L-2-hydroxyglutaric aciduria (L-2-HGA) is a rare metabolic disorder associated with an increased risk of brain tumor development. Early diagnosis can be challenging due to non-specific neurological and magnetic resonance imaging (MRI) findings in the initial stages. A literature search of PubMed/MEDLINE and Google Scholar was conducted using predefined keywords related to L-2-hydroxyglutaric aciduria and central nervous system tumors. After screening and applying eligibility criteria, 19 publications reporting 32 intracranial tumor cases were identified. Together with the current illustrative case, 33 cases were included finally. We present a case of a brain tumor that was detected in a patient with L-2-HGA after a six-year seizure-free period following the onset of focal seizures, and we performed a comparative analysis with the 33 cases reported in the literature. Serial MRI examinations revealed progression of T2 hyperintensities and nodular contrast enhancement, which is consistent with high-grade tumor transformation. Clinical observations suggest that the emergence of new neurological symptoms and rapid progression may be early indicators of tumor developmen. MRI findings that may initially be mistaken for metabolic changes or demyelinating lesions can complicate the early diagnosis of the tumor. Therefore, careful clinical follow-up involving serial contrast-enhanced MRIs is crucial for patients with L-2-HGA. A literature review and case presentation emphasize that rapid neurological changes, or the recurrence and worsening of existing neurological symptoms, may be early warning signs. Long-term and dynamic follow-up is critical for the early detection of tumor progression and appropriate treatment planning.

Antenatal hydronephrosis (ANH) is a common prenatal finding with a heterogeneous postnatal course. This study aims to describe an institutional experience and protocol adherence regarding the clinical course, intervention timing, and surgical outcomes of severe ANH secondary to ureteropelvic junction obstruction (UPJO) and its rare coexistence with ureterovesical junction obstruction (UVJO). We retrospectively reviewed the records of infants referred to our tertiary center with severe prenatal urinary tract dilation (UTD A2-3 / high risk). Out of 400 initially screened patients, 80 infants who completed a standardized 1-year postnatal follow-up protocol were included, representing a highly selected completer cohort. Postnatal evaluation included serial ultrasounds (USG) and mercatoacetyltriglycine 3 (MAG-3) renography. Surgical intervention (dismembered pyeloplasty) was indicated based on standardized empirical consensus criteria: anterior-posterior renal pelvic diameter (APRPD) ≥ 19 mm, parenchymal thickness ≤ 5 mm, or split differential renal function (DRF) ≤ 40

PURPOSE:We aimed to investigate structural changes in the hippocampus using automated segmentation techniques to evaluate the anatomy and function of the hippocampus in patients with West syndrome (WS). METHODS:The study included 48 participants (24 with WS and 24 healthy controls) aged 0-4 years. Automated segmentation methods were used to measure hippocampal volume and evaluate diffusion tensor imaging (DTI) parameters such as fractional anisotropy (FA) and mean diffusivity (MD). Bonferroni correction was applied for multiple comparisons, setting the adjusted significance threshold at p < 0.0033. RESULTS:Children with WS exhibited significantly reduced total hippocampal volume and diminished volumes in the CA2-CA3, CA4-dentate gyrus (CA4-DG), and SR-SL-SM regions compared to healthy controls (padj <0.0033). After correction, no significant differences were found in the CA1 and subiculum regions (padj >0.0033). Although initial comparisons between ongoing WS and seizure-controlled WS suggested increased volumes in several hippocampal regions in the seizure-controlled group, these differences did not remain significant after adjustment and must be interpreted with caution. Notably, patients with seizure-controlled WS displayed larger hippocampal volumes, higher FA, and lower MD values, indicating a possible link between seizure activity and structural alterations. Additionally, DTI analysis of the cingulum revealed lower FA and higher MD values in WS patients, suggesting compromised microstructural integrity. CONCLUSIONS:These findings emphasize the potential role of hippocampal alterations in the pathophysiology of WS and suggest that DTI parameters may serve as useful measures for monitoring disease progression and treatment response.

