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Sensory, motor and sympathetic neurons forming the common peroneal and tibial nerves in the macaque monkey (Macaca fascicularis)

Janjua MZ, Leong SK

J Anat, 1987 Aug;153:63-76.
PMID: 3429328

The motoneurons, dorsal root ganglion (DRG) and sympathetic ganglion (SG) cells forming the common peroneal (CPN) and tibial (TN) nerves of young and semiadult monkeys (Macaca fascicularis) were localised by the horseradish peroxidase method of tracing neuronal connections. The motoneurons forming the CPN occur in the L4-L6 segments, appearing as 1-3 groups and occupying the retroposterolateral (rpl), posterolateral (pl) and central (c) groups of motor nuclei. The motoneurons forming the TN occur in the L4-L7 segments, appearing as 1-4 groups and occupying the rpl, pl, c and anterolateral (al) groups. The motoneurons and DRG cells forming the CPN show peak frequencies at the L5 level, and the SG cells forming the same nerve, at the L6 level in most cases. The motoneurons and DRG cells forming the TN show peak frequencies at the L6 level and the SG cells forming the same nerve, also at the L6 level in most cases. The bulk of motoneurons, DRG and SG cells forming the CPN and TN are concentrated in two segmental levels. For CPN the motoneurons measure between 14-76 micron in their average somal diameters and for TN, 16-70 micron. The majority of them (65.5% for CPN motoneurons and 72% for TN motoneurons) have average somal diameters greater than 38 micron. The size spectrum of the DRG cells forming the CPN is similar to that of DRG cells forming the TN, being 12-78 micron for CPN and 10-76 micron for TN. The sympathetic neurons forming the CPN (measuring 10-44 micron) have a larger size spectrum than those forming the TN (measuring 6-33 micron). The diameter spectrum (3-20 micron for TN and 2-19 micron for CPN) and peak frequency distributions (10 micron for both TN and CPN) of the myelinated fibres present in the CPN and TN are also similar, with the CPN fibres skewing towards a slightly larger size. Many of the fibres in the young and semi-adult monkeys are not yet myelinated.

Matched MeSH terms: Ganglia, Spinal/anatomy & histology; Ganglia, Sympathetic/anatomy & histology
Fulltext Tuning attention based long-short term memory neural networks for Parkinson's disease detection using modified metaheuristics

Cuk A, Bezdan T, Jovanovic L, Antonijevic M, Stankovic M, Simic V, et al.

Sci Rep, 2024 Feb 21;14(1):4309.
PMID: 38383690 DOI: 10.1038/s41598-024-54680-y

Parkinson's disease (PD) is a progressively debilitating neurodegenerative disorder that primarily affects the dopaminergic system in the basal ganglia, impacting millions of individuals globally. The clinical manifestations of the disease include resting tremors, muscle rigidity, bradykinesia, and postural instability. Diagnosis relies mainly on clinical evaluation, lacking reliable diagnostic tests and being inherently imprecise and subjective. Early detection of PD is crucial for initiating treatments that, while unable to cure the chronic condition, can enhance the life quality of patients and alleviate symptoms. This study explores the potential of utilizing long-short term memory neural networks (LSTM) with attention mechanisms to detect Parkinson's disease based on dual-task walking test data. Given that the performance of networks is significantly inductance by architecture and training parameter choices, a modified version of the recently introduced crayfish optimization algorithm (COA) is proposed, specifically tailored to the requirements of this investigation. The proposed optimizer is assessed on a publicly accessible real-world clinical gait in Parkinson's disease dataset, and the results demonstrate its promise, achieving an accuracy of 87.4187 % for the best-constructed models.

Matched MeSH terms: Basal Ganglia
An explanation of deceptive segmental reference in intervertebral disc lesions

Pallie W, Manuel JK

Med J Malaya, 1968 Dec;23(2):96-7.
PMID: 4240828
Matched MeSH terms: Ganglia, Spinal/pathology*
Biotin-thiamine responsive basal ganglia disease: a retrospective review of the clinical, radiological and molecular findings of cases in Kuwait with novel variants

Aburezq M, Alahmad A, Alsafi R, Al-Tawari A, Ramadan D, Shafik M, et al.

