Basal Ganglia Regions Research Articles

Concurrence of Fahr's disease and brain tumor: A case report and review of the literature.

Fahr's disease is a rare entity characterized by abnormal calcification in the bilateral basal ganglion regions and cerebellum. Concurrence of Fahr's disease with brain tumor is associated with an even lower incidence; the present study describes the fifth such case, in which a 32-year-old female presented with a 1-month history of headache and unsteady walking. Pathology and imaging studies resulted in a diagnosis of low-grade astrocytoma with calcified deposition. The patient recovered uneventfully. Following a review of the literature, several similarities among the reported cases were revealed. Patients were relatively young at the onset of the disease. The pathological diagnosis for all brain tumors was astrocytoma. The cerebellum was the predominant location of the brain tumor. The imaging studies of these cerebral astrocytomas were almost identical, with a cystic glioma occurring adjacent to a neighboring calcified dentate nucleus. Furthermore, the development of astrocytoma in the bilateral cerebellar hemisphere was not uncommon, which warrants close follow-up for these patients.

Dopaminergic, serotonergic, and noradrenergic deficits in Parkinson disease.

ObjectivePeople with Parkinson disease (PD) frequently develop dementia, which is associated with neocortical deposition of alpha-synuclein (α-syn) in Lewy bodies and Lewy neurites. In addition, neuronal loss and deposition of aggregated α-syn also occur in multiple subcortical nuclei that project to neocortical, limbic, and basal ganglia regions. Therefore, we quantified regional deficits in innervation from these PD-affected subcortical nuclei, by measuring the neurotransmitters and neurotransmitter transporter proteins originating from projections of dopaminergic neurons in substantia nigra pars compacta, serotonergic neurons in dorsal raphé nuclei, noradrenergic neurons in locus coeruleus, and cholinergic neurons in nucleus basalis of Meynert.MethodsHigh-performance liquid chromatography and novel enzyme-linked immunosorbent assays were performed to quantify dopaminergic, serotonergic, noradrenergic, and cholinergic innervation in postmortem brain tissue. Eight brain regions from 15 PD participants (with dementia and Braak stage 6 α-syn deposition) and six age-matched controls were tested.ResultsPD participants compared to controls had widespread reductions of dopamine transporter in caudate, amygdala, hippocampus, inferior parietal lobule (IPL), precuneus, and visual association cortex (VAC) that exceeded loss of dopamine, which was only significantly reduced in caudate and amygdala. In contrast, PD participants had comparable deficits of both serotonin and serotonin transporter in caudate, middle frontal gyrus, IPL, and VAC. PD participants also had significantly reduced norepinephrine levels for all eight brain regions tested. Vesicular acetylcholine transporter levels were only quantifiable in caudate and hippocampus and did not differ between PD and control groups.InterpretationThese results demonstrate widespread deficits in dopaminergic, serotonergic, and noradrenergic innervation of neocortical, limbic, and basal ganglia regions in advanced PD with dementia.

Cerebral embolism secondary to atrial myxoma in a child

 A 12-year-old female with no prior neurological complaints, presented with focal seizures and loss of consciousness at the pediatric emergency department. The neurological examination revealed right hemiplegia with speech disorders. Brain computerized tomography performed 12 h after presentation revealed normal findings; however, a magnetic resonance imaging of the brain performed 24 h after presentation, demonstrated an infarct of the left basal ganglia region (Fig. 1). Among other stroke workup examination, a heart echocardiography was performed which demonstrated a tumor of the left atrium (Fig. 2). A superior visualization of the tumor was achieved after performing a heart magnetic resonance imaging (Fig. 3). Notably, the index patient had no history or other signs of cardiac disease prior to the stroke. According to these findings, patient’s stroke was considered to be embolic in nature; thus, anticoagulant therapy was initiated and the tumor was surgically removed. Pathological examination of the resected specimen demonstrated features compatible with myxoma. After the operation, the patient showed improvement: speech was totally restored and independent walking was achieved within 3 wk, though

