TY - JOUR A1 - Breun, Maria A1 - Monoranu, Camelia M. A1 - Kessler, Almuth F. A1 - Matthies, Cordula A1 - Löhr, Mario A1 - Hagemann, Carsten A1 - Schirbel, Andreas A1 - Rowe, Steven P. A1 - Pomper, Martin G. A1 - Buck, Andreas K. A1 - Wester, Hans-Jürgen A1 - Ernestus, Ralf-Ingo A1 - Lapa, Constantin T1 - [\(^{68}\)Ga]-Pentixafor PET/CT for CXCR4-mediated imaging of vestibular schwannomas JF - Frontiers in Oncology N2 - We have recently demonstrated CXCR4 overexpression in vestibular schwannomas (VS). This study investigated the feasibility of CXCR4-directed positron emission tomography/computed tomography (PET/CT) imaging of VS using the radiolabeled chemokine ligand [\(^{68}\)Ga]Pentixafor. Methods: 4 patients with 6 primarily diagnosed or pre-treated/observed VS were enrolled. All subjects underwent [\(^{68}\)Ga]Pentixafor PET/CT prior to surgical resection. Images were analyzed visually and semi-quantitatively for CXCR4 expression including calculation of tumor-to-background ratios (TBR). Immunohistochemistry served as standard of reference in three patients. Results: [\(^{68}\)Ga]Pentixafor PET/CT was visually positive in all cases. SUV\(_{mean}\) and SUV\(_{max}\) were 3.0 ± 0.3 and 3.8 ± 0.4 and TBR\(_{mean}\) and TBR\(_{max}\) were 4.0 ± 1.4 and 5.0 ± 1.7, respectively. Histological analysis confirmed CXCR4 expression in tumors. Conclusion: Non-invasive imaging of CXCR4 expression using [\(^{68}\)Ga]Pentixafor PET/CT of VS is feasible and could prove useful for in vivo assessment of CXCR4 expression. KW - vestibular schwannoma KW - CXCR4 KW - PET/CT KW - molecular imaging KW - Pentixafor Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-201863 VL - 9 IS - 503 ER - TY - JOUR A1 - Linsenmann, Thomas A1 - Monoranu, Camelia M. A1 - Alkonyi, Balint A1 - Westermaier, Thomas A1 - Hagemann, Carsten A1 - Kessler, Almuth F. A1 - Ernestus, Ralf-Ingo A1 - Löhr, Mario T1 - Cerebellar liponeurocytoma - molecular signature of a rare entity and the importance of an accurate diagnosis JF - Interdisciplinary Neurosurgery N2 - Background: Cerebellar liponeurocytoma is an extremely rare tumour entity of the central nervous system. It is histologically characterised by prominent neuronal/neurocytic differentiation with focal lipidisation and corresponding histologically to WHO grade II. It typically develops in adults, and usually shows a low proliferative potential. Recurrences have been reported in almost 50% of cases, and in some cases the recurrent tumour may display increased mitotic activity and proliferation index, vascular proliferations and necrosis. Thus pathological diagnosis of liponeurocytoma is challenging. This case presentation highlights the main clinical, radiographic and pathological features of a cerebellar liponeurocytoma. Case presentation: A 59-year-old, right-handed woman presented at our department with a short history of persistent headache, vertigo and gait disturbances. Examination at presentation revealed that the patient was awake, alert and fully oriented. The cranial nerve status was normal. Uncertainties were noted in the bilateral finger-to-nose testing with bradydiadochokinesis on both sides. Strength was full and no pronator drift was observed. Sensation was intact. No signs of pyramidal tract dysfunction were detected. Her gait appeared insecure. The patient underwent surgical resection. Afterward no further disturbances could be detected. Conclusions: To date >40 cases of liponeurocytoma have been reported, including cases with supratentorial location. A review of the 5 published cases of recurrent cerebellar. Liponeurocytoma revealed that the median interval between the first and second relapse was rather short, indicating uncertain malignant potential. The most recent WHO classification of brain tumours (2016) classifies the cerebellar liponeurocytoma as a separate entity and assigns the tumour to WHO grade II. Medulloblastoma is the most important differential diagnosis commonly seen in children and young adults. In contrast, cerebellar liponeurocytoma is typically diagnosed in adults. The importance of accurate diagnosis should not be underestimated