"CZ - \u010Cesk\u00E1 republika" . "Glioblastomy m\u00EDchy pat\u0159\u00ED mezi velmi vz\u00E1cn\u00E9 n\u00E1dory tvo\u0159\u00EDc\u00ED pouze kolem 1,5 % v\u0161ech prim\u00E1rn\u00EDch n\u00E1dor\u016F m\u00EDchy. Tato kazuistika prezentuje p\u0159\u00EDpad 20let\u00E9ho mu\u017Ee s high-grade gliomem kaud\u00E1ln\u00ED oblasti m\u00EDchy atypick\u00E9ho pr\u016Fb\u011Bhu a obrazu na magnetick\u00E9 rezonanci (MR) s rychle postupuj\u00EDc\u00EDmi sekund\u00E1rn\u00EDmi zm\u011Bnami m\u00EDchy a fat\u00E1ln\u00EDm zakon\u010Den\u00EDm. Pacient byl p\u0159ijat pro dva m\u011Bs\u00EDce se zhor\u0161uj\u00EDc\u00ED slabost a poruchu \u010Dit\u00ED doln\u00EDch kon\u010Detin s podez\u0159en\u00EDm na m\u00ED\u0161n\u00ED low-grade gliom. MR m\u00EDchy byla opakovan\u011B hodnocena jako myelitida. N\u00E1lez pleocyt\u00F3zy v likvoru podpo\u0159il hypot\u00E9zu o z\u00E1n\u011Btliv\u00E9 etiologii. V likvoru byly v\u0161ak nalezeny i atypick\u00E9 bu\u0148ky malign\u00EDho charakteru. Byla nasazena antibiotick\u00E1 a antivirotick\u00E1 medikace a kortikoidy. Klinick\u00FD obraz a n\u00E1lez na MR nicm\u00E9n\u011B d\u00E1le ascendentn\u011B postupoval. Za p\u011Bt dn\u016F od p\u0159ijet\u00ED byla provedena pro suspicium na intradur\u00E1ln\u00ED hematom v rozsahu 1. bedern\u00EDho a\u017E p\u0159echodu 3. a 4. bedern\u00EDho obratle (L1\u2013L3/4) opera\u010Dn\u00ED revize a dekomprese, histologick\u00E9 vy\u0161et\u0159en\u00ED odebran\u00FDch hmot v\u0161ak odpov\u00EDdalo diagn\u00F3ze anaplastick\u00E9ho astrocytomu s p\u0159echodem do glioblastomu. V dal\u0161\u00EDm pr\u016Fb\u011Bhu do\u0161lo u pacienta postupn\u011B k rozvoji respira\u010Dn\u00ED insuficience s nutnost\u00ED um\u011Bl\u00E9 plicn\u00ED ventilace. Dva dny od stanoven\u00ED diagn\u00F3zy, 11. den hospitalizace, pacient zem\u0159el na septick\u00FD \u0161ok p\u0159i ventil\u00E1torov\u00E9 pneumonii. Pitva n\u00E1sledn\u011B potvrdila v\u00FD\u0161e zm\u00EDn\u011Bn\u00FD typ n\u00E1doru lokalizovan\u00FD v\u0161ak pouze v kaud\u00E1ln\u00ED oblasti m\u00EDchy. Ve zbyl\u00E9 \u010D\u00E1sti m\u00EDchy a\u017E po oblongatu byly nalezeny pouze sekund\u00E1rn\u00ED zm\u011Bny \u2013 ed\u00E9m a \u00FAsekovit\u00E9 prokrv\u00E1cen\u00ED. I p\u0159es n\u00E1lez n\u00E1dorov\u00FDch bun\u011Bk v likvoru nebyla p\u0159i sekci potvrzena infiltrace mening."@cs . . . "Mach\u00E1\u010Dek, Ctirad" . "Smr\u010Dka, Martin" . . "High-Grade Glioma of the Caudal Part of the Spinal Cord Mimicking Myelitis - a Case Report"@en . "76644" . . . "Gliom vy\u0161\u0161\u00EDho stupn\u011B kaud\u00E1ln\u00ED oblasti m\u00EDchy imituj\u00EDc\u00ED myelitidu \u2013 kazuistika" . "\u010Cesk\u00E1 a slovensk\u00E1 neurologie a neurochirurgie" . "High-Grade Glioma of the Caudal Part of the Spinal Cord Mimicking Myelitis - a Case Report"@en . . . "Glioblastomy m\u00EDchy pat\u0159\u00ED mezi velmi vz\u00E1cn\u00E9 n\u00E1dory tvo\u0159\u00EDc\u00ED pouze kolem 1,5 % v\u0161ech prim\u00E1rn\u00EDch n\u00E1dor\u016F m\u00EDchy. Tato kazuistika prezentuje p\u0159\u00EDpad 20let\u00E9ho mu\u017Ee s high-grade gliomem kaud\u00E1ln\u00ED oblasti m\u00EDchy atypick\u00E9ho pr\u016Fb\u011Bhu a obrazu na magnetick\u00E9 rezonanci (MR) s rychle postupuj\u00EDc\u00EDmi sekund\u00E1rn\u00EDmi zm\u011Bnami m\u00EDchy a fat\u00E1ln\u00EDm zakon\u010Den\u00EDm. Pacient byl p\u0159ijat pro dva m\u011Bs\u00EDce se zhor\u0161uj\u00EDc\u00ED slabost a poruchu \u010Dit\u00ED doln\u00EDch kon\u010Detin s podez\u0159en\u00EDm na m\u00ED\u0161n\u00ED low-grade gliom. MR m\u00EDchy byla opakovan\u011B hodnocena jako myelitida. N\u00E1lez pleocyt\u00F3zy v likvoru podpo\u0159il hypot\u00E9zu o z\u00E1n\u011Btliv\u00E9 etiologii. V likvoru byly v\u0161ak nalezeny i atypick\u00E9 bu\u0148ky malign\u00EDho charakteru. Byla nasazena antibiotick\u00E1 a antivirotick\u00E1 medikace a