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Spontaneous brain and spinal cord/nerve neoplasms in aged Sprague-Dawley rats.

Primary malignant neoplasms of the brain and spinal cord occurred in 20/718 male (2.8%) and in 13/717 female (1.8%) Crl:CD Br strain Sprague-Dawley rats. Of 33 neoplasms, 30 were found in brain while 3 were in the spinal cord. In males and females, the most common brain neoplasm was astrocytoma (13 males, 9 females). Other neoplasms, granular cell tumor (1 male), mixed glioma (2 males, 1 female), reticulosis (1 male, 2 females), and oligodendroglioma (2 males), were especially uncommon. Spinal cord neoplasms included 2 schwannomas (1 male, 1 female) and an astrocytoma (1 male). The overall brain neoplasm incidence was similar for males (2.8%) compared to data compiled for this strain, and there was a 2-fold increase for females (1.8% vs 0.9%) compared to available incidence data.

Aging↗

Neoplasms of spinal origin involving the foramen magnum. Neurodiagnostic considerations on 36 cases.

The radiological problems concerning the diagnosis of neoplasms of spinal origin involving the foramen magnum are discussed on the basis of 36 cases studied. The high number of apparently normal neurodiagnostic examinations are investigated and accordingly explained. Some anatomical features of the area involved are examined in relation to the misleading results. As a result of the studies conducted, opaque myelography is recommended as the best neurodiagnostic procedure particularly in cases of poor clinical conditions. Of the 22% of apparently normal myelographies, 8% appears to be related either to technical features or 14% to incorrect clinical information with regard to the tumor level. Our data stress the importance of following the clinical course of the development of these neoplasms, hardly distinguishable from other degenerative processes. Our findings indicate that a normal myelogram alone does not justify the diagnosis of a non-surgical entity. Therefore repeated neuroradiological investigations are advisable.

Foramen Magnum↗

[Effectiveness of surgical treatment in metastases of spinal cord neoplasms: on the basis of the authors' own material].

The authors present 11 patients operated on for metastatic tumours of the vertebral canal. The main symptom was pain lasting for from 3 weeks to 8 months prior to the development of spinal cord compression. The primary focus was diagnosed and treated primarily surgically in only 2 patients. In all cases laminectomy was done for removal of the epidural or intravertebral body part of the tumour and in 3 patients posterior spondylodesis was done additionally. The fate of 3 patients is unknown. Three patients died. The results of the treatment of 5 patients were assessed from 3 to 40 months after operation. The authors review in the light of the pertinent literature the modern methods of management which depend mainly on the location of the tumour.

Adult↗

The role of intraoperative sonography in reducing invasiveness during surgery for spinal tumors.

The authors describe the ultrasound-guided surgical approach to 20 spinal tumors (13 extramedullary and 7 intramedullary). Intraoperative sonography (IOS) is important to reduce the extent of the laminectomy and dural opening, thus avoiding useless removal of bone structures. In cases of intramedullary tumors, IOS defines the extent of the posterior myelotomy, the presence of syringomyelic cavities caudal and/or cranial to the tumor and the deep extension of the tumor to the anterior cord surface. For these reasons, the routine use of IOS during surgery for spinal tumors reduces the surgical invasivity of this approach. The advantages and limits of the ultrasound-guided spinal surgery and the operative ultrasonographic findings of different spinal neoplasms are discussed.

Adolescent↗

[Spinal deformations as a cause for the clinical signs of spinal cord neoplasm].

An attempt was made to explain the unusual clinical manifestations at the example of an observation of a spinal-marrow tumor, which had the neurological lesion symptoms only below the upper-thoracic level. Scoliosis with a minor spinal deformation at the level of the fourth thoracic vertebra was a tumor symptom. It is suggested that the spinal scoliosis, having a mechanical impact on the spinal marrow and on its provision with blood in the minor-deformation location, was the reason of impaired sensitivity and movements, which is indicative of the spinal-marrow lesion not only in the mentioned locations but also in the total length of tumor localization. Since scoliosis can be, for some time, a single sign of the spinal-marrow lesion, the authors believe it advisable to make the magnetic-resonance therapy (MRT) in all patients with persistent scoliosis for the purpose of an early detection of a spinal-marrow neoplasm, thus, ensuring better treatment results.