especially in the view of possible further therapeutic interventions and for the determination of the patient's prognosis. KW - liponeurocytoma KW - neurocytoma KW - medulloblastoma KW - molecular signature Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-177652 VL - 16 ER - TY - JOUR A1 - Feldheim, Jonas A1 - Kessler, Almuth F. A1 - Monoranu, Camelia M. A1 - Ernestus, Ralf-Ingo A1 - Löhr, Mario A1 - Hagemann, Carsten T1 - Changes of O\(^6\)-Methylguanine DNA Methyltransferase (MGMT) promoter methylation in glioblastoma relapse—a meta-analysis type literature review JF - Cancers N2 - Methylation of the O6-methylguanine DNA methyltransferase (MGMT) promoter has emerged as strong prognostic factor in the therapy of glioblastoma multiforme. It is associated with an improved response to chemotherapy with temozolomide and longer overall survival. MGMT promoter methylation has implications for the clinical course of patients. In recent years, there have been observations of patients changing their MGMT promoter methylation from primary tumor to relapse. Still, data on this topic are scarce. Studies often consist of only few patients and provide rather contrasting results, making it hard to draw a clear conclusion on clinical implications. Here, we summarize the previous publications on this topic, add new cases of changing MGMT status in relapse and finally combine all reports of more than ten patients in a statistical analysis based on the Wilson score interval. MGMT promoter methylation changes are seen in 115 of 476 analyzed patients (24%; CI: 0.21–0.28). We discuss potential reasons like technical issues, intratumoral heterogeneity and selective pressure of therapy. The clinical implications are still ambiguous and do not yet support a change in clinical practice. However, retesting MGMT methylation might be useful for future treatment decisions and we encourage clinical studies to address this topic KW - glioblastoma multiforme (GBM) KW - glioma KW - relapse KW - temozolomide KW - MGMT promoter methylation KW - therapy KW - resistance KW - recurrence Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-193040 SN - 2072-6694 VL - 11 IS - 12 ER - TY - JOUR A1 - Hagemann, Carsten A1 - Neuhaus, Nikolas A1 - Dahlmann, Mathias A1 - Kessler, Almuth F. A1 - Kobelt, Dennis A1 - Herrmann, Pia A1 - Eyrich, Matthias A1 - Freitag, Benjamin A1 - Linsenmann, Thomas A1 - Monoranu, Camelia M. A1 - Ernestus, Ralf-Ingo A1 - Löhr, Mario A1 - Stein, Ulrike T1 - Circulating MACC1 transcripts in glioblastoma patients predict prognosis and treatment response JF - Cancers N2 - Glioblastoma multiforme is the most aggressive primary brain tumor of adults, but lacksreliable and liquid biomarkers. We evaluated circulating plasma transcripts of metastasis-associatedin colon cancer-1 (MACC1), a prognostic biomarker for solid cancer entities, for prediction of clinicaloutcome and therapy response in glioblastomas. MACC1 transcripts were significantly higher inpatients compared to controls. Low MACC1 levels clustered together with other prognosticallyfavorable markers. It was associated with patients’ prognosis in conjunction with the isocitratedehydrogenase (IDH) mutation status: IDH1 R132H mutation and low MACC1 was most favorable(median overall survival (OS) not yet reached), IDH1 wildtype and high MACC1 was worst (medianOS 8.1 months), while IDH1 wildtype and low MACC1 was intermediate (median OS 9.1 months).No patients displayed IDH1 R132H mutation and high MACC1. Patients with low MACC1 levelsreceiving standard therapy survived longer (median OS 22.6 months) than patients with high MACC1levels (median OS 8.1 months). Patients not receiving the standard regimen showed the worstprognosis, independent of MACC1 levels (low: 6.8 months, high: 4.4 months). Addition of circulatingMACC1 transcript levels to the existing prognostic workup may improve the accuracy of outcomeprediction and help define more precise risk categories of glioblastoma patients. KW - metastasis-associated in colon cancer 1 (MACC1) KW - glioblastoma multiforme KW - liquid biopsy KW - therapy response KW - prognostic