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Neurological complications of cancer

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https://www.readbyqxmd.com/read/28449529/do-hospitals-need-oncological-critical-care-units
#1
EDITORIAL
Abby Koch, William Checkley
Since the inception of critical care as a formal discipline in the late 1950s, we have seen rapid specialization to many types of intensive care units (ICUs) to accommodate evolving life support technologies and novel therapies in various disciplines of medicine. Indeed, the field has expanded such that specialized ICUs currently exist to address critical care problems in medicine, cardiology, neurology and neurosurgery, trauma, burns, organ transplant and cardiothoracic surgeries. Specialization does not only need new infrastructure, but also training and staffing of health care providers, ancillary staff, and development and implementation of processes of care...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28436378/outcomes-of-corpectomy-in-patients-with-metastatic-cancer
#2
Grzegorz Guzik
BACKGROUND: The objective of surgical management of spinal metastases is to reduce pain and improve the patient's quality of life. The operation should restore spinal stability and decompress neural structures. One surgical technique is corpectomy followed by vertebral body reconstruction and stabilisation of the spine. The procedure may be performed in patients in overall good health and a good survival prognosis. The aim of this paper is to present the outcomes of surgical management of spinal metastases in patients who underwent corpectomy followed by vertebral body reconstruction and stabilisation of the spine...
January 26, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28433114/hepatic-features-of-wilson-disease
#3
Salih Boga, Aftab Ala, Michael L Schilsky
In Wilson disease (WD) defective AT7B function leads to biliary copper excretion and pathologic copper accumulation, particularly in liver and brain, where it induces cellular damage. Liver disease most often precedes neurologic or psychiatric manifestations. In most patients with neurologic or psychiatric symptoms there is some degree of liver disease at the time of disease presentation. Hepatic manifestations of WD can be extremely variable. Patients with clinically asymptomatic WD are often found by family screening or identified on routine laboratory testing...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28431612/xeroderma-pigmentosum-complementation-group-f-a-rare-cause-of-cerebellar-ataxia-with-chorea
#4
G Carré, C Marelli, M Anheim, C Geny, M Renaud, H R Rezvani, M Koenig, C Guissart, C Tranchant
The complementation group F of Xeroderma pigmentosum (XP-F) is rare in the Caucasian population, and usually devoid of neurological symptoms. We report two cases, both Caucasian, who exhibited progressive cerebellar ataxia, chorea, a mild subcortical frontal cognitive impairment, and in one case severe polyneuropathy. Brain MRI demonstrated cerebellar (2/2) and cortical (1/2) atrophy. Both patients had only mild sunburn sensitivity and no skin cancer. Mini-exome sequencing approach revealed in ERCC4, two heterozygous mutations, one of which was never described (c...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28405535/signet-cell-in-the-brain-a-case-report-of-leptomeningeal-carcinomatosis-as-the-presenting-feature-of-gastric-signet-cell-cancer
#5
Saeed Ali, Muhammad Talha Khan, Evgeny A Idrisov, Aadil Maqsood, Fnu Asad-Ur-Rahman, Khalid Abusaada
Malignant infiltration of pia and arachnoid mater, referred to as leptomeningeal carcinomatosis (LMC), is a rare complication of gastric carcinoma. The most common underlying malignancy in patients with LMC are leukemia, breast cancer, lymphoma, and lung cancer. We report a case of gastric adenocarcinoma that presented with LMC in the absence of overt gastrointestinal signs or symptoms. A 56-year-old Hispanic woman presented to the hospital with a three-week history of intermittent headaches and visual blurring...
March 7, 2017: Curēus
https://www.readbyqxmd.com/read/28391985/-the-management-of-bone-metastasis
#6
REVIEW
Rémi Bonetto, Agnès Tallet, Anthony Mélot, Benoît Calderon, Fabrice Barlesi
Bone metastasis are the most common cause of pain related to cancer, reducing patients' quality of life, and sometimes threatening their life-expectancy. Their management has to be pluridisciplinary, because of all the therapeutic options and the diversity of bone metastasis locations. The aim of this work is to propose a rational decisional algorithm for the treatment strategy of these secondary locations. Anti-resorbtive drugs with systemic action, surgery, conventional or stereotactic radiation therapy, and new techniques of interventional radiology are options that could be used separately or combined...
April 6, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28384595/clinical-outcomes-from-maximum-safe-resection-of-primary-and-metastatic-brain-tumors-using-awake-craniotomy
#7
Anastasia Groshev, Devang Padalia, Sephalie Patel, Rosemarie Garcia-Getting, Solmaz Sahebjam, Peter A Forsyth, Frank D Vrionis, Arnold B Etame
OBJECTIVE: To retrospectively analyze outcomes in patients undergoing awake craniotomies for tumor resection at our institution in terms of extent of resection, functional preservation and length of hospital stay. PATIENTS AND METHODS: All cases of adults undergoing awake-craniotomy from September 2012-February 2015 were retrospectively reviewed based on an IRB approved protocol. Information regarding patient age, sex, cancer type, procedure type, location, hospital stay, extent of resection, and postoperative complications was extracted...
