Abstract. Hemangioblastomas are tumors of the central nervous system, and the cerebellum is the most common site of occurrence. Cerebellar hemangioblastoma with enhanced wall thickness is rare and often misdiagnosed preoperatively. At present, no unified radiological classification system based on magnetic resonance imaging (MRI) findings exists for cerebellar hemangioblastoma, and this tumor type can be solid or cystic mass, according to the MRI findings. The most common presentation of cerebellar hemangioblastoma observed radiologically is a large sac with small nodules, where the wall of the large cyst is not enhanced. A tumor with enhanced large cysts and tumor nodules is extremely rare. The most effective treatment is complete resection of the cyst and the solid growth. The present case reports the successful treatment of two cases of cerebellar hemangioblastoma with enhanced wall thickness, including the MRI findings for the differential diagnoses and the surgical experiences. IntroductionHemangioblastomas are tumors of the central nervous system that most frequently arise from the vascular system; they are classed as is WHO grade I tumors (1). In adults, 7-10% of tumors arise in the posterior fossa (2) and the cerebellum is the most common site of occurrence (3,4). As a number of features may be observed on magnetic resonance imaging (MRI), (1,(3)(4)(5)(6) according to previous reports, cerebellar hemangioblastoma can be predominantly divided into two categories on the basis of MRI findings. The most common radiological presentation of cerebellar hemangioblastoma is a large sac or cyst and small tumor nodules. We hypothesize that this type may be further divided into two subtypes: One which exhibits no enhancement at the wall of the large cyst, but with evenly enhanced tumor nodules; and another with an enhanced large cyst and tumor nodules. The less common type of cerebellar hemangioblastoma is a solid mass, and also comprises two subtypes: One type contains multiple solid tumors and exhibits homogeneous enhancement on MRI; the other subtype is a solid tumor with single or multiple cysts, where the solid portion is enhanced and the cystic region is non-enhanced (7). In addition to the two main tumor types, the rarest variant of this tumor exhibits an enhanced cyst wall, based on the cystic nodules, and is accompanied by enhanced uneven walls (6). The first type (a large sac or cyst with small tumor nodules) has surrounding edema. The other two types (one type is a solid mass, one type exhibits enhanced cyst wall) exhibit an obvious mass and do not have surrounding edema. However, in spite of these characteristic features on imaging, in the preoperative and differential diagnoses, solid cerebellar hemangioblastoma and nodular cerebellar hemangioblastoma with enhanced wall are often misdiagnosed as high-grade gliomas (6).For cerebellar hemangioblastoma with an enhanced cystic wall, surgical resection is the most effective treatment. The tumor is unlikely to recur following complete resection, therefore che...

The aim of this study was to evaluate the predictive value of prognostic factors for the surgical outcome of patients with mesial temporal lobe epilepsy (MTLE) using Engel seizure classification. The clinical data of 121 patients with MTLE who underwent anterior temporal lobectomy (ATL) and received a 1-year minimum follow-up were collected between January 2005 and December 2008. Patients were divided into seizure and seizure-free groups according to the Engel seizure classification. Univariate analysis and multivariate logistic regression analysis were used to analyze the potential predictive and prognostic factors, including medical history, clinical features of seizures, magnetic resonance imaging (MRI) and video-electroencephalogram (EEG) monitoring results. Univariate analysis indicated no statistically significant differences in gender, age at seizure onset, age at surgery, history of traumatic brain injury, perinatal anoxia, intracranial infection, family history of seizure, auras or site of surgery between the two groups; however, significant differences were detected in pre-surgical seizure duration, history of febrile seizures, seizure types, MRI and video-EEG results. Multivariate logistic regression analysis demonstrated that a pre-surgical seizure duration of <10 years, history of positive febrile seizures, simple complex partial seizure, positive MRI results and unilateral local video-EEG spikes may be considered as predictors of a good prognosis. These results indicate that remission may be achieved in patients with MTLE via the collection of accurate clinical information and adequate pre-surgical evaluation.

Central neurocytoma is a relatively rare tumor of the central nervous system. Young adults are most commonly affected, with a similar incidence in males and females. The tumor is predominantly occurs in the ventricular system of the brain. The tumor is benign and exhibits a good response to surgical resection and radiation therapy. The typical central neurocytoma occurs in the supratentorial ventricular system in young adults. Extraventricular neurocytomas are rare in the spinal cord. In the present study, two cases of craniocervical neurocytomas and the clinical presentation, magnetic resonance imaging observations, pathological features and two-year follow-up results are reported. The first case presents a 26 year old male with an intramedullary mass extending from the medualla oblongata to the T4 segement of the spine. The second case presents the case of a 48 year old female with an intramedullary mass extending from the oblongata to the T2 segement of the spine. The two patients underwent subtotal resection of the masses and post-operative radiotherapy was administered for three months. Post-operative magentic resoance imaging revealed no tumor recurrence in the two cases, two years after resection. The relevant literature is also discussed.

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