Microglia and macrophages in glioblastoma: landscapes and treatment directions.

Glioblastoma is the most common primary malignant tumour of the central nervous system and remains uniformly and rapidly fatal. The tumour-associated macrophage (TAM) compartment comprises brain-resident microglia and bone marrow-derived macrophages (BMDMs) recruited from the periphery. Immune-suppressive and tumour-supportive TAM cell states predominate in glioblastoma, and immunotherapies, which have achieved striking success in other solid tumours have consistently failed to improve survival in this 'immune-cold' niche context.

Exophytic Brainstem Cavernoma in the Floor of the Fourth Ventricle Midline Suboccipital Approach: 3-Dimensional Operative Video.

This 3-dimensional operative video covers the suboccipital approach to a brainstem cavernoma of the floor of the fourth ventricle. Brainstem cavernomas are low-flow vascular lesions associated with a 2% to 6% annual bleed rate. Repeated bleeds typically result in progressive neurological deficit, and especially for exophytic lesions surgery may arrest this progression without significantly exacerbating pre-existing deficits.

Atypical presentation of delayed communicating hydrocephalus after supratentorial glioma resection with opening of the ventricles.

We report four cases of communicating hydrocephalus, requiring shunt placement, in the subset of patients whose ventricles were breached at the time of glioma resection (a total 97 cases over 3 years). The hydrocephalus in these cases presented without ventricular dilatation on computed tomography (CT) scanning, and in 3 cases without headache. Failure to progress, visual deterioration or cerebrospinal fluid (CSF) leak in the post-operative patient after tumour resection with ventricular opening should alert clinicians to the possibility of hydrocephalus, despite the absence of headache or ventriculomegaly, and lumbar puncture should be performed without delay.