The authors describe two cases of hepatocellular carcinoma presenting with the initial manifestations of an intracranial mass lesion without any symptoms or signs suggestive of the primary hepatic site of the tumor. The only clue of hepatic dysfunction was mild elevation of the SGOT and SGPT. The diagnosis could not ...

A rare case of intracranial multiple tumor, which disappeared spontaneously on serial cranial computed tomography (CT) scans, is described. The initial CT scan showed multiple, well-enhanced lesions in the right frontal and parietal lobes. The lesions disappeared spontaneously without any treatment during the 2 following months of observation. One month ...

The antenatal diagnosis of fetal neurologic injury has profound medical and legal implications. We report a case of antenatally diagnosed intracranial lesions including parenchymal hemorrhage in an otherwise physically normal infant. Computerized tomography in the newborn period demonstrated diffused ischemic damage with secondary cystic changes in addition to intracranial hemorrhage.

Review of 70 children presenting with a solitary nontraumatic lump on the head revealed that 61% of the lesions were dermoid tumor, 9% were cephalhematoma deformans, 7% were eosinophilic granuloma, and 4% were occult meningoceles and encephaloceles. Most of the dermoid cysts occurred along sutural lines, but some did not. ...

Intracranial vascular anomalies uncommonly present as a nasal mass. We report the first documented intranasal extension of a venous angioma of the anterior and middle cranial fossas. The diagnostic evaluation and differential diagnosis of an intranasal vascular mass is emphasized. In addition, recommendations are offered regarding the surgical approach of ...

Ependymomas are common types of tumors occurring within the brain and usually derive from the ependymal lining, especially of the ventricles. Ependymomas also occur, usually within the spinal canal, as primary intramedullary lesions or as late "drop" metastases from intracranial ependymomas. Extradural ependymomas are rare. They could occur as intraspinal ...

Two cases of olfactory neuroblastoma which presented clinically as intracranial lesions are described. Prominent features of epithelial differentiation were present, which led to initial diagnoses of poorly differentiated carcinoma. The true nature of the lesions was only established subsequently by careful histological examination, immunohistochemistry and electron microscopy. The potential towards ...

A 32-year-old man had generalized tonic-clonic epileptic seizures associated with episodes of recurrent high fever for 6 years. Repeated physical examinations including neurological status, EEG and nuclear brain scan were negative. Brain CT showed a non-homogeneous parasellar cyst of low density and fat-fluid levels in the lateral ventricles. The diagnosis ...

The sonographic appearance of normal neonatal cerebral sulci may mimic that of significant intracranial pathology. An echogenic pseudolesion can be seen when a sulcus is imaged through its long axis. Criteria are discussed for the differentiation of this normal variant from true parenchymal lesions with their attendant serious clinical implications.

Intraventricular oligodendrogliomas are a rare subset of oligodendrogliomas. Analysis of the clinical and CT characteristics of 11 cases in the literature and eight new examples revealed specific radiographic features, which included the presence of an anterior, midline mass within the lateral ventricles composed of clumped calcifications within a dense, enhancing ...

Three patients developed anisocoria as a result of third nerve palsies caused by intracranial lesions: two in the cavernous sinus and one in the mesencephalon. Pharmacologic testing using low concentration pilocarpine showed apparent preganglionic parasympathetic supersensitivity of the abnormal pupil. These findings are compatible with the existence of a proposed ...

An exceptional case of a large intracranial extradural lymphoma arising from the skull and causing intracranial hypertension syndrome, in the absence of other localizations elsewhere in the body is described. Only another similar observation was reported in the literature. The diagnosis of this exceptional localization of lymphomas, which can mimic ...

Neurocysticercosis has become more prominent in the United States in recent years because of an increase in immigration from endemic regions and because of improved ease of diagnosis with computed tomography (CT). Neurocysticercosis should be suspected in any patient from a high-risk region who has symptoms or signs of a ...

We have described a 63-year-old man, taking diethylstilbestrol for adenocarcinoma of the prostate, who had papilledema. Lumbar puncture revealed intracranial hypertension without pleiocytosis. CT scan was normal, consistent with the diagnosis of pseudotumor cerebri. At craniotomy for placement of a ventriculoperitoneal shunt, the dura was found to be infiltrated with ...

A 9-year-old boy with mild left hemiparesis and left abducens nerve palsy was found to have chordoma of the clivus. Magnetic resonance imaging (MRI) was most useful not only for diagnosis but also for selection of operative approaches. The tumor was subtotally resected by a transoral-transpharyngeal approach followed by a ...

Intracranial dermoid cysts occasionally rupture spontaneously into the ventricles or into the subarachnoid space. In such cases, intraventricular fat-fluid levels are invariably evident at computed tomography and may even be visible on a conventional radiograph of the skull. A case is described in which fat was observed to remain in ...

A case of cerebellar haemangioblastoma in described in a middle-aged woman with a history of multiple psychiatric admissions for depressive and psychosomatic symptomatology. The diagnosis was not made until a late stage, largely because of the knowledge of her psychiatric history and its particular slant. Similar psychiatric symptoms were present ...