Objective: This study aimed to investigate the effect of breast fibroglandular tissue density on tumor visibility and characterization efficacy in diffusion-weighted magnetic resonance imaging (DWI-MRI). Methods: After ethics committee approval from Karadeniz Technical University (No: 2025/16, Date: 25.03.2025), 2 independent readers retrospectively evaluated the images of 216 consecutive patients (age range, 16-85 years; mean, 45.5 years) who underwent breast MRI for suspicious clinical-radiological findings and later received a definite diagnosis. Only diffusion-weighted images were used at all stages of evaluation. Evaluation parameters were tumor visibility (4-point scale), malignancy probability (7-point scale), and tumor apparent diffusion coefficient (ADC) value. The most suspicious single index lesion was evaluated for each patient. The malignancy scores were determined by considering the morphologic features and the signal of tumors on the ADC map. The ADC values were measured manually on an MRI workstation. Later on, breast densities determined jointly by the readers using T1-weighted images according to the Breast Imaging Reporting and Data System (BI-RADS) classification. Student’s t-test, Chi-square test, and receiver operating characteristic analysis were used to statistically compare tumor visibility and diagnostic efficacies in different breast density groups (A, B=non-dense, C, D=dense). Results: Of the 216 patients, 116 (54%) had dense while 100 (46%) had non-dense breast tissue. Around 131 (61%) of the lesions were malignant and 85 (39%) were benign. In 80%-90% of cases with either dense or non-dense breasts, high-moderate tumor visibility was obtained. There was no significant difference between the dense and non-dense breasts in terms of tumor visibility (P ≥ .216) (Table 1). The mean ADC value in malignant tumors was lower than in benign tumors (P < .001). The agreement between the malignancy scores of the readers was moderate (kappa=0.597, P < .001). Diagnostic accuracy values in dense breasts were generally higher than in non-dense breasts (Tables 2 and 3). However, for neither of the evaluation methods nor readers, the result was statistically significant (P ≥ .154). Conclusion: In dense breasts, the risk of cancer is higher and the diagnostic efficacy of mammography is low. Therefore, additional methods are needed to increase the diagnostic efficacy in malignant tumors. Diffusion MRI is a very popular, highly efficient, easy-to-apply non-contrast-enhanced MR-based molecular imaging method. It has become a standard in routine clinical applications as an adjunct to breast dynamic contrast-enhanced MRI but it is also suitable for standalone use. In conclusion, malignant tumors are highly visible on diffusion MRI and differentiation of malignant from benign tumors can be made with 80%-90% accuracy regardless of breast density. It provides both qualitative and quantitative data. Qualitative data might also be used to grade malignancy probability like in the BI-RADS system. As a result, especially in dense breasts, diffusion MRI might be used in addition to mammography to improve the cancer detection ability.

To assess the prognostic potential of preoperative proton MRS in predicting postoperative outcomes for patients with INPH undergoing VPS. Preoperative MRS data were obtained and analyzed from 15 patients with INPH who underwent VPS. The concentrations of key metabolites—Cho, Cr, NAA, and Lac—were quantified in the Tha, BG, PV, and MF regions. Metabolite ratios were calculated, and clinical response to shunting was assessed using the Hellström INPH scale. Prognostic accuracy was determined via ROC analysis. • Cho: Elevated levels in the left MF region were associated with favorable neuropsychological outcomes. Conversely, lower levels in the left Tha correlated with improved gait, cognitive, continence, and overall outcomes. • Cr: Decreased levels in the right Tha and BG were predictive of improved continence. • NAA: Higher levels in the right MF region and lower levels in bilateral frontal PV areas were linked to better neuropsychological response. • Lac: Elevated levels in the left BG were associated with improved balance. Threshold values predictive of a favorable total shunt response included left and average Tha Cho ≤ 6 and ≤ 5.4, respectively, and average Tha and BG NAA ≤ 9 and ≤ 7.35, respectively. Proton MRS demonstrates promising utility as a non-invasive tool for predicting postoperative outcomes in INPH patients. In particular, regional levels of Cho, Cr, and NAA provide critical insights for optimizing patient selection and surgical planning. These findings could also deepen our understanding of the intricate pathophysiological mechanisms underlying INPH.

