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  • 1
    ISSN: 1432-1920
    Keywords: Magnetic resonance imaging ; Surface anatomy scanning ; Brain tumours ; Cortical veins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the usefulness of surface anatomy scanning (SAS) in intracranial tumours, comparing it with surgical findings. We examined 31 patients with brain tumours preoperatively. The tumours included 16 meningiomas, 8 gliomas, 4 metastases and 3 others. SAS clearly demonstrated the tumours, allowing them to be distinguished from the structures of the brain surface, including oedema, except in cases of metastasis. SAS clearly demonstrated large cortical veins. SAS is useful for three-dimensional delineation of the brain surface before surgery.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1920
    Keywords: Pituitary adenoma ; Magnetic resonance imaging ; Gadolinium ; DTPA ; Normal pituitary gland
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The position of the normal pituitary gland, assessed using gadolinium-enhanced MRI was compared with the position found at surgery for pituitary adenoma in 25 patients. The tumours were five microadenomas and 20 macroadenomas. Using T1-weighted imaging, the anterior lobe could be differentiated on the sagittal image in five patients (20%) and on the coronal image in four (16%). The high intensity of the posterior lobe could be differentiated using T1-weighted sagittal imaging in 13 patients (52%). The normal pituitary gland, which enhanced more strongly than tumour, could be differentiated using Gd-DTPA-enhanced MRI on the sagittal images in 22 cases (88%) and on the coronal image in 17 (68%). In seven patients, the normal pituitary gland surrounded the tumour; it was displaced superiorly in 14 cases and superioposterorly in two but in no case was it displaced anteriorly or downwards.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1920
    Keywords: Pineal region tumours ; Magnetic resonance imaging ; Germ cell tumours ; Pineal cell tumours ; Meningiomas
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A variety of tumours may arise in the pineal region; accurate diagnosis is important in the selection of treatment and prognosis. A retrospective analysis of the MRI studies of 25 patients with pathologically proven pineal region tumours was performed, focused on the relationship between the tumour and neighbouring structures. Compression of the tectal plate was classified as expansive or invasive, and compression of the corpus callosum as inferior, anterior or posterior. In 10 of the 14 patients (71%) with germ cell tumours tectal compression was of the invasive type; 8 patients (57%) had multiple tumours and in 13 (93%) the tumour margins were irregular. Teratomas were readily diagnosed because of characteristic heterogeneous signal intensity. Pineal cell tumours were differentiated from germ cell tumours by their rounded shape, solid nature, sharp margins, and expansive type of tectal compression. Meningiomas were characterised by their falcotentorial attachments, posterior callosal compression, and a low-intensity rim on T2-weighted images. Gd-DTPA injection enabled clear demonstration of the site and extent of tumour spread and was useful in differentiating cystic and solid components. The appearances described, while not pathognomonic, are helpful in the differential diagnosis of pineal region tumours, and valuable in planning appropriate treatment.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1920
    Keywords: Germ cell tumour ; Magnetic resonance imaging ; Computed tomography ; Gd-DTPA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We reviewed MRI findings in proven intracranial germ cell tumours in 22 cases, 12 of whom received Gd-DTPA. On T1-weighted images, the signal intensity of the tumour parenchyma was moderately low in 19 cases and isointense in 3; on T2-weighted images, it was high in all cases. Regions of different intensity thought to be cysts were found in 17 (77%): 7 of 12 patients with germinoma (58%) and in all other cases. Of the 13 patients with pineal lesions T1-weighted sagittal images showed the aqueduct to be obstructed in 5, stenotic in 7 and normal in 1. Strong contrast enhancement was observed in all 12 cases. Of the 14 patients with suprasellar lesions, 5 were found to have an intrasellar extension, and in 3 of these, the normal pituitary gland, which could be distinguished from the tumour, was displaced anteriorly. Ten patients (45%) had multiple lesions.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1920
    Keywords: Key words Pineal region tumours ; Magnetic resonance imaging ; Germ cell tumours ; Pineal cell tumours ; Meningiomas
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A variety of tumours may arise in the pineal region; accurate diagnosis is important in the selection of treatment and prognosis. A retrospective analysis of the MRI studies of 25 patients with pathologically proven pineal region tumours was performed, focused on the relationship between the tumour and neighbouring structures. Compression of the tectal plate was classified as expansive or invasive, and compression of the corpus callosum as inferior, anterior or posterior. In 10 of the 14 patients (71 %) with germ cell tumours tectal compression was of the invasive type; 8 patients (57 %) had multiple tumours and in 13 (93 %) the tumour margins were irregular. Teratomas were readily diagnosed because of characteristic heterogeneous signal intensity. Pineal cell tumours were differentiated from germ cell tumours by their rounded shape, solid nature, sharp margins, and expansive type of tectal compression. Meningiomas were characterised by their falcotentorial attachments, posterior callosal compression, and a low-intensity rim on T2-weighted images. Gd-DTPA injection enabled clear demonstration of the site and extent of tumour spread and was useful in differentiating cystic and solid components. The appearances described, while not pathognomonic, are helpful in the differential diagnosis of pineal region tumours, and valuable in planning appropriate treatment.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-1920
