Spheno-orbital meningiomas are difficult tumours to manage. Surgical resection can reduce the degree of proptosis and stabilise visual function in patients with failing vision, although sustained improvement is difficult to achieve if the tumour behaves in an aggressive manner. The risk of post-operative visual loss is considerable, either due to surgery or tumour progression. Outcomes from surgical decompression may not necessarily be better than the natural history of these tumours.
The histology, confirmation of radioactivity of the material obtained from within the tumor, and latency period of presentation provide compelling support for tumor induction by the Thorotrast. Primary lesions of the central nervous system associated with Thorotrast are very rarely reported, despite its extensive use in cerebral angiography and management of brain abscess between 1930 and 1960.
This study shows that the cardiac effects of isolated diffuse cerebral injury may be harmful and even fatal despite correction of secondary factors such as anoxia and raised intracranial pressure. The findings suggest that evaluation of the potential benefits of sympathetic blockade is warranted. Cardiac complications of cerebral damage deserve wider recognition by intensive care personnel, neurologists, and neurosurgeons.
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