scholarly journals Clinical and Radiologic Characteristics, Surgical Outcomes, and Its Possible Origins of Chondroma of the Dural Convexity

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Jing Guo ◽  
Qiuyue Fang ◽  
Jianhua Cheng ◽  
Chuzhong Li ◽  
Songbai Gui ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Clinical Characteristics ◽  
Single Center ◽  
Total Resection ◽  
Rare Type ◽  
Dural Tail Sign ◽  
Female Predominance ◽  
Dural Tail ◽  
The Mean ◽  
Almost All

Chondroma of the dural convexity (CDC) is a benign and extremely rare type of intracranial chondroma. In this study, we reported five CDCs in a single center and reviewed the available literature to determine the clinical characteristics and surgical outcomes and possible origins of the disease. The clinical data of five patients (4 females) who confirmed to be CDC between 2000 and 2019 in our single center was collected together with 22 cases from literatures. The clinical characteristics and surgical outcomes were reviewed and analyzed. Among all the available CDC cases, the mean age was 31 ± 13.7   years ; the mean tumor volume was 42.3 ± 40.9   c m 3 , showing a female predominance (63% vs. 37%). The tumors showed calcification in 88.2% cases (15/17) on CT scans and hypointense on T1WI (15/19, 78.9%), mixed intense on T2WI (10/18, 55.6%), and inhomogeneous enhancement without dural tail sign after administration of gadolinium (20/21, 95.2%). Almost all the tumors were misdiagnosed as meningiomas preoperatively. In addition, almost all image available CDC lesions (24/25, 96%) located across the cranial sutures indicating that the tumor originated from ectopic chondrocytes from adjacent skull sutures. No tumors recurred after total resection in follow-up. CDCs are characterized with female predominance and may originate from ectopic chondrocytes from adjacent skull sutures. The lesion with inhomogeneous contrast enhancement without dural tail sign and avascular in cerebral angiography are key points to be differentiated from meningioma. The most effective treatment is total resection.

scholarly journals Radiological features of the intracranial extra-skeletal mesenchymal chondrosarcoma

2021 ◽  
pp. 75-79
Author(s):  
Anas Abdallah ◽  
İrfan Çınar
Keyword(s):  
Total Resection ◽  
Young Males ◽  
Radiological Features ◽  
Tof Mra ◽  
Dural Tail Sign ◽  
Female Predominance ◽  
Dural Tail ◽  
Dural Attachment ◽  
The Mean

Background: Mesenchymal chondrosarcomas are the most malignant form of chondrosarcomas. They have mostly affected bones. Rarely, these tumors can be intracranial extraskeletal (IEMC) that originates from the meninges or parenchyma. Methods and Materials: We presented two IEMC patients who were treated at our institutions and followed up for the long-term. To understand the radiological features of IEMC, we conducted a systematic literature review for previously reported series and cases of IEMCs. Results: We surgically treated two young males with IEMC initially diagnosed at their age of 18 and 20 years. The patients initially treated with gross total resection (GTR) and GTR followed by radiotherapy, and followed-up for 218 and 73 months, respectively. With both patients, we obtained 83 reported IEMC patients from the literature. Among them, only 30 cases were reported with their radiological MRI details. The mean age of the reported cases was 24.5±16.0 years (2 months–71 years). Female predominance was 54.2%. The mean progression-free and overall survivals were 27.9 and 39.0 months, respectively. Most IEMCs showed a partially calcified mass on roentgenography and a highly vascular mass on angiography. On T1WIs, IEMCs almost show hypo- to isointensity and intense heterogeneous enhancement after administering a contrast substance. On T2WIs, IEMCs show iso- to hyperintensity. Conclusions: IEMCs usually show dural attachment without a net dural tail sign and a well-identified brimmed vascular nodule on TOF-MRA. This nodule appears as a prominent blooming on SWI. TOF-MRA and SWI images can help in the radiological diagnosis of IEMCs.

scholarly journals Radiological Features of the Intracranial Extraskeletal Mesenchymal Chondrosarcoma: A Report of Two Cases Insight Into the Literature Review

