Search Our Scientific Publications & Authors

Childs Nerv Syst 2020 Jun 26. Epub 2020 Jun 26.

Department of Pediatrics, Pediatric Oncology Institute-GRAACC, Federal University of São Paulo, São Paulo, SP, Brazil.

Purpose: In neurogenesis, ASPM (abnormal spindle-like microcephaly-associated) gene is expressed mainly in the ventricular zone of posterior fossa and is the major determinant in the cerebral cortex. Besides its role in embryonic development, ASPM overexpression promotes tumor growth, including central nervous system (CNS) tumors. This study aims to investigate ASPM expression levels in most frequent posterior fossa brain tumors of childhood and adolescence: medulloblastoma (MB), ependymoma (EPN), and astrocytoma (AS), correlating them with clinicopathological characteristics and tumor solid portion size. Read More

Anticancer Res 2020 May;40(5):2975-2980

School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Background/aim: Even though advanced magnetic resonance imaging (MRI) can effectively differentiate between medulloblastoma and ependymoma, it is not readily available throughout the world. This study aimed to investigate the role of simple quantified basic MRI sequences in the differentiation between medulloblastoma and ependymoma in children.

Patients And Methods: The institutional review board approved this prospective study. Read More

J Clin Neurosci 2020 Apr 23. Epub 2020 Apr 23.

School of Electrical Engineering, Zhengzhou University, Zhengzhou 450001, China; Industrial Technology Research Institute, Zhengzhou University, Zhengzhou 450001, China; Henan Key Laboratory of Brain Science and Brain-Computer Interface Technology, Zhengzhou University, Zhengzhou 450001, China. Electronic address:

Mandatory accurate and specific diagnosis demands have brought about increased challenges for radiologists in pediatric posterior fossa tumor prediction and prognosis. With the development of high-performance computing and machine learning technologies, radiomics provides increasing opportunities for clinical decision-making. Several studies have applied radiomics as a decision support tool in intracranial tumors differentiation. Read More

Pediatr Blood Cancer 2020 Jun 14;67(6):e28189. Epub 2020 Apr 14.

Department of Neurosurgery, LeBonheur Children's Hospital, Memphis, Tennessee.

Background: Despite improved survival, many pediatric brain tumor survivors receiving radiation therapy (RT) experience late effects.

Procedure: To study calvarial lesions in this population, we retrospectively reviewed records of patients undergoing neurosurgical evaluation for calvarial bone lesions detected in posttreatment follow-up imaging at St. Jude Children's Research Hospital. Read More

Neuro Oncol 2020 Mar 10. Epub 2020 Mar 10.

Department of Pediatrics, MD Anderson Cancer Center, Houston.

Background: Recurrent pediatric medulloblastoma and ependymoma have a grim prognosis. We report a first-in-human, phase I study of intraventricular infusions of ex-vivo expanded autologous natural killer (NK) cells in these tumors, with correlative studies.

Methods: Twelve patients were enrolled, 9 received protocol therapy up to 3 infusions weekly, in escalating doses from 3x106 to 3x108 NK cells/m2/infusion, for up to 3 cycles. Read More

Neuroradiology 2020 Jun 6;62(6):705-713. Epub 2020 Mar 6.

UOC Radiodiagnostica e Neuroradiologia, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Purpose: Susceptibility-weighted imaging (SWI) is useful for glioma grading and discriminating between brain tumor categories in adults, but its diagnostic value for pediatric brain tumors is unclear. Here we evaluated the usefulness of SWI for pediatric tumor grading and differentiation by assessing intratumoral susceptibility signal intensity (ITSS).

Methods: We retrospectively enrolled 96 children with histopathologically diagnosed brain tumors, who underwent routine brain MRI exam with SWI (1. Read More

Neurol India 2020 Jan-Feb;68(1):159-162

Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.

