ObjectiveSubependymal giant cell astrocytoma (SEGA) is a low-grade glioma associated with tuberous sclerosis complex (TSC) and advancements in diagnostic techniques have facilitated earlier detection in asymptomatic patients. Current guidelines recommend mTOR inhibitors for asymptomatic SEGA, primarily due to surgical complication rates that can reach 50%. However, in our experience, surgery is associated with lower complications, possibly due to careful patient selection. This study aims to evaluate the outcomes of SEGA microsurgery, focusing on tumor control, complication rates and the need for ventriculoperitoneal shunt (VPS) placement. Additionally, we seek to identify predictors of shunt dependence and postoperative complications to define the optimal timing for surgical intervention.MethodsWe conducted a monocentric retrospective case series of children with SEGA evaluated between June 2005 and September 2024. A total of 41 SEGA cases were included, with 31 patients undergoing surgery.ResultsSurgery achieved a gross total resection (GTR) in 64.5% of cases, with a low complication rate of 19.3%. Only 6.4% of patients required postoperative VPS placement. Significant predictors of successful outcomes included tumor volume, absence of hydrocephalus and the use of the interhemispheric transcallosal approach. The meta-analysis confirmed the importance of appropriate patient selection, demonstrating that early surgical intervention, particularly for patients without preoperative hydrocephalus, is crucial for reducing the need for VPS andminimizing postoperative complications. We also propose the Surgical SEGA Score (SSS) as a decision support tool for surgical intervention.ConclusionsCareful selection of patients for elective surgery significantly reduces complications and improves outcomes, establishing surgery as a safe and curative option for managing SEGA in selected TSC patients. Early surgical intervention, especially in patients without preoperative hydrocephalus, may minimize the need for shunt placement and enhance long-term tumor control. The Surgical SEGA Score (SSS) may serve as a valuable tool for identifying candidates for early surgery.

IntroductionMultimodal MRI coupling with morphological sequences, diffusion, perfusion and spectroscopy, represents an almost essential tool in the management of surgical pathology. Used well, it allows a diagnostic approach of choice, surgical planning and therapeutic monitoring.ObjectiveEstablish the rate of correct diagnosis with the histopathology of radiologists and neurosurgeons based on MRIMaterials and MethodsThis was a cross-sectional and analytical, multicenter retrospective study from February 2017 to October 2024 and prospective from November 2024 to June 2025. Included were all patients operated on for an intracranial expansive process of nature tumor, The first retrospective part consisted of comparing the imaging results with the anatomopathology data and secondly the neurosurgeon’s hypotheses with the conclusions of the anatomopathologyResultsDuring the study we had a study population of 257 patients. The average age was 33.5 +/- 17.5 years, the sex ratio was M/F : 1.78. The supratensorial topography of the lesions was the most common. Intracranial hypertension syndrome, pyramidal syndrome, comitial syndrome, and visual disturbances were the most common. The tumor lesions identified during the study period included 25 gliomas, 19 Astrocytomas, 11 hemangioblastomas, 17 medulloblastomas, 3 Craniopharyngiomas, 156 meningiomas, 13 metastases, and 13 rare tumors. The retrospective study reported an overall positive predictive value of 72.73%, a negative predictive value of 94.12%, a sensitivity of 94% and a specificity of 72%ConclusionMultimodal MRI is effective for brain tumors and should be requested as first intention in the face of any suspicion of an expansive tumor process.IntroductionL’IRM multimodale couplant aux séquences morphologiques, la diffusion, la perfusion et la spectroscopie, représente un outil presqu’incontournable dans la prise en charge de la pathologie chirurgicale. Bien utilisée, elle permet une approche diagnostique de choix, de planification chirurgicale et de suivi thérapeutique.ObjectifEtablir le taux de bon diagnostic avec l’histopathologie des radiologues et des neurochirurgiens sur la base de l’IRM.Materiels et MethodesIL s’agissait d’une étude transversale et analytique, multicentrique rétrospective de février 2017 à Octobre 2024 et prospective de Novembre 2024 à juin 2025. Y Etaient inclus tous les patients opérés d’un processus expansif intracrânien de nature tumorale, La première partie rétrospective ayant consisté à confronter les résultats de l’imagerie aux données de l’anatomopathologie et dans un second temps les hypothèses du neurochirurgien aux conclusions de l’anatomopathologie,ResultatsNous avons eu au cours de l’étude une population d’étude de 257 patients. L’âge moyen était de 33,5 +/- 17,5 ans, La sexe ratio était de H/F : 1,78. La topographie sus tensorielle des lésions était la plus fréquente. Le syndrome d’hypertension intracrânienne, le syndrome pyramidal, le syndrome comitial, et les troubles visuels étaient les plus fréquents. Les lésions tumorales recensées durant la période d’étude regroupaient 25 gliomes, 19 Astrocytomes, 11 hémangioblastomes, 17 médulloblastomes, 3 Craniopharyngiomes, 156 méningiomes, 13 métastases, et 13 tumeurs rares. L’étude rétrospective a rapporté une valeur prédictive positive globale de 72,73%, une valeur prédictive négative de 94,12%, une sensibilité de 94% et une spécificité de 72%ConclusionIRM multimodale est performant pour les tumeurs cérébrales et devrait être demandée en première intention devant toute suspicion de processus expansif tumoral