Adolescent↗

Hanging head sign as a presenting feature of spinal cord neoplasms: a report of four cases.

A series of four patients presented with a common but unique finding: inability to hold the head in an upright position. Each complained of pain with attempts at passive extension of the neck. All subsequently were diagnosed with spinal cord neoplasms. The literature indicates that the more classic symptoms of spinal cord tumors are often slow to develop and exist for months before being accurately diagnosed. The "hanging head sign" may provide an earlier diagnosis of spinal cord lesions.

Astrocytoma↗

Preoperative transarterial embolization of spinal column neoplasms.

PURPOSE: To determine the safety and value of vertebral column embolization before surgical resection of vascular neoplastic disease. PATIENTS AND METHODS: Thirty preoperative embolization procedures were performed in 20 patients with vascular neoplasms of the vertebral column (C-2 to sacrum). Fourteen patients had metastatic renal cell carcinoma. Distal embolic agents were used in 27 cases and were coupled with more proximal agents in six. Gelatin pledgets alone were used in three cases. Twenty-six of the 27 surgical procedures involved partial to complete tumor resection. RESULTS: Seventy-two arteries were embolized (one to six per procedure). All surgical procedures were successful, and none were terminated because of blood loss. Massive blood loss occurred in one patient with paraganglioma, but embolization allowed complete vertebral resection at two levels. When this patient was excluded, blood loss ranged from 300 to 5,000 mL (mean, 1,871 mL). Transfusions required in 22 surgical procedures ranged from 1 to 10 units of packed red blood cells. Symptoms became worse after embolization in one case but improved with surgical decompression. CONCLUSION: Embolization before surgery for spinal column neoplasms appears to safely and effectively limit blood loss.

Adolescent↗

[Rehabilitative treatment of patients with primary and secondary spinal cord neoplasms].

The Authors present their studies concerning rehabilitation treatment in primary and secondary spinal cord tumors. They examine the problems inherent in this complex pathology. Rehabilitation was initiated in the acute phase of the illness with the aim of preventing secondary and tertiary damage that could jeopardize successive functional recuperation. The Authors believe that rehabilitation treatment, when used early enough, improves the day life for patients with spinal cord tumors.

Activities of Daily Living↗

Neoplasms of the spinal cord and filum terminale: radiologic-pathologic correlation.

Intramedullary spinal cord neoplasms are rare, accounting for about 4%10% of all central nervous system tumors. Despite their rarity, these lesions are important to the radiologist because magnetic resonance (MR) imaging is the preoperative study of choice to narrow the differential diagnosis and guide surgical resection. On contrast materialenhanced MR images, intramedullary spinal tumors almost always manifest as expansion of the spinal cord and show enhancement. Syringohydromyelia and cystic lesions are frequently associated with intramedullary tumors. Nontumoral cysts tend to be located at the poles of the tumors and do not enhance on contrast-enhanced MR images, whereas cysts within the substance of the tumor are considered tumoral cysts and typically demonstrate peripheral enhancement. Spinal cord ependymomas are the most common type in adults, and cord astrocytomas are most common in children. Both entities constitute up to 70% of all intramedullary neoplasms. A central location within the spinal cord, presence of a cleavage plane, and intense homogeneous enhancement are imaging features that favor an ependymoma. Intramedullary astrocytomas are usually eccentrically located within the cord, are ill defined, and have patchy enhancement after intravenous contrast material administration. Even with these characteristics, it may not be possible to differentiate these two entities on the basis of imaging features alone. Cord hemangioblastomas are the third most common type of intramedullary spinal tumor. Gangliogliomas commonly extend over more than eight vertebral segments. Paragangliomas and primitive neuroectodermal tumors have an affinity for the filum terminale and cauda equina. Other spinal cord tumors include metastatic disease, which is characterized by prominent cord edema for the size of the enhancing portion, and primary lymphoma.

Cauda Equina↗