ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

OBJECTIVE AND IMPORTANCE:Melanotic neuroectodermal tumor of infancy (MNTI) is a rare, locally aggressive tumor that arises most commonly from the maxilla or mandible. Infrequently, it originates from the cranial vault, and recent reports have described a favorable outcome after radical surgery. Some lesions are particularly problematic, such as those located along the cranial midline or cranial base and those with significant intracranial extension. Currently, there is no effective adjuvant therapy for MNTI; radiation is precluded by the patients’ young age, and chemotherapy trials have not demonstrated long-term efficacy.CLINICAL PRESENTATION:A 2-month-old infant boy presented with a firm, immobile subcutaneous mass behind the right ear. The mass had been present at birth and enlarged with time.INTERVENTION:Initial resective surgery down to the dura resulted in massive tumor recurrence within weeks. Successful management required repeat surgery including excision of the dura and dural venous sinuses.CONCLUSION:This patient’s large MNTI of the cranial base was successfully managed by radical surgery. Although MNTI is a rapidly growing tumor that is locally highly invasive, radical surgery may be associated with a favorable outcome and offers the potential for long-term cure.

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

OBJECTIVE AND IMPORTANCE:Cervical internal carotid artery disease associated with high-grade carotid siphon stenosis poses a therapeutic challenge. This report describes the combination therapy of carotid endarterectomy and intraoperative transluminal balloon angioplasty of the carotid siphon.CLINICAL PRESENTATION:A 67-year-old man sustained repeated left hemispheric and retinal transient ischemic attacks. Results of a diagnostic examination, including angiography, disclosed a 70% ulcerative stenosis of the left extracranial internal carotid artery as well as a 90% stenosis of the left intracavernous carotid artery. The decision was made for combined open and endovascular therapy.INTERVENTION:After standard endarterectomy, an introducer for the dilation catheter was placed into the common carotid artery before final closure of the arteriotomy and recirculation. Under intraoperative fluoroscopy, a 3-mm dilation balloon was navigated into the carotid siphon stenosis and inflated several times. A 30% residual stenosis in the carotid siphon was obtained as a final result. The intervention was completed without complications. No further neurological symptoms were observed during the follow-up period of 30 months.CONCLUSION:Carotid endarterectomy, combined with intraoperative transluminal angioplasty of carotid siphon stenosis, is a feasible procedure for selected patients with carotid tandem stenosis.

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

OBJECTIVE:The correlation between thallium-201 (201Tl) uptake, semiquantitative choline-containing compound values measured by proton magnetic resonance spectroscopy (1H-MRS), and Ki-67 labeling indexes (LIs) was investigated in three gangliogliomas.METHODS:The early and delayed201Tl indexes were calculated as the ratio of tumor to normal brain tissue uptake by201Tl single-photon emission computed tomography. Single-voxel1H-MRS was performed to measure the levels of metabolites in the tumors. Ki-67 LI was measured in the surgical specimens.RESULTS:All three gangliogliomas showed very high201Tl uptake on both early and delayed images.1H-MRS demonstrated malignancy based on the high choline peak relative to the creatine andN-acetylaspartate peaks. Ki-67 LI was less than 1% in two gangliogliomas and 3.5% in an anaplastic ganglioglioma.CONCLUSION:Both201Tl single-photon emission computed tomography and1H-MRS indicated malignancy, whereas Ki-67 LI indicated low growth activity.201Tl single-photon emission computed tomography and1H-MRS of ganglioglioma might be affected by metabolic characteristics other than growth activity.

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

OBJECTIVE:We examined the accuracy and repeatability of an intracranial pressure (ICP) monitor (Codman MicroSensor; Johnson & Johnson Professional, Inc., Raynham, MA) in a nonmagnetic environment and during magnetic resonance imaging (MRI). The resulting image artifact generation was calculated. ICP monitoring is essential in management of severe head injury, but few ICP monitoring devices are compatible with use in an MRI scanner. The use of MRI to assess head injury is increasing, and developing safe methods of continuously monitoring ICP may improve patient care.METHODS:A water manometer was used as the standard for comparison. We assessed pressure readings from the ICP monitor in a nonmagnetic environment using a standard and a long connector cable between the pressure transducer and display unit. This long cable permitted testing during MRI sequences because the display unit could be distanced from the magnet. Accuracy was determined during T2-weighted imaging, proton spectroscopy, and diffusion-weighted imaging, and artifact generation was assessed.RESULTS:We found a high degree of accuracy for repeated measurements over a clinical pressure range using both standard and long connector cables outside the MRI room. During MRI scanning, the ICP monitor was accurate during T2 and proton spectroscopy sequences. Accuracy during diffusion-weighted imaging, however, was clinically unacceptable. This ICP monitor creates a reduction in signal-to-noise ratio in the received signal during T2-weighted imaging and proton spectroscopic imaging, with the obtained images still radiologically interpretable.CONCLUSION:The Codman ICP monitor is sufficiently accurate and free of artifact generation to be used during most clinical MRI applications. This could enhance patient monitoring and safety.

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID