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Amyotrophic lateral sclerosis
von Hippel-Lindau disease
Acoustic neuroma (schwannoma)
Adult brain tumors
Pediatric brain tumors
Transient ischemic attack
Cavernous sinus thrombosis
Spinocerebellar ataxia (NORD)
Tethered spinal cord syndrome
Lewy body dementia
Normal pressure hydrocephalus
Acute disseminated encephalomyelitis
Central pontine myelinolysis
JC virus (Progressive multifocal leukoencephalopathy)
Idiopathic intracranial hypertension
Opsoclonus myoclonus syndrome (NORD)
Restless legs syndrome
Early infantile epileptic encephalopathy (NORD)
Cauda equina syndrome
Treponema pallidum (Syphilis)
Vitamin B12 deficiency
Concussion and traumatic brain injury
Spinal muscular atrophy
Carpal tunnel syndrome
Thoracic outlet syndrome
Lambert-Eaton myasthenic syndrome
Adult brain tumors: Pathology review
Central nervous system infections: Pathology review
Cerebral vascular disease: Pathology review
Congenital neurological disorders: Pathology review
Dementia: Pathology review
Demyelinating disorders: Pathology review
Headaches: Pathology review
Movement disorders: Pathology review
Neurocutaneous disorders: Pathology review
Neuromuscular junction disorders: Pathology review
Pediatric brain tumors: Pathology review
Seizures: Pathology review
Spinal cord disorders: Pathology review
Traumatic brain injury: Pathology review
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Pediatric CNS Tumors
Pediatric brain tumors are masses of abnormal cells that generally occur in children, and result from the uncontrolled growth of those cells within the brain.
OK - let’s start with some basic brain anatomy. First off, there’s the cerebral cortex which is the part of the brain that’s supratentorial or above the tentorium, and the cerebellum, which is infratentorial or below the tentorium.
And the brain has four interconnected cavities called ventricles, which are filled with cerebrospinal fluid - a fluid that helps provide buoyancy and protection, as well as metabolic fuel for the brain.
Highest up, are two C-shaped lateral ventricles that lie deep in each cerebral hemisphere.
The two lateral ventricles drain their cerebrospinal fluid into the third ventricle, which is a narrow, funnel-shaped, cavity at the center of the brain.
The third ventricle makes a bit more cerebrospinal fluid and then sends all of it to the fourth ventricle via the cerebral aqueduct.
The fourth ventricle is a tent-shaped cavity located between the brainstem and the cerebellum.
After the fourth ventricle, the cerebrospinal fluid enters the subarachnoid space, which is the space between the arachnoid and pia mater, two of the inner linings of the meninges which cover and protect both the brain and the spine.
So this makes it possible for cerebrospinal fluid to also flow through the central canal of the spine.
Now, focusing in on cells within the brain - there are many different types with specialized functions.
For example, neurons communicate neurologic information through neurotransmitter regulated electrical impulses.
Then there are cells that secrete hormones into circulation and regulate the functions of other cells throughout the body.
These cells are found in glands, like the supratentorial pineal gland which is located just behind the third ventricle. Or the infratentorial pituitary gland located near the front of the third ventricle.
There is also a category of cells called neuroglial cells that help support brain homeostasis, and neuronal functions.
These include astrocytes which have cellular processes coming off their cell body, giving them a star-shaped appearance.
Astrocytes are found throughout the brain and spinal cord, and their main roles include maintaining the blood-brain barrier, providing nourishment to neurons, and recycling neurotransmitters.
Ependymal cells are also neuroglial cells, and they’re cuboidal-to-columnar - so square to rectangular shaped - ciliated cells that line the ventricles and central canal.
One of their main roles is to regulate the circulation of cerebrospinal fluid.
Some brain cells have a limited ability to be replaced, especially during injury, and they do it by having undifferentiated stem cells - called embryonic stem cells - in the brain activate and mature into a specialized cell.
Now, a tumor develops if there’s a DNA mutation in any of these cell types that leads to uncontrolled cell division.
Typically these are mutations in proto-oncogenes which results in a promotion of cell division, or mutations in tumor suppressor genes which results in a loss of inhibition of cell division.
Pediatric brain tumors are a group of tumors that occur in the brain of children and adolescents. They can be benign or malignant, infratentorial, or supratentorial depending on whether they are located above or below the tentorium cerebelli.
Common pediatric brain tumors include astrocytomas, medulloblastomas, and ependymomas. The diagnosis involves medical imaging, with a definitive diagnosis being made with a tissue biopsy. Treatment depends on the tumor type, tumor grade, and accessibility, and can incorporate surgical removal and some combination of radiotherapy and chemotherapy.
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