Area postrema syndrome in a patient with brainstem glioblastoma

Natsis, K.; Athanasios-Christos, Kalyvas; Theochari, Evangelia; Papamichalis, Evangelos; Gerkou, A.

doi:10.1007/s13760-021-01736-9

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…Безусловно, САР не специфичен для NMOSD. Теоретически, любое структурное поражение АР может вызвать САР, что подтверждается обширным кругом заболеваний, при которых описан данный синдром: ишемический инсульт, рассеянный склероз, энцефалит Биккерстаффа, объёмные образования IV желудочка, хроническое лимфоцитарное воспаление с периваскулярным накоплением контрастного вещества в варолиевом мосту, реагирующее на терапию глюкокортикоидами (синдром CLIPPERS), болезнь Александера [13][14][15][16][17][18][19][20].…”

Section: Discussionunclassified

Postvaccination acute disseminated encephalomyelitis with <i>area postrema</i> syndrome and quasi benign paroxysmal positional vertigo: a case report

Богданов

KAZANTSEV

Ahunova

2022

Annals of Clinical and Experimental Neurology

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Area postrema syndrome (APS) develops in patients with lesions found in the floor of the fourth ventricle and manifests with nausea, intractable vomiting, and hiccup. APS is most commonly associated with neuromyelitis optica spectrum disorders although it may develop in some other conditions as well. We have presented a case study of APS with positional vertigo developed in a 41-year-old woman caused by acute disseminated encephalomyelitis after COVID-19 vaccination. Quasi benign paroxysmal positional vertigo acutely manifested with nausea, vomiting, and vertigo that dramatically worsened with head movement. Physical examination revealed patchy hypesthesia on the left side of the face and decreased convergence of the left eye. MRI scan showed a lesion adjacent to the floor of the fourth ventricle (area postrema). The manifestations totally regressed on glucocorticoids without any relapse during 1-year follow-up.

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Section: Discussionunclassified

Postvaccination acute disseminated encephalomyelitis with <i>area postrema</i> syndrome and quasi benign paroxysmal positional vertigo: a case report

Богданов

KAZANTSEV

Ahunova

2022

Annals of Clinical and Experimental Neurology

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“…The rst case presented in this study is an example of a WHO Grade II pilocytic astrocytoma, a relatively rare occurrence. Additionally, APS may manifest as an initial symptom of other diseases, including lupus-related neuropathy, CLIPPERS (chronic lymphocytic in ammation with pontine perivascular enhancement responsive to steroids), anti-GFAP encephalomyelitis, brainstem encephalitis, and secondary infectious myelitis, though it is uncommon in patients with multiple sclerosis or strokes [4] . APS is associated with a wide array of conditions ranging from autoimmune and in ammatory disorders to sudden infant death syndrome, Alexander disease, and radiation-induced nausea and vomiting, thereby broadening the spectrum of APS-related conditions [3,16] .…”

Section: Other Causes Of Apsmentioning

confidence: 99%

“…Area Postrema Syndrome (APS) can result from autoimmune in ammatory conditions or various tumors located in the area postrema, such as neurocutaneous melanosis, choroid plexus tumors, pilocytic astrocytoma, or neuroenteric cysts [4] . The rst case presented in this study is an example of a WHO Grade II pilocytic astrocytoma, a relatively rare occurrence.…”

Section: Other Causes Of Apsmentioning

confidence: 99%

Unraveling the Complexity of Area Postrema Lesions: Insights from Neuromyelitis Optica Spectrum Disorder and Beyond

