title: Subependymoma: clinical features and surgical outcomes.
abstract: OBJECTIVE
  Subependymomas are rare, indolent neoplasms that have been described in the brain and the spinal cord. The purpose of this study is to report the clinical and radiolographic features, and surgical outcomes of this entity.
  
  
  METHODS
  Twenty-six patients with  pathologically-verified subependymomas were treated from 1990 through 2009, with a mean follow-up of 39 months. The clinical and radiological records were reviewed and outcomes analyzed.
  
  
  RESULTS
  There were 15 fourth ventricle tumors, 6 lateral ventricle tumors, and 5 spinal tumors.  For the intracranial tumors, headaches, changes in vision, and difficulties with balance were the most common symptoms. Most tumors were heterogeneously enhancing and hypointense or isointense to gray matter on T1-imaging and hyperintense on T2-imaging. All patients with tumors in the fourth  ventricle underwent a suboccipital craniotomy and seven patients received an additional C1 laminectomy. Patients with lateral ventricular tumors underwent craniotomy with primarily a transcallosal resection. Patients with spinal tumors underwent laminectomy with intramedullary tumor resection.  All tumors were resected employing microsurgical techniques. Overall, six patients had a sub-total resection. No recurrence of tumor or symptoms was noted at last follow-up for any patient, suggesting that maximal safe resection is often sufficient to provide symptomatic relief. Three patients  had long-term complications from surgery. Tumor location was not associated with age at presentation, resection achieved, or development of complications.
  
  
  CONCLUSIONS
  Subependymomas are indolent tumors that when symptomatic can present with cerebrospinal fluid (CSF) obstructive  symptoms in the brain and myelopathy in the spinal cord. There is no one symptom diagnostic for subependymomas. Surgical treatment can provide long term tumor control.
authors: Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, MD, USA. amitjain012@gmail.com
authors: Amit
authors: A
authors: Jain
authors: Anubhav G
authors: AG
authors: Amin
authors: Punya
authors: P
authors: Jain
authors: Peter
authors: P
authors: Burger
authors: George I
authors: GI
authors: Jallo
authors: Michael
authors: M
authors: Lim
authors: Chetan
authors: C
authors: Bettegowda
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018315:Glioma, Subependymal / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013120:Spinal Cord Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D016896:Treatment Outcome