[Intramedullary tumors]

Abstract

Intramedullary tumours represent 2-4% of all central nervous system tumours. Clinical presentation can adopt any aspect of slow medullar compression. Often benign, these tumours are mostly of glial origin: ependymomas or astrocytomas. Diagnosis has been revolutionised by magnetic resonance imaging, which allows a precise analysis of the tumour with differentiation between the consistent portion and its satellite cysts. Surgery remains the treatment of choice. Total removal can often be achieved and no further complementary treatment is justified, except in proven malignancy. If resection has been partial, radiotherapy remains controversial as non-deprived of untoward effects, when delivered at efficient dose. Long term follow-up is mandatory, as there are late recurrences or secondary aggravations, evolving on their own. As post-therapeutic clinical state is highly correlated with the pretherapeutic state, intramedullary tumours are to be considered as medical emergencies.