Orphanet J Rare Dis, 2023 Sep 05;18(1):271.
PMID: 37670342 DOI: 10.1186/s13023-023-02888-y

BACKGROUND: Biotin-thiamine-responsive basal ganglia disease (BTBGD) is a rare autosomal recessive neurometabolic disorder that is caused by biallelic pathogenic SLC19A3 variants and is characterized by subacute encephalopathy associated with confusion, convulsions, dysphagia, dysarthria, or other neurological manifestations.
METHODS: A retrospective review of the data registry in Kuwait Medical Genetics Center for all cases diagnosed clinically and radiographically and confirmed genetically with BTBGD.
RESULTS: Twenty one cases from 13 different families were diagnosed with BTBGD in Kuwait. Most cases (86%) presented with confusion, dystonia, convulsions, or dysarthria, while three individuals were diagnosed pre-symptomatically during familial targeted genetic screening. Symptoms resolved completely within 2-week of treatment in two-thirds of the symptomatic cases but progressed in six of them to a variety of severe symptoms including severe cogwheel rigidity, dystonia and quadriparesis due to delayed presentation and management. Neuroradiological findings of the symptomatic cases revealed bilateral central changes in the basal ganglia. Two novel homozygous missense SLC19A3 variants were detected in a Kuwaiti and a Jordanian individuals, in addition to the previously reported Saudi founder homozygous variant, c.1264A > G; p.(Thr422Ala) in the remaining cases. Age of diagnosis ranged from newborn to 32 years, with a median age of 2-3 years. All cases are still alive receiving high doses of biotin and thiamine.
CONCLUSION: This is the first study reporting the phenotypic and genotypic spectrum of 21 individuals with BTBGD in Kuwait and describing two novel SLC19A3 variants. BTBGD is a treatable neurometabolic disease that requires early recognition and treatment initiation. This study highlights the importance of performing targeted molecular testing of the founder variant in patients presenting with acute encephalopathy in the region.

Matched MeSH terms: Basal Ganglia Diseases*
Thoracic sympathetic ganglion blocks: real-world outcomes in 207 chronic pain patients

Kim J, Yun M, Han AH, Pauzi MF, Jeong JH, Yoo Y, et al.

Reg Anesth Pain Med, 2024 Jul 08;49(7):528-535.
PMID: 37726196 DOI: 10.1136/rapm-2023-104624

BACKGROUND: Thoracic sympathetic ganglion block (TSGB) is a procedure to manage sympathetically maintained upper extremity pain (sympathetically maintained pain). To date, only a few studies have evaluated the clinical effectiveness of TSGB in pain medicine. This study investigated (1) the relationship between technical success of TSGB and pain reduction in patients with chronic upper extremity pain and (2) relevant clinical factors for a positive TSGB outcome.
METHODS: We retrospectively reviewed medical data in 232 patients who received TSGB from 2004 to 2020. Technical success and a positive outcome of TSGB were defined as a temperature increase of ≥1.5°C at 20 min and a pain reduction with ≥2 points on the 11-point Numerical Rating Scale at 2 weeks post-TSGB, respectively. Correlations were assessed using correlation coefficients (R), and multivariable regression model was used to identify factors relevant to TSGB outcomes.
RESULTS: 207 patients were ultimately analyzed; among them, 115 (55.5%) patients positively responded to TSGB, and 139 (67.1%) achieved technical success after TSGB. No significant relationship existed between the pain reduction and the temperature increase after TSGB (R=0.013, p=0.855). Comorbid diabetes (OR 4.200) and adjuvant intake (OR 3.451) were positively associated, and psychiatric comorbidity (OR 0.327) and pain duration (OR 0.973) were negatively associated with TSGB outcome.
CONCLUSIONS: We found no significant association between the temperature increase and pain reduction after TSGB. Further studies are warranted to identify significant factors associated with TSGB outcomes in patients with complex regional pain syndrome and neuropathic pain diseases.

