Tentorial dural arteriovenous fistula with perimedullary venous drainage-associated cervical myelopathy: illustrative case.

BACKGROUND: Tentorial dural arteriovenous fistulas (DAVFs) with perimedullary venous drainage causing cervical myelopathy are very uncommon conditions with an extremely aggressive behavior. When the characteristic radiological clues are missing, the unspecific clinical picture may cause delay and make the diagnosis challenging. OBSERVATIONS: Here the authors report a case of a 58-year-old man who developed progressive spastic tetraparesis and dyspnea with an extensive mild enhancing cervical cord lesion initially oriented as a neurosyphilis-associated transverse myelitis. Acute worsening after steroid administration redirected the diagnosis, and a tentorial Cognard type V DAVF was elicited. The microsurgical disconnection process is described, and previously documented cases in the literature are reviewed. LESSONS: If a DAVF is highly suspected, it is important to consider the possibility of its intracranial origin, and spinal as well as cerebral arteriography must be performed.

Monkeypox outbreak predominantly affecting men who have sex with men, Madrid, Spain, 26 April to 16 June 2022.

Up to 22 June 2022, 508 confirmed cases of monkeypox (MPX) have been reported in the Madrid region of Spain, 99% are men (n = 503) with a median age of 35 years (range: 18-67). In this ongoing outbreak, 427 cases (84.1%) reported condomless sex or sex with multiple partners within the 21 days before onset of symptoms, who were predominantly men who have sex with men (MSM) (n = 397; 93%). Both the location of the rash, mainly in the anogenital and perineal area, as well as the presence of inguinal lymphadenopathy suggest that close physical contact during sexual activity played a key role in transmission. Several cases reported being at a sauna in the city of Madrid (n = 34) or a mass event held on the Spanish island of Gran Canaria (n = 27), activities which may represent a conducive environment for MPX virus spread, with many private parties also playing an important role. Because of the rapid implementation of MPX surveillance in Madrid, one of the largest outbreaks reported outside Africa was identified. To minimise transmission, we continue to actively work with LGBTIQ+ groups and associations, with the aim of raising awareness among people at risk and encouraging them to adopt preventive measures.

Ganglioglioma anaplásico: diseminación leptomeníngea cervico-dorso-lumbar. A propósito de un caso / Anaplasic ganglioglioma: Cervical-dorso-lumbar leptomeningeal dissemination. About a case

Los ganglioglioma son tumores bien diferenciados, de crecimiento lento, compuestos por una mezcla de células ganglionares maduras y gliales. La mayoría son de grado I de la OMS. Aparecen predominantemente en niños y adultos jóvenes. La mayoría se localizan a nivel del lóbulo temporal, y la sintomatología más frecuente son las crisis epilépticas de difícil control farmacológico. En general tienen buen pronóstico tras la resección quirúrgica. La variante anaplásica, considerada grado III de la OMS, presenta mayor agresividad clínica y radiológica. La diseminación leptomeníngea es excepcional en estos tipos de tumores, pero cuando es diagnosticada presenta un curso rápidamente progresivo y fatal para el paciente (AU)

Gangliogliomas are well-differentiated, slow-growing tumors. The majority are grade I of WHO. It appears predominantly in children and young adults. Most are located at the temporal lobe, and as symptomatology more frequent epileptic seizures of difficult pharmacological control. In general, they have a good prognosis after surgical resection. The anaplasic variant, considered to be grade III of the WHO, presents greater clinical and radiological aggressiveness. Leptomeningeal dissemination is exceptional in these types of tumors, but when diagnosed it presents a rapidly progressive and fatal course for the patient (AU)

Anaplasic ganglioglioma: Cervical-dorso-lumbar leptomeningeal dissemination. About a case. / Ganglioglioma anaplásico: diseminación leptomeníngea cervico-dorso-lumbar. A propósito de un caso.

Gangliogliomas are well-differentiated, slow-growing tumors. The majority are gradeI of WHO. It appears predominantly in children and young adults. Most are located at the temporal lobe, and as symptomatology more frequent epileptic seizures of difficult pharmacological control. In general, they have a good prognosis after surgical resection. The anaplasic variant, considered to be gradeIII of the WHO, presents greater clinical and radiological aggressiveness. Leptomeningeal dissemination is exceptional in these types of tumors, but when diagnosed it presents a rapidly progressive and fatal course for the patient.