March 20, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28340041/bleeding-complications-in-patients-undergoing-intrathecal-drug-delivery-system-implantation
#8
Nafisseh S Warner, Markus A Bendel, Matthew A Warner, Jacob J Strand, Halena M Gazelka, Bryan C Hoelzer, William D Mauck, Tim J Lamer, Daryl J Kor, Susan M Moeschler
Introduction.:  Intrathecal drug delivery systems (IDDSs) have dramatically improved analgesia and the functional status of cancer patients and those with chronic pain states. However, given the close proximity to the neuraxis and frequent concomitant use of antiplatelet or anticoagulant medications, this intervention is not without risk. The goal of this investigation was to determine the incidence of bleeding complications following IDDS placement. Methods.:  This is a retrospective review from 2005 through 2014 of adult patients undergoing IDDS implantation or revision at a tertiary care center...
March 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28338450/postoperative-quality-of-life-assessment-in-patients-with-spine-metastases-treated-with-long-segment-pedicle-screw-fixation
#9
Florian Bernard, Jean-Michel Lemée, Olivier Lucas, Philippe Menei
OBJECTIVE In recent decades, progress in the medical management of cancer has been significant, resulting in considerable extension of survival for patients with metastatic disease. This has, in turn, led to increased attention to the optimal surgical management of bone lesions, including metastases to the spine. In addition, there has been a shift in focus toward improving quality of life and reducing hospital stay for these patients, and many minimally invasive techniques have been introduced with the aim of reducing the morbidity associated with more traditional open approaches...
March 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28291404/outcomes-and-effectiveness-of-posterior-occipitocervical-fusion-for-suboccipital-spinal-metastases
#10
Panya Luksanapruksa, Jacob M Buchowski, Neill M Wright, Frank H Valone, Colleen Peters, David B Bumpass
OBJECTIVE The incidence of suboccipital spinal metastases is rare but has increased given cancer patients' longer life expectancies. Operative treatment in this region is often challenging because of limited fixation points due to tumor lysis, as well as adjacent neural and vascular anatomy. Few studies have reported on this population of cancer patients. The purpose of this study was to evaluate clinical outcomes and complications of patients with suboccipital spinal metastases who had undergone posterior occipitocervical fixation...
February 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28285700/autoimmune-paraneoplastic-syndromes-associated-to-lung-cancer-a-systematic-review-of-the-literature-part-3-neurological-paraneoplastic-syndromes-involving-the-central-nervous-system
#11
REVIEW
Georgiana Bentea, Claudine Sculier, Bogdan Grigoriu, Anne-Pascale Meert, Valérie Durieux, Thierry Berghmans, Jean-Paul Sculier
The development of new immune treatment in oncology and particularly for lung cancer may induce new complications, particularly activation or reactivation of auto-immune diseases. In this context, a systematic review on the auto-immune paraneoplastic syndromes that can complicate lung cancer appears useful. This article is the third of a series of five and deals mainly with neurological paraneoplastic syndromes involving the central nervous system.
April 2017: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/28195993/subcutaneous-testosterone-letrozole-therapy-before-and-concurrent-with-neoadjuvant-breast-chemotherapy-clinical-response-and-therapeutic-implications
#12
Rebecca L Glaser, Anne E York, Constantine Dimitrakakis
OBJECTIVE: Hormone receptor-positive breast cancers respond favorably to subcutaneous testosterone combined with an aromatase inhibitor. However, the effect of testosterone combined with an aromatase inhibitor on tumor response to chemotherapy was unknown. This study investigated the effect of testosterone-letrozole implants on breast cancer tumor response before and during neoadjuvant chemotherapy. METHODS: A 51-year-old woman on testosterone replacement therapy was diagnosed with hormone receptor-positive invasive breast cancer...
February 13, 2017: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/28185615/clinical-study-of-neuroregen-scaffold-combined-with-human-mesenchymal-stem-cells-for-the-repair-of-chronic-complete-spinal-cord-injury
#13
Yannan Zhao, Fengwu Tang, Guang Han, Nuo Wang, Na Yin, Bing Chen, Xianfeng Jiang, Chen Yun, Wanjun Han, Changyu Zhao, Shixiang Cheng, Zhifeng Xiao, Sai Zhang, Jianwu Dai
Regeneration of damaged neurons and recovery of sensation and motor function after complete spinal cord injury (SCI) are challenging. We previously developed a collagen scaffold, NeuroRegen scaffold, to promote axonal growth along collagen fibers and inhibit glial scar formation after SCI. When functionalized with multiple biomolecules, this scaffold promoted neurological regeneration and functional recovery in animals with SCI. In this study, eight patients with chronic complete SCI were enrolled to examine the safety and efficacy of implanting NeuroRegen scaffold with human umbilical cord mesenchymal stem cells (MSCs)...
February 9, 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28178709/neoplastic-meningitis-due-to-lung-breast-and-melanoma-metastases
#14
REVIEW
Emilie Le Rhun, Sophie Taillibert, Marc C Chamberlain
BACKGROUND: Neoplastic meningitis, a central nervous system (CNS) complication of cancer metastatic to the meninges and cerebrospinal fluid (CSF), is relevant to oncologists due to the impact of the disease on patient quality of life and survival rates. METHODS: A review of the literature of articles published in English was conducted with regard to neoplastic meningitis. RESULTS: The incidence of neoplastic meningitis is increasing because patients with cancer are surviving longer in part because of the use of novel therapies with poor CNS penetration...
