Meet the editors

Erasmo Barros da Silva Junior is a specialist in neurosurgery at the Brazilian Society of Neurosurgery. He has a medical degree from the Federal University of Paraíba (2002) and a medical residency in neurosurgery at the Instituto de Neurologia de Curitiba (2004–2008). He has a Master's Degree in Surgery at PUC-PR (2007–2009). He is a titular member of the Brazilian Society of Neurosurgery and the Brazilian Academy of Neurosurgery, a

member of the Society of Neuro-Oncology, a member of the European Association of Neurosurgical Societies (EANS), and a neurosurgeon at Instituto de Neurologia de Curitiba/Department of Neurosurgery/Neurooncology Division.

Jerônimo Buzetti Milano is a specialist in neurosurgery at the Brazilian Society of Neurosurgery. He has a medical degree from the Federal University of Paraná (2000) and a medical residency in neurosurgery at the Instituto de Neurologia de Curitiba (2001–2004). . He has a PhD in Neurology atUSP-SP (2006– 2010). He is a titular member of the Brazilian Society of Neurosurgery and the Brazilian Academy of Neurosurgery, a member

of Spine Brazilian Society, North American Spine Society, and AOSpine, a co-chair at the Fellowship in Neurosurgery of the World Federation of Neurosurgical Societies (WFNS), a professor at AOSpine Latin America, Postgraduation Course for Capacitation in Spine Surgery, and a neurosurgeon at Instituto de Neurologia de Curitiba/Department of Neurosurgery/Head, Spine Division.

**Preface III**

Introduction **1**

**Chapter 1 3**

Diagnosis and Treatment Modalities **13**

**Chapter 2 15**

**Chapter 3 35**

**Chapter 4 61**

Management of Specific Tumors **75**

**Chapter 5 77**

*Erxi Wu, Karming Fung, The Li, Ekokobe Fonkem, Jason H. Huang and A. Rao*

Potential Use of Long Noncoding RNAs as Biomarkers for Astrocytoma *by Ruth Ruiz Esparza-Garrido, Alicia Siordia-Reyes, Gerardo Sánchez,* 

Neurosurgical Tools to Improve Safety and Survival in Patients with

*by Luis Fernando Moura da Silva, Guilherme Augusto de Souza Machado* 

Intracranial Tumors: Neuronavigation, MRI, and 5-ALA

Management of Refractory/Aggressive Pituitary Adenomas

*by Congxin Dai, Xiaohai Liu, Sihai Ma, Ming Feng, Xinjie Bao,* 

*Kan Deng, Yong Yao, Renzhi Wang, DX. Feng, E. Fonkem, Frank Y. Shan* 

Atypical and Anaplastic Meningiomas: Diagnosis and Treatment

Molecular Diagnostics and Pathology of Major Brain Tumors *by Frank Y. Shan, E. Castro, Amelia Sybenga, Sanjib Mukherjee,* 

*by Erasmo Barros da Silva Jr, Gustavo Simiano Jung, Joseph Franklin Chenisz da Silva and Ricardo Ramina*

*Griselda Ramírez and Miguel Velázquez-Flores*

Review of Current Treatment Options

**Section 1**

Contents

**Section 2**

*and Ricardo Ramina* 

*and Jason H. Huang*

**Section 3**

## Contents



Preface

Intracranial tumors represent a vast group of heterogeneous diseases, with complex and often challenging management, requiring specialized interdisciplinary teams in reference centers. Working with these professionals, focused on the most up-to-date

behavior possible, is essential to alleviate patients' anxiety and discomfort.

became one of the hallmarks for better patient survival.

definitive solutions for the well-being of patients.

tumors.

The first successful removal of a brain tumor was described in 1879 by William Macewen. With the arrival of the 20th century, the foundations of modern neurosurgery were established by Cushing and incorporated the surgical microscope in intracranial operations, with House (in 1961 in acoustic tumors) and Kurze (in 1963), and improvements from Yasargil in the following decades. Also in the 1960s, dexamethasone was introduced in the treatment of tumor swelling and

In the 1970s, computed tomography and magnetic resonance imaging allowed intracranial structures to be visualized directly. Until then, tumors were diagnosed indirectly through invasive and dated examinations. They were delayed diagnoses and, invariably, patients presented with very severe conditions. At the same time, brain irradiation was incorporated in the treatment of malignant or unresectable

The 1980s and 1990s were decisive in the development of better imaging methods, surgical techniques, and estereotatic navigation for deep lesions. In the late 1990s, Stupp demonstrated the role of temozolamide in the treatment of glioblastomas, one of the most aggressive incurable cancers in humans. Improved monitoring conditions, neuroanesthesia, intensive care, and the increasing incorporation of technology in the service of medicine have made the management of brain tumors somewhat worthy of science fiction films. The current paradigms involve the application of tumor-treating fields, molecular analyses, biological markers, and advanced imaging techniques, all in continuous transformation, and trying to offer

Such knowledge is like a regular polygon gaining more sides with each new discovery, trying to become a perfect "circle," although there are new questions that continuously arise the more we understand each disease. No matter how new divisions and classifications are created for a huge range of tumors, we can always improve the diagnostic methods, the surgery, and the adjuvant treatments.

This book presents specific and important topics about the most frequent primary intracranial tumors, highlighting the relevant contemporary literature and the
