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Pan Afr Med J 2021 4;38:128. Epub 2021 Feb 4.

Service de Neurochirurgie du Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso.

Intraspinal tumors are uncommon. Positive diagnosis is based on medical imaging exams, in particular MRI. Anatomopathological examination allows for definitive diagnosis. Read More

Int J Surg Case Rep 2021 Apr 11;81:105747. Epub 2021 Mar 11.

Spine Center, Sanbo Brain Hospital, Capital Medical University, Beijing, People's Republic of China. Electronic address:

Introduction And Importance: Huge intramedullary tumor is a rare condition. Surgical management of such huge ependymoma is technically challenging. We reported one case of 300 mm long intramedullary spinal cord ependymoma from oblongata to T4, which was satisfactorily en bloc gross total resected and the cervical spine alignment was successfully maintained by laminoplasty. Read More

Clin Spine Surg 2021 Mar;34(2):E100-E106

Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Tsurumai-cho, Showa-ku, Nagoya.

Study Design: A retrospective study of preoperative and postoperative magnetic resonance imaging (MRI) findings in spinal ependymoma.

Objective: The goal of the study was to examine MRI features, including the syrinx component volume, after surgical resection of spinal ependymoma, and to relate these features to extent of resection and improvement of postoperative neurological status.

Summary Of Background Data: Spinal ependymomas have a variety of MRI findings preoperatively, including a hemorrhage cap sign, gadolinium enhancement, and a spinal tumor cyst. Read More

Cureus 2021 Jan 7;13(1):e12558. Epub 2021 Jan 7.

Anesthesiology, McGovern Medical School, University of Texas Health Science Center, Houston, USA.

Neuraxial anesthesia is preferred over general anesthesia for cesarean delivery when appropriate because the latter is associated with a higher incidence of airway complications and an increased need for neonatal resuscitation. Common complications of neuraxial anesthesia include backache and headache, whereas feared but rare complications include paraplegia, intraspinal hemorrhage, cauda equina syndrome, nerve injury, and epidural hematoma. This case report presents a 40-year-old female with undiagnosed and asymptomatic ependymoma who presented with concerning neurological symptoms after receiving spinal anesthesia for elective cesarean delivery. Read More

BMJ Case Rep 2021 Jan 28;14(1). Epub 2021 Jan 28.

Neurosurgery, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico

This report presents the longest spanning intradural myxopapillary ependymoma consisting of 23 vertebral segments in the literature. An 11-year-old boy presented with right arm pain, mid back pain and progressive paraparesis associated with urinary retention. On MRI, the patient was found to have an intradural lesion extending from C5 to S3. Read More

Spinal Cord Ser Cases 2021 Jan 19;7(1). Epub 2021 Jan 19.

Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan.

Introduction: Of the 23 cases of spinal intradural-extramedullary ependymomas which have been reported to date, 11 were diagnosed as anaplastic. Here we present a very rare case of a thoracic intradural-extramedullary (not intramedullary) anaplastic ependymoma in an adult along with a literature review.

Case Presentation: A 29-year-old man presented with rapidly progressive gait disturbance, a sensory-deficit below the trunk and urination disorders that had begun a few months earlier. Read More

BMJ Case Rep 2020 Dec 17;13(12). Epub 2020 Dec 17.

Medical Oncology, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.

Myxopapillary ependymoma (MPE) is a rare glial tumour mainly located in the areas of the conus medullaris, cauda equina and filum terminale of the spinal cord. Ectopic MPE tends to behave more aggressively and distant metastases are often seen. Unfortunately, no standard treatment options are established as only small series of treated patients and a few reported cases are available in the literature. Read More

Am J Case Rep 2020 Oct 21;21:e925449. Epub 2020 Oct 21.

Neurosurgery Division, Surgery Department, King Saud University Medical City (KSUMC), College of Medicine, King Saud University, Riyadh, Saudi Arabia.

BACKGROUND Spinal myxopapillary ependymoma (MPE) is a slow-growing tumor arising from ependymal cells of the central nervous system. MPE rarely presents with acute neurological compromise and most commonly occur in the filum terminale or conus medullaris region. To date, only a few cases have been reported of patients presenting acutely because of hemorrhagic MPE. Read More

World Neurosurg 2021 01 3;145:338-339. Epub 2020 Oct 3.

Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France; INSERM U1051, Montpellier Neuroscience Institute, Montpellier, France.

