{"title":"Primary Brain Tumors in Childhood","authors":"R. Richterová, B. Kolarovszki","doi":"10.5772/INTECHOPEN.74510","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.74510","url":null,"abstract":"This chapter offers literary review of most frequently observed brain tumors in child - hood. It offers basics of epidemiology, clinical presentation and diagnostics of most often occurring types of tumors according to new WHO classification of brain tumors from 2016 and emphasizes molecular biological characteristics and role of altered genes and genetic pathways in brain tumor etiology, classification and treatment. This review not only concentrates on gliomas, medulloblastomas and ependymomas, but also offers characterization of other less frequently observed lesions. Each tumor characteristics also contains basics of therapeutical possibilities of these lesions with focus on targeted and individually designed therapy according to molecular and genetic alterations found in tumor tissue sample.","PeriodicalId":117964,"journal":{"name":"Brain Tumors - An Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127352534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Neuropsychiatry: Aspects of Childhood Cranial Tumours","authors":"Alexander Hegarty and Yulia Furlong","doi":"10.5772/INTECHOPEN.75679","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.75679","url":null,"abstract":"More than 90 years have passed since Baily and Cushing first introduced a histogenetic classification for tumours of the cranial nervous system (CNS). More recently, our knowl edge of the genetic and molecular basis of tumorigenesis has caused a major paradigm shift towards defining tumours genetically, thus allowing greater diagnostic accuracy and prog nostication to better guide tumour management. Correspondingly, successes in integrated management and improved survival rates have shifted attention towards overall quality of life studies, where psychosocial sequelae and adjustment implications are of particular interest to mental health professionals. To date, research relevant to this field has focused on the identification of neuropsychiatric symptoms at manifestation of illness. Such studies indicate that mood, cognition and psychosocial functioning are important factors in early diagnosis, mediating health outcomes, especially following radical and risk-adapted anti- neoplastic treatment. In addition to psychological burden, the neuropsychiatric aspects of childhood CNS tumours, including posterior fossa syndrome and cerebellar cognitive affective syndrome, are increasingly recognised as crucial causes of poor outcomes. The chapter ahead will initially address the shifting landscape of neuro-oncology, and then provide an overview of the neuropsychiatric aspects of CNS tumours in childhood, high lighting the underlying neurobiological and pathogenic mechanisms, whenever possible. syndrome, posterior fossa syndrome, cerebellar mutism, neuropsychiatric presentation, neuropsychiatric","PeriodicalId":117964,"journal":{"name":"Brain Tumors - An Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125544073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vestibular Schwannoma: Microsurgery or Radiosurgery","authors":"A. Rizk","doi":"10.5772/INTECHOPEN.74508","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.74508","url":null,"abstract":"A vestibular schwannoma (VS) is a benign tumor that arises from the neurilemmal sheath of the vestibular nerve. VSs make up to 6–8% of all intracranial tumors and 70–80% of all cerebellopontine angle tumors. Three therapeutic options are currently considered for VS: expectant treatment, microsurgical resection, and radiosurgery. No class I evidence exists to support one treatment over the others, and some clinical aspects are usually taken into consideration in the decision-making process. Very few comparative studies published so far have addressed the clinical aspects supporting any one treatment modality. The pathology, diagnosis and treatment of VS are discussed in this chapter. Moreover, we aim in this chapter to discuss the results of the most recent clinical studies performed on different treatment strategies for VS. In addition, the results of the comparative studies between microsurgical and radiosurgical treatments for VS are discussed.","PeriodicalId":117964,"journal":{"name":"Brain Tumors - An Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129668571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Breno Nery, Marcelo Nery Silva, Rodrigo Antônio Fernandes Costa, Leandro César Tângari Pereira, Eduardo Quaggio, Fred Bernardes Filho, George Peter Stevens
