... is gen-erally secondary to acoustic neuromas or gliomas of the third ventricle [2]. Russell [... more ... is gen-erally secondary to acoustic neuromas or gliomas of the third ventricle [2]. Russell [8] examined a patient with neurofibromatosis in whom unusual ependymal granula-tions in the sylvian aqueduct were the cause of obstructive hydrocephalus. Sajid and Copple [9 ...
... Reprint requests: Dr. BS Sharma, Assistant Professor, Department ofNeurosurgeiy, Post-graduat... more ... Reprint requests: Dr. BS Sharma, Assistant Professor, Department ofNeurosurgeiy, Post-graduate Institute of Medical Education and Research, Chandigaih 160 012 ... wing of sphenoid on the leftside, with contiguous hyperdense mass (with hypo-dense areas within it) in the orbit ...
Immunohistochemical analysis of 9 choroid plexus papillomas (CPPs) and 3 choroid plexus carcinoma... more Immunohistochemical analysis of 9 choroid plexus papillomas (CPPs) and 3 choroid plexus carcinomas (CPCs) using a panel of antibodies against glial fibrillary acidic protein (GFAP), cytokeratin (CK), epithelial membrane antigen (EMA), S-100 protein, vimentin (vim), and neuron specific enolase (NSE) is presented. Focal positivity was observed for GFAP in 11, vimentin in 7, cytokeratin in 2 and EMA in 3 cases. Diffuse and intense immunoreactivity for S-100 protein was seen in all papillomas, however, unreactive areas were noted in carcinomas. All cases exhibited focal to diffuse NSE positivity. Location and type of the tumour and age of the patient did not influence the staining pattern except for predominant S-100 positivity in papillomas. The significance of these findings is discussed in relation to the differential diagnosis or immunoreactivity patterns of these tumours.
An uncommon case of benign osteoblastoma of the occipital bone is presented. Poor vascularity of ... more An uncommon case of benign osteoblastoma of the occipital bone is presented. Poor vascularity of the tumor, as confirmed by the CT scan, operative and histopathological findings, was in contrast to its characteristic high vascularity. Radical resection produced an excellent result.
Intracranial tumors are sometimes known to appear first as apoplexy. This report describes a pati... more Intracranial tumors are sometimes known to appear first as apoplexy. This report describes a patient with a meningioma of the falx who experienced acute onset of symptoms due to intracerebral and subarachnoid hemorrhage and following a history of transient ischemic attacks on exertion. The tumor was an angioblastic-meningioma. The probably source of bleeding and the mechanism of transient ischemic episodes provoked by exertion are discussed.
A case of colonic perforation by a ventriculoperitoneal shunt, its subsequent migration and protr... more A case of colonic perforation by a ventriculoperitoneal shunt, its subsequent migration and protrusion from the anal orifice is reported. The shunt reservoir and ventricular catheter were removed percutaneously, and the disconnected peritoneal catheter was pulled out through the anus. Blood culture grew Klebsiella pneumoniae and Streptococcus fecalis. CT scan showed multiple subdural abscesses with evidence of ventriculitis. Removal of the shunt (as described), evacuation of subdural pus and systemic antibiotics resulted in complete recovery.
A 40-year-old male presented clinically with features of C6 radiculomyelopathy. An intradural ext... more A 40-year-old male presented clinically with features of C6 radiculomyelopathy. An intradural extramedullary malignant schwannoma was removed at laminectomy. Foraminal extension of the tumour could not be removed in spite of foraminotomy, and no root attachment was found. Frequent intraspinal recurrences were treated with local resection. Delayed appearance of a supraclavicular mass, CT scan and exploration of supraclavicular fossa disclosed its origin from the upper trunk of brachial plexus.
✓ Two patients with chronic spinal subdural hematomas are described. Both had a fluctuating clini... more ✓ Two patients with chronic spinal subdural hematomas are described. Both had a fluctuating clinical course, not previously documented in the literature. Surgical evacuation resulted in almost complete recovery. The pathogenesis of spinal subdural hematoma is discussed and the pertinent literature is reviewed.
