What is the role of MR spectroscopy in the evaluation and treatment of brain neoplasms?
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In an interface between brain tumour and surrounding tissue there occur simultaneously two very important phenomena. On the one hand there is a proliferation of peritumoral vessels penetrating into the neoplasm in which they make alike tumoral vessels. On the other hand, neoplastic cells penetrate from the tumour into the vicinity along peritumoral vessels. To determine the influence of the histological type of different brain tumours, their malignancy degree as well as location in the central nervous system on peritumoral vessels morphological appearance, the detailed morphometric analysis was carried out. The morphological examination and computerised morphometric analysis were conducted on 166 primary and metastatic CNS neoplasms taken during routine neurosurgical procedure. It turned out that the peritumoral angiogenesis depends predominantly on the malignancy of brain tumours. This angiogenesis may be modified by local environmental factors--it is more evident within the white matter than in the cerebral cortex. One of the important factors may be reactive peritumoral astrogliosis. There is no specific CNS region predisposed to the development of peritumoral angiogenesis.
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It has been nearly half a century since Leksell introduced brain radiosurgery. In the past decade, the procedure has become widely used as both a primary and adjuvant treatment. Radiosurgery is now commonly employed for arteriovenous malformations, brain metastases, and several benign lesions. Its use in primary brain malignancy remains of uncertain benefit. Improvements in imaging, hardware, and software promise an even greater role for the technique.
To evaluate risk factors for primary brain tumors, a case-control study was carried out with all death certificates and corresponding occupational histories of males registered in the Brazilian Navy Insurance from 1991 to 1995. Cases were 40 individuals with ICD-9 codes 191, 192.1, and 192.0 (brain and CNS tumors). Controls were 671 subjects who had other reported cancer sites. Men less than 56 years of age (odds ratio, OR = 4.63; 95% confidence interval, CI: 2.54, 8.45) and unmarried men (OR = 3.18; 95% CI: 1.69, 5.99) had higher mortality from brain tumors. After adjustment of age, marital status, and socioeconomic status, more brain tumors were found among health personnel (OR = 2.13; 95% CI: 1.07, 4.97) than in other occupational categories. Infantry servicemen engaged in combat training had borderline excess brain tumor mortality (OR = 2.30; 95% CI: 0.89, 5.99). More detailed occupational data on exposures and potential confounders are necessary to improve research on occupational risk factors.
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The diagnosis of brain tumor in a pregnant women is a dramatic event. The nature and timing of therapy at intracranial neoplasm are affected by the existence of the pregnancy. The authors report a two cases of cerebral neoplasm in pregnancy. Clinical syndromes, diagnosis, neurosurgical and obstetrical management are discussed.