The Association of Hydrocephalus with Intramedullary Spinal Cord Tumors: A Series of 25 Patients

Neurosurgery ◽  
1990 ◽  
Vol 27 (5) ◽  
pp. 749-754 ◽  
Author(s):  
Stephanie Rifkinson-Mann ◽  
Jeffrey H. Wisoff ◽  
Fred Epstein
Keyword(s):  
Spinal Cord ◽  
Malignant Tumors ◽  
Spinal Cord Tumor ◽  
Benign Tumors ◽  
High Grade ◽  
Spinal Cord Tumors ◽  
Increased Intracranial Pressure ◽  
Intramedullary Spinal Cord ◽  
Spinal Cysts ◽  
The Relationship

Abstract 171 patients with intramedullary spinal cord tumors were operated on, of which 25 patients (15%), mostly children, developed symptomatic hydrocephalus. Twenty patients (12%) had malignant tumors, with 13 of the 20 cases (63%) complicated by increased intracranial pressure and ventriculomegaly. Of the remaining 151 patients with benign tumors (89%), only 12 (8%) developed symptomatic hydrocephalus. In an effort to understand the relationship between hydrocephalus and intramedullary spinal cord tumor, the authors analyze the level and histology of the neoplasm, as well as its association with spinal cysts. A review of the neurosurgical literature reveals that 34 similar cases of hydrocephalus associated with intramedullary spinal cord tumors have been reported to date. The authors note that the presence of hydrocephalus in patients with malignant intramedullary astrocytomas is associated with a shorter rate of survival than in those patients with high-grade lesions but without hydrocephalus, apparently due to rapid tumor progression. The ventriculomegaly seen with benign spinal cord gliomas has no statistically significant effect upon longterm prognosis.

Intramedullary spinal cord tumors in children under the age of 3 years

1996 ◽  
Vol 85 (6) ◽  
pp. 1036-1043 ◽  
Author(s):  
Shlomo Constantini ◽  
John Houten ◽  
Douglas C. Miller ◽  
Diana Freed ◽  
Memet M. Ozek ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Glioblastoma Multiforme ◽  
Spinal Cord Tumor ◽  
Low Grade ◽  
New York University ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
Fine Print

✓ Over a 13-year period extending from 1980 to 1993, 27 children less than 3 years of age underwent operation for removal of an intramedullary spinal cord tumor (IMSCT). The majority (18 of 27) of children had undergone surgery before being referred to New York University (NYU) Medical Center. The most common reasons for radiological investigation were pain (42%), motor regression (36%), gait abnormalities (27%), torticollis (27%), and progressive kyphoscoliosis (24%). Forty procedures were performed in 27 children. Nine children underwent two operations and two children underwent three procedures. A gross-total resection was achieved in 72% of the procedures. There was no surgical mortality. A comparison of the preoperative and 3-month postoperative functional grades for the first NYU procedure (NYU-1) yielded the following findings: 20 patients' conditions remained the same, five patients improved, and two patients deteriorated. The functional outcomes of a second operation (NYU-2) were similar. The majority of the children (24 of 27, 89%) had histologically determined low-grade lesions. There were 12 patients with low-grade astrocytomas (Grades I-III), eight with gangliogliomas, two with ganglioglioneurocytomas, one with a glioneurofibroma, and one child with a mixed astro/oligodendroglioma. Two children had anaplastic astrocytomas (Grades II–III) and one child had a glioblastoma multiforme. In a median follow-up review of 76 months, two patients died and two patients were lost to follow up. The 3- and 5-year progression-free survival (PFS) rates were 81.7% (standard error of the mean (SEM) 0.083) and 76.2% (SEM 0.094), respectively. Eight of 24 patients suffered a recurrence within a mean time of 45.4 ± 28.9 months. All were treated with surgery (NYU-2). Lesions recurred in three of 12 children with low-grade astrocytomas, two of eight children with gangliogliomas, one child with an anaplastic astrocytoma, one child with a ganglioglioneurocytoma, and one child with a glioblastoma multiforme. At follow-up review, most of these children were doing well. Sixteen are in functional Grades I or II and 18 children attend a normal school system. The authors conclude that surgery for the removal of IMSCTs in children less than 3 years of age can be performed radically and safely. The postoperative functional performance is determined by the degree of the preoperative deficit. It is, therefore, of utmost importance to diagnose and treat these children as early as possible. Spinal cord tumors should be recognized as potentially excisable lesions on their initial presentation and when they recur. The optimum treatment for malignant lesions is still to be determined.

