A case of meningioma is reported. At the age of 18 years, the patient had undergone insertion of a Torkildsen shunt through a posteroparietal burr hole for obstructive hydrocephalus secondary to a tumor of the pineal region, of which no biopsy had been made. After the hydrocephalus was relieved, he underwent irradiation of the tumor. Thirty years later, he was treated for an intracranial meningioma wrapped around the shunt. The tumor followed the shunt in all of its intracranial course. Microscopy disclosed pieces of the shunt tube within the meningioma. The role of a foreign body and irradiation in the induction of meningiomas is discussed, and a comprehensive review of the literature is presented. (Neurosurgery 29:113-119, 1991)
There is a limited understanding of the pathogenesis of dolichoectatic (dolicho = long; ectatic = dilated) aneurysms of elastic arteries. Therefore, we developed a model of dolichoectatic changes in elastic arteries by injecting porcine elastase into the media of the carotid artery of male New Zealand white rabbits. After 3 months, gross examination of the carotid arteries in vivo revealed dilated and tortuous vessels. The carotid arteries were then harvested, and cross-sections of the vessels were stained by the Verhoff-van Giesson stain. Histologically, the internal elastic lamina was dissolved in the most dilated areas. The elastic lamellae of the media were also digested and there was reorientation of the innermost medial smooth muscle layer. These gross and histologic changes were present in 80% of the treated carotid arteries and in none of the contralateral control vessels. Our study suggests the importance of the elastic lamellae for the maintenance of tubular shape and length of the carotid artery and describes a new chronic animal model of dolichoectatic aneurysm of the common carotid artery.
Two cases of carcinoid tumour affecting the central nervous system through their metastases were treated surgically. The first case was carcinoid tumour of the lung with a single metastases in the right frontal lobe of the brain, while the second developed metastases of the sixth thoracic vertebra from a terminal ileum bowel primary causing spinal cord compression. Neither case developed carcinoid syndrome. The rarity of such metastases affecting the central nervous system is discussed together with a review of the literature.
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