Pilocytic astrocytoma of a spinal nerve root

2002 ◽  
Vol 97 (1) ◽  
pp. 110-112 ◽  
Author(s):  
Mark Robert Philipson ◽  
Jake Timothy ◽  
Aruna Chakrobarthy ◽  
Gerry Towns
Keyword(s):  
Mr Imaging ◽  
Pilocytic Astrocytoma ◽  
Nerve Root ◽  
Residual Tumor ◽  
Conus Medullaris ◽  
Spinal Nerve ◽  
Spinal Nerve Root ◽  
Content Type ◽  
First Case ◽  
Fine Print

✓ A case of pilocytic astrocytoma involving a spinal nerve root is reported. A 39-year-old woman presented with a 1-year history of progressive pain and numbness, predominantly in the S-1 dermatome. Magnetic resonance (MR) imaging revealed an intradural lesion at the tip of the conus medullaris. The intradural tumor was excised as was the sacrificed nerve root. Histological examination showed a pilocytic astrocytoma in which there were unusual features of calcification and ossification. At 3-year follow-up review MR imaging demonstrated no residual tumor. To the best of the authors' knowledge, this is the first case of a primary pilocytic astrocytoma, a tumor typically of central nervous system origin, arising from a spinal nerve root.

Mechanisms of cervical nerve root avulsion in injuries of the neck and shoulder

1974 ◽  
Vol 41 (6) ◽  
pp. 705-714 ◽  
Author(s):  
Sydney Sunderland
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Spinal Nerve Root ◽  
Root Avulsion ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Content Type ◽  
Nerve Root Avulsion ◽  
New Interpretation ◽  
Fine Print

✓ The author reviews the mechanisms of traumatic spinal nerve root avulsion and proposes a new interpretation.

A rare case of primary sellar melanoma

2004 ◽  
Vol 100 (5) ◽  
pp. 931-934 ◽  
Author(s):  
Jochen Tüttenberg ◽  
Wolfram Fink ◽  
Walter Back ◽  
Frederik Wenz ◽  
Dirk Schadendorf ◽  
...  
Keyword(s):  
Mr Imaging ◽  
S100 Protein ◽  
Sella Turcica ◽  
Progression Free Survival ◽  
Residual Tumor ◽  
Optic Chiasm ◽  
Pituitary Macroadenoma ◽  
Content Type ◽  
First Case ◽  
Fine Print

✓ The authors report on the case of a 37-year-old woman in whom a primary sellar malignant melanoma mimicking a hemorrhagic pituitary macroadenoma was treated. This entity is exceedingly rare; only five cases are described in the literature. The patient presented with rapid deterioration of vision within a 2-week period. After an ophthalmological diagnosis of chiasmal syndrome was made, magnetic resonance (MR) imaging of the head revealed an intra- and suprasellar mass that was elevating and compressing the optic chiasm. Because of the signal heterogeneity of the lesion a hemorrhagic pituitary macroadenoma was assumed; the lesion was transsphenoidally resected. Histological examination of the specimen showed a malignant melanocytic tumor with immunopositivity for S100 protein and HMB-45. Despite extensive staging no other primary melanotic tumor was found. Thus, a primary sellar melanoma was diagnosed. Postoperative MR images demonstrated no residual tumor. For adjuvant therapy the region around the sella turcica received 40.4 Gy stereotactically guided radiation. A 24-month follow-up examination revealed no tumor recurrence. This represents the sixth case of such a lesion reported in the literature, the third case evaluated using MR imaging, and the first case with a progression-free survival of 24 months. Thus, the authors advocate that management of primary sellar melanoma should include gross-total removal and postoperative stereotactic radiotherapy.

Radiation therapy for juvenile pilocytic astrocytoma of the pituitary stalk

1992 ◽  
Vol 77 (1) ◽  
pp. 139-142 ◽  
Author(s):  
Juji Takeuchi ◽  
Kiyoshi Kikuchi ◽  
Yuta Shibamoto ◽  
Ichiro Fujisawa
Keyword(s):  
Radiation Therapy ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Growth Retardation ◽  
Pilocytic Astrocytoma ◽  
Residual Tumor ◽  
Pituitary Stalk ◽  
Content Type ◽  
Juvenile Pilocytic Astrocytoma ◽  
Fine Print

✓ A case of juvenile pilocytic astrocytoma of the pituitary stalk is reported. The patient presented with diabetes insipidus and growth retardation. Magnetic resonance (MR) imaging was useful in diagnosing the lesion. Although the tumor could not be completely removed by surgery, radiotherapy was effective and the residual tumor disappeared 6 months after irradiation. The patient's condition has remained stable and no recurrence has been observed by MR imaging in the 4 years since radiation therapy.

