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Oncology6791 papers

Embryonal tumor of brain

Last edited: 4/23/2026

Overview

Embryonal tumors of the brain are aggressive neoplasms primarily affecting children, encompassing entities such as medulloblastomas, pineoblastomas, and supratentorial primitive neuroectodermal tumors (PNETs). These tumors often require multimodal treatment including surgery, radiation, and chemotherapy.

Diagnosis

  • Imaging studies (MRI, CT) are essential for initial diagnosis and tumor characterization 12.
  • Histopathological examination via biopsy or resection is crucial for definitive diagnosis and grading 12.
  • Functional imaging (fMRI, MEG) aids in identifying eloquent cortex to guide surgical planning 3438.
  • Management

  • Surgery: Maximal safe resection is the primary treatment to reduce tumor burden 1224.
  • Radiation Therapy: Often used post-surgery, especially in pediatric cases, with proton therapy showing promise in reducing late effects 2716.
  • Chemotherapy: Multi-agent regimens tailored to tumor type (e.g., vincristine, cisplatin, cyclophosphamide) 15.
  • Sedation During Procedures: Dexmedetomidine and propofol are used for conscious sedation during awake craniotomy, with dexmedetomidine showing benefits in preserving neuropsychological function 422.
  • Anticonvulsant Prophylaxis: Recommended for preventing perioperative seizures, often with levetiracetam or phenytoin 21.
  • Special Populations

  • Pediatrics: Proton radiation therapy to minimize long-term side effects 7.
  • Pregnancy: Rare occurrence; management involves balancing maternal and fetal risks, often delaying treatment until postpartum 22.
  • Elderly: Consider comorbidities and functional status when planning multimodal therapy 19.
  • Key Recommendations

  • Maximal safe surgical resection is critical for improving outcomes in embryonal brain tumors (Evidence: Strong 12).
  • Use of proton therapy in pediatric patients can reduce radiation-induced late effects (Evidence: Moderate 7).
  • Dexmedetomidine should be considered over propofol for conscious sedation during awake craniotomy to preserve neuropsychological function (Evidence: Moderate 422).
  • Implement anticonvulsant prophylaxis with levetiracetam or phenytoin perioperatively to prevent seizures (Evidence: Moderate 21).
  • Screen for deep vein thrombosis (DVT) using duplex ultrasound in patients undergoing craniotomy due to high VTE risk (Evidence: Moderate 610).
  • Incorporate functional imaging (fMRI, MEG) to preserve eloquent cortex function during surgical planning (Evidence: Moderate 3438).
  • References

    Showing 100 most recent of 310 indexed papers.

