{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:54:32Z","timestamp":1786125272359,"version":"build-2736575974"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T00:00:00Z","timestamp":1566518400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/ mailto:journals.permissions@oup.com"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The brainstem is a less-common location for ependymomas than the spinal cord where they are the most common adult intramedullary tumor.\n                    <jats:sup>1-18<\/jats:sup>\n                    In this first video case report in the peer-reviewed literature, we demonstrate microsurgical resection of a medulla oblongata ependymoma.\n                  <\/jats:p>\n                  <jats:p>\n                    \u2003There are several case reports of medulla oblongata ependymomas\n                    <jats:sup>1<\/jats:sup>\n                    ,\n                    <jats:sup>3<\/jats:sup>\n                    ,\n                    <jats:sup>5<\/jats:sup>\n                    ,\n                    <jats:sup>6<\/jats:sup>\n                    ,\n                    <jats:sup>13<\/jats:sup>\n                    and a few series of spinal cord ependymomas that included cases of ependymomas of the cervicomedullary junction.\n                    <jats:sup>9<\/jats:sup>\n                    ,\n                    <jats:sup>10<\/jats:sup>\n                    The goal of surgery was to stabilize the preoperative neurological function; favorable outcome is achieved in patients with good preoperative statuses and well-defined tumor boundaries.\n                    <jats:sup>9<\/jats:sup>\n                    Although gross total resection (GTR) provides the best overall outcome, it is most effective for classic grade II tumors, but not grade I (myxopapillary) and ependymomas, which have a lower GTR rate.\n                    <jats:sup>14<\/jats:sup>\n                    ,\n                    <jats:sup>15<\/jats:sup>\n                  <\/jats:p>\n                  <jats:p>\u2003A 55-yr-old patient developed 4-extremity weakness and dysphagia. Pre-\/postcontrast magnetic resonance imaging (MRI) revealed centrally located brainstem lesion situated at the lower half of the medulla oblongata. Surgery, performed by the senior author, was performed in the prone position with a small suboccipital craniectomy and C1 posterior arch removal, followed by pia opening and posterior midline myelotomy. Tumor was debulked, dissected from the white matter, and resected. Histology revealed ependymoma (World Health Organization grade II). Postoperative pre-\/postcontrast MRI revealed total resection. The patient's neurological deficit completely resolved postoperatively.<\/jats:p>\n                  <jats:p>\u2003Written consent was obtained from the patient.<\/jats:p>","DOI":"10.1093\/ons\/opz252","type":"journal-article","created":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T20:54:21Z","timestamp":1566593661000},"page":"E240-E241","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Microsurgical Resection of Brain Stem Ependymoma: 2-Dimensional Operative Video"],"prefix":"10.1227","volume":"18","author":[{"given":"Mirza","family":"Pojski\u0107","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Marburg, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goran","family":"Laki\u010devi\u0107","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenan I","family":"Arnautovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee"},{"name":"Semmes Murphey Neurologic and Spine Institute, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,6]]},"reference":[{"issue":"5","key":"bib1-20240909","first-page":"727","article-title":"Case of clear cell ependymoma of medulla oblongata: clinicopathological and immunohistochemical study with literature review","volume":"53","author":"Amatya","year":"2003","journal-title":"Acta Neuropathol"},{"issue":"5","key":"bib2-20240909","first-page":"763","article-title":"Gross total resection of large cervical intramedullary ependymoma: demonstration of microsurgical techniques","volume":"24","author":"Cikla","year":"2014","journal-title":"Turk Neurosurg"},{"issue":"6","key":"bib3-20240909","doi-asserted-by":"crossref","first-page":"E1208","DOI":"10.1227\/01.NEU.0000369513.84063.A6","article-title":"Primary myxopapillary ependymoma of the medulla: case report","volume":"66","author":"DiLuna","year":"2010","journal-title":"Neurosurgery"},{"issue":"5","key":"bib4-20240909","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.neuchi.2016.01.002","article-title":"Intramedullary ependymoma: microsurgical resection technique","volume":"63","author":"Giammattei","year":"2017","journal-title":"Neurochirurgie"},{"issue":"6","key":"bib5-20240909","first-page":"517","article-title":"[Microsurgery of cervical intramedullary ependymomas extending into the medulla oblongata]","volume":"28","author":"Hoshimaru","year":"2000","journal-title":"No Shinkei Geka"},{"issue":"1","key":"bib6-20240909","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s10014-005-0174-5","article-title":"A case of cervicomedullary junction tanycytic ependymoma associated with marked cyst formation","volume":"22","author":"Ito","year":"2005","journal-title":"Brain Tumor Pathol"},{"issue":"2","key":"bib7-20240909","doi-asserted-by":"crossref","first-page":"E6","DOI":"10.3171\/2015.5.FOCUS15161","article-title":"Spinal ependymomas. 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