Metastatic meningiomas: an unusual clinical and pathological diagnosis with highly variable outcome.

Metastatic meningioma is a rare situation. We conducted a retrospective study from our databases and identified cases of metastatic meningioma. We report three presentations of patients with medical history of surgical removal of meningioma presenting several years later a liver tumor with bone metastasis or multiple lung tumors.

Early diagnosis of pyridoxine-dependent epilepsy: video-EEG monitoring and biochemical and genetic investigation.

Pyridoxine-dependent epilepsy (PDE) is a rare autosomal recessive metabolic disease. A delay of treatment may affect outcome and early initiation of pyridoxine based on effective diagnosis is crucial to ensure good cognitive outcome in neonates. A consensus for the diagnosis of PDE is based on refractive seizures and responsiveness to pyridoxine, however, a growing body of evidence suggests that additional elements should be considered which include biochemical data, genetic screening, and EEG monitoring.

P-glycoprotein (ABCB1) and breast cancer resistance protein (ABCG2) localize in the microvessels forming the blood-tumor barrier in ependymomas.

Ependymomas are neuroepithelial tumors that arise from the ependymal layer bordering the cerebral ventricles and spinal canal. Intracranial ependymoma represents a major encephalic tumor in children, while spinal ependymoma develops more frequently in adults. To understand the pharmacoresistance that characterizes this tumoral entity, we analyzed the level of expression and localization of three major efflux transport proteins with a multidrug resistance function, P-glycoprotein, multidrug resistance-related protein 1 (MRP1) and breast cancer resistance protein (BCRP), in a series of 25 ependymomas from both children and adults.

The parallel use of endoscopic fenestration and a cystoperitoneal shunt with programmable valve to treat arachnoid cysts: experience and hypothesis.

Object: The authors share their experience of the treatment of arachnoid cysts with endoscopic fenestration and cystoperitoneal shunt placement during the same operation. The importance of this strategy is related to the fact that the shunt can induce the collapse of the cyst and that the endoscopic fenestration could make it possible to remove the shunt, avoiding the phenomenon of shunt dependence.

Methods: Between 1996 and 2005, 35 patients with an arachnoid cyst were treated using endoscopic fenestration and placement of a programmable shunt.