Mibrain cystic pilocytic astrocytoma

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-05-01 DOI:10.1016/j.jocn.2025.111291

Ali Alkhaibary , Amani AbuHassan , Moutasem Azzubi

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Abstract

Background

Pilocytic astrocytoma is a well-circumscribed tumor of the central nervous system (CNS WHO grade I), commonly affecting children. Pilocytic astrocytoma frequently arises from the cerebellum or cerebrum. Pilocytic astrocytoma arising from the brainstem is rare, accounting for 10 % of the cases. We hereby report a patient with midbrain cystic pilocytic astrocytoma.

Case description

An 8-year-old girl presented with left-sided upper and lower limbs weakness, facial deviation, and multiple episodes of headache and vomiting for one week. The neurological examination revealed a left-sided hemiparesis (Power: 3/5) and facial weakness (House-Brackman II). Brain MRI showed an expansile cystic lesion with a mural nodule in the right side of the midbrain. The patient underwent stereotactic biopsy of the solid lesion and aspiration of the cystic component. The histopathological sections were compatible with pilocytic astrocytoma; CNS WHO grade 1. Post-operatively, the patient’s hemiparesis and facial asymmetry improved immediately. She was commenced on chemotherapy and discharged with periodic clinicoradiological follow-up.

Conclusion

Midbrain cystic pilocytic astrocytoma is rare and is considered a surgical challenge. The present article describes the clinical and radiological appearance of a patient with midbrain cystic pilocytic astrocytoma.

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脑囊性毛细胞星形细胞瘤

毛细胞星形细胞瘤是一种界限明确的中枢神经系统肿瘤（CNS WHO分级I级），常见于儿童。毛细胞星形细胞瘤通常起源于小脑或大脑。起源于脑干的毛细胞星形细胞瘤是罕见的，占病例的10%。我们在此报告一例中脑囊性毛细胞星形细胞瘤。病例描述一名8岁女孩，表现为左侧上肢和下肢无力，面部偏斜，多次发作的头痛和呕吐，持续一周。神经学检查显示左侧偏瘫（Power: 3/5）和面部虚弱（House-Brackman II）。脑MRI显示中脑右侧扩张性囊性病变伴壁结节。患者接受立体定向活检实性病变和囊性成分的抽吸。组织病理切片与毛细胞星形细胞瘤相符；CNS WHO 1级。术后患者偏瘫及面部不对称症状立即改善。患者开始化疗，出院时定期进行临床放射学随访。结论中脑囊性毛细胞星形细胞瘤是一种罕见的肿瘤，被认为是一种手术挑战。本文报告一例中脑囊性毛细胞星形细胞瘤的临床和影像学表现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.