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Zhonghua Er Bi Yan Hou Ke Za Zhi Dec 1998To further explore the cause, mechanism and surgical treatment of idiopathic hemifacial spasm (IHFS).
OBJECTIVE
To further explore the cause, mechanism and surgical treatment of idiopathic hemifacial spasm (IHFS).
METHODS
Routine sagittal and coronal cryoslices of 8 (16 sides) pons were made. The sections were stained with Luxol fast blue and Nissl stains. The location of the facial nucleus and pathway of facial neurofibers in the pons were observed. Twenty-five patients with IHFS whose facial nerve root exit zone(REZ) was not compressed by vessels underwent microvascular decompression of pons.
RESULTS
The distances from the facial nucleus to the ventral surface of pons, the median line, and the ventroexterior surface were 12.0-12.5 mm, 6.0 mm, and 7.5-9.0 mm respectively. The distance from the facial neurofibers in the pons to the surface of the pons was 1.0 to 2.0 mm, with an average of 1.65 mm. The vascular compression was at the surface of pons, within 4 mm anterosuperior to the REZ in 25 IHFS patients. The compressing vessels were the anterior inferior cerebellar arteries and their branches. The results of decompression in 25 patients with IHFS were as follows: spasm immediately disappeared in 8 patients, and within one week in 17 patients. No recurrence was found during a follow-up period from 6 months to 5 years.
CONCLUSION
The main cause of IHFS was vascular compression, but the position of compression is not necessarily always at the REZ. The "short-circuiting" theory can only explain the cases with vascular compression at the REZ. But in cases who do not have vascular compression at the REZ, there might be dysfunction of the facial nucleus. In the present cases, vascular compression was at the surface of the brain stem anterosuperior to the REZ, pons microvascular decompression is an effective treatment.
Topics: Adult; Aged; Decompression, Surgical; Facial Nerve; Female; Follow-Up Studies; Hemifacial Spasm; Humans; Male; Microcirculation; Microsurgery; Middle Aged; Pons
PubMed: 11938845
DOI: No ID Found -
Neurology India 2022CLIPPERS is a rare subacute inflammatory disorder of the CNS, with a poorly understood pathogenesis and with heterogeneous clinical manifestations. Reports of... (Review)
Review
Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids (CLIPPERS) With Extrapontine and Pulmonary Involvement: Case Report of a Rare Presentation and Review of Literature.
CLIPPERS is a rare subacute inflammatory disorder of the CNS, with a poorly understood pathogenesis and with heterogeneous clinical manifestations. Reports of extra-pontine involvement in this syndrome are rare, and as far as we know there are only two cases reported with simultaneous involvement of the CNS and pulmonary parenchyma. We report the case of a young patient with a subacute condition of cognitive dysfunction, as well as motor, sensory and balance changes. Imaging showed pontine and extrapontine brain involvement in association with multiple pulmonary nodules, characterizing a very unusual presentation of this syndrome. It is important for radiologists to be aware of that rare presentation in order to make a prompt diagnosis of this condition, enabling early treatment and avoiding permanent neurological sequelae.
Topics: Brain; Humans; Inflammation; Magnetic Resonance Imaging; Pons; Steroids
PubMed: 35263929
DOI: 10.4103/0028-3886.338665 -
Journal of Child Neurology Feb 1998The distribution and development of transferrin-positive cells in the pons and cerebellum of human fetuses to adults were examined immunohistochemically, compared with... (Comparative Study)
Comparative Study
The distribution and development of transferrin-positive cells in the pons and cerebellum of human fetuses to adults were examined immunohistochemically, compared with those of ferritin-positive cells. Transferrin was present in oligodendrocytes, astrocytes, and neurons. Transferrin-positive neurons appeared at 18 weeks of gestation in Purkinje cells and the pontine reticular formation. In the pontine nuclei, transferrin-positive neurons appeared at 22 weeks of gestation. On the other hand, transferrin-positive glia also appeared at 18 weeks of gestation in the reticular formation, and at 24 weeks of gestation in the cerebellar white matter and pontine nuclei. Transferrin-positive glia and cells appeared earlier in the reticular formation of the pons than ferritin, but the order of its appearance was similar to that of ferritin and myelination. Because iron is involved in the syntheses and functions of dopamine, serotonin, and gamma-aminobutyric acid (GABA), transferrin may be carried for various iron uses from an early fetal stage.
Topics: Adult; Cerebellum; Child; Child, Preschool; Embryonic and Fetal Development; Ferritins; Humans; Immunohistochemistry; Infant; Middle Aged; Pons; Transferrin
PubMed: 9512304
DOI: 10.1177/088307389801300203 -
Operative Neurosurgery (Hagerstown, Md.) Feb 2021Brainstem cavernous malformations with symptomatic hemorrhage have a poor natural history. Those without a pial or ependymal presentation are often observed given the...
BACKGROUND
Brainstem cavernous malformations with symptomatic hemorrhage have a poor natural history. Those without a pial or ependymal presentation are often observed given the morbidity of resection. Surgical removal is considered only in patients with accessible lesions that have repeated symptomatic hemorrhagic.
OBJECTIVE
To describe a novel supracerebellar infratentorial infratrochlear trans-quadrangular lobule approach to safely resect lesions in the upper pons.
METHODS
We use a hybrid paramedian/lateral suboccipital craniotomy in the gravity-dependent supine position. Opening the cerebellomesencephalic fissure over the tentorial surface of the cerebellum brings the trochlear nerve, branches of the superior cerebellar artery, and the quadrangular lobule of the cerebellum into view. Removal of small a portion of the quadrangular lobule defines an entry point on the superomedial aspect of the middle cerebellar peduncle, and a surgical trajectory aimed superior to inferior.