Study on perfusion CT evaluation of cerebral blood flow changes before and after repairing of traumatic skull defects

Objective To investigate the effect of cranioplasty on cerebral hemodynamics and neurological symptoms in patients with traumatic skull defect. Methods Before and after skull repair, 14 patients with traumatic skull defects underwent brain perfusion CT examination. The basal ganglia level on the repair side and the basal ganglia region of the lateral ventricle body level and the temporal cortex region in 4 regions of interest were compared. Self-control comparison the mean value difference of rCBF, the mean values at 7 days before and after procedure and at 6-month before and after procedure were compared respectively, and the changes of their neurological symptoms were followed up. Results (1) The basal ganglia section of the basal ganglia level: The rCBF was improved at 7 day after procedure compared with before procedure (P=0.044, P 0.05); the rCBF was improved significantly for 6-month follow-up compared with before procedure (P=0.001, P 0.05); the rCBF was not improved for 6-month follow-up compared with before procedure (P=0.174, P>0.05). The degree of cerebral blood flow improvement was found more obviously near the large vessels at the lateral fissure on basal ganglia level because of skull repair. The neurological symptoms of patients were improved after cranioplasty. Conclusions In this study, the perfusion CT data have shown that the more intensive cerebral blood flow is, the more obvious recovery of cerebral blood flow will be. It is further enriched and improved the theoretical hypothesis of the improvement of cerebrovascular reserve function after cranioplasty. Key words: Cranioplasty; Regional cerebral blood flow; Perfusion computed tomography

Cerebral metabolism in HIV infected patients with non-cognitive disorder using single voxel magnetic resonance spectroscopy

ObjectiveTo investigate the variance of metablites, including N-Acetyl aspartate (NAA), Choline (Cho) and Creatine (Cr), in brain regions of HIV infected patients with non-cognitive disorder and healthy volunteers by a 3.0 T magnetic resonance spectroscopy. MethodsSingle voxel magnetic resonance spectroscopy was applied to measure the basal ganglia region, frontal lobe and parietal lobe in 69 HIV infected patients and 33 healthy volunteers. According to CD4 T cell count, the patients were divided into 2 groups, group A (≥200 cells/μL, 40 patients) and group B (<200 cells/μL, 29 patients). The normal control group, group C, consisted of 33 healthy volunteers. ResultsThe patients in groups A and B had lower ratio of NAA/Cr but higher ratio of Cho/Cr in the basal ganglia region than group C (P < 0.001; P = 0.021). Compared to groups B and C, the patients in group A had higher ratios of NAA/Cr and Cho/Cr (P = 0.013; P < 0.001) in the frontal lobe. In the parietal lobe, the patients in group A had higher ratio of Cho/Cr than groups B and C (P = 0.037). ConclusionHIV infection induces inflammation in basal ganglia region, frontal lobe and parietal lobe before non-cognitive disorder occurs after HIV infection. However, the basal ganga region sees more neurons loss.

Analysis of prognostic factors for hypertensive cerebral hemorrhage in patients with hypertensive intracerebral hemorrhage in basal ganglia region by surgical operation

