bromochloroacetic-acid and Headache

Epidermoids occurring within the lateral ventricles are rare. At one time, they were regarded as anatomical curiosities. The lesions are of developmental aetiology, due to migration of epiblast inclusion at the time of formation of the cerebral vesicle. They are slow growing, and presentation is non-specific in the form of deteriorating mental functions. Generally seen in the fifth decade, but they have also been observed in the paediatric age group. MRI is suggestive of a cystic lesion, and is confirmed to be a typical epidermoid within the lateral ventricle at operation, often having a connection to the midline through the choroidal fissure. The cysts should be excised with no additional morbidity. Histopathology reveals typical stratified squamous epithelium.

Topics: Brain Neoplasms; Cerebrospinal Fluid Pressure; Cerebrospinal Fluid Shunts; Cholesterol; Cognition Disorders; Disease Progression; Epidermal Cyst; Epithelial Cells; Headache; Humans; Keratins; Lateral Ventricles; Magnetic Resonance Imaging; Male; Middle Aged; Neurosurgical Procedures; Telencephalon; Treatment Outcome

The authors describe an unusual case of an intradural cerebellar chordoma, the first such case to be reported in a child. A 9-year-old girl presented with headaches and papilloedema, and a discrete cerebellar mass was resected, which was shown histologically to be chordoma. There was no bony or dural association, and after radiologically proven complete resection it was elected that the child be followed expectantly.. The case is compared with the few previously reported intradural chordomas, and insights into the origins and management of such cases are discussed.

Topics: Cerebellar Neoplasms; Child; Chordoma; Female; Headache; Humans; Keratins; Magnetic Resonance Imaging; S100 Proteins; Subarachnoid Space

The pathogenesis of endodermal cysts of the posterior fossa is still incompletely understood. The authors reviewed three new cases and those reported in the literature to clarify the clinical, pathological, radiological, and surgical characteristics of these lesions. A total of 49 cases were reviewed. Details on demographic profiles, clinical characteristics, histopathological and radiological features, and surgical methods were collected. These cysts have a predominance in male patients (61%) and can occur at any age (birth-77 years). In patients with posterior fossa endodermal cysts there is a bimodal age distribution and headache is the most frequent complaint. On immunohistopathological examination, endodermal cysts were reactive for epithelial membrane antigen and for keratin immunostains whenever the latter were tested. The cysts were reactive for carcinoembryonic antigen in nine of 11 cases. Endodermal cysts were located anterior to the brainstem in 51% of cases and in the fourth ventricle in 21% of cases. They frequently appeared hypodense on computerized tomography scans, and in five cases, the lesion was missed. The cyst's appearance on magnetic resonance imaging is variable. Resection was complete in 19 cases and partial in 11; marsupialization was achieved in two cases. Three recurrences have been reported. Total excision with preservation of neurological function should be the goal. Cranial base approaches are helpful for surgical access in selected examples of these lesions.

Topics: Adult; Brain Diseases; Brain Stem; Carcinoembryonic Antigen; Cerebral Ventricles; Cranial Fossa, Posterior; Craniotomy; Cysts; Female; Headache; Humans; Immunohistochemistry; Keratins; Magnetic Resonance Imaging; Male; Mucin-1; Recurrence; Skull Base; Tomography, X-Ray Computed