kortikoidy. Klinick\u00FD obraz a n\u00E1lez na MR nicm\u00E9n\u011B d\u00E1le ascendentn\u011B postupoval. Za p\u011Bt dn\u016F od p\u0159ijet\u00ED byla provedena pro suspicium na intradur\u00E1ln\u00ED hematom v rozsahu 1. bedern\u00EDho a\u017E p\u0159echodu 3. a 4. bedern\u00EDho obratle (L1\u2013L3/4) opera\u010Dn\u00ED revize a dekomprese, histologick\u00E9 vy\u0161et\u0159en\u00ED odebran\u00FDch hmot v\u0161ak odpov\u00EDdalo diagn\u00F3ze anaplastick\u00E9ho astrocytomu s p\u0159echodem do glioblastomu. V dal\u0161\u00EDm pr\u016Fb\u011Bhu do\u0161lo u pacienta postupn\u011B k rozvoji respira\u010Dn\u00ED insuficience s nutnost\u00ED um\u011Bl\u00E9 plicn\u00ED ventilace. Dva dny od stanoven\u00ED diagn\u00F3zy, 11. den hospitalizace, pacient zem\u0159el na septick\u00FD \u0161ok p\u0159i ventil\u00E1torov\u00E9 pneumonii. Pitva n\u00E1sledn\u011B potvrdila v\u00FD\u0161e zm\u00EDn\u011Bn\u00FD typ n\u00E1doru lokalizovan\u00FD v\u0161ak pouze v kaud\u00E1ln\u00ED oblasti m\u00EDchy. Ve zbyl\u00E9 \u010D\u00E1sti m\u00EDchy a\u017E po oblongatu byly nalezeny pouze sekund\u00E1rn\u00ED zm\u011Bny \u2013 ed\u00E9m a \u00FAsekovit\u00E9 prokrv\u00E1cen\u00ED. I p\u0159es n\u00E1lez n\u00E1dorov\u00FDch bun\u011Bk v likvoru nebyla p\u0159i sekci potvrzena infiltrace mening." . "Gliom vy\u0161\u0161\u00EDho stupn\u011B kaud\u00E1ln\u00ED oblasti m\u00EDchy imituj\u00EDc\u00ED myelitidu \u2013 kazuistika" . "Gliom vy\u0161\u0161\u00EDho stupn\u011B kaud\u00E1ln\u00ED oblasti m\u00EDchy imituj\u00EDc\u00ED myelitidu \u2013 kazuistika"@cs . . . "000314553500016" . . "6"^^ . "1210-7859" . "\u0160prl\u00E1kov\u00E1-Pukov\u00E1, Andrea" . "Gliom vy\u0161\u0161\u00EDho stupn\u011B kaud\u00E1ln\u00ED oblasti m\u00EDchy imituj\u00EDc\u00ED myelitidu \u2013 kazuistika"@cs . . . "76" . . . . "Bedna\u0159\u00EDk, Josef" . "spinal cord high-grade glioma; myelitis"@en . "1" . "I, V" . . . "\u0160toura\u010D, Pavel" . "RIV/65269705:_____/13:#0002121" . . "RIV/65269705:_____/13:#0002121!RIV14-MZ0-65269705" . "[4EFAF4BDA705]" . . . "Spinal cord glioblastomas are very rare tumours constituting only about 1.5% of all primary spinal cord malignancies. This case report presents a 20-year-old man with high-grade glioma of the caudal part of the spinal cord. Progression and magnetic resonance imaging (MRI) finding were atypical with rapidly advancing secondary changes to the spinal cord. The outcome was fatal. The patient was admitted with a history of two-month progression of weakness and numbness of the lower limbs. Low-grade glioma of the spinal cord was suspected. MRI of the spinal cord had repeatedly been interpreted as myelitis. A finding of pleocytosis in the cerebrospinal fluid supported the hypothesis of inflammatory aetiology. Atypical cells with malignant characteristics were found in the cerebrospinal fluid. Antibiotics, antiviral drugs and corticosteroids were administrated. Nevertheless, clinical and MRI findings progressively deteriorated. Because intradural haematoma was suspected, surgical decompression was performed five days after admission. Histological examination of the removed tissue corresponded to anaplastic astrocytoma converted into glioblastoma. Over the next few days, the patient developed respiratory insufficiency requiring artificial lung ventilation. The patient died of septic shock resulting from ventilator-associated pneumonia two days after the diagnosis, the 11th day of hospitalization. Autopsy confirmed glioma that, however, was localized in the caudal part of the spinal cord only. Only secondary changes - oedema and segmental haemorrhage - occurred in the remaining part of the spinal cord up to the medulla oblongata. There was no confirmed meningeal infiltration despite the presence of tumour cells in the cerebrospinal fluid.."@en . "6"^^ . "\u0160kor\u0148a, Miroslav" . "7"^^ .