The brainstem and its neurosurgical history

Cucu, Andrei; Turliuc, Şerban; Costea, Claudia Florida; Perciaccante, Antonio; Bianucci, Raffaella; Donell, Simon; Scripcariu, Dragoş Viorel; Turliuc, Mihaela Dana

doi:10.1007/s10143-021-01496-3

Cited by 13 publications

(6 citation statements)

References 147 publications

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“…Therefore, the earlier the disease is diagnosed and cleaner the tumor is resected, the better the prognosis of patients. However, surgery in the brainstem is not easy and full of risks [19].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Survival Analysis of Patients with Brainstem Cavernous Hemangioma: A Population-Based Study Using the SEER Database

Zhan

Yang

et al. 2022

Preprint

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This population-based study determined the epidemiology, incidence, and outcomes of brainstem cavernous hemangioma. Data on patients with brainstem cavernous hemangioma were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Descriptive analysis assessed the distribution and tumor-related characteristics of patients with brainstem cavernous hemangioma. The Kaplan–Meier method and Cox proportional hazard model were used to analyzed the possible prognostic indicators. The age-adjusted incidence rate between 2000 and 2019 was 0.0236 cases per 100,000 person-years. A total of 283 cases of brainstem cavernous hemangioma were identified between 2000 and 2019. The median patient age was 45 years (range, 0–87 years). Most patients were diagnosed between 40–44 and 55–59 years of age. Middle-aged adults (40–59 years old) accounted for 41.34% of all patients. White patients accounted for 82.6% of all patients. All patients diagnosed with brainstem cavernous hemangioma had benign lesions. Surgery was performed in 105 (37.1%) cases, radiation therapy in 5 (1.7%) cases, and chemotherapy in 1(0.4%) case. The median survival time was 71 months (range: 0–189 months). Age at diagnosis and surgery were two strong factors affecting occurrence and prognosis. Incidence did not differ between sexes and was higher in white patients. Tumor size had little impact on early prognosis; however, for late prognosis, smaller tumors (< 3 cm) had a better prognosis. No significant differences were observed in the outcomes between surgery and conservative treatment. We suggest that more attention should be paid to the treatment of patients with brainstem cavernous hemangioma.

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Section: Discussionmentioning

confidence: 99%

Epidemiology and Survival Analysis of Patients with Brainstem Cavernous Hemangioma: A Population-Based Study Using the SEER Database

Zhan

Yang

et al. 2022

Preprint

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“…9 Due to the intricate intracranial anatomy and its concealed central location, brainstem surgery is notably challenging. 10 Given the high risk of morbidity and mortality, resection for BSM is seldom considered. 2,6,7 Historically, whole brain radiotherapy (WBRT) or fractionated radiotherapy, rather than stereotactic radiosurgery (SRS), were chosen as the preferred approaches due to the presumed lower radiation tolerance of the brainstem to high single doses.…”

Section: Introductionmentioning

confidence: 99%

Stereotactic radiosurgery and radiotherapy for brainstem metastases: An international multicenter analysis

Ehret,

Rueß,

Blanck

et al. 2024

Intl Journal of Cancer

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Brainstem metastases (BSM) present a significant neuro‐oncological challenge, resulting in profound neurological deficits and poor survival outcomes. Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) offer promising therapeutic avenues for BSM despite their precarious location. This international multicenter study investigates the efficacy and safety of SRS and FSRT in 136 patients with 144 BSM treated at nine institutions from 2005 to 2022. The median radiographic and clinical follow‐up periods were 6.8 and 9.4 months, respectively. Predominantly, patients with BSM were managed with SRS (69.4%). The median prescription dose and isodose line for SRS were 18 Gy and 65%, respectively, while for FSRT, the median prescription dose was 21 Gy with a median isodose line of 70%. The 12‐, 24‐, and 36‐month local control (LC) rates were 82.9%, 71.4%, and 61.2%, respectively. Corresponding overall survival rates at these time points were 61.1%, 34.7%, and 19.3%. In the multivariable Cox regression analysis for LC, only the minimum biologically effective dose was significantly associated with LC, favoring higher doses for improved control (in Gy, hazard ratio [HR]: 0.86, p < .01). Regarding overall survival, good performance status (Karnofsky performance status, ≥90%; HR: 0.43, p < .01) and prior whole brain radiotherapy (HR: 2.52, p < .01) emerged as associated factors. In 14 BSM (9.7%), treatment‐related adverse events were noted, with a total of five (3.4%) radiation necrosis. SRS and FSRT for BSM exhibit efficacy and safety, making them suitable treatment options for affected patients.

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“…A significant contribution for the study of the ventricular system was attributed by Galen. He proved by experiments that the four ventricles are connected, and was the first to describe the anatomy of the fourth ventricle in detail (Cucu et al, 2021). He also discovered an opening between the ventricular system and the subarachnoid space—the MA.…”

Section: Introduction and Aimsmentioning

confidence: 99%

The debated neuroanatomy of the fourth ventricle

Spierer

2023

Journal of Anatomy

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The fourth ventricle is a small, fluid‐filled cavity located within the brain that plays a vital role in the body's physiological functions. Therefore, the anatomical elements forming it bear significant clinical relevance. However, the exact relations between the elements that form its roof are still debated in the neuroanatomical literature; the inferior medullary velum, and the ventricle's median aperture in particular. In some atlases, the inferior medullary velum is placed in the midline, while in others, it is placed in the transverse plane. The median aperture is also displayed in different ways in midsagittal drawings: as a round perforation of a midline velum, as a foramen in an uncharacterized part of the ventricle, and as a gap between the nodule and the brainstem. This work aims to provide a comprehensive review of the different descriptions of the fourth ventricle, in order to gain a clearer understanding of the ventricular system's structure.

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The brainstem and its neurosurgical history

Cited by 13 publications

References 147 publications

Epidemiology and Survival Analysis of Patients with Brainstem Cavernous Hemangioma: A Population-Based Study Using the SEER Database

Epidemiology and Survival Analysis of Patients with Brainstem Cavernous Hemangioma: A Population-Based Study Using the SEER Database

Stereotactic radiosurgery and radiotherapy for brainstem metastases: An international multicenter analysis

The debated neuroanatomy of the fourth ventricle

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