2020 ◽  
Author(s):  
Anas Abdallah ◽  
İrfan Çınar
Keyword(s):  
Literature Review ◽  
Young Males ◽  
Radiological Features ◽  
Tof Mra ◽  
Dural Tail Sign ◽  
Female Predominance ◽  
Dural Tail ◽  
Extraskeletal Mesenchymal Chondrosarcoma ◽  
Dural Attachment ◽  
The Mean

Abstract Background: Mesenchymal chondrosarcomas are the most malignant form of chondrosarcomas. They have mostly affected bones. Rarely, these tumors can be intracranial extraskeletal (IEMC) that originates from the meninges or parenchyma. Methods and Materials: We presented two IEMC patients who were treated at our institutions and followed up for the long-term. To understand the radiological features of IEMC, we conducted a systematic literature review for previously reported series and cases of IEMCs. Results: We surgically treated two young males with IEMC initially diagnosed at their age of 18 and 20 years. The patients initially treated with gross total resection (GTR) and GTR followed by radiotherapy, and followed-up for 218 and 73 months, respectively. With both patients, we obtained 83 reported IEMC patients from the literature. Among them, only 30 cases were reported with their radiological MRI details. The mean age of the reported cases was 24.5±16.0 years (2 months–71 years). Female predominance was 54.2%. The mean progression-free and overall survivals were 27.9 and 39.0 months, respectively. Most IEMCs showed a partially calcified mass on roentgenography and a highly vascular mass on angiography. On T1WIs, IEMCs almost show hypo- to isointensity and intense heterogeneous enhancement after administering a contrast substance. On T2WIs, IEMCs show iso- to hyperintensity.Conclusions: IEMCs usually show dural attachment without a net dural tail sign and a well-identified brimmed vascular nodule on TOF-MRA. This nodule appears as a prominent blooming on SWI. TOF-MRA and SWI images can help in the radiological diagnosis of IEMCs.

scholarly journals COVID-19 Vaccination in Patients with Myasthenia Gravis: A Single-Center Case Series

Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1112
Author(s):  
Zhe Ruan ◽  
Yonglan Tang ◽  
Chunhong Li ◽  
Chao Sun ◽  
Ying Zhu ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Acetylcholine Receptors ◽  
Subunit Vaccine ◽  
Clinical Characteristics ◽  
Case Series ◽  
Onset Age ◽  
Single Center ◽  
Inactivated Vaccines ◽  
Main Observation ◽  
The Mean

In this study, we report the safety of coronavirus disease 2019 (COVID-19) vaccine in patients with myasthenia gravis (MG). Patients who were vaccinated against COVID-19 were included. Demographics, clinical characteristics, medications, and vaccination information were collected. The main observation outcome is the worsening of MG symptoms within 4 weeks following COVID-19 vaccination. A total of 22 patients with MG vaccinated for COVID-19 were included. Ten (45.5%) patients had ocular MG (OMG), and 12 (55.5%) patients had generalized MG (GMG). Six (27.3%) patients were female, and the mean (SD) onset age was 45.4 (11.8) years. Nineteen (86.4%) patients were seropositive for acetylcholine receptors (AChR) antibody. Seven (31.8%) patients underwent thymectomy, and four of them confirmed thymoma pathologically. Twenty-one patients were administrated with inactivated vaccines, and the remaining one was administrated with recombinant subunit vaccine. Twenty (90.9%) patients did not present MG symptom worsening within 4 weeks of COVID-19 vaccination, and two (9.1%) patients reported slight symptom worsening but resolved quickly within a few days. Our findings suggest inactivated COVID-19 vaccines might be safe in MG patients with Myasthenia Gravis Foundation of America (MGFA) classification I to II, supporting the recommendation to promote vaccination for MG patients during the still expanding COVID-19 pandemic.

scholarly journals Transbasal versus endoscopic endonasal versus combined approaches for olfactory groove meningiomas: importance of approach selection

2018 ◽  
Vol 44 (4) ◽  
pp. E8 ◽  
Author(s):  
James K. Liu ◽  
Nicole A. Silva ◽  
Ilesha A. Sevak ◽  
Jean Anderson Eloy
Keyword(s):  
Surgical Outcomes ◽  
Tumor Volume ◽  
Vascular Involvement ◽  
Total Resection ◽  
Endoscopic Endonasal ◽  
Olfactory Groove ◽  
Significant Difference ◽  
Csf Leakage ◽  
The Mean