IntroductionMeningioma is the most common primary tumor of the central nervous system, generally benign with an incidence of 18.69/100,000 after 40 years, it affects more women. It can be disabling depending on its morphological and topographical characteristics causing signs of intracranial hypertension, neurological deficits and convulsions which impair quality of life. The tool of choice for diagnosis is MRI. The main therapeutic modality in our context is surgery which does not always guarantee an improvement in quality of life.Objectiveevaluate the quality of life of patients operated on for meningioma at the Yaoundé General Hospital.Methodologythis is a cross-sectional study carried out over a period of 5 years from January 1, 2019 to December 31, 2023 including the files of patients who had undergone surgery for a meningioma confirmed by anatomo-pathological analysis and followed at the Yaoundé General Hospital. The SF 36 and EORTC QLQ BN-20 questionnaires were used to assess quality of life.ResultsMeningiomas constituted 28.77% of all intracranial tumors. The female gender is the most represented with a sex ratio of 0.28. The most represented age group was adults aged 40-49. Quality of life was good for aspects of physical and social health and moderate for mental health ; Postoperative quality of life with regard to daily activities was mainly impaired by emotional health ; The patients experienced very little pain and were moderately full of vitality ; Quality of life in terms of general health was moderate.Conclusionthe quality of life of patients operated on for intracranial meningioma is generally moderate and especially affected by emotional health.

BackgroundCerebral metastases are the most common brain tumours in adults [1, 2]. Cerebellar metastases account for approximately 12% of all brain metastases [3]. Cystic brain metastases are relatively rare, and the pathogenesis of cyst formation is unclear [4].Case descriptionWe present the case of a 62-year-old man with this condition. Initial symptoms were intracranial hypertension with right statokinetic cerebellar syndrome. Investigations revealed a cystic process. The patient underwent surgery and was referred to oncology for further management.ConclusionThis case highlights the importance of an integrated, multidisciplinary approach to the management of brain tumours, particularly brain metastases.