Matched MeSH terms: Ganglia, Sympathetic*
Fulltext Ganglion of the Flexor Tendon Sheath at the A2 Pulley - Case Report

Gunaseelan P, Jeremy P, Chua CK, Rashdeen F

Malays Orthop J, 2015 Mar;9(1):28-29.
PMID: 28435592 MyJurnal DOI: 10.5704/MOJ.1503.002

There are few reported cases of flexor tendon sheath ganglion arising from the A2 pulley. We report a case of a flexor tendon sheath ganglion in a 17-year old female who presented with pain, triggering and a swelling at the base of her right ring finger. During the excision biopsy, a ganglion measuring 0.5×0.8×0.4 cm in size was removed from the A2 pulley area.

Matched MeSH terms: Ganglia
Movement disorder in a patient with stroke

Tai ML, Tan CT, Ramli N, Begum RJ, Lim SY

J Clin Neurosci, 2011 Feb;18(2):263, 305.
PMID: 21294301
Matched MeSH terms: Basal Ganglia Cerebrovascular Disease/complications*; Basal Ganglia Cerebrovascular Disease/pathology*
Fulltext Germinoma of the basal ganglia and thalamus--CT and MRI findings

Wong LW, Jayakumar CR

Singapore Med J, 1997 Oct;38(10):444-6.
PMID: 9529959

A case of germinoma originating in the basal ganglia and thalamus is presented. This tumour most commonly originates during childhood and adolescence, at pineal and suprasellar regions. In the early stages, the diagnosis of germinoma in the basal ganglion and thalamus is difficult because of its rarity and non-specific findings. The computed tomography (CT) and magnetic resonance imaging (MRI) findings though non-diagnostic, are discussed here. A few differential diagnoses had been discussed with radiological abnormality. Open biopsy done in this case proved to be two-cell pattern germinoma. Early detection of the tumour is desirable, since this tumour is highly sensitive to radio and chemotherapy and is potentially curable. Our patient was treated with combined chemotherapy and the response was well and no residual tumour or recurrence was seen on the repeated imaging modality, however his neurological deficits remained unchanged.

Matched MeSH terms: Basal Ganglia/pathology*; Basal Ganglia/radiography
Fulltext Unilateral striatal CT and MRI changes secondary to non-ketotic hyperglycaemia

Johari B, Hanafiah M, Shahizon AM, Koshy M

BMJ Case Rep, 2014;2014.
PMID: 24792025 DOI: 10.1136/bcr-2014-204053

A 62-year-old man presented with a right-sided hemichorea-hemiballismus secondary to underlying non-ketotic hyperglycaemia. This condition is recognised to have a unique finding of unilateral basal ganglia lesion, which is hyperdense on CT and hyperintense on T1-weighted MRI. The clinical course of this condition is benign and has a good prognosis with early correction of the hyperglycaemia.

Matched MeSH terms: Basal Ganglia/pathology; Basal Ganglia/radiography
Fulltext Leigh syndrome: MRI findings in two children

Kartikasalwah A, Lh N

Biomed Imaging Interv J, 2010 Jan-Mar;6(1):e6.
PMID: 21611066 MyJurnal DOI: 10.2349/biij.6.1.e6

Leigh syndrome is a progressive neurodegenerative disorder of childhood. The symmetrical necrotic lesions in the basal ganglia and/or brainstem which appear as hyperintense lesions on T2-weighted MRI is characteristic and one of the essential diagnostic criteria. Recognising this MR imaging pattern in a child with neurological problems should prompt the clinician to investigate for Leigh syndrome. We present here two cases of Leigh syndrome due to different biochemical/genetic defects, and discuss the subtle differences in their MR neuroimaging features.

