Isolated brain metastasis from malignant melanoma of choroid seven years following enucleation

Abstract

of left vertebral artery and reduced caliber of both the posterior cerebral arteries [ Figure 2]. Biochemistry was normal and procoagulant workup and also the workup for young stroke were negative. 2D echo was normal. Patient was put on antiplatelets and at three months follow-up his modified Rankin scale score was 2D echo.Cocaine, cannabis, amphetamines and marijuana are the common recreational drugs associated with ischemic and hemorrhagic strokes. The side-effects of acute cannabis intoxication include: (1) psychiatric -behavioral abnormalities and increased risk of schizophrenia; [1] (2) cardiovascular -tachycardia, supine hypertension, postural hypotension, myocardial infarction, paroxysmal atrial fibrillation and sudden death; [2] (3) cerebral -hemorrhagic and recurrent ischemic strokes. The mechanisms postulated in cannabis-related strokes are vasospasm, vasculopathy, postural hypotension with abnormal regulation of the cerebral blood flow and paroxysmal atrial fibrillation. [3] A predilection for infarcts in the posterior circulation as seen in our patient has been attributed to a poor autoregulatory mechanism in this vascular bed as compared to the anterior circulation. [4] Toxicological screening for cannabinoid metabolites should be done in young patients with strokes with no apparent vascular risk factors or evidence of dissection. This holds good even in our country with increasing drug abuse among the youth. 3. Cooles P, Michaud R. Stroke after heavy cannabis smoking. Postgrad Med J 1987;63:511. 4. Mateo I, Pinedo A, Gomez-Beldarrain M, Basterretxea JM, Garcia-Monco JC. Recurrent stroke associated with cannabis use.

Pilocytic Midbrain Astrocytoma Presenting with Fresh Bleed after Twenty-one-years Survival Following First Surgery: A Unique Case of Longest Brainstem Glioma Survival

“…[121718] However, it remains a speculation, if it was bleeding due to malignant transformation which can occur de novo by conversion into higher grade with neoangiogenesis leading to tumor bleed. [161920] However, a biopsy would have clearly demonstrated the exact nature of cause and histopathological diagnosis. However, more evidence lies in favor of radiation-induced arteriopathy following gamma knife therapy as there is a uniform restriction of diffusion in diffusion-weighted MRI study images.…”

Brain metastasis from ocular malignant melanoma: a case report of a brain secondary lesion occurring 5 years after the primary lesion treatment

“…Most often they are located in the liver, less often in lungs. Brain metastases from ocular malignant melanoma are very rare and usually observed with parallel occurrences of the liver [2]. In this paper we present a case of brain metastasis from choroidal melanoma, which occurred 5 years after the primary lesion treatment.…”