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Jiang Q, Tao B, Gao G, Sun M, Wang H, Li J, Wang Z, Shang A. Filum Terminale: A Comprehensive Review with Anatomical, Pathological, and Surgical Considerations. World Neurosurg 2022; 164:167-176. [PMID: 35500871 DOI: 10.1016/j.wneu.2022.04.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 11/28/2022]
Abstract
The conus medullaris is the distal tapering end of the spinal cord, and the filum terminale (FT) is regarded as a bundle of non-functional fibrous tissue; therefore, some scholars call it the spinal ligament, while others describe the human FT as "remnants of the spinal cord." It was later found that in the human spinal cord, the FT is composed of an intradural segment and an epidural segment, and the end of the FT is connected to the coccyx periosteum. Because some nerve tissue is also found in the FT, as research progresses, FT may have the potential for transplantation. A lack of exhaustive overviews on the FT in the present literature prompted us to conduct this review. Considering that a current comprehensive review seemed to be the need of the hour, herein, we attempted to summarize previous research and theories on the FT, elucidate its anatomy, and understand its pathological involvement in various diseases.
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Affiliation(s)
- Qingyu Jiang
- Chinese PLA Medical School, Beijing 100853, China
| | - Benzhang Tao
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China; Tianjin Medical University
| | - Gan Gao
- Chinese PLA Medical School, Beijing 100853, China
| | - Mengchun Sun
- Chinese PLA Medical School, Beijing 100853, China; Medical School, Nankai University, Nankai District, Tianjin, China
| | - Hui Wang
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Junyang Li
- Chinese PLA Medical School, Beijing 100853, China; Medical School, Nankai University, Nankai District, Tianjin, China
| | | | - Aijia Shang
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China.
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Fujii Y, Nishisho T, Tezuka F, Iwanami A, Yamashita K, Toki S, Morimoto M, Sugiura K, Sakai T, Maeda T, Sairyo K. Hemangioblastoma of the Cauda Equina : A Case Report and Review of the Literature. THE JOURNAL OF MEDICAL INVESTIGATION 2022; 69:312-315. [PMID: 36244787 DOI: 10.2152/jmi.69.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Introduction : Hemangioblastoma in the spine mainly occurs at the cervical and thoracic levels and is often associated with von Hippel-Lindau (VHL) syndrome. Here, we reported a quite rare case of spinal sporadic hemangioblastoma arising from the cauda equina. Case presentation : A 66-year-old woman presented with a 5-year history of low back and leg pain. Imaging revealed a hypervascular intradural extramedullary tumor in the lumbar region. Preoperative angiography helped to identify the feeding arteries and draining vein, and so facilitated subsequent tumor resection. The pain was dramatically improved but weakness of the left tibialis anterior and left extensor hallucis longus muscles persisted. Discussion : We reported a rare case of spinal hemangioblastoma arising from the cauda equina. Preoperative angiography may be useful for diagnosis and understanding of the anatomy of feeding veins. J. Med. Invest. 69 : 312-315, August, 2022.
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Affiliation(s)
- Yugen Fujii
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Toshihiko Nishisho
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Fumitake Tezuka
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Akio Iwanami
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
- Department of Orthopaedic Surgery, Spine Center, Koga Hospital, Koga, Ibaraki, Japan
| | - Kazuta Yamashita
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Shunichi Toki
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Masatoshi Morimoto
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Kosuke Sugiura
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Toshinori Sakai
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Toru Maeda
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
| | - Koichi Sairyo
- Department of Orthopedics, Tokushima University, Tokushima, Tokushima, Japan
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Primary Intradural Extramedullary Sporadic Spinal Hemangioblastomas: Case Report and Systematic Review. World Neurosurg 2021; 152:84-94. [PMID: 34087464 DOI: 10.1016/j.wneu.2021.05.105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Hemangioblastomas are benign vascular neoplasms of the central nervous system that may occur sporadically or in association with Von Hippel-Lindau disease. A minority of these lesions can occur in the spine, mostly as intramedullary masses. The authors present a rare case of primary sporadic spinal hemangioblastoma occurring as an intradural extramedullary (IDEM) lesion. Diagnostic workup and surgical management of the patient are described. METHODS A systematic MEDLINE search was conducted using the keywords "hemangioblastoma" and "intradural extramedullary," "extramedullary," or "cauda equina." Clinicopathological characteristics and outcomes of the present case were reviewed and compared with those in the literature. RESULTS A 72-year-old man was found to have an IDEM lesion in his cervical spine after presenting with neck and shoulder pain. Gross total resection was successfully performed with sacrifice of an involved dorsal nerve rootlet. Screening for Von Hippel-Lindau was negative. Thirty-three additional patients with sporadic IDEM hemangioblastomas are reported in the literature. There was a slight male preponderance (54%) with a median age of 52 years. Patients presented with pain (54%), radiculopathy (33%), or myelopathy (32%). The majority of lesions were located in the lumbosacral spine (56%). All patients underwent maximal safe resection with stable or improved clinical status. CONCLUSION Primary IDEM hemangioblastomas are a rare entity. Differential diagnosis includes other IDEM lesions, such as schwannomas, meningiomas, or some vascular malformations. Resection of these sporadic tumors can be safely performed and result in improvement of neurologic deficits associated with mass effect from the tumor with low likelihood of recurrence.
