Biomedical subjects
Publications and source records attributed to R Carrillo.
A case is reported of a glial hamartoma located in the orbital fossa, with an extradural extension to the middle fossa. This location of a glial hamartoma has not previously been reported.
Two cases of cavernous angiomas of the pineal region are presented. The possibility that a mass in the pineal region could be a cavernous angioma should be considered when deciding upon early surgery or a trial of radiotherapy.
A malignant teratoid medulloepithelioma (ME) first became symptomatic in a 41-year-old woman. Her eye was enucleated for advanced glaucoma when the patient was aged 43 years, making her the oldest patient known to have had this tumor. The tumor showed little epitheliomatous differentiation, but a large rhabdomyoblastic component and nodules of cartilage. It had extended over the retina, creating a change in macular reflex as an early clinical sign, and eventually produced large retinal contraction folds. The lens was invaded by tumor, and an active phakoanaphylactic uveitis was in progress. Three of the four MEs recognized in adults have been malignant.
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The authors present a case of primary carcinoma of the choroid plexus in a 26-years-old female, localized in the left lateral ventricle. Four years after total removal plus local radiotherapy, the patient presented with an intraparenchymatous metastasis in the right cerebellar hemisphere and intraspinal metastatic seeding. With this kind of malignant growth, a therapeutic approach consisting of radical removal of the tumour plus radiotherapy to the whole neuraxis is proposed.
We encountered inverted papilloma of the conjunctiva in three cases. To the best of our knowledge, this tumor, which typically involves the nose, paranasal sinuses, and lacrimal sac, has not been described previously in the conjunctiva. Two of the tumors occurred as purely inverted lesions of the inner canthal region )caruncle and plica) and the third as a mixed inverted-exophytic papilloma over the tarsus. Melanotic pigmentation in one of the lesions was clinically confused with malignant melanoma. Because of the high incidence of recurrence of these tumors in the sinuses and lacrimal sac, and their unknown biologic behavior in the conjunctiva, inverted papillomas should be removed completely and the patients carefully observed.
The association of an empty sella with rhinorrhea is an unusual finding. Of 29 cases of empty sella observed by the authors, eight underwent surgery for rhinorrhea. None of the patients showed clinical evidence of increased intracranial pressure or hydrocephalus. Seven were cases of primary empty sella, the eighth was an acromegalic patient, who had received radiotherapy 4 years before. Except for this patient, the others showed no clinical signs of a previous tumor. In the surgical treatment of these patients, the authors used both the transfrontal and transsphenoidal approaches. In spite of generally accepted good results following surgical closure of this type of fistula, four patients needed more than one operation. The fistula closed in only three of them; in the last patient rhinorrhea persisted after three operations.
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Epicranial plexiform neurofibroma is a rare presentation of neurofibromatosis. Two such cases are presented in which epicranial tumors constituted isolated manifestations of the disease except for skin pigmentation. Tumor development began at two and three months of age respectively; one case showed a calvarian bony defect associated with the tumor.
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Within the germinal neoplasms of the central nervous system, the embryonal carcinoma is a very rare tumor. The authors report such a lesion arising on the corpus callosum in a child 8 months after a differentiated teratoma was totaly removed from the pineal region. The classification of the germ cell tumors of the central nervous system and their relation with similar tumors of the gonads are discussed. The treatment of the pineal tumors is also discussed.
It is generally possible to evaluate a malfunctioning shunt on the basis of clinical signs. Neuroradiologic evaluation is recommended for the difficult cases when this is not possible. The neuroradiologic procedure of choice is cerebral angiography since it permits the determination of ventricular size, an estimate of the presence of intraventricular hypertension, and an evaluation of the nature and degree of brain shift or herniation. Furthermore, such complications of hydrocephalus as porencephaly or subdural accumulations of fluid may also be diagnosed.
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INTRODUCTION: Radionuclide ventriculography (RNV) evaluates segmental and global ventricular contractility and also detects conduction abnormalities. OBJECTIVE: To assess the temporal parameters of ventricular synchronization in the normal heart by a third harmonic (3H) Fourier phase analysis in a RNV and introduce this technique in our center. MATERIAL AND METHODS: Thirty normal subjects (19 men and 11 women) were included. An equilibrium RNV was performed in 35 degree left anterior oblique projection with 10 degree caudal tilt. The onset (T0); mean time (T(m)); total contraction time (T(t)); final time (T(f)) and propagation time (T(p)) for right (RV) and left ventricle (LV); as well as total propagation time (T(TP)); interventricular time (T(RV-LV)) and septum-lateral wall conduction time (T(S-LW)) were measured on the 3H Fourier histogram of the time-activity curve. RESULTS: Right ventricle contraction started 5 ms before that of the left ventricle (T(0RV) = 66 +/- 38 ms; T(OLV) = 71 +/- 30 ms), with a longer total contraction time (T(tVD) = 67 +/- 28 ms vs T(tVI) = 64 +/- 38 ms). Total propagation time (T(TP)) was 69 +/- 37 ms and the interventricular time (T(RV-LV)) was 2 +/- 25 ms. Contraction progressed from septum to lateral wall, with a septum-lateral wall conduction time (T(S-LW)) of 4 +/- 22 ms. CONCLUSION: Simultaneous contraction of right and left ventricles can be quantified by RNV phase analysis, providing a useful tool for ventricular resynchronization assessment in multisite pacing.
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