The authors present a statistical survey of the general incidence, age distribution, and preferential site of 631 tumors of the brain which have been surgically treated at Korea university medical center, department of neurosurgery over the last period of 10 years from 1985 to 1994. Among them 269 cases were males and 362 were females. Of the 631 intracranial neoplasms verified histologically, tumors of neuroepithelial tissue comprised 34%(212 cases), tumors of meninges 23%(148 cases), pituitary adenoma 18%(114 cases), metastatic tumors 8%(50 cases), neurilemmomas 8%(49 cases), germ cell tumors 3%(13 cases), cyst and tumor like lesions 3%(16 cases), and lymphomas 1%(5 cases). Of the 178 gliomas, astrocytic tumors comprised 83%(148 cases), oligodendroglial tumors 11%(20 cases), ependymal tumors 3%(6 cases) and mixed gliomas 1.7%(3 cases). Brain tumors occurred most frequently in the age group of 45-50 years, as seen by an incidence of 63 cases(10%). The male to female ratio was 0.74: 1. Tumors that showed a definitive preponderance of females over males were meningiomas, neurilemmomas, and pituitary adenomas. Supratentoral and infratenorial cases were 73%(461 cases) and 26%(162 cases), respectively and the remaining cases involved both sites. Of the 114 cases of childhood and adolescent tumors, 60 were male and 54 were female. Supratentorial tumors were 56% and infratentorial were 44%. The tumors in order of frequency were astrocytomas(28%), primitive neuroectodermal tumors(21%), craniopharyngioma(10%) and so on. Meningiomas occurred most frequently in parasagittal/falx area(25%), followed by cerebral convexity 23%, sphenoid 14%, posterior fossa 13%. Among pituitary adenomas, prolactinomas(32%) were the most common and followed by null cell adenomas 31%, growth hormone cell adenomas 15%, mixed GH-PRL cell adenomas 11%.
Academic Medical Centers ; Adenoma ; Adolescent ; Age Distribution ; Astrocytoma ; Brain Neoplasms* ; Brain* ; Female ; Glioma ; Growth Hormone ; Humans ; Incidence ; Korea* ; Lymphocytes, Null ; Lymphoma ; Male ; Meninges ; Meningioma ; Neoplasms, Germ Cell and Embryonal ; Neural Plate ; Neurilemmoma ; Neurosurgery ; Pituitary Neoplasms ; Supratentorial Neoplasms

Cerebral metastases are the most common intracranial tumors in adults,with an increasing incidence in recent years.Radiomics can quantitatively analyze and process medical images to guide clinical practice.In recent years,CT and MRI-based radiomics has been gradually applied to the precise diagnosis and treatment of cerebral metastases,such as the precise detection and segmentation of tumors,the differential diagnosis with other cerebral tumors,the identification of primary tumors,the evaluation of treatment efficacy,and the prediction of prognosis.This article reviews the advances in radiomics of cerebral metastases.
Brain Neoplasms/diagnostic imaging* ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Supratentorial Neoplasms

Two-thirds of ependymomas arise in the infratentorial or intraventricles, whereas one-third are located supratentorially. But supratentorial "cortical" ependymomas are very rare. We report a case of a cortical ependymoma in a 21-month-old boy. The patient presented with simple partial seizures. This tumor was located in the postcentral gyrus and he had gross total excision. Microscopy and immunohistochemistry showed grade II differentiation ependymoma.
Ependymoma* ; Epilepsies, Partial ; Humans ; Immunohistochemistry ; Infant* ; Male ; Microscopy ; Pediatrics ; Supratentorial Neoplasms

Pleomorphic xanthoastrocytoma is a rare, usually benign, supratentorial tumor involving the leptomeninges and superficial cortex, and usually occurs during the second and third decades. We experienced a case of right frontotemporal pleomorphic xanthoastrocytoma with moderate peritumoral edema in a 28-year-old female who complained of seizures and headache, and describe the CT, MRI and pathologic findings.
Adult ; Astrocytoma ; Edema* ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Seizures ; Supratentorial Neoplasms

Slowly growing intracranial tumors, especially located in the supratentorial compartment, permit major volume-spacial compensation. Patient with large supratentorial tumor may not even present any specific symptoms or signs related to the elevated intracranial pressure. We experienced a patient who showed delayed emergence from general anesthesia for total knee replacement without any pharmacologic or metabolic causes. Computerized tomogram scan and magnetic resonance image revealed an unnoticed large supratentorial tumor considered as a cause of delayed emergence. After removal of intracranial tumor, the patient regained consciousness and discharged from the hospital in a relatively good health.
Anesthesia, General* ; Arthroplasty, Replacement, Knee ; Brain ; Compensation and Redress ; Consciousness ; Humans ; Intracranial Hypertension ; Supratentorial Neoplasms

A 17-year-old female had headache for several weeks and she developed an episode of seizure one day prior to admission. She underwent both CT and MRI, which both revealed a large tumor with cystic and solid portions at the right frontoparietal convexity. During operation, a well-defined tumor was found to have a stalk connecting the tumor itself with the brain parenchyma, proving that it was growing exophytically and expanding into the subarachnoid space. Histopathological examination revealed an anaplastic ependymoma with high cellularity. We report here on this case of an unusual supratentorial ependymoma with exophytic growth, and this can be mistaken as another exophytic growing intra-axial tumor or even as an extra-axial tumor.
Adolescent ; Brain ; Ependymoma* ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Seizures ; Subarachnoid Space ; Supratentorial Neoplasms