Profilaxis preexposición al VIH en España: situación política y administrativa / HIV pre-exposure prophylaxis (PrEP) in Spain: political and administrative situation

Este estudio se ha centrado en las actuaciones a nivel político y administrativo que se han realizado en España en relación con la implementación de la profilaxis preexposición (PrEP) al VIH. Se ha analizado todo tipo de iniciativas formales por parte de los actores políticos y administrativos implicados. Las fuentes utilizadas son las fuentes oficiales públicas. Hasta febrero de 2018, la PrEP no ha sido implementada. La decisión depende de los niveles estatal y autonómico. El Ministerio de Sanidad y algunas Comunidades Autónomas trabajan en diversas intervenciones sin establecer un calendario de implementación. Los partidos políticos por su parte han promovido escasas iniciativas relacionadas con la implementación de la PrEP. En el terreno jurídico, se han producido vaivenes legales relacionados con la extensión de la patente. El papel de los órganos intergubernamentales e interdepartamentales es vital para la implementación de la PrEP

This study focuses on actions at the political and administrative level in Spain in relation to the implementation of pre-exposure prophylaxis (PrEP). We analysed a whole range of different formal initiatives taken by the political and administrative actors involved. The information was obtained from official public data sources. As of February 2018, PrEP had not been implemented. The decision is dependent on both state and regional governments. The Ministry of Health and some Autonomous Regions are working on different interventions, but without providing an implementation timetable. The political parties have kept a very low profile in terms of initiatives related to the implementation of PrEP. From a legal point of view, proceedings are passing back and forth with the extension of the patent. The role of intergovernmental and interdepartmental institutions is very important for the implementation of PrEP in Spain

Fluorescence Guided Surgery with 5-Aminolevulinic Acid for Resection of Spinal Cord Ependymomas.

STUDY DESIGN: A retrospective study. PURPOSE: We report our experience with 5-aminolevulinic acid (5-ALA)-assisted resection of spinal cord ependymomas in adults. OVERVIEW OF LITERATURE: Ependymoma is the most frequent primary spinal cord tumor in adults. Surgery is the treatment of choice in most cases. However, while complete resection is achieved in approximately 80% of cases, clinical improvement is achieved in 15% only. Five-ALA fluorescence-guided surgery seems to be useful for this tumor type. METHODS: We studied 14 patients undergoing 5-ALA fluorescence-guided surgery for spinal cord ependymomas in our service. The modified McCormick classification was used to determine clinical status and the degree of resection was assessed with magnetic resonance imaging. RESULTS: Of the 14 patients, the tumor showed an intense emission of fluorescence in 12 and the fluorescence was weak and nonuniform in two. Complete resection was achieved in 11 cases. According to the McCormick classification, 10 patients improved, two remained the same, and two deteriorated. CONCLUSIONS: Our results confirm that 5-ALA fluorescence-guided resection is useful in spinal cord ependymoma resection. Although the rate of complete resections is similar to that in published series without 5-ALA, clinical results are better when using 5-ALA with a lower percentage of clinical deterioration.

HIV pre-exposure prophylaxis (PrEP) in Spain: political and administrative situation. / Profilaxis preexposición al VIH en España: situación política y administrativa.

This study focuses on actions at the political and administrative level in Spain in relation to the implementation of pre-exposure prophylaxis (PrEP). We analysed a whole range of different formal initiatives taken by the political and administrative actors involved. The information was obtained from official public data sources. As of February 2018, PrEP had not been implemented. The decision is dependent on both state and regional governments. The Ministry of Health and some Autonomous Regions are working on different interventions, but without providing an implementation timetable. The political parties have kept a very low profile in terms of initiatives related to the implementation of PrEP. From a legal point of view, proceedings are passing back and forth with the extension of the patent. The role of intergovernmental and interdepartmental institutions is very important for the implementation of PrEP in Spain.

