Current opinion in neurology
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Curr. Opin. Neurol. · Dec 2009
ReviewPseudoprogression and pseudoresponse in the treatment of gliomas.
Treatment response of brain tumours is typically evaluated with gadolinium-enhanced MRI using the Macdonald criteria. These criteria depend on changes in the area of enhancement. However, gadolinium enhancement of brain tumours primarily reflects impairment of the blood-brain barrier. ⋯ Both pseudo-phenomenona confuse the assessment of outcome of brain tumours in clinical practice and in clinical trials. To overcome these issues, alternative endpoints and response criteria are being developed by an international working party [response assessment in neuro-oncology (RANO)]. It is as yet unclear to what extent alternative imaging tools (positron emission tomography and MRI techniques) provide more reliable indicators of outcome.
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Curr. Opin. Neurol. · Dec 2009
ReviewManagement of cervical spondylotic myelopathy with insights from metabolic imaging of the spinal cord and brain.
Cervical spondylotic myelopathy (CSM) is a potentially debilitating disorder primarily related to spinal cord injury caused by degenerative changes of the spine. As the population continues to age and live longer, it is likely that this disorder will be encountered with increasing frequency. ⋯ CSM is a complex disorder whose incidence is likely to increase in coming years. Prospective, randomized studies are required to help establish the optimal treatment paradigm. Recent advances such as novel neuroimaging techniques and the continued development of neural repair strategies to treat the secondary biological injury associated with this disorder are likely to play key roles in the future management of CSM.