Hemangioma of spinal nerve root

1999 ◽  
Vol 91 (2) ◽  
pp. 175-180 ◽  
Author(s):  
Federico Roncaroli ◽  
Bernd W. Scheithauer ◽  
William E. Krauss
Keyword(s):  
Nerve Root ◽  
Cauda Equina ◽  
Spinal Nerve ◽  
Nerve Fibers ◽  
Capillary Hemangioma ◽  
Spinal Nerve Root ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Content Type ◽  
Fine Print

Object. Hemangiomas of the spinal nerve roots are rare. Only 12 cases have been reported in the literature, all since 1965. These lesions occurred in adults, primarily in males, and were located in the cauda equina. Of the 12 lesions, eight were cavernous hemangiomas. The authors report here the clinicopathological features of 10 cases of hemangioma of the spinal nerve root, nine of which were of the capillary type. Methods. The group included six men and four women who ranged in age from 40 to 62 years. The majority of patients presented with pain and weakness. One patient also experienced worsening of pain during menses. In all cases, gadolinium-enhanced magnetic resonance imaging or computerized tomography myelography demonstrated a discrete intraspinal extramedullary mass. Administration of contrast agent resulted in uniform, intense enhancement. A gross-total resection was achieved in all but one case; in most cases, it was necessary to sacrifice the parent nerve root. Preoperative symptoms and signs improved in nine cases. On histological examination, all but one tumor, a spindle-cell hemangioendothelioma, were shown to be ordinary capillary hemangiomas. Two lesions exhibited a cavernous component, and five showed a partly solid growth pattern resembling juvenile capillary hemangioma. In all cases, the relationship with the nerve root was histologically confirmed. The tumor—nerve relation varied. The intact nerve was displaced by the epineurial mass in three cases. The fascicles appeared separated in six cases, and individual nerve fibers were seen throughout one lesion with endoneurial involvement. Conclusions. Hemangiomas of spinal nerve roots pose a challenging diagnostic problem. Knowledge of their existence is relevant in that they may mimic tumors and are amenable to surgical treatment.

Lumbosacral intersegmental epispinal axons and ectopic ventral nerve rootlets

1987 ◽  
Vol 67 (2) ◽  
pp. 269-277 ◽  
Author(s):  
Wesley W. Parke ◽  
Ryo Watanabe
Keyword(s):  
Nerve Root ◽  
Sensory Nerve ◽  
Conus Medullaris ◽  
Spinal Nerve ◽  
Nerve Fibers ◽  
Ventral Horn ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Content Type ◽  
Almost All

✓ An epispinal system of motor axons virtually covers the ventral and lateral funiculi of the human conus medullaris between the L-2 and S-2 levels. These nerve fibers apparently arise from motor cells of the ventral horn nuclei and join spinal nerve roots caudal to their level of origin. In all observed spinal cords, many of these axons converged at the cord surface and formed an irregular group of ectopic rootlets that could be visually traced to join conventional spinal nerve roots at one to several segments inferior to their original segmental level; occasional rootlets joined a dorsal nerve root. As almost all previous reports of nerve root interconnections involved only the dorsal roots and have been cited to explain a lack of an absolute segmental sensory nerve distribution, it is believed that these intersegmental motor fibers may similarly explain a more diffuse efferent distribution than has previously been suspected.

