).¹ Las fracturas de coronoides, condilares y de arco cigomático, pueden enmascarar un fractura de cavidad glenoidea, ya que clínicamente existe 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 ar [...] e 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 movements. 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.

Carlos Alain, Rodríguez Piña; José Ernesto, Miranda Villasana.

2013-09-01

281

Skin tests and in vitro allergy tests have a poor diagnostic value for benign skin rashes due to ?-lactams in children.  

Science.gov (United States)

Skin rashes are frequent in children treated by ?-lactams (BL), with an estimated incidence ranging between 1% and 5% (1). In clinical practice, most of these children are labeled as "penicillin allergic" without appropriate testing, mostly due to fear of life-threatening reactions. However, an allergic reaction can be demonstrated by an oral provocation test (OPT) in less than 10% of the patients developing a rash while treated by BL (2-4). This article is protected by copyright. All rights reserved. PMID:25469811

Caubet, Jean-Christoph; Frossard, Christophe; Fellay, Benoit; Eigenmann, Philippe A

2014-12-01

282

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

283

Bone changes in the condylar head and mandibular fossa in patients with temporomandibular disorders. Helical CT observation  

International Nuclear Information System (INIS)

In the present study, we investigated whether bone changes are present in sites impossible to observe by panoramic X-ray and Schuller's X-ray examination, namely the medial of the condylar head and mandibular fossa, in patients with type IV temporomandibular joint disorders. We observed the articular fossa using computed tomography, which is able to obtain detailed 3-dimensional information, in patients with type IV temporomandibular disorders. We examined 120 joints of 60 patiens who visited the Department of Oral Surgery, Osaka Medical College Hospital. Each condylar head was clearly visualized in panoramic X-ray and Schuller's X-ray examination findings, and shown to have possible changes unilaterally. Each joint was diagnosed as type IV, according to the diagnostic guidelines set by Japanese Society for Temporomandibular Joint, and further examined using helical CT. Changes in condylar head; We concluded that bone changes were present with considerable probability in the medial of condylar head in a manner similar to those found in the lateral and center of joints with type IV temporomandibular disorders. Changes in mandibular fossa; The bone changes occurred in various locations of the mandibular fossa, while they appeared significantly more frequently in the condylar head. We think that our finding will contribute to development of treatment strategies for temporomandibular disorders, as they clarify bone changes in sites previously unreported. (author)s previously unreported. (author)

284

Role of Cerebellum in Fine Speech Control in Childhood: Persistent Dysarthria after Surgical Treatment for Posterior Fossa Tumour  

Science.gov (United States)

Dysarthria following surgical resection of childhood posterior fossa tumour (PFT) is most commonly documented in a select group of participants with mutism in the acute recovery phase, thus limiting knowledge of post-operative prognosis for this population of children as a whole. Here we report on the speech characteristics of 13 cases seen…

Morgan, A. T.; Liegeois, F.; Liederkerke, C.; Vogel, A. P.; Hayward, R.; Harkness, W.; Chong, K.; Vargha-Khadem, F.

2011-01-01

285

Microsurgical Localization of the Cochlea in the Extended Middle Fossa Approach  

Science.gov (United States)

Objective?In the extended middle fossa approach, a portion of the petrous bone known as Kawase's rhomboid can be drilled to expose the posterior fossa through a middle fossa corridor. During this bony resection, the cochlea is placed at risk. The objective of this study was to objectively detail the position of the cochlea in relation to reliable surgical landmarks. Methods?Eleven cadaveric specimens were dissected—including six cadaveric heads and five dry temporal bones by means of an anterior petrosectomy with skeletonization of the cochlea. Three anatomic measurements describing the location of the cochlea in relation to the extrapolated intersection of the greater superficial petrosal nerve (GSPN) and facial nerve were recorded. These measurements were then correlated with thin-cut temporal bone computed tomography scans from 25 patients with morphologically normal inner ears. Results?In the cadaveric specimens, the anterior border of the membranous basal turn of the cochlea was located an average of 7.56?mm (6.4 to 8.9 mm) anterior to the extrapolated junction of the GSPN and facial nerve, as measured along the course of the GSPN. The medial border of the membranous cochlea (medial margin of basal turn) was located an average of 8.2?mm (6.9 to 8.9 mm) medial to the extrapolated junction of the GSPN and facial nerve, as measured along the course of the facial nerve. The average maximum distance from the extrapolated junction of the GSPN and facial nerve to the membranous cochlea was 9.3?mm (8.2 to 10.3 mm). These anatomic measurements correlated well with radiologic measurements of the same parameters. Conclusion?When drilling Kawase's rhomboid, it is useful to locate the extrapolated junction of the GSPN and the facial nerve. Drilling of the anteromedial petrous bone outside of a radius of 12.5?mm from the extrapolated junction of GSPN and facial nerve appears to be associated with a low degree of risk to the cochlear apparatus. PMID:24294559

Forbes, Jonathan A.; Rivas, Alejandro; Tsai, Betty; Ehtesham, Moneeb; Zuckerman, Scott; Wanna, George; Weaver, Kyle

2012-01-01

286

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

OpenAIRE

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 allogeneic stem cell transplantation.

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

2011-01-01

287

Incidence and risk of rash to mTOR inhibitors in cancer patients - a meta-analysis of randomized controlled trials.  

Science.gov (United States)

Abstract Background. Inhibitors of the mammalian target of rapamycin (mTOR) are currently approved for the treatment of several cancers, and their use is associated with serious rash, which affects patient's quality of life and leads to undesirable dose reductions or interruptions. A meta-analysis of randomized controlled trials (RCTs) was performed to determine the overall risk of developing high-grade rash with mTOR inhibitors in cancer patients. Methods. We searched the PubMed database and abstracts presented at the American Society of Clinical Oncology (ASCO) meetings up to December 2013 for relevant studies. Eligible studies included RCTs in which everolimus or temsirolimus was compared to controls in cancer patients. The summary incidence, relative risk (RR), and 95% confidence intervals (CI) were calculated using a random- or fixed-effects model depending on the heterogeneity of the included trials. Results. A total of 11 RCTs with 4752 patients (mTORs: 2725, controls: 2027) with a variety of solid tumors were included in the analysis. The incidences of all-grade (grade 1-4) and high-grade rash (grade 3-4) were 27.3% (95% CI 21.0-34.7%) and 1.0% (95% CI 0.6-1.4%), respectively. In comparison with controls, mTOR inhibitors significantly increased the risk for developing all-grade rash (RR = 3.55, 95% CI 3.0-4.20, p < 0.001) and high-grade rash (RR = 4.25, 95% CI 1.63-11.10, p = 0.003). The increased risk of high-grade rash did not vary significantly among different tumors (p = 0.91). There was no significant difference between everolimus and temsirolimus (p = 0.60). There was also no significant difference between mTOR inhibitors alone and in combination with other agents (p = 0.57). Conclusions. Everolimus and temsirolimus significantly increased the risk of high-grade rash in cancer patients. Early recognition and appropriate treatment is recommended. PMID:24914484

Shameem, Raji; Lacouture, Mario; Wu, Shenhong

2015-01-01

288

Cranial CT with 64-, 16-, 4- and single-slice CT systems-comparison of image quality and posterior fossa artifacts in routine brain imaging with standard protocols  

International Nuclear Information System (INIS)

Posterior fossa artifacts constitute a characteristic limitation of cranial CT. To identify practical benefits and drawbacks of newer CT systems with reduced collimation in routine cranial imaging, we aimed to investigate image quality, posterior fossa artifacts and parenchymal delineation in non-enhanced CT (NECT) with 1-, 4-, 16- and 64-slice scanners using standard scan protocols. We prospectively enrolled 25 consecutive patients undergoing NECT on a 64-slice CT. Three groups with 25 patients having undergone NECT on 1-, 4- and 16-slice CT machines were matched regarding age and sex. Standard routine CT parameters were used on each CT system with helical acquisition in the posterior fossa; the parameters varied regarding collimation and radiation dose. Three blinded readers independently assessed the cases regarding image quality, infra- and supratentorial artifacts and delineation of brain parenchymal structures on a five-point ordinal scale. Reading orders were randomized. A proportional odds model that accounted for the correlated nature of the data was fit using generalized estimating equations. Posterior fossa artifacts were significantly reduced, and the delineation of infratentorial brain structures was significantly improved with the thinner collimation used for the newer CT systems (p0.5). The thinner collimation available on modern CT systems leads to reduced posterior fossa artitems leads to reduced posterior fossa artifacts and to a better delineation of brain parenchyma in the posterior fossa. (orig.)

289

Syrinx shunt to posterior fossa cisterns (syringocisternostomy) for bypassing obstructions of upper cervical theca.  

Science.gov (United States)

Syrinx shunts to the spinal subarachnoid space are likely to fail if the cerebrospinal fluid pathways rostral to the syrinx are blocked. To bypass obstructions at or below the level of the foramen magnum, a technique was developed for shunting the syrinx to the posterior fossa cisterns, termed "syringocisternostomy." Syrinxes were shunted to the cisterna magna in two patients with spinal arachnoiditis and to the cerebellopontine angle cistern in four patients with Chiari I malformations. There was symptomatic improvement and collapse of the syrinx in each case, with no complications or recurrences over a follow-up interval of 14 to 27 months (average 20.3 months). The surgical technique and results of treatment are described. PMID:1432128

Milhorat, T H; Johnson, W D; Miller, J I

1992-12-01

290

Acoustic neurinoma and posterior fossa meningioma - clinical and CT radiologic findings  

International Nuclear Information System (INIS)

Clinical and computed tomography (CT) findings of twenty-three patients with acoustig neurinoma (AN) and eleven patients with posterior fossa meningioma (PFM) are described. AN frequently (94%) presents with the complaint of hearing loss, while PFM often (60%) presents with non-specific pains in the head or neck. The CT characteristics of AN and PFM in this series were similar to those found in most previous publications. The maximal measured mean diamter of PFM (40.2 mm) was significantly larger than that of AN (26.4 mm). Hydrocephalus was apparently influenced by tumor location rather than by its size. It is concluded that diagnostic ability has been improved in cases of CPA tumors, but not in those of non-CPA PFM, probably because of the earlier clinical presentation of the former. Clinical efforts are still necessary to detect the smaller tumors. (orig.)

291

Acoustic neurinoma and posterior fossa meningioma - clinical and CT radiologic findings  

Energy Technology Data Exchange (ETDEWEB)

Clinical and computed tomography (CT) findings of twenty-three patients with acoustig neurinoma (AN) and eleven patients with posterior fossa meningioma (PFM) are described. AN frequently (94%) presents with the complaint of hearing loss, while PFM often (60%) presents with non-specific pains in the head or neck. The CT characteristics of AN and PFM in this series were similar to those found in most previous publications. The maximal measured mean diamter of PFM (40.2 mm) was significantly larger than that of AN (26.4 mm). Hydrocephalus was apparently influenced by tumor location rather than by its size. It is concluded that diagnostic ability has been improved in cases of CPA tumors, but not in those of non-CPA PFM, probably because of the earlier clinical presentation of the former. Clinical efforts are still necessary to detect the smaller tumors. (orig.).

Catz, A.; Reider-Groswasser, I.

1986-01-01

292

Beware frontotemporal dermoids - they may have intracranial extension: a case of a middle cranial fossa cyst.  

Science.gov (United States)

Congenital orbitofacial dermoid cysts are epithelial lined structures of ectodermal origin that may be associated with sinus tracts and variable deep extension. Midline lesions may extend intracranially, while lateral lesions are thought never to do so. Consequently only midline lesions are usually imaged prior to surgery. We describe a lateral dermoid sinus communicating with an intracerebral dermoid cyst within the middle cranial fossa in a 3 year-old with recurrent periorbital cellulitis and intermittent discharge from a small pimple in the temporal region. This case demonstrates that some lateral "dermoids" need to be treated with more caution if there are unusual features such as dimpling, discharge of material or recurrent wider infection, and preoperative imaging should be carried out to exclude intracranial extension. PMID:22370605

Barnard, A R; Jones, A P; Hodgkinson, P D; Jenkins, A J

2012-07-01

293

Large solid hemangioblastoma in the cerebellopontine angle: complete resection using the transcondylar fossa approach.  

Science.gov (United States)

Hemangioblastomas (HBMs) in the cerebellopontine angle (CPA) have rarely been reported. When they are within the CPA, they may be misdiagnosed as vestibular schwannoma (VS) or cystic meningioma. Therefore, differential diagnosis is important for the safe treatment of the lesion. Large solid HBMs, similar to intracranial arteriovenous malformations (AVMs), are difficult to surgically remove from an eloquent area because of their location and hypervascularity. We report a case of an HBM in the CPA, which manifested as a hearing impairment or VS. Similar to AVM surgery, the tumor was widely opened and removed en bloc without a new neurological complication using the modified transcondylar fossa approach without resection of the jugular tubercle. Accurate diagnosis, pre-operative embolization, and a tailored approach were essential for the safe treatment of the HBM in the CPA. PMID:25408939

Moon, Byung Hoo; Park, Sang Kyu; Han, Young-Min

2014-10-01

294

Radiological evaluation of mine water discharges from hard coal mining in the Fossa Eugeniana Area, Germany  

International Nuclear Information System (INIS)

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.)

295

Cholecystokinin-Assisted Hydrodissection of the Gallbladder Fossa during FDG PET/CT-guided Liver Ablation  

International Nuclear Information System (INIS)

A 68-year-old female with colorectal cancer developed a metachronous isolated fluorodeoxyglucose-avid (FDG-avid) segment 5/6 gallbladder fossa hepatic lesion and was referred for percutaneous ablation. Pre-procedure computed tomography (CT) images demonstrated a distended gallbladder abutting the segment 5/6 hepatic metastasis. In order to perform ablation with clear margins and avoid direct puncture and aspiration of the gallbladder, cholecystokinin was administered intravenously to stimulate gallbladder contraction before hydrodissection. Subsequently, the lesion was ablated successfully with sufficient margins, of greater than 1.0 cm, using microwave with ultrasound and FDG PET/CT guidance. The patient tolerated the procedure very well and was discharged home the next day

296

Cholecystokinin-Assisted Hydrodissection of the Gallbladder Fossa during FDG PET/CT-guided Liver Ablation  

Energy Technology Data Exchange (ETDEWEB)

A 68-year-old female with colorectal cancer developed a metachronous isolated fluorodeoxyglucose-avid (FDG-avid) segment 5/6 gallbladder fossa hepatic lesion and was referred for percutaneous ablation. Pre-procedure computed tomography (CT) images demonstrated a distended gallbladder abutting the segment 5/6 hepatic metastasis. In order to perform ablation with clear margins and avoid direct puncture and aspiration of the gallbladder, cholecystokinin was administered intravenously to stimulate gallbladder contraction before hydrodissection. Subsequently, the lesion was ablated successfully with sufficient margins, of greater than 1.0 cm, using microwave with ultrasound and FDG PET/CT guidance. The patient tolerated the procedure very well and was discharged home the next day.

Tewari, Sanjit O., E-mail: tewaris@mskcc.org [Memorial Sloan-Kettering Cancer Center, Molecular Imaging and Therapy Service, Department of Radiology (United States); Petre, Elena N., E-mail: petree@mskcc.org [Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States); Osborne, Joseph, E-mail: osbornej@mskcc.org [Memorial Sloan-Kettering Cancer Center, Molecular Imaging and Therapy Service, Department of Radiology (United States); Sofocleous, Constantinos T., E-mail: sofoclec@mskcc.org [Memorial Sloan-Kettering Cancer Center, Interventional Radiology Service, Department of Radiology (United States)

2013-12-15

297

Reinterpretation of Tractus Fossae region as an asymmetric rift system on Mars  

Science.gov (United States)

The Tractus Fossae region of Mars is a wide area dominated by grabens, normal faults and pit crater chains. In this work, based on previous studies on the area and the new interpretation of topographic data and morphological units based on images as a geologic framework we present a new insight on the origin of the graben structures as well as on the processes associated with the formation of the volcanic features. Here we propose a new model for this region, on the basis of new measurements of graben extension and geological interpretations, together with a reinterpretation of the stratigraphy and the geologic history of the area. Finally, it is postulated that this region underwent a tectonic regime analog to an asymmetric rift system on Earth.

Spagnuolo, Mauro G.; Figueredo, Patricio H.; Ramos, Victor A.

2008-12-01

298

Effect of Texture, Shape, and Intensity Feature Fusion for Posterior-Fossa Tumor Segmentation in MRI  

Directory of Open Access Journals (Sweden)

Full Text Available In this study, we systematically investigate efficacy of using several different image features such as intensity, fractal texture, and level-set shape in segmentation of posterior-fossa (PF tumor for pediatric patients. We explore effectiveness of using four different feature selection and three different segmentation techniques, respectively, to discriminate tumor regions from normal tissue in multimodal brain MRI. We further study the selective fusion of these features for improved PF tumor segmentation. We further study the selective fusion of these features for improved PF tumor segmentation. Our result suggests that Kullback–Leibler divergence measure for feature ranking and selection and the expectation maximization algorithm for feature fusion and tumor segmentation offer the best results for the patient data in this study.

Channu Kokila, K. Ramesh

2013-04-01

299

[Contrast medium enhanced MRT of tumors of the posterior fossa in children and adolescents].  

Science.gov (United States)

The results of contrast-enhanced MR in 24 children and adolescents with tumours of the posterior cranial fossa are presented. During initial diagnosis, the majority of tumours showed intensive enhancement with improved demarcation from neighbouring structures. The solid component of a cystic tumour, even when small and not visible on the original scan, could be demonstrated in all cases by means of gadolinium-DTPA. Post-operatively, T2-weighted scans regularly showed areas of high signal strength at the margin of the resection; in the absence of a mass or demonstrable progression, the significance of this is uncertain. In these cases gadolinium-DTPA, because of the function of the blood-brain barrier, greatly increases accuracy in demonstrating residual or recurrent tumours. PMID:2548250

Kahn, T; Roosen, N; Fürst, G; Lenard, H G; Bock, W J; Göbel, U; Mödder, U

1989-08-01

300

Estimates of seismic activity in the Cerberus Fossae region of Mars  

Science.gov (United States)

The 2016 NASA InSight lander is the first planetary mission designed to study the deep interior of Mars. InSight's Seismic Experiment for Interior Structure (SEIS) package will quantify global and regional seismic activity and determine parameters like core properties, mantle composition, and Martian lithospheric thickness. An improved understanding of the location, magnitude, and frequency of potential seismic sources is essential for optimization of instrument design, sampling strategy, and interpretation of mission data. We focus on forecasting seismic activity for the Cerberus Fossae of the Elysium Planitia, chosen for their proximity to the proposed landing site and their recent formation and assuming these are active tectonic grabens. The minimum age we determine for the units around the Fossae, using Context Camera and High Resolution Imaging Science Experiment imagery for crater density surveying, is 10 Ma, placing them in the Late Amazonian. We are able to determine the rate of motion from measurements of observed throw, assuming that the faults remain active. Digital terrain models, made from stereo-image pairs from the High Resolution Stereo Camera (HRSC), are used to determine the maximum throw on four graben systems. Using these measured throws to estimate a length-averaged slip and assuming an inferred slip rate from surface age, we estimate an annual moment release of 1.58-1.03+2.35×1017Nm. From this we calculate an annual size-frequency distribution of events using the Gütenberg-Richter relationship. We estimate that between 1.5×100and 1.9×105events per year will have an amplitude greater than the peak band noise and so will be detectable at the InSight landing site.

Taylor, J.; Teanby, N. A.; Wookey, J.

2013-12-01

301

Therapeutic strategy and long-term outcome of meningiomas located in the posterior cranial fossa.  

