The central neurocytoma has recently been added to the differential diagnosis of intraventricular tumors. Histopathologically, this tumor is characterized by a uniform neoplastic cell population with features of neuronal differentiation. Central neurocytomas occur in young adults, develop in the area of the foramen of Monro, and are usually associated with the septum pellucidum. Initial reports appeared to indicate that these tumors are benign lesions with a favorable postoperative prognosis. The authors present clinical and neuropathological findings in a series of eight patients with central neurocytoma. An anterior transcallosal microneurosurgical approach yielded good outcomes. Postoperative radiation therapy was restricted to two patients with a malignant variant of central neurocytoma and one patient with a recurrent tumor. Observations of anaplastic variants of this neoplasm in two cases and local tumor recurrences in three indicate that the biological behavior and postoperative prognosis of central neurocytoma may not always be as favorable as previously assumed.
Seventy of 178 patients with acoustic tumors initially were treated conservatively and have been followed up for an average of 26 +/- 2 months. The tumor size was determined by the mean maximum anteroposterior and mediolateral diameters, using computed tomographic or magnetic resonance imaging scans obtained sequentially throughout the follow-up period. The average tumor growth was 1.6 +/- 0.4 mm the 1st year, and 1.9 +/- 1.0 mm the 2nd year (range, -2 to 17 mm/y): 4 tumors showed apparent regression, 28 (40%) had no detectable growth, and 37 (53%) exhibited growth (average, 3.8 +/- 1.2 mm/y). Within individual patients, the tumor growth rate determined during the 1st year of follow-up was predictive of tumor growth rate determined during the following year. Rapid tumor growth or clinical deterioration in 9 of the 70 patients (13%) who initially were treated conservatively necessitated subsequent surgery an average of 14 +/- 5 months after the patient was initially seen. This group had a larger initial tumor size (27.0 +/- 3.4 mm vs. 21.3 +/- 0.9 mm, P less than 0.05), and a faster 1-year growth rate (7.9 +/- 2.3 mm/y vs. 1.3 +/- 0.3 mm/y, P less than 0.05) than the 61 patients who did not require surgery. Two patients, however, experienced neurological deterioration that required surgery, even though there was no tumor growth. The high incidence of acoustic tumors with no detectable growth or apparent spontaneous regression must be taken into account when evaluating the indications for surgery and the efficacy of radiotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Heavily T2-weighted spin echo sequences of the brain show age-dependent low signal intensity in many extrapyramidal nuclei. Although it has been suggested that this low intensity results from non-haem iron, the specific influence of non-haem iron on the T2 relaxation time has not been quantified and remains controversial. The T2 relaxation times of the globus pallidus and putamen were measured from MRI at 1.5T in 27 healthy patients, by using a mathematical model. They were then plotted as a function of age and compared to the curve of age-dependent iron concentration determined post mortem. The curves of T2 relaxation time in the basal ganglia are congruent with published curves of iron concentration, indicating a high probability that the changes in T2 relaxation times and the low signal in the basal ganglia result from the local, age-dependent iron deposition. Individual measurements of T2 relaxation time show less variation before than after 45 years of age, indicating the influence of a second, more individual factor.
Objectives-To assess the incidence of post-traumatic syringomyelia (PTS) Materials and methods Four hundred and forty nine paraplegic and tetraplegic patients were admitted from within four hours to up to three weeks after injury and followed up up until 1 July 1994. Most of these patients had been seen clinically at least once a year. Conventional radiographs of the injured spine were performed before each MRI study. Kyphosis angle of the spine was measured taking the inferior end plate of the first unbroken vertebra above and below the fracture site. Kyphosis angles of the thoracic and thoracolumbar spine were then compared with normal values."' For the cervical spine all positive angles (kyphosis) were considered as abnormal as under normal conditions the cervical spine is in lordosis. In most patients MRI studies were carried out on the day of the trauma and thereafter yearly after diagnosis of PTS. Osteosynthesis material was removed whenever necessary to allow MRI examinations. In cases of surgical revision of the syrinx, MRI was performed six months after surgery and then yearly. Non-contrast MRI was done using either a 0-5, 1-0, or 1-5 T superconducting magnet. Spin echo images were obtained as TI weighted sagittal and axial planes and T2 weighted sagittal planes in most patients. Dual echo sagittal and coronal weighted images were sometimes also performed.
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