Diffusion-weighted imaging-gadolinium enhancement mismatch sign in diffuse midline glioma.

Background: Diffuse midline glioma (DMG), H3 K27M-mutant including diffuse intrinsic pontine glioma (DIPG) is a disease with dismal prognosis. We focused on diffusion-weighted imaging (DWI) and gadolinium enhanced T1WI (Gd), especially high intensity on DWI at non-enhanced lesion, i.e.

Detecting non-germinomatous germ cell tumor component by arterial spin labeling perfusion-weighted MR imaging in central nervous system germ cell tumor.

Purpose: Differentiating between germinoma and non-germinomatous germ cell tumor (NGGCT) is important because sensitivity to chemotherapy and/or radiotherapy is quite different between these two subgroups. In this study, we evaluated whether the arterial spin labeling (ASL) based perfusion-weighted imaging (PWI) could provide additional information for the differential diagnosis between germinoma and NGGCT.

Method: Between 2011 and 2018, 20 patients with central nervous system (CNS) germ cell tumor (GCT) who underwent preoperative MR imaging including ASL-PWI were enrolled in this study.

Advantage of high b value diffusion-weighted imaging for differentiation of common pediatric brain tumors in posterior fossa.

Purpose: The pediatric posterior fossa (PF) brain tumors with higher frequencies are embryonal tumors (ET), ependymal tumors (EPN) and pilocytic astrocytomas (PA), however, it is often difficult to make a differential diagnosis among them with conventional MRI. The ADC calculated from DWI could be beneficial for diagnostic work up.

Method: We acquired DWI at b = 1000 and 4000(s/mm).

Primary and Recurrent Growing Teratoma Syndrome in Central Nervous System Nongerminomatous Germ Cell Tumors: Case Series and Review of the Literature.

Background: The term "growing teratoma syndrome (GTS)" has been used as follows: patients with germ cell tumor (GCT) who present with enlarging original/metastatic masses during or after appropriate systemic chemotherapy despite normalized serum markers. In other words, the definition of the term GTS is not fully established. We analyzed and reviewed our case series regarding GTS that developed after the treatment of central nervous system (CNS) nongerminoatous germ cell tumors (NGGCTs).

Effect of bevacizumab against cystic components of brain tumors.

Background: Bevacizumab improves symptoms via reducing the peritumoral edema and/or normalizing blood brain barrier, and occasionally via reducing the tumor size. However, the effect against active cystic components has not been documented yet.

Materials And Methods: Between 2008 and 2018, 139 patients with primary or metastatic brain tumors were treated with bevacizumab (BEV) in our institution.

Usefulness of Histogram-Profile Analysis in Ring-Enhancing Intracranial Lesions.

Background: Several intracranial pathologies present as a ring-enhancing lesion on conventional magnetic resonance imaging (MRI), creating diagnostic difficulty. We studied the characteristics of the anatomical border of gadolinium enhancement on T1-weighted imaging (WI) and hypointensity on T2WI to employ a simple technique of histogram-profile analysis of MRI for differentiation of various ring-enhancing intracranial lesions.

Methods: After approval from the institutional review board, preoperative MRI (T2WI, postcontrast T1WI) scans were analyzed retrospectively in 18 patients with histologically confirmed brain abscess, 66 glioblastomas, 46 brain-metastases, and 16 tumefactive multiple sclerosis (MS).

Usefulness of Preoperative Simulation in Skull Base Approach: A Case Report.

Skull base approach is a neurosurgical challenge requiring dexterity of the operating surgeon for good postoperative outcome. In addition to the experience of the operating surgeon, adequate preoperative information of the tumor is necessary to ensure better outcome. In clinoid meningioma, it is sometimes difficult to determine its relationship with the surrounding structure and the feeding artery.

Isolated Tuberculoma Mimicking Foramen Magnum Meningioma in the Absence of Primary Tuberculosis: A Case Report.

Central nervous system tuberculosis is a devastating complication of systemic tuberculosis. Intradural extramedullary (IDEM) tuberculoma at the foramen magnum is rare, and mimics en plaque meningioma. We report the case of a 53-year-old woman who presented with dysesthesia of the tongue and lower cranial nerve (CN) palsy, with onset 4 months prior to admission.

Perfusion Computed Tomography Parameters Are Useful for Differentiating Glioblastoma, Lymphoma, and Metastasis.

Background: Perfusion computed tomography (PCT) reflects blood flow and capillary condition, which is valuable in assessing brain tumors. We evaluated PCT parameters at the tumor (t) and peritumoral (p) region to differentiate malignant brain tumors.

Methods: We performed PCT in 39 patients with supratentorial malignant brain tumors (22 glioblastomas, 6 lymphomas, 11 metastases).