El significado de las relaciones sociales como mecanismo para mejorar la salud y calidad de vida de las personas mayores, desde una perspectiva interdisciplinar / The importance of social relationships as a mechanism to improve the health and quality of life of the elderly, from an interdisciplinary perspective

Introducción: Este artículo analiza los efectos de las relaciones sociales positivas como determinantes en el estado de salud de las personas mayores, desde un punto de vista interdisciplinar. Materiales y métodos: Se realizó en la provincia de Toledo un muestreo en el que participaron 2.332 sujetos, donde se aplicaron diversas escalas relacionadas. Para el análisis multivariable de los datos, se calculó la recta de regresión, junto a la bondad de ajuste con las pruebas de Cox, Snell y R-cuadrado de Nagelkerke, para averiguar la correlación entre las relaciones sociales, las redes y los contactos con la salud. Resultados: Las buenas relaciones sociales redundan en un mejor estado de salud, porque permiten sentirse bien y añadir vida a los años. El tamaño de la red social, y la frecuencia de los contactos, aunque disminuyen con la edad, cobran vital importancia en esta etapa de la vida. Todos estos factores constituyen estímulos para mejorar la percepción de salud y proporcionar apoyo social tanto en actividades de la vida diaria como en las instrumentales o de gestión de la enfermedad. Conclusiones: El principal resultado de este estudio es que las relaciones sociales positivas pueden considerarse como un determinante en la salud de las personas mayores, pero no todas estas interacciones influyen en la misma medida. El factor de la relación humana en cuanto a la proximidad emocional, junto con la frecuencia o cantidad de estos encuentros, también están correlacionados con la salud, debido al impacto emocional que implican

Introduction: This study presents an analysis on the effects of positive social relationships as determining factors on the health status of the elderly, from an interdisciplinary point of view. Materials and methods: A survey was carried out on a total of 2,332 subjects in the province of Toledo, Spain, using several scales related to the study objectives. For the multivariable analysis of the data, the linear regression, along with goodness of fit, as well as the tests of Cox, Snell and R-squared of Nagelkerke, were calculated to determine the correlation between the networks and the social contacts with the health. Results: Good social relationships result in better health, because they allow us to feel good and add life to the years. The size of the social network, and the frequency of contacts, although decreasing with age, become vitally important at this stage of life. All these factors constitute stimuli to improve the perception of health, to provide social support in activities of daily living, as well as for instrumental or disease management. Conclusions: The main outcome of this study is that positive social relationships can be considered as a determining factor in the health of the elderly, but not all these interactions influence the same extent. The factor of the human relationship in terms of emotional proximity, together with the frequency or quantity of these encounters, are also correlated with health, due to the emotional impact they imply

The Impact of Quality of Life on the Health of Older People from a Multidimensional Perspective.

BACKGROUND: This research analyzes the impact of quality of life as a metavariable that conditions the health and social welfare of the elderly. The sample of this study is composed of 500 people, randomly selected from the major day centers for the elderly in the province of Granada (Spain). METHOD: For the inferential analysis, we used the CUBRECAVI questionnaire, which is a multidimensional scale of health and quality of life, along with the Katz and García measure questionnaires, which are also applied to quality of life. Through the technique of the interview, we have distributed the participants into two groups: experimental and control. RESULTS AND CONCLUSIONS: Once the tests have been completed, we have concluded from the meta-analysis and validation tests that the participants have a good perception of their quality of life, considering health, leisure, environmental quality, functional capacity, level of satisfaction, social support, social networks, and positive social interactions as the determinants of their well-being, although social contact reduces as the age advances. We conclude that multidimensional evaluation is an effective tool to evaluate the quality of life and the objective and subjective health of the elderly. These variables can be related to the improvement of health and well-being.

[The importance of social relationships as a mechanism to improve the health and quality of life of the elderly, from an interdisciplinary perspective]. / El significado de las relaciones sociales como mecanismo para mejorar la salud y calidad de vida de las personas mayores, desde una perspectiva interdisciplinar.

INTRODUCTION: This study presents an analysis on the effects of positive social relationships as determining factors on the health status of the elderly, from an interdisciplinary point of view. MATERIALS AND METHODS: A survey was carried out on a total of 2,332 subjects in the province of Toledo, Spain, using several scales related to the study objectives. For the multivariable analysis of the data, the linear regression, along with goodness of fit, as well as the tests of Cox, Snell and R-squared of Nagelkerke, were calculated to determine the correlation between the networks and the social contacts with the health. RESULTS: Good social relationships result in better health, because they allow us to feel good and add life to the years. The size of the social network, and the frequency of contacts, although decreasing with age, become vitally important at this stage of life. All these factors constitute stimuli to improve the perception of health, to provide social support in activities of daily living, as well as for instrumental or disease management. CONCLUSIONS: The main outcome of this study is that positive social relationships can be considered as a determining factor in the health of the elderly, but not all these interactions influence the same extent. The factor of the human relationship in terms of emotional proximity, together with the frequency or quantity of these encounters, are also correlated with health, due to the emotional impact they imply.

