Peritumoural Brain Research Articles

Immunofluoroscopic investigation of extravasation of serum proteins in human brain tumours and adjacent structures.

Forty-seven neurosurgical human specimens taken from malignant gliomas and peritumoural brain structures were investigated for extravasation of serum proteins. Serum proteins were visualized microscopically in paraffin-embedded material using a double layer immunofluorescence technique. Proteins accumulated in the tumour and in the adjacent peritumoural white matter, and were mainly located extracellularly. Intracellular uptake was observed in some but not all tumour cells, in reactive astrocytes and, occasionally, in oligodendrocytes and neurons. Diffuse infiltration of products was present in necrotic, cystic and haemorrhagic regions. The distribution of extravasated proteins corresponded precisely to that previously observed in transplanted tumours in cats (Hossmann et al. 1979), suggesting that the pathophysiology of human tumour oedema is similar to that of the experimental material. Since all patients were operated without corticosteroid therapy, the present results can be used as a reference for forthcoming studies on the effect of corticosteroids on peritumorous oedema.

Influence of alpha-methyl-prednisolone on perifocal brain edema--CT observations in ten patients with circumscribed supratentorial brain tumours

Under treatment of peritumoural brain oedema with 6-methyl-prednisolone, in most cases there are no significant density changes to be seen on the CT although there is undoubted clinical improvement. In order to get data for an optimal timing of pre-operative treatment with steroids we had to prove the effect of 6-methyl-prednisolone (Urbason, Hoechst) with intermittent measurements of the so-called CT "Region of interest" in always the same parts of the perifocal brain oedema for seven days pre-operatively. This study was carried out in ten patients with solitary supratentorial brain tumours. CT measurements on the first day without medication, continued with an initial dosage of 1000 mg Urbason, followed by 3 X 40 mg daily during the second to the fifth day, and finally on the seventh day after the steroid was stopped. In all cases we found increasing attenuation coefficients due to decreasing oedema with a peak on the fourth and fifth days.

Corticosteroid therapy of experimental tumour oedema.

Experimental brain tumours were produced in cats by stereotactic implantation of 4 million suspended cells of a rat glioma clone into the internal capsule. Three weeks after implantation a spherical tumour developed with a diameter of up to 10 mm which was surrounded by vasogenic white matter oedema. In untreated animals water content in the peritumoural white matter increased form 69.1 +/- 0.9 to 80.0 +/0 0.8 ml/100 g w. w., and regional blood flow reciprocally decreased from 32.2 +/- 5.6 to 18.9 +/- 0.05 ml/100 g/min. A single injection of a crystalline suspension of 10 mg/kg dexamethasone given intramuscularly one week before the animals were killed, led to a significant amelioration of brain oedema. Peritumoural white matter water content decreased to 73.0 +/- 0.5 ml/100 g w w. and blood flow rose to 35.7 +/- 2.8 ml/100 g/min. These changes were accompanied by parallel shifts of electrolyte content buy did not correlate with EEG activity, as assessed by Fourier frequency analysis. Corticosteroids did not prevent extravasation of peroxidase or Evans blue across the tumour vessels. The beneficial effect, therefore, is attributed to either an acceleration of resorption or an inhibition of the spread of oedema from tumour into the peritumoural brain tissue.