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INTRODUCTION: The aim of this study was to reproducibly determine if any of the polymorphisms were associated with the susceptibility to brain arteriovenous malformations (BAVM) or the risk of intracranial hemorrhage (ICH) presentation. METHODS: We recruited 63 BAVM patients and 96 controls. The polymorphisms selected for evaluation were apolipoprotein E (APOE), tumor necrosis factor alpha (TNF 238G>A - rs361525), interleukin 1 beta (IL1B 511C>T - rs16944 and IL1B -31T>C - rs1143627), activin-like kinase 1 (ACVRL1 IVS3-35A>G - rs2071219), endoglin (ENG 207G>A - rs11545664), and interleukin 6 (IL6 174G>C - rs1800795). RESULTS: In the single analysis, we observed statistically signiï¬cant differences in the allele distributions for IL1B -31T>C (rs1143627) between the BAVM patients and control subjects (P = 0.02). There was a trend toward significance for the association between the IL1B 511C>T (rs16944) allele and BAVM risk (P = 0.07). In further logistic regression analysis, no polymorphism was significantly associated with the risk of BAVM. No polymorphisms were associated with hemorrhage presentation according to both single and multivariable analyses. CONCLUSIONS: In our sample from a south Brazil population, we found no association between the risks of BAVM and ICH presentation with any of the selected polymorphisms.
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Neurocitomas centrais são tumores do sistema nervoso central de comportamento usualmente benigno, que costumam ocorrer nos ventrículos laterais de indivíduos jovens. Apresentamos o caso de um paciente do sexo masculino, de 31 anos de idade, com uma lesão expansiva intraventricular ocasionando quadro de hidrocefalia e queixas visuais. O paciente foi submetido à ressecção completa da lesão. Apresentou hidrocefalia persistente no pós-operatório, necessitando de derivação ventrículo-peritoneal. A evolução foi favorável e o paciente recebeu alta para seguir acompanhamento ambulatorial. Exame anatomopatológico evidenciou neurocitoma central atípico. O objetivo deste relato é apresentar um caso clássico de uma neoplasia rara, realizando uma revisão da literatura e mostrando sua importância, dado o prognóstico favorável.
Central neurocytomas are central nervous system tumors. They are usually benign and tend to occur in the lateral ventricles of young adults. We report the case of a 31-year-old male patient with an intraventricular lesion, causing hydrocephalus and visual complaints. The patient was submitted to a complete surgical resection of the lesion. However, he persisted with hydrocephalus in the postoperative period and required a ventriculoperitoneal shunt. The clinical course was favorable and the patient was discharged to follow-up. Anatomic pathology test revealed an atypical central neurocytoma. The objective of this case report is to describe a classic presentation of a rare neoplasm, including a review of the literature, highlighting the importance of this diagnosis because of the favorable prognosis.
Assuntos
Humanos , Masculino , Adulto , Neurocirurgia , Neoplasias do Sistema Nervoso Central/diagnóstico , Neurocitoma/cirurgia , Neurocitoma/diagnóstico , Hidrocefalia , Sistema Nervoso Central/patologiaRESUMO
BACKGROUND: Stereotactic CT-guided biopsy is a valuable and safe procedure for diagnosing intracranial lesions. The objectives of this article are to analyze the diagnostic yield in a series of stereotactic CT-guided brain biopsies and to evaluate whether predictive factors may influence diagnostic yield. METHODS: The medical records of a series of patients who underwent stereotactic CT-guided brain biopsy from 1993 to 2005 in a neurosurgical center were reviewed. Clinical data were stored and analyzed with Microsoft Access (Microsoft Corp, Seattle, WA) and SPSS V11.0 software (SPSS, Inc, Chicago, IL). The following variables were analyzed: age, sex, anatomopathologic diagnosis, lesion topography and volume, postsurgical complications, and predictive factors that may affect diagnostic yield. RESULTS: One hundred seventy patients (102 males, 68 females; average age, 48.5 years) were analyzed. Stereotactic CT-guided biopsies allowed diagnosis in 157 cases (92%). The most frequent anatomopathologic diagnoses were high-grade glioma (n = 45), low-grade glioma (n = 31), nonspecific inflammatory lesions (n = 19), metastasis (n = 10), and lymphoma (n = 10). The most frequent topographies were frontal (n = 42), basal ganglia (n = 40), and parietal (n = 27) and front-parietal lobes (n = 9). Complications occurred in 5 patients (2.9%). Mortality rate was 1.2% (2 patients). Age had a positive impact, whereas female sex negatively affected diagnostic yield. All other predictive factors analyzed were not significant. CONCLUSION: Stereotactic CT-guided brain biopsies performed presented acceptable anatomopathologic diagnostic rate. Age had a positive impact, whereas female sex negatively affected diagnostic yield in this series.