Although meningitis is the most common form of central nervous system (CNS) blastomycosis, solitary mass lesions are not an infrequent presentation. Four of our patients presented with focal neurological deficits as a result of single intracranial mass lesions. Only 1 had clearcut evidence of extraneural blastomycosis. One was a coal ...

Experience with fifteen consecutive cases of intracranial tuberculomas, treated between 1981 and 1986, is summarized. Histological confirmation was obtained in twelve patients, and acid fast bacilli (AFB) were found in and cultured from the excised lesions and biopsy specimens in nine patients. Difficulties in diagnosis are discussed. A plan of ...

The use of a computer program that allows the integration of stereotactically gathered CT, MRI and digital angiographic data in the planning of a biopsy trajectory is described. This system has been used to perform 447 stereotactic biopsies in 439 patients. Intracranial hemorrhages occurred in three patients; combined morbidity and ...

Manifestations of cysticercosis in 11 children (mean age 9.5 years) are presented. Features of raised intracranial pressure dominated the clinical picture (10 cases), followed by seizures (7 cases). Subretinal cysts occurred in three children. Focal signs were infrequent and often not attributable to anatomical lesions. Electro-encephalograms were invariably abnormal, but ...

Since the introduction of computer tomography (CT) (Ambrose 1973, Hounsfield 1973) it has become an essential instrument in the diagnosis of acute intracranial lesions. The precise analysis of the CT and in particular the evaluation of the basal cisterns, yields results which are already wellknown, basically, from post-mortem investigations and ...

Although CT scanning has considerably improved diagnostic accuracy, problems remain in establishing a precise preoperative diagnosis in cases of intracranial lesions especially when a cyst is present. Five cases of cystic lesions are presented to illustrate these problems. The CT features of cystic lesions as well as the pathophysiological processes ...

Cerebral cysticercosis is a parasitic infestation with a highly variable prognosis and diverse clinical manifestations. Over the period of two years 51 patients were studied prospectively with this infestation, paying particular attention to the duration and severity of the illness, clinical course, CT findings and therapeutic modalities. Patients with parenchymal ...

Retinoblastoma is the most common primary malignant intraocular tumor in children. The clinical features are leucocoria and/or strabismus. The ophthalmic diagnosis is straight forward in clear eye media with a white gray mass in the fundus. With opaque ocular media, other diagnostic procedures such as CT and ultrasonography are important. ...

Intracerebral haemorrhage is rare in childhood. We have reviewed the last 10 years' experience, in our referral area, of parenchymatous intracerebral haemorrhage in children from 1 month to 16 years of age. There were 27 cases, five of which were intracerebellar and two predominantly intraventricular. The commonest aetiology was vascular ...

A 12-year-old Japanese girl with a primary intracranial choriocarcinoma arising from the pituitary fossa is reported. There was a markedly high level of serum human chorionic gonadotropin (HCG) throughout the clinical course. Postmortem examination revealed metastatic lesions found in the cerebellum, dura mater, skull (clivus, sphenoidal bone), and lungs. Immunohistochemical ...

A patient with multiple myeloma developed neurological symptoms consistent with an expanding intracranial lesion. The CT scan showed evidence of a posterior fossa mass. This was pathologically confirmed to be a plasmacytoma. There was no CT or pathological evidence of bone involvement. When the neurological symptoms developed, there was no ...

Thirteen cases of deep-seated intracranial lesions that were biopsied by the technique of CT (computed tomography) stereotactic guidance are presented. In 11 cases a diagnosis of brain neoplasm was made. One case of a cystic thalamic astrocytoma was treated by stereotactic insertion of a cannula attached to an s.c. reservoir. ...

A unique combination of occurrence of the 3rd ventricular germinoma and hypothalamic cystic mixed astrocytoma and oligodendroglioma is encountered in a 15-year-old man who presented clinically with stunted growth of the body, diabetes insipidus, and stupor. The germinoma was diagnosed by biopsy but the hypothalamic glioma was discovered at autopsy. ...

Ultrasonography in the diagnosis of fetal abnormalities is well documented, and improvements in technology have made possible detailed visualization of the intracranial anatomy. Ten per cent of major fetal abnormalities involve the head and neck. A case of simulation of a posterior fossa cyst by normal, hypoechoic white matter on ...

A study was carried out on parasitic intracranial space-occupying lesions in children in south India. Such lesions constitute a fraction of 1% of intracranial space-occupying lesions in India. This paper discusses three cases of cerebral and two cases of intradiploic cranial hydatid cysts, as well as six cases of cysticercosis, ...

Intracerebral abscess is a diagnosis which occasionally can be difficult to establish by using CT scan only. This survey describes the usefulness of a supplementary indium-111 autologous granulocyte scan which may increase the diagnostic specificity in the differential diagnosis between neoplasm and intracranial abscess. Judging from the literature and our ...

