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Look at This Crazy Brain Cyst


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Look at This Crazy Brain Cyst

Image: Jennifer de Longpre

A 27-year-old man had been suffering frequent headaches and had been falling over frequently for around three years. But when he had a seizure, he headed to the emergency department. They took an MRI and found THIS.

Image: Jennifer de Longpre

If you need to get your bearings, the squished brain looking stuff is a squished brain. The black horror is an arachnoid cyst. Internist Jennifer De Longpre at Metro Health Hospital in Michigan spotted it and wrote the case report up forThe New England Journal of Medicine.

Arachnoid cysts are actually benign: They’re just the sac between the brain and the skull, filled with fluid, often present from birth. But this one was so big it had been causing neurological effects from pressing on the patient’s brain.

I emailed 15 and called 70 neuroradiologists before finally getting Maria Gisele Matheus, professor of radiology at the Medical University of South Carolina, to answer my very simple question: how severe is this seemingly massive cyst?

“This case doesn’t look especially bad,” she said. Oof.

“We’ve seen this before, not so extreme like this one,” she said. “The patient comes with a headache. Usually, these cysts don’t grow—they stay and do some minor deformities on the bone.”

Generally, said Matheus, the brain adjusts to the new pressure shift until symptoms begin to occur, but it doesn’t kill the patient. Her department sees maybe one or two minor arachnoid cysts a week, she said, and cases like this come less than once per year.

In the case here, Longpre and her team cut into the skull and opened up the cyst to let the fluid drain. They also installed a drain for the fluid, called a shunt.

The treatment didn’t change the cyst’s size, the patient still gets headaches, and doctors now just treat his seizures. Bummer.

[NEJM]

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Diarrhea: Causes, Symptoms & Treatments


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Diarrhea: Causes, Symptoms & Treatments

Why One Woman Had Oil in Her Lung for Decades


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Why One Woman Had Oil in Her Lung for Decades

This Heart in a Jar Could Make Heart Transplants Safer


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This Heart in a Jar Could Make Heart Transplants Safer

3/11/16 3:59pm

What looks like a prop from a steampunk movie is actually a partially decellularized heart in a bioreactor. And this heart has the potential to save the lives of heart attack patients, and, one day, people who need heart transplants too.

In a new paper in Circulation Research, scientists at Massachusetts General Hospital describe a process that was first tested on rat hearts and those of large mammals, and is now being applied to human organs. The process involves stripping away the muscle cells in the heart, leaving the rest of the structures intact, and then rebuilding the heart with new muscle cells. That sounds redundant, but it could provide people with “patches” that replace damaged tissue, and save heart transplant patients from rejecting their new organs.

The process starts with hearts from organ donors. A special detergent strips away the muscle cells, but leaves the proteins and blood vessels. This decellularization gets rid of not just muscle cells, but also of human leukocyte antigens (HLAs). HLAs are the proteins that the body uses to know which cells to sic the immune system on. They’re passed down from parents to children, which is why siblings are the best possible donors for patients in need of kidneys or livers. The wrong HLA markers will cause a patient to reject organs. Stripping the HLAs will help transplant patients accept foreign tissue.

But before that happens, the team has to rebuild the tissue. They started with pluripotent stem cells, which they induced into forming cardiac muscle cells. The cardiac cells were grown in a tissue culture for several days, and then injected into the decellularized hearts. The hearts were put in a bioreactor—a device that supplies nutrients to the cells and sometimes gently moves the organs to encourage cell growth. After two weeks, the team found cardiac cells that, through immature, could contract like regular cardiac muscle tissue.

Recreating an entire human heart is still a few years away. The immediate next step are “myocardial patches” that will allow people who have suffered heart attacks to replaced badly damaged muscle tissue—without worrying about rejection.

[Circulation Research]

Nearly Two-Thirds of Cancers Are Due to Random DNA ‘Mistakes’


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Nearly Two-Thirds of Cancers Are Due to Random DNA ‘Mistakes’

‘Tree Man’ Has Surgery: What Causes This Rare Condition?


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‘Tree Man’ Has Surgery: What Causes This Rare Condition?

 

Surgeons shocked to find fully formed teeth in a baby’s brain tumor


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Surgeons shocked to find fully formed teeth in a baby’s brain tumor

2/27/14 2:20pm

Sometimes, when biology goes squirrely, it really goes squirrely. Case in point, a bizarre medical case in which a 4-month-old infant in Maryland was found to have several fully formed teeth embedded within a brain tumor. Warning: Graphic image to follow.

The boy was admitted to hospital because his head was growing faster than normal. Subsequent MRI scans showed a “heterogeneous, enhancing suprasellar mass” — but it contained multiple structures along the right side that looked startlingly like teeth that form in the lower jaw.

During the procedure to remove the tumor, the surgeons encountered multiple fully formed teeth. Fully formed! And not just bits of enamel or calcium deposits.

Subsequent analysis of the tumor revealed a craniopharyngioma, a rare brain tumor that can grow to be larger than a golf ball, but does not spread.LiveScience‘s Rachael Rettner explains more:

Researchers had always suspected that these tumors form from the same cells involved in making teeth, but until now, doctors had never seen actual teeth in these tumors, said Dr. Narlin Beaty, a neurosurgeon at the University of Maryland Medical Center, who performed the boy’s surgery along with his colleague, Dr. Edward Ahn, of Johns Hopkins Children’s Center.

“It’s not every day you see teeth in any type of tumor in the brain. In a craniopharyngioma, it’s unheard of,” Beaty said.

Craniopharyngiomas commonly contain calcium deposits, “but when we pulled out a full tooth…I think that’s something slightly different,” Beaty told Live Science.

Teeth have been found in people’s brains before, but only in tumors known as teratomas, which are unique among tumors because they contain all three of the tissue types found in an early-stage human embryo, Beaty said. In contrast, craniopharyngiomas have only one layer of tissue.

The boy’s case provides more evidence that craniopharyngiomas do indeed develop from the cells that make teeth, Beaty said.

Incredibly, the boy is doing well, but the tumor destroyed his capacity to release certain hormones, so he’ll have to undergo hormone treatments for the rest of his life.

Read more at LiveScience. The entire report can be found at the New England Journal of Medicine: “Adamantinomatous Craniopharyngioma Containing Teeth.”