Intracranial Rosai—Dorfman disease treated with microsurgical resection and stereotactic radiosurgery

2003 ◽  
Vol 98 (1) ◽  
pp. 165-168 ◽  
Author(s):  
Constantinos G. Hadjipanayis ◽  
Ghassan Bejjani ◽  
Clayton Wiley ◽  
Toshinori Hasegawa ◽  
Melissa Maddock ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Cervical Lymphadenopathy ◽  
Residual Tumor ◽  
Content Type ◽  
First Case ◽  
Excess Morbidity ◽  
Rosai Dorfman Disease ◽  
Microsurgical Resection ◽  
Partial Labyrinthectomy ◽  
Fine Print

✓ Sinus histiocytosis or Rosai—Dorfman disease (RDD) is a rare idiopathic histioproliferative disorder typically characterized by painless cervical lymphadenopathy, fever, and weight loss. Extranodal, intracranial disease is uncommon. In this report the authors describe the first case of intracranial RDD treated with stereotactic radiosurgery after resection. This 52-year-old man with known RDD presented with a 7-day course of fever, headache, diplopia, left facial paresthesias, and difficulty swallowing. No cranial nerve deficits were evident on examination, but right submandibular and inguinal node enlargements were noted. On neuroimaging, the patient was found to have a homogeneously contrast-enhancing petroclival lesion with extension into the left cavernous sinus. The patient underwent a combined left petrosal craniotomy and partial labyrinthectomy with duraplasty for biopsy sampling and partial microsurgical resection of the lesion. Microscopic examination of the biopsy specimen revealed the presence of a mixed cellular population with predominant mature histiocytes consistent with RDD. The residual tumor was treated with stereotactic radiosurgery 2 months after resection. On follow-up imaging the lesion had regressed significantly, with only slight dural enhancement remaining. Microsurgical resection for histological diagnosis, followed by stereotactic radiosurgery for residual tumor represents one treatment alternative in the management of intracranial RDD in which a complete resection carries the potential for excess morbidity.

Updated assessment and current classification of spinal meningeal cysts

1988 ◽  
Vol 68 (3) ◽  
pp. 366-377 ◽  
Author(s):  
Michael W. Nabors ◽  
T. Glenn Pait ◽  
Edward B. Byrd ◽  
Najmaldin O. Karim ◽  
David O. Davis ◽  
...  
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Water Soluble ◽  
Type I ◽  
Spinal Nerve Root ◽  
Content Type ◽  
Spinal Meningeal Cysts ◽  
Spinal Nerve Root Fibers ◽  
Meningeal Cysts

✓ The classification of spinal meningeal cysts (MC's) in the literature is indistinct, confusing, and in certain categories histologically misleading. Based on a series of 22 cases, the authors propose a classification comprising three categories: spinal extradural MC's without spinal nerve root fibers (Type I); spinal extradural MC's with spinal nerve root fibers (Type II); and spinal intradural MC's (Type III). Although water-soluble myelography may disclose a filling defect for all three categories, computerized tomographic myelography (CTM) is essential to reveal communication between the cyst and the subarachnoid space. Communication demonstrated by CTM allows accurate diagnosis of a spinal MC and rules out other mass lesions. Magnetic resonance imaging appears useful as an initial study to identify an intraspinal cystic mass. Final characterization is based on operative inspection and histological examination for all three categories.

Sciatica of nondisc origin and piriformis syndrome: diagnosis by magnetic resonance neurography and interventional magnetic resonance imaging with outcome study of resulting treatment

2005 ◽  
Vol 2 (2) ◽  
pp. 99-115 ◽  
Author(s):  
Aaron G. Filler ◽  
Jodean Haynes ◽  
Sheldon E. Jordan ◽  
Joshua Prager ◽  
J. Pablo Villablanca ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Nerve Root ◽  
Piriformis Syndrome ◽  
Piriformis Muscle ◽  
Mr Neurography ◽  
Content Type ◽  
Interventional Mr ◽  
Interventional Mr Imaging ◽  
Fine Print