    1 Sadigh Y, Schouten JW, Vincent AJPE, Dirven CMF, Dippel DWJ, Dang KTK et al.. Incidence and effect of supratentorial postoperative deep cerebral perforator territory ischemia in neurosurgical patients with intra-axial and extra-axial tumors. Journal of neurosurgery 2026. link 2 Murphy ES, Sahgal A, Regis J, Levivier M, Fariselli L, Gorgulho A et al.. Pediatric cranial stereotactic radiosurgery: Meta-analysis and international stereotactic radiosurgery society practice guidelines. Neuro-oncology 2025. link 3 Batista NM, Corrigan M, Chen JG. Procedural sedation performed by pediatric critical care physicians for children undergoing daily radiation therapy is effective and safe. Pediatric hematology and oncology 2025. link 4 Pillay S, Maruska B, Butts AM, Saber M, Gross WL. The Differential Effects of Propofol and Dexmedetomidine on Intraoperative Neuropsychological Testing During Awake Craniotomies. World neurosurgery 2025. link 5 Neymeyer ML, Rybka L, Hoekzema N, Schneider H, Engelhardt M, Tomasello R et al.. rTMS-based neuromodulation for treatment of postoperative aphasia after brain tumor resection: a case report. Neurocase 2025. link 6 Avitsian R, Mohammadi AM, Beresian J, Nuti AM, Jolly S, Volovetz J et al.. Duplex Ultrasound Screening for Deep Venous Thrombosis in Patients Undergoing Craniotomy for Intracranial Tumors: A Single Institutional Series. Journal of neurosurgical anesthesiology 2025. link 7 Gill GS, Baliga S, Lewy J, Bajaj BV, Gallotto SL, Fitzpatrick A et al.. Exploring the Relationship Between Radiation-Induced Moyamoya Syndrome and Radiation Dose for Pediatric Patients Treated With Proton Radiation Therapy. International journal of radiation oncology, biology, physics 2025. link 8 Ferrier CH, Ruis C, Zadelhoff D, Robe PAJT, van Zandvoort MJE. IDEAL monitoring of musical skills during awake craniotomy: From step 1 to step 2. Journal of neuropsychology 2024. link 9 Ibáñez-Juliá MJ, Picca A, Leclercq D, Berzero G, Jacob J, Feuvret L et al.. Late-onset vascular complications of radiotherapy for primary brain tumors: a case-control and cross-sectional analysis. Journal of cancer survivorship : research and practice 2024. link 10 Zeng Q, Lu G, Yuan J, Ding J, Chen J, Gao X et al.. Prevalence, characteristics, and risk factors of venous thromboembolism in patients with brain tumor undergoing craniotomy: a meta-analysis. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology 2024. link 11 Mo Y, Zhang Y, Zhuang L, Wang J, Yan S, Li Y et al.. Stroke-like onset of calcified brain metastases with Wallerian degeneration: a case report and review of the literature. The International journal of neuroscience 2024. link 12 Grahn P, Remes T, Kivisaari R, Suo-Palosaari MH, Arikoski PM, Koskenkorva PKT et al.. Early disc degeneration in radiotherapy-treated childhood brain tumor survivors. BMC musculoskeletal disorders 2023. link 13 Schipmann S, Spille DC, Gallus M, Lohmann S, Schwake M, Warneke N et al.. Postoperative surveillance in cranial and spinal tumor neurosurgery: when is this warranted?. Journal of neurosurgery 2023. link 14 Ashtari P, Sima DM, De Lathauwer L, Sappey-Marinier D, Maes F, Van Huffel S. Factorizer: A scalable interpretable approach to context modeling for medical image segmentation. Medical image analysis 2023. link 15 Mohile NA, Messersmith H, Gatson NT, Hottinger AF, Lassman A, Morton J et al.. Therapy for Diffuse Astrocytic and Oligodendroglial Tumors in Adults: ASCO-SNO Guideline. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2022. link 16 Whipple EC, Favero CA, Kassell NF. Focused ultrasound in neuro-oncology: the role of the Focused Ultrasound Foundation in driving adoption and innovation. Journal of neuro-oncology 2022. link 17 Iyengar V, Patell R, Zwicker J. Challenges in anticoagulation for patients with brain tumors. Best practice & research. Clinical haematology 2022. link 18 Suarez-Meade P, Marenco-Hillembrand L, Sherman WJ. Neuro-oncologic Emergencies. Current oncology reports 2022. link 19 Sass D, Vera E, Choi A, Acquaye A, Briceno N, Christ A et al.. Evaluation of the key geriatric assessment constructs in primary brain tumor population - a descriptive study. Journal of geriatric oncology 2022. link 20 Shenker RF, Elizabeth McLaughlin M, Chino F, Chino J. Disparities in place of death for patients with primary brain tumors and brain metastases in the USA. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 2022. link 21 Walbert T, Harrison RA, Schiff D, Avila EK, Chen M, Kandula P et al.. SNO and EANO practice guideline update: Anticonvulsant prophylaxis in patients with newly diagnosed brain tumors. Neuro-oncology 2021. link 22 Molina-Botello D, Rodríguez-Sanchez JR, Cuevas-García J, Cárdenas-Almaraz BV, Morales-Acevedo A, Mejía-Pérez SI et al.. Pregnancy and brain tumors; a systematic review of the literature. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2021. link 23 Takami H, Khoshnood N, Bernstein M. Preoperative factors associated with adverse events during awake craniotomy: analysis of 609 consecutive cases. Journal of neurosurgery 2021. link 24 Policicchio D, Ticca S, Dipellegrini G, Doda A, Muggianu G, Boccaletti R. Multimodal Surgical Management of Cerebral Lesions in Motor-Eloquent Areas Combining Intraoperative 3D Ultrasound with Neurophysiological Mapping. Journal of neurological surgery. Part A, Central European neurosurgery 2021. link 25 . VEGFC-Mediated Lymphatic Drainage Increases Brain Tumor Immunogenicity. Cancer discovery 2020. link 26 Lai JS, Beaumont JL, Kupst MJ, Peipert JD, Cella D, Fisher AP et al.. Symptom burden trajectories experienced by patients with brain tumors. Cancer 2020. link 27 Ma K, Uejima JL. Awake Craniotomy in a Patient With History of Post-Traumatic Stress Disorder-A Clinical Dilemma: A Case Report. A&A practice 2020. link 28 Riemenschneider MJ, Fischer J, Grassow-Narlik M, Mawrin C, von Deimling A, Pietsch T et al.. Quality assurance in neuropathology: Experiences from the round robin trials on . Clinical neuropathology 2020. link 29 O'Neill M, Henderson M, Duffy OM, Kernohan WG. The emerging contribution of speech and language therapists in awake craniotomy: a national survey of their roles, practices and perceptions. International journal of language & communication disorders 2020. link 30 Lo C, Le S, Bell M, Kim E. Continuous Intravenous Lidocaine Provides Effective Pain Control in a Palliative Child: A Case Report. A&A practice 2020. link 31 Mansour S, Echeverry N, Shapiro S, Snelling B. The Use of BrainPath Tubular Retractors in the Management of Deep Brain Lesions: A Review of Current Studies. World neurosurgery 2020. link 32 Scala M, Fiaschi P, Cama A, Consales A, Piatelli G, Giannelli F et al.. Radiation-Induced Moyamoya Syndrome in Children with Brain Tumors: Case Series and Literature Review. World neurosurgery 2020. link 33 Kamata K, Maruyama T, Iseki H, Nomura M, Muragaki Y, Ozaki M. The Impact of Intraoperative Magnetic Resonance Imaging on Patient Safety Management During Awake Craniotomy. Journal of neurosurgical anesthesiology 2019. link 34 Flexman AM, Wang T, Meng L. Neuroanesthesia and outcomes: evidence, opinions, and speculations on clinically relevant topics. Current opinion in anaesthesiology 2019. link 35 Sewell D, Smith M. Awake craniotomy: anesthetic considerations based on outcome evidence. Current opinion in anaesthesiology 2019. link 36 Chakravarthi SS, Kassam AB, Fukui MB, Monroy-Sosa A, Rothong N, Cunningham J et al.. Awake Surgical Management of Third Ventricular Tumors: A Preliminary Safety, Feasibility, and Clinical Applications Study. Operative neurosurgery (Hagerstown, Md.) 2019. link 37 Hanashima Y, Homma T, Maebayashi T, Igarashi T, Ishige T, Hao H et al.. A symptomatic large subependymoma with neuroradiological features mimicking a high-grade glioma: A case report. Neurocirugia 2019. link 38 Lee JY, Choi Y, Ahn KJ, Nam Y, Jang JH, Choi HS et al.. Seed-Based Resting-State Functional MRI for Presurgical Localization of the Motor Cortex: A Task-Based Functional MRI-Determined Seed Versus an Anatomy-Determined Seed. Korean journal of radiology 2019. link 39 Phillips KA, Fadul CE, Schiff D. Neurologic and Medical Management of Brain Tumors. Neurologic clinics 2018. link 40 Kulikov A, Lubnin A. Anesthesia for awake craniotomy. Current opinion in anaesthesiology 2018. link 41 Balter S. Always on My Mind. Techniques in vascular and interventional radiology 2018. link 42 Dover LL, Dulaney CR, Williams CP, Fiveash JB, Jackson BE, Warren PP et al.. Hospice care, cancer-directed therapy, and Medicare expenditures among older patients dying with malignant brain tumors. Neuro-oncology 2018. link 43 Lin RJ, Green DL, Shah GL. Therapeutic Anticoagulation in Patients with Primary Brain Tumors or Secondary Brain Metastasis. The oncologist 