Imaging characteristics and growth of subependymal giant cell astrocytomas

Clarke, Michelle J.; Foy, Andrew B.; Wetjen, Nicholas M.; Raffel, Corey

doi:10.3171/foc.2006.20.1.6

Cited by 43 publications

(26 citation statements)

References 14 publications

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“…Currently, a SEN that exceeds 1 cm in diameter, enhances with gadolinium contrast enhancement, and is not calcified is considered at high-risk for developing into a SEGA, although there is both a pathologic and a radiologic continuum between the two [70]. Early differentiation of SEGAs from SENs before the foramen of Monro is obstructed may provide opportunity to prevent hydrocephalus and associated morbidity and mortality [71,72].…”

Section: Structural Cns Abnormalities and Dtimentioning

confidence: 99%

Diffusion Tensor Imaging and Related Techniques In Tuberous Sclerosis Complex: Review and Future Directions

et al. 2013

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In this article, the authors aim to introduce the nonradiologist to diffusion tensor imaging (DTI) and its applications to both clinical and research aspects of tuberous sclerosis complex. Tuberous sclerosis complex is a genetic neurocutaneous syndrome with variable and unpredictable neurological comorbidity that includes refractory epilepsy, intellectual disability, behavioral abnormalities and autism spectrum disorder. DTI is a method for modeling water diffusion in tissue and can noninvasively characterize microstructural properties of the brain. In tuberous sclerosis complex, DTI measures reflect well-known pathological changes. Clinically, DTI can assist with detecting the epileptogenic tuber. For research, DTI has a putative role in identifying potential disease biomarkers, as DTI abnormalities of the white matter are associated with neurocognitive morbidity including autism. If indeed DTI changes parallel phenotypical changes related to the investigational treatment of epilepsy, cognition and behavior with mTOR inhibitors, it will facilitate future clinical trials.

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Section: Structural Cns Abnormalities and Dtimentioning

confidence: 99%

Diffusion Tensor Imaging and Related Techniques In Tuberous Sclerosis Complex: Review and Future Directions

et al. 2013

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“…2 When the clinical signs of TS are evident, an early diagnosis of SEGAs is common. However, in cases with no evidence of TS, SEGAs almost always present urgently 3,4 due to elevated intracranial pressure.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] The prognostic implications are obvious, and the diagnostic challenge becomes one of differentiating an additional and new process within the peripheral motor unit from the benign focal muscular atrophy of MS.…”

Section: Introductionmentioning

confidence: 99%

Subependymal giant cell astrocytoma with intratumoral hemorrhage in the absence of tuberous sclerosis

Stavrinou

Spiliotopoulos

Patsalas

et al. 2008

Journal of Clinical Neuroscience

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“…[10][11][12]19,24,35,37 The most common clinical presentation is elevated ICP due to CSF obstruction at one or both foramina of Monro. Cases of sudden death have been reported.…”

Section: Discussionmentioning

confidence: 99%

A management strategy for intraventricular subependymal giant cell astrocytomas in tuberous sclerosis complex

Harter¹,

Bassani²,

Rodgers³

et al. 2014

PED

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Object Subependymal giant cell astrocytomas (SEGAs) are benign tumors, most commonly associated with tuberous sclerosis complex (TSC). The vast majority of these tumors arise from the lateral ependymal surface adjacent to the foramen of Monro, therefore potentially encroaching on one or both foramina, and resulting in obstructive hydrocephalus that necessitates surgical decompression. The indications for surgery, intraoperative considerations, and evolution of the authors' management paradigm are presented. Methods Patients with TSC who underwent craniotomy for SEGA resection at New York University Langone Medical Center between January 1997 and March 2011 were identified. Preoperative imaging, clinical characteristics, management decisions, operative procedures, and outcomes were reviewed. Results Eighteen patients with TSC underwent 22 primary tumor resections for SEGAs. The indication for surgery was meaningful radiographic tumor progression in 16 of 21 cases. The average age at the time of operation was 10.3 years. Average follow-up duration was 52 months (range 12–124 months). The operative approach was intrahemispheric-transcallosal in 16 cases, transcortical-transventricular in 5, and neuroendoscopic in 1. Nine tumors were on the right, 9 on the left, and 3 were bilateral. Gross-total resection was documented in 16 of 22 cases in our series, with radical subtotal resection achieved in 4 cases, and subtotal resection (STR) in 2 cases. Two patients had undergone ventriculoperitoneal shunt placement preoperatively and 7 patients required shunt placement after surgery for moderate to severe ventriculomegaly. Two patients experienced tumor progression requiring reoperation; both of these patients had initially undergone STR. Conclusions The authors present their management strategy for TSC patients with SEGAs. Select patients underwent microsurgical resection of SEGAs with acceptable morbidity. Gross-total resection or radical STR was achieved in 90.9% of our series (20 of 22 primary tumor resections), with no recurrences in this group. Approximately half of our patient series required CSF diversionary procedures. There were no instances of permanent neurological morbidity associated with surgery.

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Imaging characteristics and growth of subependymal giant cell astrocytomas

Cited by 43 publications

References 14 publications

Diffusion Tensor Imaging and Related Techniques In Tuberous Sclerosis Complex: Review and Future Directions

Diffusion Tensor Imaging and Related Techniques In Tuberous Sclerosis Complex: Review and Future Directions

Subependymal giant cell astrocytoma with intratumoral hemorrhage in the absence of tuberous sclerosis

A management strategy for intraventricular subependymal giant cell astrocytomas in tuberous sclerosis complex

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