{"title":"Trigeminal Schwannomas","authors":"Breno Nery, Marcelo Nery Silva, Rodrigo Antônio Fernandes Costa, Leandro César Tângari Pereira, Eduardo Quaggio, Fred Bernardes Filho, George Peter Stevens","doi":"10.1097/01.cne.0000530178.41097.7e","DOIUrl":"https://doi.org/10.1097/01.cne.0000530178.41097.7e","url":null,"abstract":"Trigeminal schwannomas (TS) are rare entities occurring in various trigeminal nerve locations and present a peak incidence between the fourth and fifth decades of life, being more common in women. Patients usually present with symptoms of trigeminal nerve dysfunction. Depending on the tumor’s topography, various approaches might be used to obtain its gross total resection. Trigeminal schwannoma’s classification, nuances of the approaches, pathology, postoperative care, and outcomes are revised as follows. In conclusion, anatomical knowledge and the disease’s comprehension are essential when dealing with such lesions, and despite their rarity, we must be obstinately committed to the surgical technique and devoted to the patient’s functional postoperative outcome.","PeriodicalId":117964,"journal":{"name":"Brain Tumors - An Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128109357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Modern Management of Craniopharyngioma","authors":"Anirudh Penumaka and Ekkehard Kasper","doi":"10.5772/INTECHOPEN.74512","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.74512","url":null,"abstract":"Craniopharyngiomas (CPs) have had a prominent place in neurosurgery due to both the technical difficulty and controversy regarding the optimal treatment of these benign tumors. Harvey Cushing famously described craniopharyngiomas in 1936 as “the most forbidding of the intracranial tumors.” Seventy years later, Rutka still wrote: “There is no other primary brain tumor that evokes more passion, emotion, and as a result, controversy than does the CP.” Craniopharyngiomas comprise 1–2% of all brain tumors and occur in a bimodal distribution, with 40% of cases occurring between age 5–15 years and 60% occurring at ages >55 years. The differential diagnosis for craniopharyngioma can include a variety of entities, including pituitary macroadenoma, metastasis, Rathke’s cleft cyst, colloid cyst, glioma, meningioma, germinoma, abscess, sarcoid, or aneurysm. Imaging characteristics usually include a solid cystic lesion, speckled with calcifications in 50– 80% of craniopharyngiomas (especially pediatric patients), as well a presentation with hypopituitarism and diabetes insipidus, which influence clinical thinking toward establishing this diagnosis.","PeriodicalId":117964,"journal":{"name":"Brain Tumors - An Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128790091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Role of an Alternatively Spliced KCNMA1 Variant in Glioma Growth","authors":"D. Khaitan, N. Ningaraj, L. B. Joshua","doi":"10.5772/INTECHOPEN.74509","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.74509","url":null,"abstract":"Gliomas develop genetic traits to rapidly form aggressive phenotypes. Hence, man- agement of gliomas is complicated and difficult. Besides genetic aberrations such as oncogenic copy number variation and mutations, alternative mRNA splicing triggers prooncogenic episodes in many cancers. In gliomas, we found alternative splicing at the KCNMA transcription process. KCNMA1 encodes the pore forming α-subunit of large-conductance calcium-activated voltage-sensitive potassium (BK Ca ) channels. These channels play critical role in glioma invasion and proliferation. We identified a novel KCNMA1 mRNA splice variant with a deletion of 108 base pairs ( KCNMA1v ) mostly overexpressed in high grade gliomas. We found that KCNMA1 alternative pre-mRNA splicing enhanced glioma growth, progression and diffusion. The role of KCNMA1 and its splicing as a critical posttranscriptional regulator of BK Ca channel expression is pre- sented in this chapter. Our research implies that high grade gliomas express KCNMA1v and BK Ca channel isoform to accelerate growth and transformation to glioblastoma multiforme (GBM). We demonstrated that tumors hardly develop in mice injected with KCNMA1v transfected cell line expressing short-hairpin RNA (shRNA) compared to mice injected with KCNMA1v transected glioma cells. We conclude that targeting the KCNMA1 variants may be a clinically beneficial strategy to prevent or at least slow down glioma transformation to GBM .","PeriodicalId":117964,"journal":{"name":"Brain Tumors - An Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116821710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Medulloblastoma","authors":"Asifur Rahman","doi":"10.5772/intechopen.76783","DOIUrl":"https://doi.org/10.5772/intechopen.76783","url":null,"abstract":"Among the pediatric brain tumors, medulloblastoma (MB) is the most common solid variety and entirely occur in the posterior fossa with tendency to seed into CSF spaces. Despite innovations in technological developments and understanding of tumor biology, modern