Anterior sacral meningocele presenting as intracystic bleeding.

PURPOSE: To report a case of anterior sacral meningocele with intralesional bleeding secondary to sacrococcygeal trauma. Likewise, there is a discussion about the physiopathology and the surgical approach to these types of lesions. METHODS: A 43-year-old man diagnosed with Marfan syndrome suffered sacrococcygeal trauma. He was admitted to the emergency room due to symptoms of headache, nausea, and lower limb subjective weakness. CT and MRI showed a large retroperitoneal mass with hemorrhagic content close to the sacrum. Likewise, the MRI showed an image compatible with subarachnoid hemorrhage in the thoracic spinal area, cerebral convexity, and the basal cisterns. The patient went into surgery for an anterior abdominal approach in the midline to reduce the content of the lesion, and subsequently, in the same act, a posterior approach was done with an S1-S2 laminectomy and obliteration of the pedicle. Postoperative MRI 5 months later showed resolution of the ASM. RESULTS: Anterior sacral meningocele is characterized by herniation of the dura mater and the arachnoid mater outside the spinal canal through a defect of the sacrum. We add the risk of bleeding after trauma-never seen in the literature-as one of the possible inherent complications of this lesion. CONCLUSIONS: This report highlights a complication never seen in the literature of a relatively rare condition. In our case, the combined approach was effective for both clinical control and lesion regression.

Fluorescence guided resection with 5-aminolevulinic acid of a pilomyxoid astrocytoma of the third ventricle / Resección guiada por fluorescencia con ácido 5-aminolevulínico de un astrocitoma pilomixoide del tercer ventrículo

Fluorescence-guided resection with 5-aminolevulinic acid has been shown to be useful in the resection of certain brain tumors other than high grade gliomas, facilitating the intraoperative differentiation of neoplastic tissue. The technique enables the surgeon to ensure that no tumor fragments remain, thereby achieving higher rates of complete resection. Tihan first described pilomyxoid astrocytomas in 1999. They are currently classified as grade II astrocytoma according to the WHO classification system and, because of their tendency to recur and their dissemination through the cerebrospinal fluid pathways, they are considered to be more aggressive than pilocytic astrocytoma. As a result, management of these tumors must be more aggressive, always aiming for complete macroscopic resection whenever possible. In this article, we present a case of pilomyxoid astrocytoma of the third ventricle in which the use of fluorescence-guided resection with 5-ALA facilitated complete resection. Imaging tests performed after five years revealed no signs of recurrence and no adjuvant radiotherapy or chemotherapy was required. This article also comprises a review of the literature concerning the characteristics and management of this tumor, which was recently considered to be a different histopathological entity

La resección guiada por fluorescencia con 5-ALA se ha mostrado útil en tumores diferentes a los gliomas de alto grado, permitiendo la diferenciación intraoperatoria del tejido tumoral. La técnica permite revisar el lecho quirúrgico para comprobar que no quedan fragmentos tumorales, consiguiéndose así mejorar las tasas de resección completa. El astrocitoma pilomixoide, descrito en 1999 por Tihan, se clasifica actualmente como un astrocitoma grado II en la clasificación de la OMS y es considerado como una variante con mayor agresividad que el astrocitoma pilocítico por su tendencia a la recidiva y a la diseminación por el líquido cefalorraquídeo. Por ello el tratamiento debe ser más agresivo, fundamentado en una resección macroscópicamente completa siempre que se pueda. En este artículo presentamos el caso de un astrocitoma pilomixoide del tercer ventrículo en el que la fluorescencia con 5-ALA permitió una resección completa, sin signos de recidiva en pruebas de imagen a los 5 años, sin haber precisado tratamiento complementario con radioterapia ni quimioterapia. Se hace además una revisión de la literatura acerca de las características y el manejo de este tumor recientemente considerado como una entidad histopatológica diferente

Fluorescence guided resection with 5-aminolevulinic acid of a pilomyxoid astrocytoma of the third ventricle.