Background: CSF drainage from the ventricular system is a popular and effective technique for intraoperative brain relaxation as it reduces ICP, enlarges extra-axial operative corridors, and slackens the brain increasing its tolerance for surgical manipulation. However, sometimes when the ventricular chambers distant from the site of pathology are tapped, there is a risk of neurological worsening due to paradoxical herniation of the brain, exemplified by the phenomenon of upward transtentorial herniation observed in posterior fossa tumors, consequent to a supratentorial ventriculostomy. Expectation of an analogous phenomenon precludes contralateral ventricular drainage in supratentorial brain tumors producing midline shift, subfalcine herniation, and resultant distension of the opposite lateral ventricles. Read More

Front Oncol 2020 7;10:71. Epub 2020 Feb 7.

Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States.

We applied machine learning algorithms for differentiation of posterior fossa tumors using apparent diffusion coefficient (ADC) histogram analysis and structural MRI findings. A total of 256 patients with intra-axial posterior fossa tumors were identified, of whom 248 were included in machine learning analysis, with at least 6 representative subjects per each tumor pathology. The ADC histograms of solid components of tumors, structural MRI findings, and patients' age were applied to construct decision models using Classification and Regression Tree analysis. Read More

Childs Nerv Syst 2020 May 5;36(5):941-949. Epub 2020 Feb 5.

Department of Neurosurgery, Division of Pediatric Neurosurgery, Acıbadem University School of Medicine, Istanbul, Turkey.

Purpose: Posterior fossa ependymomas (PFE) are among the most frequently occurring solid tumors in children. Their definitive treatment is surgical excision and adjuvant radio-chemotherapy. This study aimed to investigate prognostic effects of age, H3K27me3 status, extent of resection, radiation treatment (RT), Ki67 index, WHO grade, and ATRX and H3K27M mutations in PFE patients. Read More

Cell Rep 2020 Feb;30(5):1300-1309.e5

Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA 94143, USA; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA 94143, USA. Electronic address:

Ependymomas exist within distinct genetic subgroups, but the molecular diversity within individual ependymomas is unknown. We perform multiplatform molecular profiling of 6 spatially distinct samples from an ependymoma with C11orf95-RELA fusion. DNA methylation and RNA sequencing distinguish clusters of samples according to neuronal development gene expression programs that could also be delineated by differences in magnetic resonance blood perfusion. Read More

Zhonghua Yi Xue Za Zhi 2020 Jan;100(3):178-181

School of Biological Science and Medical Engineering, Southeast University, International laboratory for Children's Medical Imaging Research Nanjing, Nanjing 210096, China.

To evaluate the classification of the types of pediatric posterior fossa brain tumors based on routine MRI (T(1)WI, T(2)WI and ADC) using wavelet transformation analysis of whole tumor. MRI images of medulloblastoma (59), ependymoma (13) and pilocytic astrocytoma (27) confirmed by pathology before treatments in Children's Hospital of Nanjing Medical University from January 2014 to February 2019 were enrolled in this retrospective study as well as the clinical data of age, gender and symptoms. Registration was performed among the three sequences and wavelet features of ROI were acquired. Read More

J Neuroimaging 2020 Mar 6;30(2):192-197. Epub 2020 Jan 6.

Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD.

Background And Purpose: Posterior fossa syndrome (PFS), characterized by loss of language and other neurological impairments within the immediate postoperative period, occurs in approximately 25% of children who undergo surgical resection of posterior fossa tumors. Diffusion tensor imaging connectomics offer promise for elucidation of pathway-level disruption in neural connectivity of patients with this disorder. We aim to determine differences in pre- and postoperative connectomics between children with PFS and children with mild or no language deficit after surgery. Read More

World Neurosurg 2020 Apr 31;136:32-36. Epub 2019 Dec 31.

Unit of Neuroradiology, Azienda Ospedaliera di Rilievo Nazionale "Gaetano Rummo," Benevento, Italy.

Background: Ring-shaped lateral ventricular nodules (RSLVNs) are commonly considered as benign asymptomatic lesions, which are sporadically detected as incidental findings on routine brain magnetic resonance imaging scans. Despite their not irrelevant frequency, the exact biological nature of these lesions remains largely unknown due to the lack of histopathologic studies. Here we present the clinical, neuroradiologic, and histopathologic findings of an unusual case of symptomatic multiple RSLVNs. Read More

Am J Case Rep 2019 Dec 25;20:1936-1941. Epub 2019 Dec 25.