2018. link 44 Sierpowska J, Fernandez-Coello A, Gomez-Andres A, Camins À, Castañer S, Juncadella M et al.. Involvement of the middle frontal gyrus in language switching as revealed by electrical stimulation mapping and functional magnetic resonance imaging in bilingual brain tumor patients. Cortex; a journal devoted to the study of the nervous system and behavior 2018. link 45 Pereira S, Meier R, McKinley R, Wiest R, Alves V, Silva CA et al.. Enhancing interpretability of automatically extracted machine learning features: application to a RBM-Random Forest system on brain lesion segmentation. Medical image analysis 2018. link 46 Höhne J, Schebesch KM, Ott C, Brawanski A, Lange M. The risk of hypotension and seizures in patients receiving prophylactic anti-epileptic drugs for supratentorial craniotomy. Journal of neurosurgical sciences 2018. link 47 Hulbert ML. The tip of the thrombos-is-berg. Science translational medicine 2017. link 48 Mohile NA. Medical Complications of Brain Tumors. Continuum (Minneapolis, Minn.) 2017. link 49 Dilmen OK, Akcil EF, Oguz A, Vehid H, Tunali Y. Comparison of Conscious Sedation and Asleep-Awake-Asleep Techniques for Awake Craniotomy. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2017. link 50 Decavèle M, Weiss N, Rivals I, Prodanovic H, Idbaih A, Mayaux J et al.. Prognosis of patients with primary malignant brain tumors admitted to the intensive care unit: a two-decade experience. Journal of neurology 2017. link 51 Buttrick S, Komotar RJ. Introduction for Laser Interstitial Thermal Therapy (LITT) in Neurosurgery Supplement. Neurosurgery 2016. link 52 Joswig H, Bratelj D, Brunner T, Jacomet A, Hildebrandt G, Surbeck W. Awake Craniotomy: First-Year Experiences and Patient Perception. World neurosurgery 2016. link 53 Ma R, Livermore LJ, Plaha P. Fast Track Recovery Program After Endoscopic and Awake Intraparenchymal Brain Tumor Surgery. World neurosurgery 2016. link 54 Diamond EL, Russell D, Kryza-Lacombe M, Bowles KH, Applebaum AJ, Dennis J et al.. Rates and risks for late referral to hospice in patients with primary malignant brain tumors. Neuro-oncology 2016. link 55 Cote DJ, Smith TR. Venous thromboembolism in brain tumor patients. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2016. link 56 Menze BH, Van Leemput K, Lashkari D, Riklin-Raviv T, Geremia E, Alberts E et al.. A Generative Probabilistic Model and Discriminative Extensions for Brain Lesion Segmentation--With Application to Tumor and Stroke. IEEE transactions on medical imaging 2016. link 57 Willemse RB, Hillebrand A, Ronner HE, Vandertop WP, Stam CJ. Magnetoencephalographic study of hand and foot sensorimotor organization in 325 consecutive patients evaluated for tumor or epilepsy surgery. NeuroImage. Clinical 2016. link 58 Johansson G, Andersson U, Melin B. Recent developments in brain tumor predisposing syndromes. Acta oncologica (Stockholm, Sweden) 2016. link 59 Alswaina N, Elkhamary SM, Shammari MA, Khan AO. Ophthalmic Features of Outpatient Children Diagnosed with Intracranial Space-Occupying Lesions by Ophthalmologists. Middle East African journal of ophthalmology 2015. link 60 Shahar T, Rozovski U, Shapira Y, Nossek E, Zelikovich B, Jossiphov J et al.. Conflicting pathology reports: a diagnostic dilemma. Journal of neurosurgery 2015. link 61 Bian W, Banerjee S, Kelly DA, Hess CP, Larson PE, Chang SM et al.. Simultaneous imaging of radiation-induced cerebral microbleeds, arteries and veins, using a multiple gradient echo sequence at 7 Tesla. Journal of magnetic resonance imaging : JMRI 2015. link 62 Schiff D, Lee EQ, Nayak L, Norden AD, Reardon DA, Wen PY. Medical management of brain tumors and the sequelae of treatment. Neuro-oncology 2015. link 63 Nadkarni TN, Andreoli MJ, Nair VA, Yin P, Young BM, Kundu B et al.. Usage of fMRI for pre-surgical planning in brain tumor and vascular lesion patients: task and statistical threshold effects on language lateralization. NeuroImage. Clinical 2015. link 64 Smith TR, Nanney AD, Lall RR, Graham RB, McClendon J, Lall RR et al.. Development of venous thromboembolism (VTE) in patients undergoing surgery for brain tumors: results from a single center over a 10 year period. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2015. link 65 Bansal LR, Belair J, Cummings D, Zuccoli G. Late-onset radiation-induced vasculopathy and stroke in a child with medulloblastoma. Journal of child neurology 2015. link 66 Ma L, Mason E, Sneed PK, McDermott M, Polishchuk A, Larson DA et al.. Clinical realization of sector beam intensity modulation for Gamma Knife radiosurgery: a pilot treatment planning study. International journal of radiation oncology, biology, physics 2015. link 67 Ganz JC. The earliest gamma unit patients. Progress in brain research 2014. link 68 Ganz JC. From Stockholm to Pittsburgh. Progress in brain research 2014. link 69 Ganz JC. Stereotactic and radiosurgery concepts in Sweden. Progress in brain research 2014. link 70 Ott C, Kerscher C, Luerding R, Doenitz C, Hoehne J, Zech N et al.. The impact of sedation on brain mapping: a prospective, interdisciplinary, clinical trial. Neurosurgery 2014. link 71 Blackburn VE, Sibtain A, Sabin HI. The use of ionising radiation for the purpose of arresting external haemorrhage from an intracranial mass lesion. British journal of neurosurgery 2014. link 72 Shen SL, Zheng JY, Zhang J, Wang WY, Jin T, Zhu J et al.. Comparison of dexmedetomidine and propofol for conscious sedation in awake craniotomy: a prospective, double-blind, randomized, and controlled clinical trial. The Annals of pharmacotherapy 2013. link 73 Arland LC, Hendricks-Ferguson VL, Pearson J, Foreman NK, Madden JR. Development of an in-home standardized end-of-life treatment program for pediatric patients dying of brain tumors. Journal for specialists in pediatric nursing : JSPN 2013. link 74 Drazin D, Spitler K, Cekic M, Patel A, Hanna G, Shirzadi A et al.. Incidental finding of tumor while investigating subarachnoid hemorrhage: ethical considerations and practical strategies. Science and engineering ethics 2013. link 75 Van Dycke A, Okito JP, Acou M, Deblaere K, Hemelsoet D, Van Roost D. Spontaneous delayed brain herniation through a subdural membrane after tumor surgery. Journal of neurological surgery. Part A, Central European neurosurgery 2013. link 76 Thaler J, Preusser M, Ay C, Kaider A, Marosi C, Zielinski C et al.. Intratumoral tissue factor expression and risk of venous thromboembolism in brain tumor patients. Thrombosis research 2013. link 77 Chaichana KL, Pendleton C, Jackson C, Martinez-Gutierrez JC, Diaz-Stransky A, Aguayo J et al.. Deep venous thrombosis and pulmonary embolisms in adult patients undergoing craniotomy for brain tumors. Neurological research 2013. link 78 Saito R, Kumabe T, Kanamori M, Sonoda Y, Mugikura S, Takahashi S et al.. Medial posterior choroidal artery territory infarction associated with tumor removal in the pineal/tectum/thalamus region through the occipital transtentorial approach. Clinical neurology and neurosurgery 2013. link 79 Seidel K, Beck J, Stieglitz L, Schucht P, Raabe A. The warning-sign hierarchy between quantitative subcortical motor mapping and continuous motor evoked potential monitoring during resection of supratentorial brain tumors. Journal of neurosurgery 2013. link 80 Kim DL, Cohen-Gadol AA. Indocyanine-green videoangiogram to assess collateral circulation before arterial sacrifice for management of complex vascular and neoplastic lesions: technical note. World neurosurgery 2013. link 81 Alotaibi NM, Lanzino G. Cerebral vasospasm following tumor resection. Journal of neurointerventional surgery 2013. link 82 Roth P, Eisele G, Weller M. Immunology of brain tumors. Handbook of clinical neurology 2012. link 83 Gofton TE, Graber J, Carver A. Identifying the palliative care needs of patients living with cerebral tumors and metastases: a retrospective analysis. Journal of neuro-oncology 2012. link 84 Di Ieva A, Matula C, Grizzi F, Grabner G, Trattnig S, Tschabitscher M. Fractal analysis of the susceptibility weighted imaging patterns in malignant brain tumors during antiangiogenic treatment: technical report on four cases serially imaged by 7 T magnetic resonance during a period of four weeks. World neurosurgery 2012. link 85 Wrede KH, Stieglitz LH, Fiferna A, Karst M, Gerganov VM, Samii M et al.. Patient acceptance of awake craniotomy. Clinical neurology and neurosurgery 2011. link 86 Weller M, Platten M, Roth P, Wick W. Geriatric neuro-oncology: from mythology to biology. Current opinion in neurology 2011. link 87 Fan L, Liu Y, Ying H, Xue Y, Zhang Z, Wang P et al.. Increasing of blood-tumor barrier permeability through paracellular pathway by low-frequency ultrasound irradiation in vitro. 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    Original source

