Hematochezia and the False Negative Meckel's Scan: A Continued Need for Barium Studies

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73313/1/j.1572-0241.1985.tb01988.x.pd

Increased leukotriene C 4 and vasogenic edema surrounding brain tumors in humans

Leukotrines are pharmacologically active compounds that promote vascular permeability. In this study we sought to determine whether tissue leukotriene–like immunoreactivity was increased in intracranial tumors associated with peritumoral edema. In 20 patients undergoing craniotomy tissue specimens were immediately frozen after removal and tissue leukotriene C 4 levels were determined by radioimmunoassay. An index of peritumoral edema was estimated from preoperative contrast-enhanced computed tomographic scans. There was a significant correlation between brain edema and tissue leukotriene levels ( p < 0.003). Metastatic tumors (n = 8) had the highest leukotriene C 4 level at 13.8 ± 8.5 pg/mg tissue (mean ± SE) and the highest index of edema 5.7 ± 1.8. The mean leukotriene C 4 level in the gliomas (n + 5) ws 6.2 ± 2.3 pg/mg tissue and the edema index was 2.1 ± 0.6. There was no edema and no neoplasma in he temporal lobes removed for seizure (n + 2), and their level of leukotriene C 4 was 0.4 ± 0.1 pg/mg tissue. The formation of leukotriene C 4 is stimulated by intracranial tumors. Leukotrienes increase blood–brain barrier permeability and may be important in the formation of vasogenic edema surrounding tumors.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/50315/1/410190613_ftp.pd

Olfactory groove meningioma: Discussion of clinical presentation and surgical outcomes following excision via the subcranial approach

Objectives/Hypothesis: To describe surgical outcomes and radiographic features of olfactory groove meningiomas treated by excision through the subcranial approach. Special emphasis is placed on paranasal sinus and orbit involvement. Study Design: Retrospective review of a series of patients. Methods: Nineteen patients underwent excision of olfactory groove meningioma (OGM) via the transglabellar/subcranial approach between December 1995 and November 2009. Nine patients had previously undergone prior resection at outside institutions, and four had prior radiotherapy in addition to a prior excision. Transglabellar/subcranial surgical approach to the anterior skull base was performed. Results: Tumor histology included three World Health Organization (WHO) grade III lesions, one WHO grade II lesion, and 15 WHO grade I lesions. Fourteen patients had evidence of extension into the paranasal sinuses, with the ethmoid sinus being most commonly involved. Kaplan‐Meier estimates of mean overall and disease‐free survival were 121.45 months and 93.03 months, respectively. The mean follow‐up interval was 41.0 months, and at the time of data analysis three patients had recurrent tumors. Seven (36.8%) patients experienced a major complication in the perioperative period; there were no perioperative mortalities. Orbit invasion was observed in four patients, with optic nerve impingement in 11 patients. Of these, three patients had long‐term diplopia. No patients experienced worsening of preoperative visual acuity. Conclusions: Olfactory groove meningiomas demonstrate a propensity to spread into the paranasal sinuses, particularly in recurrent cases. Given a tendency for infiltrative recurrence along the skull base, this disease represents an important area of collaboration between neurosurgery and otolaryngology. The subcranial approach offers excellent surgical access for excision, particularly for recurrences that involve the paranasal sinuses and optic apparatus.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87044/1/22174_ftp.pd

Hippocampal formation volume, memory dysfunction, and cortisol levels in patients with Cushing's syndrome

Patients with chronic hypercortisolemia due to Cushing's syndrome (CS) exhibit cognitive dysfunction. Because glucocorticoid excess is associated with hippocampal damage in animals, and the hippocampus participates in learning and memory, we explored the relationships between hippocampal formation (HF) volume, memory dysfunction, and cortisol levels in 12 patients with CS. After magnetic resonance imaging, HF volume was determined using digital sum of track ball traces of dentate gyrus, hippocampus proper and subiculum, correcting for total intracranial volume. For 27% of the patients, HF volume fell outside the 95% confidence intervals for normal subject volume given in the literature. In addition, there were significant and specific correlations between HF volume and scores for verbal paired associate learning, verbal recall, and verbal recall Corrected for fullscale IQ (r = 0.57 to 0.70, p &lt; 0.05). HF volume was negatively correlated with plasma cortisol levels (r = -0.73, p &lt; 0.05). These studies suggest an association between reduced HF volume, memory dysfunction, and elevated cortisol in patients with CS.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29769/1/0000107.pd

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No Abstract.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/50314/1/410190427_ftp.pd

Identification of brain lesions in neuropsychiatric systemic lupus erythematosus by magnetic resonance scanning

Cranial magnetic resonance imaging in 28 systemic lupus erythematosus patients who had experienced 30 acute neuropsychiatric events showed focal brain lesions in 16 of 30 events (53%) and low brain volume (atrophy) in 20 of 30 events (67%). Definite focal lesions were significantly more frequent in patients with clinically localized neurologic deficits (8 of 8, 100%), or seizures (5 of 6, 83%) than in patients without such localizing signs (3 of 16, 19%). Many of these lesions were occult on intravenous contrast-enhanced x-ray computed tomography. In 2 patients, lesions in gray matter resolved within 2 or 3 weeks, in association with clinical improvement. Magnetic resonance imaging is an important technique for detecting the extent of brain injury in cerebral lupus.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/37779/1/1780310202_ftp.pd

RESPONSE OF MOYAMOYA DISEASE TO VERAPAMIL

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/25780/1/0000341.pd

Massive symptomatic subependymoma of the lateral ventricles: case report and review of the literature

Subependymomas are benign intraventricular tumors with an indolent growth pattern, which are usually asymptomatic, and most commonly occur in the fourth and lateral ventricles. When symptomatic, subependymomas often obstruct critical portions of the cerebrospinal fluid (CSF) pathway, causing hydrocephalus, and range from 3 cm to 5 cm in size. We report a case of an unusually massive subependymoma of the lateral ventricles treated with subtotal resection, ventriculoperitoneal shunt, and post-surgical radiation. The clinical course, radiographic and pathologic characteristics of this massive intraventricular subependymoma are discussed, as well as the differential diagnosis of lateral ventricular masses and a review of the literature concerning subependymomas.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46667/1/234_2005_Article_1342.pd

Intra-arterial 5-bromo-2-deoxyuridine (BUR) radiosensitization with external beam radiation in rhesus monkeys: A toxicity study

A primate toxicity study was performed to test the hypothesis that BUdR does not increase the likelihood of unilateral or bilateral central nervous system damage secondary to radiation therapy.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45393/1/11060_2004_Article_BF00177431.pd