Immunotherapy‐responsive brainstem lesion accompanied with anti‐galactocerebroside antibody

2021 ◽  
Author(s):  
Wataru Shiraishi
Keyword(s):  
Brainstem Lesion

scholarly journals Neuromyelitis optica spectrum disorder with deafness and an extensive brainstem lesion

Heliyon ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e06106
Author(s):  
Asako Onda ◽  
Mikihiro Yamazaki ◽  
Takashi Shimoyama ◽  
Hiroshi Yaguchi
Keyword(s):  
Neuromyelitis Optica ◽  
Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Brainstem Lesion

scholarly journals HGG-40. EXCEPTIONAL SYNCHRONOUS OCCURENCE OF A BRAF V600E MUTANT GLIOBLASTOMA AND A H3.3K27M MUTANT DIFFUSE INTRINSIC PONTINE GLIOMA: A CASE REPORT

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii351-iii351
Author(s):  
Emilie De Carli ◽  
Blandine Boisselier ◽  
Luc Le Fournier ◽  
Stéphane Supiot ◽  
Coralie Mallebranche ◽  
...  
Keyword(s):  
Parietal Lobe ◽  
Genetic Alterations ◽  
Braf V600e ◽  
Driver Gene ◽  
Histopathological Analysis ◽  
Repair System ◽  
Who Grade ◽  
Brainstem Lesion ◽  
Her Family ◽  
Concomitant Radiochemotherapy

Abstract We report herein the case of a 17-year-old female who presented with intracranial hypertension and diplopia. Magnetic resonance imaging showed a large left cystic and solid temporoparietal lesion, associated with an infiltrating lesion of the brainstem, hypointense in T1 and hyperintense in FLAIR sequences, without enhancement after injection of gadolinium. Complete resection of the parietal mass and biopsy of the brainstem lesion were performed. Histopathological analysis of the parietal mass showed glioblastoma (WHO grade IV) with no IDH1/2 or H3.3/H3.1 gene mutation detected by Sanger sequencing. Immunohistochemistry found the expression of the proteins of mismatch repair system. Whole exome and RNA sequencing identified a BRAF-V600E mutation. The brainstem lesion was a diffuse midline glioma, H3K27M-mutant (grade IV) according to the 2016 WHO classification. Pan-genomic SNP arrays of the 2 tumors showed distinct genetic alterations. The parietal glioblastoma displayed complex genomic alterations whereas the brainstem glioma harbored chromosome 7q gain, chromosome 9p and 10 losses, and RB, TP53 and CDKN2A homozygous deletions. The patient was treated by concomitant radiochemotherapy (according to Stupp protocol). After 12 cycles of temozolomide, there was complete remission persistant in the parietal lobe. The brainstem tumor was stable but progressed after 3 months of temozolomide discontinuation. Treatment with mTOR inhibitors was initiated. At 21-month follow-up, the patient remains with few symptoms. No predisposition syndrome was identified in the patient or her family. Concurrent glioblastomas with distinct driver gene mutations are exceptional.

scholarly journals Sound movement detection deficit due to a brainstem lesion.

1997 ◽  
Vol 62 (5) ◽  
pp. 522-526 ◽  
Author(s):  
T D Griffiths ◽  
D Bates ◽  
A Rees ◽  
C Witton ◽  
A Gholkar ◽  
...  
Keyword(s):  
Movement Detection ◽  
Brainstem Lesion

FLGS-03. Fluorescein sodium-guided biopsy or resection in patients with contrast enhancing brainstem lesion in MRI

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi226-vi226
Author(s):  
Fuhua Lin ◽  
Zhenghe Chen ◽  
Xiangheng Zhang ◽  
Yonggao Mou
Keyword(s):  
Small Cell Lung Carcinoma ◽  
Cancer Center ◽  
Sodium Fluorescein ◽  
Target Area ◽  
Fluorescein Sodium ◽  
Fluorescence Staining ◽  
Strong Fluorescence ◽  
Cell Lung Carcinoma ◽  
Brainstem Lesion ◽  
Guided Surgery

Abstract BACKGROUND It is challenging to resect or just biopsy the lesions in the brainstem, due to the essential function of the surfaces and limited space. Neuro-navigation is not always reliable and stereotatic biopsy is infrequently inconclusive due to small or inadequate samples. We want to share our experiences in the application of fluorescein sodium in surgery on patients with brainstem lesion which is contrast enhancing in MRI. METHODS Between January 2017 and June 2021, 5 patients with brainstem lesion underwent fluorescein sodium-guided surgery in neurosurgery department of Sun Yat-sen University Cancer Center. After injection of low dose of sodium fluorescein (3 mg/kg), the lesions with strong fluorescence staining were identified as the target area for biopsy or resection. RESULTS 5 consecutive patients (aged 6–47 years) with brainstem lesions prospectively underwent fluorescein sodium-guided surgery. The lesions were located in pontine in 3 patients and in the medulla in 2 patients. Gross total resection was achieved in 2 patients, and partial resection in the other 3 patients. In all patients, a pathological diagnosis was obtained (4 gliomas and 1 metastasis from non-small cell lung carcinoma) without severe complications, including mild facial or abduct nerve palsy in 3 patients. And all the specimens with strong fluorescence staining sent for pathology were proved to be tumorous. CONCLUSION Fluorescein sodium-guided technique was helpful to locate the lesion in brainstem which was contrast-enhanced in MRI. It was effective and safe to figure out an ideal trajectory to avoid damage of the crucial structures and improve the diagnostic rate.

