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Vth,VIth,VIIth,VIIIth,IXth
Xth,XIth,XIIth nerve and
brainstem encased
tumor→difficult total
removal
FALX PARASAGITAL
Sinus
Sagitalis
Superior
encased
MENINGIOMA SPHENOID WING
Post ops
TUMOR SPINAL
Meningothelial meningioma
Glioma / Astrocytoma
Intrinsic tumors, no clear border with the surrounding brain
There is a ‘continuum’ from the benign to the most malignant GBM
Benign (children) and malignant (adult).
Tend to dedifferentiate/ change toward higher grade
Malignant : aggressive biological behavior and grave prognosis
Low grade tumor relatively avascular and fibrous
High grade = nuclear pleomorphism & anaplastic astro=mitosis,
and GBM=endothelial proliferation & central necrosis
Invade the whole hemisphere, called Gliomatosis Cerebri
Calcium deposit (15%)
Distribution
WHO Grade II Grade III Grade IV
LOCATION :
Supratentorial 75.6% 90.0% 95.4%
Infratentorial 24.4% 10.0% 4.6%
Survival rate
in supratentorial glioma
CT pattern 1Y 5Y 1Y 5Y 1Y 5Y
precontrast
lowdensity 16.8 7.8 3.4 0.2 0.8 0.2
Isodensity 14.2 8.4 5.1 2.1 1.4 4.3
High-densi 12.8 8.6 8.0 8.9 5.1 19.4
Mixed-den 18.8 19.3 14.4 17.8 14.1 25.8
others 17.0 20.5 19.6 26.7 26.3 23.5
Histologic Classification Astrocytoma
Astocytoma
AWAKE
SURGERY=malignant tumor in eloquent area
Trageting therapy
CD 133 (CD in Cancer Stem Cell of brain tumor)
Experimental Vaccine Targets Cancer Stem Cells in Brain Tumors
John Yu, vice chair of the Department of Neurosurgery, director of surgical neuro-oncology, medical
director of the Brain Tumor Center and neurosurgical director of the Gamma Knife Program at
Cedars-Sinai.
CHROMOSOMES ANALYSE
GENE THERAPY
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