Neurosurgery
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Case Reports Clinical Trial
Transient late magnetic resonance imaging changes suggesting progression of brain stem glioma: implications for entry criteria for phase II trials.
An 8-year-old boy was treated with irradiation (66 Gy) for a brain stem glioma. Five months after the completion of radiotherapy, magnetic resonance imaging demonstrated apparent tumor progression despite the patient's neurological improvement. The child continued to improve, with subsequent radiographic evidence of tumor regression, without additional therapeutic intervention. The evaluations of response and recurrence of brain tumors as well as entry criteria for Phase II studies are discussed.
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Low velocity firearm damage to the upper cervical spine without neurological deficit occurs infrequently. Four cases of gunshot fragments involving the anterior elements of C1 and C2 are presented. In all four cases, the fragments were removed via a transoral approach without neurological complications or mechanical instability.