BACKGROUND:Idiopathic intracranial hypertension (IIH) is a condition characterized by increased cerebrospinal fluid (CSF) pressure without an identifiable cause. Although neuroimaging features are often used to support diagnosis, the relationship between CSF pressure and MRI findings remains unclear, particularly in pediatric populations. OBJECTIVE:To investigate the association between CSF opening pressure and clinical as well as MRI features in children diagnosed with IIH. METHODS:We retrospectively reviewed 30 pediatric patients (aged 6-18 years) diagnosed with IIH between 2015 and 2020. Patients were divided into two groups based on CSF opening pressure: Group 1 (200-350 mm H₂O) and Group 2 (≥350 mm H₂O). Clinical symptoms and MRI features-including optic nerve sheath dilation, posterior globe flattening, optic nerve tortuosity, and transverse sinus stenosis-were compared between groups. RESULTS:The mean CSF opening pressure was 363.8 mm H₂O. No statistically significant differences were observed between groups with respect to demographic features, clinical symptoms, or MRI abnormalities (p > 0.05). The most frequent imaging findings were posterior globe flattening (73.3 %) and optic nerve sheath dilation (70 %). Spearman correlation analysis demonstrated a significant positive association between CSF opening pressure and optic nerve sheath dilation (r = 0.417, p = 0.022), with borderline correlations noted for optic nerve tortuosity (r = 0.358, p = 0.052) and transverse sinus stenosis (r = 0.438, p = 0.069). DISCUSSION:CSF opening pressure alone did not distinguish clinical or imaging features between groups. However, higher pressures correlated with optic nerve sheath dilation and showed trends toward tortuosity and venous stenosis, suggesting these may be secondary markers of disease severity. CONCLUSION:Pediatric IIH appears multifactorial rather than purely pressure-driven. Multimodal evaluation is essential, and larger prospective studies are warranted to clarify the prognostic value of imaging correlates.

Purpose: Most meningiomas can be treated by surgical resection. However, depending on the location of the lesion, incomplete resection or high-grade meningiomas may have a poor prognosis. The new methods such as immunotherapy may improve our options for effective, patient-specific treatment of meningiomas. We aim to contribute to the development of new personalized treatment strategies by investigating the status of Gal-9 in meningiomas. Materials and Methods: Four hundred two cases diagnosed in our laboratory between 2007 and 2020 were used for the study. New blocks of multiple tissues were prepared for immunohistochemistry using the tissue microarray method. Immunohistochemical staining of Gal-9 antibody was evaluated using the H-score method. Results: Of the 402 cases studied, 289 were female and 113 were male. Two hundred and seventy-one (67.4%) cases were WHO grade 1; 121 (30.1%) were grade 2 and 10 (2.5%) were grade 3. A high H-score was observed in grade 1 and 2 tumors (H-score: 93.38 and 93.91) and a low H-score in grade 3 tumors (H-score: 59.40). There was no significant correlation between brain invasion and Gal-9 expression. No significant correlation was found between Gal-9 expression and minor criteria used in tumor grading. Conclusion: A statistically significant difference was found between Gal-9 H-score and tumor grade. Gal-9 had a lower H-score in high-grade meningiomas and its expression level decreased. Therefore, Gal-9 with different expression levels can be used as a prognostic and predictive biomarker as well as an important molecule for treatment.