Magnetic resonance imaging of intramedullary spinal cord schwannomas

2003 ◽  
Vol 99 (1) ◽  
pp. 114-117 ◽  
Author(s):  
Cesare Colosimo ◽  
Alfonso Cerase ◽  
Luca Denaro ◽  
Giulio Maira ◽  
Romano Greco
Keyword(s):  
Spinal Cord ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Spinal Cord Tumor ◽  
Spinal Nerve ◽  
Benign Tumors ◽  
Imaging Features ◽  
Spinal Nerve Root ◽  
Resonance Imaging ◽  
Intramedullary Spinal Cord

✓ Intramedullary spinal cord schwannomas are rare benign tumors for which resection is possible and safe. The purpose of this paper is to present the magnetic resonance (MR) imaging features in two cases of intramedullary spinal cord schwannoma to assist both neurosurgeons and pathologists in preventing misdiagnosis and resultant partial resection. The MR imaging evidence of a small- or medium-sized well-marginated intramedullary spinal cord tumor in a patient in whom no syringomyelia is present but in whom moderate edema with marked Gd enhancement can be seen should be considered in the differential diagnosis of intramedullary spinal cord schwannoma. In cases in which an associated thickened Gd-enhancing spinal nerve root is seen the diagnosis of schwannoma should be assumed.

Subependymomas: An analysis of Clinical and Imaging Features

Neurosurgery ◽  
2006 ◽  
Vol 58 (5) ◽  
pp. 881-890 ◽  
Author(s):  
Brian T. Ragel ◽  
Anne G. Osborn ◽  
Kum Whang ◽  
Jeannette J. Townsend ◽  
Randy L. Jensen ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Spinal Cord Tumor ◽  
Benign Tumors ◽  
Resonance Spectroscopy ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Radiographic Appearance ◽  
Intramedullary Spinal Cord

Abstract OBJECTIVE: Subependymomas are slow-growing, benign tumors usually found incidentally in the fourth ventricle at autopsy. They are typically associated with the ventricular system and become apparent clinically only when symptoms of hydrocephalus or mass effect develop. We review clinical, histological, and contemporary radiographic presentations of 16 subependymomas, including 2 intraparenchymal tumors. METHODS: We retrospectively evaluated eight patients with pathologically proven subependymomas. Initial magnetic resonance imaging and magnetic resonance spectroscopy were reviewed when available. Imaging was also available on eight outside subependymoma cases reviewed by our radiology department. RESULTS: Twelve of these subependymomas were intraventricular, one was in the posterior fossa, two were intraparenchymal, and one was an intramedullary spinal cord tumor. These lesions were hypo- to hyperintense on T1- and T2-weighted magnetic resonance imaging, with minimal to moderate enhancement. Initial complaints included headache, seizures, tingling sensations, and weakness. Among our eight patients who underwent gross total resection with no adjuvant therapy, no recurrences have been noted on follow-up magnetic resonance imaging. CONCLUSION: Subependymomas are rare, representing only 0.51% of all central nervous system tumors operated on during an 8-year period at the University of Utah. Clinical symptoms were associated with tumor location: intracranial masses caused headaches, seizures, and neurological complaints, and spinal cord locations resulted in neurological deficit. The authors review the clinical presentation, management, and contemporary radiographic appearance of this rare tumor.

scholarly journals Features and risk factors for recurrence of intradural spinal tumors

2019 ◽  
Vol 18 (1) ◽  
pp. 21-29
Author(s):  
V. A. Byvaltsev ◽  
I. A. Stepanov
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Neurological Deficit ◽  
Malignant Tumors ◽  
Significant Risk ◽  
Partial Resection ◽  
Spinal Tumors ◽  
Benign Tumors ◽  
Spinal Cord Tumors ◽  
Risk Factors For Recurrence