Objective To analyze the related influence factors on the prognosis of hypertensive cerebral hemorrhage in basal ganglia with operation treatment, provide the basis for clinical prevention and treatment. Methods 80 patients for treatment of hypertensive cerebral hemorrhage were selected.By a retrospective study, we collected the clinical data and postoperative following-up data, status, complications, and observed the postoperative recovery. Statistical different hypertension, preoperative breaking into the ventricle, disturbance of consciousness, operation time and preoperative hematoma volume of the prognosis. Results In 80 patients,48 cases(60.00%)of patients has good prognosis; moderate disability, taking care of themselves life 10 cases(12.50%); severe disability, life can not take care of 9 cases(11.25%); plant survival of 5 cases(6.25%)and 8 cases of death(10.00%).22 cases of patients with brain hemorrhage again,3 cases postoperative pulmonary infection, 6 cases of secondary organ dysfunction.Poor prognosis of preoperative ventricle prognosis and disturbance of consciousness of patients was 88.26%(18/23)and 63.64%(21/33),which was higher than the preoperative without breaking into the ventricle and no disturbance of consciousness 24.54%(14/57)and 36.36%(21/33), the difference was statistically significant(χ2=10.38,9.76,P 60m L was 47.62% (20/42),which was higher than the preoperative hematoma volume 40-60m Lpatients31.38%(12/38),the difference was statistically significant(χ2=9.12,P<0.05). Conclusion It has obvious effect on surgery operation prognosis of patients with hypertensive cerebral hemorrhage, including optimal time for operation; bleeding time, intraventricular hemorrhage, disturbance of consciousness and bleeding volume.If the clinical treatment in the prevention and treatment to improve the survival and quality of life of patients with cerebral hemorrhage. Key words: Hypertension; Cerebral hemorrhage; Surgical operation; The prognosis; Influence factors

Manganese-Induced Parkinsonism and Parkinson's Disease: Shared and Distinguishable Features.

Manganese (Mn) is an essential trace element necessary for physiological processes that support development, growth and neuronal function. Secondary to elevated exposure or decreased excretion, Mn accumulates in the basal ganglia region of the brain and may cause a parkinsonian-like syndrome, referred to as manganism. The present review discusses the advances made in understanding the essentiality and neurotoxicity of Mn. We review occupational Mn-induced parkinsonism and the dynamic modes of Mn transport in biological systems, as well as the detection and pharmacokinetic modeling of Mn trafficking. In addition, we review some of the shared similarities, pathologic and clinical distinctions between Mn-induced parkinsonism and Parkinson’s disease. Where possible, we review the influence of Mn toxicity on dopamine, gamma aminobutyric acid (GABA), and glutamate neurotransmitter levels and function. We conclude with a survey of the preventive and treatment strategies for manganism and idiopathic Parkinson’s disease (PD).

Subcortical glutamate mediates the reduction of short-range functional connectivity with age in a developmental cohort.

Marked changes in brain physiology and structure take place between childhood and adulthood, including changes in functional connectivity and changes in the balance between main excitatory and inhibitory neurotransmitters glutamate (Glu) and GABA. The balance of these neurotransmitters is thought to underlie neural activity in general and functional connectivity networks in particular, but so far no studies have investigated the relationship between human development related differences in these neurotransmitters and concomitant changes in functional connectivity. GABA+/H2O and Glu/H2O levels were acquired in a group of healthy children, adolescents, and adults in a subcortical (basal ganglia) region, as well as in a frontal region in adolescents and adults. Our results showed higher GABA+/Glu with age in both the subcortical and the frontal voxel, which were differentially associated with significantly lower Glu/H2O with age in the subcortical voxel and by significantly higher GABA+/H2O with age in the frontal voxel. Using a seed-to-voxel analysis, we were further able to show that functional connectivity between the putamen (seed) and other subcortical structures was lower with age. Lower subcortical Glu/H2O with age mediated the lower connectivity in the dorsal putamen. Based on these results, and the potential role of Glu in synaptic pruning, we suggest that lower Glu mediates a reduction of local connectivity during human development.