January 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28178708/clinical-presentation-diagnosis-and-radiological-findings-of-neoplastic-meningitis
#15
REVIEW
Georgios Rigakos, Chrysoula I Liakou, Naillid Felipe, Dennis Orkoulas-Razis, Evangelia Razis
BACKGROUND: Neoplastic meningitis is a complication of solid and hematological malignancies. It consists of the spread of malignant cells to the leptomeninges and subarachnoid space and their dissemination within the cerebrospinal fluid. METHODS: A literature review was conducted to summarize the clinical presentation, differential diagnosis, laboratory values, and imaging findings of neoplastic meningitis. RESULTS: Neoplastic meningitis is an event in the course of cancer with a variable clinical presentation and a wide differential diagnosis...
January 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28156637/complications-of-intrathecal-pump-therapy-in-malignancy-related-pain
#16
Egidio Del Fabbro
102 Background: Intrathecal pumps (ITP) are used to manage severe malignancy related pain by delivering analgesics directly into the cerebrospinal fluid, in theory allowing for a reduced opioid dose and fewer complications. Although there is literature to support efficacy in patients with cancer, including improved survival, this mode of drug delivery also carries a risk of serious complications. Reports of complications in non-malignant pain suggest the risks and mortality related to ITP may be under-appreciated and that injury and liability occur with both ITP placement and ITP maintenance...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28114816/a-case-of-chronic-hypomagnesemia-in-a-cancer-survivor
#17
Marko Velimirovic, Joshua Charles Ziperstein, Andrew Zoltan Fenves
OBJECTIVES: Hypomagnesemia is common among hospitalized patients, particularly those who are critically ill. It can be associated with a number of potentially life-threatening cardiovascular, neurological and behavioral manifestations. As opposed to acute, chronic hypomagnesemia is often underdiagnosed and underreported and as such may pose a diagnostic and therapeutic problem. CASE PRESENTATION: We describe a case of magnesium wasting in a middle-aged woman with head and neck cancer who presented with recurrent syncopal episodes complicated by a femur fracture 4 months after completing a course of carboplatin-containing chemotherapy...
April 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28096918/perioperative-outcomes-following-radical-prostatectomy-for-patients-with-disseminated-cancer-an-analysis-of-the-national-surgical-quality-improvement-program-database
#18
Raj Satkunasivam, Christopher J D Wallis, James Byrne, Azik Hoffman, Douglas C Cheung, Girish S Kulkarni, Avery B Nathens, Robert K Nam
INTRODUCTION: We sought to determine whether patients undergoing radical prostatectomy (RP) in the context of disseminated cancer have higher 30-day complications. METHODS: We conducted a retrospective cohort study of the National Surgical Quality Improvement Program (NSQIP) database. Men undergoing RP (from January 1, 2005 to December 31, 2014) for prostate cancer were identified and stratified by presence (n=97) or absence (n=27 868) of disseminated cancer. The primary outcome was major complications (death, re-operation, cardiac or neurologic events) within 30 days of surgery...
November 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28088217/surgical-treatment-of-upper-cervical-spine-metastases-a-retrospective-study-of-39-cases
#19
Jian Yang, Qi Jia, Dongyu Peng, Wei Wan, Nanzhe Zhong, Yan Lou, Xiaopan Cai, Zhipeng Wu, Chenglong Zhao, Xinghai Yang, Jianru Xiao
BACKGROUND: The surgical treatment of upper cervical spine metastases are controversial up to now. By summarizing and analyzing the clinical data of the upper cervical spine involved metastases treated surgically in our center, we mainly aimed to investigate the surgical decisions and outcomes so as to provide more references for the clinical treatment of this special and complex spine metastasis. METHODS: We evaluated the patients' pre- and post-operative neck pain and neurologic function with paired t test, followed by the statistics of the selection of surgical approaches, ways of reconstruction, and related complications...
January 14, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28068233/multi-institutional-nomogram-predicting-survival-free-from-salvage-whole-brain-radiation-after-radiosurgery-in-patients-with-brain-metastases
#20
Daniel Gorovets, Diandra Ayala-Peacock, David J Tybor, Paul Rava, Daniel Ebner, Deus Cielo, Georg Norén, David E Wazer, Michael Chan, Jaroslaw T Hepel
PURPOSE: Optimal patient selection for stereotactic radiosurgery (SRS) as the initial treatment for brain metastases is complicated and controversial. This study aimed to develop a nomogram that predicts survival without salvage whole brain radiation therapy (WBRT) after upfront SRS. METHODS AND MATERIALS: Multi-institutional data were analyzed from 895 patients with 2095 lesions treated with SRS without prior or planned WBRT. Cox proportional hazards regression model was used to identify independent pre-SRS predictors of WBRT-free survival, which were integrated to build a nomogram that was subjected to bootstrap validation...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
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