Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Sep 2006
Review Case ReportsConcomitant choroid plexus papillomas involving the third and fourth ventricles: A case report and review of the literature.
Choroid plexus papillomas (CPP) are histopathologically benign and rare central nervous system (CNS) neoplasms arising from the epithelium of the choroid plexus. The most common site of presentation of these lesions is in the fourth ventricle in adults and lateral ventricles in children. Third ventricular CPP are uncommon. ⋯ Concomitant CPPs may be secondary to mere coincidental tumor occurrence or to biologic seeding of cerebrospinal fluid (CSF) from a primary CPP despite otherwise benign histopathology. The primary treatment for CPP is surgical resection. Post-operative chemotherapy or radiation for CPP is of controversial benefit.
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We report the case of a 20-year-old man with a gunshot injury as an example of spontaneous migration of a metallic foreign body within the brain. Computed tomography (CT) showed the bullet in the left temporoparietal region. At 10 days follow-up, CT revealed that the bullet had migrated posteriorly, due to the effect of gravity, lodging in the occipital lobe. Although there are a few literature reports of spontaneous migration of a bullet within the brain, this case was unique as the patient was fully conscious without any neurological deficit.
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Clin Neurol Neurosurg · Jul 2006
Freezing of gait after bilateral subthalamic nucleus stimulation for Parkinson's disease.
To determine the long-term effect of bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) on freezing of gait in Parkinson's disease patients. ⋯ Off period freezing of gait is significantly improved with STN DBS up to 24 months; however, on period freezing is not affected by STN DBS.
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Clin Neurol Neurosurg · Jul 2006
Case ReportsCheiro-oral-pedal syndrome due to brainstem hemorrhage.
Cheiro-oral-pedal syndrome is characterized by specific sensory disturbance around the corner of the mouth, in the hand and in the foot on the same side. Lesions responsible for causing this syndrome vary. We report two cases of cheiro-oral-pedal syndrome due to midbrain and pontine hemorrhage, respectively. ⋯ Difference in the threshold may explain the specific sensory pattern in this syndrome. Cheiro-oral-pedal syndrome is caused by lacunar infarction in majority of the cases. However, it should be kept in mind that hematomas can cause cheiro-oral-pedal syndrome.
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Clin Neurol Neurosurg · Jul 2006
Treatment of intraventricular hemorrhage with intraventricular administration of recombinant tissue plasminogen activator A clinical study of 18 cases.
Intraventricular hemorrhage is associated with a very poor outcome. Simple external ventricular drainage alone has not resulted in a decline of mortality. The aim was to study the effect of direct intraventricular administration of recombinant tissue plasminogen activator (rtPA). ⋯ We conclude that the procedure of intraventricular administration of a thrombolytic agent, i.e. rtPA, seems effective in lysis of the intraventricular hematoma and may, therefore, improve outcome.