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  • 1
    ISSN: 0942-0940
    Keywords: Subarachnoid haemorrhage ; Acetazolamide ; SPECT ; 123I-IMP
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cerebral vasodilatory capacity was evaluated by acetazolamide-activated N-isopropyl-p-[12 3I]iodoamphetamine (123I-IMP) single photon emission computed tomography (SPECT) in 42 patients with subarachnoid haemorrhage (SAH). A low perfusion area was present in the corresponding region of haematoma seen on the CT and continued to be noted throughout the time courses. Deteriorated acetazolamide reactivity affected by surgical intervention was seen in 100% of the patients who underwent aneurysm repair in the 1st postoperative week, 92% in the second week, 73% in the third week, and 47% in the fourth week. Three patients with acute diffuse brain swelling seen on CT showed intracranial non-filling of123I-IMP on SPECTs performed on Day 6, and all three died by Day 10. Some low perfusion areas, due to probable vasospasm, were present in 77% of Hunt and Hess grades I and II patients and in 100% of grades III, IV, and V patients throughout their time courses. Overall, low perfusion areas, due to probable vasospasm, were seen in 10 patients (31%) of 32 who underwent SPECT between Day 4 and 8, 23 (77%) of 30 between Day 9 and 14, 21 (72%) of 29 between Day 15 and 21, and 11 (48%) of 23 between Day 22 and 28. The results suggest acetazolamide-activated123I-IMP study is of value in evaluating changes in vasodilatory capacity in SAH patients in the acute and subacute stages.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 0942-0940
    Keywords: Keywords: Choroid plexus carcinoma; infant; surgery; chemotherapy; radiotherapy.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Choroid plexus carcinoma (CPC) is a rare malignant brain tumour which occurs predominantly in childhood. We present the cases of two infants with CPC. One, a 6-month-old boy with the tumour in the right lateral ventricle, who died of a postoperative intracranial haemorrhage and severe gastrointestinal bleeding, and the other, a 9-month-old boy with the tumour in the fourth ventricle, who has been well without recurrence for 12 months after total removal in combination with chemotherapy using cisplatin and VP-16 and local radiotherapy. In the 54 CPC cases in children under 2 years of age including our 2 cases in which the clinical results were described in the literature since 1983, tumour location (lateral ventricle, p=0.0225), surgery (gross total resection, p=0.0447), and chemotherapy (yes, p=0.0010) were revealed to be significant positive prognostic factors by the univariate analysis using the log rank test, and surgery (gross total removal, p=0.0259) and chemotherapy (yes, p=0.0016) were independent, significant positive prognostic factors in the multivariate analysis using the Cox proportional hazard regression model. Although there is a risk in doing a statistical analysis of other people's reports, these results suggest that, at present, the gross total removal of the tumour with intensive chemotherapy is the best choice of initial treatment for young children with CPC, and that radiotherapy should be considered for patients after 24 months of age and/or should be performed locally.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 98 (1989), S. 1-8 
    ISSN: 0942-0940
    Keywords: Cerebellum ; malignant astrocytic tumours ; children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors reviewed 5 cases of histopathologically verified malignant cerebellar astrocytic tumours (2 anaplastic astrocytomas and 3 glioblastomas) in children admitted to our department. All cases exhibited symptoms and signs of increased intracranial pressure and of a cerebellar lesion. Brain stem symptoms were present in 4 cases. All of the tumours were located in or near the midline of the cerebellum with no large cyst. Surgical removal (70 to 90% removal) of the tumour was performed in 4 cases. In one case only a biopsy was done. Even with subsequent follow-up treatment including radiotherapy, chemotherapy, and/or immunotherapy, the course of the disease could not be reversed, and all of the children died 3 to 13 months (mean 7 months) after admission due to tumour re-growth or recurrence. Tumour dissemination along the walls of the ventricular system was seen in 2 cases, and was considered to be a peculiar, fatal form of tumour recurrence in patients with this type of tumour. Malignant cerebellar astrocytic tumours in children have an extremely poor prognosis. Until, improved therapy is available to counteract this tragic consequence, it will remain so.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 0942-0940
    Keywords: Subarachnoid haemorrhage ; vasospasm ; 123I-IMPSPECT ; acetazolamide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Prediction of cerebral infarction due to vasospasm (VS) following aneurysmal subarachnoid haemorrhage (SAH) was investigated using acetazolamide-activated (A-A) N-isopropyl-p-[123I] iodoamphetamine (123I-IMP) single photon emission computed tomography (SPECT) in 79 SAH patients. A-A SPECT was undertaken twice or more for one each patient by Day 18. Fifty-six (71%) of the 79 patients presented with reduction of cerebral vasodilatory capacity (CVC) on SPECT due to VS by Day 18. Of the 56 patients, 29 showed CVC by Day 8 (Group A), while the other 27 first showed CVC reduction between Day 9 and 18 (Group B). Cerebral infarction on CT was revealed by Day 18 in 15 patients (52%) of Group A and 3 (11%) of Group B. Of the 56 patients, 20 showed reduced CVC in watershed[s] (Type 1), 12 in a sole territory of the intracranial major arterial trunk (Type 2), and 24 in several territories or in a sole territory with distant watershed[s] (Type 3). Cerebral infarction on CT by Day 18 was revealed in one patient (5%) in Type 1, 3 (25%) in Type 2, and 14 (58%) in Type 3. Twelve (71%) of 17 patients belonging to both Group A and Type 3 resulted in cerebral infarction. These results suggest that early and extensive CVC reduction are significant factors responsible for cerebral infarction due to VS following SAH. Cerebral infarction can be reasonably predicted using A-A SPECT in SAH patients.
    Type of Medium: Electronic Resource
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