Department of Neurosurgery, Agia Sophia Pediatric Hospital, Athens, Greece.

BACKGROUND The ventriculoperitoneal shunt remains, despite recent advances, the mainstay of treatment for hydrocephalus. Although it is used as a routine practice, and besides its recorded and documented safety, it often malfunctions due to a variety of reasons, most commonly referred to as obstruction, breakage, migration and infection. A usual finding of those children suspected to magnetic resonance imaging is the detection of a rim of hyperintensity in the periventricular white matter (halo). Read More

Clin Neuroradiol 2019 Nov 21. Epub 2019 Nov 21.

2nd Department of Clinical Radiology, Medical University of Warsaw, ul. Zwirki i Wigury 61, 02-091, Warsaw, Poland.

Background And Purpose: Recent attempts to utilize diffusion tensor imaging (DTI) to identify the extent of microinfiltration of a tumor in the brain have been successful. It was therefore speculated that this technique could also be useful in the spinal cord. The aim of this study was to differentiate between infiltrating and noninfiltrating intramedullary spinal tumors using DTI-derived metrics. Read More

World Neurosurg 2020 Feb 8;134:e761-e770. Epub 2019 Nov 8.

Biomanufacturing Center, Department of Mechanical Engineering, Tsinghua University, Beijing, P. R. China.

Objective: To demonstrate the use of 3-dimensional (3D)-printed intracranial lesion models for complex neurosurgery to increase the success rate of clinical surgeries via practice in simulated surgeries.

Methods: We collected computed tomographic, magnetic resonance (MR), and computed tomographic images from patients with intracranial tumor or aneurysm, conducted multimodal image reconstruction, and then constructed a 3D-printed model with the skull base, cerebral arteries, and brain tumor or aneurysm. Forty-nine simulated surgeries were carried out on the model under a microscope, and actual surgery was carried out after validation and accumulation of experience. Read More

Open Access Maced J Med Sci 2019 Aug 14;7(15):2413-2418. Epub 2019 Aug 14.

Department of Radiology, Pham Ngoc Thach University of Medicine, Vietnam.

Background: Magnetic Resonance Imaging (MRI) nowadays plays an important role in the evaluation of posterior fossa brain tumours in children for appropriate diagnosis, treatment planning, and follow-up.

Aim: To assess the MRI features of common posterior fossa brain tumours including medulloblastomas, ependymomas, and pilocytic astrocytomas along with the postoperative parameters to contribute the local knowledge to the neuroradiology and neurosurgery fields.

Methods: The study was performed at Children's Hospital 02 from January 2016 to June 2019. Read More

AJNR Am J Neuroradiol 2019 11 10;40(11):1796-1803. Epub 2019 Oct 10.

Department of Radiology (L.A.H.), New York Presbyterian Hospital, New York, New York.

Background And Purpose: Supratentorial primitive neuroectodermal tumors and pineoblastomas have traditionally been grouped together for treatment purposes. Molecular profiling of these tumors has revealed a number of distinct entities and has led to the term "CNS-primitive neuroectodermal tumors" being removed from the 2016 World Health Organization classification. The purpose of this study was to describe the MR imaging findings of histologically diagnosed primitive neuroectodermal tumors and pineoblastomas and correlate them with molecular diagnoses and outcomes. Read More

Stereotact Funct Neurosurg 2019 7;97(3):189-194. Epub 2019 Oct 7.

Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California, USA.

Objective/background: We report efficacy and toxicity outcomes with stereotactic radiosurgery (SRS) for intracranial and spinal ependymoma.

Methods: We analyzed adult and pediatric patients with newly diagnosed or recurrent intracranial or spinal ependymoma lesions treated with SRS at our institution. Following SRS, local failure (LF) was defined as failure within or adjacent to the SRS target volume, while distant failure (DF) was defined as failure outside of the SRS target volume. Read More

Nat Commun 2019 10 4;10(1):4529. Epub 2019 Oct 4.

Department of Biomedical Engineering, Tufts University, Medford, MA, 02155, USA.