Science.gov (United States)

The clinical and surgical findings of 41 consecutive cases of posterior cranial fossa meningiomas operated on between January 1987 and December 2011 at Saitama Medical Center/Saitama Medical University were reviewed. The 31 female and 10 male patients were aged from 19 to 74 years (mean 54 years). The tumors were located in the petroclival (N=15), craniovertebral junction (N=6), lateral tentorial (N=12), and cerebellopontine angle (N=8) regions. Mean tumor equivalent diameter was 4.3 cm (range 2-9 cm). Head pain (46.3%) and gait disturbance (26.8%) were the most common presenting symptoms, and cranial neuropathies were the most common neurological signs on admission. Mean preoperative performance status (Karnofsky scale) was 83% (range 40-100%). Surgical approaches to these tumors included presigmoidal transpetrosal, retrosigmoidal, transcondylar, and combined approaches. In 4 cases, a staged procedure was performed. Gross total resection was achieved in 85.4% of patients, and subtotal/partial resection in 12.2%. Surgical mortality was 2.4% and complications were encountered in 11 patients (26.8%) including temporary neurological deficits in 4 patients. The mean follow-up period was 8.2 years, ranging from 1 to 24 years, and the mean performance status of patients at 12 months after the last surgery was 92% (range 0-100%). Recurrence or progression of disease was found in 9.8% of cases. Postoperative adjuvant therapy was performed in 6 cases. My experience suggests that although posterior cranial fossa meningiomas represent a continuing challenge for contemporary neurosurgeons, such tumors may be completely or subtotally removed with low rate of mortality and acceptable morbidity, allowing most of these patients to achieve good outcome in long-term follow up. PMID:23095262

Matsui, Toru

2012-01-01

302

Treatment and diagnosis of middle fossa arachnoid cyst. Ventriculofiberscopy and cine-MRI  

International Nuclear Information System (INIS)

The treatment of intracranial arachnoid cysts is controversial regarding its surgical indication and operative procedures. Conventional surgical approaches such as fenestration, membranectomy, and shunting operation are invasive. Also CT cisternography and/or RI cisternography are invasive, when it has been performed to evaluate the possible CSF communications between the arachnoid cyst and subarachnoid space. Between July 1994 and February 1997, 10 patients with intracranial middle fossa arachnoid cysts were treated with a newly developed ventriculofiberscope which is characterized by splendid mechanical flexibility and high resolution. The cine-MRI, which is a non-invasive diagnostic tool, is used to evaluate the CSF circulation around the cyst fenestration. The patients' ages ranged from 4 months to 10 years, with a mean of 4.46 years. The cyst locations were left middle fossa (9), and right (1). Eight patients presented with macrocrania, 4 with developmental delay, three with seizure, two with headache, and one with subdural hematoma. The patients were preoperatively evaluated by means of MRI and cine-MR images. In all patients ventriculofiberscopic procedures including cyst fenestration, membranous dissection, cyst puncture and shriveling were successfully performed. Postoperative MR and cine-MR studies have shown reduction of the cyst size and appropriate CSF circulation. Neuroendoscopic procedures seem to be the first choice for children with arachnoid cysts anhoice for children with arachnoid cysts and the ventriculofiberscope proved to be very useful not only for cyst fenestration but also for cyst dissection. In addition, the non-invasive cine-MR studies are useful for long follow-up at OPD. (author)

303

Magnetic resonance imaging (MRI) of neurosurgical disorders in the posterior fossa  

International Nuclear Information System (INIS)

Since July, 1985, we have studied 247 patients with neurosurgical disorders using the superconductive magnetic resonance imaging (MRI) system (Philips Gyroscan S5). The lesions were in the posterior fossa in 31 cases, including nine intramedullary and 11 extramedullary tumors, five vascular malformations, two hemorrhages, two infarctions, and two congenital malformations. Each examination involved the use of T1-weighted (SE400/30), proton-density-weighted (SE1200 - 1500/50), T2-weighted (SE1200 - 1500/100, 150, 200), and inversion-recovery images (IR1400 - 1800/400/30). In general, the tumors showed a high intensity in the T2-weighted images and a low intensity in the T1-weighted images. With the T2-weighted images, perifocal edema was most clearly detectable, but the interface between tumor and edema became less clear. Contrast enhancement with Gadolinium-DTPA (0.1 mmol/kg, I.V.) was performed in five out of the twenty patients with tumors. After the administration of Gd-DTPA, an increased signal intensity from the tumor was observed in all five patients. The differentiation of the tumor from the perifocal edema was best in the postcontrast, T1-weighted images. In the patient with a cerebellar venous angioma, an enlarged draining vein showed a low signal intensity on the first-spin echo image and an increased signal intensity on the second-spin echo image. A comparison of the MRI and X-ray CT findings showed that the MRI indicated more precisely the extent and naturecated more precisely the extent and nature of lesions. It is concluded that MRI could be the first screening procedure in patients with a suspected neurosurgical disorder in the posterior fossa. (author)

304

Incidence, Risks, and Sequelae of Posterior Fossa Syndrome in Pediatric Medulloblastoma  

International Nuclear Information System (INIS)

Purpose: To investigate the incidence, risks, severity, and sequelae of posterior fossa syndrome (PFS) in children with medulloblastoma. Methods and Materials: Between 1990 and 2007, 63 children with medulloblastoma at Emory University and Children's Healthcare of Atlanta were treated with craniectomy followed by radiation. Fifty-one patients were assigned to a standard-risk group, and 12 patients were assigned to a high-risk group. Five patients had 2 residual tumor, 4 had ?1.5-cm2 residual tumor, and the remainder had no residual tumor. Eleven patients had disseminated disease. Patients received craniospinal irradiation at a typical dose of 23.4 Gy or 36 Gy for standard- or high-risk disease, respectively. The posterior fossa was given a total dose of 54 or 55.8 Gy. Nearly all patients received chemotherapy following cooperative group protocols. Results: Median follow-up was 7 years. PFS developed in 18 patients (29%). On univariate analysis, brainstem invasion, midline tumor location, younger age, and the absence of radiographic residual tumor were found to be predictors of PFS; the last two variables remained significant on multivariate analysis. From 1990 to 2000 and from 2001 to 2007, the proportions of patients with no radiographic residual tumor were 77% and 94%, respectively. During the same eras, the proportions of patients with PFS were 17% and 39%. Only 4 patients had complete recovery at last follow-up. Conclusions: The inciat last follow-up. Conclusions: The incidence of PFS increased in the latter study period and is proportional to more aggressive surgery. Children with midline tumors exhibiting brainstem invasion are at increased risk. With the increased incidence of PFS and the permanent morbidity in many patients, the risks and benefits of complete tumor removal in all patients need to be reexamined.

305

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 SciELO Brazil | Language: Portuguese 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 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. 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 1 [...] 8-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.

1995-09-01

306

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

1995-09-01

307

Dermatitis, atopic on the arms (image)  

Science.gov (United States)

This person has inherited allergic skin inflammation (atopic dermatitis) on the arms. Red (erythematous), scaly plaques can be seen on the inside of the elbows (antecubital fossa). In adults, atopic dermatitis ...

308

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  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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 nov [...] a 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. Abstract in english 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.

2013-04-01

309

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  

Directory of Open Access Journals (Sweden)

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

2013-04-01

310

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  

OpenAIRE

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...

Sebastião Timo laria; Furlanetto, Sirde?ia M. P.; Campos, Maria Lu?cia C.

1980-01-01

311

Long-lasting "christmas tree rash" in an adolescent: isotopic response of indeterminate cell histiocytosis in pityriasis rosea?  

Science.gov (United States)

A 13-year-old girl developed a non-pruritic pityriasis rosea-like rash, which did not respond to topical corticosteroids or UV therapy but persisted for 2 years. The lymphohistiocytic infiltrate in the upper dermis showed mononuclear cells immunoreactive with S100, CD68, factor XIIIa and CD1a. Electron microscopic evaluation of these cells demonstrated lamellated dense bodies but no Birbeck granules, lipid vacuoles or cholesterol crystals. Two diagnoses were made: a primarily clinical diagnosis of generalized eruptive histiocytosis and a more cell-biology-based diagnosis of an indeterminate cell histiocytosis. Three years later, the lesions are showing spontaneous resolution, with loss of erythema and flattening. Our patient's indeterminate cells fulfil Rowden's classical definition (dendritically shaped epidermal non-keratinocytes without identifying cytoplasmic features), as well as Zelger's newer definition (cells with features of both macrophages and dendritic cells). A Christmas tree pattern has not been previously described in indeterminate cell histiocytosis. Development of indeterminate cell histiocytosis in the lesions of a healing pityriasis rosea might explain the unusual distribution pattern. The development of a skin disorder at the site of an unrelated, already healed skin disease is known as an isotopic response. Key PMID:12361135

Wollenberg, Andreas; Burgdorf, Walter H C; Schaller, Martin; Sander, Christian

2002-01-01

312

Clinical validity of MR based program for analysis of fluid/brain index of posterior cranial fossa structures in patients with spinocerebellar ataxia  

International Nuclear Information System (INIS)

Spinocerebellar ataxia type 1 (SCA1) and type 2 (SCA2) belong to the group of neurodegenerative disorders of autosomal dominant inheritance, genetically and clinically heterogeneous, caused by CAG trinucleotide repeat expansion, which leads to productions of protein carrying the abnormal polyglutamine chain (polyQ). Molecular abnormalities cause degenerative changes - atrophy of posterior cranial fossa structures. The clinical symptoms typical of this disorder include progressive gait and limb ataxia, dysarthria, occulomotor disturbances, pyramidal tract and peripheral nerves involvement. The aim of the study is to evaluate the usefulness of a computer program prepared in our department for volumetric measurements of posterior cranial fossa structures (the pons, vermis and cerebellar hemispheres) in a group of SCA patients. MR examinations of 22 patients suffering from SCA were used to calculate the value of fluid/brain index of posterior cranial fossa structures and compared with the results of group of 10 healthy volunteers. The degree of atrophy of posterior cranial fossa structures can be objectively evaluated by special volumetric measurements. We found fluid/brain index (FBI) of posterior cranial fossa structures in group of SCA patients to vary from 0.1411 to 0.3929 (mean 0.2456 SD±0.601). 1. MR-based calculation of fluid/brain index of posterior fossa structures is a valuable tool for morphological assessment of SCA-related changes in brain structures. 2. Thelated changes in brain structures. 2. The presented software enables objective evaluation of the course and stage of posterior fossa structures atrophy. 3. Our self-made computer program to calculate the fluid/brain index of posterior cranial fossa structures is easy to use on a personal computer- it is a good tool in everyday radiological practice. (author)

313

A comparison in 101 dairy cows of right paralumbar fossa omentopexy and right paramedian abomasopexy for treatment of left displacement of the abomasum  

OpenAIRE

Right paramedian abomasopexy and right paralumbar fossa omentopexy appear to be the most widely used means of correcting left displacement of the abomasum in dairy cattle. We compared these two procedures in a prospective study of 101 cows with uncomplicated left displaced abomasum. The surgical treatment (right paramedian abomasopexy, n = 48; or right paralumbar fossa omentopexy, n = 53) was assigned randomly. Follow-up information was obtained, at regular intervals, from one week through si...

Fubini, Susan L.; Ducharme, Norm G.; Erb, Hollis N.; Sheils, Robin L.

1992-01-01

314

Evaluation of articular cartilage thickness of the humeral head and the glenoid fossa by MR arthrography: anatomic correlation in cadavers  

International Nuclear Information System (INIS)

To evaluate the accuracy of MR arthrography in determining the thickness of articular cartilage of the humeral head and glenoid fossa. Results. The correlation coefficients for MR arthrographic measurement versus anatomic measurement of the cartilage thickness were 0.7324 and 0.8757 for humeral head and glenoid fossa, respectively. With regard to the humeral head, there was a tendency to overestimate regions of thin cartilage and underestimate regions of thick cartilage. This tendency was not found in the assessment of glenoid cartilage. The mean of the absolute value of MR-anatomic differences was similar on the glenoid side (0.27 mm) and the humeral side (0.29 mm). The accuracy of measurement was significantly better on the glenoid side (Fisher's r-to-Z transformation: Z=5.21, P=0.000001). (orig.)

315

Behandling af defaekationsblokade som følge af dyb fossa recto-genitalis med total baekkenbundsrekonstruktion med Prolene-net.  

DEFF Research Database (Denmark)

The causes of severe defaecation blockage resulting from compression of the rectum and deep recto-genital fossa are reviewed and are illustrated by three patients who had previously undergone hysterectomy and who had incapacitating defaecation blockage and abdominal pain requiring morphine in two of the patients. The condition had not been diagnosed despite previous hospital contact for many years in two of the patients. Complete reconstruction of the pelvic floor with prolene net was performed. Subsequent defaecography showed normalization of defaecation without rectal compression and with relief of the abdominal pain and dependence on morphine in two of the patients. Rectal compression resulting from an abnormally deep recto-genital fossa should be included in the differential diagnostic deliberations in patients with severe constipation and defaecation blockage. Complete reconstruction of the pelvic floor with prolene net is considered, in the preliminary findings, to be a reasonable alternative in the treatment of this condition.

MØller, P; Monrad, H

1992-01-01

316

Ultrasound Imaging of the Sciatic Nerve Division in the Popliteal Fossa: A Volunteer Study  

Directory of Open Access Journals (Sweden)

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

2013-07-01

317

Microarray-based gene expression profiling and DNA copy number variation analysis of temporal fossa arachnoid cysts  

OpenAIRE

Abstract Background Intracranial arachnoid cysts (AC) are membranous sacs filled with CSF-like fluid that are commonly found in the temporal fossa. The majority of ACs are congenital. Typical symptoms are headache, dizziness, and dyscognition. Little is known about genes that contribute to the formation of the cyst membranes. Methods In order to identify differences in gene expression between normal arachnoid membrane (AM) and cyst membrane, we have performed a ...

Helland Christian A; Aarhus Mads; Lund-Johansen Morten; Wester Knut; Knappskog Per M

2010-01-01

318

A comparative study of the pterygopalatine fossa and its ganglion in a South African skeletal and cadaver population  

OpenAIRE

Blocking the contents of the pterygopalatine fossa (PPF) is a highly effective method in alleviating pain in trigeminal neuralgia (TN) and other facial pain syndromes. This, however, is not a widely used technique, due to the difficulty in locating the PPF which is obscured by bony and soft tissue structures. Despite the various unspecific techniques that have been attempted, in many cases radiography still seems to be used as it is the most effective method in locating the ...

Du Plessis, Maira

2009-01-01

319

Entrapped Catheter across the Fossa Ovalis in an Adult with Pulmonary Stenosis - A Case Report of Surgical Relief.  

Science.gov (United States)

Percutaneous pulmonary balloon valvuloplasty as a procedure of choice in adults has been established since the last three decades. Even though the complications are rare, they are scarcely reported in the literature. We report such a case in an adult female patient of severe pulmonary valular stenosis in whom, entrapped catheter across the fossa ovalis was noted in chest x-ray and echocardiogram following unsuccessful percutaneous pulmonary balloon valvuloplasty. Our case emphasizes this rare complication and its successful surgical outcome. PMID:24757650

Betigeri, Vithalkumar Malleshi; Gopinathan, Girish; Malik, Indira; Sanwal, Manoj Kumar; Datt, Vishnu; Satsangi, Deepak Kumar

2014-01-01

320

Medial longitudinal fasciculus syndrome associated with a subdural hygroma and an arachnoid cyst in the middle cranial fossa.  

Science.gov (United States)

A 60-year-old man complaining of diplopia and vertigo showed bilateral medial longitudinal fasciculus (MLF) syndrome. The CT scan revealed a space-occupying lesion with watery fluid in the left cranial fossa, which was divided into two parts by a thin septum. Surgical trepanation was performed followed by 4 weeks of prednisolone therapy. He was completely cured 5 months later. The plausible causes of MLF syndrome relevant to preexisting space-occupying lesions are discussed. PMID:1295625

Minamori, Y; Yamamoto, M; Tanaka, A; Kanai, K; Uenishi, H; Tanaka, M; Hayashi, K; Tsuji, K; Wakahara, M

1992-11-01

321

The clinical utility of ultra-low field (0.02 T) MRI for the diagnosis of posterior fossa lesions  

International Nuclear Information System (INIS)

It is clear that high and middle field MRI be superior to CT on evaluation of neurological diseases. However, the clinical utility of ultra-low magnetic field (0.02 T) MRI has not been established yet. In this article, the usefulness of ultra-low field MRI in the diagnosis of posterior fossa lesions is studied as comparison with that of CT. We reviewed 128 patients who had both ultra-low magnetic field MRI and CT examinations. In these cases, 87 patients had posterior fossa lesion and 41 patients didn't. The specificity of MRI and CT were the same as 85.4%. Sensitivity of MRI and CT were 96.8% and 78.9%, respectively. Accuracy of MRI and CT were 93.4% and 80.9%. Superiority of MRI was well demonstrated in the pathology of medulla oblongata, pons and lower portion of cerebellar hemisphere, because of lack of beam-hardening artifacts, that often exist on CT. In the true-positive cases of CT, MRI had one false-negative case (dolicho-ectatic basilar artery). Infarction and demyelinization were more accurately detected by MRI than CT. T2 weighted image was more sensitive in the evaluation of posterior fossa lesions than T1 weighted image. Short T1 IR (STIR) image was proved to be a good method for evaluation of small lesions adjacent to CSF space. As conclusion, it is warranted to say that ultra-low magnetic field MRI be superior to CT in the evaluation of posterior fossa lesions and is a good modality for screening. (author)

322

Familial Posterior Fossa Brain Tumors of Infancy Secondary to Germline Mutation of the hSNF5 Gene  

OpenAIRE

We have identified a family afflicted over multiple generations with posterior fossa tumors of infancy, including central nervous system (CNS) malignant rhabdoid tumor (a subset of primitive neuroectodermal tumors, or PNET) and choroid plexus carcinoma. Various hereditary tumor syndromes, including Li-Fraumeni syndrome, Gorlin syndrome, and Turcot syndrome, have been linked to increased risk of developing CNS PNETs and choroid plexus tumors. Malignant rhabdoid tumors of the CNS and kidney sho...

Taylor, Michael D.; Gokgoz, Nalan; Andrulis, Irene L.; Mainprize, Todd G.; Drake, James M.; Rutka, James T.

2000-01-01

323

Appendicular endometriosis as a cause of chronic abdominal pain alone in the right iliac fossa: case report and literature review  

OpenAIRE

Endometriosis is a disease characterized by the presence of ectopic endometrial glands and stroma. Although its etiology is undefined, it is suggested to be a result of coelomic metaplasia, retrograde menstruation, to provide a genetic component, or to be one that occurs due to blood or lymphatic spread. The involvement of the gastrointestinal tract is common. However, appendicular endometriosis is a rare condition. It is usually asymptomatic. Recurrent pain in the right iliac fossa is an unu...

Marcelo Pandolfi Basso; Adriana Borgonovi Christiano; André Luís Cozetto de Oliveira; Geni Satomi Cunrath; João Gomes Netinho

2012-01-01

324

Incidence of rubella IgM antibodies in individuals with febrile rash illness attending clinics in Akwa Ibom State, Nigeria, 2006-2009  

OpenAIRE

Background: Rubella is an infectious disease of public health importance because infection ac-quired during early pregnancy often results in foetal abnormalities that are classified as con-genital rubella syndrome (CRS). The burden of rubella infection in most developing countries is however not well documented because of lim-ited epidemiological data. Methods: Between 2006 and 2009, 781individuals with febrile rash illness seen in clinics in Akwa Ibom State were screened for rubella specific...