RESULTS
A total of 6 patients underwent this approach. All presented with symptomatic hemorrhage and all cavernous malformations were completely resected. Five patients were improved or unchanged with modified Rankin scale scores of 1 or 2.
CONCLUSION
The trans-quadrangular lobule approach allows safe resection of upper pontine cavernous malformations along a superior to inferior trajectory.
Topics: Cerebellum; Craniotomy; Dura Mater; Humans; Pons
PubMed: 33432968
DOI: 10.1093/ons/opaa373 -
BMJ Case Reports Sep 2022
Topics: Antineoplastic Combined Chemotherapy Protocols; Humans; Lymphoma, Large B-Cell, Diffuse; Pons
PubMed: 36137641
DOI: 10.1136/bcr-2022-250945 -
Science (New York, N.Y.) Nov 1958
Topics: Body Fluids; Cell Respiration; Humans; Pons; Respiration
PubMed: 13592305
DOI: 10.1126/science.128.3333.1206 -
Child's Nervous System : ChNS :... Jun 2015Rosai-Dorfman Disease (RDD) is a benign histiocytic disorder that commonly presents with massive lymphadenopathy. Central nervous system (CNS) involvement is only 5%;...
INTRODUCTION
Rosai-Dorfman Disease (RDD) is a benign histiocytic disorder that commonly presents with massive lymphadenopathy. Central nervous system (CNS) involvement is only 5%; isolated CNS involvement is much rarer. The patient presented here has been diagnosed with isolated pontine RDD.
CASE REPORT
A 5-year-old child was admitted to the hospital with the history of double vision and ptosis of the left eye. Magnetic resonance imaging revealed presence of a mass at the pontomesencephalic junction. Subtotal tumor excision was performed. Microscopic examination of the lesion showed histologic features consistent with RDD. The patient was followed up without medication, with a small residue.
CONCLUSION
RDD is rare in childhood, and isolated CNS involvement is also quite rare. The tumor is located in pons in our case. The treatment of choice is gross total resection. Even total excision is not possible, follow up without medication may be an option because of the indolent and self-limited course of the disease.
Topics: Child, Preschool; Histiocytes; Histiocytosis, Sinus; Humans; Magnetic Resonance Imaging; Male; Neurosurgical Procedures; Pons
PubMed: 25686891
DOI: 10.1007/s00381-015-2632-7 -
Journal of Neuro-ophthalmology : the... Sep 2017A paramedian pontine stroke may herald the unique symptom of "salt and pepper" eye pain, in which patients describe the sensation of pepper rubbed into the eye. While...
A paramedian pontine stroke may herald the unique symptom of "salt and pepper" eye pain, in which patients describe the sensation of pepper rubbed into the eye. While localization of the lesion is a common thread among published cases, the mechanism for the sensation of eye pain is still a matter of conjecture. It is important for clinicians to be aware of this unique symptom because strokes rarely present with eye pain and failure to establish this diagnosis might lead to a poor clinical outcome.
Topics: Brain Infarction; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Pons
PubMed: 27525479
DOI: 10.1097/WNO.0000000000000437 -
Archives of Neurology May 1980Following a gunshot wound to the face, a 17-year-old male patient experienced a right trigeminal and abducens paralysis, dysarthria, right-sided ataxia, left-sided...
Following a gunshot wound to the face, a 17-year-old male patient experienced a right trigeminal and abducens paralysis, dysarthria, right-sided ataxia, left-sided weakness of the lower part of the face and limbs, and left-sided sensory loss from his neck down. Brainstem auditory evoked potentials showed a decreased P5/P1 amplitude ratio for left ear presentation, and inconsistent replication of P2 and P3 on the right and, to a lesser extent, on left ear click presentations. A computerized tomography scan showed right pontine atrophy. These findings point to a unilateral lesion of the right pons.
Topics: Adolescent; Brain Injuries; Brain Stem; Evoked Potentials; Humans; Male; Pons; Tomography, X-Ray Computed; Wounds, Gunshot
PubMed: 7387445
DOI: 10.1001/archneur.1980.00500540056005 -
Collegium Antropologicum Jan 2011Various combinations of vascular malformations of the brain in one lesion have been reported, while others seem to be very rare. In this report, the authors discuss the...
Various combinations of vascular malformations of the brain in one lesion have been reported, while others seem to be very rare. In this report, the authors discuss the case of a coexistence of an capillary telangiectasia of the pons and intracerebral venous anomaly. To our knowledge, this is the first report of coexistence of a capillary telangiectasia of the pons and intracerebral venous anomaly apparted from each other. These discrete vascular malformations of the brain raise attention on possible interrelations in the pathogenesis of these entities. We report a case of pontine capillary telangiectasia and intracerebral venous anomaly in a 42-year-old woman with a right side facial palsy. Hight field magnetic resonance imaging suggested presence of a capillary telangiectasia of the pons. Another lesion in the left frontal gyrus was attributable to the venous anomaly. Along with neuroradiological findings, results of the somatosensor evoked potentials, brain stem auditory potentials, laboratory analysis including blood, cerebrospinal fluid and urine investigation are demonstrated. Awareness of the magnetic resonance imaging finding of the capillary telangiectasias and of the venous anomalies may help in defining clinical correlates of this vascular malformations, while the follow up of these malformations might help to asses risk of vascular rupture. We and others previously selects capillary telangiectasia and venous anomaly in two discrete entities. Coexistence of these malformations in the brain apparted from each other appear to be very rare and raise attention on possible interactions in their natural history and pathogenesis.
Topics: Adult; Aged; Central Nervous System Vascular Malformations; Cerebral Angiography; Female; Humans; Infant; Magnetic Resonance Imaging; Male; Middle Aged; Pons
PubMed: 21648357
DOI: No ID Found