Ex vivo magnetic resonance imaging in South African manganese mine workers

BackgroundManganese (Mn) exposure is associated with increased T1-weighted magnetic resonance imaging (MRI) signal in the basal ganglia. T1 signal intensity has been correlated with occupational Mn exposure but not with clinical symptomatology or neuropathology. ObjectivesThis study investigated predictors of ex vivo T1 MRI basal ganglia signal intensity in neuropathologic tissue obtained from deceased South African mine workers. MethodsA 3.0T MRI was performed on ex vivo brain tissue obtained from 19 Mn mine workers and 10 race- and sex-matched mine workers of other commodities. Basal ganglia regions of interest were identified for each subject with T1-weighted intensity indices generated for each region. In a pathology subset, regional T1 indices were compared to neuronal and glial cell density and tissue metal concentrations. ResultsIntensity indices were higher in Mn mine workers than non-Mn mine workers for the globus pallidus, caudate, anterior putamen, and posterior putamen with the highest values in subjects with the longest cumulative Mn exposure. Intensity indices were inversely correlated with the neuronal cell density in the caudate (p=0.040) and putamen (p=0.050). Tissue Mn concentrations were similar in Mn and non-Mn mine workers. Tissue iron (Fe) concentration trended lower across all regions in Mn mine workers. ConclusionsMn mine workers demonstrated elevated basal ganglia T1 indices when compared to non-Mn mine workers. Predictors of ex vivo T1 MRI signal intensity in Mn mine workers include duration of Mn exposure and neuronal density.

Brain Hyperechogenicities are not Associated with Venous Insufficiency in Multiple Sclerosis: A Pilot Neurosonology Study.

The "venous hypothesis" of multiple sclerosis (MS) postulates that intracranial venous congestion disintegrates the blood-brain barrier, resulting in iron accumulation in brain parenchyma triggering the inflammatory process of MS. Transcranial sonography (TCS) reveals brain parenchyma hyperechogenic alterations (BPHA) that are thought to reflect iron accumulation. We sought to investigate potential association of BPHA with chronic cerebrospinal venous insufficiency (CCSVI) in MS. MS patients were evaluated according to established TCS protocol for extrapyramidal disorders examining the presence of hyperechogenicities in different basal ganglia regions. Cerebral and cervical venous system was assessed according to proposed ultrasound protocol for CCSVI detection. In a total of 32 MS patients (age = 40 ± 14 years; male = 41%; EDSS-score = 3.1 ± 2.2) brain parenchyma hyperechogenic alterations were detected in twelve (38%) patients. The two sonographers agreed independently in 28 (87.5%) of the 32 examinations, resulting in a substantial to almost perfect agreement (Cohen's weighted kappa: substantia nigra = 0.904, Lentiform nucleus = 0.871, Thalamus = 0.784, caudate nucleus = 0.651). Two (6%) patients fulfilled the neurosonology criteria of CCSVI, while in 7 patients (22%) one positive criterion was detected. No BPHA were observed in any MS patient fulfilling CCSVI criteria. The prevalence of one positive CCSVI feature did not differ (P = .999) among patients with present (25%) or absent (20%) BPHA. There was no association of BPHA with CCSVI findings. Our findings do not support the "venous hypothesis" resulting in iron accumulation even in the few MS patients fulfilling CCSVI-criteria.

Widespread increase of functional connectivity in Parkinson's disease with tremor: a resting-state FMRI study.

Parkinson’s disease (PD) is a clinically heterogeneous disease in the symptomatology dominated by tremor, akinesia, or rigidity. Focusing on PD patients with tremor, this study investigated their discoordination patterns of spontaneous brain activity by combining voxel-wise centrality, seed-based functional connectivity, and network efficiency methods. Sixteen patients and 20 matched healthy controls (HCs) were recruited and underwent structural and resting-state functional MRI scan. Compared with the HCs, the patients exhibited increased centrality in the frontal, parietal, and occipital regions while decreased centrality in the cerebellum anterior lobe and thalamus. Seeded at these regions, a distributed network was further identified that encompassed cortical (default mode network, sensorimotor cortex, prefrontal and occipital areas) and subcortical (thalamus and basal ganglia) regions and the cerebellum and brainstem. Graph-based analyses of this network revealed increased information transformation efficiency in the patients. Moreover, the identified network correlated with clinical manifestations in the patients and could distinguish the patients from HCs. Morphometric analyses revealed decreased gray matter volume in multiple regions that largely accounted for the observed functional abnormalities. Together, these findings provide a comprehensive view of network disorganization in PD with tremor and have important implications for understanding neural substrates underlying this specific type of PD.