OBJECTIVEThere has been much debate regarding the optimal surgical approach for resecting olfactory groove meningiomas (OGMs). In this paper, the authors analyzed the factors involved in approach selection and reviewed the surgical outcomes in a series of OGMs.METHODSA retrospective review of 28 consecutive OGMs from a prospective database was conducted. Each tumor was treated via one of 3 approaches: transbasal approach (n = 15), pure endoscopic endonasal approach (EEA; n = 5), and combined (endoscope-assisted) transbasal-EEA (n = 8).RESULTSThe mean tumor volume was greatest in the transbasal (92.02 cm3) and combined (101.15 cm3) groups. Both groups had significant lateral dural extension over the orbits (transbasal 73.3%, p < 0.001; combined 100%), while the transbasal group had the most cerebral edema (73.3%, p < 0.001) and vascular involvement (66.7%, p < 0.001), and the least presence of a cortical cuff (33.3%, p = 0.019). All tumors in the combined group were recurrent tumors that invaded into the sinonasal cavity. The purely EEA group had the smallest mean tumor volume (33.33 cm3), all with a cortical cuff and no lateral dural extension. Gross-total resection was achieved in 80% of transbasal, 100% of EEA, and 62.5% of combined cases. Near-total resection (> 95%) was achieved in 20% of transbasal and 37.5% of combined cases, all due to tumor adherence to the critical neurovascular structures. The rate of CSF leakage was 0% in the transbasal and combined groups, and there was 1 leak in the EEA group (20%), resulting in an overall CSF leakage rate of 3.6%. Olfaction was preserved in 66.7% in the transbasal group. There was no significant difference in length of stay or 30-day readmission rate between the 3 groups. The mean modified Rankin Scale score was 0.79 after the transbasal approach, 2.0 after EEA, and 2.4 after the combined approach (p = 0.0604). The mean follow-up was 14.5 months (range 1–76 months).CONCLUSIONSThe transbasal approach provided the best clinical outcomes with the lowest rate of complications for large tumors (> 40 mm) and for smaller tumors (< 40 mm) with intact olfaction. The role of EEA appears to be limited to smaller, appropriately selected tumors in which olfaction is already absent. EEA also plays an important adjunctive role when combined with the transbasal approach for recurrent OGMs invading the sinonasal cavity. Careful patient selection using an individualized, tailored strategy is important to optimize surgical outcomes.

scholarly journals Intradural Extramedullary Spinal Sarcoidosis Mimicking Meningioma

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Sho Ishiwata ◽  
Yoichi Iizuka ◽  
Tokue Mieda ◽  
Junko Hirato ◽  
Hiromi Koshi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Rare Entity ◽  
Resonance Imaging ◽  
Spinal Cord Tumors ◽  
Total Resection ◽  
Case Presentation ◽  
Dural Tail Sign ◽  
Dural Tail ◽  
Intradural Extramedullary ◽  
Magnetic Resonance Imaging Mri

Background. Spinal sarcoidosis is a rare subgroup of neurosarcoidosis. Although most sarcoid lesions develop in the intramedullary compartment, intradural extramedullary (IDEM) spinal sarcoidosis is an extremely rare entity. Case Presentation. We herein report a case of IDEM spinal sarcoidosis mimicking a meningioma. A 32-year-old man presented to the hospital with clumsy hands and was unable to walk without assistance. Magnetic resonance imaging (MRI) of the cervical spine revealed a dural tail sign that is common in meningiomas. The patient underwent gross total resection. The pathological findings consisted with a sarcoid leision of the spinal cord. The patient’s myelopathy recovered after surgery. Conclusions. Physicians should be alert for the possibility of IDEM sarcoidosis mimicking a meningioma in the differential diagnosis of IDEM spinal cord tumors.

scholarly journals 0953 The Maintenance of Wakefulness Test (MWT) in Pediatric Hypersomnia