... Postgraduate Institute of Medical Education and Research, Chandi-garh-160012, India Address f... more ... Postgraduate Institute of Medical Education and Research, Chandi-garh-160012, India Address for correspondence and reprint requests: Dr Vijay K. Kak, Professor and Head ... J Neurol Neurosurg Psychiat 1987; 50:1705-6. 4 BREWER NS, MACCARTY cs, WELLMAN WE. ...
Seventy children with posterior fossa tumours treated over a period of 6 1/2 years were studied. ... more Seventy children with posterior fossa tumours treated over a period of 6 1/2 years were studied. Most patients presented in the late stage of disease. Sixty-four required insertion of a precraniotomy shunt for one or more of the following: persistent vomiting, severe headache, dehydration, poor general condition, failing vision, altered sensorium, marked periventricular lucency, and brain stem involvement deferring total removal of the tumour. Insertion of precraniotomy shunt improved the general condition and signs and symptoms of increased intracranial pressure. It also provided a lax brain during definitive surgery and a smooth postoperative course. Shunt-related complications, consisting of block and/or infection, were observed in 21 patients. It was concluded that precraniotomy shunt is important in the management of children with posterior fossa tumours in developing countries where these patients present in the late stage of disease.
A case of gliosarcoma with cartilaginous component is described. Immunohistochemical and electron... more A case of gliosarcoma with cartilaginous component is described. Immunohistochemical and electron microscopic studies confirmed the presence of glial and fibroblastic elements. A major part of the sarcomatous tissue was undifferentiated and not labeled by any of the markers used including those for endothelial cells. The cartilage cells also were not labeled either by antiglial fibrillary acidic protein or any other marker. The occurrence and histogenesis of cartilage in gliomas and gliosarcomas have been reviewed. Cancer 63518423, 1989. LIOSARCOMA or mixed glioblastoma and sarcoma G is a well-established entity. It has been estimated that about 2% to 8% of otherwise typical glioblastomas may contain sarcomatous elements mostly in the form of fibrosar~oma.'-~ Recently, we came across an unusual neoplasm which, in addition to glial and sarcomatous elements, contained cartilaginous tissue. Although the occurrence of cartilage has been documented in different types of gliomas, its presence in gliosarcoma seems to be exceedingly rare and has not been emphasized previously. The origin of cartilage in gliomas generally has been ascribed to chondroid metaplasia of the mesnchymal ~t r o m a .~-~ However, in a recent study using immunohistochemical methods, Kepes et a1.l' concluded that neoplastic astrocytes probably play an important role in the formation of cartilage in gliomas. In view of this interesting observation, we studied our case with a battery of immunohistochemical stains and electron microscopic study to explore the relationship, if any, among the glial, sarcomatous and cartilaginous elements comprising the tumor. Case Report A 40-year-old man was admitted with complaints of headache and vomiting and behavior changes of 6 weeks' duration. Three days before admission he became confused and disoriented. Two months before the onset of the present complaints he had pain,
✓ The results of proximal carotid ligation for internal carotid aneurysms in 106 patients over a ... more ✓ The results of proximal carotid ligation for internal carotid aneurysms in 106 patients over a 20-year period are presented. These confirm the belief that carotid ligation is a useful definitive procedure in patients with aneurysms on the internal carotid artery, including its bifurcation. Common carotid ligation is effective protection against recurrent hemorrhage, at the same time being safer than internal carotid ligation. Matas' test has limited applicability in patients being prepared for carotid ligation. Cerebral vasospasm seen on arteriograms, cerebral circulation studies with and without carotid compression, and intravascular pressure determinations at the time of surgery are more reliable methods to decide the timing, rate, and degree of occlusion of the vessel, and to decrease the incidence of postoperative ischemic complications.