    Keywords: Pituitary adenoma ; Craniopharyngioma ; Rathke cleft cyst ; Magnetic resonance imaging ; Gadolinium DTPA ; Normal pituitary gland
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We compared the position of the normal pituitary gland as estimated by gadolinium (Gd)-DTPA-enhanced MRI, with its position at surgery in 40 patients with intra- and juxtasellar tumours: 22 pituitary adenomas, 4 craniopharyngiomas, 7 meningiomas, 2 germinomas, and 5 Rathke cleft cysts. In 37 of these, the normal gland showed more intense contrast enhancement than the adjacent tumour, from which it could be differentiated by Gd-DTPA-enhanced MRI, especially in the sagittal plane. The direction of displacement of the normal pituitary gland correlated well with tumour type, so that its position proved helpful in the differential diagnosis. The normal gland was typically displaced superiorly by pituitary adenomas, inferiorly by craniopharyngiomas, and anteriorly by germinomas. It showed variable displacement by Rathke cleft cysts, and was not usually displaced by meningiomas.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1920
    Keywords: Key words Magnetic resonance imaging ; Surface anatomy scan- ; ning ; Brain tumours ; Cortical veins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the usefulness of surface anatomy scanning (SAS) in intracranial tumours, comparing it with surgical findings. We examined 31 patients with brain tumours preoperatively. The tumours included 16 meningiomas, 8 gliomas, 4 metastases and 3 others. SAS clearly demonstrated the tumours, allowing them to be distinguished from the structures of the brain surface, including oedema, except in cases of metastasis. SAS clearly demonstrated large cortical veins. SAS is useful for three-dimensional delineation of the brain surface before surgery.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 0942-0940
    Keywords: Keywords: Dissecting aneurysm; posterior inferior cerebellar artery; subarachnoid haemorrhage; anastomosis.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ Dissecting aneurysms of intracranial posterior circulation have recently been shown to be less uncommon than previously thought. However, those involving the posterior inferior cerebellar artery (PICA) and not vertebral artery at all are extremely rare. We report here a case of a patient with a dissecting aneurysm of the lateral medullary segment of PICA which presented as subarachnoid haemorrhage. The aneurysm was treated by trapping surgery and the distant PICA was anastomosed to the occipital artery. The patient showed a slight ataxia immediately after surgery but recovered fully.  Recovery from immediately postoperative cerebellar symptoms due to intra-operative ischemia seemed to be due largely to recovery of flow in the region of cortical branches of PICA.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 0942-0940
    Keywords: Keywords: Cavernous sinus; pituitary adenoma; lateral growth; transsphenoidal surgery.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ Background. The purpose of this study was to evaluate the usefulness of an oblique “cross court” transsphenoidal approach using a speculum with slightly modified projections for pituitary adenomas showing lateral extension.  Method. The projection of the speculum on the side of the cavernous lesion was shortened by 5 mm. The tip of the longer projection was placed in the sphenoid sinus, while the end of the shorter projection was placed on the concha sphenoidalis. An oblique transsphenoidal view was then easily obtained by opening the speculum. The contralateral nasal incisura had to be widened in some cases to achieve a more oblique view.  Findings. Twenty-eight patients diagnosed with pituitary adenoma showing lateral growth underwent adenomectomy under direct observation of the medial portion of the cavernous sinus using this approach. Postoperative normalization of hyperendocrinopathy or gross total removal of the tumour was achieved in the majority of patients.  Interpretation. An oblique transsphenoidal approach using this speculum and contralateral minor maxillary osteotomy afforded a direct view of the medial cavernous sinus, sufficient for the removal of adenomas showing minor to moderate lateral growth.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1437-2320
    Keywords: Key words Brain tumor ; Merkel cell carcinoma ; Metastasis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Merkel cell carcinoma (MCC) is a rare primary cutaneous neuroendocrine tumor that is locally aggressive and has potential for metastatic spread. However, brain metastases are rare, and therapy for such tumors has never reported. The authors present a 48-year-old woman with MCC of the left elbow and a right cerebellar metastasis. After the right cerebellar mass was totally resected, radiation treatment and chemotherapy were performed. Eight cases of brain metastasis have been reported in the literature, but only 5 have been presented in sufficient detail for analysis. Therapy for brain metastases has always been palliative whole-brain irradiation and chemotherapy except for our patient, who underwent total removal of the tumor and survived for 11 months without neurological deficit. Except in the case of 1 with a particularly radiosensitive MCC, the patients with brain metastases died within 9 months after detection of the brain lesions. If possible, aggressive excision of brain metastases as well as of the primary lesion should be done.
    Type of Medium: Electronic Resource
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