Subependymoma of the spine

Subependymoma is a rare benign CNS tumor [WHO grade I]. The common sites of origin for this type of tumor are the lateral and the fourth ventricles. A spinal intramedullary location is rare. Radiological features of intramedullary subependymoma can mimic more common and more aggressive tumor types. We report a case of a 61-year-old male who presented with a 3-year history of low back pain, associated with right lower limb progressive weakness and sensory numbness. An MRI of the lumbar spine revealed an intradural intramedullary lesion extending from the level of T10-L1. Clinical presentation, radiological, and pathological studies of this case of subependymoma are presented. The incidence of spinal subependymoma was also discussed in light of a literature review

Diagnostic yield of stereotactic brain biopsy

To evaluate the diagnostic yield, accuracy, and safety of frame-based stereotactic brain biopsy procedures. A retrospective study of all pathologically diagnosed intracranial lesions, using frame-based stereotactic guided brain biopsy procedures performed at King Faisal Specialist Hospital and Research Centre [KFSH and RC], Riyadh, Kingdom of Saudi Arabia between 1993 and 2005 was conducted. Medical charts, radiological studies, and pathological slides were reviewed. A total of 120 consecutive patients who had frame-based stereotactic diagnostic biopsy procedures were identified. Data regarding procedural techniques, lesion locations, pathological diagnosis, and postoperative complications were collected. Patients' ages ranged from 3-72 years [mean +/- standard deviation: 39.4 +/- 20.3], 67 males and 53 females. Sites of biopsied lesions included: 49 thalamic, 29 deep frontal, 23 parietal, 9 temporal, and 10 others. Targeting accuracy was 99.2%. General anesthesia was used in 103 patients [85.8%]. The rest was carried out under local anesthesia. Diagnostic yield was estimated at 96%. Most frequently encountered pathological diagnosis includes gliomas [63%], infections [16%], and lymphomas [7%]. One mortality [0.8%], and 5 [4%] morbidities were encountered. Stereotactic brain biopsy is a relatively safe technique to obtain a tissue biopsy that represents the pathology of the lesion. Recent advances in stereotactic neurosurgical techniques have helped to improve the safety and diagnostic yield of such procedures