1. Spinal Astrocytoma
Reported by Richard

2. Epidemiology and pathology
Rare lesion (1/3 of spinal cord glioma, < Ependymomas)
affect all age: mean 29 y/o
Male (58%)> female
Thoracic (67%) > cervical (49%) (usually span multiple spinal levels in adult, more holocord in children )
Classification:
Low-grade > high-grade (10~15%)
Young children: juvenile pilocytic
Adult: fibrillary

4. Presentation Symptoms often last months before diagnosis
Pain is the most common initial presentation: from local to redicular
Sensory loss with parathesia or dysesthesias (uni-or bilateral)
Spastic, and weakness
loss of bowel and bladder function. (less common)
Others: gait abnormality, torticolis, scoliosis…etc

5. Diagnostic image Plain X-ray: CT/myelography:
have little place in the diagnosis of spinal cord astrocytomas: enlarged spinal canal, scoliosis…etc
CT/myelography:
Can demonstrate spinal cord widening but can’t differentiate. Only useful when MRI is contraindicated.
Intraoperative Ultrasound:
Asymmetric expansion of spinal cord with variable echogenicity.

6. Diagnostic image
MRI:
isointense or hypointense with the spinal cord on Tl weighted imaging, hyperintense on T2.
Average involvement: 7 vertebral segmant
Cyst (+)
Usually eccentric (57%)

10. Treatment
Surgical resection
Radiotherapy

11. Outcome Low grade: High grade: Prognositic indicators:
five-year survival of 57%
High grade:
Survival after surgery averages six months in adults and thirteen months in children
Prognositic indicators:
Age, the younger the more length of time to recur
Preoperative neurological level

12. Thank you for the listening…
The End
Thank you for the listening…