Bassey Enya; Moses Anietie Effiong; Udo Sunde Moffat; Bassey Emem

2011-01-01

325

Severe toxicity of skin rash, fever and diarrhea associated with imatinib: case report and review of skin toxicities associated with tyrosine kinase inhibitors  

Directory of Open Access Journals (Sweden)

Full Text Available Xuan Huang1, Samir Patel2, Nasir Ahmed2, Karen Seiter2, Delong Liu21Department of Medicine, Richmond University Medical Center, New York, NY, USA; 2Division of Oncology and Hematology, New York Medical College and Westchester Medical Center, New York, NY, USAAbstract: Chronic myeloid leukemia (CML is characterized by a Philadelphia chromosome which contains an oncogene, bcr-abl. This oncogene encodes a tyrosine kinase which is constitutively activated. Imatinib, a tyrosine kinase inhibitor (TKI, has been widely used in the treatment of CML. Dasatinib and nilotinib were recently approved for the treatment of CML. Other TKIs, such as bosutinib, erlotinib, and sunitinib, are under study for the treatment of CML as well as other hematologic and solid malignancies. Skin rash has been reported as one of the most common side effects of the TKIs. Here we present a case of severe skin rash together with unusual symptoms of high fever and diarrhea induced by imatinib in a CML patient. The dermatologic toxicities from a variety of tyrosine kinase inhibitors are reviewed and general principles of management are also discussed.Keywords: chronic myeloid leukemia, skin rash, tyrosine kinase inhibitor, imatinib

Delong Liu

2008-10-01

326

Visualization of the angio-architecture in the posterior fossa using image fusion  

International Nuclear Information System (INIS)

Recently, the authors reported a novel image fusion technique, which combines three-dimensional digital subtraction angiography (3D DSA) and magnetic resonance (MR) images, to produce DSA-MR fusion. This technique visualizes both angioarchitecture imaged by 3D DSA and soft tissues imaged by MR. The goal of this study was to evaluate the utility of DSA-MR fusion in visualizing arteries and veins, as well as intracranial lesions, brain tissues, and cranial nerves, in the posterior fossa. Thirty-seven consecutive patients (10 with neurovascular compression syndrome, 24 with brain tumors and 3 with cerebrovascular diseases) underwent preoperative DSA-MR fusion. The authors compared the DSA-MR fusion images with intraoperative findings. Image fusion was performed within 20 minutes and the registration error was insignificant in all cases. Image fusion successfully and clearly visualized the 3D relationships between arteries or veins, cranial nerves, brain tissues and lesions; furthermore, specific vessels were easily identified. The findings of DSA-MR fusion images were surgically confirmed in all patients. Using this advanced image fusion technique with its reasonable post-processing time, neurosurgeons may more easily and precisely understand the surgical anatomy preoperatively than by analyzing 3D DSA and MR images separately. (author)

327

Effect of radiation therapy on extracerebral cavernous hemangioma in the middle fossa  

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We report three cases of extracerebral cavernous hemangiomas in the middle fossa all of which had received radiotherapy. Follow-up study with serial computed tomography during and after irradiation were presented. In Case 1, radiotherapy after partial removal of the tumor reduced the tumor's size and CT number, and facilitated total removal. In Case 2 as well, irradiation was started before the operation. The tumor responded very well to irradiation and showed significant reduction in the size and CT number of the tumor with a dose of about 3,000 rads. Subtotal romoval was possible. In Case 3, the tumor responded very well clinically to irradiation, and vertigo were much improved with a dose of about 3,000 rads, and CT scan at that time showed significant reduction in the size and CT number of the tumor, therefore she only received radiation therapy, no surgical intervention. It is concluded that in cases of extracerebral cavernous hemangioma with massive hemorrhage, radiation of up to 3,000 rads was a method of choice. The treatment results in an increased probability of total removal of the tumor, and moreover the possibility of eliminating surgery.

Shibata, Shobu; Fukushima, Masaaki; Mori, Kazuo; Tsujimura, Masaki; Yokoyama, Hiroaki

1987-03-01

328

Effect of radiation therapy on extracerebral cavernous hemangioma in the middle fossa  

International Nuclear Information System (INIS)

We report three cases of extracerebral cavernous hemangiomas in the middle fossa all of which had received radiotherapy. Follow-up study with serial computed tomography during and after irradiation were presented. In Case 1, radiotherapy after partial removal of the tumor reduced the tumor's size and CT number, and facilitated total removal. In Case 2 as well, irradiation was started before the operation. The tumor responded very well to irradiation and showed significant reduction in the size and CT number of the tumor with a dose of about 3,000 rads. Subtotal romoval was possible. In Case 3, the tumor responded very well clinically to irradiation, and vertigo were much improved with a dose of about 3,000 rads, and CT scan at that time showed significant reduction in the size and CT number of the tumor, therefore she only received radiation therapy, no surgical intervention. It is concluded that in cases of extracerebral cavernous hemangioma with massive hemorrhage, radiation of up to 3,000 rads was a method of choice. The treatment results in an increased probability of total removal of the tumor, and moreover the possibility of eliminating surgery. (author)

329

Imaging of lesions in the posterior cranial fossa using single photon emission computed tomography  

International Nuclear Information System (INIS)

Lesions in the posterior cranial fossa were visualized by single photon emission computed tomography (SPECT) with 123I-IMP (N-isopropyl-p-123I-iodoamphetamine) and 99mTc-HM-PAO (99mTc-hexametylpropyleneamine oxime). It is generally held that these radiopharmaceuticals penetrate the walls of cerebral blood vessels and that their accumulations in the brain tissue may reflect the cerebral blood flow. Six patients with lesions in the central nervous system all showed wider areas of abnormality in SPECT than in X-ray CT, indicating a larger lesion of blood flow disturbance. In the next series of 11 patients with vertigo or dizziness of unknown etiology, eight had abnormal findings in the scan with 123I-IMP as did four of the nine in the scan with 99mTc-HM-PAO. Thus, most patients with dizziness of unknown etiology may have some vertebral blood flow disorder, which in some cases is not clearly diagnosed by conventional vestibular examinations or even by X-ray CT scan. The accuracy of the diagnostic measures for otoneurological problems awaits further studies of their sensitivity and specificity. (author)

330

Subtemporal-anterior transtentoral approach to middle cranial fossa microsurgical anatomy.  

Science.gov (United States)

This study aimed to describe the topography of inferior and external dura mater of the middle cranial fossa through subtemporal-anterior transpetrosal approach and discuss the feasibility of improving the approach. Eight formalin-fixed adult cadaveric heads were studied, with the bones milled away in the lateral triangle region of the petrous bone, Kawase rhombus region, and inner triangle region of the petrous apex. The distances between the targets in these regions, as well as the angles after the dissection of zygomatic arch, were measured, and then the exposed petroclival and retrochiasmatic areas were observed under the microscope. There were significant variations in the distances between targets in the 3 milled regions among the specimens. After the dissection of zygomatic arch, the surgical view got an average increase of 12 degrees. The subtemporal anterior transpetrosal approach, as an improved subtemporal approach, can expose the lesions optimally, causing no injury to the hearing and reducing injuries to temporal lobe. On the other hand, the lateral bone of the petrous parts of the temporal bone is removed so as to improve the view to the retrochiasmatic area and expand the operative field. PMID:25377976

Xu, Zhiming; Wang, Weimin; Zhang, Jingjing; Liu, Wei; Feng, Yugong; Li, Gang

2014-11-01

331

Atypical meningioma in the posterior fossa associated with colpocephaly and agenesis of the corpus callosum.  

Science.gov (United States)

Colpocephaly is an abnormal enlargement of the occipital horns, i.e., the posterior or rear portions of the lateral ventricles of the brain, and is associated with several other brain abnormalities. Colpocephaly is occasionally misdiagnosed as hydrocephalus, and various etiologies have been postulated, including genetic disorders and errors of morphogenesis. Meanwhile, chromosomal losses including 22q and rarely 21q are observed in malignant and atypical meningiomas. We report an uncommon case of a 67-year-old woman with colpocephaly and an atypical meningioma in the posterior fossa. There were no neurological deficits or family history of hereditary neuropsychiatric disorders. Brain magnetic resonance (MR) images showed bilateral enlarged occipital horns, agenesis of corpus callosum, and a cerebellar mass in the right cerebellar hemisphere. Right suboccipital craniotomy was performed, and the tumor was resected totally. Pathological study of the surgical specimen showed findings of atypical meningioma, and the postoperative course was uneventful until hydrocephalus developed. At 36th day after tumor removal, the patient undertook an external ventricular drainage followed by replacement of the ventriculoperitoneal shunt. We discuss the importance of colpocephaly in terms of the differential diagnosis for hydrocephalus and review the pertinent literature. PMID:22116445

Cheong, Jin Hwan; Kim, Choong Hyun; Yang, Mun Sul; Kim, Jae Min

2012-01-01

332

Developmental venous anomalies of the posterior fossa with transpontine drainage: report of 3 cases  

Energy Technology Data Exchange (ETDEWEB)

Developmental venous anomalies (DVA) are considered as variant patterns of cerebral venous drainage. Although generally not rare in the cerebellum, DVA of the brain stem or of the cerebellum with drainage through the brain stem are exceptional findings. Because it is not clear whether DVA may sometimes be of clinical significance, we try to correlate the clinical findings of the patients with the course of the variant vessels. We reviewed the literature and report three additional cases. All patients were examined by MRI and digital subtraction angiography. In particular, we discuss the drainage route as compared with the established patterns of posterior fossa blood drainage, which is directed to the dural sinuses, the petrosal vein or the vein of Galen. In one of our patients suffering from trigeminal neuralgia, the close topical relation of the DVA and the trigeminal nucleus and trigeminal nerve entry zone suggests a causal relationship. In a second case the brain stem symptoms were due to haemorrhage of a concomitant cavernoma. It remains unclear if the occurrence of dysarthria and dysaesthesia in the third patient with brain stem DVA was purely coincidental. The only clinical symptom directly attributable to a DVA with transpontine drainage in our series was trigeminal neuralgia. (orig.). With 3 figs., 1 tab.

Kueker, W. [Department of Neuroradiology, Technical University, Pauwelsstrasse 30, D-52 057 Aachen (Germany); Mull, M. [Department of Neuroradiology, Technical University, Pauwelsstrasse 30, D-52 057 Aachen (Germany); Thron, A. [Department of Neuroradiology, Technical University, Pauwelsstrasse 30, D-52 057 Aachen (Germany)

1997-08-01

333

Developmental venous anomalies of the posterior fossa with transpontine drainage: report of 3 cases  

International Nuclear Information System (INIS)

Developmental venous anomalies (DVA) are considered as variant patterns of cerebral venous drainage. Although generally not rare in the cerebellum, DVA of the brain stem or of the cerebellum with drainage through the brain stem are exceptional findings. Because it is not clear whether DVA may sometimes be of clinical significance, we try to correlate the clinical findings of the patients with the course of the variant vessels. We reviewed the literature and report three additional cases. All patients were examined by MRI and digital subtraction angiography. In particular, we discuss the drainage route as compared with the established patterns of posterior fossa blood drainage, which is directed to the dural sinuses, the petrosal vein or the vein of Galen. In one of our patients suffering from trigeminal neuralgia, the close topical relation of the DVA and the trigeminal nucleus and trigeminal nerve entry zone suggests a causal relationship. In a second case the brain stem symptoms were due to haemorrhage of a concomitant cavernoma. It remains unclear if the occurrence of dysarthria and dysaesthesia in the third patient with brain stem DVA was purely coincidental. The only clinical symptom directly attributable to a DVA with transpontine drainage in our series was trigeminal neuralgia. (orig.). With 3 figs., 1 tab

334

Total spine and posterior fossa MRI screening in adolescent idiopathic scoliosis (177 cases  

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Full Text Available Background: MRI screening for idiopathic scoliosis is controversial. Considering our clinical experiences, the results of MRI in all patients with idiopathic scoliosis were evaluated. Methods: In a prospective clinical study, all neurologically normal patients with idiopathic scoliosis screened by posterior fossa and total spine MRI. Results: After excluding 9 patients for mild neurological findings, in other 177 patients (132 female, 45 male, the average age and curve angle was 15±2 years and 59±17º (30 to 135º, respectively. Convexity was to right in 146 and to left in 31 cases. MRI was positive in 12 cases (6.8%. In 5 cases (2.8%, neurosurgical intervention was necessary prior to scoliosis surgery. There was no relation between age, sex, presence of pain or curve angle and positive MRI findings (P>0.05. Left convexity was significantly related to positive MRI findings (P=0.013. In males with left convex curves, the probability of positive MRI findings was 8.8 folds other patients. Conclusion: Considering our results and other reported articles, it seems that routine MRI screening of all patients presenting as idiopathic scoliosis is necessary for detection of underlying pathologies. Key words: Idiopathic Scoliosis, MRI, Spine Syrinx, Chiari

MR Etemadifar

2005-05-01

335

Declarative and procedural learning in children and adolescents with posterior fossa tumours  

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Full Text Available Abstract Background This quasi-experimental study was designed to assess two important learning types – procedural and declarative – in children and adolescents affected by posterior fossa tumours (astrocytoma vs. medulloblastoma, given that memory has an important impact on the child's academic achievement and personal development. Methods We had three groups: two clinical (eighteen subjects and one control (twelve subjects. The learning types in these groups were assessed by two experimental tasks evaluating procedural-implicit and declarative memory. A Serial Reaction-Time Task was used to measure procedural sequence learning, and the Spanish version 1 of the California Verbal Learning Test-Children's Version- CVLT- 2 to measure declarative-explicit learning. The learning capacity was assessed considering only the blocks that represent learning, and were compared with MANOVA in clinical and normal subjects. The Raven, simple reaction-time, finger-tapping test, and grooved pegboard tests were used to assess the overall functioning of subjects. The results were compared with those from a control group of the same age, and with Spanish norm-referenced tools where available Results The results indicate the absence of procedural-implicit learning in both clinical groups, whereas declarative-explicit learning is maintained in both groups. Conclusion The clinical groups showed a conservation of declarative learning and a clear impairment of procedural learning. The results support the role of the cerebellum in the early phase of procedural learning.

Casares Encarnación

2006-03-01

336

Lumbar meningeal enhancement after surgery in the posterior cranial fossa: a normal finding in children?  

International Nuclear Information System (INIS)

Purpose: Spinal meningeal Gd-DTPA enhancement after cranial surgery is a known observation of a not well understood underlying mechanism. This paper demonstrates that this MRI finding is a normal meningeal reaction to subarachnoid hemorrhage, which should not be mistaken for metastatic spread. Material and methods: Three pediatric patients were examined by MRI for metastatic spread of malignant infratentorial tumors along the spinal canal two to nine days after the removal of the primary cerebral lesion. The findings were compared with a control group that underwent cranial surgery (cyst resection or fenestration of the posterior cranial fossa) without major bleeding into the subarachnoid space. Unenhanced and enhanced sequences were obtained to prove that the high singal within the CSF is caused by an abnormal Gd-DTPA uptake and not by methemoglobin. Results: Meningeal enhancement was observed in all patients with intraoperative bleeding resembling subarachnoid masses on enhanced T1-weighted images. This was not present in any patient of the control group. This finding lasts for approximately two weeks. Conclusion: The meningeal enhancement renders immediate postoperative studies inconclusive for the detection of metastatic spread. Consequently, the obligatory tumor staging along the spinal canal should ideally be done prior to the resection of a cerebral tumor. (orig.)

337

Hypophyseal fossa aspergillosis mimicking a pituitary macro adenoma with bleed: A case report  

International Nuclear Information System (INIS)

Background: Aspergillus infection of the sinuses is a common condition in those predisposed due to immunosuppression. However, its intracranial extension is rare, with sellar extension being even rarer and therefore is difficult to diagnose on imaging. Case Report: A case of sellar and sinusal aspergillosis mimicking a pituitary macroadenoma with bleed is presented. The initial CT examination of head of a diabetic patient revealed a hyperdense lesion in the hypophyseal fossa and in the sphenoid sinus with extension into the right cavernous sinus, showing foci of calcification. The differential diagnosis included fungal disease or meningioma and MRI was advised. Unfortunately, the imaging was done after a five months delay when CT and MRI revealed interval growth of the lesion. Although, the MRI presentation was highly suggestive of pituitary macroadenoma with bleeding, the diagnosis of invasive aspergillosis was made when clinical data became available. The diagnosis of aspergillosis was proven by histology. Conclusions: The diagnosis of hypophyseal extension of aspergillosis is difficult, because of its rarity. It is important to consider possibility of fungal infection in those predisposed to it. The judgment based only on MRI findings and incomplete clinical data could easily lead into false diagnosis of an invasive pituitary macroadenoma with bleed. (authors)

338

Efficacy of texture, shape, and intensity features for robust posterior-fossa tumor segmentation in MRI  

Science.gov (United States)

Our previous works suggest that fractal-based texture features are very useful for detection, segmentation and classification of posterior-fossa (PF) pediatric brain tumor in multimodality MRI. In this work, we investigate and compare efficacy of our texture features such as fractal and multifractional Brownian motion (mBm), and intensity along with another useful level-set based shape feature in PF tumor segmentation. We study feature selection and ranking using Kullback -Leibler Divergence (KLD) and subsequent tumor segmentation; all in an integrated Expectation Maximization (EM) framework. We study the efficacy of all four features in both multimodality as well as disparate MRI modalities such as T1, T2 and FLAIR. Both KLD feature plots and information theoretic entropy measure suggest that mBm feature offers the maximum separation between tumor and non-tumor tissues in T1 and FLAIR MRI modalities. The same metrics show that intensity feature offers the maximum separation between tumor and non-tumor tissue in T2 MRI modality. The efficacies of these features are further validated in segmenting PF tumor using both single modality and multimodality MRI for six pediatric patients with over 520 real MR images.

Ahmed, S.; Iftekharuddin, K. M.; Ogg, R. J.; Laningham, F. H.

2009-02-01

339

An indirect computerized tomography sign of chronic subdural hematoma demonstrated in the posterior fossa  

International Nuclear Information System (INIS)

In cases of chronic subdural hematoma (CSH), brain computerized tomography (CT) scans frequently disclose a low density band in the posterior fossa (LDBP) between the lateral margin of the cerebellum and the adjacent petrous bone/tentorium cerebelli. Out of 121 cases of CSH, 56 (46%) showed the LDBP. The LDBP was mostly ipsilateral to the side of the CSH or bilateral. The frequency of the LDBP had no correlation with the severity of the cerebral midline shift or the thickness of the hematoma. As normal controls, CT scans of 257 cases in which no organic lesions were detected were used. Also 30 cases with dementing diseases, 2 cases with spinocerebellar degeneration and 428 cases of other neurological diseases such as head trauma other than CSH, brain tumor, cerebrovascular disease etc. were studied as disease controls. The incidence of the LDBP in both controls was significantly lower than in CSH. Therefore, the LDBP in cases of CSH was considered to be a significant associated finding of CT scans. The mechanism of the LDBP is discussed. (author)

340

Herniography: A prospective, randomized study between midline and left iliac fossa puncture techniques  

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AIM: To determine whether an optimal site of injection exists for herniography. MATERIALS AND METHODS: This was a prospective, randomized study of 93 consecutive patients who were referred for herniography over a period of 9 months. Patients underwent either a left iliac fossa (LIF) or midline puncture. Parameters assessed included initial adequate needle placement, complications, pain scores and body mass index (BMI). The groups were compared using Chi-squared test for categorical data, Student's t-test for continuous data and the Mann-WhitneyU-test for skewed data, withP < 0.05 considered statistically significant RESULTS: Four complications were encountered (4%), and these were equally distributed between the two groups. Adequate initial positioning of the needle was similar in both groups. The volume of local anaesthetic used was correlated with discomfort using a pain scale: a volume of >6 ml resulted in significantly more pain. More frequent initial adequate needle placement was observed in thin patients (BMI < 45 kg/m{sup 2}) with experienced operators. Conversely, increased body mass index resulted in more difficult needle placement. CONCLUSION: Herniography is a safe procedure with few complications. There was no significant difference comparing the midline and LIF approaches. Nadkarni, S. et al. (2001)

Nadkarni, Sanjay; Brown, Peter W.G.; Beek, Edwin J.R. van; Collins, Michael C

2001-05-01

341

Improved Treatment of the Breast and Supraclavicular Fossa Based on a Simple Geometrical Principle  

International Nuclear Information System (INIS)

In breast cancer, nodal irradiation has become routine, but adds time and creates concerns for field overlap if the “match” is not accurate. We developed a technique to address these issues by using only one isocenter for both areas. Tangents are designed at simulation. The isocenter is then shifted to the upper border of the breast using a straightforward geometrical calculation. After determining the new isocenter, fields are recreated wherein the tangents are treated with a quarter beam and the supraclavicular field fashioned with a half-beam block. The gantry, collimator, and couch angles of the supraclavicular field are adjusted to achieve an accurate match. Ten patients were evaluated. Doses to the spinal cord and brachial plexus were lowered relative to conventional techniques. The hot spots were not augmented. In comparison with standard arrangements, setup time decreased. Accurate matching was consistently achieved and verified by portal imaging. A new approach for treating the supraclavicular fossa is easily executed. Advantages include negligible doses to the critical neural structures (i.e., spinal cord and brachial plexus), optimized matchline, and reduced setup time.

342

Progressive tumefactive fibroinflammatory lesion of the infratemporal fossa treated by radiation therapy  

Directory of Open Access Journals (Sweden)

Full Text Available Tumefactive fibroinflammatory lesion (TFIL is a rare benign tumor in the head and neck region. We present a case of a 40-year-old female with a benign but progressive lesion of the infratemporal fossa, which was diagnosed as TFIL. Patient responded briefly to a course of steroid treatment but eventually showed progression and was unresponsive to further steroids. She was then treated with external beam radiation to a dose of 60 Gy in 30 fractions. After radiation a slow, gradual decrease in tumor size was noted over the course of years and she is free of disease after more than 11 years of follow-up. The major longterm side effect this patient developed was an expected unilateral radiation-induced retinopathy, due to the close proximity of the lesion to the orbit. The dilemma of treatment of benign disease with radiation with potential long-term complications is discussed and a review of the literature on TFIL is presented.

