الفهرس 
History Of The ThalamusOnly 14 pages are availabe for public view
 |  | from | 155 |  |  |
| | | from | 155 | | |
Abstract
Thalamic tumors are rare brain neoplasms, particularly in the pediatric population, accounting for only 5% of all brain tumors. The literature on the management of these tumors is limited, often encompassing both adult and pediatric cases, making it challenging to focus on the pediatric subset. However, recent advancements in diagnostic imaging techniques have improved the ability to precisely identify the anatomical origin of thalamic tumors and allow for more extensive surgical resection.
Pediatric thalamic tumors are classified into two major groups: unilateral thalamic tumors and bi-thalamic tumors. Bi-thalamic tumors are typically low-grade and are often managed through observation since surgery offers no significant benefit. Unilateral thalamic tumors, on the other hand, are usually surgically excised with varying degrees of resection depending on factors such as the presence of functionally important structures near the tumor and the extent of infiltration into surrounding tissues. The extent of resection and histological grading strongly influence the outcome of these tumors.
Patients with thalamic tumors commonly experience deficits due to disruptions in the relay and integration of motor, sensory, and regulatory signals. Symptoms can vary and include intracranial hypertension, headache, vomiting, convulsions, motor weakness, abnormal movements, and altered consciousness levels. The specific symptoms depend on the location and mass effect of the tumor within the thalamus. Improved imaging modalities and micro neurosurgical techniques have facilitated surgical excision with reduced morbidity and mortality rates while maximizing the extent of safe resection. Different surgical approaches, such as transfrontal, transcallosal, transtemporal, subtemporal, and transparietooccipital, have been utilized, but clear indications for their use are yet to be defined. Intraoperative guidance techniques, such as neuronavigation or ultrasonography, play a crucial role in surgical management by assisting in tumor localization, visualization of tumor margins, and assessment of residual tumor tissue.
To confirm the presence of neoplastic thalamic lesions, MR spectroscopy is often employed. In cases where neoplastic lesions are detected, a stereotactic biopsy is performed to confirm the diagnosis and determine the specific pathology. It is important to differentiate neoplastic thalamic lesions from non-neoplastic causes, such as encephalitis or metabolic disorders, as the treatment approaches differ.
Chemotherapy and radiation therapy are employed based on the type of tumor and the patient’s age. Chemotherapy is often used as a primary treatment for non-surgical patients with low-grade gliomas to delay or avoid radiation therapy. High-grade tumors typically receive radiation therapy regardless of surgical resection extent, while chemotherapy outcomes vary. In young children and infants with lowgrade gliomas, chemotherapy is used to delay or replace radiation therapy to minimize long-term side effects.