marker Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-197327 SN - 2072-6694 VL - 11 IS - 6 ER - TY - JOUR A1 - Vadokas, Georg A1 - Koehler, Stefan A1 - Weiland, Judith A1 - Lilla, Nadine A1 - Stetter, Christian A1 - Westermaier, Thomas T1 - Early antiinflammatory therapy attenuates brain damage after SAH in rats JF - Translational Neuroscience N2 - Background Early inflammatory processes may play an important role in the development of early brain injury (EBI) after subarachnoid hemorrhage (SAH). Experimental studies suggest that anti-inflammatory and membrane-stabilizing drugs might have beneficial effects, although the underlying mechanisms are not fully understood. The aim of this study was to investigate the effect of early treatment with methylprednisolone and minocycline on cerebral perfusion and EBI after experimental SAH. Methods Male Sprague-Dawley rats were subjected to SAH using the endovascular filament model. 30 minutes after SAH, they were randomly assigned to receive an intravenous injection of methylprednisolone (16mg/kg body weight, n=10), minocycline (45mg/kg body weight, n=10) or saline (n=11). Mean arterial blood pressure (MABP), intracranial pressure (ICP) and local cerebral blood flow (LCBF) over both hemispheres were recorded continuously for three hours following SAH. Neurological assessment was performed after 24 hours. Hippocampal damage was analyzed by immunohistochemical staining (caspase 3). Results Treatment with methylprednisolone or minocycline did not result in a significant improvement of MABP, ICP or LCBF. Animals of both treatment groups showed a non-significant trend to better neurological recovery compared to animals of the control group. Mortality was reduced and hippocampal damage significantly attenuated in both methylprednisolone and minocycline treated animals. Conclusion The results of this study suggest that inflammatory processes may play an important role in the pathophysiology of EBI after SAH. Early treatment with the anti-inflammatory drugs methylprednisolone or minocycline in the acute phase of SAH has the potential to reduce brain damage and exert a neuroprotective effect. KW - subarachnoid hemorrhage KW - early brain injury KW - methylprednisolone KW - minocycline KW - neuroprotection Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-201440 VL - 10 IS - 1 ER - TY - THES A1 - Dösch, Janine Dorothee T1 - Ergebnisse von 100 konsekutiven endovaskulären Aneurysmaausschaltungen (EVAR) mit dem Endurant® - Stentgraft unter klinischen Alltagsbedingungen T1 - Clinical results of 100 patients with abdominal aortic aneurysm treated with the Endurant® stent graft N2 - Die endovaskuläre Behandlung (EVAR) des abdominellen Aortenaneurysmas (AAA) hat sich den vergangenen Jahren zur Standardtherapie etabliert. Die Vielzahl an verfügbaren Stentgrafts wird in der Regel in Zulassungsstudien und Registern, die die Gefahr eines Selektionsbias beinhalten, evaluiert und spiegelt oftmals den klinischen Nutzen nur unzureichend wider. Ziel dieser Arbeit war es zu evaluieren, ob unter klinischen Alltagsbedingungen die kurz- und mittelfristigen Ergebnisse nach Endurant® Stentgraftimplantation mit denen des 1262 Patienten umfassenden ENGAGE-Registers vergleichbar sind. Diese Arbeit beinhaltet die Daten der ersten, konsekutiven 100 Patienten (91,0 % Männer und mittleres Patientenalter von 73,1 ± 8,4 Jahren), die im Zeitraum Februar 2009 bis August 2014 mit dem Endurant® Stentgraft (Medtronic, Inc., Minneapolis, MN, USA) an der Universitätsklinik Würzburg unter klinischen Alltagsbedingungen behandelt wurden. Präoperativ wies das Patientenkollektiv einen mittleren Aortenaneurysmadurchmesser von 57,2 mm ± 11,9 mm, eine mittlere proximale Aortenhalslänge von 27,8 mm ± 13,7 mm und einen mittleren proximalen Aortenhalsdurchmesser von 24,0 mm ± 3,4 mm auf. Die infrarenale Angulation betrug 22,0 ± 15,6 Grad und war signifikant unterschiedlich zu ENGAGE. Die klinische Alltagssituation, die diese Studie im Gegensatz zum großen, weltweiten ENGAGE-Register bietet, ergibt sich durch den Einschluss von Notfalleingriffen bei rupturierten AAA (5 %) und der Durchführung von operativen Ausbildungseingriffen