Dynamic alterations in the unique brain extracellular matrix (ECM) are involved in malignant brain tumors. Yet studies of brain ECM roles in tumor cell behavior have been difficult due to lack of access to the human brain. We present a tunable 3D bioengineered brain tissue platform by integrating microenvironmental cues of native brain-derived ECMs and live imaging to systematically evaluate patient-derived brain tumor responses. Read More

Oper Neurosurg (Hagerstown) 2020 Jun;18(6):E240-E241

Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee.

The brainstem is a less-common location for ependymomas than the spinal cord where they are the most common adult intramedullary tumor.1-18 In this first video case report in the peer-reviewed literature, we demonstrate microsurgical resection of a medulla oblongata ependymoma.  There are several case reports of medulla oblongata ependymomas1,3,5,6,13 and a few series of spinal cord ependymomas that included cases of ependymomas of the cervicomedullary junction. Read More

BJR Case Rep 2019 Jun 10;5(2):20180068. Epub 2019 Jan 10.

Department of Radiology, Hospital Beneficencia Portuguesa de Sao Paulo, Sao Paulo, Brazil.

Slow-growing intraventricular masses are sometimes imaging findings in asymptomatic patients. The neuroimaging characteristics frequently help making the correct diagnosis and the treatment decision. Subependymomas usually present as single lesions poorly vascularized, without invasion into adjacent brain parenchyma or cerebrospinal fluid dissemination. Read More

Int J Radiat Oncol Biol Phys 2019 12 28;105(5):1034-1042. Epub 2019 Aug 28.

Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address:

Purpose: Brainstem necrosis is a rare, but dreaded complication of radiation therapy; however, data on the incidence of brainstem injury for tumors involving the posterior fossa in photon-treated patient cohorts are still needed.

Methods And Materials: Clinical characteristics and dosimetric parameters were recorded for 107 pediatric patients who received photon radiation for posterior fossa tumors without brainstem involvement from 2000 to 2016. Patients were excluded if they received a prescription dose <50. Read More

J Clin Imaging Sci 2019 27;9. Epub 2019 Feb 27.

Division of Neuroradiology, Department of Radiology, The Ohio State University Medical Center Columbus, OH 43210 USA.

Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare, reversible phenomenon that occurs several years after radiotherapy in patients treated for intracranial neoplastic lesions. Patients typically present with symptoms of headache, seizures, and other focal neurologic deficits concerning for stroke or disease recurrence. In this report, we describe SMART syndrome in a 70-year-old male who developed a persistent right temporal headache, right-sided neck pain, and new-onset seizures 12 years after surgical resection of a temporal anaplastic ependymoma followed by irradiation. Read More

Beijing Da Xue Xue Bao Yi Xue Ban 2019 Aug;51(4):769-774

Department of Neurology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui, China.

Superficial siderosis of the central nervous system (SSCNS) is a rare disorder caused by hemosiderin deposits in the subpial layers of the brain and spinal cord due to prolonged or recurrent low-grade bleeding into the cerebrospinal fluid (CSF). Central nervous system tumor could be one of the sources of bleeding. Some problems exist at present regarding the diagnosis and treatment of SSCNS in China. Read More

World Neurosurg 2019 Nov 31;131:e155-e169. Epub 2019 Jul 31.

Department of Neurosurgery, University Marburg, Marburg, Germany.

Objective: To integrate 3-dimensional (3D) intraoperative ultrasound (iUS) data in spinal navigation.

Methods: In 11 patients with intradural spinal tumors, 3D-iUS was performed before and after tumor resection. Intraoperative computed tomography (iCT) was used for automatic patient registration for spinal navigation; fiducial-based registration was performed in 1 case. Read More

Acta Neurochir (Wien) 2019 10 12;161(10):2181-2193. Epub 2019 Jul 12.

Department of Neurosurgery, University Marburg, Baldingerstrasse, 35033, Marburg, Germany.

Background: Microscope-based augmented reality (AR) is commonly used in cranial surgery; however, until recently, this technique was not implemented for spinal surgery. We prospectively investigated, how AR can be applied for intradural spinal tumor surgery.