Matched MeSH terms: Basal Ganglia
Fulltext Cellular and molecular profiles of anterior nervous system regeneration in Diopatra claparedii Grube, 1878 (Annelida, Polychaeta)

Ahmad Nazri MUI, Mahmud MH, Saidi B, Mat Isa MN, Ehsak Z, Ross O, et al.

Heliyon, 2021 Feb;7(2):e06307.
PMID: 33681499 DOI: 10.1016/j.heliyon.2021.e06307

The polychaete Diopatra claparedii Grube, 1878 is among those organisms successfully carrying out full body regeneration, including the whole nervous system. Thus, D. claparedii potentially can be regarded for the nervous system regeneration (NSR) study. However, data on the property of its nervous system and the NSR profile are still lacking. In this study, we investigated the morphology of D. claparedii anterior nervous system (ANS) and examined the cellular and molecular profiles on its early anterior NSR. The nervous system of D. claparedii consists of a symmetry brain with nerves branching off, circumpharyngeal connectives that connect the brain and nerve cord as well as obvious segmental ganglia. Moreover, we identified changes in the cellular condition of the ganglionic cells in the regenerating tissue, such as the accumulation of lysosomes and lipofuscins, elongated mitochondria and multiple nucleoli. Furthermore, mRNA of tissues at two regenerating stages, as well as intact tissue (non-regenerating), were sequenced with Illumina sequencer. We identified from these tissues 37,248 sequences, 18 differential expressed proteins of which upregulated were involved in NSR with noelin-like isoform X2 turned up to be the highest being expressed. Our results highlight the cellular and molecular changes during early phase of NSR, thus providing essential insights on regeneration within Annelida and understanding the neurodegenerative diseases.

Matched MeSH terms: Ganglia, Invertebrate
Toluene-induced leukodystrophy from glue sniffing

Lau YH, Mawardi AS, Zain NR, Viswanathan S

Pract Neurol, 2021 Oct;21(5):439-441.
PMID: 34039751 DOI: 10.1136/practneurol-2021-002942

A 33-year-old man with a history of chronic toluene abuse through glue sniffing, developed tremors, cerebellar signs and cognitive decline. MR scan of the brain showed global cerebral and cerebellar atrophy with symmetrical T2-weighted hypointensities in the basal ganglia, thalami and midbrain. After stopping glue sniffing, his tremors, ataxia of gait, speech and cognition partially improved. Early recognition and intervention of toluene-induced leukodystrophy could prevent ongoing morbidity and premature mortality.

Matched MeSH terms: Basal Ganglia
Eyes on MEGDEL: distinctive basal ganglia involvement in dystonia deafness syndrome

Wortmann SB, van Hasselt PM, Barić I, Burlina A, Darin N, Hörster F, et al.

Neuropediatrics, 2015 Apr;46(2):98-103.
PMID: 25642805 DOI: 10.1055/s-0034-1399755

Pediatric movement disorders are still a diagnostic challenge, as many patients remain without a (genetic) diagnosis. Magnetic resonance imaging (MRI) pattern recognition can lead to the diagnosis. MEGDEL syndrome (3-MethylGlutaconic aciduria, Deafness, Encephalopathy, Leigh-like syndrome MIM #614739) is a clinically and biochemically highly distinctive dystonia deafness syndrome accompanied by 3-methylglutaconic aciduria, severe developmental delay, and progressive spasticity. Mutations are found in SERAC1, encoding a phosphatidylglycerol remodeling enzyme essential for both mitochondrial function and intracellular cholesterol trafficking. Based on the homogenous phenotype, we hypothesized an accordingly characteristic MRI pattern. A total of 43 complete MRI studies of 30 patients were systematically reevaluated. All patients presented a distinctive brain MRI pattern with five characteristic disease stages affecting the basal ganglia, especially the putamen. In stage 1, T2 signal changes of the pallidum are present. In stage 2, swelling of the putamen and caudate nucleus is seen. The dorsal putamen contains an "eye" that shows no signal alteration and (thus) seems to be spared during this stage of the disease. It later increases, reflecting progressive putaminal involvement. This "eye" was found in all patients with MEGDEL syndrome during a specific age range, and has not been reported in other disorders, making it pathognomonic for MEDGEL and allowing diagnosis based on MRI findings.