Brian O’Sullivan

2012-01-01

343

Volcanic emissions from soils at the base of La Fossa volcano, Vulcano island, Italy  

Science.gov (United States)

A top-sealed plastic tube with a diameter of ca. 15 cm had been buried vertically at the base of La Fossa volcano, Volcano island, Italy, next to the front of the obsidian flow. The tube had been filled with quartz wool to condense vapors emanating from the soil. At ca. 75 cm below the surface the sample had been exposed to vapors from Sept. 2005 to April 2006. The leached sample had not been in touch with the ground. Another glass wool cushion (ca. 3 cm thick) had been underneath to minimize capillary effects. Leaching of the quartz wool and ICP-MS analysis documented positive values for: Mg, Al, Si, P, K, Ca, Cr, Mn, Ni, Cu, Zn, Cd, Sn, Pb. Leaching with nitric acid documented also V and Fe. Acid leaching produced higher values for all elements, except K and Sn, than leaching with deionized water. Negative values had been obtained for As, Se, Mo. Influence from soil breathing can be excluded as the active fumaroles contain As and Se. This experiment documents for the first time an unknown element transport by vapors/gases through a volcanic edifice interacting with hydrothermal and magmatic gases. It remains unknown if elements detected are entering the atmosphere or are getting adsorbed onto the volcanic ash soil particles derived from reworked surge beds. This question is very important as soils might be an unknown filter medium to filter volcanically polluted air in case of major volcanic crises. Data can be obtained from the authors.

Obenholzner, J. H.; Parks, J. L.

2006-12-01

344

Posterior Cranial Fossa Crowdedness Is Related to Age and Sex: an Magnetic Resonance Volumetric Study  

International Nuclear Information System (INIS)

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 <0.001). PCF CI declined with age for both men ( r = -0.61; P = 0.002) and women ( r = -0.68; P <0.001). The association with age - but not HB volume - was maintained after we controlled for sex and body height. On multiple regression, both age and sex accounted for 57.5% of the PCF CI variance. Conclusion: Our study shows that PCF CI is associated with age and sex, and can therefore be used as a surrogate to assess hindbrain atrophy in a cross-sectional sample. Moreover, sex- and age-specific normal ranges may be needed to evaluate the PCF CI in clinical practice

345

Progressive tumefactive fibroinflammatory lesion of the infratemporal fossa treated by radiation therapy.  

Science.gov (United States)

Tumefactive fibroinflammatory lesion (TFIL) is a rare benign tumor in the head and neck region. We present a case of a 40-year-old female with a benign but progressive lesion of the infratemporal fossa, which was diagnosed as TFIL. Patient responded briefly to a course of steroid treatment but eventually showed progression and was unresponsive to further steroids. She was then treated with external beam radiation to a dose of 60 Gy in 30 fractions. After radiation a slow, gradual decrease in tumor size was noted over the course of years and she is free of disease after more than 11 years of follow-up. The major long-term side effect this patient developed was an expected unilateral radiation-induced retinopathy, due to the close proximity of the lesion to the orbit. The dilemma of treatment of benign disease with radiation with potential long-term complications is discussed and a review of the literature on TFIL is presented. PMID:22532910

Hoebers, Frank J P; Ordonez, Bayardo Perez; Irish, Jon; Simpson, Rand E; Yu, Eugene; O'Sullivan, Brian

2012-01-01

346

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 SciELO Cuba | Language: Spanish 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 ensa [...] yo 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. 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 prepar [...] ation 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.

2012-03-01

347

Simple Technique for in Field Samples Collection in the Cases of Skin Rash Illness and Subsequent PCR Detection of Orthopoxviruses and Varicella Zoster Virus  

Science.gov (United States)

Background In case of outbreak of rash illness in remote areas, clinically discriminating monkeypox (MPX) from severe form of chickenpox and from smallpox remains a concern for first responders. Objective The goal of the study was therefore to use MPX and chickenpox outbreaks in Democratic Republic of Congo (DRC) as a test case for establishing a rapid and specific diagnosis in affected remote areas. Methods In 2008 and 2009, successive outbreaks of presumed MPX skin rash were reported in Bena Tshiadi, Yangala and Ndesha healthcare districts of the West Kasai province (DRC). Specimens consisting of liquid vesicle dried on filter papers or crusted scabs from healing patients were sampled by first responders. A field analytical facility was deployed nearby in order to carry out a real-time PCR (qPCR) assay using genus consensus primers, consensus orthopoxvirus (OPV) and smallpox-specific probes spanning over the 14 kD fusion protein encoding gene. A PCR-restriction fragment length polymorphism was used on-site as backup method to confirm the presence of monkeypox virus (MPXV) in samples. To complete the differential diagnosis of skin rash, chickenpox was tested in parallel using a commercial qPCR assay. In a post-deployment step, a MPXV-specific pyrosequencing was carried out on all biotinylated amplicons generated on-site in order to confirm the on-site results. Results Whereas MPXV proved to be the agent causing the rash illness outbreak in the Bena Tshiadi, VZV was the causative agent of the disease in Yangala and Ndesha districts. In addition, each on-site result was later confirmed by MPXV-specific pyrosequencing analysis without any discrepancy. Conclusion This experience of rapid on-site dual use DNA-based differential diagnosis of rash illnesses demonstrates the potential of combining tests specifically identifying bioterrorism agents and agents causing natural outbreaks. This opens the way to rapid on-site DNA-based identification of a broad spectrum of causative agents in remote areas. PMID:24841633

Magazani, Edmond K.; Garin, Daniel; Muyembe, Jean-Jacques T.; Bentahir, Mostafa; Gala, Jean-Luc

2014-01-01

348

Rashes: The Itchy Truth  

Science.gov (United States)

... Kids For Parents MORE ON THIS TOPIC Athlete's Foot Chickenpox Fungal Infections Lyme Disease Poison Ivy Scabies Checking Out Cuts, Scratches, and Abrasions Taking Care of Your Skin Help With Hives Eek! It's Eczema! Learning About ...

349

Clock face model applied to tibial intraneural ganglia in the popliteal fossa  

International Nuclear Information System (INIS)

Tibial intraneural ganglia occurring in the popliteal fossa are often misdiagnosed because of their relative rarity. Their joint connection is typically not recognized and therefore not treated, leading to recurrence. This is a retrospective clinical study. Magnetic resonance images (MRIs) of six patients with confirmed tibial intraneural ganglia arising from the superior tibiofibular joint were analyzed and were compared to ten individuals with normal tibial nerves who were imaged with MRI. All studies were interpreted as left-sided. A previously designed clock face model introduced for peroneal intraneural ganglia was used to describe the superior tibiofibular joint connection (tail sign). A single axial image was sought to determine the normal anatomic and pathologic relationships of the tibial nerve and tibial articular branch to the superior tibiofibular joint. In all patients with intraneural ganglia, a single conventional axial image at the mid-fibular head level could reliably demonstrate: (1) intraneural cyst within the articular branch at the superior tibiofibular joint connection (tail sign) between 8 and 9 o'clock and intraneural cyst within the tibial nerve, (2) the central location of the tibial nerve posterior to the tibia, and (3) popliteus muscle denervation changes and atrophy (popliteus sign). This technique can provide radiologists and surgeons with rapid and reproducible information for diagnosis and treatment planning of tibial intraneural gangliment planning of tibial intraneural ganglia. Similar to its use with the clock face model in peroneal intraneural ganglia, a standard axial image at the mid-fibular head level can be used to interpret key features of tibial intraneural ganglia and identify the joint connection. Improved identification of the presence of a joint connection will change the therapeutic approach of this pathology and reduce cyst recurrences. (orig.)

350

Characteristic findings of metrizamide CT cisternography in an epidermoid in the posterior fossa  

International Nuclear Information System (INIS)

A case of epidermoid cyst in the posterior fossa showing a characteristic finding upon metrizamide CT cisternography is reported. A 42-year-old man was admitted with gait disturbance. The abnormal signs were trunucal ataxia, gait ataxia, left cerebellar sign and nystagmus. A CT scan revealed a large, low-density area and the fourth ventricle could not be seen clearly. Absorption values were in the range of 5 - 18 Hounsfield units. There was no change in the absorption values of the lesion following intravenous injection of contrast medium. Metrizamide CT cisternography was performed No remarkable change was seen 1 hour after intrathecal injection of metrizamide. However, metrizamide irregularly surrounded the left margin of the low-density area 3 hours after intrathecal injection. Moreover, metrizamide stained the area heterogeneously like a honeycomb or sponge at 6 hours. Finally, only a small amount of metrizamide remained in this area after 24 hours. Suboccipital craniectomy revealed a pearly tumor in the cisterna magna, wrapped in a thin white capsule and partially adherent to the cerebellomedullary junction. The tumor was totally removed. Histopathological investigation showed stratified squamous epithelium with keratinous material. A honeycomb- or sponge-like image seems to be a characteristic finding in metrizamide CT cisternography of the epidermoid cyst. This finding has not been previously reported. However, pneumoencephalographical findings in some cases ofcephalographical findings in some cases of epidermoid were reported as crumb- or sponge-like images. These images were thought to be caused by air covering the surface of the pearly tumor. These images should be similar to the one found in the present study using CT cisternography. (author)

351

Multifractal modeling, segmentation, prediction, and statistical validation of posterior fossa tumors  

Science.gov (United States)

In this paper, we characterize the tumor texture in pediatric brain magnetic resonance images (MRIs) and exploit these features for automatic segmentation of posterior fossa (PF) tumors. We focus on PF tumor because of the prevalence of such tumor in pediatric patients. Due to varying appearance in MRI, we propose to model the tumor texture with a multi-fractal process, such as a multi-fractional Brownian motion (mBm). In mBm, the time-varying Holder exponent provides flexibility in modeling irregular tumor texture. We develop a detailed mathematical framework for mBm in two-dimension and propose a novel algorithm to estimate the multi-fractal structure of tissue texture in brain MRI based on wavelet coefficients. This wavelet based multi-fractal feature along with MR image intensity and a regular fractal feature obtained using our existing piecewise-triangular-prism-surface-area (PTPSA) method, are fused in segmenting PF tumor and non-tumor regions in brain T1, T2, and FLAIR MR images respectively. We also demonstrate a non-patient-specific automated tumor prediction scheme based on these image features. We experimentally show the tumor discriminating power of our novel multi-fractal texture along with intensity and fractal features in automated tumor segmentation and statistical prediction. To evaluate the performance of our tumor prediction scheme, we obtain ROCs and demonstrate how sharply the curves reach the specificity of 1.0 sacrificing minimal sensitivity. Experimental results show the effectiveness of our proposed techniques in automatic detection of PF tumors in pediatric MRIs.

Islam, Atiq; Iftekharuddin, Khan M.; Ogg, Robert J.; Laningham, Fred H.; Sivakumar, Bhuvaneswari

2008-03-01

352

Posterior fossa syndrome in adults: a new case and comprehensive survey of the literature.  

Science.gov (United States)

Although the posterior fossa syndrome (PFS) can be considered as an aetiologically heterogeneous condition affecting children and adults, it most often occurs in paediatric patients after cerebellar tumour surgery. In patients with a tumoural aetiology, the syndrome is typically characterised by a short symptom-free postoperative period followed by mutism of variable duration and behavioural and affective changes. More than 200 paediatric cases have been described but reports of adult patients are extremely rare. This paper discusses PFS in adults on the basis of a comprehensive literature survey and describes the pre- and postoperative findings in a new adult patient. In the preoperative phase, cognitive, behavioural and affective abnormalities were identified, matching a diagnosis of cerebellar cognitive affective syndrome (CCAS) (Schmahmann and Sherman, 1998; Schmahmann, 2004). The immediate postoperative course was characterised by prefrontal-like behavioural and affective abnormalities, peduncular hallucinations and confusion evolving to psychosis. Akinetic mutism subsequently developed, lasted for 12 days and then alternated with episodes of diminished responsiveness in which pathological laughing and crying (PLC) occurred. Akinetic mutism resolved after treatment with a non-ergoline dopamine-agonist but CCAS persisted during longitudinal follow-up. From a semiological point of view "relapsing-remitting akinetic mutism" and PLC in our patient might add relevant information to current insights in the clinical expression of the PFS. As evidenced by a close parallelism between single photon emission computed tomography (SPECT) and clinical findings, CCAS as well as PFS seem to reflect functional disruption of the cerebello-cerebral network involved in cognitive, behavioural and affective functions. These findings may indicate that both syndromes share overt semiological resemblances and a common pathophysiological substrate. Consequently, CCAS and PFS may both be regarded as cerebellar-induced clinical conditions showing different aspects of a spectrum that range in degree of severity and symptom duration. PMID:21855865

Mariën, Peter; De Smet, Hyo Jung; Wijgerde, Ellen; Verhoeven, Jo; Crols, Roel; De Deyn, Peter P

2013-01-01

353

Posterior cranial fossa single-hole arteriovenous fistulae in children: 14 consecutive cases  

International Nuclear Information System (INIS)

We report 14 consecutive children with 23 posterior cranial fossa arteriovenous fistula (AVF); six had multifocal lesions, involving the supratentorial brain in three and the spinal cord in one. There were two boys and four girls with a family history compatible with hereditary haemorrhagic telangiectasia. The diagnosis was made in infancy in eight cases and in a further six before the age of 12 years; mean age at diagnosis was 3.5 years. The male-to-female ratio was 1.8:1. Presenting features were macrocrania in four cases, haemorrhage or headache in three and nonhaemorrhagic neurological deficits or and cardiac overload in two. Dominant supply to the symptomatic fistula arose from the posterior inferior cerebellar artery in five cases, anterior inferior cerebellar artery in two and the upper basilar artery system in seven. All children were primarily treated by transarterial embolisation. We treated thirteen children (93%) by transarterial embolisation alone; one older child with a history of haemorrhage also underwent radiosurgery. We obtained 100% exclusion of the fistula(e) in six children, 95-80% in five, 80-50% in one and <50% in one. Of the incompletely treated cases, three had conservative management, and two with 80% and one with 60% reduction of their lesion are scheduled for elective treatment; two partially treated case died. There was no morbidity due to the endovascular procedures. Follow-up since referral is 6 months-10 years (mean 4.5 years). Ten chilmonths-10 years (mean 4.5 years). Ten children are neurologically normal, two have persistent (pre-existing) neurological deficits and two are dead. (orig.)

354

Characteristic findings of metrizamide CT cisternography in an epidermoid in the posterior fossa  

Energy Technology Data Exchange (ETDEWEB)

A case of epidermoid cyst in the posterior fossa showing a characteristic finding upon metrizamide CT cisternography is reported. A 42-year-old man was admitted with gait disturbance. The abnormal signs were trunucal ataxia, gait ataxia, left cerebellar sign and nystagmus. A CT scan revealed a large, low-density area and the fourth ventricle could not be seen clearly. Absorption values were in the range of 5 - 18 Hounsfield units. There was no change in the absorption values of the lesion following intravenous injection of contrast medium. Metrizamide CT cisternography was performed No remarkable change was seen 1 hour after intrathecal injection of metrizamide. However, metrizamide irregularly surrounded the left margin of the low-density area 3 hours after intrathecal injection. Moreover, metrizamide stained the area heterogeneously like a honeycomb or sponge at 6 hours. Finally, only a small amount of metrizamide remained in this area after 24 hours. Suboccipital craniectomy revealed a pearly tumor in the cisterna magna, wrapped in a thin white capsule and partially adherent to the cerebellomedullary junction. The tumor was totally removed. Histopathological investigation showed stratified squamous epithelium with keratinous material. A honeycomb- or sponge-like image seems to be a characteristic finding in metrizamide CT cisternography of the epidermoid cyst. This finding has not been previously reported. However, pneumoencephalographical findings in some cases of epidermoid were reported as crumb- or sponge-like images. These images were thought to be caused by air covering the surface of the pearly tumor. These images should be similar to the one found in the present study using CT cisternography.

Murayama, K.; Chen, M.N.; Kuzuhara, M.; Shimura, T.; Yajima, K.; Nakazawa, S. (Nippon Medical School, Tokyo)

1982-05-01

355

Analysis by computed tomography of bone changes in the mandibular head and mandibular fossa in relation to clinical findings in patients with temporomandibular joint (TMJ) disorders  

International Nuclear Information System (INIS)

Bone changes in the mandibular head and mandibular fossa in 33 patients with temporomandibular joint (TMJ) disorders were studied with axial computed tomography in relation to clinical findings to clarify possible factors leading to bone changes in this phenomenon. Bone changes of the mandibular head were observed in 45 (68%) of the 66 TMJs. The mandibular head was juxtaposed to the mandibular fossa in 13 (29%) of the 45 joints in centric occlusion and in 29 joints (64%) in the anterior position on CT, whereas the mandibular head with no pathological bone change was juxtaposed to the mandibular fossa in none of the 21 joints in centric occlusion and in only 1 joint (5%) in the anterior position. In the two groups of patients with and without juxtaposition of the mandibular head and mandibular fossa with bone changes, the incidence of the initial symptoms such as pain, crepitus, and difficulty in opening the mouth was increased compared with the symptoms at presentation. However, the former group had severer symptoms than the latter group. These findings suggest that bony degeneration of the TMJ is accelerated by juxtaposition of the head and fossa. (author)

356

Conformal proton radiation therapy of the posterior fossa: a study comparing protons with three-dimensional planned photons in limiting dose to auditory structures  

International Nuclear Information System (INIS)

Purpose: Conventional radiation therapy for pediatric posterior fossa tumors can cause sequelae such as hearing loss and impairments in language and learning. Modern three-dimensional (3D) treatment techniques have improved dose conformity to the posterior fossa. This report compares the normal tissue dose-sparing capabilities of proton radiation therapy (PRT) with 3D conformal photon plans. Methods and Materials: Nine children underwent previous PRT for primary CNS malignancies. Using original planning CT scans, the posterior fossa, inner and middle ear, and temporal lobes were delineated. Three-dimensional treatment plans were generated for protons and photons. Normal tissue exposures were calculated by averaging mean doses received and by analysis of dose-volume histogram. Results: The 95% isodose encompassed the posterior fossa in all plans. Normal structures received markedly less radiation from PRT plans than from 3D photon plans. The cochlea received an average mean of 25 ± 4% of the prescribed dose from PRT, and 75 ± 6% from photons. Forty percent of temporal lobe volume was completely excluded using protons; with photons 90% of the temporal lobe received 31% of the dose. Conclusion: PRT resulted in increased dose sparing of normal structures analyzed. Posterior fossa conformity of 3D photons came at the expense of increasing amounts of normal tissue receiving low to moderate doses

357

Localization of the Internal Maxillary Artery for Extracranial-to-Intracranial Bypass through the Middle Cranial Fossa: A Cadaveric Study*  

OpenAIRE

The internal maxillary artery (IMAX) is a promising arterial pedicle to function as a donor vessel for extracranial-to-intracranial (EC-IC) bypass procedures. The access to the IMAX through the anterior portion of the middle cranial fossa floor allows a much shorter interposition graft to be used to create a bypass to the ipsilateral middle cerebral artery and prevents a second incision in the neck. One of the challenges of this technique, however, is the difficulty to find the IMAX through a...

Eller, Jorge L.; Sasaki-adams, Deanna; Sweeney, Justin M.; Abdulrauf, Saleem I.

2012-01-01

358

Detection of parvovirus B19 in skin biopsy, serum, and bone marrow of a patient with fever, rash, and polyarthritis followed by pneumonia, pericardial effusion, and hepatitis.  

Science.gov (United States)

A previously healthy 33-year-old male patient presented with fever, rash and polyarthritis. Subsequently, he developed pleuropneumonitis, pericardial effusion and hepatitis. The diagnosis of parvovirus B19 infection was based on the detection of parvovirus DNA by PCR in a skin biopsy, bone marrow cells and serum. The patient had high parvovirus IgG antibody titres but remained negative for IgM at a three month follow-up, suggesting persistence of the virus or reinfection. It is concluded that detection of viral DNA is needed to verify a parvovirus B19 infection even in an immunologically healthy host. PMID:9031882

Nikkari, S; Lappalainen, H; Saario, R; Lammintausta, K; Kotilainen, P

1996-12-01

359

Clinical and Laboratory evaluation of measleslike rash in children and young adults Avaliação clínica e laboratorial de exantema semelhante ao sarampo em crianças e jovens adultos  

OpenAIRE

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. Clinica...

