Medulloblastoma Presenting as Severe Headache during Pregnancy: A Case Report and Review of the Literature

Headache is a common complaint during pregnancy and the puerperium. The differentiation between a benign headache and a headache that has an underlying more endangering cause, such as an intracranial tumor, can be difficult and often requires diagnostic procedures and brain imaging techniques. We report the case of an 18-year-old female patient who developed clinical symptoms—persistent headache followed by neurological deficit—in the last part of her pregnancy. A medulloblastoma (MB) was diagnosed and treated after delivery. We review 11 other cases of MB in pregnancy reported in the literature. The most common clinical manifestation at diagnosis was headache followed by neurological deficits. We discuss the association of brain tumor growth with physiological changes during pregnancy. We conclude that clinical features of intracranial tumors can be misinterpreted as pregnancy-related symptoms and should not be dismissed.

The Involvement of miRNAs in Pituitary Adenomas Pathogenesis and the Clinical Implications

Pituitary adenomas (PAs) account for the top three primary intracranial tumors in terms of total incidence rate. PAs can cause severe endocrine disorders and even malignant features, such as invasion, metastasis, and recurrence. Therefore, the early diagnosis and accurate prognosis would be greatly beneficial for clinical treatment of PAs. MicroRNAs (miRNAs) are small, protein-noncoding RNAs that regulate gene expression posttranscriptionally. They regulate essential physiological processes, including proliferation, growth, and apoptosis, and also they involve in the invasion and metastasis of malignant tumors. At the tissue level, differential miRNA expression in endocrine malignancies including PAs has been reported. When miRNAs have been successfully detected in various biofluids and cell-free environments, their important roles as potential screening or prognostic biomarkers have been extensively investigated. The current work reviews recent studies on the emerging roles of miRNAs in PAs and the clinical significance.

Rare Brain Tumors with Infrequent Clinical Manifestations: Illustrative Cases

This chapter describes the epidemiology, clinical and neuroimaging features, histological characteristics, surgical approach, outcomes, and prognostic factors of different cases of very rare intracranial tumors, associated with complex clinical syndromes. Highlighting the important aspects in the diagnosis and management that were considered relevant through the experience of our center. Here we included an intracranial Rosai-Dorfman disease manifested as an apparent multiple meningiomatosis, a choroid plexus papilloma clinically manifested as a hemifacial spasm originated by a compression of the facial colliculus, and a neuroenteric cyst associated with Klippel-Feil syndrome. This type of tumor presents a challenge to the neurosurgeon, originating various questions about its management. In this chapter, we present the experience we had with these pathologies to establish the most appropriate management decisions.

Epidemiological Profile of 96 Intracranial Tumors Treated in a Single Reference Center

Objectives The present study aims to categorize the prevalence of intracranial tumors surgically treated at the neurosurgery service of Hospital Universitário Evangélico Mackenzie (HUEM) between 2016 and 2018. Material and Methods This survey included patients surgically treated due to primary or metastatic intracranial neoplasia between 2016 and 2018 at a referral center in the city of Curitiba. These patients were analyzed for epidemiological, histopathological, and topographic data, and they underwent an assessment of the outcome at the time of hospital discharge. Results A total of 96 patients met the inclusion criteria. The most prevalent tumor was the glioma, with 39.6% of the sample, with glioblastoma being the most prevalent histological type. Brain metastases and meningiomas represented, respectively, 21.9% and 18.8% of the total. There was a predominance of supratentorial and intra-axial tumors in our sample. Conclusion Glioma was the most commonly found tumor, directly associated with high morbidity and mortality. The development of new and more effective drugs with action directed at the molecular level of intracranial tumors may be the path to a longer survival and improvement in the quality of life of these patients.

Revisiting the Awareness and Understanding the Associations between Intracranial Tumors and Optic Neuropathy

The aim of this paper is to report clinically various cases of intracranial tumors in patients referred to glaucoma clinic for consultation. The secondary aim was to increase the awareness of intracranial tumors in atypical cases of glaucoma. We present the retrospective analysis of five patients referred to glaucoma clinic for consultation. Due to atypical course of the disease, in addition to standard glaucoma examinations, all patients had a neurologic full visual field, color vision, and MRI done. In all patients, intracranial malignancies were found, some patients underwent surgery of the lesions with consecutive clinical improvements. Interestingly, in some patients, coexisting glaucoma was diagnosed. Patients were selected deliberately to present a wide spectrum of possible clinical scenarios when glaucoma may be complicated by intracranial tumors. Sometimes, the relevance of intracranial tumors with respect to their influence on the clinical picture of the optic nerve cannot be established. To conclude, in the “atypical cases of glaucoma” the assessment of the optic nerve may indicate the necessity of neuroimaging in differential diagnostics.

Craniopharyngioma in children: Report of three cases and review of the literature

Craniopharyngioma is a rare benign epithelial tumor, originating in the pituitary stem or pituitary gland and developing in the sellar and / or suprasellar region. Of embryonic origin, craniopharyngiomas are considered to develop from epithelial remains of Rathke's pouch. It affects children as well as adults. All ages combined, craniopharyngiomas represent between 3 to 4% of intracranial tumors worldwide, or 0.5 to 2 new cases per year and per million inhabitants. In children, they represent 10% of all intracranial tumors with a peak frequency between 7 and 13 years and a predominance of men. Although benign, this tumor remains a serious pathology because of the frequent visual, endocrine, neuro-intellectual sequelae and the risk of recurrence that it entails, involving the visual and vital functional.The management of this pathology is multidisciplinary and involves several modalities such as surgery, radiotherapy and medical treatment of hormonal deficits very often associated. We report in this article three cases of boys aged 9, 10 and 12; treated for symptomatic craniopharyngiomas with a favorable clinical and radiological outcome after partial surgical excision and adjuvant external radiotherapy. The aim of this article is to review the epidemiological, diagnostic, therapeutic and evolutionary aspects of these benign tumors of the sellar and / or suprasellar region, with an emphasis on the interest of radiotherapeutic treatment.

Meningiomas in dogs

Background: Meningiomas and gliomas are the two most common types of human intracranial tumors. However, meningiomas are not exclusively human tumors and are often seen in dogs and cats. Methods: To present meningioma surgery in dogs and compare the surgical possibilities, tumor location, and to show the differences between human and veterinary approaches to tumor profiling. Eleven dogs with meningiomas were treated surgically for 5 years. All tumors except one were resected radically (Simpson 2). Localization of tumors mirrored that of human meningiomas. Results: Two dogs died in direct relation to surgery. One died 14 months after surgery due to tumor regrowth. Three dogs died of unrelated causes 10–36 months after tumor resection and five dogs are alive and tumor-free 2–42 months after surgery. Conclusion: Radical surgery in dogs is as effective as in humans. Thus, we propose that it should be implemented as first-line treatment. The article is meant to please all those overly curious neurosurgeons in the world.