Stereotactic Biopsy of Brainstem Lesion in Children: Techniques, Efficacy and Safety: Case Review of Single Institutional Experience

2021 ◽  
Vol 4 (2) ◽  
pp. 01-05
Author(s):  
Ugwuanyi U.C.
Keyword(s):  
Brain Stem ◽  
Stereotactic Biopsy ◽  
Case Reports ◽  
Current Trend ◽  
Safe Procedure ◽  
Case Review ◽  
Brainstem Lesion ◽  
Institutional Experience ◽  
Brain Stem Lesions ◽  
Stem Lesions

Introduction: Stereotactic biopsy of brain stem lesions in children evolved from a controversial background but the current trend seems towards a safe procedure that will yield diagnostic accuracy to guide targeted and individualized treatments. Aims and Objectives: To confirm safety, accuracy and usefulness of biopsy of brain stem lesions using our institutional experience on two index cases that underwent stereotactic procedures. Methodology: A review of two case reports were conducted to expose diagnostic success and procedure-related highpoints. Results: In both cases presented the procedure was uneventful, yielded the desired diagnostic tissue and there were no procedure related complications. Conclusion: Stereotactic biopsy of pediatric brain stem lesion is safe. Tissue sampling was accurate in both cases and served as a prerequisite more targeted oncology referral and potentially individualized treatment.

Spontaneous remission of a diffuse brainstem lesion in a neonate

2007 ◽  
Vol 37 (4) ◽  
pp. 399-402 ◽  
Author(s):  
Leena Schomerus ◽  
Andreas Merkenschlager ◽  
Thomas Kahn ◽  
Wolfgang Hirsch
Keyword(s):  
Spontaneous Remission ◽  
Brainstem Lesion

Intrinsic brainstem choroid plexus papilloma

2004 ◽  
Vol 100 (6) ◽  
pp. 1076-1078 ◽  
Author(s):  
Ashok Pillai ◽  
Kariyattil Rajeev ◽  
Sushil Chandi ◽  
Muthukuttiparambil Unnikrishnan
Keyword(s):  
Central Nervous System ◽  
Choroid Plexus ◽  
Choroid Plexus Papilloma ◽  
Residual Tumor ◽  
Brainstem Lesion ◽  
Content Type ◽  
The Central Nervous System ◽  
Choroid Plexus Papillomas ◽  
Fine Print ◽  
Plexus Papilloma

✓ The authors report an intrinsic brainstem lesion that was diagnosed initially as a pontine cavernoma, which finally proved to be a choroid plexus papilloma. Choroid plexus papillomas are rare tumors of the central nervous system and are usually intraventricular in location. The occurrence of this tumor in an intraparenchymal location is extremely rare, and its occurrence within the brainstem is previously unreported. The authors also report a trial of chemotherapy with lomustine in the management of the residual tumor.

Intrinsic Well-Demarcated Midline Brainstem Lesion Successfully Resected through a Midline Pontine Splitting Approach

2020 ◽  
pp. 1-6
Author(s):  
Kentaro Chiba ◽  
Yasuo Aihara ◽  
Takakazu Kawamata
Keyword(s):  
Surgical Approach ◽  
Fourth Ventricle ◽  
Axial Direction ◽  
Surgical Approaches ◽  
Lateral Side ◽  
Navigation Systems ◽  
Oculomotor Nucleus ◽  
Total Removal ◽  
Brainstem Lesion ◽  
Case Presentation

<b><i>Introduction:</i></b> Surgical approaches to intrinsic pontine lesions are technically difficult and prone to complications. The surgical approach to the brainstem through midline pontine splitting is regarded as safe since there are no crossing vital fibers in the midline between the abducens nuclei at the facial colliculi in the pons and the oculomotor nucleus in the midbrain, although its actual utilization has not been reported previously. <b><i>Case Presentation:</i></b> A 6-year-old boy presented with a large intrinsic cystic lesion in the pons. We successfully achieved gross total removal via the median sulcus of the fourth ventricle. The fixation in adduction and limitation of abduction were newly observed in the left eye after surgery. <b><i>Discussion:</i></b> The advantage of the surgical approach through the median sulcus is the longer line of dissection in an axial direction and the gain of a wider operative view. On the other hand, the disadvantage of this approach is the limited orientation and view toward lateral side and a possible impairment of the medial longitudinal fasciculi and paramedian pontine reticular formation, which are located lateral to the midline sulcus bilaterally and are easily affected via the median sulcus of the fourth ventricular floor. Ongoing developments in intraoperative neuro-monitoring and navigation systems are expected to enhance this promising approach, resulting in a safer and less complicated procedure in the future. <b><i>Conclusion:</i></b> The surgical approach through midline pontine splitting is suitable for midline and deep locations of relatively large pontine lesions that necessitate a wider surgical window.

Sign in / Sign up

Export Citation Format

Share Document