Li,

yang,

et al. 2024

Preprint

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Lesions in the area postrema may lead to symptoms including hiccupping, nausea, and vomiting. Often termed area postrema syndrome, these symptoms are commonly linked to neuromyelitis optica spectrum disorders (NMOSD). This study analyzes two case studies to illustrate the varied clinical manifestations of area postrema lesions. The first case involves a 57-year-old male presenting with persistent symptoms of nausea, vomiting, and dizziness. Subsequent examination led to a diagnosis of WHO Grade II astrocytoma. The second case details a 24-year-old woman with hiccupping, deteriorating vision, incontinence, and limb numbness. She was subsequently diagnosed with concurrent neuromyelitis optica spectrum disorder (NMOSD) and Sjögren's syndrome. Importantly, the second case showed distinct gastrointestinal symptoms before treatment, leading to a crucial diagnosis of lesions in the posterior medullary region. These case studies highlight the risk of misdiagnosis and underscore the importance of quickly recognizing posterior medulla-related symptoms. A deep understanding of postrema lesions is essential for accurate diagnosis and prompt management. This underscores the need for a comprehensive clinical approach to enhance patient outcomes.

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“…The ECM, in turn, is tailored by each cell component of the GBM TME, often resulting in conditions favorable to tumor progression (Hambardzumyan & Bergers, 2015). A total of 90% of all GBMs originates in the temporal, parietal or frontal lobe, while only 10% is found in the occipital lobe and, rarely, on the cerebellum, spinal cord or brainstem (Natsis et al, 2021). Primary GBM develops de novo (around 90% of the cases), affects mostly the elderly, and is characterized by epidermal growth factor receptor (EGFR) amplification (36% of cases), p16INK4a deletion (31% of cases), loss of heterozygosity 10q (70% of cases) and PTEN mutations (25% of cases).…”

Section: Gbm Niches Key Cell Players and Tmementioning

confidence: 99%

Multi‐ligand functionalized blood‐to‐tumor sequential targeting strategies in the field of glioblastoma nanomedicine

Martins

Sarmento

2023

WIREs Nanomed Nanobiotechnol

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Glioblastoma (GBM) is an unmet clinical need characterized by a standard of care (SOC) 5‐year survival rate of only 5%, and a treatment mostly palliative. Significant hurdles in GBM therapies include an effective penetration of therapeutics through the brain protective barrier, namely the blood–brain barrier (BBB), and a successful therapeutic delivery to brain‐invading tumor cells post‐BBB crossing. These hurdles, along with the poor prognosis and critical heterogeneity of the disease, have shifted attention to treatment modalities with capacity to precisely and sequentially target (i) BBB cells, inducing blood‐to‐brain transport, and (ii) GBM cells, leading to a higher therapeutic accumulation at the tumor site. This sequential targeting allows therapeutic molecules to reach the brain parenchyma and compromise molecular processes that support tumor cell invasion. Besides improving formulation and pharmacokinetics constraints of drugs, nanomedicines offer the possibility of being surface functionalized with multiple possibilities of targeting ligands, while delivering the desired therapeutic cargos to the biological sites of interest. Targeting ligands exploit the site‐specific expression or overexpression of specific molecules on BBB and GBM cells, triggering brain plus tumor transport. Since the efficacy of single‐ligand functionalized nanomedicines is limited due to the GBM anatomical site (brain) and disease complexity, this review presents an overview of multi‐ligand functionalized, BBB and GBM sequentially‐ and dual‐targeted nanomedicines reported in literature over the last 10 years. The role of the BBB in GBM progression, treatment options, and the multiple possibilities of currently available targeting ligands will be summarized.This article is categorized under: Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease

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Area postrema syndrome in a patient with brainstem glioblastoma

Cited by 4 publications

References 5 publications

Postvaccination acute disseminated encephalomyelitis with <i>area postrema</i> syndrome and quasi benign paroxysmal positional vertigo: a case report

Postvaccination acute disseminated encephalomyelitis with <i>area postrema</i> syndrome and quasi benign paroxysmal positional vertigo: a case report

Unraveling the Complexity of Area Postrema Lesions: Insights from Neuromyelitis Optica Spectrum Disorder and Beyond

Multi‐ligand functionalized blood‐to‐tumor sequential targeting strategies in the field of glioblastoma nanomedicine

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