Background/aim:Meningiomas are the most common primary brain tumors of the central nervous system. Immunotherapy is a promising treatment method applied in many types of cancer. There is no standard and effective medical treatment to reduce recurrence and mortality in cases of incomplete resection of meningiomas and in high-grade cases. In order to investigate medical treatments in addition to surgery and radiotherapy, in this study, the status of immune checkpoint molecules (PD-L1/PD-1), which are the target of immunotherapy, in meningiomas was investigated. Materials and methods:Four hundred two cases of meningioma diagnosed between 2007 and 2020 at our institution were used. New blocks were prepared from the appropriate blocks of the cases using the tissue microarray method. Sections obtained from these blocks were immunohistochemically stained with PD-1 and PD-L1 antibodies. Obtained data were interpreted with statistical analysis. Results:Expression of PD-L1 was observed in 28.4% of meningiomas. Staining rates are higher in high-grade tumors. The staining rate of PD-L1 in the tumor increased significantly with pattern loss. PD-L1 expression in immune cells is 19.9%. Immune cell expression and the number of expressing immune cells correlate with spontaneous necrosis. Immune cell expression and the number of expressing immune cells are increased in high-grade meningiomas. PD-1 expression in immune cells is 9.0%, and this correlates with brain invasion. Conclusions:With these data, it was observed that the expression of immune checkpoint molecules PD-L1 and PD-1 increased especially in high-grade meningiomas. It may be the subject of research that these molecules may be targets of immunotherapy in the treatment of meningiomas.

Background Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome with numerous etiologies, mostly characterized by magnetic resonance imaging (MRI) abnormalities in the posterior cerebral white and gray matter and acute neurological symptoms. Aim To examine the predisposing factors, clinical results, and radiological features of PRES in children diagnosed with malignancy. Materials and Methods The study included 20 patients (7 F/13 M) aged 4-16 years at the time of diagnosis who were diagnosed with malignancy and developed PRES during chemotherapy. Results All the patients were diagnosed as having PRES both clinically and radiographically during chemotherapy. The time from the initiation of the chemotherapy to the onset of PRES ranged from 7-675 days. Hypertension was detected in nine patients, seizure was the most common presenting symptom - had involvement in the occipital and parietal lobes on MRI (n=14)/followed by headache (n=8)/altered consciousness (n=5)/visual impairment (n=4). Hydrocephalus and tentorial herniation were observed in one patient. Most of the lesions on MRI resolved within 10-33 days and the EEG findings within 9 months. Clinical symptoms of PRES also disappeared completely the 5-year Press frequency was found to be 2.48%. Conclusion PRES may complicate the oncological treatment in children. Hypertension is a leading risk factor for PRES, while it should be kept in mind that the blood pressure may be normal in chemotherapy-induced PRES cases. PRES should be included in the differential diagnosis of all patients receiving chemotherapy and presenting with acute neurological symptoms.

Introduction: Necrotizing enterocolitis (NEC) is a severe gastrointestinal problem that predominantly affects premature babies. The aim of this retrospective study was to evaluate patients who underwent surgical treatment for NEC and newborns who initially recovered with medical treatment but later developed a stricture and required surgery. Materials and Methods: We analyzed patients diagnosed with NEC between January 2009 and December 2021. Our study included patients who developed strictures after initially receiving medical treatment for NEC and subsequently underwent surgery. Demographic findings, mother's age, gestational weeks, birth weight, type of birth, postnatal age at NEC diagnosis, pH, first C-reactive protein (CRP) after onset of symptoms, leukocytes, hemoglobin and thrombocytes at the onset of NEC, echocardiography results, age at surgery, blood values before surgery, surgery technique, and outcomes were retrospectively analyzed. Results: Out of 40 patients who underwent primary surgery for NEC during the newborn period, 6 patients underwent surgery after initially receiving medical treatment. The female-to-male ratio was 15/31, and the median gestational age was 29 weeks. The median mother's age was 30 years, and the median birth weight was 1097g. The median postnatal age at NEC onset was 6 days (range 2-39). Echocardiography was performed in 43 patients, with 6 showing normal results and 28 having congenital cardiac anomalies. The median surgery day for patients who underwent primary surgery for NEC was 19 days (range 2-90). Ileostomy was performed in 26 patients, colostomy in 8 patients, and ileostomy plus colostomy in 1 patient. Surgery was conducted in 6 out of 392 patients who developed post- NEC strictures after initial medical treatment. Comparison between post-NEC stricture patients and those who underwent surgery for NEC revealed significant differences only in the age at surgery (p=0.024). Conclusion: Patients who clinically experience NEC should be considered for the development of strictures, especially in cases of prolonged feeding intolerance, distention, gastric residual, and rectal bleeding. Therefore, close follow-up and multidisciplinary approaches are crucial, and contrast barium radiography should be the initial diagnostic step.