Matched MeSH terms: Basal Ganglia/pathology*
Antipsychotic treatment in older schizophrenia patients with extrapyramidal side effects in Asia (2001 - 2009)

Xiang YT, Kreyenbuhl J, Dickerson FB, Ungvari GS, Wang CY, Si TM, et al.

Int J Clin Pharmacol Ther, 2012 Jul;50(7):500-4.
PMID: 22541750 DOI: 10.5414/CP201683

This study surveyed the prescribing patterns of antipsychotic medications in Asian older schizophrenia patients with extrapyramidal side effects (EPS) during the period between 2001 and 2009.

Matched MeSH terms: Basal Ganglia Diseases/chemically induced*
Extremely low nerve growth facior (NGF) activity of sea snake (Hydrophiidae) venoms

Mariam K, Tu AT

J Nat Toxins, 2002 Dec;11(4):393-8.
PMID: 12503884

Sea snake venoms contain less protein than those of land snakes (Toom et al., 1969). Sea snake venoms lack arginine ester hydrolyzing activity, whereas those of Crotalidae and Viperidae have such activity (Tu et al., 1966). Sea snakes live in salty water, and their venoms may be different from those of land snakes. Because of the difficulty in obtaining sea snake venoms, information about sea snake venoms is quite incomplete. NGF is commonly present in the venoms of land snakes such as Elapidae, Viperidae, and Crotalidae (Cohen and Levi-Montalcini, 1956; Lipps, 2002). It is therefore of interest to investigate the presence or absence of NGF in sea snake venoms. In order to investigate the presence or absence of NGF, five sea snake venoms were selected. Lapemis hardwickii (Hardwick's sea snake) and Acalyptophis peronii venom were obtained from the Gulf of Thailand. Hydrophis cyanocinctus (common sea snake) and Enhydrina schistosa (beaked sea snake) venom were obtained from the Strait of Malacca. Laticauda semifasciata (broad band blue sea snake) venom was also examined and the venom was obtained from Gato Island in the Philippines.

Matched MeSH terms: Ganglia, Spinal/drug effects
Fulltext Palm Fruit Bioactives augment expression of Tyrosine Hydroxylase in the Nile Grass Rat basal ganglia and alter the colonic microbiome

Weinberg RP, Koledova VV, Subramaniam A, Schneider K, Artamonova A, Sambanthamurthi R, et al.

Sci Rep, 2019 Dec 09;9(1):18625.
PMID: 31819070 DOI: 10.1038/s41598-019-54461-y

Tyrosine hydroxylase (TH) catalyzes the hydroxylation of L-tyrosine to L-DOPA. This is the rate-limiting step in the biosynthesis of the catecholamines - dopamine (DA), norepinephrine (NE), and epinephrine (EP). Catecholamines (CA) play a key role as neurotransmitters and hormones. Aberrant levels of CA are associated with multiple medical conditions, including Parkinson's disease. Palm Fruit Bioactives (PFB) significantly increased the levels of tyrosine hydroxylase in the brain of the Nile Grass rat (NGR), a novel and potentially significant finding, unique to PFB among known botanical sources. Increases were most pronounced in the basal ganglia, including the caudate-putamen, striatum and substantia nigra. The NGR represents an animal model of diet-induced Type 2 Diabetes Mellitus (T2DM), exhibiting hyperglycemia, hyperinsulinemia, and insulin resistance associated with hyperphagia and accelerated postweaning weight gain induced by a high-carbohydrate diet (hiCHO). The PFB-induced increase of TH in the basal ganglia of the NGR was documented by immuno-histochemical staining (IHC). This increase in TH occurred equally in both diabetes-susceptible and diabetes-resistant NGR fed a hiCHO. PFB also stimulated growth of the colon microbiota evidenced by an increase in cecal weight and altered microbiome. The metabolites of colon microbiota, e.g. short-chain fatty acids, may influence the brain and behavior significantly.

