SciELO - Scientific Electronic Library Online

 
vol.52 issue2Magnetic resonance imaging of spinal dysraphismTemporal lobe epilepsy and aura with happiness and pleasure: report of two cases and literature revision author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.52 no.2 São Paulo June 1994

http://dx.doi.org/10.1590/S0004-282X1994000200017 

Tumores intrínsecos benignos da região tectal: considerações a propósito de dois casos

 

Benign intrinsic tectal tumors: report of two cases

 

 

J. Francisco Salomão; Renê D. Leibinger; João G. S. Carvalho; Maria Laura B. de Menezes

Serviço de Neurocirurgia Pediátrica, Departamento de Cirurgia, Instituto Fernandes Figueira (MS-Fiocruz), Rio de Janeiro

 

 


RESUMO

O diagnóstico e as condutas terapêuticas nos tumores intrínsecos do tronco encefálico, sofreram grandes transformações com o advento da tomografia computadorizada e da ressonância nuclear magnética. Estes métodos diagnósticos permitiram a identificação de diferentes subgrupos de tumores da região, alguns dos quais passíveis de extirpação cirúrgica, com sobrevida prolongada e eventual cura. Os autores apresentam dois casos de um peculiar grupo de rumores do tectum do mesencéfalo, cujos aspectos tomográficos e manifestações clínicas sugeriam estenose do aqueduto de Sylvius de início tardio. O diagnóstico definitivo foi estabelecido por RNM. Em ambos, os sintomas desapareceram após instalação de derivação ventricular. As características clínico-patológicas e as alternativas terapêuticas deste subgrupo particular de tumores do tronco encefálico são discutidas.

Palavras-chave: tumores do tronco encefálico, tumores tectais, hidrocefalia, estenose de aqueduto de início tardio.


SUMMARY

The introduction of computerized tomography and magnetic resonance imaging led to the knowledge that brain stem tumors are not a homogeneous group with regard to their clinical, pathological and biological features. The classical concept of an uniformly poor prognosis has been modified and some subtypes of tumors are amenable to surgical treatment and long-term survival. The authors report two cases of patients with tumors of the tectal region whose symptoms and CT features were consistent with late-onset aqueductal obstruction. In both cases definitive diagnosis was established by MRI and symptoms resolved after ventriculo-peritoneal shunt implantation. The clinic and pathological features and therapeutical alternatives as well, are discussed.

Key words: brain stem tumors, tectal tumors, hydrocephalus, late onset aqueduct stenosis.


 

 

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

 

 

REFERÊNCIAS

1. Chapman PH. Indolent gliomas of the midbrain tectum. In Marlin AE (ed). Concepts in pediatric neurosurgery, Vol 10. Basel: Karger, 1989, p 97-107.         [ Links ]

2. Cushing H. Notes on a series of intracranial tumors and conditions simulating them. Tumors suspects; tumors unverified; tumors verified. Arch Neurol Psychiatry 1923, 10:605-627.         [ Links ]

3. Epstein F, Wissof J. Intra-axial tumors of the cervicomedullary junction. J Neurosurg 1987, 67:483-487.         [ Links ]

4. Epstein F, Wissof JH. Surgical management of brain stem tumors of childhood and adolescence. Neurosurg Clin N Am 1990, 1:111-121.         [ Links ]

5. Hoffman HJ, Becker L, Craven MA. A clinically distinct group of benign brain stem gliomas. Neurosurgery 1980, 243-248.         [ Links ]

6. Lapras C, Bret P (eds). Les sténoses de l'aqueduc de Sylvius. Neuro-chirurgie 1980, 26 (Suppl): p 152.         [ Links ]

7. Lassiter KRL, Alexander E Jr, Davis CH Jr, Kelly DL Jr. Surgical treatment of brain stem gliomas. J Neurosurg 1971, 34: 719-725.         [ Links ]

8. May PL, Blaster SI, Hoffman HJ, Humphreys RP, Harwood-Nash DC. Benign intrinsic tectal "tumors"in children. J Neurosurg 1991, 74: 867-871.         [ Links ]

9. Packer RJ, Nicholson S, Vezina LG, Johnson DL. Brainstem gliomas. Neurosurg Clin N Am 1992, 3: 863-879.         [ Links ]

10. Raffel C, Hudgins R, Edwards MSB. Symptomatic hydrocephalus: initial findings in brain stem gliomas not detected on computed tomography scans. Pediatrics 1988, 82: 733-737.         [ Links ]

11. Sanford RA, Bebin J, Smith RW. Pencil gliomas of the aqueduct of Sylvius. Report of two cases. J Neurosurg 1982, 57: 690-696.         [ Links ]

12. Steinbock P, Boyd CM. Periaqueductal tumors as a cause of late-onset aqueductal stenosis. Childs Nerv Syst 1987, 3: 170-174.         [ Links ]

13. Stookey B, Scarf JE. Occlusion of the aqueduct of Sylvius by neoplastic and non-neoplastic processes with a rational surgical treatment for relief of resultant obstructive hydrocephalus. Bull Neurol Inst NY 1936,5:348-377.         [ Links ]

14. Stroink AR, Hoffman HJ, Hendrick EB, Humphreys RP, Davidson G. Transependymal benign dorsally exophytic brain stem gliomas in childhood: diagnosis and treatment recommendations. Neurosurgery 1987, 20: 439-444.         [ Links ]

15. Vandertop WP, Hoffman HJ, Humphreys RP, Rutka JT, Amstrong DC, Becker LE. Focal midbrain tumors in children. Neurosurgery 1992, 31: 186-194.         [ Links ]

 

 

Aceite: 19-novembro-1993.

 

 

Dr. J. Francisco Salomão - Av. N.S. de Copacabana 1018/608 - 22060-130 Rio de Janeiro RJ - Brasil.