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

2000-01-01

360

Mapping Medusae Fossae Formation materials in the southern highlands of Mars  

Science.gov (United States)

The Medusae Fossae Formation (MFF) is an extensive deposit (2.2 × 10 6 km 2, Bradley, B.A., Sakimoto, S.E.H., Frey, H., Zimbelman, J.R. [2002]. J. Geophys. Res. 107, 5058) 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 patterns, erosional styles and channel-like forms and has been mapped into five main outcrops and three geological members according to exposure and stratigraphy (Scott, D.H., Tanaka, K.L., 1986. USGS Map I-1802-A; Greeley, R., Guest, J.E., 1987. Map I-1802-B; Zimbelman, J.R., Crown, D., Jenson, D., 1996. Lunar Planet. Sci. XXVII. Abstract #1748.). Away from the three main lobes are numerous outliers of MFF materials. These have mainly been reported in the northern lowlands regions (Keszthelyi, L., Jaeger, W.L., and HiRISE team, 2008. Lunar Planet. Sci. XXXIX. Abstract #2420.) but few studies have examined the possibility of MFF outliers on high ground south of the dichotomy boundary. We have searched Mars Orbiter Camera Narrow Angle (MOC NA) images for outliers in this region. Our observations show that there are many MFF outliers on the southern highlands. The characteristics of the outliers indicate materials which overlie the underlying terrain for they appear widely in dips, craters and topographic lows. The surfaces are typified by yardang fields and have a similar patchy and discontinuous nature to materials of the upper member of the MFF. Most have consistent lineation orientations across the wider area which match the dominant orientation of yardangs in the main MFF outcrops. Furthermore, elevation data shows that the maximum, minimum and mean elevations of these newly discovered outliers are closest to those of the upper member of the MFF. We therefore conclude that these deposits are MFF outliers and that they probably represent remnant upper member material. We suggest that there might be two possible explanations for these outliers: (1) the MFF had a much greater pre-erosional extent than previously estimated, or (2) materials from the main outcrops were eroded and then blown south to accrue in the highland areas, where they were subsequently reworked. We suggest that the topography of the region favors the first option. We outline an "overflowing" layer-cake deposition model, in which layers of sediment stacked up against the dichotomy boundary until they reached the topographic level of the highlands. Further materials (that went onto become upper-member MFF material and outliers) were then deposited across a wider area, including south of the dichotomy boundary. Severe erosion subsequently removed much of this material.

Harrison, S. K.; Balme, M. R.; Hagermann, A.; Murray, J. B.; Muller, J.-P.

2010-10-01

361

Wet surge deposits at La Fossa di Vulcano: Depositional and eruptive mechanisms  

Science.gov (United States)

Wet surge deposits of different volcanic cycles of the recent Fossa activity at Vulcano have been measured on a bed-by-bed basis, with data recorded to millimeter detail. The wet surge layers are varicoloured with variable thickness, with the most recurrent thickness being about 1 cm. The beds consist of fine ash without internal structures. Textural features include: (a) accretionary lapilli, of maximum size of 0.5 cm, dispersed thoroughout the layer or forming continuous layers of submillimeter size; (b) vesiculated layers which represent 10% to 65% of the total deposit; vesicles have different shapes and smooth walls, varying in volume from 1% to 15-20%; (c) soft-sediment types of bedding deformation, such as gravity flowage ripples, load cast and slumps. The slope angle has not influenced either the concentration and size of the accretionary lapilli or the shape, size, and distribution of vesicles. Only the thickness of the layers decreases with distance from the vent. SEM investigations show features indicating the hydromagmatic origin of the deposits and stressing the role of the fluid phase. Noteworthy is the presence of vesiculated grains, produced by magmatic exsolution, which show chilling effects on the internal walls of the broken bubbles. Grain size analyses reveal that the layers are not graded and most of the samples have a median size finer than 50 ?m. The grain size distributions are frequently polymodal, suggesting several closely timed explosions. As all the beds exhibit the same textures, grain size, and particle morphology a single mechanism can explain their deposition. The depositional unit formed at the base of the cloud through the lateral expansion on the ground of a sticky muddy medium consisting of ash and fluid. In general each layer lost its plasticity before the deposition of the next layer. The deposition occurred in a nearly continuous sequence without periods of rest long enough to permit erosional discontinuity. The eruptions are hydromagmatic and occur where magma, at least partially fragmented, comes into effective contact with subsurface water. The process follows a model suggested by Wohletz (1983b, 1986), developing in more than one fragmentation event. In the turbulent surge cloud both severe hydration and alteration of glassy grains and the formation of accretionary lapilli occur.

Dellino, P.; Frazzetta, G.; La Volpe, L.

1990-10-01

362

Body mass index and patient CT measurements as a predictor of benefit of intensity-modulated radiotherapy to the supraclavicular fossa  

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Full Text Available Vicky Koh,1 Johann I Tang,1 Bok Ai Choo,1 Chek Wee Tan,1 Boon Keat Lim,2 Liang Shen,3 Jiade Jay Lu1 1Department of Radiation Oncology, National University Cancer Institute, Singapore; 2Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore; 3Department of Biostatistics, National University of Singapore, Singapore Background: Irradiation of the supraclavicular fossa is commonly used as part of adjuvant breast radiotherapy. Intensity-modulated radiotherapy (IMRT may be used to target this region accurately, and there are subgroups of patients that may benefit more from IMRT than others. We identify the benefit of IMRT over fixed-depth dose prescription to the supraclavicular fossa in patients of different builds in a clinical setting. Methods: Fifteen patients who received radiotherapy to the left breast and supraclavicular fossa were selected. Computed tomographic planning was used to generate plans for supraclavicular fossa coverage. Dose prescription to 1.5 cm and 3.0 cm depths was compared with IMRT plans. Coverage of the planning target volume and dose to the organs at risk were compared and correlated with patient body mass index (BMI and computed tomography measurements. Results: Within the IMRT group, increasing depth of the supraclavicular fossa produced significantly better coverage of the planning target volume with IMRT. IMRT resulted in lower mean doses to the brachial plexus (P = 0.00 when compared with 1.5 cm and 3 cm depth dose prescriptions, but higher maximum brachial plexus doses. IMRT was more beneficial in patients with lower BMI because this resulted in a decreased maximum brachial plexus dose (P-values of 0.03 and 0.001 when compared with 1.5 cm and 3.0 cm depth dose prescriptions, respectively. Higher patient BMI resulted in a lower dose contribution of IMRT to the cord (P-values 0.066 and 0.034 when compared with 1.5 cm and 3.0 cm depth dose prescriptions respectively. Conclusion: IMRT of the supraclavicular fossa results in lower brachial plexus doses for patients with low BMI while patients with higher BMI benefit from lower mean cord doses. IMRT provides superior coverage of the planning target volume, especially in patients with a deeper supraclavicular fossa. Keywords: intensity-modulated radiotherapy, radiotherapy, breast cancer, supraclavicular fossa

Koh V

2013-11-01

363

Ultrasonographic and magnetic resonance imaging findings of transitional ceII carcinoma arising at penile fossa navicularis: case report  

International Nuclear Information System (INIS)

Primary carcinoma of the male urethra are rare. Among the malignant tumors of the male urethra, squamous cell carcinoma is the most common. Transitional cell carcinoma is very rare, particularly in the distal urethra. We experienced a case of distal urethral transitional cell carcinoma, arising at the fossa navicuIaris of the penis, which we report here with a review of the literature. A 68-year-old male patient presented with bloody discharge from the prepuce for 1 month. Ultrasonography showed a poorly marginating, heterogeneous mass, invading the glans penis and the corpus spongiosum. The mass encircled the glandular urethra of the penis glans, and obstructed the glandular urethra and the fossa navicularis. A Doppler ultrasonogram revealed hypervascularity in this mass. The mass was isointense to the corpus carvernosum on the T1-weighted images and slightly hypointense to the corpus carvernosum on the T2-weighted images. Contrast-enhanced MR imaging showed a poorly enhancing mass in the glans penis. This mass was confirmed as a transitional cell carcinoma by histologic study and a partial penectomy was performed

364

A case of symptomatic mass in the right iliac fossa a Bermuda Triangle which often lies the right diagnosis.  

Science.gov (United States)

Disease of the iliac fossa can often be accompanied by non-specific symptoms and some of these are exclusively caused by the compression of bulky masses of other neighboring structures. In young women a differential diagnosis is a non trivial task as several possible causes have to be taken into account. Thus, intraligamentary tumors, which are extremely rare finding, are frequently confused with uterus, ovary or intestinal tumors. Even if myomas are the most benign tumors of the female genital tract, broad ligament leiomyomas are an unusual finding in women of reproductive age. These tumors are often asymptomatic until they reach a volume likely to cause symptoms related to the mass pressure. An accurate patient's anamnesis and examination serve as a guide to further examinations. Ultrasound is the first line imaging as it can show ovarian or other pelvic mass and doesn't involve exposure to radiations in young patients, who can be pregnant. We describe the clinical presentation and imaging features of a broad ligament leiomyoma, which presented as an inguinal mass in a patient with a right iliac fossa pain. We also report our diagnostic process performing the differential diagnosis with other potential pathologies of RIF. In these cases, a preoperative disease classification discriminating the benign or malignant tumor nature is closely linked to the proper patient management. PMID:24566476

Panarese, Alessandra; Pironi, Daniele; Pontone, Stefano; Vendettuoli, Maurizio; De Cristofaro, Flaminia; Antonelli, Manila; Romani, Annamaria; Filippini, Angelo

2014-01-01

365

Ultrasonographic and magnetic resonance imaging findings of transitional ceII carcinoma arising at penile fossa navicularis: case report  

Energy Technology Data Exchange (ETDEWEB)

Primary carcinoma of the male urethra are rare. Among the malignant tumors of the male urethra, squamous cell carcinoma is the most common. Transitional cell carcinoma is very rare, particularly in the distal urethra. We experienced a case of distal urethral transitional cell carcinoma, arising at the fossa navicuIaris of the penis, which we report here with a review of the literature. A 68-year-old male patient presented with bloody discharge from the prepuce for 1 month. Ultrasonography showed a poorly marginating, heterogeneous mass, invading the glans penis and the corpus spongiosum. The mass encircled the glandular urethra of the penis glans, and obstructed the glandular urethra and the fossa navicularis. A Doppler ultrasonogram revealed hypervascularity in this mass. The mass was isointense to the corpus carvernosum on the T1-weighted images and slightly hypointense to the corpus carvernosum on the T2-weighted images. Contrast-enhanced MR imaging showed a poorly enhancing mass in the glans penis. This mass was confirmed as a transitional cell carcinoma by histologic study and a partial penectomy was performed.

Lee, Seung Woo; Cho, Jae Ho; Jang, Han Won; Kim, Dong Sug; Moon, Gi Hak [College of Medicine, Yeungnam Univ., Daegu (Korea, Republic of)

2004-08-01

366

Long-term cognitive deficits following posterior fossa tumor resection: a neuropsychological and functional neuroimaging follow-up study.  

Science.gov (United States)

The posterior fossa syndrome (PFS) consists of transient cerebellar mutism, cognitive symptoms, and neurobehavioral abnormalities that typically develop in children following posterior fossa (PF) tumor resection. The pathophysiological substrate of the syndrome remains unclear. We investigated eight children of whom five presented with a variety of clinically relevant non-motor language symptoms associated with cognitive and behavioral disturbances after PF tumor resection. Four children developed transient cerebellar mutism followed by dysarthric speech. Non-motor language symptoms consisted of agrammatism, anomia, impaired verbal fluency, comprehension deficits, and a spontaneous speech. Neurocognitive deficits included executive dysfunctions, concentration deficits, and visuo-spatial disorders. In addition, all children presented with behavioral and affective disturbances. Functional neuroimaging studies during the phase of mutism by means of SPECT showed perfusional deficits in the anatomo-clinically suspected supratentorial areas subserving language dynamics, syntax, naming, executive functioning, affective regulation, and behavior. A significant improvement of frontal perfusional deficits paralleled the clinical remission of mutism. These results add to the view that the PFS might represent a cerebello-cerebral diaschisis phenomenon, reflecting the metabolic impact of the cerebellar lesion on supratentorial cognitive and affective functions. PMID:19899828

De Smet, Hyo Jung; Baillieux, Hanne; Wackenier, Peggy; De Praeter, Mania; Engelborghs, Sebastiaan; Paquier, Philippe F; De Deyn, Peter P; Mariën, Peter

2009-11-01

367

Morphometric CT study of Down's syndrome showing small posterior fossa and calcification of basal ganglia  

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We report characteristic and morphometric changes of cranial computed tomography (CT) with increasing age in 56 patients with Down's syndrome aged from 0 month to 37 years. Patients were compared with 142 normal controls aged 0 to 59 years. Width of ventricles, Sylvian fissures, posterior fossa, pons and cisterna magna were measured on CT. The incidences of the cavum septi pellucidi, cavum vergae and cavum veli interpositi and high density in the basal ganglia were examined. There was high incidence (10.7%) of bilateral calcification of basal ganglia in Down's syndrome, although that of pineal body and choroid plexus calcification was similar in Down's syndrome and controls. Basal ganglia calcification is more frequently seen in young Down's syndrome and may be related to the premature aging characteristic of Down's syndrome. The CT in Down's syndrome showed relatively small posterior fossa, small cerebellum, small brain stem and relatively large Sylvian fissures in those under one year of age. There was a high frequency of midline cava and large cisterna magna. There were no significant atrophic changes on CT except after the fifth decade comparing with controls.

Ieshima, A.; Yoshino, K.; Takashima, S.; Takeshita, K.; Kisa, T.

1984-11-01

368

Patterns of failure following treatment for medulloblastoma: is it necessary to treat the entire posterior fossa?  

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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 <18 years with medulloblastoma were treated at the University of Michigan and Children's Hospital of Philadelphia, with RT following surgical resection. Of 114, 27 (24%) were found to have a recurrence and form the basis for this study. RT consisted of CSRT followed by a boost to the entire posterior fossa. Some patients received adjuvant chemotherapy. Patient's preoperative magnetic resonance imaging (MRI) and/or computerized tomography (CT) studies were used to compare the original tumor volume with the specific region of local relapse. Failure was defined as MRI or CT evidence of recurrence or positive cerebT evidence of recurrence or positive cerebrospinal fluid cytology. Relapse was scored as local, if it was within the original tumor bed, and regional if it was outside of the tumor bed but still within the PF. Results: The median age of the 27 patients who relapsed was 8.6 years. Three patients were <3 years old. Of 27, 21 had disease localized to the PF. Of 26, 22 patients received chemotherapy during their treatment regimen; 1 patient did not have information on systemic treatment. The median dose of RT to the craniospinal axis was 32.5 Gy and to the PF was 55.2 Gy. The median time to recurrence was 19.5 months. Local failure within the tumor bed as any component of first failure occurred in 52% (14 of 27) of all failures, but as the solitary site of first failure in only 2 of 27 failures. Of 14 patients who failed in the tumor bed, 11 also failed in the spine, 8 of 14 also failed within the PF but outside the tumor bed, and 7 of 14 failed in all three locations. Local failure within the PF but outside the tumor bed as any component of first failure occurred in 41% (11 of 27) of all failures, but as the solitary site of first failure in only 1 of 27 failures. Of 11 patients who failed in the PF but outside the tumor bed, 9 also failed in the spine, 8 also failed within the tumor bed, and 7 failed in the all three locations. Of the failures outside the tumor bed but still within the PF, 7 of 11 failed in the leptomeninges, 1 in the brainstem parenchyma, and 3 in the PF parenchyma. Of 7 who failed in the PF leptomeninges, 6 also failed within the spine. Failure within the spine as any component of first failure occurred in 70% (19 of 27) of all failures and as the only site of first failure in 5 of 27 patients. Of 19 patients who failed in the spine, 11 also failed in the tumor bed, 9 also failed within the PF but outside the tumor bed, and 9 failed in the all three locations. Conclusions: Leptomeningeal failure is a common component of failure and occurs in the leptomeninges of the PF, as well as the spine. Isolated tumor bed failure is a rarely observed event and occurred in only 2 of 27 failures described here. Similarly, parenchymal (nonleptomeningeal) failures in the PF but outside of the tumor bed were rare: 4 patients recurred in this manner, only 1 of whom was an isolated event without other sites of recurrence. Our data suggest that, when the entire PF is treated, very few failures develop in isolation in the PF outside the tumor bed. Further studies will be necessary to determine if RT to the tumor bed alone will suffice as opposed to a boost to th

369

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 < 18 yr with medulloblastoma, who were treated at the University of Michigan and Children's Hospital of Philadelphia, with RT following surgical resection were found to have a recurrence. RT consisted of CSRT followed by a boost to the entire posterior fossa. Patient's preoperative MRI and/or CT studies were used to compare the original tumor volume with the specific region of local relapse. Failure was defined as MRI or CT evidence of recurrence or positive cerebrospinal fluid cytology. Relapse was scored as local, if it was within the original tumor bed and regional, if it was outside of the tumor bed but still within the PF. Resule tumor bed but still within the PF. Results: The median age of the patients was 8.6 years. Three patients were < 3 years old. (21(27)) had disease localized to the PF. (19(21)) patients received chemotherapy during their treatment regimen; 6 patients did not have information on systemic treatment. The median dose of RT to the craniospinal axis was 32.5 Gy and to the PF was 55.2 Gy. The median time to recurrence was 19.5 months. Local failure within the tumor bed as any component of first failure occurred in 52% ((14(27))) of all failures but as the solitary site of first failure in only (1(27)) failures. (11(14)) patients who failed in the tumor bed also failed in the spine, (8(14)) also failed within the PF but outside the tumor bed, and (7(14)) failed in the all three locations. Local failure within the PF but outside the tumor bed as any component of first failure occurred in 41% ((11(27))) of all failures but as the solitary site of first failure in only (1(27)) failures. Nine of 11 patients who failed in the PF but outside the tumor bed also failed in the spine, (8(11)) also failed within the tumor bed, and (7(11)) failed in the all three locations. Of the failures outside the tumor bed but still within the PF, (7(11)) failed in the leptomeninges, (1(11)) in the brainstem parenchyma, and (3(11)) in the PF parenchyma. (6(7)) who failed in the PF leptomeninges also failed within the spine. Failure within the spine as any component of first failure occurred in 70% ((19(27))) of all failures and as the only site of first failure in (5(27)) patients. (11(19)) patients who failed in the spine also failed in the tumor bed, (9(19)) also failed within the PF but outside the tumor bed, and (9(19)) failed in the all three locations. Conclusions: Leptomeningeal failure is a common component of failure and occurs in the leptomeninges of the PF as well as the spine. Isolated tumor bed failure is a rarely observed event and occurred in only (1(27)) failures here described. Similarly, parenchymal (non-leptomengingeal) failures in the PF but outside of the tumor bed were rare: 4 patients recurred in this manner, only 1 of which was an isolated event without other sites of recurrence. These data suggest that when the entire PF is treated, very few failures develop in the PF outside the tumor bed. Further studies will be necessary to determine whether RT the tumor bed alone will suffice as opposed to a boost to the entire PF. The former approach using 3D conformal therapy may minimize the ototoxicity and other morbidity associated with full PF irradiation

370

Anatomical Examination of the Foramens of the Middle Cranial Fossa / Examinación Anatómica de los Forámenes de la Fosa Craneal Media  

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Full Text Available SciELO Chile | Language: English Abstract in spanish Tres forámenes pueden ser identificados en el ala mayor del esfenoides: El foramen redondo (FR), foramen oval (FO) y el foramen espinoso (FS). Puede además existir otro foramen llamado foramen oval accesorio o foramen de Vesalio (FV), que conecta la fosa craneal media a la fosa pterigoidea. Se descr [...] ibe como una abertura con paredes lisas por anterior y medial al foramen oval, que conduce a un canal oblicuo dirigido hacia la fosa pterigoidea. FV estuvo presente entre FO y FR en 14 (31,8%) de 44 cráneos secos y 6 (33,3%), en 18 lados en la base de cráneos de cadáveres (total 20 (32,3%) de 62). El diámetro de los forámenes en los lados derecho e izquierdo se observó casi simétricos. Las distancias de FR desde la línea mediana en el lado izquierdo fue mayor que en el lado derecho. Además, la distancia entre FO y el vértice de la porción petrosa y la distancia entre el FS y el vértice porción petrosa fueron mayores en el lado izquierdo. En el lado derecho la distancia entre A y FR, así como la distancia entre A y FS fueron mayores. Por otra parte, la distancia entre los FR y el vértice del porción petrosa fue mayor en el lado derecho. Las variaciones anatómicas en el tamaño de la apariencia y la distancia de FR, DE, FS y FV son de gran importancia quirúrgica. Podemos inferir que la información proporcionada en este estudio puede ayudar al neurocirujano y anatomista para aumentar el conocimiento sobre la anatomía de la fosa craneal media. Abstract in english Three foramina can be identified in the greater wing of the sphenoid bone: The foramen rotundum (FR), foramen ovale (FO) and foramen spinosum (FS). In addition, there may be another foramen called foramen ovale accessorium or foramen vesalius (FV) which connects the middle cranial fossa to the fossa [...] pterygoidea (pterygoid fossa). It is described as an opening with smooth walls in front and medial to foramen ovale which leads to an oblique channel directed towards the fossa pterygoidea. FV was present between FO and FR in 14 (31.8%) of 44 dry and 6 (33.3%) of 18 cadaver skullbase sides (total 20 (32.3%) of 62). The diameter values of foramens on both the right and the left side were observed to be almost symmetrical. FR's distance from the midline on the left side was greater than the right side. Also, the distance between FO and the petrous apex and the distance between FS and the petrous apex were greater on the left side. On the right side the distance between FO and FR, and the distance between FO and FS were greater. Also, the distance between FR and the petrous apex was greater on the right side. Anatomical variations in appearance size and distance of FR, FO, FS and FV are of great surgical importance. In conclusion, we can infer that the information provided with this study can help the neurosurgeon and anatomist to increase the knowledge about anatomy of middle cranial fossa.

