Intramedullary Spinal Tumors of Disordered Embryogenesis

Abnormal spinal embryogenesis is quite commonplace. While greater than 90 percent of these errors of embryogenesis leads to occult spinal dysraphism with minimal neurologic or orthopedic sequelae, there is a significant minority of these anomalies which leads to the formation of the so-called ‘congentital tumors of disordered embryogenesis’. The purpose of this article is to discuss the embryology, presentation, diagnosis and management of the spinal dysraphic states with particular emphasis on those errors which lead to mass lesions in the spinal canal such as dermoids, epidermoids, lipoma/lipomyelomeningocoele and neurenteric cysts. We also include lesions such as dermal sinus tracts and thickened filum terminale in our discussion with particular emphasis on their relationship to the tethered cord syndrome. Proper surgical management of these various conditions necessitates a thorough understanding of their embryologic etiology and the anatomic/physiologic ramifications that such lesions have on the developing spinal cord.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45389/1/11060_2004_Article_269963.pd

Adults With Cerebral Palsy Who Had a Rhizotomy as a Child: Long‐term Follow‐up

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147123/1/pmr2s3.pd

Intraoperative Phase Contrast MRI Analysis of Cerebrospinal Fluid Velocities During Posterior Fossa Decompression for Chiari I Malformation

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154938/1/jmri26953_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154938/2/jmri26953.pd

8‐Year‐Old Boy with Progressive Headache

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/99694/1/bpa12074.pd

Cerebrospinal fluid velocity amplitudes within the cerebral aqueduct in healthy children and patients with Chiari I malformation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/133626/1/jmri25160_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/133626/2/jmri25160.pd

Surgical reversal of prolonged blindness from a metastatic neuroblastoma

Reports of tumor-related anterior visual pathway blindness that have resolved after surgical decompression are rare. The longest reported duration of tumor-related blindness completely reversed by optic nerve decompression is 3 days. We describe a pediatric patient with 7 days of no light perception who experienced reversal of blindness following tumor resection and optic nerve decompression.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47141/1/381_2004_Article_1062.pd

The Role of CD 133+ Cells in a Recurrent Embryonal Tumor with Abundant Neuropil and True Rosettes ( ETANTR )

Embryonal tumor with abundant neuropil and true rosettes ( ETANTR ) is a recently described embryonal neoplasm of the central nervous system, consisting of a well‐circumscribed embryonal tumor of infancy with mixed features of ependymoblastoma (multilayer ependymoblastic rosettes and pseudorosettes) and neuroblastoma (neuroblastic rosettes) in the presence of neuropil‐like islands. We present the case of a young child with a very aggressive tumor that rapidly recurred after gross total resection, chemotherapy and radiation. Prominent vascular sclerosis and circumscribed tumor led to the diagnosis of malignant astroblastoma; however, rapid recurrence and progression of this large tumor after gross total resection prompted review of the original pathology. ETANTR is histologically distinct with focal glial fibrillary acid protein ( GFAP ) and synaptophysin expression in the presence of neuronal and ependymoblastic rosettes with focal neuropil islands. These architectural features, combined with unique chromosome 19q13.42 amplification, confirmed the diagnosis. In this report, we describe tumor stem cell ( TSC ) marker CD 133, CD 15 and nestin alterations in ETANTR before and after chemotherapy. We found that TSC marker CD 133 was richly expressed after chemotherapy in recurrent ETANTR , while CD 15 is depleted compared with that expressed in the original tumor, suggesting that CD 133+ cells likely survived initial treatment, further contributing to formation of the recurrent tumor.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102077/1/bpa12079.pd

Magnetic Resonance Imaging of Ethyl-nitrosourea-induced Rat Gliomas: A Model for Experimental Therapeutics of Low-grade Gliomas

Human low-grade gliomas represent a population of brain tumors that remain a therapeutic challenge. Preclinical evaluation of agents, to test their preventive or therapeutic efficacy in these tumors, requires the use of animal nobreak models. Spontaneous gliomas develop in models of chemically induced carcinogenesis, such as in the transplacental N-ethyl-N-nitrosourea (ENU) rat model. However, without the ability to detect initial tumor formation, multiplicity or to measure growth rates, it is difficult to test compounds for their interventional or preventional capabilities. In this study Fisher-334 rats, treated transplacentally with ENU, underwent magnetic resonance imaging (MRI) examination in order to evaluate this approach for detection of tumor formation and growth. ENU-induced intracranial cerebral tumors were first observable in T2-weighted images beginning at 4 months of age and grew with a mean doubling time of 0.487 ± 0.112 months. These tumors were found histologically to be predominately mixed gliomas. Two therapeutic interventions were evaluated using MRI, vitamin A (all-trans retinol palmitate, RP), as a chemopreventative agent and the anti-angiogenic drug SU-5416. RP was found to significantly delay the time to first tumor observation by one month ( P = 0.05). No differences in rates of tumor formation or growth rates were observed between control and RP-treated groups. MRI studies of rats treated with SU-5416 resulted in reduction in tumor growth rates compared to matched controls. These results show that MRI can be used to provide novel information relating to the therapeutic efficacy of agents against the ENU-induced tumor model.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45391/1/11060_2004_Article_352248.pd

Sonographically Guided Lumbar Puncture in Pediatric Patients

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135581/1/jum201332122191.pd

CSF H3F3A K27M circulating tumor DNA copy number quantifies tumor growth and in vitro treatment response

https://deepblue.lib.umich.edu/bitstream/2027.42/145434/1/40478_2018_Article_580.pd