Fluorescence-guided resection with 5-aminolevulinic acid has been shown to be useful in the resection of certain brain tumors other than high grade gliomas, facilitating the intraoperative differentiation of neoplastic tissue. The technique enables the surgeon to ensure that no tumor fragments remain, thereby achieving higher rates of complete resection. Tihan first described pilomyxoid astrocytomas in 1999. They are currently classified as grade II astrocytoma according to the WHO classification system and, because of their tendency to recur and their dissemination through the cerebrospinal fluid pathways, they are considered to be more aggressive than pilocytic astrocytoma. As a result, management of these tumors must be more aggressive, always aiming for complete macroscopic resection whenever possible. In this article, we present a case of pilomyxoid astrocytoma of the third ventricle in which the use of fluorescence-guided resection with 5-ALA facilitated complete resection. Imaging tests performed after five years revealed no signs of recurrence and no adjuvant radiotherapy or chemotherapy was required. This article also comprises a review of the literature concerning the characteristics and management of this tumor, which was recently considered to be a different histopathological entity.

Support and Social Contact as a Decisive Meta-Variable in Morbidity and Social Welfare of the Older Person.

Bacground: This article tackles social support as a meta-variable that is reinforced by a set of social variables, which correlate and act as predictors of social welfare and life quality of the older person. OBJECTIVE: The objective of the study is to know how social support, networks and social contacts can influence the health of the elderly person, especially if these are interrelated factors. METHOD: The population studied are individuals from both sexes living in Toledo (Spanish people) and who were 65 years of age or over. Several scales were applied to assess the frequency of and the degree of satisfaction with perceived social support received from different sources in relation to social support. The co relational analysis showed significant positive associations between scores and measures of and social support, social relations, contact and social networks. RESULTS: We conclude that the support in general is very good, over 90% of people from the sample have someone who would help if needed. Social and health factors are interrelated with social support. Social contact can also be considered as a life quality estimate. He progressive loss of contact over the years is a social factor that affects the quality of life. CONCLUSION: The meta-analysis we find that social support and the emotional factor, along with social interactions, have powerful effects on preventing morbidity and mortality, which are important social indicators. We conclude that social support based on positive social interactions provides an optimal state of health in the older person.

¿Cuál es su diagnóstico?: Osteosarcoma mandibular radioinducido / What would your diagnosis be?: Radiation-induced jaw osteosarcoma

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Osteosarcoma mandibular radioinducido / Radiation-induced jaw osteosarcoma

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Meningioma intraóseo primario osteolítico del hueso occipital / Primary osteolytic intraosseous meningioma of the occipital bone

Los meningiomas intraóseos primarios son considerados meningiomas extradurales siempre que no tengan relación con la duramadre. La mayoría crecen de huesos del cráneo, pudiendo ser osteoblásticos u osteolíticos. Estos últimos son los más raros, habiendo muy pocos casos descritos en la literatura. Con mayor frecuencia tienen signos de malignidad, por lo que es importante el diagnóstico histológico precoz de una lesión osteolítica craneal para su correcto tratamiento. El tratamiento debe ser la cirugía, con resección completa siempre que se pueda. Presentamos el caso de un gran meningioma intraóseo primario osteolítico del hueso occipital tratado quirúrgicamente mediante craniectomía y sin signos de recidiva a los 5 años de seguimiento

Primary intraosseous meningiomas are considered extradural meningiomas when no dural attachment is present. Most of them arise from the cranial bones and can present either as an osteoblastic or an osteolytic lesion. Osteolytic intraosseous meningiomas are the rarest and very few cases have been reported. Given that many of these may develop signs of malignancy, early histological confirmation is important in order to ensure appropriate treatment. The recommended therapy is surgery, with complete resection whenever possible. We present the case of a large primary intraosseous osteolytic meningioma within the occipital bone, which was completely excised five years ago, currently presenting no signs of recurrence

Quiste sinovial de articulación temporomandibular: presentación de un caso / Synovial cyst of the temporomandibular joint: presentation of a case

