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Posterior fossa tumors

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https://www.readbyqxmd.com/read/28089417/venous-sinus-compromise-after-pre-sigmoid-transpetrosal-approach-for-skull-base-tumors-a-study-on-the-asymptomatic-incidence-and-report-of-a-rare-dural-arteriovenous-fistula-as-symptomatic-manifestation
#1
Walter C Jean, Daniel R Felbaum, Andrew B Stemer, Michael Hoa, H Jeffrey Kim
The sigmoid sinus is routinely exposed and manipulated during pre-sigmoid, transpetrosal approaches to the skull base, but there is scant data available on the incidence of venous sinus compromise after surgery. We encountered a dural arteriovenous fistula as a result of sigmoid sinus occlusion and examined the incidence of venous sinus thrombosis or narrowing after transpetrosal surgeries. We performed a retrospective analysis of a series of patients treated by the senior surgeons (WCJ, MH, HJK), who underwent either a posterior petrosectomy or translabyrinthine approach for various skull base tumors...
January 12, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28074148/apraxia-of-speech-and-cerebellar-mutism-syndrome-a-case-report
#2
E De Witte, I Wilssens, D De Surgeloose, G Dua, M Moens, J Verhoeven, M Manto, P Mariën
BACKGROUND: Cerebellar mutism syndrome (CMS) or posterior fossa syndrome (PFS) consists of a constellation of neuropsychiatric, neuropsychological and neurogenic speech and language deficits. It is most commonly observed in children after posterior fossa tumor surgery. The most prominent feature of CMS is mutism, which generally starts after a few days after the operation, has a limited duration and is typically followed by motor speech deficits. However, the core speech disorder subserving CMS is still unclear...
2017: Cerebellum & Ataxias
https://www.readbyqxmd.com/read/28049034/hypervascular-lesions-of-the-cerebellopontine-angle-the-relevance-of-angiography-as-a-diagnostic-and-therapeutic-tool-and-the-role-of-stereotactic-radiosurgery-in-management-a-comprehensive-review
#3
REVIEW
Yosef Laviv, Ajith Thomas, Ekkehard M Kasper
The cerebellopontine angle (CPA) is a narrowed skull base area, containing important cranial nerves and vessels and bordering with eloquent areas of the posterior fossa. Tumors of the CPA are a heterogeneous group and can arise extradural, intradural-extraaxial or intraaxial. Accordingly, their vascular supply changes, depending on their anatomical origin. Symptomatic, large CPA tumors require surgical resection in order to prevent irreversible, severe neurological damages. However, its tight and strategical location make surgery in the CPA very challenging and require appropriate pre-surgical planning...
December 31, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28048662/su-f-t-206-proton-treatment-techniques-for-posterior-fossa-tumors-consequences-for-let-and-dose-volume-parameters-for-the-brainstem-and-organs-at-risk
#4
D Giantsoudi, J Adams, S MacDonald, H Paganetti
PURPOSE: In proton radiation therapy of posterior fossa tumors, to spare other sensitive structures, the preferred beam geometry results in placing the treatment field distal edge within or just beyond the brainstem, including in at least partially in the treatment volume. Concerns for brainstem toxicity are increased and a controversy exists as to weather the beam's distal edge should be placed within the brainstem or beyond it, to avoid elevated linear energy transfer (LET) and relative biological effectiveness (RBE) within the brainstem...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046661/su-f-t-208-an-efficient-planning-approach-to-posterior-fossa-tumor-bed-boosts-using-proton-pencil-beam-scanning-in-fixed-beam-room
#5
N Ju, C Chen, S Gans, E Hug, O Cahlon, S Wolden, B Chon, B Yeh, H Tsai, K Sine, D Mah
PURPOSE: A fixed-beam room could be underutilized in a multi-room proton center. We investigated the use of proton pencil beam scanning (PBS) on a fixed-beam as an alternative for posterior fossa tumor bed (PF-TB) boost treatments which were usually treating on a gantry with uniform scanning. METHODS: Five patients were treated with craniospinal irradiation (CSI, 23.4 or 36.0 Gy(RBE)) followed by a PF-TB boost to 54 Gy(RBE) with proton beams. Three PF-TB boost plans were generated for each patient: (1) a uniform scanning (US) gantry plan with 4-7 posterior fields shaped with apertures and compensators (2) a PBS plan using bi-lateral and vertex fields with a 3-mm planning organ-at-risk volume (PRV) expansion around the brainstem and (3) PBS fields using same beam arrangement but replacing the PRV with robust optimization considering a 3-mm setup uncertainty...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28013334/cerebellopontine-angle-medulloblastoma-with-extensive-nodularity-in-a-child-case-report-and-review-of-the-literature
#6
Raywat Noiphithak, Vich Yindeedej, Chatchai Thamwongskul
BACKGROUND: Cerebellar medulloblastomas (MBs) are one of the most common posterior fossa tumors in children but rarely occur in the cerebellopontine angle (CPA). Only 39 cases of CPA MBs were reported in the literature, and most of them were classic and desmoplastic MBs. CASE PRESENTATION: A 22-month-old girl presented with progressive cerebellar ataxia. Magnetic resonance imaging showed a large tumor in the right CPA and obstructive hydrocephalus. Surgical resection was performed and achieved total tumor removal...