Sialoblastoma is rare low-grade malignant tumor, which is originated from parotid or submandibular gland. Although this tumor can be successfully, treated surgically, distant metastases to different anatomical regions may be seen depending on the histopathological features of the tumor. In this article, we present a 11-year-old patient who underwent an operation due to ectopic sialoblastoma and had pleural metastasis during the follow-up. To the best of our knowledge, this is the first case report of sialoblastoma-related pleural metastasis.

Glioblastoma Multiforme is a primary malignant neoplasm of the central nervous system which has aggressive progression and mostly seen in adults. Literature accepts the treatment for Glioblastoma Multiforme as combined process of surgical, concurrent chemo-radiotherapy, adjuvant chemotherapy. Glioblastoma Multiforme can spread in a variety of ways. Intraparenchymal spread by using white matter tracts is the most known way of spreading. Dissemination of Glioblastoma Multiforme through cerebrospinal fluid can happen, causing drop metastases, leptomeningeal spread and spinal metastasis. Treatment guideline for leptomeningeal spread in patients with Glioblastoma Multiforme has never been prepared. However, complete surgical removal of the tumor is the accepted treatment of Glioblastoma Multiforme. Surgical treatment is an important option in patients with spinal cord compression with solitary metastases. However, palliative radiotherapy and chemotherapy can be used in the treatment of patients with extensive spinal canal involvement and spinal cord compression. We present a case in which we applied radiotherapy because of spinal cord metastasis that developed after Glioblastoma Multiforme treatment in an adult patient. Through these observations, we analyze therapeutic options of Glioblastoma Multiforme with spinal cord involvement.

Migraine is a recurrent headache syndrome with a wide spectrum of symptoms. The diagnosis of migraine is mostly made retrospectively, taking into account the characteristics of the headache and other symptoms. It is not known enough how migraine headache starts and in which brain regions it occurs. It is known that changes in the excitability of brainstem nuclei affect endogenous pain mechanisms and unilateral involvement of trigeminovascular structures are effective mechanisms in migraine development. Understanding the role of the cerebellum in migraine disease is a fairly new topic in neuroscience. 19 Mıgraıne Patıents (MP) and 14 Healthy Controllers (HC) partıcıpated ın our study. For the volumetric analysis of the cerebellum, the ceres method of volbrain, which is an automatic brain volume calculation method, was used and the volumes of the cerebellum structures were obtained. SPSS 22.0 program was used for the analysis of the data and the level of significance was accepted as p

Essential tremor (ET) and Parkinson's disease (PD) are the two most commonly encountered tremor disorders in movement disorders. Diffusion tensor imaging (DTI) is one of the best in vivo ways of mapping white matter pathways in the human brain. The aim of our study was to investigate diffusion variables and cerebellum volume in ET and PD using parcellation methods. Our study included 20 ET, 20 PD and 20 healthy controls. Fraction Anisotropy (FA) and Mean Diffusivity (MD) values were obtained with DTI, while the volume of each lobe of the cerebellum was obtained with T1 images. One-way ANOVA was used for intergroup analysis and Scheffe test was used for post-hoc analysis. Significant differences were found in the diffusion values of the pedunculus cerebellaris, fornix stria, superior longitudinal fasciculus, sagittal stratum, cerebral pedunculus, tapatum and thalamus of ET and PD. Lobule V, Lobule IX, Lobule X volumes of the cerebellum showed significant differences between the groups. Stria thermialis shows involvement of mesolimbic dopaminergic system in PD and it is thought that disruption of strial networks leads to changes in the activity of cerebellar networks and reveals the role of the cerebellum in tremor. It is obvious that cerebellar thalamocortical pathways are affected in Parkinson's disease. In Parkinson's disease, patients should be evaluated for visual processing, conceptualisation, postural instability and gait disturbance to clarify the diagnosis or to differentiate from essential tremor.