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Marchesini N, Ricci UM, Pinna G. Sporadic cauda equina hemangioblastoma: surgical management in a pregnant woman. Br J Neurosurg 2021; 37:1-5. [PMID: 33877021 DOI: 10.1080/02688697.2021.1914820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
Abstract
Hemangioblastoma is a rare benign vascular tumour of the central nervous system that occurs either sporadically or in association with Von Hippel-Lindau syndrome. Hemangioblastoma can be found throughout the central nervous system and usually present with late manifestations due to their slow growth rate. Cauda equina hemangioblastomas are extremely rare, and in the literature, no cases are reported on the surgical management of pregnant patients with this condition. We report the case of a young woman with back pain and sphincter dysfunctions in whom an L1-L2 hemangioblastoma was diagnosed. We describe the perioperative and surgical strategies we adopted to successfully treat the patient and preserve the fetus well-being.
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Affiliation(s)
- Nicolò Marchesini
- Department of Neurosurgery, Borgo Trento Hospital, University of Verona, Verona, Italy
| | - Umberto Maria Ricci
- Department of Neurosurgery, Borgo Trento Hospital, AOUI Verona, Verona, Italy
| | - Giampietro Pinna
- Department of Neurosurgery, Borgo Trento Hospital, AOUI Verona, Verona, Italy
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Evzikov GY, Konovalov NA, Kushel YV, Timonin SY, Argylova VN. [Hemangioblastomas of the filum terminale and cauda equina]. ZHURNAL VOPROSY NEĬROKHIRURGII IMENI N. N. BURDENKO 2021; 85:60-66. [PMID: 33864669 DOI: 10.17116/neiro20218502160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hemangioblastoma of the filum terminale and cauda equina is a rare tumor of nervous system. There are only few case reports in the literature. In this manuscript, the authors analyze the diagnosis and treatment of patients with this disease. MRI data and intraoperative images of stage-by-stage resection allow one to get an idea about radiological characteristics of hemangioblastoma of the filum terminale and surgical intervention. The authors discuss the world experience of surgical treatment and consider intraoperative complications.
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Affiliation(s)
- G Yu Evzikov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | - Yu V Kushel
- Burdenko Neurosurgical Center, Moscow, Russia
| | | | - V N Argylova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Chen X, Xu G, Bi Q, Huang Y, Shao H, Jin M, Mesfin A, Zhang J. Cauda Equina Syndrome as First Manifestation of von Hippel-Lindau Disease. World Neurosurg 2019; 125:316-319. [DOI: 10.1016/j.wneu.2019.01.269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 01/25/2019] [Accepted: 01/29/2019] [Indexed: 11/16/2022]
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da Mota Silveira Rodrigues A, Simões Fernandes F, Farage L, Almeida Prado Franceschi LE, de Fátima Brito Vogt M, Zaconeta AM. Pregnancy-induced growth of a spinal hemangioblastoma: presumed mechanisms and their implications for therapeutic approaches. Int J Womens Health 2018; 10:325-328. [PMID: 29950904 PMCID: PMC6016583 DOI: 10.2147/ijwh.s166216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Hemangioblastomas are benign tumors of the central nervous system (CNS) that may occur either sporadically or as part of von Hippel-Lindau (VHL) disease, in which they coexist with a series of other tumors outside the CNS. Because of their low mitosis rate, hemangioblastomas usually have slow-growing and late manifestations, but may cause sudden neurological symptoms if tumor hemorrhage occurs. Few studies have evaluated the impact of pregnancy on the evolution of hemangioblastomas. Some authors have reported tumor growth in women with VHL disease, but no such association was observed by others. The influence of pregnancy on sporadic hemangioblastomas remains largely unexplored. We report here the case of a pregnant woman whose first manifestation of sporadic spinal hemangioblastoma was life-threatening, rapidly progressive dysautonomia. In addition, we discuss the role of pregnancy in the triggering of symptoms, as well as the possibility of medically indicated delivery for the management of these tumors.