December 24, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27999713/intracranial-aneurysm-formation-after-radiotherapy-for-medulloblastoma
#7
Tomoya Kamide, Masanao Mohri, Kouichi Misaki, Naoyuki Uchiyama, Mitsutoshi Nakada
BACKGROUND: The development of an intracranial aneurysm after radiotherapy is rare but secondary effect of cranial irradiation in a primary disease treatment. CASE DESCRIPTION: The patient was a 17-year-old male adolescent who was diagnosed as having a posterior fossa medulloblastoma when he was 8 years old. He had undergone tumor resection with radiotherapy and chemotherapy. A distal posterior inferior cerebellar artery aneurysm was identified by magnetic resonance imaging 8 years after radiotherapy and grew rapidly throughout the next 1 year...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27986346/proton-treatment-techniques-for-posterior-fossa-tumors-consequences-for-linear-energy-transfer-and-dose-volume-parameters-for-the-brainstem-and-organs-at-risk
#8
Drosoula Giantsoudi, Judith Adams, Shannon M MacDonald, Harald Paganetti
PURPOSE: In proton therapy of posterior fossa tumors, at least partial inclusion of the brainstem in the target is necessary because of its proximity to the tumor and required margins. Additionally, the preferred beam geometry results in directing the field distal edge toward this critical structure, raising concerns for brainstem toxicity. Some treatment techniques place the beam's distal edge within the brainstem (dose-sparing techniques), and others avoid elevated linear energy transfer (LET) of the proton field by placing the distal edge beyond it (LET-sparing techniques)...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27936528/infratentorial-ganglioglioma-mimicking-pilocytic-astrocytoma
#9
Kirti Gupta, Madhivanan Karthigeyan, Pravin Salunke
Majority of tumors arising in posterior fossa in children are pilocytic astrocytoma. However, a small subset of these have a neuronal component that may either be admixed throughout with the glial component or may be segregated to one or two regions within the glial element. Interestingly, the radiological features of this subgroup are also distinctive, showing midline location, frequent cyst formation, hemorrhage, and circumscribed nature. Taken together, both radiological and pathological features can fairly predict the subgroup categorization within infratentorial gangliogliomas (GG), as has been recently elucidated...
December 12, 2016: Clinical Neuropathology
https://www.readbyqxmd.com/read/27923226/intraoperative-tumoral-bleeding-of-hypervascular-medulloblastoma-after-ventricular-drainage-a-case-report
#10
Han-Seung Ryu, Tae-Young Jung, Moon-Soo Han, Seul-Ki Kim, Kyung-Hwa Lee
We report a rare case of intraoperative tumoral bleeding of a hypervascular medulloblastoma. A 12-year-old girl presented with dizziness and nausea. Brain magnetic resonance (MR) images revealed an approximately 4.2-cm enhanced mass on the cerebellar vermis associated with mild perilesional edema and increased cerebral blood volume. Angiography showed tumoral staining and developed occipital and circular dural sinuses in the venous phase. A suboccipital craniotomy was performed. To relieve the intracranial pressure, cerebrospinal fluid (CSF) was drained via a lateral ventricular catheter in the occipital horn...