Nadire, Unver Dogan; Zeliha, Fazliogullari; Ismihan Ilknur, Uysal; Muzaffer, Seker; Ahmet Kagan, Karabulut.

2014-03-01

371

Uncommon evolution of probable central nervous system histoplasmosis: from leptomeningitis to posterior fossa granuloma. A case report with magnetic resonance images  

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We report a case of a young immunocompetent patient with probable central nervous system histoplasmosis with evolutive peculiar findings seen on magnetic resonance imaging. Leptomeningeal thickening was initially observed which subsequently became a posterior fossa granuloma. The diagnosis of fungal infection was only reached by histopathological study and the treatment was based on long term therapy with fluconazole wth good initial response. (author)

372

Hematoma within the Outer Membrane of the Arachnoid Cyst Located in the Middle Fossa: A Mechanism of Development of Chronic Subdural Hematoma Associated with Arachnoid Cysts  

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Full Text Available It is well known that chronic subdural hematoma (CSDH occasionally arises in patients harboring an arachnoid cyst (AC located in the middle fossa. Although the pathogenesis of CSDH associated with ACs remains unknown, several possible mechanisms have been proposed. In many reported cases, the patients with ACs in the middle fossa would be symptomatic according to development of CSDH. A 9-year-old girl presenting with a headache, nausea, and diplopia was referred to our department. Magnetic resonance imaging showed an AC in the left-side middle fossa and ipsilateral CSDH with a remarkable mass effect. Irrigation of the CSDH, partial removal of the outer membrane of the AC and CSDH, and endoscopic cystocisternostomy were performed to relieve her symptoms. Postoperative clinical course was excellent. Histopathological examination of the outer membrane of the CSDH demonstrated an arachnoid cell layer and hemorrhage from the granulation inside the membrane, and collagen fibers outside the membrane. These findings strongly suggested that the membrane and the content of the CSDH were derived from the outer membrane of the AC, and the CSF including the hemorrhage within the membrane, respectively. Laceration and hemorrhage from granulation tissue within the outer membrane of the AC are considered as one of the developmental mechanisms of the CSDH associated with AC in the middle fossa.

Yasuhiko Hayashi

2014-04-01

373

RADIATION THERAPY QUALITY IN CCG/POG INTERGROUP 9961: IMPLICATIONS FOR CRANIOSPINAL IRRADIATION AND THE POSTERIOR FOSSA BOOST IN FUTURE MEDULLOBLASTOMA TRIALS  

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Results: Of the 308 patients who were evaluable for volume deviations, 101 patients (33% did not have any. Of the remaining 207 patients, 50% had only minor deviations, 29% had only major deviations, and 21% had both minor and major deviations. Of the patients with major deviations, 73% had a single major deviation. The most common major deviation was in the cribriform plate region, followed by the posterior fossa; posterior fossa deviations resulted from treating less than whole posterior fossa. There were no significant differences in PFS or OS between patients with deviations and those without. There was no evidence of associations of deviations with patient age. Conclusions: Approximately one-third of patients had major volume deviations. There was no evidence of a significant association between these and outcome. This lack of correlation likely reflects the current high quality of radiation therapy delivered in COG institutions, our strict definition of volume deviations, and the relatively few instances of multiple major deviations in individual patients. In is noteworthy that the types of posterior fossa volume deviations observed in this study were not adversely associated with outcome. As we move forward, quality assurance will continue to play an important role to ensure that deviations on study do not influence study outcome.

BernadineDonahue

2012-12-01

374

Ultrasound and magnetic resonance imaging findings in Schistosomiasis mansoni: expanded gallbladder fossa and fatty hilum signs Achados da ultrassonografia e da ressonância magnética na esquistossomose mansônica: sinais da expansão da fossa da vesícula e do hilo gorduroso  

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Full Text Available INTRODUCTION: There is no study relating magnetic resonance imaging (MRI to ultrasound (US findings in patients with Schistosomiasis mansoni. Our aim was to describe MRI findings inpatients with schistosomal liver disease identified by US. METHODS: Fifty-four patients (mean age 41.6±13.5years from an area endemic for Schistosomiasis mansoni were selected for this study.All had US indicating liver schistosomal fibrosis and were evaluated with MRI performed witha 1.5-T superconducting magnet unit (Sigma. RESULTS: Forty-seven (87% of the 54 patientsshowing signs of periportal fibrosis identified through US investigation had confirmed diagnosesby MRI. In the seven discordant cases (13%, MRI revealed fat tissue filling in the hilar periportalspace where US indicated isolated thickening around the main portal vein at its point of entryto the liver. We named this the fatty hilum sign. One of the 47 patients with MRI evidence ofperiportal fibrosis had had his gallbladder removed previously. Thirty-five (76.1% of the other46 patients had an expanded gallbladder fossa filled with fat tissue, whereas MRI of the remainingeleven showed pericholecystic signs of fibrosis. CONCLUSIONS: Echogenic thickening of thegallbladder wall and of the main portal vein wall heretofore attributed to fibrosis were frequentlyidentified as fat tissue in MRI. However, the gallbladder wall thickening shown in US (expandedgallbladder fossa in MRI is probably secondary to combined hepatic morphologic changes inschistosomiasis, representing severe liver involvement.INTRODUÇÃO: Não existem estudos que correlacionam os achados da ressonância magnética (RM aos da ultrassonografia (US em pacientes com esquistossomose mansônica. O objetivodeste estudo foi descrever os achados da imagem por RM em pacientes com doença hepática esquistossomótica identificada por US. MÉTODOS: Selecionaram-se 54 pacientes com idade média de 41,6±13,5 anos, provenientes de área endêmica para a esquistossomose mansônica. Todos apresentavam US indicativa de fibrose hepática esquistossomótica, e foram avaliados com imagens por RM, realizadas com uma unidade magnética supercondutora de 1,5-T(Sigma. RESULTADOS: Quarenta e sete (87% entre 54 pacientes com sinais ultrassonográficosde fibrose periportal esquistossomótica tiveram este diagnóstico confirmado pela RM. Nos sete(13% casos discordantes, a RM revelou tecido adiposo preenchendo o espaço periportal hilaronde a US indicava espessamento isolado da parede da veia porta em seu ponto de entrada no fígado. Este achado foi nomeado sinal do hilo gorduroso. Um dos 47 pacientes com evidência de fibrose periportal RM era colecistectomizado. Trinta e quatro (76,1% dos 46 pacientes restantes apresentavam expansão da fossa da vesícula, que se encontrava preenchida portecido adiposo. Nos outros sete, a RM revelou sinais de fibrose pericolecística. CONCLUSÕES: Os espessamentos ecogênicos central da parede da veia porta, e da parede da vesícula biliar, até o momento, atribuídos à fibrose, foram frequentemente identificados como tecido adiposopela RM. Entretanto, o espessamento da parede da vesícula identificado pela US (expansão da fossa da vesícula na RM é provavelmente secundário a alterações morfológicas hepáticas na esquistossomose, e representa comprometimento grave do fígado.

Luciana Cristina dos Santos Silva

2012-08-01

375

The overcrowding of osteal posterior cranial fossa in adults: multi-slice CT measurements and clinical significance  

International Nuclear Information System (INIS)

Objective: To assess the clinical value of MSCT in diagnosing the overcrowding of osteal posterior cranial fossa (PCF) in adults. Methods: MSCT images of a cohort of 52 adult patients with foramen magnum osteal malformation confirmed by surgery (diseased group), and 100 healthy adults (control group) were retrospectively reviewed. Images post-processing techniques included multi-planer reformation (MPR) and volume rendering (VR). The posterior cranial fossa volume (PCFV), posterior cranial fossa height (PCFH), clivus length (CL), clivus gradient (CG), supraocciput length (SL), and 100 normal adults. Independent-sample student's t test was used to compare the differences between patients and normal adults. Results: The results of PCFV, PCFH, CL, SL, FMD and CG, male of control group were (168.2 ± 12.3) cm3, (38.2 ± 1.2), (47.1 ± 2.8), (41.1 ± 1.8), (36.6 ± 4.9)mm, (51.5 ± 3.6)degree, female of control group were (157.5 ± 10.2) cm3, (36.5 ± 1.4), (46.2 ± 2.2), (39.7 ± 1.3), (35.2 ± 3.8), (49.6 ± 3.1)degree; diseased group were (128.7 ± 11.7) cm3, (30.6 ± 1.9), (36.2 ± 1.4), (37.3 ± 0.9), (33.9 ± 3.5)mm, (44.5 ± 2.8)degree. There was significant sex difference in PCFV, PCFH, CL, SL and CG in control group (t=4.70, 6.44, 4.84, 4.43 and 2.81 respectively, P<0.01), but FMD was not significant (t=1.97, P<0.05); the results of PCFV, PCFH, CL, CG and SL were significant different between diseasdifferent between diseased group and male of control group (t=16.62, 24.04, 25.01, 14.17 and 10.99 respectively, P<0.01); the results of PCFV, PCFH, CL, CG and SL were significant different between diseased group and female of control group (t=13.23, 17.80, 27.50, 11.67 and 8.73 respectively, P<0.01); but there were no significant differences of FMD between diseased group and control group, both male and female (t=2.96, 2.07, P<0.05). Conclusions: The overcrowding of PCF can be accurately measured by MCST. As a routine preoperative examination, MSCT is helpful in the therapeutic selection and the anatomic and pathologic study of PCF. (authors)

376

Adenocarcinoma Polimorfo de Bajo Grado de fosa nasal / Polymorphous low-grade adenocarcinoma of the nasal fossa  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Se presenta un inusual caso de Adenocarcinoma Polimorfo de Bajo Grado en estadio IV (T4N2CMx) localizado en la fosa nasal con extensión hacia región pterigoidea. El tumor primario fue tratado mediante una resección del mismo a través una osteotomía de maxilar superior tipo Lefort I y a nivel cervica [...] l se realizó un vaciamiento ganglionar cervical supraomohioideo homolateral. Posteriormente recibió tratamiento coadyuvante con radioterapia postoperatoria. Abstract in english An unusual case of a T4N2CMx polymorphous low grade adenocarcinoma located in the nasal fossae and extending to the pterygoid area is presented. The primary tumor was excised through a Lefort I maxillotomy and the neck was managed with a supraomohyoid neck dissection. Adjuntive postoperative radioth [...] erapy was also administered to the patient.

Javier, González Lagunas; Cristian, Alasà Caparrós; Gerard, Vendrell Escofet; Pere, Huguet Redecilla; Guillermo, Raspall Martin.

2005-10-01

377

Transient asystole during surgery for posterior fossa meningioma caused by activation of the trigeminocardiac reflex: three case reports.  

Science.gov (United States)

Three patients undergoing surgery for cerebello-pontine angle meningioma suffered transient episodes of asystole. All patients exhibited return to the previous heart rate with cessation of surgical manipulations and administration of anticholinergic agents. These reactions were apparently elicited by activation of the trigeminocardiac reflex (TCR) by direct stimulation of the trigeminal nerve or branches in the dura mater or cerebellar tentorium. Remifentanil was used in all three cases as an anesthetic agent, so may be a cause of the TCR. The possibility of activation of the TCR should be considered during surgical manipulation around the trigeminal nerve or the distribution of the trigeminal nerve branches. Transient bradycardia, hypotension, or asystole can occur regardless of whether there is pressure on the brainstem during posterior fossa meningioma surgery. PMID:20448432

Usami, Kenichi; Kamada, Kyousuke; Kunii, Naoto; Tsujihara, Hiroko; Yamada, Yoshitsugu; Saito, Nobuhito

2010-01-01

378

Beware of arteria lusoria during lymph node dissection of the right paratracheal fossa for lung cancer surgery.  

Science.gov (United States)

An asymptomatic elderly woman presented with a solitary right upper lobe mass revealed to be non-small cell lung cancer following routine surveillance post mastectomy. Upon review of CT with contrast in preparation for rigid bronchoscopy and right upper lobectomy, we noticed that the patient had a rare case of arteria lusoria. This is the presence of an aberrant right subclavian artery extending from the left side of the aortic arch, crossing posteriorly across the midline to supply the upper limb. We suggest that with a documented 100% diagnostic sensitivity on 64 multislice computed tomography, the presence of arteria lusoria within the posterior paratracheal fossa may cause life-threatening complications in the unaware during systematic lymph node dissection for non-small cell lung cancer (NSCLC). PMID:25590005

Pan, Daniel; Cufari, Maria Elena; Lim, Eric

2014-12-01

379

Segmental myoclonus as the sole manifestation of a choroid plexus papilloma in the posterior fossa. Case report.  

Science.gov (United States)

The authors describe the case of a 22-year-old woman with involuntary contractions of the sternocleidomastoid and trapezius muscles that resulted in turning movements of the head. The jerks displayed the clinical and neurophysiological characteristics of segmental myoclonus (SM) restricted to muscles supplied bilaterally by the first four cervical segments. Magnetic resonance imaging disclosed a tumor in the midline above the cisterna magna that was later histologically proven to be a choroid plexus papilloma. The patient's involuntary movements did not extend to other muscle groups or, in particular, to the palate, as one might have expected in the case of brainstem lesions. Myoclonus was the sole clinical manifestation of the tumor in this patient; other signs and symptoms invariably reported in other cases of posterior fossa papilloma, such as increased intracranial pressure or cranial nerve palsies, were absent. Release from suprasegmental control is suggested as a possible pathophysiological mechanism in this case of SM. PMID:11780907

Chroni, E; Paschalis, C; Konstantinou, D; Maraziotis, T; Bonas, M; Papapetropoulos, T

2001-08-01

380

Pedicled Gastrocnemius Flap: Clinical Application in Limb Sparing Surgical Resection of Sarcoma Around the Knee Region and Popliteal Fossa  

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To highlight on the versatility of superiorly based pedicled gastrocnemius muscle flap in the limb-sparing surgery for bone or soft tissue sarcoma around the knee and popliteal fossa. Patients and Methods: A total of 30 patients with localized bone or soft tissue sarcoma around the knee and popliteal fossa were treated with limb-salvage procedure. The study included 5 cases with bone sarcoma of the distal femur, 15 cases having bone sarcoma of proximal tibia and 10 cases having soft tissue sarcoma around the knee region and popliteal fossa. Routine preoperative staging studies were done for every patient and included local plain radiography, local MRI, isotopic bone scan and CT chest. Local MRA or angiography was done in selected cases. According to the Enneking staging system, 19 patients had stage IIB and 11 had stage IIA. Patients having bone sarcoma of the proximal tibia were subjected to wide resection, endo prosthetic reconstruction and reconstruction of the extensor mechanism by the medial gastrocnemius muscle flap. Patients having bone sarcoma of the distal femur were subjected to wide resection, endo prosthetic reconstruction and coverage of the prosthesis and re balance of the patellar tendon by the medial gas-trocnemius flap. Patients having soft tissue sarcoma were subjected to wide resection and soft tissue coverage with either medial or lateral myocutaneous gastrocnemius flap or muscle flap with grafting. Limb function was evaluated according to MSTS functional scores. Adjuvant chemotherapy or radiotherapy was given according to nationally agreed protocols. Results: There were 18 males and 12 females with a mean age of 29 years at the time of surgery (range 11-44 years). The mean follow-up period was 52 months (range 25-72 months). Resection with a negative bony and soft tissue margins could be achieved in all cases. A total of 30 flaps were used and included medial gastrocnemius muscle flaps in 21 cases (15 cases had proximal tibia endoprothesis, 5 cases had distal femur endoprothesis, 2 cases had soft tissue sarcoma infiltrating the chin of tibia myocutaneous gastrocnemius flaps in 8 cases having, tissue sarcoma (5 had medial head flap and 3 cases 1 head flap). Flap survival was 100%. The success rate of limb salvage was 96.6% with high score functional result according to MSTS functional scores. The area of the skin island harvested in cases of myocutaneous flaps ranged from 11 to 18 cm in length and from 5 to 8 cm in width and all these cases required grafting of the donor sit Complications included partial wound dehiscence in case, revision of the prosthesis in one case, amputatjf due to local recurrence in one case and significant extension lag in 2 cases. Conclusion: The unique vascularisation of the ga trocnemius muscle (one pedicle to each head), the size of the muscle belly, the fact that it is situated in the dissection field and that its transfer does not affect the function, the spared limb too adversely, makes it particularly suita for limb sparing procedures for sarcoma in the region of the knee and popliteal fossa. The medial head is workhorse muscle flap for soft tissue coverage of knee endoprothesis and reconstruction of extensor mechanism This decreases the rate of complications and improves I functional outcome. Reconstruction of the soft issue defect improves wound healing, protects exposed deep structures and subsequently prevents wound problems, delays adjauvant therapy and secondary amputation.

381

Saneamento rural no Brasil: impacto da fossa séptica biodigestora / Rural sanitation in Brazil: impact analysis of the septic tank digester  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O Brasil tem mais de 23 milhões de pessoas na zona rural sem coleta ou tratamento de esgoto, o que corresponde a 75% da população rural. Este estudo teve como objetivo mensurar os impactos social, ambiental e econômico decorrente da atual falta de saneamento rural no país em relação à implementação [...] de uma proposta tecnológica de tratamento do esgoto, a fossa séptica biodigestora. Foi observado que, ao ano, a construção desse sistema de saneamento poderia evitar cerca de 250 mortes e 5,5 milhões de infecções causados por doenças diarreicas; reduzir a poluição dos cursos d'água em cerca de 129 mil toneladas de resíduos; e que cada R$ 1,00 investido na implementação da alternativa tecnológica avaliada poderia causar um retorno para a sociedade de R$ 1,6 em renda interna bruta. Além disto, a construção da fossa séptica biodigestora promoveria a geração de cerca de 39 mil empregos. Abstract in english Brazil has more than 23 million rural people with unimproved sanitation, which corresponds to about 75% of rural population. This study aimed to measure the social, environmental and economic impacts caused by the implementation of a technological proposal for sanitation, the septic cesspool biodige [...] ster. It was observed that, per year, the implementation of this technology in rural homes with unimproved sanitation could reduce about 250 deaths and 5.5 million infections caused by diarrheal diseases; reduce pollution of waterways by about 129 thousand tons of sediment; and that every R$ 1.00 invested in the implementation of the alternative technology evaluated could cause a return to the society of R$ 1.6 in gross domestic product. Moreover, the implementation of septic cesspool biodigesters would promote the creation of 39 thousand jobs.

Cinthia Cabral da, Costa; Joaquim José Martins, Guilhoto.

382

Copépodes parasitos de fossas nasais de cinco espécies de peixes (Characiformes da planície de inundação do alto rio Paraná, Paraná, Brasil - DOI: 10.4025/actascibiolsci.v29i4.887 Parasitic copepods in the nasal fossae of five fish species (Characiformes from the upper Paraná river floodplain, Paraná, Brazil - DOI: 10.4025/actascibiolsci.v29i4.887  

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Full Text Available 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 quatro famílias 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.The present work had the objective to study parasitic copepods in the nasal 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.

