A rare case of medulloblastoma with excessive nodularity: imagistic features

Medulloblastoma is the most common malignant tumor of childhood. Neuroimaging can play a role in the diagnosis of medulloblastoma, however atypical features do exist [2]. We report the case of a 1 year and 10- month-old infant diagnosed with a medulloblastoma with what we term “excessive” nodularity based on neuroimaging features and confirmed by neuropathology. CT-scan (CT) and magnetic resonance imaging (MRI) examination of the brain revealed a very large posterior fossa tumor attached to tentorium. On T2-weighted and post-gadolinium sequences, the tumor shows an extensive nodular grape-like appearance. Initial the patient was underwent a ventriculo-peritoneal shunt.The second operative procedure was tumour resection. Histology examen revealed a diagnosis of medulloblastoma desmoplastic with extensive nodularity. The neuroradiographic features of this medulloblastoma with what we describe as “excessive” nodularity are important to recognize as these children may be cured with chemotherapy alone

Professor Constantin Arseni between myth and reality

 

3D diffuse tensor imaging important acquisition in diagnostic and preoperative planning of intracranial lesions

Diffusion tensor imaging (DTI) is a MRI technique that enables the measurement of the diffusion of water in tissue in order to produce neural tract images. DTI allows clinicians to look at anisotropic diffusion in white-matter tracts, but it is limited in demonstrating spatial and directional anisotropy. Advanced methods such as color coding and tractography (fiber tracking) have been used to investigate the directionality. The localization of tumors in relation to the white matter tracts (infiltration, deflection), has been one the most important initial applications. Tractography potentially solves a problem for a neurosurgeon in terms of minimizing functional damage and determining the extent of diffuse infiltration of pathologic tissue to minimize residual tumor volume. In this way, tractography facilitates preoperative planning. Tractographic images may help to clarify whether a tumor is compressing, abutting, or infiltrating the contiguous white-matter tracts. DTI identify different tumor components, and to differentiate tumor invasion from normal brain tissue or edema. The recent development of DTI allows for direct examination of the brain microstructure, and DTI has become a useful tool for investigation of brain disorders such as stroke, epilepsy, MS, brain tumors, and demyelinating disorders

Neuromodulation devices nowadays

Introduction. Neuromodulation devices have known a great progress in the past years being used in treatment of drug resistant neurological diseases such as epilepsies and migraines. A neuromodulation device can stimulate profound or superficial neural pathways in order to balance chronic drug-resistant disorders that involve disturbances of cellular electrical potentials. Material. Cranial neuromodulation devices implants used until now usually determined skull irregularities, implant site infection, resorption of the bone flap or osteomyelitis. In order to solve these problems, it was needed a customized cranial implant that integrates the neuromodulation device. We report the first description of a fully integrated neuromodulation device within a customized cranial implant, publicised in 2018 by Gordon et al., that demonstrates the utility of a computerized neurostimulation device combined with clear custom-designed cranial implant. Conclusion. The new approach of neurotechnology confines a better solution for neuroimplants devices with less follow-up complications and great patient’s satisfaction

Adult quality of life in congenital hydrocephalus operated cases: A twenty years retrospective study

Congenital hydrocephalus is a health problem in many countries and in Romania the pediatric neurosurgical department of the Emergency Hospital “Bagdasar-Arseni” has a large number of such patients. This is a retrospective study and it includes the patients with congenital hydrocephalus operated between 1992 and 2012 in the pediatric neurosurgical department of the Emergency Hospital “Bagdasar-Arseni”. The functional outcome was assessed using Karnofsky Performance Scale, Hydrocephalus Outcome Questionnaire and Glasgow outcome scale. The total number of the patients was 372, with a predominance of boys (212 boys versus 160 girls) and at the time of our study 168 patients were over 16 years old. Functional outcome of the children over 16 years old assessed using Karnofsky Performance Scale, showed that 73 patients were above 80 and leading independent lives, and 95 were less than 80 points. The results would be better if all these patients would benefit from schooling for children with special needs