With the increasing frequency of neuroimaging, incidental intramedullary cavities are diagnosed more frequently. We present a case of asymptomatic incidental intramedullary cervical cavity diagnosed as an idiopathic syringomyelia as initial magnetic resonance imaging (MRI) showed an isolated cystic image without contrasted component. The patient had no subsequent MRI follow-up, but eventually showed symptoms 8 years later. Read More

No Shinkei Geka 2020 Sep;48(9):819-825

Department of Neurosurgery, National Defense Medical College.

Ependymoma is the most common primary intramedullary tumor of the spinal cord, accounting for a quarter of these tumors. We experienced a case of 'ependymoma of the spinal cord with a cystic lesion that presented as an intradural extramedullary tumor extending from the thoracic to lumbar vertebrae. In review of past literature on reports of spinal intradural extramedullary ependymoma, lesions spanning three or more vertebrae with cystic lesions were frequent, and about half were World Health Organization grade II or higher. Read More

World Neurosurg 2021 01 2;145:13-18. Epub 2020 Sep 2.

Department of Neurosurgery, Nagoya University Hospital, Nagoya, Japan.

Background: Spinal myxopapillary ependymoma (SME), generally considered a benign entity, can exhibit brain and whole-spine metastases as well as local recurrence after surgery. However, the presence of preoperative retrograde intracranial dissemination at the time of diagnosis is very rare.

Case Description: We report a case of SME in a 22-year-old man who presented with acute exacerbation of chronic back pain shooting down both thighs and weakness in both legs. Read More

Asian J Neurosurg 2020 Apr-Jun;15(2):354-362. Epub 2020 May 29.

Department of Neurosurgery, University of Health Sciences, Bakirköy Research and Training Hospital for Neurology Neurosurgery, and Psychiatry, Istanbul, Turkey.

Aim: Preoperatively performed magnetic resonance images (MRIs) are essential before treating spinal tumors surgically. This study aims to investigate the compatibility of MRI preliminary diagnosis and proven histopathologic diagnosis of consecutively operated 96 spinal tumors.

Material And Methods: Medical records were retrospectively reviewed for all spinal tumors operated at our institute during a period of 6 years. Read More

J Clin Neurosci 2020 Aug 26;78:411-413. Epub 2020 Jun 26.

Kenneth J Jamieson Department of Neurosurgery, Royal Brisbane And Women's Hospital, Australia; University of Queensland, Faculty of Medicine, Australia.

Classic type intradural extramedullary (IDEM) ependymomas of the lumbar spine are rare entities. Only two such cases have previously been reported in the literature. Here the authors report a new case and describe radiological, surgical and histological findings as well as review the literature. Read More

Ann Afr Med 2020 Apr-Jun;19(2):144-146

Department of Radiotherapy and Oncology, K. S. Hegde Medical Academy, Mangalore, Karnataka, India.

Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms of fibroblastic origin. They commonly arise from visceral pleura, but also arise from nonserosal sites such as meninges, central nervous system parenchyma, and spinal cord. In the spinal cord, SFTs commonly arise from the thoracic spinal cord, followed by cervical spinal cord, lumbar spinal cord, and sacrum. Read More

Asian Spine J 2020 Dec 29;14(6):821-828. Epub 2020 May 29.

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Study Design: Single-center retrospective study.

Purpose: We aimed to explore the postoperative prognostic factors for spinal intramedullary ependymoma.

Overview Of Literature: Ependymoma (World Health Organization grade II) is the most frequent intramedullary spinal tumor and is treated by total resection. Read More

World Neurosurg 2020 10 23;142:e66-e72. Epub 2020 May 23.

Department of Neurosurgery, King's College Hospital, London, England.

Background: Paragangliomas are uncommon neuroendocrine tumors, rarely occurring in the lumbar spine. Primary lumbar paragangliomas are prominently vascularized, can present variably, and pose both diagnostic and surgical challenges. We report on a large case series with long-term follow-up and intraoperative footage to characterize the natural history, diagnostic approach, and operative approach to this rare surgical disease. Read More

J Neurosurg Spine 2020 May 1:1-6. Epub 2020 May 1.

3Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic; and Departments of.

Objective: The authors sought to describe the long-term recurrence patterns, prognostic factors, and effect of adjuvant or salvage radiotherapy (RT) on treatment outcomes for patients with spinal myxopapillary ependymoma (MPE).

Methods: The authors reviewed a tertiary institution IRB-approved database and collected data regarding patient, tumor, and treatment characteristics for all patients treated consecutively from 1974 to 2015 for histologically confirmed spinal MPE. Key outcomes included relapse-free survival (RFS), postrecurrence RFS, failure patterns, and influence of timing of RT on recurrence patterns. Read More

Int J Neurosci 2020 Apr 30:1-8. Epub 2020 Apr 30.

Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University, Cerebral Vascular Disease Research Centre, Anhui Medical University, Hefei, China.

Intradural extramedullary (IDEM) ependymomas are very rare, and IDEM ependymomas with craniospinal disseminated metastasis are exceptionally rare; only 2 preoperative cases have been confirmed, and postoperative cases have not been reported. We present a case of a 21-year-old female with an IDEM ependymoma of the craniocervical junction who experienced head and neck pain for more than 1 month. Magnetic resonance imaging (MRI) of the cervical spine revealed a large IDEM cystic lesion located in the medulla oblongata and the upper cervical spinal cord. Read More

World Neurosurg 2020 07 3;139:20-22. Epub 2020 Apr 3.

Department of Neurosurgery, Fudan University Huashan Hospital, Shanghai, China. Electronic address:

Background: Ten-segment intramedullary tumors are rare lesions in adults.

Case Description: In this report, we describe the case of a 30-year-old woman who presented with a 2-year history of right lower limb numbness. Spinal magnetic resonance imaging showed an expansive 10-segment intramedullary lesion and syringomyelia. Read More

Neurosurg Clin N Am 2020 Apr 31;31(2):237-249. Epub 2020 Jan 31.

Department of Neurological Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; Department of Neurological Surgery, Weill Cornell Medical College, 525 E. 68th St, New York, NY 10065, USA.

Intramedullary spinal cord tumors (IMSCT) comprise a rare subset of CNS tumors that have distinct management strategies based on histopathology. These tumors often present challenges in regards to optimal timing for surgery, invasiveness, and recurrence. Advances in microsurgical techniques and technological adjuncts have improved extent of resection and outcomes with IMSCT. Read More

World Neurosurg 2020 Feb 28;134:549-554. Epub 2019 Nov 28.

Department of Neurosurgery, Leeds Teaching Hospitals NHS Trust, Leeds, England.

Background: Intradural extramedullary spinal ependymomas arising from outside the region of the conus medullaris are rare clinical entities, and anaplastic transformation of these lesions is even more exceptional.

Case Description: We report on a case of an intradural extramedullary T5-T6 ependymoma that underwent gross total resection. Histologic analysis of the initial tumor revealed a World Health Organization grade 2 ependymoma. Read More

Oper Neurosurg (Hagerstown) 2020 06;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

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

Oper Neurosurg (Hagerstown) 2020 Jun;18(6):E235

Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida.

We present a surgical video illustrating the technique for en bloc resection of an intradural-extramedullary lumbar tumor. The patient is a 63-yr-old woman presenting with worsening bilateral leg pain. Imaging of her lumbar spine showed an enhancing, circumscribed intradural-extramedullary tumor compressing her cauda equina at the L2 level. 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

Neuroradiology 2019 Aug 14;61(8):945-948. Epub 2019 Jun 14.

Department of Imaging Sciences and Interventional Radiology, Sreechitra Institute of Medical Sciences and Technology, Trivandrum, Kerala, 695011, India.

A 37-year-old female presented with gradually progressive asymmetric ascending paraesthesia and weakness involving bilateral upper and lower limbs. The MRI spine images revealed expansile intramedullary, solid cystic, peripherally enhancing lesion with a haemosiderin cap along the lower margin. The lesion extended into the left C5 and C6 nerve root exit zones, along with thickening and enhancement of the nerve roots. Read More

World J Clin Cases 2019 May;7(10):1142-1148

Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia.

Background: Myxopapillary ependymomas are rare spinal tumours. Although histologically benign, they have a tendency for local recurrence.

Case Summary: We describe a patient suffering from extra- and intradural myxopapillary ependymoma with perisacral spreading. Read More

J Neurol Surg A Cent Eur Neurosurg 2020 Jan 24;81(1):71-74. Epub 2019 May 24.

Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia.

Ectopic adrenal cortical neoplasms of the spinal cord are extremely rare. To date only 10 such cases have been described. We present a case of a 46-year-old woman with lower back pain radiating to the right gluteal and posterior femoral regions, without a history of traumatic injury. Read More

J Clin Neurosci 2019 Jul 30;65:34-40. Epub 2019 Apr 30.

Children's Hospital of Philadelphia, Department of Neurosurgery, Philadelphia, PA, USA.

Pediatric patients presenting with intramedullary spinal cord lesions often require specific diagnoses to guide their treatment plans. Though results from magnetic resonance imaging and lumbar puncture may narrow the differential diagnosis, these tests cannot always provide a definitive diagnosis. In such cases, spinal cord biopsy may be undertaken to provide a specific histopathologic diagnosis for guiding treatment. Read More