Methods: For ten patients with intradural spinal tumors (ependymoma, glioma, hemangioblastoma, meningioma, and metastasis), AR was provided by head-up displays (HUDs) of operating microscopes. Read More

Neuro Oncol 2019 12;21(12):1540-1551

Department of Pediatrics, University of Colorado Denver, Aurora, Colorado.

Background: Treatment for pediatric posterior fossa group A (PFA) ependymoma with gain of chromosome 1q (1q+) has not improved over the past decade owing partially to lack of clinically relevant models. We described the first 2 1q+ PFA cell lines, which have significantly enhanced our understanding of PFA tumor biology and provided a tool to identify specific 1q+ PFA therapies. However, cell lines do not accurately replicate the tumor microenvironment. Read More

Acta Oncol 2019 Oct 4;58(10):1457-1462. Epub 2019 Jul 4.

Danish Centre for Particle Therapy , Aarhus , Denmark.

Several brain substructures associated with cognition (BSCs) are located close to typical pediatric brain tumors. Pediatric patients therefore have considerable risks of neurocognitive impairment after brain radiotherapy. In this study, we investigated the radiation doses received by BSCs for three common locations of pediatric brain tumor entities. Read More

Prog Neurol Surg 2019 16;34:200-206. Epub 2019 May 16.

Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Stereotactic radiosurgery (SRS) has become a standard management option for less common glial tumors. When imaging defines a recurrent or progressive ependymoma after initial resection in a child who has completed adjuvant fractionated radiation therapy, SRS may be used as a boost or salvage strategy. For patients with oligodendrogliomas diagnosed by biopsy or after cytoreductive surgery, SRS may be used as a primary option in smaller volume tumors, or as an adjuvant option for tumors that have progressed after initial surgery, chemotherapy, or fractionated radiation therapy. Read More

Neuroradiol J 2019 Aug 24;32(4):259-266. Epub 2019 Apr 24.

1 Pediatric Radiology Department, Clocheville Hospital, University Hospital Center of Tours, France.

Background: Magnetic resonance imaging (MRI) with a gadolinium injection is currently used in the follow-up of children in remission of cerebral tumors (CTs). Intracerebral gadolinium deposition has been recently reported with unknown risks. The aim of this study was to evaluate the sensitivity of unenhanced brain MRI (U-MRI) in detection of tumor recurrence. Read More

Medicine (Baltimore) 2019 Apr;98(14):e15019

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China.

Rationale: Cerebellopontine angle (CPA) ependymomas are atypical kind of ependymomas that characteristically occur in the pediatric age group. Therefore, finding a case of CPA ependymoma in a young male adult is not a common occurrence.

Patient Concerns: We present a case of a 28-year-old male who was involved in road traffic accident with suspected mild head injury. Read More

Oncologist 2019 09 8;24(9):e921-e929. Epub 2019 Mar 8.

Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

Background: Data on frequency, clinical presentation, and outcome of primary metastatic intracranial ependymoma in children are scarce.

Patients And Methods: Prospective data on patients younger than 21 years with metastatic intracranial ependymoma at first diagnosis, registered from 2001 to 2014 in the HIT-2000 trial and the HIT-2000 Interim Registry, were analyzed.

Results: Of 453 registered patients with intracranial ependymoma and central neuropathology review, initial staging included spinal magnetic resonance imaging in all patients and lumbar cerebrospinal fluid (CSF) analysis in 402 patients. Read More

Int J Radiat Oncol Biol Phys 2019 03;103(3):542-543

Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts.

Pediatr Neurosurg 2019 30;54(2):98-107. Epub 2019 Jan 30.

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,

Objective: The purpose of this study was to explore the clinical features and risk factors of outcomes in pediatric posterior cranial fossa ependymoma. We aim to provide evidence-based recommendations for the improvement of prognoses.

Patients And Methods: The clinical data, treatment modalities, approaches performed, recurrence rates and times, as well as the outcomes of 94 cases were analyzed retrospectively. Read More

Turk Neurosurg 2019 ;29(4):497-505

Cairo University, Faculty of Medicine, Department of Neurosugery, Cairo, Egypt.