Investigating the microstructural and neurochemical environment within the basal ganglia of current methamphetamine abusers

BackgroundMethamphetamine is a highly addictive psychostimulant and the medical, social, and economic consequences associated with its use have become a major international problem. Current evidence has shown methamphetamine to be particularly neurotoxic to dopamine neurons and striatal structures within the basal ganglia. A previous study from our laboratory demonstrated larger putamen volumes in actively using methamphetamine-dependent participants. The purpose of this current study was to determine whether striatal structures in the same sample of participants also exhibit pathology on the microstructural and molecular level. MethodsDiffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS) were carried out in current methamphetamine users (n=18) and healthy controls (n=22) to investigate diffusion indices and neurometabolite levels in the basal ganglia. ResultsContrary to findings from previous DTI and MRS studies, no significant differences in diffusion indices or metabolite levels were observed in the basal ganglia regions of current methamphetamine users. ConclusionsThese findings differ from those reported in abstinent users and the absence of diffusion and neurochemical abnormalities may suggest that striatal enlargement in current methamphetamine use may be due to mechanisms other than edema and glial proliferation.

Neonatal brain abscess: An atypical presentation

Brain abscesses occur as an uncommon complication of bacterial meningitis in the neonatal period. A 34 weeks preterm at-risk neonate presented with abnormal breathing pattern and inability to maintain the oxygen saturation in room air. Magnetic resonance imaging (MRI) study revealed intra-parenchymal brain abscesses in the left basal ganglion and bilateral fronto-parietal regions. Intravenous piperacillin – tazobactam was commenced and continued for 6 weeks in Neonatal Intensive Care Unit. No surgical intervention was required. The patient responded to the medical management and was discharged after the documentation of radiological clearance in repeat MRI study. No complications were recorded. An appropriate neuro-developmental outcome was observed on follow-up. Brain abscesses may not be preceded by meningitis in all neonates. A strong clinical suspicion is required for the diagnosis especially in cases with atypical presentation.

Ketamine interactions with biomarkers of stress: A randomized placebo-controlled repeated measures resting-state fMRI and PCASL pilot study in healthy men

Ketamine, an NMDA receptor antagonist, is increasingly used to study the link between glutamatergic signaling dysregulation and mood and chronic pain disorders. Glutamatergic neurotransmission and stress corticosteroids (cortisol in human) are critical for Ca2+ mediated neuroplasticity and behavioral adaptation. The mechanisms of action of glutamatergic neurotransmission and stress corticosteroids on the NMDA-receptors of the hippocampus have been long investigated in animals, but given little attention in human studies. In this randomized single-blinded placebo-controlled crossover study (12 healthy young men), five sets of resting-state fMRI (RSFMRI), pseudocontinuous arterial spin labeling (PCASL), and corresponding salivary cortisol samples were acquired over 4h, at given intervals under pharmacokinetically-controlled infusion of subanesthetic ketamine (20 & 40mg/70kg/h). An identical procedure was repeated under a sham placebo condition. Differences in the profile of ketamine versus placebo effect over time were examined. Compared to placebo, ketamine mimicked a stress-like response (increased cortisol, reduced calmness and alertness, and impaired working memory). Ketamine effects on the brain included a transient prefrontal hyperperfusion and a dose-related reduction of relative hippocampal perfusion, plus emerging hyperconnectivity between the hippocampus and the occipital, cingulate, precuneal, cerebellar and basal ganglia regions. The spatiotemporal profiles of ketamine effects on different hippocampal subnetworks suggest a topographically dissociable change in corticohippocampal functional connectivity. We discuss our findings in the context of the negative feedback inhibition theory of the hippocampal stress-control. This pilot study provides a methodological framework for multimodal functional neuroimaging under resting-state conditions, which may be generalized for translational studies of glutamatergic- or stress-related etiology of neuropsychiatric disorders.

