BackgroundSeizures are a common and disabling symptom of adult-type diffuse gliomas, affecting quality of life and potentially influencing tumor progression. Despite their clinical significance, seizure outcomes are often underreported or heterogeneously measured in clinical trials. Objective: To assess how seizure outcomes are reported in clinical trials for adult-type diffuse glioma. Methods: We systematically reviewed glioma clinical trials initiated after January 1, 2010, through June 16, 2025, on ClinicalTrials.gov that included seizure-related outcomes. Each trial was manually screened to characterize how seizures were defined, measured, and categorized. Results: Of 2,801 clinical trials identified, 65 (2.3%) included seizure-related outcomes. Among these, 20 designated seizures as a primary outcome, though many grouped them within broader safety endpoints. Seizures were often listed as secondary outcomes (n = 23), adverse events (n = 11), or within quality-of-life assessments (n = 8). Reporting was highly variable; many trials used binary metrics. As few as 9 trials systematically assessed seizures using International League Against Epilepsy (ILAE) guidelines for seizure tracking (eg seizure diaries or structured EEG evaluation), and only 7 reported outcomes with standardized scales such as the ILAE outcome classification or the Engel classification, with rare use of newer tools such as the Seizure Control Composite Index. Conclusions: Despite their clinical significance, seizure outcomes are rarely and heterogeneously reported in clinical trials for adult-type diffuse gliomas. Incorporating standardized, seizure-specific endpoints may better align glioma research with patient-centered and disease-specific outcomes.

The mammalian target of rapamycin (mTOR) is a serine/threonine kinase that integrates metabolic and environmental signals to regulate cell growth and survival. In the central nervous system, mTOR plays a pivotal role in neuronal development, plasticity, and circuit homeostasis. In diffusely infiltrating gliomas, including glioblastomas, mTOR signaling is frequently dysregulated and contributes to malignant progression, therapeutic resistance, and metabolic adaptation. Beyond tumor-intrinsic effects, recent evidence reveals that gliomas actively reprogram peritumoral neurons via mTOR-dependent mechanisms, leading to synaptic remodeling, hyperexcitability, and neurological symptoms such as seizures and cognitive dysfunction. These results position mTOR as a central mediator of both oncogenesis and neurological dysfunction in diffusely infiltrating glioma. While clinical trials of mTOR inhibitors in gliomas have so far shown limited efficacy, emerging data suggest these agents may ameliorate tumor-associated neurological dysfunction. This review synthesizes current knowledge of mTOR signaling across tumor and neuronal compartments in diffusely infiltrating glioma and highlights its potential as a therapeutic target at the intersection of cancer biology and neuroscience.

Introduction: Intracranial teratomas are rare congenital neoplasms that typically arise in midline structures such as the pineal and suprasellar regions. Occipital region teratomas are exceedingly uncommon. Case Presentation: We report a case of a full-term neonate born with an occipital region mass initially presumed to be an encephalocele. Postnatal surgical resection revealed a mature teratoma. At eight months of age, the patient showed no evidence of tumor recurrence. Conclusion: This case illustrates the unique clinical and operative considerations in managing rare congenital occipital region lesions.

Background/Objectives: Brain metastases (BMs) represent a significant clinical challenge affecting 10–26% of patients who die from cancer. While surgery plays an established role in the management of selected patients, its representation within the registered clinical trial landscape has not been systematically characterized. Methods: In this cross-sectional registry analysis, ClinicalTrials.gov was searched on 20 December 2025, using condition terms related to BMs combined with the Boolean operator OR. Interventional and observational studies were included without restrictions on phase, status, sex, or age; trials not updated since 1 January 2015 were excluded. Included studies were classified as surgery-focused, surgery-enabled, or non-surgical. Data were extracted on study characteristics, interventions, and outcomes. Results: A total of 493 trials were included. Of these, 57 (11.6%) involved surgery, including 9 (1.8%) surgery-focused and 48 (9.7%) surgery-enabled trials, whereas 436 (88.4%) were non-surgical. Radiotherapy was the dominant treatment platform, present in 262 trials (53.1%), with stereotactic radiosurgery reported in 179 (36.3%). Among the 57 surgical trials, the most common primary endpoint categories were periprocedural/safety and local control outcomes (each 26/57, 45.6%) and survival (20/57, 35.1%). Only 4 surgical trials (7.0%), all surgery-focused, had a primary endpoint that directly measured an operative outcome. Conclusions: Surgery accounted for a minority of registered brain metastasis trials and more commonly served as context for evaluating adjuvant, radiation-based, and multimodality approaches than as the primary intervention under study. Surgical trials were weighted toward safety, local control, and survival endpoints, with less frequent emphasis on surgery-specific and functional outcomes.

Primary motor cortex metastases (pMCM) often result in functionally impairing symptoms. The aim of this study was to determine the local control and functional outcomes of patients who underwent combined microsurgical resection followed by stereotactic radiosurgery (SRS) for pMCM. A retrospective review was performed to identify patients who received microsurgical resection followed by SRS for pMCM at a single institution between 2013 and 2021. Tumor volumes, treatment parameters, local control data, and functional motor scores using the Response Assessment in Neuro-Oncology Brain Metastases criteria were analyzed for a follow-up period of one year after treatment. Eleven patients who received microsurgical resection followed by SRS within 35 days were included in the analysis. Median SRS dose was 18 Gy to the 50% isodose line delivered in 1-3 fractions. The mean tumor volume was 13.2 cm³. All patients with follow-up data had stable or improved strength scores up to one year after treatment, with no patients showing disease progression, based on Neuro-Oncology Brain Metastases criteria at 3, 6, and 12 months after treatment. In this single-center case series, microsurgical resection followed by SRS for pMCM is safe and results in rapid and durable improvements in functional motor outcomes, particularly for patients with larger tumor sizes.