... is gen-erally secondary to acoustic neuromas or gliomas of the third ventricle [2]. Russell [... more ... is gen-erally secondary to acoustic neuromas or gliomas of the third ventricle [2]. Russell [8] examined a patient with neurofibromatosis in whom unusual ependymal granula-tions in the sylvian aqueduct were the cause of obstructive hydrocephalus. Sajid and Copple [9 ...
... Reprint requests: Dr. BS Sharma, Assistant Professor, Department ofNeurosurgeiy, Post-graduat... more ... Reprint requests: Dr. BS Sharma, Assistant Professor, Department ofNeurosurgeiy, Post-graduate Institute of Medical Education and Research, Chandigaih 160 012 ... wing of sphenoid on the leftside, with contiguous hyperdense mass (with hypo-dense areas within it) in the orbit ...
Immunohistochemical analysis of 9 choroid plexus papillomas (CPPs) and 3 choroid plexus carcinoma... more Immunohistochemical analysis of 9 choroid plexus papillomas (CPPs) and 3 choroid plexus carcinomas (CPCs) using a panel of antibodies against glial fibrillary acidic protein (GFAP), cytokeratin (CK), epithelial membrane antigen (EMA), S-100 protein, vimentin (vim), and neuron specific enolase (NSE) is presented. Focal positivity was observed for GFAP in 11, vimentin in 7, cytokeratin in 2 and EMA in 3 cases. Diffuse and intense immunoreactivity for S-100 protein was seen in all papillomas, however, unreactive areas were noted in carcinomas. All cases exhibited focal to diffuse NSE positivity. Location and type of the tumour and age of the patient did not influence the staining pattern except for predominant S-100 positivity in papillomas. The significance of these findings is discussed in relation to the differential diagnosis or immunoreactivity patterns of these tumours.
An uncommon case of benign osteoblastoma of the occipital bone is presented. Poor vascularity of ... more An uncommon case of benign osteoblastoma of the occipital bone is presented. Poor vascularity of the tumor, as confirmed by the CT scan, operative and histopathological findings, was in contrast to its characteristic high vascularity. Radical resection produced an excellent result.
Intracranial tumors are sometimes known to appear first as apoplexy. This report describes a pati... more Intracranial tumors are sometimes known to appear first as apoplexy. This report describes a patient with a meningioma of the falx who experienced acute onset of symptoms due to intracerebral and subarachnoid hemorrhage and following a history of transient ischemic attacks on exertion. The tumor was an angioblastic-meningioma. The probably source of bleeding and the mechanism of transient ischemic episodes provoked by exertion are discussed.
A case of colonic perforation by a ventriculoperitoneal shunt, its subsequent migration and protr... more A case of colonic perforation by a ventriculoperitoneal shunt, its subsequent migration and protrusion from the anal orifice is reported. The shunt reservoir and ventricular catheter were removed percutaneously, and the disconnected peritoneal catheter was pulled out through the anus. Blood culture grew Klebsiella pneumoniae and Streptococcus fecalis. CT scan showed multiple subdural abscesses with evidence of ventriculitis. Removal of the shunt (as described), evacuation of subdural pus and systemic antibiotics resulted in complete recovery.
A 40-year-old male presented clinically with features of C6 radiculomyelopathy. An intradural ext... more A 40-year-old male presented clinically with features of C6 radiculomyelopathy. An intradural extramedullary malignant schwannoma was removed at laminectomy. Foraminal extension of the tumour could not be removed in spite of foraminotomy, and no root attachment was found. Frequent intraspinal recurrences were treated with local resection. Delayed appearance of a supraclavicular mass, CT scan and exploration of supraclavicular fossa disclosed its origin from the upper trunk of brachial plexus.
✓ Two patients with chronic spinal subdural hematomas are described. Both had a fluctuating clini... more ✓ Two patients with chronic spinal subdural hematomas are described. Both had a fluctuating clinical course, not previously documented in the literature. Surgical evacuation resulted in almost complete recovery. The pathogenesis of spinal subdural hematoma is discussed and the pertinent literature is reviewed.