December 7, 2016: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27895770/classical-intracranial-chondrosarcoma-a-case-report
#11
Jingyang Chi, Mingchao Zhang, Jianmin Kang
Intracranial chondrosarcoma is a rare malignant cartilage-forming tumor, with only a small number of cases in the posterior cranial fossa reported previously. The present study reports the case of a 40-year-old male patient who was admitted to Tianjin Huanhu Hospital with a progressive headache and dizziness that had lasted for 2 years. Physical and neurological examinations were normal. Radiography of the skull identified an opaque lesion in the left frontal region of the brain. Cranial computed tomography and magnetic resonance imaging revealed a lesion with calcification and homogenous contrast enhancement in the left frontal region...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27889018/posterior-fossa-tumors
#12
REVIEW
Lara A Brandão, Tina Young Poussaint
Pediatric brain tumors are the leading cause of death from solid tumors in childhood. The most common posterior fossa tumors in children are medulloblastoma, atypical teratoid/rhabdoid tumor, cerebellar pilocytic astrocytoma, ependymoma, and brainstem glioma. Location, and imaging findings on computed tomography (CT) and conventional MR (cMR) imaging may provide important clues to the most likely diagnosis. Moreover, information obtained from advanced MR imaging techniques increase diagnostic confidence and help distinguish between different histologic tumor types...
February 2017: Neuroimaging Clinics of North America
https://www.readbyqxmd.com/read/27885877/surgical-outcomes-of-middle-fossa-approach-in-intracanalicular-vestibular-schwannoma
#13
Woo Seok Kang, Shin Ae Kim, Chan Joo Yang, Sung Hoon Nam, Jong Woo Chung
CONCLUSION: Middle fossa approach (MFA) shows a hearing preservation rate of 86% and facial nerve function was preserved with HB grade I or II in 93%. MFA is a good treatment option for intra-canalicular vestibular schwannomas when surgical excision is needed. BACKGROUND: Surgical outcomes of vestibular schwannoma have progressively improved with the advancement of microsurgical instruments. MFA is known to have better chances to preserve hearing, while it has limited access to the posterior fossa, limitation of tumor size, and higher risk of post-operative facial nerve weakness...
November 25, 2016: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/27881822/lowered-h3k27me3-and-dna-hypomethylation-define-poorly-prognostic-pediatric-posterior-fossa-ependymomas
#14
Jill Bayliss, Piali Mukherjee, Chao Lu, Siddhant U Jain, Chan Chung, Daniel Martinez, Benjamin Sabari, Ashley S Margol, Pooja Panwalkar, Abhijit Parolia, Melike Pekmezci, Richard C McEachin, Marcin Cieslik, Benita Tamrazi, Benjamin A Garcia, Gaspare La Rocca, Mariarita Santi, Peter W Lewis, Cynthia Hawkins, Ari Melnick, C David Allis, Craig B Thompson, Arul M Chinnaiyan, Alexander R Judkins, Sriram Venneti
Childhood posterior fossa (PF) ependymomas cause substantial morbidity and mortality. These tumors lack recurrent genetic mutations, but a subset of these ependymomas exhibits CpG island (CpGi) hypermethylation [PF group A (PFA)], implicating epigenetic alterations in their pathogenesis. Further, histological grade does not reliably predict prognosis, highlighting the importance of developing more robust prognostic markers. We discovered global H3K27me3 reduction in a subset of these tumors (PF-ve ependymomas) analogous to H3K27M mutant gliomas...
November 23, 2016: Science Translational Medicine
https://www.readbyqxmd.com/read/27872228/child-neurology-diencephalic-syndrome-like-presentation-of-a-cervicomedullary-brainstem-tumor
#15
Melanie Conway, Resham Ejaz, Elizabeth Kouzmitcheva, Deena Savlov, James T Rutka, Mahendranath Moharir
Diencephalic syndrome is a rare clinical entity, traditionally encompassing severe failure to thrive, nystagmus, and hyperkinesis, secondary to an intracranial neoplasm that is classically located in the hypothalamic region and its vicinity. However, the presenting features can be variable, often resulting in delayed diagnosis, which may worsen prognosis. This case report describes the atypical presentation of a posterior fossa tumor with features reminiscent of diencephalic syndrome that have not previously been reported in the literature...