Maria de los Angeles Perez Lizama

2008-02-01

383

Interest of the sup(99m)Tc-Sn-gluconate in the detection of tumor of the posterior fossa. Comparative study with pertechnetate (56 cases)  

International Nuclear Information System (INIS)

In a study on 56 patients, the advantages of the sup(99m)Tc-Sn-gluconate complex in the detection of tumors of the posterior fossa are demonstrated. Comparison with pertechnetate showed it to possess more interesting biological properties (higher plasma clearance, thus decreasing vascular background noise, and greater concentration in the tumor). Overall analysis of the results, in every case found to be positive with pertechnetate, revealed better tumor visualisation with gluconate scanning. Furthermore, in 46% of the cases studied, gluconate scanning revealed tumors not demonstrated by pertechnetate. The development of the use of this molecule thus appears of interest. Association with the gluconate scan of a kinetic study by angioscintigraphy would probably improve the detection rate and the exactness of the etiological diagnosis of tumors of the posterior fossa

384

Cystic malformations of the posterior cranial fossa originating from a defect of the posterior membranous area. Mega cisterna magna and persisting Blake's pouch: two separate entities.  

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Cystic malformations of the posterior cranial fossa are all but arachnoid cysts contained within the general context of the Dandy-Walker complex and may be further classified in two groups on the basis of their embryological origin: anomalies of the anterior membranous area (AMA) and anomalies of the posterior membranous area (PMA). Whether the latter group of malformations can be regarded as separate entities is still quite controversial. The present authors give a detailed account of the various embryological stages in the formation of the posterior cranial fossa and its contents and propose the identification of two anomalies derived from a defect of the PMA: the mega cisterna magna (MCM) and the persisting Blake's pouch, a new entity with different MRI features from MCM. Criteria for their recognition are discussed, stressing the capital importance of a differential diagnosis in view of the radically different therapeutic approach. PMID:8816293

Tortori-Donati, P; Fondelli, M P; Rossi, A; Carini, S

1996-06-01

385

Uncommon evolution of probable central nervous system histoplasmosis: from leptomeningitis to posterior fossa granuloma. A case report with magnetic resonance images; Evolucao incomum de provavel histoplasmose de sistema nervoso central: de leptomeningite para granuloma da fossa posterior. Relato de caso com imagens por ressonancia magnetica  

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We report a case of a young immunocompetent patient with probable central nervous system histoplasmosis with evolutive peculiar findings seen on magnetic resonance imaging. Leptomeningeal thickening was initially observed which subsequently became a posterior fossa granuloma. The diagnosis of fungal infection was only reached by histopathological study and the treatment was based on long term therapy with fluconazole wth good initial response. (author)

Carrilho, Paulo Eduardo Mestrinelli; Alves, Orival [Universidade Estadual do Oeste do Parana - UNIOESTE, Cascavel, PR (Brazil). Curso de Medicina. Disciplina de Neurologia e Neurocirurgia]. E-mail: carrilho@certto.com.br; Budant, Manfredo [UNITOM - Unidade de Diagnostico por Imagem, Cascavel, PR (Brazil). Centro de Tomografia; Bozo, Marlon K.; Meirelles, Noel [Universidade Estadual do Oeste do Parana - UNIOESTE, Cascavel, PR (Brazil). Curso de Medicina; Bueno, Alexandre Galvao [ANATOM - Instituto de Anatomia Patologica de Cascavel, PR (Brazil)

2006-01-15

386

Appendicular endometriosis as a cause of chronic abdominal pain alone in the right iliac fossa: case report and literature review  

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Full Text Available Endometriosis is a disease characterized by the presence of ectopic endometrial glands and stroma. Although its etiology is undefined, it is suggested to be a result of coelomic metaplasia, retrograde menstruation, to provide a genetic component, or to be one that occurs due to blood or lymphatic spread. The involvement of the gastrointestinal tract is common. However, appendicular endometriosis is a rare condition. It is usually asymptomatic. Recurrent pain in the right iliac fossa is an unusual clinical manifestation. There are no non-invasive complementary tests to confirm the diagnosis. Laparoscopy is the main option for research, due to its diagnostic and therapeutic features. A histopathological examination is necessary for the diagnosis. Although surgical and drug therapies have special indications, the combination therapy showed lower symptom recurrence. This study reports a case of appendicular endometriosis that was diagnosed and treated in the service of Coloproctology of the Base Hospital at Faculdade de Medicina of São Jose do Rio Preto. There is also a literature review about this situation.Endometriose é uma doença caracterizada pela presença de estroma e glândulas endometriais ectópicas. Apesar de sua etiologia não definida, sugere-se que seja decorrente de metaplasia celômica, menstruação retrógada, apresente componente genético, ou ocorra devido à disseminação linfática ou sanguínea. O acometimento do trato gastrointestinal é comum; no entanto, a endometriose apendicular é condição rara e se apresenta com maior frequência de forma assintomática. Dor recorrente em fossa ilíaca direita é uma manifestação clínica incomum. Não há exames complementares não invasivos que confirmem o diagnóstico. A laparoscopia é a principal opção durante a investigação, por sua característica diagnóstica e terapêutica. O diagnóstico pode ser feito apenas após um exame histopatológico. Embora as terapias medicamentosa e cirúrgica apresentem indicações particulares, a terapêutica combinada mostra menor recorrência dos sintomas. O objetivo do trabalho é relatar um caso de endometriose apendicular diagnosticado e tratado na Disciplina de Coloproctologia do Hospital de Base da Faculdade de Medicina de São José do Rio Preto, além de revisar a literatura acerca dessa situação.

Marcelo Pandolfi Basso

2012-03-01

387

Intermediate and long-term followup of percutaneous device closure of fossa ovalis atrial septal defect by the Amplatzer septal occluder in a cohort of 529 patients  

OpenAIRE

Objectives : The aim of present study is to analyze the intermediate and long-term follow up results of percutaneous closure of fossa ovalis atrial septal defect (ASD) with Amplatzer septal occluder (ASO) in a large cohort of patients including children and adults. Methods : Between May 1998 and July 2008, 529 patients (age group 2-77 years, median 28 years) underwent successful device closure with an ASO at single tertiary referral cardiac center in India.. This was out of an a...

Tomar Munesh; Khatri Sanjay; Radhakrishnan Sitaraman; Shrivastava Savitri

2011-01-01

388

Delayed Airway Obstruction in Posterior Fossa Craniotomy with Park-Bench Position—A Case Report and Review of the Literatures  

OpenAIRE

Background: Park-bench position is a commonly used position in patients operated with cerebellopontine tumor, microvascular decompression, or lesions of cerebellar hemisphere and vertebral artery. Several complications associated with this positioning have been described. However, the delayed airway complication resulting from park-bench position has been rarely reported in the literatures. Herein, we report a rare case of delayed airway obstruction after a posterior-fossa craniotomy with par...

Szu-Kai Hsu; Cheng-Ta Hsieh; Chih-Ta Huang; Jing-Shan Huang

2012-01-01

389

Body mass index and patient CT measurements as a predictor of benefit of intensity-modulated radiotherapy to the supraclavicular fossa  

OpenAIRE

Vicky Koh,1 Johann I Tang,1 Bok Ai Choo,1 Chek Wee Tan,1 Boon Keat Lim,2 Liang Shen,3 Jiade Jay Lu1 1Department of Radiation Oncology, National University Cancer Institute, Singapore; 2Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore; 3Department of Biostatistics, National University of Singapore, Singapore Background: Irradiation of the supraclavicular fossa is commonly used as part of adjuvant breast radiotherapy. Intensity-modulated radiotherapy (IMRT) may be used to ...

Koh V; Ji, Tang; Ba, Choo; Cw, Tan; Bk, Lim; Shen L; Jj, Lu

2013-01-01

390

Mandibular Fossa Depth Variations: Relation to Age and Dental State / Variaciones en la Profundidad de la Fosa Mandibular: Relaciones con Edad y Estado Dental  

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Full Text Available SciELO Chile | Language: English Abstract in spanish Se observó la correlación entre la profundidad de la fosa mandibular con la condición dental y la edad en los humanos. 120 fosas mandibulares frescas de hombres fueron medidas desde la zona más profunda de la fosa a una línea horizontal de referencia. Las muestras fueron clasificadas de acuerdo a la [...] edad y el estado dental (dentados, parcialmente dentados y desdentados en total) empleando un análisis multivariado. La edad media de los sujetos fue de 41,1 (20-85). Hubieron más personas parcialmente dentadas (59,16%) que los dentadas (30%) o desdentadas (10,83%). La profundidad media de la fosa media fue de 6,9mm (6.6 a 7.1 mm, IC 95%) la cual disminuyó significativamente con el aumento de edad y el deterioro de la salud dental (p Abstract in english A mandibular fossa depth correlation with dental condition and age in humans. 120 fresh male mandibular fossas were measured from the deepest area of the fossa to a horizontal reference line. The samples were classified according to age and dental state (dentate, partially dentate and totally edentu [...] lous) and a multivariate analysis was employed. Subjects average age was 41.1 (20-85). There were more partially dentate individuals (59.16%) than dentate (30%) or edentulous ones (10.83%). Average fossa depth was 6.9 mm (6.6-7.1 mm 95%CI) which significantly decreased with increased age and dental health deterioration (p

Luis Ernesto, Ballesteros Acuña; Luis Miguel, Ramirez Aristeguieta; Gerardo, Muñoz Mantilla.

1189-11-01

391

Posterior fossa dural arteriovenous fistulas: diagnosis and follow-up with time-resolved imaging of contrast kinetics (TRICKS) at 1.5T  

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Background Time-of-flight MR angiography (TOF MRA) is currently the most widely used non-invasive imaging tool to diagnose dural arteriovenous fistula (DAVF). It is, however, not as sensitive as invasive digital subtraction angiography (DSA) for detecting the arteriovenous shunting inherent in DAVF. Dynamic contrast-enhanced MR angiography allows separation of arterial and venous phases of contrast passage though the brain and can thus demonstrate early venous filling through the arteriovenous shunt. Purpose To compare the diagnostic value of TOF MRA and a commercially available dynamic contrast-enhanced MR angiography sequence (TRICKS) at 1.5T in detecting posterior fossa DAVF. Material and Methods We retrospectively collected image data for 19 patients who underwent TOF MRA, TRICKS, and DSA either for primary diagnosis or for follow-up of posterior fossa DAVF and assessed the performance of TOF MRA and TRICKS in demonstrating the arteriovenous shunt, with DSA as the reference standard. Results TRICKS detected early arterial filling at 94.4% sensitivity and 83.3% specificity. TOF MRA detected high flow-related signal within venous structures at 64.7% sensitivity and 80% specificity. Conclusion The commercially available dynamic MR angiography sequence TRICKS with fully automatic vendor postprocessing at 1.5T is more sensitive than TOF MRA in detecting the arteriovenous shunt in posterior fossa DAVF

Pekkola, Johanna; Kangasniemi, Marko (Helsinki Medical Imaging Center, Helsinki Univ. Central Hospital, Helsinki (Finland)), email: johanna.pekkola@hus.fi

2011-05-15

392

Middle fossa decompression of the trigeminal sensory root for trigeminal neuralgia--a re-appraisal and a modification of the technique.  

Science.gov (United States)

Twenty-three patients with intractable trigeminal neuralgia were treated by a modified technique of middle fossa extradural decompression of the trigeminal sensory root at the petrous ridge. After exposing the ganglion and the root at the petrous ridge, by an extradural Frazier's approach a thin layer of autogenous fat was interposed between the dura propria and the middle fossa dura anteriorly, and between the petrous ridge and the root posteriorly. The fat layers were used to prevent dural adhesions and to maintain a space between the petrous ridge and the root. The dura propria was preserved intact. All patients obtained immediate relief of pain following surgery. Twenty patients continue to remain pain free. Two patients have mild occasional pains and one has a persistent pain of moderate intensity. One patient developed a dense sensory loss and two had delayed facial weakness which recovered completely within a month. The mechanism of trigeminal neuralgia is discussed on the basis of anatomical, histopathological and electrophysiological findings and the rationale of middle fossa decompression of the root is stressed. This method is short, simple and safe and may serve as an alternative to the more recent methods of treating trigeminal neuralgia. PMID:8719829

Vengsarkar, U S; Mokashi, Y B; Bhatjiwale, M G

1995-01-01

393

Microarray-based gene expression profiling and DNA copy number variation analysis of temporal fossa arachnoid cysts  

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Full Text Available Abstract Background Intracranial arachnoid cysts (AC are membranous sacs filled with CSF-like fluid that are commonly found in the temporal fossa. The majority of ACs are congenital. Typical symptoms are headache, dizziness, and dyscognition. Little is known about genes that contribute to the formation of the cyst membranes. Methods In order to identify differences in gene expression between normal arachnoid membrane (AM and cyst membrane, we have performed a high-resolution mRNA microarray analysis. In addition we have screened DNA from AC samples for chromosomal duplications or deletions using DNA microarray-based copy number variation analysis. Results The transcriptome consisting of 33096 gene probes showed a near-complete similarity in expression between AC and AM samples. Only nine genes differed in expression between the two tissues: ASGR1, DPEP2, SOX9, SHROOM3, A2BP1, ATP10D, TRIML1, NMU were down regulated, whereas BEND5 was up regulated in the AC samples. Three of the AC samples had unreported human DNA copy number variations, all DNA gains. Conclusions Extending results of previous anatomical studies, the present study has identified a small subset of differentially expressed genes and DNA alterations in arachnoid cysts compared to normal arachnoid membrane.

Helland Christian A

2010-02-01

394

[Intracranial granulocytic sarcoma extending from the posterior fossa to the carotid space via the jugular foramen: a case report].  

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Granulocytic sarcoma consists of neoplastic granulocytic precursors and myeloblasts. It is a focal lesion seen in 2-10.9% of acute myelogenous leukaemia (AML) patients. It usually develops either concurrently with the AML or after a remission. On rare occasions, it may be an initial manifestation of AML. Most common involvement sites are bone, periostium, soft tissue, lymph nodes and skin. Intracranial granulocytic sarcoma rarely occurs in meningeal or parenchymal form. We present an extremely rare case of intracranial granulocytic sarcoma extending from the posterior fossa to the carotid space via the jugular foramen in a 69 year old female. This form of involvement has not been previously reported. On MRI, the lesion appears isointense compared with normal grey matter in T1 and T2 weighted images and shows homogeneous contrast enhancement. With these findings, it is difficult to differentiate the lesion from other extraaxial tumours such as meningioma, paraganglioma, schwannoma, carcinoma, metastatic tumor, malignant lymphoma. However, granulocytic sarcoma, densely increased tumour cells restrict diffusion and reduce the extracellular volume fraction, tends to be markedly hyperintense on diffusion-weighted MR images and exhibits a marked decrease in ADC values. Therefore, DWI may be helpful in differentiating granulocytic sarcoma from other intracranial lesions. PMID:20085103

Baba, Shiro; Matsuo, Takayuki; Ishizaka, Shunsuke; Morikawa, Minoru; Suyama, Kazuhiko; Nagata, Izumi

2010-01-01

395

Detection of tumors lesions in posterior fossa in CT brain images for different conditions acquisition and dose  

International Nuclear Information System (INIS)

The posterior fossa brain area is likely to be the seat of tumors young of many types and origins. These lesions are sometimes beyond the level of detectability of routine CT of the skull, where conditions acquisition and processing are not the most appropriate. This paper provides a study of tomographic images acquired with a new anthropomorphic skull phantom showing minor tumor lesions in the above mentioned area. 13 axial CT were performed. The acquisition parameters were varied tube current, time exposure, slice thickness and collimation, looking for better conditions allowing good detectability of lesions under study by applying lower doses. We measured the air kerma at the entrance of the phantom. We studied the quality of imagery expert observer approach, investigating the detectability of lesions, as well as from 4 figures of merit: Value Contrast-Noise, Signal to Noise Ratio, Mean Square Error and Index Structural similarity with respect to the reference condition in each type of acquisition. It shows that it is possible to reduce doses from applying under MAS values without affecting the detectability of such injuries in the CT skull, with good in image quality. Are also proposed, optimized acquisition protocols for technology acquisition employed. (author)

396

Bilateral lipoma arborescens of the bicipitoradial bursa  

International Nuclear Information System (INIS)

A 37-year-old military mechanic presented to our institution with a chronic history of a slowly enlarging left elbow antecubital fossa mass. There was no history of other chronic illness or trauma. Magnetic resonance imaging (MRI) and excisional biopsy revealed fatty villi and synovial inflammation within the left bicipitoradial bursa, consistent with lipoma arborescens. Four years later the patient presented with a 6-month history of swelling at the antecubital fossa of the opposite elbow. Diagnostic computed tomography and MRI examinations were performed. The surgical and pathologic findings confirmed the imaging diagnosis of lipoma arborescens at the right bicipitoradial bursa. (orig.)

397

White matter tract alterations assessed with diffusion tensor imaging and tractography in patients with solid posterior fossa tumors  

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Full Text Available Background: This study assesses the tract alterations observed before and after resection of solid posterior fossa tumors (PFTs using diffusion tensor imaging (DTI and white matter tractography (WMT. Materials and Methods: Pre- and post-surgical DTI and WMT data were acquired in eight patients undergoing surgical resections of PFT. A tensor deflection algorithm was used to reconstruct the tracts adjacent to the lesions. The tracts were evaluated regarding their spatial orientation and integrity. A software additionally assessed the luminosity and pixel values from specific regions of interest (ROIs quantifying the magnitude of tract alterations. The individual neurological condition was additionally evaluated. Results: In eight tumors (metastases (4, neurinomas (2 and meningiomas (2, the preoperative WMT revealed different tract alterations, including deviation (all cases, deformation (7 cases, thinning (8 cases and apparent tract interruption (4 cases. The ROI histograms from noncompromised tracts showed a tendency for value concentration and peak formation, while affected tracts showed different dispersion patterns. After tumor resection, the compromised white matter tracts showed a resolution (3 cases or reduction (5 cases of the deviation. Postoperatively, 7 cases of tract thinning and 3 cases with tract interruptions showed an improvement. The comparison between ROI histograms from preoperative and postoperative compromised tracts mostly revealed a postoperative accentuated reduction of the luminosity with a simultaneous increase of pixels and improved histogram definition (homogeneous values distribution. At this time (5 weeks post-surgery, several neurological functions had improved to different levels. Conclusions: Preoperative and postoperative tract alterations in patients with solid PFT can be accurately assessed with WMT. The magnitude of tract changes can be quantitatively analyzed by assessing color, signal brightness in compromised bundles.

Carvi y Nievas Mario

2010-01-01

398

Clinical and methodological confounders in assessing the cerebellar cognitive affective syndrome in adult patients with posterior fossa tumours.  

