The aim of this study was to compare the pre- and postoperative function of patients qualifying for resection of malignant and nonmalignant primary brain tumors to determine the relationship among tumor type, function, and the course of rehabilitation after surgery. This single-center, prospective, observational study recruited 92 patients requiring prolonged postoperative rehabilitation during their inpatient stay, who were divided into a nonmalignant tumor group (n = 66) and a malignant tumor group (n = 26). Functional status and gait efficiency were assessed using a battery of instruments. Motor skills, postoperative complications, and length of hospital stay (LoS) were recorded and compared between groups. The frequency and severity of postoperative complications, the time needed to attain individual motor skills, and the proportion of patients losing independent gait (~30%) were similar between groups. However, paralysis and paresis were more frequent in the malignant tumor group before surgery (p < 0.001). While nonmalignant tumor patients deteriorated more according to all scales after surgery, patients with malignant tumors were still characterized by worse ADL, independence, and performance at discharge. Worse functional outcomes in the malignant tumor group did not affect LoS or rehabilitation. Patients with malignant and nonmalignant tumors have similar rehabilitation needs, and patient expectation—especially those with nonmalignant tumors—should be appropriately managed.

Background/Objectives: While most studies on the postoperative condition of patients with spinal cord tumors describe long-term outcomes, data are needed on immediate surgical outcomes demanding rehabilitation to make informed assessments for postoperative planning. The aim of this study was to identify factors predicting function and rehabilitative needs after intradural spinal tumor surgery. Methods: Eighty-five prospectively recruited patients underwent surgery for intradural intramedullary (ID-IM; n = 23) and extramedullary (ID-EM; n = 62) tumors. Neurological and functional status were assessed before surgery, after surgery, and at discharge using the modified McCormick scale (MMS), Karnofsky performance status (KPS) scale, Barthel index (BI), and the gait index (GI). Results: There were no significant predictors of early postoperative rehabilitation in the ID-IM group. In the ID-EM group, age, thoracic level, subtotal resection (STR), repeat surgery, and functional scale scores predicted the need for rehabilitation. In multivariable analysis, MMS (odds ratio (OR) 8.7; 95% confidence interval (CI): 2.37–32.44) and STR (OR 13.00; 95%CI: 1.56–107.87) remained independent predictors of rehabilitation need (area under curve, 92%). Despite their younger age, most patients with ID-IM tumors, especially ependymomas, required rehabilitation but improved quickly (KPS, BI, p < 0.001). Among ID-EM tumors, meningiomas were characterized by poorer preoperative function and low gross total resection (GTR) rates, but did not deteriorate neurologically after surgery. Patients with schwannoma and ID-EM ependymomas achieved the highest GTR rate and had the best function both before and after surgery. Conclusions: These results may be useful for estimating early rehabilitation needs after intradural tumor surgery and counseling patients before surgery about the expected postoperative course.