Background. Intrathyroidal ectopic thymus (IET), a benign lesion due to aberrant thymic migration during embryogenesis, is often discovered incidentally. We aimed to present the ultrasound (US) features, diagnostic methods, and follow-up of IET in children and adolescents. Methods. We searched our database of patients with a nodular thyroid lesion detected by US, between January 2007 and December 2019. In 30/255 (11.7%), IET was diagnosed. Results. The study included 30 patients (20 males/10 females), mean age 5 years (0.1-12.2, median 5.6) with 34 lesions diagnosed by US as `incidentalomas.` None of the patients had palpable nodules. On US, IET appeared as a hypoechoic lesion, with multiple punctuate internal echoes. 29/34 of lesions had well-defined margins. The most common location of IET was in the middle part (27/34) of the left lobe (19/34). The mean longest diameter at diagnosis was 6.4 mm (2.5-21, median 4.5). Sonographic follow-up was available in 25 patients with 27 lesions. The mean time of observation was 2.7 years (0.3-7.5, median 2.1). While 13/27 cases showed decreased size or regression during follow-up, the other 13 increased in size, and there was no change in size in one. Pubertal progression was associated with both increment and decrease in size of IET. Fine needle aspiration (FNA) was performed in 5 patients and surgery in one. Conclusions. IET should be considered in the differential diagnosis of pediatric thyroid nodules as a cause of FNA and/or surgery. Regular US monitoring can be used safely in the follow-up of this lesion. We present one of the largest series in the literature with long-term follow-up and description of patients` pubertal status. IET prevalence was 11.7% among children and adolescents with a nodular thyroid lesion, higher than that stated in the literature.

Vitamin B12 begins to accumulate in infants within the first six months while mothers often remain asymptomatic and infantile vitamin B12 deficiency may not be noticed until the onset of neurological effects. In infants with Cbl deficiency, long-term exposure to elevated methylmalonic acid and homocysteine (MMA-HC) may have toxic effects on the central nervous system. The aim of this study was to evaluate cranial magnetic resonance (MRI) findings of 23 hypotonic infants that were followed up with a diagnosis of nutritional Cbl deficiency and combined MMA-HC. Of the 78 infants that presented with hypotonicity, 23 (29.4%) infants were detected with vitamin B12 deficiency. Elevated MMA-HC levels were detected in all patients (100%). Cranial MRI showed cortical atrophy in 6 (26.0%)-large sylvian fissures in 7 (30.4%)-ventricular dilatation in 5 (21.7%)-corpuscallosal thinning in 6 (26.0%)-delayed myelination in 3 (13%), and normal in 8 (34.7%) infants.Infants detected with corpus callosal thinning and cortical atrophy on MRI. Vitamin B12 deficiency is a treatable condition, it should be suspected in infants presenting with hypotonicity. Neuroradiological findings should be considered in the diagnosis of such patients. İnfantile nutritional vitamin B12 deficiency, which can be a source of persistent neurological deficits during the long term, should be treated to allow the patient to allow healthy neuro-development for infants. Maternal and fetal vitamin B12 levels should be assessed during the third trimester of pregnancy to prevent long-term exposure to infantile vitamin B12 deficiency.