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A362-A362
Author(s):  
R Jaroenying ◽  
S Hantragool ◽  
Y Xu ◽  
M M Hossain ◽  
N Simakajornboon
Keyword(s):  
Clinical Characteristics ◽  
Sleep Latency ◽  
Medical Center ◽  
Pediatric Population ◽  
Limited Data ◽  
Simulation Test ◽  
Maintenance Of Wakefulness Test ◽  
Idiopathic Hypersomnia ◽  
The Mean ◽  
Almost All

Abstract Introduction The Maintenance of Wakefulness Test (MWT) is a recommended procedure to evaluate the efficacy of treatment for hypersomnia. Limited data have been published on the use of the MWT in children and adolescents. This study aims to describe the clinical characteristics, MWT findings and their implication in the management of children with hypersomnia. Methods This study reviewed the charts of children with hypersomnia who had MWT performed at Cincinnati Children’s Hospital Medical Center (CCHMC) between January 1, 2007 and January 31, 2018. Demographics, clinical characteristics, MWT findings, diagnoses and managements of children with hypersomnia were obtained. Results Fifty-three patients with hypersomnia who had MWT were included (mean age 17.29 years, range 12.5-22.75 years), 32 (60%) were male, and 40 (75%) were Caucasian. The diagnosis included narcolepsy (41, 77%), idiopathic hypersomnia (7, 13.2%), narcolepsy with OSA (11, 20%) and OSA (4, 7.5%). A mean sleep latency for all studies was 23.24 minutes (range 1.25-40 minutes). Twenty seven (50.9%) patients had mean sleep latency &gt;20 minutes (passed MWT) which indicate adequate control of treatment, while 26 (49.1%) had mean sleep latency &lt;20 minutes (failed MWT) including 5 (9.4%) with mean sleep latency &lt;8 minutes. There was no difference between patients who had passed MWT and failed MWT in the mean of Epworth sleepiness scale (12 vs 11), age (16.8 vs 17.6 years), or BMI (29.2 vs 26.3). Higher percentage of narcolepsy with cataplexy was found in patients who failed MWT (46.2% vs 22.2%, P 0.06). Findings from the MWT caused the changes of management in 25/26 (96.1%) who failed MWT, and 8/27 (29.6%) who passed MWT (P&lt;0.001). Conclusion Our result suggests that the MWT has clinical usefulness in evaluating responses to treatment for conditions associated with hypersomnia in children. Changes in management occurred in almost all patient who failed MWT. Interesting, there was no difference in subjective sleepiness between adolescents who passed and failed MWT, indicating the need to obtain objective data in this population. Future study is required to explore normative MWT data in pediatric population and to compare MWT with other tools such as driving simulation test. Support None

scholarly journals Cortical ependymoma: an unusual epileptogenic lesion

2011 ◽  
Vol 114 (4) ◽  
pp. 1187-1194 ◽  
Author(s):  
Jamie J. Van Gompel ◽  
Kelly K. Koeller ◽  
Fredric B. Meyer ◽  
W. Richard Marsh ◽  
Peter C. Burger ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Gross Total Resection ◽  
Low Grade ◽  
Total Resection ◽  
Rare Type ◽  
High Association ◽  
Cross Sectional ◽  
Who Grade ◽  
The Mean ◽  
Grade Iii