We reported a case of supratentorial extra-axial hemangioblastoma diagnosed by magnetic resonance imaging (MRI). As a simple solid mass,this tumor has its unique MRI features due to its tissue structures.
Hemangioblastoma ; diagnostic imaging ; Humans ; Magnetic Resonance Imaging ; Supratentorial Neoplasms ; diagnostic imaging

OBJECTIVE: The purpose of this study was to assess the feasibility and clinical efficacy of motor evoked potential (MEP) monitoring for supratentorial tumor surgery. METHODS: Between 2010 and 2012, to prevent postoperative motor deterioration, MEP recording after transcranial stimulation was performed in 84 patients with supratentorial brain tumors (45 males, 39 females; age range, 24-80 years; median age, 58 years). MEP monitoring results were correlated with postoperative motor outcome compared to preoperative motor status. RESULTS: MEP recordings were stable in amplitude (<50% reduction in amplitude) during surgery in 77 patients (91.7%). No postoperative motor deficit was found in 66 out of 77 patients with stable MEP amplitudes. However, postoperative paresis developed in 11 patients. False negative findings were associated with edema in peri-resectional regions and postoperative bleeding in the tumor bed. MEP decrease in amplitude (>50%) occurred in seven patients (8.3%). However, no deficit occurred postoperatively in four patients following preventive management during the operation. Three patients had permanent paresis, which could have been associated with vascular injury during tumor resection. CONCLUSIONS: MEP monitoring during supratentorial tumor surgery is feasible and safe. However, false negative MEP results associated with postoperative events may occur in some patients. To achieve successful monitoring, collaboration between surgeon, anesthesiologist and an experienced technician is mandatory.
Brain Neoplasms ; Cooperative Behavior ; Edema ; Evoked Potentials, Motor ; Female ; Hemorrhage ; Humans ; Male ; Monitoring, Intraoperative* ; Paresis ; Supratentorial Neoplasms* ; Vascular System Injuries

OBJECTIVETo observe the effects of electro-acupuncture combined with sevoflurane anesthesia used in neurosurgery patients and the speed of recovery following surgery.

METHODSEighty patients with supratentorial tumor resection were anesthetized with sevoflurane and randomly allocated into the complete anesthesia group (Group A) and the electro-acupuncture combined with sevoflurane group (Group B). Han's acupoint nerve stimulator with 2/100 Hz frequency was used to stimulate the points. Patients in Group B received electroacupuncture at Fengchi (GB20) toward Tianzhu (BL10) and Cuanzhu (BL2) toward Yuyao (EX-HN4) at the same side of the craniotomy before anesthesia induction. The stimulation was lasted from anesthesia induction until the end of operation. Patients in Group A were pasted with the conducting wire at the aforesaid points, but with no acupuncture or electric stimulation. All patients were induced with propofol 2 mg/kg, sufentanyl 0.3 microg/kg, and vecuronium 0.1 mg/kg, and maintained anesthesia with 2% sevoflurane. The bispectral index (BIS) was maintained ranging 40 -50. The sevoflurane was stopped inhaling at the end of the operation. The end-tidal sevoflurane concentration, minimum alveolar concentration (MAC), BIS, and the anesthesia recovery at each time point were recorded in the two groups.

RESULTSThere was no statistical difference in the mean arterial pressure or the heart rate. The end-tidal concentration and MAC of sevoflurane were significantly lower in Group B than in Group A at each time point (P<0.05). The dose of sevoflurane was reduced by 8.34% +/- 1.24% in Group B when compared with that of Group A. The BIS value could be maintained ranging 40 - 50 in both groups, thus guaranteeing the anesthesia depth. The time for the spontaneous respiration recovery, the extubation time, the time for opening eyes, the time for the voluntary movement recovery, and the time for orientation recovery, and the time for leaving the operation room were significantly shorter in Group B than in Group A (P<0.01). The occurrence of dysphoria, nausea and vomiting was less in Group B than in Group A.

CONCLUSIONSElectro-acupuncture combined with sevoflurane used in neurosurgery could save the dose of sevoflurane, significantly shorten the anesthesia recovery time, and improve the quality of the anesthesia recovery. It was a favorable anesthesia method.

Adult ; Anesthesia ; methods ; Electroacupuncture ; Female ; Humans ; Male ; Methyl Ethers ; therapeutic use ; Middle Aged ; Neurosurgery ; methods ; Supratentorial Neoplasms ; surgery

OBJECTIVETo summarize the experience in applying acupunctural anesthesia (AA) with new combination principle (NCP) of acupoints in supratentorial craniocerebral operation of tumor in functional area or deep site of brain.

METHODSWith the acupoints selection of AA changed from the previous combination principle of near segmental and peri-operational region to the NCP of near-remote along corresponding meridian, craniotomy was carried out under AA in 23 patients.

RESULTSOperation was performed successfully in all the patients, 82.6% of them with the effectiveness reaching I A grade. In those operated on the vital functional area, such as central anterior/posterior gyrus and language center, the accidental functional injury could be well prevented.

CONCLUSIONAA with NCP of acupoints has satisfactory effect in supratentorial craniocerebral operation of functional area or deep site of brain, it is especially valuable in monitoring the effect of operation on function of around normal cerebral area to avoid accident injury.

Acupuncture Analgesia ; methods ; Acupuncture Points ; Adolescent ; Adult ; Electroacupuncture ; Female ; Glioma ; surgery ; Humans ; Male ; Middle Aged ; Supratentorial Neoplasms ; surgery