Object. Because lumbar magnetic resonance (MR) imaging fails to identify a treatable cause of chronic sciatica in nearly 1 million patients annually, the authors conducted MR neurography and interventional MR imaging in 239 consecutive patients with sciatica in whom standard diagnosis and treatment failed to effect improvement. Methods. After performing MR neurography and interventional MR imaging, the final rediagnoses included the following: piriformis syndrome (67.8%), distal foraminal nerve root entrapment (6%), ischial tunnel syndrome (4.7%), discogenic pain with referred leg pain (3.4%), pudendal nerve entrapment with referred pain (3%), distal sciatic entrapment (2.1%), sciatic tumor (1.7%), lumbosacral plexus entrapment (1.3%), unappreciated lateral disc herniation (1.3%), nerve root injury due to spinal surgery (1.3%), inadequate spinal nerve root decompression (0.8%), lumbar stenosis (0.8%), sacroiliac joint inflammation (0.8%), lumbosacral plexus tumor (0.4%), sacral fracture (0.4%), and no diagnosis (4.2%). Open MR—guided Marcaine injection into the piriformis muscle produced the following results: no response (15.7%), relief of greater than 8 months (14.9%), relief lasting 2 to 4 months with continuing relief after second injection (7.5%), relief for 2 to 4 months with subsequent recurrence (36.6%), and relief for 1 to 14 days with full recurrence (25.4%). Piriformis surgery (62 operations; 3-cm incision, transgluteal approach, 55% outpatient; 40% with local or epidural anesthesia) resulted in excellent outcome in 58.5%, good outcome in 22.6%, limited benefit in 13.2%, no benefit in 3.8%, and worsened symptoms in 1.9%. Conclusions. This Class A quality evaluation of MR neurography's diagnostic efficacy revealed that piriformis muscle asymmetry and sciatic nerve hyperintensity at the sciatic notch exhibited a 93% specificity and 64% sensitivity in distinguishing patients with piriformis syndrome from those without who had similar symptoms (p < 0.01). Evaluation of the nerve beyond the proximal foramen provided eight additional diagnostic categories affecting 96% of these patients. More than 80% of the population good or excellent functional outcome was achieved.

Conus medulla—cauda compression from nerve root hypertrophy in a child with Dejerine—Sottas syndrome: improvement with laminectomy and duraplasty

2002 ◽  
Vol 97 (2) ◽  
pp. 244-247 ◽  
Author(s):  
Kleopas A. Kleopa ◽  
Leslie N. Sutton ◽  
Joseph Ong ◽  
Gihan Tennekoon ◽  
Albert E. Telfeian
Keyword(s):  
Magnetic Resonance Imaging ◽  
Nerve Root ◽  
Cauda Equina ◽  
Conus Medullaris ◽  
Myelin Protein Zero ◽  
Resonance Imaging ◽  
Content Type ◽  
Leg Weakness ◽  
Protein Zero ◽  
Fine Print

✓ This 7-year-old boy with Dejerine—Sottas syndrome caused by a mutation in the myelin protein zero gene began to suffer rapid deterioration with increasing leg weakness, loss of the ability to ambulate, and bowel and bladder incontinence. Magnetic resonance imaging of the spine revealed nerve root hypertrophy resulting in compression of the conus medullaris and cauda equina. Decompressive surgery was successful in reversing some of his deficits.

En bloc removal of the lower lumbar vertebral body for chordoma

2001 ◽  
Vol 94 (2) ◽  
pp. 284-291 ◽  
Author(s):  
Jark J. D. Bosma ◽  
Timothy J. D. Pigott ◽  
Bruce H. Pennie ◽  
David C. Jaffray
Keyword(s):  
Mr Imaging ◽  
En Bloc Resection ◽  
Retroperitoneal Approach ◽  
En Bloc ◽  
Content Type ◽  
First Case ◽  
Lumbar Vertebral Body ◽  
Anterior Retroperitoneal Approach ◽  
Lower Lumbar ◽  
Fine Print

✓ En bloc removal of the lower lumbar vertebral bodies (VBs) is a major surgical challenge. The authors describe the surgical technique used in two patients who presented with chordoma confined to the L-5 and L-4 VB, respectively. These tumors were diagnosed using magnetic resonance (MR) imaging during investigation for back pain. Both patients underwent a combined (two-stage) anterior—posterior approach. In the first case the posterior stage of the procedure was followed by an anterior retroperitoneal approach, and in the second case a lateral retroperitoneal approach was used. Complete en bloc excision of the tumor was achieved in each case, even though in the second case the VB fractured when it was mobilized. The correlation between the MR imaging findings and surgical specimens was remarkable. The authors conclude that en bloc resection is feasible in these cases. Because mobilization of the VB is more difficult in the lateral approach, the authors favor the anterior retroperitoneal approach. The authors anticipate the need for such procedures to increase with the widespread use of MR imaging, which demonstrates the extent of these tumors with remarkable accuracy.

Sign in / Sign up

Export Citation Format

Share Document