Occult community acquired Klebsiella pneumoniae purulent meningitis in an adult: A case report.

Rationale: Klebsiella pneumonia (K. pneumonia), primarily a hospital-acquired pathogen, can cause a variety of deep-seated infections with significant morbidities. However, in the current scenario of global rise in antibiotic abuse, unexpected infection could be caused by K.

Multivariate risk factor analysis and literature review of postoperative deterioration in Karnofsky Performance Scale score in elderly patients with skull base meningioma.

OBJECTIVE Elderly patients are particularly at risk for severe morbidity following surgery. Among the various risk factors, age and skull base location of meningioma are known to be poor prognostic factors in meningioma surgery. The authors conducted this study to analyze significant preoperative risk factors in elderly patients with skull base meningioma.

Proton Magnetic Resonance Spectroscopy Detection of High Lipid Levels and Low Apparent Diffusion Coefficient Is Characteristic of Germinomas.

Background: The differentiation of germinoma from other tumors by conventional magnetic resonance imaging (MRI) can be very difficult. The purpose of our study was to determine whether diffusion-weighted imaging (DWI) and single-voxel proton magnetic resonance spectroscopy (1H-MRS) could provide additional useful information for a definitive diagnosis of germinomas.

Methods: Our hospital's Institutional Review Board approved this retrospective study.

Role for loss of nuclear PTEN in a harbinger of brain metastases.

Background: Earlier studies proposed phosphatase and tensin homolog (PTEN) acts as a 3'-specific phosphatidylinositol phosphatase and inhibits the PI3K pathway. Recent reports show that PTEN mRNA expression is significantly downregulated in brain metastases compared to primary breast cancer. We focused on the differential expression of nuclear and cytoplasmic PTEN between primary tumors and brain metastases.

Post-traumatic Unilateral Avulsion of the Abducens Nerve with Damage to Cranial Nerves VII and VIII: Case Report.

Traumatic injuries of the abducens nerve as a consequence of facial and/or head trauma occur with or without associated cervical or skull base fracture. This is the first report on unilateral avulsion of the abducens nerve in a 29-year-old man with severe right facial trauma. In addition, he exhibited mild left facial palsy, and moderate left hearing disturbance.

Neurologic Decline in an Older Patient with Repaired Myelomeningocele Complicated with Lumbar Canal Stenosis.

Background: Tethered cord syndrome is a well-known complication after myelomeningocele (MMC) repair in childhood. However, late complications in adults with a repaired MMC are not well understood. In particular, the influence of a degenerative spinal deformity on a sustained tethered cord is still unclear.

Diffuse leptomeningeal glioneuronal tumor (DLGNT) mimicking Whipple's disease: a case report and literature review.

Introduction: Diffuse leptomeningeal glioneuronal tumor is a new entity under the neuronal and mixed neuronal-glial tumors in the WHO 2016 updated classification and commonly found in children and adolescents. The initial diagnosis is challenging because of its non-specific radiologic feature and negative CSF cytology analysis. A 17 years male was presented with intractable headache subsequently followed by back pain and joint pain.

Development of cystic malacia after high-dose cranial irradiation of pediatric CNS tumors in long-term follow-up.

Purpose: The purpose of this study is to investigate the incidence of cystic malacia in long-term survivors of pediatric brain tumors treated with high-dose cranial irradiation.

Materials And Methods: Between 1997 and 2015, we treated 41 pediatric patients (26 males, 15 females; age ranging from 3.3 to 15.

The Position and Role of Four-Dimensional Computed Tomography Angiography in the Diagnosis and Treatment of Spinal Arteriovenous Fistulas.

Background: Localization of the arteriovenous fistula (AVF) is a crucial step in the diagnosis and treatment of spinal vascular malformations (VMs). Noninvasive angiographic techniques such as dynamic magnetic resonance angiography and three-dimensional computed tomography angiography (CTA) have been used as standard modalities to localize AVF. With the increasing prevalence of high-specification computed tomography scanners, four-dimensional (4D) CTA is being increasingly used in the evaluation of cerebrovascular disorders.

Nonenhancing peritumoral hyperintense lesion on diffusion-weighted imaging in glioblastoma: a novel diagnostic and specific prognostic indicator.

OBJECTIVE Glioblastoma differentials include intracranial tumors, like malignant lymphomas and metastatic brain tumors with indiscernible radiological characteristics. The purpose of this study was to identify a distinct radiological feature for the preoperative differentiation of glioblastoma from its differentials, which include malignant lymphomas and metastatic brain tumors. METHODS Preoperative MR images, including diffusion-weighted imaging (DWI) studies (b = 1000 and 4000 sec/mm), obtained in patients with newly diagnosed malignant tumor, were analyzed retrospectively after receiving approval from the institutional review board.