Spinal cord tumors include a variety of nosological units and are classified according to their localization and histological type. The search for literature sources in the Pubmed, EMBASE and eLibrary databases demonstrated the absence of studies devoted to study of the features and risk factors for the recurrence of intradural spinal tumors. the purpose of this study was to reveal features and risk factors of recurrence of intradural spinal tumors after microneurosurgical resection. material and methods. The study included medical records of 196 patients with intradural extramedullary and intramedullary spinal tumors. The extent of microneurosurgical tumor resection, clinical efficacy of surgery, and risk factors for recurrence of intradural spinal cord tumors were been analyzed. results. Improvement in neurologic deficit after surgery was noted in 116 (59.1 %) cases, neurologic status remained the same in 47 (24.0 %) patients, and worsening of neurological deficit was observed in 33 (16.8 %) cases. Total microneurosurgical resection of intradural spinal tumors was performed in 140 (71.4 %) patients, subtotal resection in 22 (11.2 %) patients, partial resection in 25 (12.7 %) patients and spinal cord decompression or biopsy and/or its roots were performed in 9 (4.6 %) of patients. The likelihood of recurrence-free survival of patients with benign intradural spinal cord tumors was significantly higher than that of patients with malignant tumors (p<0.001). Benign tumors (χ2=34.7, p<0.05), thoracic and lumbosacral tumors (χ2=10.3, p<0.05), low degree of neurological deficit (χ2=31.5, p<0.05), absence of syringomyelia/syringobulbia signs (χ2=13,2, p<0,05), as well as extramedullary tumors (χ2=12,6, p<0.05) allowed us to perform total degree microneurosurgical resection. Malignant tumors (χ2=34.8, p<0.05), cervical and thoracic tumors (χ2=8,4, p<0,05), high degree of neurological deficit (χ2=12,9, p<0.05), partial resection, biopsy or decompression of neural structures (χ2=9.7, p<0.05) and intramedullary tumors statistically significantly increased the risk of their recurrence. conclusion. Histological pattern, tumor localization, preoperative clinical and neurological deficit according to the McCormick classification and the extent of surgery are significant risk factors for recurrence of intradural spinal tumors.

scholarly journals Resection of Intramedullary Spinal Cord Tumor under Awake Anesthesia: A Novel Approach to Minimize Postoperative Motor Deficits

2017 ◽  
Vol 3 (1) ◽  
pp. 28-34
Author(s):  
Ahsan Ali Khan ◽  
Lukui Chen ◽  
Xiaoyuan Guo ◽  
Hong Wang ◽  
Guojian Wu ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Evoked Potential ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
Motor Deficits ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Intramedullary Spinal Cord Tumor ◽  
Advantages And Disadvantages ◽  
Sensory Evoked

Objective To observe advantages and disadvantages of the resection of intramedullary spinal cord tumor under awake anesthesia. Methods Two patients with intramedullary spinal cord tumor underwent resection under awake anesthesia and followed up post-operatibely for any motor deficits. Results Patients who underwent tumor resection under awake (AAA) anesthesia combined with intraoperative NPM had no motor deficits postoperatively. More accurate and nondelayed responses were observed in the awake cycle of anesthesia and helped guide surgery, thus avoiding injuries to the spinal cord. Conclusion Intramedullary spinal cord tumors are not common, but only gross total resection (GTR) can provide complete remission of symptoms and progression-free survival. However, GTR sometimes results in motor function deficits postoperatively, particularly when the cervical cord is involved, and especially if surgery is done under general anesthesia with intraoperative neurophysiological monitoring (NPM) alone, because of delayed sensory evoked potential and motor evoked potential responses. We present two cases that underwent GTR of cervical intramedullary spinal cord tumors under an asleep-awake-asleep (AAA) cycle of anesthesia, combined with intraoperative NPM in which no postoperative motor deficits were observed on 6-months follow up.

scholarly journals Cervical Intramedullary Spinal Cord Glioblastoma in a 10 Year-Old Child. Case Report

2019 ◽  
Vol 30 (3) ◽  
pp. 261-266
Author(s):  
Otávio Garcia Martins ◽  
Amir José dos Santos ◽  
Antonio Carlos Garcia D’Almeida ◽  
Samir Cezimbra dos Santos ◽  
Anna Júlia Ramos Fontanari ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Rare Case ◽  
High Grade ◽  
Pediatric Tumors ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
High Grade Gliomas