Object Supratentorial cortical ependymomas (CE) are rare, with 7 cases reported. The lesions, typically occurring in the superficial cortex in young adults and associated with a history of seizures, are not fully characterized. Furthermore, their relationship with the recently described angiocentric glioma (AG) is still being debated. This study was undertaken to summarize the authors' experience with CEs. Methods Between 1997 and 2009, 202 cases of ependymoma were surgically treated at the Mayo Clinic, 49 of which were supratentorial. Among these, 9 CE cases were retrospectively identified. Clinical, imaging, and pathological features of each case were reviewed. Results Tumors arose from the frontal (5 cases), parietal (3), and occipital (1) lobes. No tumor occurred in the temporal lobe, despite its reported association with seizures. The mean age at presentation was 27 ± 19 years (± SD) and age at resection was 36 ± 16 years. The mean size of the lesion was 16 ± 14 cm3. Seizures were the presenting symptom in 78%. Cross-sectional imaging in 8 cases was characterized by a heterogeneous mass with multiple cystlike areas and enhancement of the soft-tissue component. Gross-total resection was achieved in 8 of 9 tumors. Pathologically, 6 were low-grade (WHO Grade II) and 3 were anaplastic (WHO Grade III) ependymomas. All tumors exhibited the focal presence of perivascular pseudorosettes, but only 1 (11%) exhibited the focal presence of a true rosette. A bipolar spindle cell component resembling AG was present in 3 (33%) and “Schwannian-like” nodules in 2 (22%). Subpial aggregation and peripheral infiltration were present in 4 cases (44%). With a mean postsurgery follow-up of 62 ± 38 months, only 2 lesions recurred locally after imaging-confirmed gross-total resection, both being Grade III. In 5 (71%) of 7 patients presenting with seizures an Engel Class I outcome was achieved. Conclusions Cortical ependymomas represent a rare type of ependymoma occurring superficially in the cortex. Morphologically, these tumors are protean, varying from classic to epithelioid, clear cell, and tanycytic. Some also exhibited features typical of AG. Most tumors were low grade and cured with resection. Anaplastic tumors occur and may recur locally despite provision of radiation therapy. Cortical ependymomas frequently, but not always, present with seizures, but despite their high association with epilepsy, none occurred in the temporal lobe in any of the authors' 9 patients. Overall, CEs appear to have a relatively favorable prognosis compared with other supratentorial ependymomas.

Hypervascular Vestibular Schwannomas: Clinical Characteristics, Angiographical Classification, and Surgical Considerations

2017 ◽  
Vol 15 (3) ◽  
pp. 251-261 ◽  
Author(s):  
Yu Teranishi ◽  
Michihiro Kohno ◽  
Shigeo Sora ◽  
Hiroaki Sato ◽  
Osamu Nagata
Keyword(s):  
Vestibular Schwannoma ◽  
Surgical Outcomes ◽  
Clinical Characteristics ◽  
Tumor Resection ◽  
External Carotid Artery ◽  
Survival Duration ◽  
External Carotid ◽  
Rare Type ◽  
Vertebrobasilar System ◽  
Identifiable Risk Factor

Abstract BACKGROUND There is a rare type of vestibular schwannoma, scarcely discussed in the literature, known as a hypervascular vestibular schwannoma (HVS). OBJECTIVE To evaluate its biological characteristics, angiographical classification, surgical outcomes, and the significance for surgical consideration, using a large series of this clinical entity. METHODS The definition for HVS in this study was the tumor stain from the vertebrobasilar system (VBS) in angiography. The authors conducted a retrospective analysis of 36 patients who were angiographically diagnosed with HVS and underwent surgery between 2008 and 2015. Their biological findings and their surgical outcomes were compared with non-HVS subjects. With regard to the tumor feeders and AV shunt, we classified HVS into 5 types. RESULTS HVS occurred more commonly in younger subjects (mean: 39.4 yr), as a larger solid tumor with multiple flow voids (mean: 34.1 mm), and involved higher levels of cerebrospinal fluid protein (mean: 202 mg/dl) and a higher MIB1-index (mean: 4.3%). The average resection rate for these 36 cases was 95.3%, and recurrence was seen in 6 cases (16.7%). Compared with non-HVS, the extent of tumor resection was significantly lower, and the recurrence rate was significantly higher. Especially in HVS type 2B (the tumor stain is fed by the VBS and the external carotid artery, with an arteriovenous shunt from the VBS), the recurrence-free survival duration was significantly shorter compared with other HVS types and non-HVS, and HVS type 2B exhibited an identifiable risk factor for recurrence. CONCLUSION HVS have the distinct clinical characteristics compared with those of non-HVS subjects.

Clinical characteristics and survival of patients with paraganglioma: a single center experience

2017 ◽  
Author(s):  
Valentina Elezovic ◽  
Djuro Macut ◽  
Sanja Ognjanovic ◽  
Tatjana Isailovic ◽  
Bojana Popovic ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Single Center ◽  
Single Center Experience
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