[A progressive psychosyndrome without symptoms of cerebral lesions. Case reports of a 39-year-old patient and a 60-year-old patient].
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Biomedical subjects
Publications and source records attributed to O Stochdorph.
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Computer assisted tomography (CAT) data from 10 patients with histologically verified primary malignant lymphomas of the brain are reported. Studies both prior to and after contrast medium administration were done on nine patients. In all these patients, tumor nodules presented with slightly increased density in the precontrast scan and considerable contrast enhancement. The appearance of malignant lymphomas in the CAT scan may be similar to that of meningiomas. Pituitary adenoma, medulloblastoma, and metastasis of malignant melanoma may not be ruled out in a particular case from the CAT picture alone. Blurred margin of the tumor after contrast enhancement was found in half the patients. Diffusely growing malignant lymphomas produce low density areas in the CAT scan without contrast medium uptake.
Based on the experience collected in 108 patients from a series of more than 7500 CT examinations, the possibilities and limitations of computed tomography in non-tumorous space-occupying lesions are discussed. Serious problems of differential diagnosis are encountered mainly in the case of cerebral abscesses and acute demyelinization, as well as granulomas. Cystic processes are usually easier to classify. Anamnesis will often be helpful in the case of parasites. Old intracerebral hemorrhages can simulate tumors and calcifications. The same applies to giant angiomas and giant aneurysms. In cerebral infarction, too, an occasional confusion with a tumor in the blood-brain barrier disturbance phase cannot be excluded.
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A sacro-presacral myxopapillary ependymoma with a long anamnesis is described. A total of 46 other cases have heretofore been reported in the literature, which were systematized in this paper from a clinical as well as developmental point of view. Surgical interventions performed in the early and later phases of the disease resulted in restoration to health and subjective alleviation, respectively.
The clinical and electroencephalographic observations in two patients with verified necrotising herpes-encephalitis are presented. In one of the ill persons it was possible to isolate the virus. With these two observations four additional ones published previously are compaired electroencephalographically. Thereby the EEG reveal a certain variation in form and local distribution of periodic discharges (bursts) from relatively regularly recurring slow waves to stereotype periodicity complexes. Next an attempt is made to arrive at physiopathogenetic explanations for the EEG-changes by compairing the pathologico-anatomical findings of the six cases presented with those of ten more cases. The topographical distribution of the anatomical lesions in these inflammatory precesses seem to be of special importance for the occurence of the EEG-changes.
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The unusual status of the cerebellar astrocytoma is based upon clinical and histological evidence. "Bergstrand Tumour" is proposed as a new name for it. A new concept of its origin is put forward, namely that it is derived from the "tanycytes" (Horstmann) of the periventricular structures.
Metastases of a meningioma occurred in a 45-year-old man 4 years after removal of a falx meningioma and 1 year after removal of a malignant relapse. They were situated in the cervical, nuchal, and supra-clavicular lymph nodes. The review of 63 cases of metastasising meningial tumours from the literature, shows that lymph nodes are the most frequent site of metastases after lung and liver. The spreading of the tumour into the regional lymph nodes requires a penetration of the primary tumour into the galea, where the tumour cells may reach the lymphatic system. According to the literature, lymph node metastases are caused by benign as often as by malignant meningiomas, the majority being cases who underwent operation. Discussed, are the different theories as to why intracranial tumours only rarely show extracranial metastases.
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