Journal of neurosurgery
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Journal of neurosurgery · Apr 2013
Biography Historical ArticleThe lucid interval associated with epidural bleeding: evolving understanding.
The aim of this paper was to elucidate the evolution of our understanding of the term "lucid interval." A number of texts were reviewed to assess their suitability for analysis. The primary requirement was that the text contain detailed descriptions of a series of patients. Details of the clinical course, the findings and timing of surgery, and, when relevant, the time of death and postmortem findings were required. ⋯ The first to have a proper understanding of the interval in relation to an EDH was John Abernethy. The modern description and definition of the lucid interval was the work of Hutchinson and Jacobson in the latter half of the 19th century. Understanding of the pathophysiology of the lucid interval has been advanced by the work of Ford and McLaurin in Cincinnati and a group in Oslo, with the demonstration of what it takes to loosen dura and how an arteriovenous shunt slows down for a while the accumulation of an EDH.
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Journal of neurosurgery · Apr 2013
Review Case ReportsIntracranial phosphaturic mesenchymal tumors: report of 2 cases.
Hypophosphatemia with osteomalacia may be due to a neoplasm that produces fibroblast growth factor 23 (FGF-23), which inhibits phosphate reabsorption in the kidneys. Most of these tumors occur in bone or soft tissue and occasionally in the head, although intracranial occurrence is very rare. This report describes a tumor that caused hypophosphatemia and osteomalacia and was located entirely in the right anterior cranial fossa. ⋯ The authors also studied another PMTMCT initially diagnosed as a hemangiopericytoma that involved the left anterior cranial fossa and ethmoid sinus, and reviewed reports of 6 other intracranial tumors that induced osteomalacia, 3 entirely in the anterior cranial fossa, 2 involving the anterior cranial fossa and ethmoid sinus, and 1 in the cavernous sinus. In older children or adults who have hypophosphatemia with osteomalacia and no personal or family history of metabolic, renal, or malabsorptive disease, a neoplasm should be suspected and an imaging workup that includes the brain is warranted, with particular attention to the anterior cranial fossa. Additionally, because there are some overlapping histological features between PMTMCTs and hemangiopericytomas, it may be helpful to assess tumoral FGF-23 expression by reverse transcriptase polymerase chain reaction or immunohistochemical analysis in patients with oncogenic osteomalacia from an intracranial tumor diagnosed as, or resembling, hemangiopericytoma.