tailieunhanh - Báo cáo y học: "Sudden deterioration due to intra-tumoral hemorrhage of ependymoma of the fourth ventricle in a child during a flight: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Sudden deterioration due to intra-tumoral hemorrhage of ependymoma of the fourth ventricle in a child during a flight: a case report. | Mahdavi et al. Journal of Medical Case Reports 2010 4 143 http content 4 1 143 jA CASE REPORTS CASE REPORT Open Access Sudden deterioration due to intra-tumoral hemorrhage of ependymoma of the fourth ventricle in a child during a flight a case report Ali Mahdavi 1 Nima Baradaran1 Farideh Nejat 1 Mostafa El Khashab2 and Maryam Monajemzadeh3 Abstract Introduction To the best of our knowledge the association between air travel and intra-tumoral hemorrhage in pediatric populations has never been described previously. Case presentation We report the case of a two-and-a-half-year-old Caucasian Iranian boy with a hemorrhaging brain tumor. He had a posterior fossa midline mass and severe hydrocephalus. He had been shunted for hydrocephalus four weeks earlier and was subsequently referred to our center for further treatment. The hemorrhage occurred in an infratentorial ependymoma precipitated by an approximately 700-mile air journey at a maximum altitude of 25 000 feet. Conclusions A pre-existing intra-cranial mass lesion diminishes the ability of the brain to accommodate the mild environmental disturbances caused by hypercarbia increased venous pressure and reduced cerebral blood flow during long air journeys. This is supported by a literature review based on our current knowledge of physiological changes during air travel. Introduction Hemorrhage into brain neoplasms is a relatively uncommon but not a rare occurrence with obvious relevance to the neurosurgeon. In general about 5 to 10 of all brain tumors develop hemorrhage of some type. The tissue type of the tumor itself is clearly related to its propensity to bleed as metastatic lesions are known to carry a high risk of hemorrhage. Of the primary brain tumors glioblastoma appears to be the most common source of intracerebral hemorrhage. Oligodendrogliomas astrocytomas ependymomas and medulloblastomas have also been associated with intra-cranial hemorrhage. Less commonly .