The effect of human recombinant interleukin-1β (hrIL-1β) on tumor growth was studied in eight glioma cell lines. hrIL-1β inhibited growth in all cell lines, but to varying extents. Two cell lines were suppressed by 0.5 ng⁄ml hrIL-1β, and three cell lines required 20 ng⁄ml. hrIL-1β also induced morphological changes and increased F-actin contents. hrIL-1β-treated cells demonstrated multipolar shapes and numerous processes with a greater number of cell-cell contacts 24 hours after treatment. Fluorescence microscopy revealed that these processes contained a large amount of polymerized F-actin. These results suggest that hrIL-1β-mediated growth inhibition may be related to the differentiation of glioma cells.
To investigate the relationship between focal and diffuse traumatic brain injury (TBI) and regional cerebral blood flow (rCBF), rCBF changes in the first 24 hours post-trauma were studied in 12 severe head trauma patients using single photon emission computed tomography (SPECT) with 99mtechnetium-hexamethyl propyleneamine oxime. Patients were classified as focal or diffuse TBI based on x-ray computed tomographic (X-CT) findings and neurological signs. In six patients with focal damage, SPECT demonstrated 1) perfusion defect (focal severe ischemia) in the brain region larger than the brain contusion by X-CT, 2) hypoperfusion (focal CBF reduction) in the brain region without abnormality by X-CT, and 3) localized hyperperfusion (focal CBF increase) in the surgically decompressed brain after decompressive craniectomy. Focal damage may be associated with a heterogeneous CBF change by causing various focal CBF derangements. In six patients with diffuse damage, SPECT revealed hypoperfusion in only one patient. Diffuse damage may be associated with a homogeneous CBF change by rarely causing focal CBF derangements. The type of TBI, focal or diffuse, determines the type of CBF change, heterogeneous or homogeneous, in the acute severe head trauma patient.
Sixty patients with acute subdural hematoma were treated at Tokyo Metropolitan Hiroo Hospital between 1981 and 1989. The overall mortality was 55% and the functional recovery rate 30%. Thirteen (93%) of 14 patients with a Glasgow Coma Scale (GCS) score of 3 died, while all eight patients with a GCS score of 7 or more achieved functional recovery. The mortality of patients with GCS scores of 4-6 ranged from 45 to 67%. Patients with GCS scores of 4-6 over 65 years old had a mortality of 82%, compared to 50% mortality for those aged 19-40 years. The mortality for patients with GCS scores of 4-6 operated on within 4 hours of injury was 62% in contrast to 33% for those operated on from 4 to 10 hours. Patients with GCS scores of 4-6 who underwent craniotomy with evacuation of the hematoma achieved significantly better recovery than those treated by burr holes. Four patients with GCS scores of 4-6 died in spite of decompressive craniectomy or craniotomy with duroplasty. The mortality is only influenced by age and type of surgical intervention among patients with GCS scores of 4-6. Shorter time from injury to surgical evacuation does not affect mortality within 10 hours of injury.
Two patients with complete absence of light perception due to optic nerve compression were treated by decompressive procedures. Visual function progressively improved to the level of useful vision. A 42-year-old female with a partially thrombosed aneurysm in the right A1 of the anterior cerebral artery presented with right visual loss without light perception. The aneurysm was trapped and the intraluminal organized blood clot removed without dissecting the dome from the optic nerve. Her vision recovered to 20⁄20 1 week later. A 29-year-old male with a partially thrombosed saccular aneurysm of the anterior communicating artery presented with left monocular blindness. The aneurysm was clipped and the intraluminal clot removed without dissecting the aneurysmal wall from the optic nerve. His visual acuity gradually recovered to 10⁄20 12 days later. Visual recovery after decompressive procedures following prolonged absence of light perception due to optic nerve compression by aneurysms is rare. The pathophysiological mechanism of prompt visual recovery is unknown, but surgical treatment should be considered for any such patients.
Multiple cerebral arteriovenous malformations occurred in a 48-year-old male complaining of headache, after orthopedic treatment for a leg fracture. He was free from neurological deficits and signs of hereditary hemorrhagic telangiectasia. Postcontrast computed tomography showed two abnormally enhanced lesions in the right occipital and left parietal regions. Magnetic resonance imaging showed these lesions as tiny vascular flow void signs, with neither new nor old hemorrhages. Angiography showed these lesions to be arteriovenous malformations. He declined treatment, and was followed as an outpatient.
A 24-year-old male presented with a metastatic germinoma in the thoracic vertebra 7 years after irradiation of a pineal germinoma. Combination chemotherapy with cisplatin and etoposide was highly effective. No recurrence has appeared in the 2 years since chemotherapy.
A very rare primary choroid plexus carcinoma occurred in a 44-year-old male presenting with occipitalgia, nausea, and blurred vision. The tumor had progressed from a choroid plexus papilloma in the fourth ventricle which was totally removed 6 years previously. Lectin histochemistry might be useful for the differential diagnosis of primary choroid plexus neoplasms and other brain tumors such as secondary carcinoma.
A 67-year-old male presented with a left temporal convexity vacuolated meningioma associated with acute subdural hematoma manifesting as sudden headache, nausea, and vomiting without neurological deficit. Magnetic resonance imaging disclosed an extra-axial mass as mixed low and high-signal intensities and a crescent high-intensity area in the left convexity. Histological examination diagnosed meningotheliomatous meningioma with vacuolated components and hemorrhagic foci. The tumor and hematoma were removed without postoperative complications.
An 11-month-old boy presented with a huge subdural empyema in the left hemisphere associated with a subsequent contralateral chronic subdural hematoma. Burr-hole drainage and antibiotic therapy achieved a successful outcome. Subdural empyema may result from hematogenous seeding of infection into a pre-existing chronic subdural hematoma.
We describe a technique using a cryoprobe as a retractor in the removal of intracranial vascular tumors. This simple method is safe and effective especially for the extraction of tumor embedded in the brain tissue.