This paper reviews the clinical findings, pituitary gonadotrophin reserve and plasma oestradiol, neurological findings and pelvic ultrasound appearance in 47 girls with precocious puberty starting before the age of 7 years. Of the 39 girls who had air encephalograms or cranial CT scans, 19 showed intracranial abnormalities (hamartomas 11; hydrocephalus ...

The case of a four-year-old boy is reported in whom the diagnosis of multiple cerebral and cerebellar focal tuberculous infections ("tuberculomas") was made. The diagnosis was based on a positive skin test, a history of contact, typical x-ray findings in the lung, CSF findings, and CT scan. The patient was ...

The efficacy of intraoperative neurosurgical ultrasound (US) scanning was determined in studies of 191 lesions (186 patients). US was deemed to have played a useful role in operations on 101 (53%) of these lesions, including 66 (49%) of the 136 brain tumors. The main utility of US imaging was in ...

A patient, aged 47 is described in whom changes in hormonal profiles were observed following surgical excision of the pineal. She presented with a clinical syndrome of increased intracranial pressure and postmenopausal symptoms. Computerized tomographic scans showed obstructive hydrocephalus from a cystic lesion in the pineal region. Surgical removal of ...

The authors report a patient with acute lymphocytic leukemia in hematological remission who presented with both intracranial and otological manifestations of the disease. The patient presented with clinical symptoms and computed tomographic findings consistent with otomastoiditis and a contiguous brain abscess. However, both lesions were identified at operation as leukemic ...

Three cases of intracranial perineural metastasis from adenoid cystic carcinoma of the head and neck are presented. The metastases presented more than 1 year (14 months to 5.5 years) after the primary tumor had been successfully treated without any evidence of local recurrence. Computed tomography of the intracranial metastasis demonstrated ...

A case of cerebral gumma is reported. The appearance of this kind of lesion is exceptional at the present time. Gummas are the expression of localized meningovascular forms of neurosyphilis and their clinical symptoms and signs are similar to those of any other space-occupying intracranial lesion. Computed tomography scan showed ...

High resolution ultrasound has been used intraoperatively on forty-five patients with various intracranial lesions. The technique is quickly and easily carried out under sterile conditions in the operating room. Successful localization of both primary and metastatic tumors of various sizes, depths and consistencies have been made prior to extirpation or ...

A cavernous angioma of the tentorium cerebelli, first disclosed by perinatal serial ultrasonographic studies, was extirpated totally without remarkable neurological deficit in a neonate. The tumor was accompanied by a calcified expansive hematoma in the posterior fossa. To our knowledge, this is the first case not only of cavernous angioma ...

A case of locally invasive cutaneous cylindroma is reported. This neglected scalp tumor, 6.5 cm in greatest dimension, initially invaded the calvaria at the time of the first operation. A recurrence infiltrated the dura and presented as an intracranial space-occupying lesion. No brain invasion was present and distant metastases were ...

Intracranial metastasis of Wilms' tumor is very rare. Furthermore, intracerebral hemorrhage is an unusual presentation of metastases. We report the case of a 4-year-old girl who had multiple intracranial metastatic lesions, initially presenting as an intracranial hemorrhage. Removal of the tumors and hematoma was followed by radiation therapy and chemotherapy. ...

The ultrasonic detection of periventricular leukomalacia is described in two neonatal patients. Confirmation of this condition by CT and post mortem was obtained in one case. CT scan and further echography was positive in the other. Neither patient had evidence of an intracranial hemorrhage. It is suggested that echography is ...

Neoplasms of the third ventricle are lesions arising within the ventricular cavity, often free but more often pedunculated. True third ventricle tumours are surgically removable. In a consecutive surgical series of 580 intracranial tumours the authors operated on 27 lesions of the third ventricle, 7 of which were benign gliomas. ...

Positional nystagmus may be persistent or transitory. Of the persistent forms, type I refers to nystagmus changing direction in different head positions and type II to nystagmus beating in a single direction. Both types may denote either peripheral or central abnormality. Transitory, or paroxysmal, positional nystagmus is classified as type ...

Intraoperative neurosonography was performed in 44 patients with contact transdural or transgyral scanning technique. Localization of intracranial pathology included primary brain tumors (24), metastatic tumors (11), aneurysms (two), abscesses (two), arteriovenous malformation (one), thrombosed arteriovenous malformations (two), and plasmacytoma (one). Sonographic guidance was used in transdural decompression of three cystic ...

The Cavitron ultrasonic surgical aspirator causes localised ultrasonic tissue fragmentation and has recently been used to remove intracranial tumours. We have examined tissue fragments from 17 operations in which the apparatus was used: in all cases a definitive diagnosis could be made from the material aspirated. This finding has not ...

We describe a patient with a history of cerebral cysticercosis who presented with signs and symptoms of increased intracranial pressure; CT showed what seemed to be a subdural hematoma. At operation, the "hematoma" proved to be a subdural collection of multiple cysticercal cysts. This is the first report of this ...