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Affiliation(s)
| | | | - Luciano Farage
- Faculty of Medicine, University of Brasília, Brasília, Brazil
| | | | - Maria de Fátima Brito Vogt
- Department of Gynecology and Obstetrics, University Hospital of Brasilia, University of Brasília, Brasília, Brazil
| | - Alberto Moreno Zaconeta
- Department of Gynecology and Obstetrics, University Hospital of Brasilia, University of Brasília, Brasília, Brazil
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Extraneuraxial Hemangioblastoma: Clinicopathologic Features and Review of the Literature. Adv Anat Pathol 2018; 25:197-215. [PMID: 29189208 DOI: 10.1097/pap.0000000000000176] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Extraneuraxial hemangioblastoma occurs in nervous paraneuraxial structures, somatic tissues, and visceral organs, as part of von Hippel-Lindau disease (VHLD) or in sporadic cases. The VHL gene plausibly plays a key role in the initiation and tumorigenesis of both central nervous system and extraneuraxial hemangioblastoma, therefore, the underlying molecular and genetic mechanisms of the tumor growth are initially reviewed. The clinical criteria for the diagnosis of VHLD are summarized, with emphasis on the distinction of sporadic hemangioblastoma from the form fruste of VHLD (eg, hemangioblastoma-only VHLD). The world literature on the topic of extraneuraxial hemangioblastomas has been comprehensively reviewed with ∼200 cases reported to date: up to 140 paraneuraxial, mostly of proximal spinal nerve roots, and 65 peripheral, 15 of soft tissue, 6 peripheral nerve, 5 bone, and 39 of internal viscera, including 26 renal and 13 nonrenal. A handful of possible yet uncertain cases from older literature are not included in this review. The clinicopathologic features of extraneuraxial hemangioblastoma are selectively presented by anatomic site of origin, and the differential diagnosis is emphasized in these subsets. Reference is made also to 10 of the authors' personal cases of extraneuraxial hemangioblastomas, which include 4 paraneuraxial and 6 peripheral (2 soft tissue hemangioblastoma and 4 renal).
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Blaty D, Malos M, Palmrose T, McGirr S. Sporadic Intradural Extramedullary Hemangioblastoma of the Cauda Equina: Case Report and Literature Review. World Neurosurg 2018; 109:436-441. [DOI: 10.1016/j.wneu.2017.10.104] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 10/17/2017] [Accepted: 10/20/2017] [Indexed: 10/18/2022]
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Accelerated growth of hemangioblastoma in pregnancy: the role of proangiogenic factors and upregulation of hypoxia-inducible factor (HIF) in a non-oxygen-dependent pathway. Neurosurg Rev 2017; 42:209-226. [DOI: 10.1007/s10143-017-0910-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 09/16/2017] [Accepted: 09/19/2017] [Indexed: 12/28/2022]
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Nishimura Y, Hara M, Natsume A, Takemoto M, Fukuyama R, Wakabayashi T. Intra-extradural dumbbell-shaped hemangioblastoma manifesting as subarachnoid hemorrhage in the cauda equina. Neurol Med Chir (Tokyo) 2013; 52:659-65. [PMID: 23006882 DOI: 10.2176/nmc.52.659] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 56-year-old man presented with a rare intra-extradural dumbbell-shaped hemangioblastoma in the lumbar spine associated with von Hippel-Lindau (VHL) disease manifesting as subarachnoid hemorrhage. The tumor, which was exiting at the right L2-3 intervertebral foramen, was removed successfully by total facetectomy and posterior spinal fusion at the L2-3 segment. Nine years later, a recurrent tumor due to VHL was also totally removed with minimal neurological complications. Accurate diagnosis of this vascular-rich lesion is essential for developing an adequate surgical strategy. The dumbbell-shaped tumor requires total facetectomy and spinal reconstruction, and care should be taken to preserve the entire nerve root origin by only identifying the affected nerve fascicles at the origin, if possible. Postoperative adhesion must be minimized for second surgery in patients with genetic disease such as VHL, who are likely to suffer recurrence.