Pleomorphic xanthoastrocytoma with anaplastic features: one case report and review of literature

Objective To investigate the clinicopathological features of pleomorphic xanthoastrocytoma with anaplastic features (PXA-A). Methods The clinical manifestations, imaging, histopathological features, and immunophenotype were analyzed in one case of PXA-A, and relevant literatures were reviewed. Results The patient was a 58-year-old woman. MRI examination revealed a parenchyma mass with irregularly long T1 and long T2 signal in right temporal lobe and basal ganglia region. The border was clear and peritumoral edema was inconspicuous. The mesocephalon and right ventricle were compressed, and the midline was shifted to left. Enhanced MRI showed multiple flaky and nodular enhancement. Histologically, tumor cells showed remarkable cellular pleomorphism, and they were composed of mononuclear cells, multinuclear giant tumor cells, frothy tumor cells and spindle cells. Eosinophilic granular bodies and intranuclear inclusions were seen. Tumor cells in partial regions were intensively arranged, with obvious atypia. Immunohistochemical analysis showed immunoreactivity of the cells to glial fibrillary acidic protein (GFAP), Vimentin (Vim), S-100 protein (S-100), neuronal nuclei (NeuN) and P53. The cells showed a negative reaction for synaptophysin (Syn), chromogranin A (CgA), neurofilament protein (NF), CD34 and isocitrate dehydrogenase 1 (IDH1). The Ki-67 label index was 8.20% . Conclusions PXA-A is a rare tumor. The imaging features can offer a few diagnostic cues. However, a definite diagnosis depends on the histological and immunohistochemical features. doi: 10.3969/j.issn.1672-6731.2014.12.013

Longitudinal midbrain changes in early Parkinson's disease: iron content estimated from R2*/MRI.

To determine whether, in patients with early Parkinson's disease (PD), longitudinal changes in midbrain iron content are associated with declining motor function over a period of three years. Nineteen untreated subjects with early PD and 13 age- and sex-matched controls were followed clinically for 36 months. MRI with a 3 T magnet was performed at baseline, 18 months and 36 months with a multiple gradient echo sequence designed for rapid single-scan mapping of the proton transverse relaxation rate R2*. R2* was calculated for midbrain and forebrain basal ganglia regions. A difference in R2* between patients and controls was observed at baseline (p = 0.035) but not at 18 or 36 months in the lateral substantia nigra pars compacta (SNc). Linear regression indicated significant correlations between the change in R2* in the lateral SNc and the change score in UPDRS III (p = 0.008) and the PDQ-39 -mobility sub-score (p = 0.03) from baseline to 36 months. R2* tended to increase in those with more advanced disease and to decrease in those with milder disease. High field MRI demonstrates lateral SNc abnormalities that progress over 3 years in early PD consistent with increased iron content in those with more advanced disease, corresponding to the known distribution of neuronal loss occurring in this disorder, and correlating with motor symptomatology. Larger and longer investigations with more precise mapping of iron-containing midbrain structures are needed to fully evaluate the potential of R2* as a biomarker of disease progression in PD.

Differential FoxP2 and FoxP1 expression in a vocal learning nucleus of the developing budgerigar.

