Cortical laminar necrosis in childhood intracranial germ cell tumor survivors
ABSTRACT We report two childhood germ cell tumor survivors treated for multifocal or large suprasellar tumors followed by the presentation of acute neurological deficits and extensive cortical laminar necrosis on magnetic resonance imaging (MRI), 7 and 34 months after cranial irradiation. This complication, though uncommon, represents another manifestation of delayed treatment-related brain injury that can be catastrophic and leads to significant morbidity.
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ABSTRACT: Brain tumours are the second commonest form of childhood malignancy. In Hong Kong, around 25 to 40 children below 15 years are diagnosed to have various types of brain tumours each year. But the term "brain tumour" in fact includes a heterogeneous group of tumours and their classification, diagnostic criteria, treatment modalities and outcome have undergone major changes in the past 2 decades. In this review, the objectives are to provide brief and update information on various developments in these areas. These will include: 1) the recent consensus in the classification of childhood brain tumours; 2) the current epidemiology of children with brain tumours, both locally and aboard; 3) the current hypotheses on the pathogenesis of some common paediatric brain tumours; 4) the common presenting features of the commonest types of childhood brain tumours locally; 5) the current diagnostic and therapeutic approaches and lastly; 6) the commonly encountered long-term sequalae among paediatric brain tumours survivors. In summary, many common forms of childhood brain tumours found locally can be cured nowadays. Current challenge is to further improve the outcome in those with poor outcome and minimise therapy related toxicity in those with good prognosis.
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ABSTRACT: ObjectivesLaminar cortical necrosis, defined as focal or diffuse necrosis of one or more cortical lamina, represents an increasingly recognized neuropathological endpoint of vascular, endocrine, immunologic, metabolic, or toxic conditions, of which mitochondrial disorders (MIDs) are the third most frequent after cerebral ischemia and hypoxia.AimsTo investigate the prevalence of laminar cortical necrosis in MIDs, types of MIDs associated with laminar cortical necrosis, and the morphological characteristics on imaging and autopsy.MethodsMedline literature review for the terms “laminar cortical necrosis”, “cortical signal change”, “mitochondrial” and all acronyms of syndromatic MIDs.ResultsAmong 139 hits for “laminar cortical necrosis”, 10 articles fulfilled the inclusion criteria (7%). Among the ten hits five were case series and the other five single case reports. The syndromic MID most frequently associated with laminar cortical necrosis is the MELAS syndrome, but was also described in a single patient each with Leigh syndrome, mitochondrial depletion syndrome, and mitochondrial spinocerebellar ataxia. The morphological and pathohistological features of laminar cortical necrosis in MIDs were not at variance from those in non-mitochondrial disorders.ConclusionsIn MIDs laminar cortical necrosis represents the histopathological and imaging endpoint of a stroke-like lesion. Though laminar cortical necrosis may have a wide pathophysiological background the histological and imaging characteristics do not vary between the different underlying conditions.Clinical neurology and neurosurgery 10/2009; DOI:10.1016/j.clineuro.2009.07.010 · 1.25 Impact Factor
Article: Thalamic laminar necrosisActa neurologica Belgica 10/2012; 113(2). DOI:10.1007/s13760-012-0148-4 · 0.60 Impact Factor