Biomedical subjects
Publications and source records attributed to B Blumenkopf.
A 34-year old man presented with headaches. Computed tomography scanning revealed an enhancing subdural mass extending from the skull base to the convexity, thought to represent an en-plaque meningioma. Pathologic study revealed extraaxial subdural granulomatous inflammation consistent with neurosarcoidosis.
A patient presented comatose with an intraventricular hemorrhage of unknown etiology, and manifested the unusual clinical phenomenon of ocular bobbing. Further evaluation revealed a giant aneurysm of the distal posterior inferior cerebellar artery, which was successfully treated surgically. The pathophysiology of ocular bobbing is discussed as well as the association of this unusual sign with a rare aneurysm.
A 48-year-old man presented with the numb, clumsy hand syndrome. Evaluation revealed a high cervical cord lesion. Surgical exploration discovered leptomeningeal gliomatosis with no discernible intraparenchymal component. The clinical features of the case, the neuroimaging studies including magnetic resonance scanning, and the most unusual pathological nature of the lesion are discussed.
Hemangioblastomas of the spinal cord are uncommon, accounting for 1.6% and 2.1% of all spinal cord tumors (1). Until recently these vascular lesions were best evaluated angiographically. Several cervical hemangioblastomas have been studied by computed tomography with intravenous contrast medium enhancement (2-4). This report illustrates the use of computed tomography with combined intravenous and intrathecal contrast medium enhancement, which permitted preoperative diagnosis and treatment planning of an intramedullary hemangioblastoma.
A 6-year-old girl with tuberous sclerosis was found to have multiple intracranial fusiform arterial aneurysms. This represents the fifth reported case of this association. The concepts of an arterial dysplasia being present in cases of tuberous sclerosis and of developmental defects being the cause of some intracranial aneurysms are discussed. The need for a prospective study to assess the prevalence of intracranial aneurysms in patients with tuberous sclerosis is suggested.
The finding of a number of peptides in the central nervous system and the discovery of the endogenous opiates represent major recent advances in the understanding of neural transmission. A number of these neuropeptides are found in the dorsal root entry zone and may play a role in pain. An analysis of changes in distribution of substance P, methionine-enkephalin, and somatostatin after simulated nerve root avulsion injury suggested a possible mechanism for deafferentation pain. A review of the localizations and actions of these peptides in the dorsal root entry zone is included.
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A 33-year-old right-handed woman had intractable simple and complex partial seizures (SPS, CPS) that began with global aphasia. EEG closed-circuit TV (EEG-CCTV) monitoring with sphenoidal electrodes showed left inferomesial temporal ictal onset of CPS. Subdural electrodes were implanted over the left frontotemporal convexity, subtemporally and subfrontally. Stimulation of the basotemporal cortex produced global aphasia. A posterolaterotemporal language area was also identified. Spontaneous SPS had focal onset in the basal temporal language area (BTLA). Ictal discharges did not involve the posterotemporal region. This case shows that aphasic speech arrest at seizure onset may be due to seizure discharge in the basotemporal region and that the BTLA is clinically relevant in seizure semiology.
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