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Preoperative differentiation between primary central nervous system lymphoma (PCNSL) and high grade astrocytoma (HGA) on conventional magnetic resonance imaging (MRI) can be difficult and even impossible. However, differentiation is important to guide therapeutic strategy. Several authors have reported the leakage pattern in dynamic susceptibility-contrast (DSC)-MRI in PCNSL. It describes the shape of the signal intensity curve which does not return to the baseline after the first pass of the bolus of contrast agent but crosses above it and sometimes even slopes up. In this retrospective study, our goal was to define the sensitivity and specificity of this sign.Patients with first ever diagnosed PCNSL and HGA who were treatment naive and received DSC-MRI were included. In all patients, a histological specimen was available. Patients did not receive corticosteroids prior to imaging and were HIV negative. The presence of a leakage pattern was assessed by two neuroradiologists working in consensus and correlated with the histological diagnosis.Nine patients with PCNSL (2 women, 7 men, age 59 ± 10 years) and 14 patients with HGA (3 women, 11 men, age 58 ± 17 years) were included. Six of the patients with PCNSL exhibited a leakage pattern, while only two patients with HGA did (P = 0.0227, Fischer's exact test). Sensitivity was 0.67, and specificity was 0.86.Although the leakage pattern does not prove PCNSL, it is an important diagnostic clue and can be easily assessed.

Objective: Hypermethylation of the DNA repair gene O6-methylguanine DNA methyltranferase (MGMT) has been associated with an increased survival of patients with glioblastomas receiving standard chemotherapy with the alkylating agent temozolomide. In the latest chemotherapy trials, the MGMT promoter methylation[for full text, please go to the a.m. URL], 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Objective: The primary central nervous system lymphoma (PCSNL), as one of the uncommon extranodal lymphomas, has been recently paid more attention especially for its increasing incidence, unsatisfactory therapy and poor prognosis. MGMT is one of the most important factors for determining drug resistance[for full text, please go to the a.m. URL], 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Objective: The role of radical surgery as one possible aspect of treating patients with malignant brain tumor is a matter of controversy. We discuss the benefit of the iMRI used in 118 cases of malignant brain tumor surgery versus 78 cases without usage of the iMRI. Methods: We analyzed 196 patients,[for full text, please go to the a.m. URL], 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien

Objective: Local chemotherapy with gliadel® has been increasingly used in the last years. A study by Giese et al. with 11 patients receiving the actual BCNU wafers had shown no difference of recurrence patterns in local and systemic chemotherapy. It also made no difference in total or subtotallyresected[for full text, please go to the a.m. URL], 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien

SUMMARY: Elevated intracranial intravenous pressure seems to be of importance in pseudotumor cerebri syndromes, either as a cause (secondary intracranial hypertension) or as a consequence (idiopathic intracranial hypertension) of increased intracranial pressure. We present 3 case reports in which diagnostic imaging before and after CSF diversion provided evidence that narrowing of the transverse sinuses is a secondary phenomenon. Stent angioplasty of the venous sinuses should not be considered a therapeutic approach in these cases.