IntroductionHTIC and neurological focal signs are the main revealing signs of brain tumors, however psychiatric manifestations of these lesions are not rare. The prevalence of major psychiatric disorder (DSM IV) in patients with brain tumors is 28% for malignant tumors in Africa, 41% of patients with brain tumors present a psychiatric disorder responsible for initial diagnostic error.The Objective of Our StudyTo describe psychiatric disorders in patients with brain tumors. METHODOLOGY/ This is a multicenter retrospective study of ten patients seen over the period from March 2022 to January 2025 for psychiatric disorders with secondary discovery of brain tumor. Their epidemiological, clinical, radiological and histological profiles were sought. The initial test performed was the Mini Mental State TEST. RESULTS AND COMMENTS/ The presence of these disorders is found in 26% (10/26), the average age of patients is 44.1 years [26-63], the sex ratio = 6M /4F. The surgical treatment time = 21.55 months [1-60]. The psychiatric signs found are euphoria (1), depression (3), hypersomnia (1), anxiety, ideo-motor slowing (2), guilt, hallucinations (1), inhibition, neglect (1), ego hypertrophy (1). These patients were referred by unit general practitioners in 6 cases, neurologists in 2 cases, and psychiatrists in 2 cases. The pathological examination was in favor of frontal meningiomas (4), giant pituitary adenoma (2), glioma (2), left fronto-temporal arteriovenous malformation (1). CONCLUSION/ Frontal meningiomas are mainly responsible for psychiatric disorders. The presence of psychiatric manifestations must be assessed and the prescription of brain imaging should not be delayed with a view to neurosurgical treatment.IntroductionL’HTIC et les signes de focalisation neurologique sont les principaux signes révélateurs des tumeurs cérébrales, par contre les manifestations psychiatriques de ces lésions ne sont pas rares. La prévalence de trouble psychiatrique majeur (DSM IV) chez des patients présentant des tumeurs cérébrales est de 28% pour les tumeurs malignes en Afrique, 41% des patients ayant des tumeurs cérébrales présentent un trouble psychiatrique responsable d’erreur diagnostic initialement.L’objectif De Notre EtudeDécrire les troubles psychiatriques chez les patients présentant une tumeur cérébrale.MethodologieIl s’agit d’une étude rétrospective multicentrique de dix patients vus sur la période de Mars 2022 à janvier 2025 pour troubles psychiatriques avec découverte secondaire de tumeur cérébrale. Leurs profils épidémiologiques, cliniques, radiologiques, histologiques ont été recherchés. Le test initial réalisé a été le Mini Mental State TEST.Resultats et CommentairesLa présence de ces troubles est retrouvée chez 26 % (10/26), l’âge moyen des patients est de 44,1 ans [26-63], le sex ratio= 6H /4F. Le délai de prise en charge chirurgical = 21,55mois [1-60]. Les signes psychiatriques retrouvés sont/ l’euphorie (1), la dépression (3), l’hypersomnie (1), l’anxiété, ralentissement idéo moteur (2), la culpabilité, les hallucinations (1), l’inhibition, la négligence (1), l’hypertrophie du moi (1). Ces patients ont été référés par des médecins généralistes d’unité dans 6cas, des neurologues dans 2cas, et psychiatres dans 2cas. L’examen anatomopathologie était en faveur de ; Méningiomes frontaux (4), adénome hypophysaire géant (2), gliome (2), Malformation arterio-veineuse fronto-temporal gauche (1).ConclusionLes méningiomes frontaux sont responsables en majorité de troubles psychiatriques. La présence de manifestations psychiatriques doit être évaluée et la prescription d’une imagerie cérébrale ne doit être retardée en vue d’une prise en charge neurochirurgicale.

Backgroundvisual disturbances and hallucinations may be linked to a meningioma when the tumor exerts pressure on the brain régions involved on vision or visual perception.Objectiveto report a clinical case of olfactory sulcus meningioma revealed by visual hallucinations.CaseMs EAH, 64 years ils, with no particular medical history, has been followed for two years for declining visual acuity. It was following the onset of visual hallucinations coupled with psychomotor agitation that she was hospitalized on a psychiatric ward. The physical examination revealed a psychosis syndrome involving hallucinatoire delirium associated with involvement of the third cranial nerve and glaucomatous retinopathy. Brain MRI revealed a meningioma of the olfactory groove with suprasellar extension. She was referred to the Neurosurgery Department of the Saint Joseph Moscati Hospital for treatment. A transnasal endoscopic approach was performed 17 days after diagnosis. The short-term postoperative course is uneventful.Conclusionan organic lesion, particularly a meningioma, should be investigated in the presence of visual disturbances, particularly hallucinations.

IntroductionMeningiomas of the lesser wing of the sphenoid bone represent the third most common location of intracranial meningiomas. Their close relationship with the vasculonervous structures makes their surgery complex. Thus, their excision can be fraught with sometimes formidable complications.ObjectiveReport the evolution of a series of 10 patients retained in our department.Methodologywe conducted a retrospective study with a descriptive aim, covering all patients with a meningioma of the small wing of the sphenoid bone in our department between January 1, 2022 and December 31, 2024. Data collection and analysis were carried out with Jamovi software.Results10 files met our inclusion criteria with a female predominance (sex ratio : 9/1). The median age was 43 years, with extremes ranging from 31 to 64 years. All patients presented with headache associated with vomiting (10%), decreased visual acuity (80%) and exophthalmos (30%). Only one patient presented with a motor deficit preoperatively. Brain CT was performed in all patients and only 60% underwent preoperative brain MRI. The excision was type II according to the SIMPSON classification in 50%, type III in 30% and type IV in 20%. Immediate intraoperative and postoperative complications were vascular in 30% and nervous in 10%. The mortality rate was 30%.Conclusionsurgery for meningioma of the small wing of the sphenoid bone remains a delicate surgery given the high risk of complications, especially vascular, that it can cause.