Matched MeSH terms: Basal Ganglia/drug effects; Basal Ganglia/metabolism*
Fulltext Effects of happy music on repetitive and restricted behaviours in children with autism spectrum disorders: a concept paper

Nurul Izzah Wahidul Azam, Amir Muhriz Abdul Latiff, Chandra Kannan Thanapalan, Raja Mohamad Alif Raja Adnan

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):93-93.
MyJurnal

Introduction: Restricted and repetitive behaviours (RRBs) is one of autism spectrum disorders (ASD) core criteria. Exhibitions of RRBs produce profound implications on the functional aspect of these children and family. Evidence found that RRBs is related to the reward system dysfunction in the basal ganglia of these children. RRBs induces intrinsically rewarding effects on children with ASD. Listening to music was found to influence the reward system on the typical population and also discover to be promising as complementary strategies for ASD. A study found that high functioning adolescents with ASD cognitively stimulated through listening to happy music. Planning inter-vention for RRBs by looking towards the mechanism of reward system function remained unexplored. The primary objectives of this study is to examine the effect of happy music on RRBs symptoms. Methods: This study will use a randomised control trial research design with pre-test and post-test assessments in 20 children with ASD. Two parallel randomly assigned group will undergo twelve weeks of intervention sessions. The experimental group will listen to happy music and engage in free play sessions. For the control group, they will engage in free play session only without the music. Parents will complete the Repetitive Behaviour Scale-Revised, which consists of 6 subscales on RRBs to measure the outcome of the study. Results: The study will compare the RRBs between two groups. Con-clusion: Outcome of this study may set forth further investigation on the management of RRB using non-aversive contemporary approach.

Matched MeSH terms: Ganglia
Hydralazine administration activates sympathetic preganglionic neurons whose activity mobilizes glucose and increases cardiovascular function

Parker LM, Damanhuri HA, Fletcher SP, Goodchild AK

Brain Res, 2015 Apr 16;1604:25-34.
PMID: 25662772 DOI: 10.1016/j.brainres.2015.01.049

Hypotensive drugs have been used to identify central neurons that mediate compensatory baroreceptor reflex responses. Such drugs also increase blood glucose. Our aim was to identify the neurochemical phenotypes of sympathetic preganglionic neurons (SPN) and adrenal chromaffin cells activated following hydralazine (HDZ; 10mg/kg) administration in rats, and utilize this and SPN target organ destination to ascribe their function as cardiovascular or glucose regulating. Blood glucose was measured and adrenal chromaffin cell activation was assessed using c-Fos immunoreactivity (-ir) and phosphorylation of tyrosine hydroxylase, respectively. The activation and neurochemical phenotype of SPN innervating the adrenal glands and celiac ganglia were determined using the retrograde tracer cholera toxin B subunit, in combination with in situ hybridization and immunohistochemistry. Blood glucose was elevated at multiple time points following HDZ administration but little evidence of chromaffin cell activation was seen suggesting non-adrenal mechanisms contribute to the sustained hyperglycemia. 16±0.1% of T4-T11 SPN contained c-Fos and of these: 24.3±1.4% projected to adrenal glands and 29±5.5% projected to celiac ganglia with the rest innervating other targets. 62.8±1.4% of SPN innervating adrenal glands were activated and 29.9±3.3% expressed PPE mRNA whereas 53.2±8.6% of SPN innervating celiac ganglia were activated and 31.2±8.8% expressed PPE mRNA. CART-ir SPN innervating each target were also activated and did not co-express PPE mRNA. Neurochemical coding reveals that HDZ administration activates both PPE+SPN, whose activity increase glucose mobilization causing hyperglycemia, as well as CART+SPN whose activity drive vasomotor responses mediated by baroreceptor unloading to raise vascular tone and heart rate.