Aim: To describe our institution’s experience with the telovelar approach as well as factors governing radicality and outcome for pediatric fourth ventricle tumors.

Material And Methods: During March 2015â€"January 2017, 44 children with fourth ventricular tumors were operated using the telovelar approach. Radicality, neurological outcome, complications, and survival rates were evaluated. Read More

Surg Neurol Int 2018 23;9:211. Epub 2018 Oct 23.

Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA.

Background: Ependymomas represent 50-60% of all brain and central nervous system tumors. Previous lumbar spine surgery for resection of an ependymoma should not be considered a relative contraindication for the administration of epidural/subarachnoid anesthesia to patients in labor.

Case Description: A 34-year-old G1P0, who underwent resection of an L1-L3 intramedullary ependymoma 8 years previously, presented in active labor with residual left leg numbness and tingling. Read More

Ann Pathol 2018 Dec 4;38(6):381-385. Epub 2018 Jul 4.

Service de neurochirurgie, centre hospitalier universitaire Ibn Rochd, 1, rue des hôpitaux, Casablanca, Maroc.

Astroblastoma is a rare neuroepithelial tumor most commonly seen in children and young adults. Due to its rarity, this tumor can be easily misdiagnosed as its classification, histogenesis and therapeutic management are still being discussed. We report the case of a 21 year old man, who presented at the Emergency Room for loss of consciousness. Read More

J Neurooncol 2019 Jan 20;141(2):449-457. Epub 2018 Nov 20.

Developmental and Stem Cell Biology Program, The Arthur and Sonia Labatt Brain Tumour Center, Division of Neurosurgery, Hospital for Sick children, Toronto, ON, Canada.

Background: DNA methylation inhibitors are logical therapeutic candidates for ependymomas originating in the posterior fossa of the brain. Our objective was to test the safety of infusing 5-Azacytidine (5-AZA), a DNA methylation inhibitor, directly into cerebrospinal fluid (CSF) spaces of the fourth ventricle or tumor resection cavity in children with recurrent ependymoma originating in the posterior fossa.

Materials And Methods: In patients with recurrent ependymoma whose disease originated in the posterior fossa, a maximal safe subtotal tumor resection was performed. Read More

Med J Armed Forces India 2018 Oct 5;74(4):407-409. Epub 2017 Oct 5.

Classified Specialist (ENT), Command Hospital (Central Command), Lucknow, India.

Neurofibromatosis is a neurocutaneous, tumor predisposing, inheritable disorder characterized by tumors of the brain and spine and the presence of skin lesions. The most important tumors associated with neurofibromatosis are vestibular nerve schwannomas, with others being meningiomas and ependymomas. The cord is also affected by tumors, ependymoma being the commonest, besides meningiomas and schwannomas. Read More

World Neurosurg 2019 Feb 16;122:e1300-e1304. Epub 2018 Nov 16.

Department of Radiology, Stanford University School of Medicine, Stanford, California, USA.

Background: Current standard of care for children with infratentorial ependymoma includes maximal safe resection and local radiation of 54-59 Gray. High-dose local radiation has been associated with declines in multiple cognitive domains. The anatomic and physiologic correlates of this cognitive decline remain undefined, and there have been no radiographic studies on the long-term effects of this treatment paradigm. Read More

J Clin Neurosci 2019 Jan 6;59:310-312. Epub 2018 Nov 6.

Department of Pathology and Molecular Medicine/Neuropathology, McMaster University, Hamilton, Ontario, Canada. Electronic address:

The diagnosis and management of ependymoma may be challenging when there is a comorbidity of ependymoma and Parkinson's disease (PD). We report the first case to demonstrate unusual clinical and pathological features of an ependymoma associated with PD. A 77-year-old male with a history of PD had brain magnetic resonance imaging (MRI) that showed signal abnormalities in the right temporal lobe, most consistent with a low-grade glioma. Read More

Cureus 2018 Jul 18;10(7):e3000. Epub 2018 Jul 18.

Department of Pathology, Osceola Regional Medical Center, Orlando, USA.