El quiste sinovial localizado en la articulación temporomandibular es una entidad rara, con pocos casos reportados en la literatura médica. Gaisford et al. fueron los primeros autores que informaron de un caso de quiste sinovial, patología que afecta más frecuentemente a articulaciones como la muñeca o la rodilla. Estos quistes están delimitados por células sinoviales, y pueden estar comunicados o ser independientes de la cavidad articular. Se han propuesto varias teorías para explicar la etiología de esta patología, un incremento de la presión en la cavidad articular causado por una inflamación o traumatismo puede ser clave para producir una herniación de la membrana sinovial dando lugar a la entidad. Entre los diagnósticos que hay que considerar ante una tumoración preauricular se encuentran los tumores de parótida, los quistes sebáceos, los gangliones y los quistes sinoviales, entre otros. El tratamiento quirúrgico es el tratamiento frecuentemente propuesto por la literatura, logrando una escasa tasa de recurrencia (AU)

A synovial cyst located in the temporomandibular joint is rare, with few cases reported in the medical literature. Gaisford et al. were the first authors to report a case of a synovial cyst. This a condition that more frequently affects joints such as the wrist or knee. These cysts are delimited by synovial cells, and may be connected to, or be independent of, the joint cavity. Several theories have been proposed to explain the etiology of this disease: an increase in pressure in the joint cavity caused by inflammation or trauma may be the reason that a herniation of the synovial membrane could be produced. Among the diagnoses to be considered when faced with a tumor are pre-auricular parotid tumors, sebaceous cysts, ganglia and synovial cysts, among others. Surgery is the treatment most frequently proposed in the literature, achieving a low rate of recurrence (AU)

Sarcoma de Ewing extraesquelético epidural. Caso clínico y revisión de la literatura / Epidural extraskeletal Ewing sarcoma. Case report and literature review

El sarcoma de Ewing es un tumor óseo maligno que en ocasiones presenta afectación extraesquelética, siendo rara la localización epidural. Presentamos el caso de una mujer de 45 años que presentó parestesias, debilidad progresiva y retención urinaria. La resonancia magnética mostró una masa epidural desde C6 a D3. Se realizó una laminectomía de C7 a D2 y exéresis parcial de la lesión. El estudio anatomopatológico fue compatible con sarcoma de Ewing. La paciente recibió quimioterapia y radioterapia, no existiendo evidencia de enfermedad a los 8 meses de seguimiento. Presentamos una revisión de la literatura de todos los casos publicados de sarcoma de Ewing extraesquelético con afectación epidural

Ewing sarcoma is a malignant tumour of the bone that sometimes presents extraskeletal involvement, with the epidural location being rare. We report the case of a 45-year-old woman with paresthesia, paresis and urinary retention. Magnetic resonance imaging showed an epidural mass from C6 to D3. Laminectomy from C7 to D2 and partial resection of the lesion was performed. Pathological analysis was consistent with Ewing sarcoma. The patient received chemotherapy and radiotherapy, without evidence of disease at 8 months follow-up. A review of the literature on all published cases of extraskeletal Ewing sarcoma with epidural involvement is presented

Fluorescence-guided resection with 5-aminolevulinic Acid of subependymomas of the fourth ventricle: report of 2 cases: technical case report.

BACKGROUND AND IMPORTANCE: The usefulness of 5-aminolevulinic acid (5-ALA) for resection of malignant astrocytomas has been established in recent years. In addition to these tumors, it has been reported that 5-ALA fluorescence could be elicited in other tumors such as intracranial and spinal meningiomas or posterior fossa and spinal cord ependymomas, resulting in improved resections. Here, we present 2 cases of subependymomas of the fourth ventricle that showed intense fluorescence after 5-ALA administration. To the best of our knowledge, these are the first reported cases of subependymomas in this location in which 5-ALA elicited useful fluorescence. CLINICAL PRESENTATION: Case 1 was a 61-year-old woman with a history of headaches accompanied by vomiting in the last month. Magnetic resonance imaging (MRI) revealed a tumor occupying the fourth ventricle with slight irregular enhancement. She was operated on after administration of 5-ALA. The tumor emitted intense red fluorescence when illuminated with blue light. An MRI performed 48 hours after surgery confirmed complete resection of the tumor. The pathological diagnosis was subependymoma. Case 2 was a 35-year-old man with a history of several months of headaches and vomiting. An MRI revealed a tumor occupying the caudal part of the fourth ventricle with moderate and irregular enhancement. He was operated on after administration of 5-ALA. The tumor showed intense fluorescence. An MRI performed 48 hours after surgery confirmed a complete resection of the tumor. The pathological diagnosis was subependymoma. CONCLUSION: Fluorescence-guided resection with 5-ALA may be useful for resection of subependymomas of the fourth ventricle. However, further studies are needed.