World Neurosurg
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Meningioma, a common primary brain tumor in adults, is graded based on World Health Organization criteria that rely on histology alone. This approach is unable to determine conclusively which tumors, especially benign or atypical, will recur. ⋯ Immunotherapy is also being trialed in treating high-grade and recurrent meningioma. This review summarizes recent developments characterizing meningioma using genetic and immunologic biomarkers and how these molecular tools may be integrated into existing care together with current World Health Organization grading to improve diagnosis, prognosis, and therapy.
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Hemorrhagic meningiomas, although relatively uncommon, represent a distinct clinical entity. In some cases, these meningiomas can closely mimic a thrombosed aneurysm. We present a case of a jugular tubercle meningioma whose radiographic and clinical picture initially suggested a ruptured, thrombosed vertebrobasilar aneurysm. This case serves to highlight several key differences between these 2 pathologies that can assist in diagnosis. ⋯ Hemorrhagic meningiomas can have a clinical and radiologic picture that closely resembles a ruptured, thrombosed cerebral aneurysm. Based on our single case, we suggest several important diagnostic differentiators between these 2 entities. We found the hemorrhagic meningioma to exhibit eggshell-like rim calcification, thick, irregular peripheral enhancement, and a central cystic component. This can be contrasted to the classic appearance of a thrombosed aneurysm with mixed T1-, T2-weighted signal intensity, and occasional regular, thin peripheral enhancement.
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Review Case Reports
Intradural Juvenile Xanthogranuloma with Involvement of Multiple Nerve Roots: A Case Report and Review of the Literature.
Juvenile xanthogranuloma (JXG) is a rare, non-Langerhans cell histiocytic disorder that primarily presents as multiple cutaneous lesions in young males. Solitary lesions in the spinal column are an especially rare presentation of this disease, and central nervous system involvement can portend a poor prognosis. We report an unusual case of an adult woman with an unresectable JXG of the lumbar spine. A review of the reported cases of thoracolumbar JXG and the current data regarding diagnosis and treatment are presented. ⋯ JXG of the spine is a rare disease with nonspecific clinical and radiographic findings that can make it difficult to diagnose and dictates the use of immunohistochemical staining. If possible, total surgical resection will offer the best outcomes; however, other modalities such as chemotherapy can be viable alternatives or adjuvant modalities.
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Review Case Reports
Pediatric Intracranial Anaplastic Gangliogliomas: Illustrative Case and Systematic Review.
We present an illustrative case of pediatric intracranial anaplastic ganglioglioma and systematically reviewed the current reported data of anaplastic ganglioglioma in the pediatric population. ⋯ Our results contribute to our understanding of the characteristics of this rare malignant tumor and show that anaplastic ganglioglioma should be considered in the differential diagnosis of intracranial tumors in pediatric patients.
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Review Case Reports
Traumatic Unilateral L3-4 Jumped Facet Treated with Open Reduction and Short Segment Fusion.
Facet dislocations, or jumped facets, are part of a spectrum of flexion-distraction spine injuries. Bilateral and unilateral facet dislocations are commonly seen in the cervical spine. Traumatic jumped facets in the lumbar spine are rare injuries, and most involve the lumbosacral junction. Lumbar facet subluxations occur commonly in young patients owing to flexion-distraction forces on the lumbar spine at the time of injury combined with ligamentous laxity that exists in young patients. ⋯ Following anatomic reduction, unilateral jumped facets can be effectively treated with instrumented stabilization. This report provides evidence for the durability of short segment arthrodesis in select cases of a rare lumbar facet subluxation.