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      Incidence and effect of supratentorial postoperative deep cerebral perforator territory ischemia in neurosurgical patients with intra-axial and extra-axial tumors.Sadigh Y, Schouten JW, Vincent AJPE, Dirven CMF, Dippel DWJ, Dang KTK et al. Journal of neurosurgery (2026)
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      Pediatric cranial stereotactic radiosurgery: Meta-analysis and international stereotactic radiosurgery society practice guidelines.Murphy ES, Sahgal A, Regis J, Levivier M, Fariselli L, Gorgulho A et al. Neuro-oncology (2025)
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      Duplex Ultrasound Screening for Deep Venous Thrombosis in Patients Undergoing Craniotomy for Intracranial Tumors: A Single Institutional Series.Avitsian R, Mohammadi AM, Beresian J, Nuti AM, Jolly S, Volovetz J et al. Journal of neurosurgical anesthesiology (2025)
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      Exploring the Relationship Between Radiation-Induced Moyamoya Syndrome and Radiation Dose for Pediatric Patients Treated With Proton Radiation Therapy.Gill GS, Baliga S, Lewy J, Bajaj BV, Gallotto SL, Fitzpatrick A et al. International journal of radiation oncology, biology, physics (2025)
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      Late-onset vascular complications of radiotherapy for primary brain tumors: a case-control and cross-sectional analysis.Ibáñez-Juliá MJ, Picca A, Leclercq D, Berzero G, Jacob J, Feuvret L et al. Journal of cancer survivorship : research and practice (2024)
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      Prevalence, characteristics, and risk factors of venous thromboembolism in patients with brain tumor undergoing craniotomy: a meta-analysis.Zeng Q, Lu G, Yuan J, Ding J, Chen J, Gao X et al. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (2024)
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      Postoperative surveillance in cranial and spinal tumor neurosurgery: when is this warranted?Schipmann S, Spille DC, Gallus M, Lohmann S, Schwake M, Warneke N et al. Journal of neurosurgery (2023)
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      Factorizer: A scalable interpretable approach to context modeling for medical image segmentation.Ashtari P, Sima DM, De Lathauwer L, Sappey-Marinier D, Maes F, Van Huffel S Medical image analysis (2023)
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      Disparities in place of death for patients with primary brain tumors and brain metastases in the USA.Shenker RF, Elizabeth McLaughlin M, Chino F, Chino J Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (2022)
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