... Postgraduate Institute of Medical Education and Research, Chandi-garh-160012, India Address f... more ... Postgraduate Institute of Medical Education and Research, Chandi-garh-160012, India Address for correspondence and reprint requests: Dr Vijay K. Kak, Professor and Head ... J Neurol Neurosurg Psychiat 1987; 50:1705-6. 4 BREWER NS, MACCARTY cs, WELLMAN WE. ...
Seventy children with posterior fossa tumours treated over a period of 6 1/2 years were studied. ... more Seventy children with posterior fossa tumours treated over a period of 6 1/2 years were studied. Most patients presented in the late stage of disease. Sixty-four required insertion of a precraniotomy shunt for one or more of the following: persistent vomiting, severe headache, dehydration, poor general condition, failing vision, altered sensorium, marked periventricular lucency, and brain stem involvement deferring total removal of the tumour. Insertion of precraniotomy shunt improved the general condition and signs and symptoms of increased intracranial pressure. It also provided a lax brain during definitive surgery and a smooth postoperative course. Shunt-related complications, consisting of block and/or infection, were observed in 21 patients. It was concluded that precraniotomy shunt is important in the management of children with posterior fossa tumours in developing countries where these patients present in the late stage of disease.
A case of gliosarcoma with cartilaginous component is described. Immunohistochemical and electron... more A case of gliosarcoma with cartilaginous component is described. Immunohistochemical and electron microscopic studies confirmed the presence of glial and fibroblastic elements. A major part of the sarcomatous tissue was undifferentiated and not labeled by any of the markers used including those for endothelial cells. The cartilage cells also were not labeled either by antiglial fibrillary acidic protein or any other marker. The occurrence and histogenesis of cartilage in gliomas and gliosarcomas have been reviewed. Cancer 63518423, 1989. LIOSARCOMA or mixed glioblastoma and sarcoma G is a well-established entity. It has been estimated that about 2% to 8% of otherwise typical glioblastomas may contain sarcomatous elements mostly in the form of fibrosar~oma.'-~ Recently, we came across an unusual neoplasm which, in addition to glial and sarcomatous elements, contained cartilaginous tissue. Although the occurrence of cartilage has been documented in different types of gliomas, its presence in gliosarcoma seems to be exceedingly rare and has not been emphasized previously. The origin of cartilage in gliomas generally has been ascribed to chondroid metaplasia of the mesnchymal ~t r o m a .~-~ However, in a recent study using immunohistochemical methods, Kepes et a1.l' concluded that neoplastic astrocytes probably play an important role in the formation of cartilage in gliomas. In view of this interesting observation, we studied our case with a battery of immunohistochemical stains and electron microscopic study to explore the relationship, if any, among the glial, sarcomatous and cartilaginous elements comprising the tumor. Case Report A 40-year-old man was admitted with complaints of headache and vomiting and behavior changes of 6 weeks' duration. Three days before admission he became confused and disoriented. Two months before the onset of the present complaints he had pain,
✓ The results of proximal carotid ligation for internal carotid aneurysms in 106 patients over a ... more ✓ The results of proximal carotid ligation for internal carotid aneurysms in 106 patients over a 20-year period are presented. These confirm the belief that carotid ligation is a useful definitive procedure in patients with aneurysms on the internal carotid artery, including its bifurcation. Common carotid ligation is effective protection against recurrent hemorrhage, at the same time being safer than internal carotid ligation. Matas' test has limited applicability in patients being prepared for carotid ligation. Cerebral vasospasm seen on arteriograms, cerebral circulation studies with and without carotid compression, and intravascular pressure determinations at the time of surgery are more reliable methods to decide the timing, rate, and degree of occlusion of the vessel, and to decrease the incidence of postoperative ischemic complications.
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