imaging facilities, advances in surgical practices, and newer chemotherapeutic and radiation techniques, this malignant type of tumor continues to be a formidable entity. Even though, the outcome in terms of survival rate is better than any time before, the overall result is still disappointing. With advances in management strategy, chances of survival with good quality of life have been amplified, where newer targeted thera pies and rehabilitation plays an immense role. While the adverse effects of surgery and adjuvant therapies are still on play, researchers are trying ceaselessly to minimize those to give maximum wellbeing to these unfortunate children.","PeriodicalId":117964,"journal":{"name":"Brain Tumors - An Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126735781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Tătăranu, V. Ciubotaru, T. Cazac, OanaAlexandru, O. Purcaru, D. Tache, S. Artene, A. Dricu
{"title":"Current Trends in Glioblastoma Treatment","authors":"L. Tătăranu, V. Ciubotaru, T. Cazac, OanaAlexandru, O. Purcaru, D. Tache, S. Artene, A. Dricu","doi":"10.5772/INTECHOPEN.75049","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.75049","url":null,"abstract":"Glioblastoma (also called glioblastoma multiforme – GBM) is a primary brain neoplasm, representing about 55% of all gliomas. It is a very aggressive and infiltrative tumor. Glioblastoma is usually highly malignant, with more than 90% 5-year mortality and a median survival of about 14.6 months. Compared to other cancers, the survival rate has not greatly changed over time and no current treatment is curative for this disease. Because the tumor has a heterogeneous cell population containing several types of cells, the treatment for GBM is one of the most challenging in clinical oncology. This chapter will discuss the current approaches in glioblastoma treatment, including resection techniques, chemotherapy and radiation GBM, postoperative reactive changes and parenchymal damage as a result of surgery. Postoperative contrast-enhancing tumor mass is typically used to delineate residual GBM and completeness of removal. It is better to use volumetric analysis of the preopera tive and postoperative tumor to accurately measure EOR and residual volume (RV). Reactive postoperative changes can be seen as early as 18 hours on MRI, but usually does not appear in the first 3–4 days. The EOR was identified as a strong prognostic factor for survival in GBM, together with patient’s age and patient’s functional status. Surgical removal has a critical role in GBM management because the only potentially modifiable risk factor associated with survival is EOR. The gross-total resection is not always possible. Thus, several studies have been conducted to evaluate EOR threshold which may serve as minimum surgical goal to achieve. Other studies demonstrated that EOR is not an ideal indicator to the success of the surgery, because it is a percentage value, reported to initial volume of the tumor, which can vary widely. Contrast-enhancing RV is considered a more clinically relevant measure and a stronger predictor of survival than EOR, representing the tumor mass existing prior to starting medical therapy. Chaichana et al. in 2014 evaluated newly diagnosed GBM patients who","PeriodicalId":117964,"journal":{"name":"Brain Tumors - An Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123891807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Stem Cell Research for the Treatment of Malignant Glioma","authors":"R. Tamura, M. Toda","doi":"10.5772/INTECHOPEN.72504","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.72504","url":null,"abstract":"Glioblastoma is the most aggressive brain tumor. Gene therapies, such as cytokine-based, suicide gene, and oncolytic virus therapies, are different types of treatments from chemo therapy such as using temozolomide as a standard treatment. However, overall survival was not prolonged in some clinical trials because of the low efficiency of gene transduc tion and viral infection. Neural stem cells (NSCs) have tumor trophic migratory capacity and can be cellular delivery vehicles of cytokines, suicide genes, and oncolytic virus. NSCs can be differentiated from embryonic stem cells. In addition, mesenchymal stem cells can be another cellular delivery vehicle. Recently, induced pluripotent stem cells (iPSCs) have been established. iPSCs are multipotent; hence, they can efficiently differentiate to NSCs and can possibly overcome ethical and practical issues in clinical application. In this study, current topics about stem cell therapy for malignant glioma are reviewed.","PeriodicalId":117964,"journal":{"name":"Brain Tumors - An Update","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122076113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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