New technics for removal of intradural spinal tumours

Introduction. Neuronavigation is a computer-assisted technology based on pre- and intraoperative images that permit neurosurgeons to have a better approach of the brain and intradural spinal tumors. The neuronavigation systems have been a significant progress in neurosurgery. These systems allow neurosurgeons to evaluate surgical risks, select the best interventional method, localize better the tumors in order to improve the accuracy of the resection and decide on the optimal trajectory for the surgical procedure, resulting in decreased patient morbidity and mortality. Material: Spinal cord tumors are rare and uncommon lesions. Their growth result in compression of the spinal cord, which can cause severe neurologic deficits such as limb dysfunction, motor and sensation loss with the possibility of leading to death. We present o short report of a study publicated by Stefini et al. in 2018 regarding the use of neuronavigation for removal of intradural spinal tumors. Conclusion: The benefits of using neuronavigation in resection of the intradural spinal tumors include decreased risk of bad localization of the tumor, minimal invasive surgery technique and reduction of bone removal

Controversies in multimodal treatment of pineal tumors: Experience of 84 cases

The pineal tumors represent one of the most difficult and challenging disease from all brain pathology due to the complex anatomy of the area and because of the diverse pathology of this type of tumors. The management of these tumors is multi modal and comprises the surgical approach followed by radiotherapy and chemotherapy. The authors present a large series of 84 consecutive operated cases of pineal tumors. All these cases have undergone one of the two main surgical approaches (occipito-transtentorial approach and supracerebellar - infratentorial approach). In 22 cases (26,1%) the tumor was totally removed, in 18 cases (21,4%) near total removal was obtained, in 33 cases (39,2%) partial removal and biopsy was performed in 11 cases (13,1%). From all 84 cases, 39 cases (46%) were germ cells tumors, 16 cases (19%) were pineal parenchyma tumors, in 27 cases (32%) were glial cell tumors and in 2 cases (3%) were miscellaneous tumors. As adjuvant therapy, radiotherapy played an important role within the multimodal management of pineal tumors. Therefore 61 cases have undergone the radiotherapy, which have been indicated for all sensitive tumors. The chemotherapy was applied in 41 cases, and consisted in a combination of cisplatin, bleomycin and actinomycin D. The outcome was good recovery in 56 cases (66%), moderate disability in 12 cases (14.7%), severe disability in 9 cases (10.2%) and death in 7 cases (8.8%).&nbsp

Determination of the 233^{233}Pa(n,f) reaction cross section from 0,5 to 10 MeV neutron energy using the transfer reaction 232^{232}Th(3^{3}He,p)234^{234}Pa

The fission probability distributions of 232, 233, 234Pa and 231Th have been measured up to an excitation energy of 15 MeV, using the transfer reactions 232Th(3He, t)232Pa, 232Th(3He, d)233Pa, 232Th(3He, p)234Pa and 232Th(3He, 4He)231Th. From these measurements, the neutron induced fission cross sections of 231Pa, 233Pa and 230Th have been determined from the product of the fission probabilities of 232Pa, 233Pa and 231Th respectively with the calculated compound nucleus formation cross sections in the 231Pa+n, 233Pa+n and 230Th+n reactions. The validity of the applied method has been successfully tested with the existing neutron induced fission cross sections of 230Th and 231Pa. Special emphasis is put on the 233Pa(n, f) reaction which is of importance for thorium fueled nuclear reactors. Based on a statistical model analysis of the neutron induced fission cross section as a function of neutron energy, it has been possible to determine the barrier parameters of the 234Pa fissioning nucleus. Cross sections for the compound nucleus inelastic scatttering 233Pa(n, n′) and radiative capture 233Pa(n, γ) reactions have also been calculated and compared with recent evaluations

Proton emitters [Formula Presented] and [Formula Presented]: Probing the structure of unbound Nilsson orbitals

Two new proton emitting states in the deformed nuclei [Formula Presented] [Formula Presented] and [Formula Presented] [Formula Presented] have been identified. Experimental data are interpreted using the coupled-channels Schrödinger equation with outgoing wave boundary conditions. The observed resonances are discussed in terms of deformed single-proton orbitals close to the [Formula Presented] Fermi level. © 1999 The American Physical Society