Background: Spinal epidural lipomatosis (SEL) is a rare disorder characterized by excessive epidural fat accumulation. Diagnosis may be challenging because imaging findings are frequently overlooked, and evidence-based management guidelines, particularly thoracic disease, remain limited. Case report: We present a case report of a 54-year-old male patient, who suffered from lower limb spastic paresis and associated muscle spasms (Nurick grade V). After a difficult diagnostic process, MRI of the thoracic spine confirmed dorsal/posterior spinal epidural lipomatosis (SEL; Manjila grade IIb-α) extending from Th2 to Th9, with moderate thecal sac compression. A small Th6–Th7 intervertebral disc prolapse was also present, without evidence of scoliosis, syrinx, spinal cord edema, or myelomalacia. Following bilateral thoracic decompression and complete resection of the SEL tissue, the patient’s neurological function improved markedly, from Nurick grade V preoperatively to Nurick grade II at 11 months of follow-up. Consequently, bilateral laminectomy of the thoracic region was performed with total resection of the SEL tissue. Following surgery, the patient’s neurological symptoms improved markedly (Nurick grade II; 11 months postoperatively), and histopathological examination confirmed the diagnosis of spinal epidural lipomatosis. Methods: We performed a systematic review of case reports of SEL occurring, or co-occurring in the thoracic region based on the literature identified on PubMed, Scopus and Web of Science databases, after using search terms: “(thoracic) AND (“spinal” OR “epidural”) AND (lipomatosis)” and filters: [English], [humans] and [year 2020–2026], with the accordance to the PRISMA guidelines. Results: We identified 21 cases of thoracic SEL from 19 articles. In 12 cases the patients were male, in 9 female. Reported etiological associations included type 1 diabetes mellitus, exogenous corticosteroid exposure, obesity/metabolic syndrome, Cushing syndrome, and CLOVES syndrome. Given the small, case-report-based sample, these findings should be considered reported associations rather than estimates of prevalence or independent risk factors. Surgical treatment of thoracic SEL can be accomplished by various techniques such as laminectomy (continuous or skip), laminoplasty, or minimally invasive procedures—including endoscopic spine surgery. Conclusions: Large-volume, multicenter studies with long-term clinico-radiological follow-up would be necessary to understand the natural history and treatment outcomes, and to form evidence-based guidelines for interventions. Our case report and findings highlight that thoracic SEL should be included in the differential diagnosis of unexplained compressive myelopathy, even when imaging studies are inconclusive. Rapid identification or possibly reversible causes of myelopathy and initiation of treatment can significantly relieve symptoms, so it is important to remember this disease in the diagnostic process.

Background: Intraventricular central nervous system (CNS) lymphoma is an atypical presentation of extranodal lymphoma, whether primary or secondary. The most commonly diagnosed subtype of lymphoma is diffuse large B-cell lymphoma (DLBCL). There is a documented relation of HIV, EBV and KSHV infections with lymphomagenesis. AIDS-related lymphomas (ARLs) are described as a defining illness of the acquired immunodeficiency syndrome (AIDS). This study presents a novel case and systematic review of clinical, radiographic and histopathological features of intraventricular lymphomas. Methods: We report on a 27-year-old woman with a left lateral ventricle DLBCL with surrounding edema treated with steroids. A systematic review of 147 additional cases (1977–2025) was conducted, analyzing patient demographics, tumor characteristics, clinical features, imaging, treatment, and outcomes. The tumor locations were divided into three groups depending on the extent of ventricular involvement. Descriptive statistics summarized findings. Findings: 147 cases (mean age, 54.2 years; range, 3–87; 63.3% male) were analyzed. Immunodeficiency in patients was unusual (6.1%). Fully intraventricular lesions were the most common presentation (52.4%), with systemic involvement solely in 10 cases (6.8%). The lesions were predominantly located in the lateral ventricles or fourth ventricles (46 times each), and bilateral involvement was noted 37 additional times. DLBCL was diagnosed in 101 cases (78.9%). Interpretation: Intraventricular involvement in central nervous system lymphoma poses a diagnostic and therapeutic challenge due to non-specific symptoms and atypical locations. Adding to the diagnostic difficulty of intraventricular masses in young patients, we wish to highlight that immunocompromised patients are a notably insignificant subgroup of patients in our study.

Background: Disseminated intracranial and spinal dysembryoplastic neuroepithelial tumors (DNETs) are exceptionally rare, with only five prior cases reported. Methods: This study presents a case of a 47-year-old woman with DNETs in the right hippocampus and lumbar spine, treated surgically, and systematically reviews the existing literature (total n = 6). Results: While primary tumors occurred in both locations, secondary lesions were predominantly spinal (83%). The key features included frequent obstructive hydrocephalus (67%, often requiring shunting) but rare epilepsy (n = 1, 17%). Two fatal outcomes were possibly associated with West Nile virus infection (the S100B protein pathway). MRI was performed in all cases, and surgical intervention (craniotomy/laminectomy) constituted the primary treatment modality (67%). Conclusions: This multifocal presentation poses significant challenges, underscoring the potential need for spinal MRI in intracranial DNET cases and multidisciplinary management. Further molecular studies and case registries are crucial to understand pathogenesis and optimize care.