The forkhead domain FOXP2 and FOXP1 transcription factors are implicated in several cognitive disorders with language deficits, notably autism, and thus play a central role in learned vocal motor behavior in humans. Although a similar role for FoxP2 and FoxP1 is proposed for other vertebrate species, including songbirds, the neurodevelopmental expression of these genes are unknown in a species with lifelong vocal learning abilities. Like humans, budgerigars (Melopsittacus undulatus) learn new vocalizations throughout their entire lifetime. Like songbirds, budgerigars have distinct brain nuclei for vocal learning, which include the magnocellular nucleus of the medial striatum (MMSt), a basal ganglia region that is considered developmentally and functionally analogous to Area X in songbirds. Here, we used in situ hybridization and immunohistochemistry to investigate FoxP2 and FoxP1 expression in the MMSt of juvenile and adult budgerigars. We found FoxP2 mRNA and protein expression levels in the MMSt that were lower than the surrounding striatum throughout development and adulthood. In contrast, FoxP1 mRNA and protein had an elevated MMSt/striatum expression ratio as birds matured, regardless of their sex. These results show that life-long vocal plasticity in budgerigars is associated with persistent low-level FoxP2 expression in the budgerigar MMSt, and suggests the possibility that FoxP1 plays an organizational role in the neurodevelopment of vocal motor circuitry. Thus, developmental regulation of the FoxP2 and FoxP1 genes in the basal ganglia appears essential for vocal mimicry in a range of species that possess this relatively rare trait.

Aberrant functional networks connectivity and structural atrophy in silent lacunar infarcts: relationship with cognitive impairments.

Silent or asymptomatic lacunar infarcts (LACI) are common in elderly individuals, but it remains largely unclear how these often neglected silent brain infarcts lead to multiple domain cognitive deficits and even Alzheimer's disease (AD). In this study, we investigated the difference between patients with silent LACI in basal ganglia region and healthy controls for the structural and functional changes in the aspects of alterations of gray matter (GM) volume and intra-/inter-default mode network (DMN) and salience network (SN) connectivity. Thirty patients with silent LACI in the basal ganglia region and thirty healthy controls participated in the study. Voxel-based morphometry analysis was employed to measure the GM volume. We further investigated the intra/inter-network connectivity of DMN and SN using resting-state functional magnetic resonance imaging. Compared with healthy controls, patients performed worse in cognitive function in the aspects of general mental status, attention, and memory. The LACIs showed more severe GM atrophy in insula, anterior cingulate cortex, caudate, and superior temporal pole than controls. The connectivity within and between two networks was also reduced in patients. Importantly, the disrupted connectivity correlated with the patients' cognitive performance. Our findings support the hypothesis that silent lacunar infarcts result in cognitive decline, GM, and functional connectivity loss.

Correlation between cerebral blood volume values and outcomes in endovascular therapy for acute ischemic stroke

BackgroundNeurointerventionalists do not agree about the optimal imaging protocol when evaluating patients with acute stroke for potential endovascular revascularization. Preintervention cerebrovascular blood volume (CBV) has been shown to predict outcomes...

Diagnostic analysis of 162 cases of primary intracranial germ cell tumors

Objective To summarize the clinical features of primary intracranial germ cell tumors (GCTs).Methods Based on the WHO 2007 classification criteria for CNS tumors,we retrospectively analyzed 162 cases of primary intracranial GCTs admitted into Nanfang Hospital from Jan.2004 to Oct.2013.Results There were 135 cases of single-focus tumors and 27 multi-focus tumors.70.4％ of tumors were originated in pineal region,20.4％ in supra-sellar region,7.4％ in basal ganglion region,and 1.8％ in other regions.The average age of all cases,pineal region cases,supra-sellar region,and basal ganglion region cases,was 14.4 years,14.5 years,14.9 years,and 12.6 years,respectively.The male/female ratio was 7.1∶1 in all cases,and 18∶1 in pineal region cases,1.4∶1 in supra-sellar region cases,and 5∶1 in basal ganglion region cases.The positive rate of tumor markers was 42.5％,and germinomas accounted for 46.9％ of all cases.Conclusions The clinical features of GCTs are special,and detailed analysis of clinical data is helpful for the diagnosis.More than a half of patients will achieve ideal therapeutic results through timely diagnosis and reasonable treatment. Key words: Central nervous system; Pineal region; Sellar region; Basal ganglion region; Germ cell tumors; Pathology