an einer Universitätsklinik. Bezüglich der technischen und klinischen Erfolgsrate, sowie der Operationsdauer resultierten somit signifikante Unterschiede. Intraoperativ zeigten sich in 24 % ein Endoleak-Typ-II und in jeweils 3 % ein Endoleak-Typ-I bzw. Endoleak-Typ-III. Im Nachbeobachtungszeitraum verkleinerte sich der maximale Aneurysmadurchmesser in 43,9 % der Fälle um mehr als 3 mm und 7,3 % der Patienten dagegen wiesen eine Zunahme des Aneurysmadurchmessers auf. Die Reinterventionsrate lag im Patientenkollektiv bei 13,4 %. Die 30-Tages-Letalitätsrate lag mit 2 % über der des ENGAGE-Registers mit 1,3 %. EVAR mit dem Endurant®-Stentgraft ist bei sorgfältiger Einhaltung der „instruction for use“ auch außerhalb von prospektiven Studien und großen Registern eine sichere und effektive Behandlung. Große Register wie ENGAGE sind wichtig, jedoch nicht in allen Aspekten „real world“. Eine Überprüfung der Ergebnisse im klinischen Alltag ist somit weiterhin erforderlich. N2 - The purpose of this study was to evaluate and compare the outcomes in 100 patients with abdominal aortic aneurysms (AAAs) treated with the Endurant® stent graft (Medtronic, Inc., Minneapolis, MN, USA) at the Department of Vascular Surgery, University Hospital Wuerzburg versus the results of the large Endurant Stent Graft Natural Selection Global Postmarket Registry (ENGAGE). Between February 2009 and August 2014, 100 patients (91 men (91.0% of total); mean age 73.1 ± 8.4 years, range 53 to 89 years) with an AAA underwent an endovascular aneurysm repair (EVAR) using the Endurant® stent graft. The mean aneurysm diameter was 57.2 ± 11.9 mm; the mean proximal neck length was 27.8 ± 13.7 mm; the mean proximal neck diameter was 24.0 ± 3.4 mm. The mean infrarenal angulation was with 22.0 ± 15.6 degrees significant different compared to ENGAGE. Before and after the procedure and during the follow-up, computer tomography scans, digital subtraction angiography and/or color-coded duplex sonography were performed. Outcome analysis included survival, endoleaks, aneurysm expansion >3 mm, secondary intervention. Clinical data, AAA characteristics, presence of endoleaks and other EVAR-related complications were noted. Real-world conditions were provided by including ruptured AAAs and supervised surgery as a teaching hospital. As a result significant differences in primary technical and clinical success and procedural duration were observed between ENGAGE and this study. Primary type II endoleaks were observed in 24.0%, type I endoleak in 3.0% and type III endoleaks in 3.0%. Secondary interventions were required in 13.4%. Aneurysm-related mortality was reported in 2.0% compared to 1.3% in ENGAGE. Maximal aneurysm diameter decreased >3 mm in 43.9% and increased >3 mm in 7.3% of patients. The Endurant® stent graft used under instructions for use proved to be a safe and effective endovascular treatment for AAA. Nevertheless, further evaluation of outcomes in real-world clinical practice, beside large registries as ENGAGE, is needed to provide results of EVAR in real-world conditions. KW - Bauchaorta KW - EVAR KW - Aneurysma KW - Endurant® KW - Stentgraft Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-175107 ER - TY - JOUR A1 - Jungwirth, Gerhard A1 - Yu, Tao A1 - Moustafa, Mahmoud A1 - Rapp, Carmen A1 - Warta, Rolf A1 - Jungk, Christine A1 - Sahm, Felix A1 - Dettling, Steffen A1 - Zweckberger, Klaus A1 - Lamszus, Katrin A1 - Senft, Christian A1 - Loehr, Mario A1 - Keßler, Almuth F. A1 - Ketter, Ralf A1 - Westphal, Manfred A1 - Debus, Juergen A1 - von Deimling, Andreas A1 - Simon, Matthias A1 - Unterberg, Andreas A1 - Abdollahi, Amir A1 - Herold-Mende, Christel T1 - Identification of KIF11 as a Novel Target in Meningioma JF - Cancers N2 - Kinesins play an important role in many physiological functions including intracellular vesicle transport and mitosis. The emerging role of kinesins in different cancers led us to investigate the expression and functional role of kinesins in meningioma. Therefore, we re-analyzed our previous microarray dataset of benign, atypical, and anaplastic meningiomas (n = 62) and got evidence for