Science.gov (United States)

The cerebellar cognitive affective syndrome (CCAS) was first described by Schmahmann and Sherman as a constellation of symptoms including dysexecutive syndrome, spatial cognitive deficit, linguistic deficits and behavioural abnormalities in patients with a lesion in the cerebellum with otherwise normal brain. Neurosurgical patients with cerebellar tumours constitute one of the cohorts in which the CCAS has been described. In this paper, we present a critical review of the literature of this syndrome in neurosurgical patients. Thereafter, we present a prospective clinical study of 10 patients who underwent posterior fossa tumour resection and had a detailed post-operative neuropsychological, neuropsychiatric and neuroradiological assessment. Because our findings revealed a large number of perioperative neuroradiological confounding variables, we reviewed the neuroimaging of a further 20 patients to determine their prevalence. Our literature review revealed that study design, methodological quality and sometimes both diagnostic criteria and findings were inconsistent. The neuroimaging study (pre-operative, n = 10; post-operative, n = 10) showed very frequent neuroradiological confounding complications (e.g. hydrocephalus; brainstem compression; supratentorial lesions and post-operative subdural hygroma); the impact of such features had largely been ignored in the literature. Findings from our clinical study showed various degree of deficits in neuropsychological testing (n = 1, memory; n = 3, verbal fluency; n = 3, attention; n = 2, spatial cognition deficits; and n = 1, behavioural changes), but no patient had full-blown features of CCAS. Our study, although limited, finds no robust evidence of the CCAS following surgery. This and our literature review highlight a need for guidelines regarding study design and methodology when attempting to evaluate neurosurgical cases with regard to the potential CCAS. PMID:24881640

Omar, Dashne; Ryan, Tracy; Carson, Alan; Bak, Thomas H; Torrens, Lorna; Whittle, Ian

2014-12-01

399

Incidence of rubella IgM antibodies in individuals with febrile rash illness attending clinics in Akwa Ibom State, Nigeria, 2006-2009  

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Full Text Available Background: Rubella is an infectious disease of public health importance because infection ac-quired during early pregnancy often results in foetal abnormalities that are classified as con-genital rubella syndrome (CRS. The burden of rubella infection in most developing countries is however not well documented because of lim-ited epidemiological data. Methods: Between 2006 and 2009, 781individuals with febrile rash illness seen in clinics in Akwa Ibom State were screened for rubella specific IgM antibodies using the ELISA technique. Statistical analysis was done using Graph prime version 5.3 statis-tical package at 95% confidence interval. The level of significance was established at P = 0.05 using Fisher’s exact two-tailed values. Results: Of 781 individuals screened for rubella specific IgM antibodies, 94 (12% were found to be posi-tive. Incidence of 8.7% recorded in 2006 gradu-ally rose to 9.3% in 2007, 11.6% in 2008 and 14.3% in 2009. Those in the reproductive age group (> 16 years were most affected (51.7%. However, this was not statistically significant (P = 0.228. Females (17.4% were more suscepti-ble than males (6.2% (P < 0.0001 an rural dwellers (12.8% more susceptible than urban dwellers (10.5% (P = 0.416. Conclusion: The study shows that the incidence of rubella in Akwa Ibom State, Nigeria is high. The lowest incidence was however found among individu-als below the reproductive age. Thus, the find-ings of this study can be used by policy makers to model the introduction of routine rubella vaccination into the country’ Expanded Program on Immunization Schedule (EPI.

Bassey Enya

2011-06-01

400

Evaluation of osteal posterior cranial fossa in adults by multi-slice CT measurements before and after operation in basilar invagination patients  

International Nuclear Information System (INIS)

Objective: To evaluate the clinical effect of MSCT measurements in the pre- and post- operational osteal posterior cranial fossa for the adult patients of basilar invagination. Methods: We reviewed the images of a cohort of 31 adult patients with basilar invagination, which were treated by surgical operation. According to the presence of atlantoaxial dislocation, the patients were divided into groups A and B. The basion-dens interval (BDI), atlanto-dental interval (ADI), space available of the spinal cord (SAC), clivus-canal angle (CCA), Highly index (HI), and Chamberlian line (CBL) of the posterior cranial fossa were obtained in all the patients. Independent-sample Student's t test was used to compare the differences between groups A and groups B. Spearman correlations were analyzed between CT measurement data and effects of operations. Results: In Group A, the BDI, ADI, SAC, CCA, HI, CBL before and after surgery were 12.6 mm, 8.3 mm, 4.5 mm, 3.3 mm; 18.2 mm, 20.8 mm, 138.3°, 150.4°, 28.7 mm, 43.4 mm, 6.3 mm, 3.3 mm respectively. There were significant differences (t=5.603, 2.323, 3.124, 5.531, 4.278 and 2.375, respectively, P0.05). The preoperative JOA score in groups B was 11 points, and the postoperative score was 16 points. JOA scores before and after surgery were significantly different (t=2.874, P 0.05), and CBL, SAC and CCA were correlated (r=-0.756, -0.728; 0.651, 0.672; 0.726, 0.695, P< 0.05). Conclusion: MSCT measurements for basilar invagination before and after surgery are helpful for understanding changes of osteal posterior fossa anatomy and comprehensive evaluation of surgical treatment. (authors)

401

Distribution of olfactory and nonolfactory surface area in the nasal fossa of Microcebus murinus: implications for microcomputed tomography and airflow studies.  

Science.gov (United States)

The nasal fossa of most mammals exemplifies extreme skeletal complexity. Thin scrolls of bone (turbinals) that both elaborate surface area (SA) and subdivide nasal space are used as morphological proxies for olfactory and respiratory physiology. The present study offers additional details on the nasal fossa of the adult mouse lemur (Microcebus murinus), previously described by Smith and Rossie (Smith and Rossie [2008]; Anatomical Record 291:895-915). Additional, intervening histological sections of the specimen were used to map and quantify the distribution of olfactory and nonolfactory mucosa on the smaller turbinal of the frontal recess (FR; frontoturbinal) and those that occur between ethmoturbinals (ETs; interturbinals). A second adult Microcebus specimen, available as a dried skull, was scanned using microcomputed tomography (microCT) and reconstructed to infer the position of these turbinals within the nasal airway. Overall, turbinal bones comprise more than half of internal nasal SA. All ETs combined comprise about 30% of total nasal fossa SA, and contribute nearly half of all olfactory SA. Of these, the nasoturbinal (NT) is most completely covered with olfactory mucosa, whereas ET I is least covered with olfactory mucosa. The FR contributes significantly to total olfactory SA (ca. 20%). This recess and the single frontoturbinal within it lie in a more lateral pathway of airflow compared with interturbinals, which lie in more central zone just anterior to the olfactory recess of Microcebus. Variations in the turbinals and recesses that complicate central and paranasal in primates should be investigated further in light of zone-specific distributions of olfactory receptors (ORs) that differ between these regions in rodents. PMID:21618705

Smith, Timothy D; Eiting, Thomas P; Rossie, James B

2011-07-01

402

Corpos estranhos de fossas nasais: descrição de tipos e complicações em 420 casos Nasal foreign bodies: description of types and complications in 420 cases  

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Full Text Available Corpos estranhos de fossas nasais são acidentes comuns em crianças, podendo, de acordo com a literatura, levar a complicações supurativas e bronco-aspiração do corpo estranho. O diagnóstico é feito quase sempre pela rinoscopia anterior, mas a nasofibroscopia e exames radiológicos podem ser úteis. OBJETIVO: Analisar um total de 420 casos de corpos estranhos de fossas nasais removidos no serviço de ORL-EPO do Hospital Municipal Souza Aguiar quanto a vários parâmetros como sexo, idade, tipo e complicações. MATERIAL E MÉTODO: 420 casos de corpos estranhos de fossas nasais removidos no serviço de Otorrinolaringologia e Endoscopia Per-oral (ORL-EPO do Hospital Municipal Souza Aguiar, no período de dezembro de 1992 a dezembro de 1998, quanto aos parâmetros acima referidos. RESULTADOS: Foi encontrada uma maior incidência na faixa etária de 0 a 4 anos, sendo os mais comuns, pela ordem fragmentos de espuma, fragmentos de material plástico, grãos de feijão e fragmentos de papel. As complicações ocorreram em 9,05% dos casos, sendo as mais comuns a epistaxe e a vestibulite. CONCLUSÃO: Os corpos estranhos de fossas nasais são acidentes encontrados principalmente na faixa etária de 0 a 4 anos, sendo os mais comuns, em nossa casuística, os fragmentos de espuma e pequenos artefatos de plástico. Complicações não são freqüentes, sendo as mais encontradas a epistaxe e vestibulite nasal.Nasal cavities foreign bodies are common accidents in children, sometimes leading, in accordance with the literature, to complications such as epistaxis and bronchoaspiration. Diagnosis is often made with anterior rhinoscopy, but sometimes nasal fibroendoscopy and imaging may be useful. AIM: To evaluate 420 cases of nasal foreign bodies removed in ENT Service of Souza Aguiar Hospital, Rio de Janeiro, as related to sex, age, type of foreign body and complications. MATERIALS AND METHOD: 420 cases of nasal foreign bodies removed in the ENT service of Souza Aguiar Hospital between December 1992 and December 1998 were evaluated according to the parameters related above. RESULTS: We found higher incidence between 0 and 4 years of age, and the most frequently found foreign bodies were foam fragments, plastic pieces of little toys, beans and paper fragments. Complications occurred in 9.05% of the cases, epistaxis and vestibulitis being the commonest. CONCLUSION: Nasal foreign bodies are especially found between the ages of 0 and 4 years. In our study, foam fragments and small plastic objects were the most frequent foreign bodies found. Complications were found in 9.05% of the cases, headed by epistaxis and nasal vestibulitis.

Ricardo Rodrigues Figueiredo

2006-02-01

403

Corpos estranhos de fossas nasais: descrição de tipos e complicações em 420 casos / Nasal foreign bodies: description of types and complications in 420 cases  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Corpos estranhos de fossas nasais são acidentes comuns em crianças, podendo, de acordo com a literatura, levar a complicações supurativas e bronco-aspiração do corpo estranho. O diagnóstico é feito quase sempre pela rinoscopia anterior, mas a nasofibroscopia e exames radiológicos podem ser úteis. OB [...] JETIVO: Analisar um total de 420 casos de corpos estranhos de fossas nasais removidos no serviço de ORL-EPO do Hospital Municipal Souza Aguiar quanto a vários parâmetros como sexo, idade, tipo e complicações. MATERIAL E MÉTODO: 420 casos de corpos estranhos de fossas nasais removidos no serviço de Otorrinolaringologia e Endoscopia Per-oral (ORL-EPO) do Hospital Municipal Souza Aguiar, no período de dezembro de 1992 a dezembro de 1998, quanto aos parâmetros acima referidos. RESULTADOS: Foi encontrada uma maior incidência na faixa etária de 0 a 4 anos, sendo os mais comuns, pela ordem fragmentos de espuma, fragmentos de material plástico, grãos de feijão e fragmentos de papel. As complicações ocorreram em 9,05% dos casos, sendo as mais comuns a epistaxe e a vestibulite. CONCLUSÃO: Os corpos estranhos de fossas nasais são acidentes encontrados principalmente na faixa etária de 0 a 4 anos, sendo os mais comuns, em nossa casuística, os fragmentos de espuma e pequenos artefatos de plástico. Complicações não são freqüentes, sendo as mais encontradas a epistaxe e vestibulite nasal. Abstract in english Nasal cavities foreign bodies are common accidents in children, sometimes leading, in accordance with the literature, to complications such as epistaxis and bronchoaspiration. Diagnosis is often made with anterior rhinoscopy, but sometimes nasal fibroendoscopy and imaging may be useful. AIM: To eval [...] uate 420 cases of nasal foreign bodies removed in ENT Service of Souza Aguiar Hospital, Rio de Janeiro, as related to sex, age, type of foreign body and complications. MATERIALS AND METHOD: 420 cases of nasal foreign bodies removed in the ENT service of Souza Aguiar Hospital between December 1992 and December 1998 were evaluated according to the parameters related above. RESULTS: We found higher incidence between 0 and 4 years of age, and the most frequently found foreign bodies were foam fragments, plastic pieces of little toys, beans and paper fragments. Complications occurred in 9.05% of the cases, epistaxis and vestibulitis being the commonest. CONCLUSION: Nasal foreign bodies are especially found between the ages of 0 and 4 years. In our study, foam fragments and small plastic objects were the most frequent foreign bodies found. Complications were found in 9.05% of the cases, headed by epistaxis and nasal vestibulitis.

Ricardo Rodrigues, Figueiredo; Andréia A., Azevedo; Arthur Octávio de Ávila, Kós; Shiro, Tomita.

2006-02-01

404

Skin Rashes and Other Changes  

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... and are blisters forming? Yes This could be ALLERGIC CONTACT DERMATITIS, caused by POISON IVY, poison oak or poison sumac. The oil from these plants causes an ALLERGIC REACTION. Wash the area with soap and water ...

405

Recurrent inverted papilloma with intracranial and temporal fossa involvement: A case report and review of the literature;Papillome inverse recidivant avec extension temporale et intracranienne: cas clinique et revue de la litterature  

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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)

Acevedo-Henao, C.M.; Pradier, O. [Department of Radiotherapy, Morvan Hospital, CHU de Brest, Brest University, 29 - Brest (France); Talagas, M. [Department of Pathology, Morvan Hospital, CHU de Brest, 29 - Brest (France); Marianowski, R. [Department of Head and Neck Surgery, Morvan Hospital, CHU de Brest, 29 - Brest (France)

2010-06-15

406

Tratamento cirúrgico na recidiva retroperitoneal tardia por carcinoma renal de células claras após nefrectomia radical / Surgical treatment for late renal cell carcinoma recurrence in the renal fossa after radical nephrectomy  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese [...] Abstract in english Late renal cell carcinoma recurrence in the renal fossa is a rare event. This condition occurs in 1 to 2% of radical nephrectomies. We reported a late recurrence at the renal fossa about four and half years after radical nephrectomy due to a renal cell carcinoma (RCC) without metastasis elsewhere. D [...] iagnosis in an outpatient follow-up was made during an abdominal computed tomography and we observed a retroperitoneal mass in the renal fossa. The excision at the recurrence area was made through a subcostal transversal incision without any difficulty. After 6 months from this second procedure, there was no evidence of recurrence. The surgical aggressive treatment for late retroperitoneal RCC recurrence is a good method in this rare situation. Abdominal computed tomography must be done during long periods of follow-up for patients with radical nephrectomy for RCC to search for late retroperitoneal recurrences.

Carlos Márcio Nóbrega de, Jesus; Filemón Anastásio Silva, Casafus; Aparecido Donizetti, Agostinho.

2007-12-01

407

Clinical and Laboratory evaluation of measleslike rash in children and young adults / Avaliação clínica e laboratorial de exantema semelhante ao sarampo em crianças e jovens adultos  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese Apresenta-se um estudo sobre a avaliação clínica e laboratorial de crianças e adultos jovens com exantema semelhante ao sarampo, durante a ocorrência do surto epidêmico de sarampo na região metropolitana da Grande São Paulo no final de 1996 que se alastrou por todo o país durante o ano de 1997. O di [...] agnóstico laboratorial de sarampo foi firmado em 7 dos 11 pacientes examinados, por detecção direta de IgM específico em amostras de soro da fase aguda da doença, por soroconversão de IgG em um par de amostras da fase aguda e convalescente, pelo isolamento do vírus em culturas de linhagem B95a e pela detecção do RNA viral por PCR em linfócitos do sangue periférico e na urina. O quadro clínico apresentado pelos pacientes nem sempre correspondeu à forma clássica do sarampo. Um jovem adulto, que havia sido vacinado contra o sarampo, apresentou um quadro clínico modificado. Os 4 casos restantes foram negativos em todas as provas laboratoriais para o sarampo, tendo diagnóstico final de exantema súbito (2 casos), escarlatina e Doença de Kawasaki. O presente estudo reforça o ponto de vista de que os sinais e sintomas clínicos são geralmente insuficientes para estabelecer um diagnóstico preciso de sarampo na era pós-vacinal, sendo indispensável um sistema de vigilância baseado em resultados laboratoriais que confirmam todos os casos suspeitos, inclusive os casos de sarampo com sorologia IgM-negativa Abstract in english 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 detec [...] tion 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.

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

2000-10-01

408

Hematoma de fosa posterior no traumático: consideraciones clínicas y terapéuticas / Non-traumatic Posterior Fossa Hematomas: Clinical and Therapeutical issues  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Se analizan 52 pacientes portadores de hematoma de fosa posterior no traumático. Correspondieron a 28 hombres y 24 mujeres, con una media de edad de 60 años. Diez (19,2%) fueron secundarios a malformación arteriovenosa (5), cavernomas (3), angioma venoso (1) y hemangioblastoma (1). Cuarenta y dos (8 [...] 0,7%) fueron catalogados como primarios, encontrándose el antecedente de hipertensión arterial en 31, trastornos de coagulación en 5 y en 6 no se demostró un factor predisponente. Hipertensión intracraneana fue el cuadro clínico de presentación en la mayoría (84%). La Tomografía Computarizada demostró el hematoma en todos los casos. Cuatro de ellos medían menos de 2 cm., 24 entre 2 y 3 cm. y 24 eran mayores de 3 cm. Hidrocefalia estuvo presente en 22 casos (42,3%). Angiografía digital se realizó en 12 pacientes, siendo positiva en 7 (5 malformaciones arteriovenosas, 1 angioma venoso y 1 hemangioblastoma). Resonancia Magnética fue practicada en 2 enfermos, demostrando en uno angioma cavernoso. Treinta y un pacientes fueron operados realizándose vaciamiento del hematoma en 24, 14 de ellos con drenaje de LCR. En los restantes solo se trató la hidrocefalia. Se observó buenos resultados en el 67,3% y la mortalidad global fue de 9,6%. La mortalidad quirúrgica fue de 12,5%. Incide en los resultados el estado de conciencia inicial y el tamaño. Las cisternas troncales no fueron evaluadas en nuestra casuística. Sin embargo, creemos que el tratamiento debiera ser evaluado en cada caso en particular, ya que ningún factor influyen en forma absoluta en la evolución Abstract in english Fifty two patients (28 male and 24 female) with non-traumatic posterior fossa hematomas were analyzed. Average age of the patients was 60 years old. In ten cases (19.2%), the hematomas were secondary to arteriovenous malformations (5), cavernomas (3), venous angiomas (1) and hemangioblastoma (1). Fo [...] rty two (80.7%) were considered primary, with a history of high blood pressure in 31 patients and coagulation disorders in 5. Six cases had no predisposing factors. Most subjects also had intercraneal hypertension (84%). Computerized tomography showed hematomas in all cases, of which four were under 2 cm in size, 24 were between 2 and 3 cm, and 24 were larger than 3 cm. Hydrocephalus was present in 22 cases (42.3%). Twelve patients underwent digital angiography, with favorable results in seven (5 arteriovenous malformations, 1 venous angioma and 1 hemangioblastoma). Magnetic resonance imaging was done with two patients, and showed one cavernous angioma. Thirty-one patients underwent surgery; the hematoma was drained in 24 cases, 14 of which involved LCR draining. The remaining cases were treated for hydrocephalus only. Favorable results were seen in 67.3% of the cases, and the overall mortality rate was 9.6%. Surgical mortality was 12.5%. The initial state of consciousness and size had a bearing on results. We believe that treatment must be evaluated on a case-by-case basis, since no single factor has an absolute effect on a patient's outcome

Patricio, Tagle; Luis Carlos, Vintimilla; Sergio, Del Villar; Gonzalo, Torrealba; Pablo, Villanueva; Jorge, Méndez; Sergio, Rey.

2002-04-01

409

A study of sup(81m)Kr perfusion images before and after vascular reconstructive surgery in the posterior fossa by using single-photon emission computed tomography  

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sup(81m)Kr perfusion images obtained by means of single-photon emission computed tomography (SPECT) were studied in 8 patients with occlusive lesions of the vertebrobasilar system. Seven of these patients had occlusions or stenoses of one or both vertebral arteries, and one had a kink of the vertebral artery. Superficial temporal-superior cerebellar artery (STA-SCA) anastomosis and the occipital-posterior inferior cerebellar artery anastomosis were performed on three and one patients respectively. In three other patients, endarterectomy of the vertebral artery was performed, while the repair of the kink in the vertebral artery was done in one patient. In the preoperative perfusion images after sup(81m)Kr infusion into the ascending aorta, an irregular distribution in the posterior fossa was found in 3 out of 6 patients. Among these three patients, a low perfusion was observed in the brain stem of two and in the cerebellar hemisphere of one patient. One patient with a low perfusion in the brain stem had a low-density lesion in X-ray computed tomographic scans, but the other two patients had no obvious low-density lesions. The irregular distribution of perfusion after sup(81m)Kr infusion into the ascending aorta was improved in the resting state of one patient after STA-SCA anastomosis. In all four patients, after the bypass surgery, a marked reduction in the perfusion in the posterior fossa was found by compression of the donar artery. By the reduction of the perfusion artery. By the reduction of the perfusion, not only the patency of the anastomosis, but also the area perfused by the donar and the degree of the dependence on the donar were disclosed. After STA-SCA anastomosis in one patient, the perfusion images after sup(81m)Kr infusion into the external carotid artery revealed the perfused area through STA in the posterior fossa. sup(81m)Kr perfusion images by SPECT seemed to be useful for learning of cerebral hemodynamics easily. (J.P.N.)

410

Aneurysm of antecubital vein: an unusual complication of peripheral intravenous cannulation  

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Full Text Available Abstract Background Intravenous cannulation is a very common procedure. Venous aneurysm secondary to peripheral intravenous cannulation is extremely rare. Moreover, venous aneurysm can mimic other conditions and may confuse the issue. Case presentation We describe a case of a 45-year-old woman who was referred with the diagnosis of varicose vein of right a