Hypoxic ischemic encephalopathy (HIE) is an important cause of mortality and morbidity in newborns. Our study aimed to determine the neurodevelopmental outcomes, risk factors, and the relationship between risk factors and prognosis of cases followed up with HIE diagnosis and who were treated with hypothermia treatment. Medical records of 23 patients who were followed up with HIE diagnosis in the pediatric neurology outpatient clinic between January 1, 2018, and December 31, 2021, and treated with therapeutic hypothermia in the newborn period were retrospectively reviewed. Denver Developmental Screening Test II was used in the developmental evaluation. Neurodevelopment was normal in 12 (52.2%) of 23 cases and retarded for age in 11 (47.8%) cases. Variables such as Sarnat encephalopathy score in the neonatal period, need for prolonged ventilation, presence of severe acidosis at birth, Apgar scores at the 1st and 5th minutes, and abnormal cranial magnetic resonance (Mrg) findings were determined to be major factors in determining neurodevelopmental prognosis in asphyxic cases. The male gender was found to be riskier in terms of prognosis. Of the patients with HIE, retardation was determined for fine motor skills in 52.2%, speaking in 39.1%, gross motor skills in 26.1%, and personal development in 21.7%. Epilepsy, cerebral palsy, and speech disorders were the most common chronic period problems in patients with HIE. Despite therapeutic hypothermia treatment, neurodevelopmental problems are still observed in newborns with HIE. We found that male gender, low Apgar score, severe acidosis, and abnormal cranial Mrg findings in the neonatal period are risk factors in determining the neurodevelopmental prognosis of newborns with HIE. Monitoring and supporting the development of HIE cases with risk factors from the first months of life and intervening in developmental problems promptly are crucial in order to improve long-term outcomes.

Meningiomas are the most common primary intracranial tumor thought to derived from arachnoidal cap cells in the meningeal coverings of the spinal cord and brain. The current WHO classification, published in 2016, includes nine different subtypes of grade 1 meningiomas, three different subtypes of grade 2 meningiomas, and three different subtypes of grade 3 meningiomas. Metaplastic meningioma is a rare variant which shows focal or diffuse mesenchymal tissue component. Xanthomatous meningioma which has foamy cell changes is a quite rare variant of metaplastic meningioma. Two patients, 54 and 59 years old, who applied to our clinic with similar symptoms, were operated for meningioma. Histopathological examination of their biopsy showed that neoplastic cells had oval-round nuclei and eosinophilic cytoplasm. In xanthomatous meningioma, some neoplastic cells had clear vacuolated cytoplasm (foamy cells). In microscopic examination of resection material in one of these patients, cells in some areas of the tumor had clear vacuolated cytoplasm (foamy cells). These neoplastic cells were scattered among other meningothelial cells and they were positive for EMA. To the best of our knowledge, until today there have been only 14 reported xanthomatous meningioma cases in English literature. Here, we aimed to discuss the pathogenesis and differential diagnosis of xanthomatous meningioma in two different cases.

Background/aim:To reveal the contribution of magnetic resonance imaging (MRI) to ultrasound (US) in prenatal diagnosis of fetal craniospinal anomalies by retrospectively comparing the prenatal and postnatal findings.Materials and methods:After institutional review board approval, between January 2010 and May 2020, 301 pregnant women, which had a gestational age between 19–37 weeks (mean 26.5 ± 6.1 weeks), diagnosed with cranial and spinal anomalies on fetal US and later on imaged with MRI were evaluated, and in 179 of those cases prenatal imaging findings were compared with postnatal findings.Results:A total of 191 fetal craniospinal anomalies were detected in 179 pregnant women. MRI and US diagnosis were completely correct in 145 (75.9%) and 112 (58.6%), respectively. Diagnostic performance of MRI was significantly higher than that of the US (p < 0.05). Both prenatal MRI and US findings were concordant with postnatal diagnosis in 53% of the cases. In 28.7% cases, prenatal MRI contributed to US by either changing the wrong US diagnosis (8.9%), demonstration of additional findings (14%), or confirming the suspicious US diagnosis (5.8%).Conclusion:Due to its high resolution and multiplanar imaging capability, fetal MRI contributes significantly to US in the correct prenatal diagnosis of craniospinal anomalies. This contribution especially is significant in neural tube defects, cortical malformations, and ischemic-hemorrhagic lesions.