Matched MeSH terms: Ganglia, Sympathetic/cytology; Ganglia, Sympathetic/drug effects*; Ganglia, Sympathetic/metabolism
The efficacy of pulsed radiofrequency intervention of the lumbar dorsal root ganglion in patients with chronic lumbar radicular pain

Marliana A, Yudianta S, Subagya DW, Setyopranoto I, Setyaningsih I, Tursina Srie C, et al.

Med J Malaysia, 2020 03;75(2):124-129.
PMID: 32281592

INTRODUCTION: In recent years, pulsed radiofrequency (PR) has been used as a minimally invasive pain intervention. However, various studies on the efficacy of PR as modalities for the treatment of radicular pain in lumbar disc herniation have had varied results.
OBJECTIVE: This study aims to determine the efficacy of PR in reducing radicular pain among lumbar disc herniation patients compared with conservative treatment.
METHODS: This study was conducted using the before-andafter quasi experimental design. There were 50 subjects that fulfilled the inclusion and exclusion criteria and they were divided into an intervention group (n=25) and control group (n=25). The intervention group was given once PR in the dorsal root ganglion. All subjects were assessed for Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) before treatment, at 1- , 2- and 4-week after treatment.
RESULTS: At1-, 2- and 4-week, the VAS reduction in the intervention group was statistically significant compared to the control group. Four weeks after the intervention, the VAS score decreased in the intervention group (mean VAS -78.5, SD 16.8) more significantly compared to the control group (p<0.001). The ODI score decreased in the intervention group (mean ODI -61.8, SD 20.1) more significantly than in the control group (p<0.001).
CONCLUSION: Finding showed that at1- , 2- and 4-weekPR was more efficacious in reducing radicular pain among lumbar disc herniation patients compared to the conservative therapy.

Matched MeSH terms: Ganglia, Spinal
Fulltext Bilateral Carotid Body Tumours

Amran, A.R., Jayaram, G., Kumar, G.

International Medical Journal Malaysia, 2006;5(1):1-6.
MyJurnal

Paragangliomas are slow growing hypervascular tumour arising from neural crest cell derivatives throughout the body. In the head and neck region, the major paraganglial cells are located at the carotid bifurcation (carotid body), along the ganglia of the vagus nerve and along the nerves supplying the middle ear and jugular bulb. Less common locations include the larynx, orbit, nose and the aortic arch. Carotid body tumours are very rare neoplasms constituting less than 0.5% of all tumours. The true nature of the tumour is established at the time of attempted biopsy or surgical resection, sometimes with disastrous consequences. Only a few of the more than 500 cases reported in the literature have been studied and diagnosed preoperatively. These tumours must be considered in the evaluation of any lateral neck mass, even one located far from the carotid bifurcation. We report a case of bilateral carotid body tumours detected using 16-slice MDHCT in a patient who presented with pulsatile neck swelling for two years. This tumour is rarely malignant; however it produces serious problems by its progressive enlargement and impairment of adjacent structures in the neck. The treatment of choice is surgical resection; preferably to excise this lesion when it is small, because large, very vascular tumours are intimately attached to the carotid vessels and make surgical resection more hazardous. Pre-operative embolization can be performed in large tumours, as to facilitates surgery and reduce complication. In most of the cases, there is strong attachment of the tumour to the carotid arteries. When this is the situation, removal of the tumour means complete excision of both great arteries as well, and the mortality rate is 40 to 45 %. When surgical removal is not feasible, radiotherapy may help to control the tumour growth, although the results have not been encouraging. As it is very slow growing tumour with the growth rate of less than 5 mm per year tumours in old patients with significant risk factors for surgical intervention can be managed by observation alone.

Matched MeSH terms: Ganglia

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