Among all pediatric tumors in CNS, the intramedullary spinal cord tumors are less than one-third of 1% and only about 1-3% of them are high-grade gliomas. Intramedullary glioblastoma (GBM) is considered highly threatening because of its aggressiveness and, even with intense management, lesion progress and patients develop severe deficits. Authors report a very rare case of a 10-year-old patient with extensive cervical GBM with an unusual outcome.

scholarly journals Hydrocephalus and Papilledema in Spinal Cord Tumors: A Report of Two Cases

2016 ◽  
Vol 02 (02) ◽  
pp. e51-e58 ◽  
Author(s):  
Ahmad Marzban ◽  
Ankur Saxena ◽  
Dev Bhattacharyya ◽  
Marcel Ivanov
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Intracranial Pressure ◽  
Visual Disturbance ◽  
History Taking ◽  
Spinal Cord Tumors ◽  
Increased Intracranial Pressure ◽  
Tumor Excision ◽  
Spinal Lesion ◽  
The Relationship

Background The association between spinal cord tumors and hydrocephalus is a rarely reported phenomenon. Diagnosis in this group of patients is difficult as they present with findings of an intracranial pathology and the symptoms of a spinal lesion may be absent. Case Report We report two cases of spinal cord tumors presenting with visual disturbance and findings of increased intracranial pressure. Discussions Mechanisms describing the relationship between spinal cord tumors and increased intracranial pressure have been explained. Most of the literature reported marked regression of these manifestations after tumor excision. Conclusions Spinal cord tumors associated with hydrocephalus and papilledema are rare conditions. The diagnosis of these conditions may be difficult or confusing because the symptoms referable to the spinal lesion may be minimal. Meticulous history taking, examination, and investigations are mandatory to diagnose this entity.

The Evolution of Intramedullary Spinal Cord Tumor Surgery

2009 ◽  
Vol 65 (suppl_6) ◽  
pp. ons84-ons92 ◽  
Author(s):  
Daniel M. Sciubba ◽  
Daniel Liang ◽  
Karl F. Kothbauer ◽  
Joseph C. Noggle ◽  
George I. Jallo
Keyword(s):  
Spinal Cord ◽  
New Technologies ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
Surgical Techniques ◽  
Surrounding Tissue ◽  
Tumor Surgery ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Intramedullary Spinal Cord Tumor

Abstract Objective: Resections of intramedullary spinal cord tumors were attempted as early as 1890. More than a century after these primitive efforts, profound advancements in imaging, instrumentation, and operative techniques have greatly improved the modern surgeon’s ability to treat such lesions successfully, often with curative results. Methods: We review the history of intramedullary spinal cord tumor surgery, as well as the evolution and advancement of technologies and surgical techniques that have defined the procedure over the past 100 years. Results: Surgery to remove intramedullary spinal cord tumors has evolved to include sophisticated imaging equipment to pinpoint tumor location, laser scalpel systems to provide precise incisions with minimal damage to surrounding tissue, and physiological monitoring to detect and prevent intraoperative motor deficits. Conclusion: Modern surgical devices and techniques have developed dramatically with the availability of new technologies. As a result, continual advancements have been achieved in intramedullary spinal cord tumor surgery, thus increasing the safety and effectiveness of tumor resection, and progressively improving the overall outcomes in patients undergoing such procedures.

Microsurgical resection of intramedullary spinal cord ependymoma

2014 ◽  
Vol 37 (v2supplement) ◽  
pp. Video9
Author(s):  
Paul C. McCormick
Keyword(s):  
Spinal Cord ◽  
Growth Rate ◽  
Spinal Cord Tumor ◽  
Intramedullary Spinal Cord ◽  
Clear Margin ◽  
Intramedullary Spinal Cord Tumor ◽  
Link Type ◽  
Microsurgical Resection ◽  
Spinal Cord Ependymoma ◽  
Posterior Midline

Ependymomas are the most commonly occurring intramedullary spinal cord tumor in adults. With few exceptions these tumors are histologically benign, although they exhibit some biologic variability with respect to growth rate. While unencapsulated, spinal ependymomas are non-infiltrative and present a clear margin of demarcation from the surrounding spinal cord that serves as an effective dissection plane. This video demonstrates the technique of microsurgical resection of an intramedullary ependymoma through a posterior midline myelotomy.The video can be found here: http://youtu.be/lcHhymSvSqU.

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