China
Africa
Explore chapters and articles related to this topic
Cranial Neuropathies I, V, and VII–XII
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Brainstem: lesions are often associated with other CN deficits and long tract involvement: Stroke (lateral medullary syndrome).Multiple sclerosis (MS).Tumor (brainstem glioma, lymphoma, and metastases).Syringobulbia.Hemorrhage from hypertension, ruptured vascular anomalies.Inflammatory conditions: sarcoidosis, connective tissue diseases, and vasculitis.Infectious conditions.
Ernesto
Published in Walter J. Hendelman, Peter Humphreys, Christopher R. Skinner, The Integrated Nervous System, 2017
Walter J. Hendelman, Peter Humphreys, Christopher R. Skinner
A C-P angle meningioma, although somewhat less common, would also be possible. A brainstem glioma is also to be considered, but these are always associated with long tract sensory and motor deficits. CNS lymphoma may also involve cranial nerves but typically affects many nerves simultaneously. A condition known as metastatic carcinomatosis of the meninges can cause multiple cranial nerve palsies including CN VII and VIII. A solitary metastasis is unlikely in this case, as there is no known primary.
Neuro-Oncology
Published in John W. Scadding, Nicholas A. Losseff, Clinical Neurology, 2011
Brainstem gliomas are mainly seen in children aged 5–10 years and in young adults. Most are high-grade astrocytomas arising in the pons, extending into the medulla and midbrain, presenting with a short history of ataxia, long tract signs and cranial nerve palsies. This typical history with the characteristic MRI features of a diffuse, poorly T1-enhancing lesion, is considered diagnostic of the high-grade diffuse intrinsic pontine glioma, and obviates the need for a brainstem biopsy, with its high morbidity and failure rate.
Dilated Virchow Robin spaces in brainstem
Published in British Journal of Neurosurgery, 2023
Nishanth Sadashiva, Jitender Saini
A 18-year-old boy presented with a history of intermittent hemi-cranial headaches since 1 year. He was evaluated by a physician and had undergone imaging. The imaging had revealed a multicystic lesion in the brainstem and was diagnosed to have a brainstem glioma. He was subsequently referred to neurosurgery for a possible surgery or a biopsy. A detailed neurological examination of the patient showed no focal neurological deficits. On reviewing the magnetic resonance imaging (MRI), a multicystic brain stem lesion was noticed predominantly in the upper pons and midbrain. The lesion did not show any significant perilesional white matter signal intensity changes (Figure 1) and there was no enhancement after gadolinium contrast administration (Figure 2). Rest of the supra-tentorial brain appeared normal on MRI. A diagnosis of dilated Virchow Robin spaces (dVRS) was made, and the patient was advised treatment for his migraine with neurologist consultation.
Prognostic value of O-(2-[18F]-fluoroethyl)-L-tyrosine PET in relapsing oligodendroglioma
Published in Acta Oncologica, 2020
Florian Schneider, Fabian Wolpert, Paul Stolzmann, Abdulrahman A. Albatly, David Kenkel, Jonathan Weller, Michael Weller, Spyros S. Kollias, Elisabeth J. Rushing, Patrick Veit-Haibach, Martin W. Huellner
There are limited studies on the association of 18F-FET-PET parameters with PFS of glioma patients. Thiele et al. reported a significant correlation between measures based on background (SUV/BG) and PFS, but not overall survival, in glioblastoma [44]. Albatly et al. provided evidence of a more favorable outcome of adult brainstem glioma patients whose tumors had lower SUVmax and TBRmax [11]. Galldiks et al. reported that low TBRmax of glioblastoma is a significant predictor for PFS and overall survival [45]. In low-grade glioma, lower 18F-FET uptake was also shown to significantly correlate with PFS in a study by Floeth et al. [46]. In all these instances, the PFS was significantly higher in subjects with lower tumoral 18F-FET uptake. Our study provides evidence that – among well-known clinical parameters such as the WHO grade of the initial tumor and surgery of the relapsing tumor – also 18F-FET-PET parameters might play a role for prediction of further progression. Taking into account TBRmax, which is known to typically exhibit co-linearities with SUVmax, yielded the highest AUC (0.945, CI 0.881–1.000) and the highest true classification rate (88.1%) [47].
Pediatric brain tumor care in a Sub-Saharan setting: current poise of a precariously loaded dice
Published in British Journal of Neurosurgery, 2021
Enoch Ogbonnaya Uche, Christopher B. Eke, Okechukwu C. Okafor, Nkechinyere Judith Uche, Obinna V. Ajuzieogu, Dubem S. Amuta, Ephraim E. Onyia, Dung A. Guga, Samuel Okpara, Wilfred C. Mezue, Magnus Tisell, Mats Ryttlefors
However, from our series, patients treated with radiotherapy had poorer overall survival (Table 3) as well as school performance. Poor school outcomes with radiotherapy may partly reflect the reality that more high-grade tumors with intrinsic propensity to poorer outcomes are treated with this modality including brainstem gliomas. However, the long-term sequelae of radiation therapy among paediatric brain tumor survivors, especially its harmful effect on brain vasculature and neurocognitive functions have been previously reported.29,30Despite these sequelae, radiotherapy together with cerebrospinal fluid diversion remain the mainstay for treatment of brain stem gliomas which constitute 10.6% of PBTs in our series.8Radiation treatment for brainstem gliomas was associated with 40 and 0%, 1-year and 5-year survival respectively. Our findings are similar to those from a recent Asian study.29We treated serum marker positive ICGCT’s with radiotherapy as well and the 1-year and 5-year survival rates for ICGCT from our series is 60 and 40%, respectively, which is similar to some previously reported outcomes for non germinomatous germ cell tumors.9,31 From our index study, marker positive ICGCT constitutes 6% of all paediatric brain tumors. The use of generous radiation dose for tumor bed and ventricular space with or without craniospinal irradiation and chemotherapy is considered a vital component of the standard treatment protocol for ICGCT.8,30 Treatment complications and 30-day mortality rates varied with tumor phenotype.