Background and AimsPediatric brain tumors (PBT) are a major cause of cancer-related mortality in children and display wide variation in histopathology, molecular characteristics, and prognosis. Although low-grade gliomas and glioneuronal tumors are relatively rare, they represent approximately 30% of pediatric central nervous system (CNS) tumors. Most data on PBT originate from high-income countries, resulting in limited epidemiologic information from low- and middle-income countries (LMICs). This study aims to describe the incidence and treatment modalities of pediatric low-grade gliomas at the Kilimanjaro Christian Medical Center (KCMC) Cancer Care Center in Northern Tanzania between December 2016 and October 2024.MethodsData on pediatric patients treated at the Cancer Care Center (CCC) between December 2016 and October 2024 were analyzed. Inclusion criteria were a diagnosis of a pediatric low-grade glioma and patients aged 0-19 at the time of diagnosis. All patients were previously diagnosed by computed tomography (CT)/magnetic resonance (MR) imaging. Variables were retrospectively collected from the patients’ medical records, which were: demographic characteristics (age, gender, Place of residence, and insurance status), previous history of malignant diseases, incidence date, and treatment modality.ResultsBetween 2016 and 2024, 35 pediatric brain tumor cases (4.6% of pediatric cancers) were diagnosed at CCC; low-grade gliomas comprised 20%, mostly males (57.1%). At diagnosis, 42.8% received curative care, 28.6% palliative care, 14.3% observation, and 14.3% died. All underwent surgery (VP shunt insertion and/or tumor resection), 57.1% had chemotherapy, 42.9% had radiotherapy, and 28.6% received all three treatments.ConclusionImproving access to screening, accurate diagnosis by specifically addressing challenges in histopathology, and treatment modalities are essential in identifying and managing pediatric low-grade glioma patients in our setting.

IntroductionWith an incidence of 9.12/100,000 per year increasing with age, intracranial meningiomas are the most common intracranial neoplasms. They represent 1/3 of CNS tumors with a female predominance. These are extra-axial tumors developed at the expense of arachnoid cells. In 35% of cases they are located at the convexity. Around 80% are considered benign and classified as WHO grade 1 ; slow progression with a good prognosis. The standard treatment is surgical excision, the extent of which is assessed by the Simpson grade. However, this excision can be difficult due to the location and thus influence the Simpson grade, thus favoring recurrences. The objective of this work is to study the correlation between location ; Simpson grade and occurrence of recurrence after surgical resection.MethodThis is a multicenter, retrospective, descriptive and analytical study carried out in three hospitals in Abidjan covering neuroimaging data, anatomo-pathological results and operative reports of patients operated on for meningiomas from 2014 to 2024. The data were analyzed with Excel software.ResultsWe collected 16 files of meningiomas. The average age was 45.81 years with extremes of 26 and 64 years. Located in 68.75% at the base of the skull and 43.75% of excisions were Simpson grade 2.ConclusionThe location of meningiomas influences the quality of excision and the risk of recurrence. The more complex shapes of the skull base require rigorous preoperative evaluation to optimize surgical and prognostic results.

IntroductionBrain tumors, whether primary or secondary, are a common cause of spinal cord compression, requiring surgical treatment. If radiotherapy has become the reference strategy, particularly in metastatic cases, certain situations still require circumferential decompression associated with spinal stabilization. This study aims to evaluate the feasibility, safety and medium-term results of total vertebrectomy performed by a single posterior approach.MethodsThis is a retrospective study including 10 preferential patients between 2018 and 2023 for a spinal tumor (6 primary tumors, 4 metastases). All received a total vertebrectomy via an exclusive posterior approach, performed by the same surgeon. The parameters analyzed included : operating time, blood loss, complications, spinal stability, pain, functional recovery and bone fusion.ResultsThe mean age of patients was 64.4 ± 10.9 years, with a mean follow-up of 730 ± 200 days. Surgical exposure, although complex, allowed for immediate posterior instrumentation. The average operating time was 4 hours. The complication rate was 20%, with two cases of postoperative hemothorax. At 6 months, functionality was recorded in the majority of cases. Satisfactory bone fusion was noted in most patients at one year.ConclusionSingle posterior vertebrectomy constitutes a reliable and effective surgical technique. It allows adequate spinal cord decompression, ensures spinal stability and contributes to pain relief, particularly in cases requiring complete care.