November 22, 2016: Neurology
https://www.readbyqxmd.com/read/27857878/magnetic-resonance-imaging-assessment-of-vascular-contact-of-the-facial-nerve-in-the-asymptomatic-patient
#16
Nicholas L Deep, Geoffrey P Fletcher, Kent D Nelson, Ameet C Patel, David M Barrs, Bernard R Bendok, Joseph M Hoxworth
Objective The objective of this study was to determine the prevalence of facial nerve vascular contact on magnetic resonance imaging (MRI) in patients without hemifacial spasm (HFS). Study Design Our radiology database was queried to identify consecutive adult patients without a history of HFS, intracranial tumor, brain radiation therapy, intracranial surgery, traumatic brain injury, or trigeminal nerve vascular compression. One hundred high-resolution MRIs of the posterior fossa were independently reviewed by two neuroradiologists for facial nerve vascular contact (200 sides)...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27857799/a-rare-case-of-infantile-cerebellar-pilocytic-astrocytoma-and-thrombocytopenia-presenting-with-intratumoral-hemorrhage
#17
Shashank R Ramdurg, Jaybrata Maitra
Incidence of gliomas presenting with hemorrhage is around 3.7-7.2%. Low-grade gliomas account for <1% tumor with hemorrhage. Infants presenting with cerebellar pilocytic astrocytomas (PAs) and hemorrhage with thrombocytopenia have not been reported. We report an interesting case of a 9-month-old infant who presented to the emergency department in a drowsy state with recurrent vomiting. Laboratory investigations showed anemia, thrombocytopenia, and coagulopathy. Radiological evaluation showed a large PA with bleed...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27846874/treatment-implications-of-posterior-fossa-ependymoma-subgroups
#18
Vijay Ramaswamy, Michael D Taylor
Posterior fossa ependymoma comprises two distinct molecular entities, ependymoma_posterior fossa A (EPN_PFA) and ependymoma_posterior fossa B (EPN_PFB), with differentiable gene expression profiles. As yet, the response of the two entities to treatment is unclear. To determine the relationship between the two molecular subgroups of posterior fossa ependymoma and treatment, we studied a cohort of 820 patients with molecularly profiled, clinically annotated posterior fossa ependymomas. We found that the strongest predictor of poor outcome in patients with posterior fossa ependymoma across the entire age spectrum was molecular subgroup EPN_PFA, which was recently reported in the paper entitled "Therapeutic impact of cytoreductive surgery and irradiation of posterior fossa ependymoma in the molecular era: a retrospective multicohort analysis" in the Journal of Clinical Oncology...
November 15, 2016: Chinese Journal of Cancer
https://www.readbyqxmd.com/read/27830331/posterior-fossa-syndrome-with-delayed-mr-evidence-of-unilateral-superior-cerebellar-peduncle-scp-damage
#19
Kevin Carr, Pegah Ghamasaee, Achint Singh, Izabela Tarasiewicz
Posterior fossa syndrome (PFS) is a well-known sequela of midline posterior fossa tumor resection. Patients typically exhibit transient behavioral, motor, and oculomotor disturbances that resolve within a few weeks to several months after surgery. The underlying pathophysiology of PFS is not completely understood, but contemporary literature has implicated injury to the dentate nucleus and/or exiting dentatothalamocortical fiber bundles as a causative factor. The authors present a case of a young male who developed a delayed variant of PFS typified by motor deficits and demonstrated diffusion restriction in the ipsilateral superior cerebellar peduncle...
November 9, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27825904/ruptured-massa-intermedia-secondary-to-hydrocephalus-a-case-report
#20
Ahmed El Damaty, Soenke Langner, Henry W S Schroeder
BACKGROUND: We report a case of ruptured massa intermedia (MI) as a sequela of hydrocephalus. CASE DESCRIPTION: A single case report is presented describing the sequelae of tumor bed hematoma after a posterior fossa hemangioblastoma resection in which the patient bled 3 days after surgery, resulting in secondary hydrocephalus and subsequently dilatation of the third ventricle, which resulted in rupture of the MI. The patient was managed on emergency basis with an external ventricular drain then endoscopically with a third ventriculostomy and clot extraction...
November 4, 2016: World Neurosurgery
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