Medulloblastoma is the most common type of aggressive pediatric primary brain malignancy. This case describes a 45-year-old Hispanic male with no significant past medical history who presented to the emergency department (ED) complaining of 15 days of 10/10 intractable headaches with one day of lightheadedness, confusion, and loss of balance. An urgent magnetic resonance imaging (MRI) of the brain revealed a 4. Read More

World Neurosurg 2019 Feb 25;122:71-76. Epub 2018 Oct 25.

Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada. Electronic address:

Background: The occurrence of isolated fourth ventricle and injury to the Guillain-Mollaret triangle in the setting of posterior fossa ependymoma represents a new association. In this case report, we discuss the clinical, theoretical, and therapeutic aspects of this problem. We describe a lateral transcerebellar trajectory and shunt valve configuration for safe fourth ventricle shunting in a patient with prior posterior fossa surgery. Read More

World Neurosurg 2019 Feb 18;122:e427-e435. Epub 2018 Oct 18.

Department of Neurosurgery, IRCCS National Cancer Institute "Regina Elena", Rome, Italy.

Objective: To assess usefulness and limitations of flexible fiber carbon dioxide (CO) laser in the microsurgical treatment of intraventricular tumors.

Methods: We reviewed a series of 9 patients treated with microsurgical resection of intraventricular tumors using a flexible fiber CO laser. The lesions involved the third ventricle (8) and the frontal horn of the right lateral ventricle (1). Read More

Brain Pathol 2019 05 28;29(3):325-335. Epub 2018 Nov 28.

Department of Neuropathology, Sainte-Anne Hospital, Paris, France.

Ependymoma with RELA fusion has been defined as a novel entity of the revised World Health Organization 2016 classification of tumors of the central nervous system (CNS), characterized by fusion transcripts of the RELA gene and consequent pathological activation of the NFkB pathway. These tumors represent the majority of supratentorial ependymomas in children. The validation of diagnostic tools to identify this clinically relevant ependymoma entity is essential. Read More

Brain Pathol 2019 03 11;29(2):205-216. Epub 2018 Nov 11.

Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany.

Ependymoma with YAP1-MAMLD1 fusion is a rare, recently described supratentorial neoplasm of childhood, with few cases published so far. We report on 15 pediatric patients with ependymomas carrying YAP1-MAMLD1 fusions, with their characteristic histopathology, immunophenotype and molecular/cytogenetic, radiological and clinical features. The YAP1-MAMLD1 fusion was documented by RT-PCR/Sanger sequencing, and tumor genomes were studied by molecular inversion probe (MIP) analysis. Read More

Neuroradiol J 2018 Dec 19;31(6):554-564. Epub 2018 Sep 19.

1 Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, USA.

Purpose: We applied voxelwise apparent diffusion coefficient (ADC) histogram analysis in addition to structural magnetic resonance imaging (MRI) findings and patients' age for differentiation of intraaxial posterior fossa tumors involving the fourth ventricle.

Participants And Methods: Pretreatment MRIs of 74 patients with intraaxial brain neoplasm involving the fourth ventricle, from January 1, 2004 to December 31, 2015, were reviewed. The tumor solid components were segmented and voxelwise ADC histogram variables were determined. Read More

World Neurosurg 2018 Dec 6;120:125-128. Epub 2018 Sep 6.

Division of Neurosurgery, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan.

Background: Li-Fraumeni syndrome is a genetic disease that is caused by mutation of the tumor suppressor gene TP53. Patients with this syndrome may develop multiple malignant neoplasms including brain tumors. We herein report the first case of Li-Fraumeni syndrome in which development of supratentorial anaplastic ependymoma led to difficulty in terms of selecting the optimal postoperative therapeutic protocol. Read More

Mymensingh Med J 2018 Jul;27(3):665-668

Dr Kohinoor Jahan Shyamaly, Resident Phase-B, Department of General Paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.

Primitive neuroectodermal tumors are malignant tumor of pluripotent cells of neural crest. It has diverse clinical presentation and aggressive clinical behaviour. Clinical features may provide some clue but imaging studies such as MRI of brain; tissue histopathology, immune histochemistry and cytogenetic are essential to confirm the diagnosis. Read More