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Affiliation(s)
- Yusuke Nishimura
- Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, Japan.
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Ye DY, Bakhtian KD, Asthagiri AR, Lonser RR. Effect of pregnancy on hemangioblastoma development and progression in von Hippel-Lindau disease. J Neurosurg 2012; 117:818-24. [PMID: 22937928 DOI: 10.3171/2012.7.jns12367] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Prior cases suggest that pregnancy increases the development and progression of CNS hemangioblastomas and/or peritumoral cysts. To determine the effect of pregnancy on CNS hemangioblastomas and peritumoral cysts, the authors prospectively evaluated serial clinical and imaging findings in patients with von Hippel-Lindau (VHL) disease who became pregnant and compared findings during pregnancy to findings in the same patients when they were not pregnant as well as to findings from a cohort of VHL patients who did not become pregnant. METHODS Female VHL disease patients enrolled in a prospective natural history study who were of reproductive age (16-35 years at study entrance) were included. Analysis of serial clinical and imaging findings was performed. RESULTS Thirty-six consecutive female VHL disease patients harboring 177 hemangioblastomas were included (mean follow-up [± SD] 7.5 ± 2.3 years). Nine patients (25%) became pregnant (pregnancy cohort). The mean rates of development of new hemangioblastomas and peritumoral cysts in these women during pregnancy (0.4 ± 0.4 tumors/year; 0.1 ± 0.2 cysts/year) did not differ significantly (p > 0.05) from the mean rates in the same group during nonpregnant periods (0.3 ± 0.4 tumors/year; 0.1 ± -0.1 cysts/year) or from the rate in the 27 patients who did not become pregnant (the no-pregnancy cohort: 0.3 ± 0.5 tumors/year; 0.1 ± 0.2 cysts/year). Hemangioblastoma growth rates were similar (p > 0.05) during pregnancy (mean 29.8% ± 42.7% increase in volume per year) compared with during nonpregnant periods (41.4% ± 51.4%) in the pregnancy cohort and the no-pregnancy cohort (34.3% ± 55.3%). Peritumoral cyst growth rates during pregnancy (571.0% ± 887.4%) were similar (p > 0.05) to those of the no-pregnancy cohort (483.9% ± 493.9%), but the rates were significantly higher for women in the pregnancy cohort during nonpregnant periods (2373.6% ± 3392.9%; p < 0.05 for comparison with no-pregnancy cohort). There was no significant difference (p > 0.05) in the need for resection or the mean age at resection between the pregnancy (28% of hemangioblastomas in cohort; mean patient age at resection 30.2 ± 2.6 years) and no-pregnancy cohorts (19%; 32.3 ± 5.6 years). CONCLUSIONS Pregnancy is not associated with increased hemangioblastoma or peritumoral cyst development or progression in patients with VHL disease.
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Affiliation(s)
- Donald Y Ye
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1414, USA
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Hénaux PL, Zemmoura I, Riffaud L, François P, Hamlat A, Brassier G, Morandi X. Surgical treatment of rare cauda equina tumours. Acta Neurochir (Wien) 2011; 153:1787-96. [PMID: 21789588 DOI: 10.1007/s00701-011-1094-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Accepted: 07/14/2011] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cauda equina tumours (CET) are rare and usually benign. Treatment of schwannomas and benign ependymomas, which are the most frequent histopathological types of CET, is now well established. However, management of other presumed histopathological types of CET is still a matter of debate. The aim of this study was to assess the incidence and the surgical treatment of rare CET. METHOD A retrospective study was carried out on 176 adult patients surgically treated for CET in our two departments from 1994 to 2010. We reviewed pre- and postoperative symptoms, magnetic resonance imaging aspects, surgical findings, outcome including operative neurological morbidity, local recurrence rate and operative mortality, and incidence of rare CET. FINDINGS Seventeen percent (30 patients) of CETs operated on were neither schwannomas nor benign ependymomas. Half of these cases were benign tumours, with paragangliomas being the most common. Two patients were in poorer clinical condition after surgery, one patient experienced a local recurrence, and one died following surgery, from the progress of his disease (Von Hippel-Lindau disease). The other half were malignant tumours, with metastases being the most common. One third of the patients were worsened by surgery, and the mortality rate was 1/3 at 8 months (1-27 months). CONCLUSIONS Roughly one in six CET were neither schwannomas nor benign ependymomas. This study demonstrated the efficiency of surgery for rare benign CET with a low local recurrence rate. Surgical treatment of rare malignant CET led to a high rate of increased postoperative neurological deficit in patients with a reduced life expectancy.
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Affiliation(s)
- Pierre-Louis Hénaux
- Department of Neurosurgery, Pontchaillou University Hospital, Rennes, France.
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Lee JH, Kim JU, Paeng SS, Jang JS, Lee SH. Solitary Hemangioblastoma at the Filum Terminale: A Case Report and Review of Literature. KOREAN JOURNAL OF SPINE 2011. [DOI: 10.14245/kjs.2011.8.2.125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Jung-Hoon Lee
- Department of Neurosurgery, Seoul Wooridul Hospital, Seoul, Korea
| | - Jin-Uk Kim
- Department of Orthopaedic Surgery, Seoul Wooridul Hospital, Seoul, Korea
| | - Sung-Suk Paeng
- Department of Pathology, Seoul Wooridul Hospital, Seoul, Korea
| | - Jee-Soo Jang
- Department of Neurosurgery, Seoul Wooridul Hospital, Seoul, Korea
| | - Sang-Ho Lee
- Department of Neurosurgery, Seoul Wooridul Hospital, Seoul, Korea
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KUNIHIRO N, TAKAMI T, YAMAGATA T, TSUYUGUCHI N, OHATA K. Spinal Hemangioblastoma of Cauda Equina Origin Not Associated With Von Hippel-Lindau Syndrome -Case Report-. Neurol Med Chir (Tokyo) 2011; 51:732-5. [DOI: 10.2176/nmc.51.732] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Noritsugu KUNIHIRO
- Department of Neurosurgery, Osaka City University Graduate School of Medicine
| | - Toshihiro TAKAMI
- Department of Neurosurgery, Osaka City University Graduate School of Medicine
| | - Toru YAMAGATA
- Department of Neurosurgery, Osaka City University Graduate School of Medicine
| | - Naohiro TSUYUGUCHI
- Department of Neurosurgery, Osaka City University Graduate School of Medicine
| | - Kenji OHATA
- Department of Neurosurgery, Osaka City University Graduate School of Medicine
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Delgado Capel M, Mourelo S, Cannata P. [A 38-year-old woman with polyglobulia and a abdominal mass]. Med Clin (Barc) 2010; 134:116-22. [PMID: 19500806 DOI: 10.1016/j.medcli.2009.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2009] [Accepted: 03/06/2009] [Indexed: 11/26/2022]
Affiliation(s)
- María Delgado Capel
- Servicio de Medicina Interna, Hospital de Mataró, Mataró, Barcelona, España.
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Mandigo CE, Ogden AT, Angevine PD, McCormick PC. OPERATIVE MANAGEMENT OF SPINAL HEMANGIOBLASTOMA. Neurosurgery 2009; 65:1166-77. [DOI: 10.1227/01.neu.0000359306.74674.c4] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
HEMANGIOBLASTOMAS OCCUR IN 2% to 15% of reported series of intramedullary spinal cord tumors. They are benign, highly vascular tumors that can be cured with surgical resection. Complete removal of these tumors with low morbidity is possible with current microneurosurgical techniques and a thorough understanding of the typical relationship of the tumor to adjacent neural structures. We describe our experience with 16 intramedullary and 2 lumbosacral nerve root hemangioblastomas and review the relevant published literature. A detailed discussion of the operative technique is provided along with an operative video. Three illustrative cases are used to demonstrate clinical considerations that can arise with these tumors, including surgery during pregnancy, symptoms related to syrinx or syringomyelia, and postoperative consequences of neurological deficits.
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Affiliation(s)
- Christopher E. Mandigo
- Department of Neurological Surgery, Columbia University College of Physicians and Surgeons, New York, New York
| | - Alfred T. Ogden
- Department of Neurological Surgery, Columbia University College of Physicians and Surgeons, New York, New York
| | - Peter D. Angevine
- Department of Neurological Surgery, Columbia University College of Physicians and Surgeons, New York, New York
| | - Paul C. McCormick
- Department of Neurological Surgery, Columbia University College of Physicians and Surgeons, New York, New York
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Hayden MG, Gephart R, Kalanithi P, Chou D. Von Hippel-Lindau disease in pregnancy: A brief review. J Clin Neurosci 2009; 16:611-3. [DOI: 10.1016/j.jocn.2008.05.032] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Revised: 05/19/2008] [Accepted: 05/22/2008] [Indexed: 11/29/2022]
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