differential expression of five kinesins (KIFC1, KIF4A, KIF11, KIF14 and KIF20A). Further validation in an extended study sample (n = 208) revealed a significant upregulation of these genes in WHO°I to °III meningiomas (WHO°I n = 61, WHO°II n = 88, and WHO°III n = 59), which was most pronounced in clinically more aggressive tumors of the same WHO grade. Immunohistochemical staining confirmed a WHO grade-associated upregulated protein expression in meningioma tissues. Furthermore, high mRNA expression levels of KIFC1, KIF11, KIF14 and KIF20A were associated with shorter progression-free survival. On a functional level, knockdown of kinesins in Ben-Men-1 cells and in the newly established anaplastic meningioma cell line NCH93 resulted in a significantly inhibited tumor cell proliferation upon siRNA-mediated downregulation of KIF11 in both cell lines by up to 95% and 71%, respectively. Taken together, in this study we were able to identify the prognostic and functional role of several kinesin family members of which KIF11 exhibits the most promising properties as a novel prognostic marker and therapeutic target, which may offer new treatment options for aggressive meningiomas. KW - meningioma KW - KIF KW - kinesin KW - KIF11 KW - NCH93 Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-197402 SN - 2072-6694 VL - 11 IS - 4 ER - TY - THES A1 - Klein, Philipp T1 - Kephalometrische Verlaufsuntersuchungen bei Kindern vor und nach operativer Versorgung einer isolierten Sagittalnahtsynostose T1 - Long term cephalometric follow up of children with operated isolated sagittal synostosis N2 - In dieser retrospektiven Arbeit wurde das Schädelwachstum von Patienten mit einer operierten nonsyndromalen prämaturen Sagittalnahtsynostose untersucht. Hierzu wurden die prä- und postoperativ angefertigten Röntgenaufnahmen von 37 Kindern, die zwischen 1995 und 2008 im Cranio-Fazialen Zentrum der Universitätsklinik Würzburg operiert wurden, vermessen und ausgewertet. Die Patienten wurden nach der gewählten Operationstechnik in zwei Gruppen unterteilt. Die erste Gruppe wurde mittels einer medianen Kraniektomie therapiert. Bei der zweiten Gruppe wurde die mediane Kraniektomie durch ein Kippen des Stirnsegmentes erweitert. Nach der statistischen Auswertung ergaben sich im postoperativen Verlauf signifikante Unterschiede zwischen beiden Operationstechniken. Es konnte gezeigt werden, dass ein adjuvantes Kippen der Stirn gegenüber einer alleinigen breiten medianen Kraniektomie zu keiner Verbesserung der Schädelausformung führt. Darüber hinaus ist zu vermuten, dass das Kippen des Stirnsegmentes die Wahrscheinlichkeit eines Rezidivs erhöht. N2 - In this retrospective work, cranial growth of patients with operated nonsyndromal prematurary sagittal suture synostosis was investigated. For this purpose, the pre- and postoperative radiographs of 37 children operated between 1995 and 2008 in the Cranio-Facial Center of the University Hospital Würzburg were measured and evaluated. The patients were divided into two groups according to the surgical technique chosen. The first group was treated with a median craniectomy. In the second group, median craniectomy was augmented by tilting the forehead segment. Statistical evaluation showed significant differences between the two surgical techniques during the postoperative period. It could be shown that an adjuvant tipping of the forehead compared to a sole wide median craniectomy does not lead to an improvement of the skull formation. In addition, it is likely that tilting the forehead segment increases the likelihood of recurrence. KW - Sagittalnahtsynostose KW - isoliert KW - Kephalometrie Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-188079 ER - TY - JOUR A1 - Pasos, Uri E. Ramirez A1 - Steigerwald, Frank A1 - Reich, Martin M. A1 - Matthies, Cordula A1 - Volkmann, Jens A1 - Reese, René T1 - Levodopa modulates functional connectivity in the upper beta band between bubthalamic nucleus and muscle activity in tonic and phasic motor activity patterns in Parkinson’s disease JF - Frontiers in Human Neuroscience N2 - Introduction: Striatal dopamine depletion disrupts basal ganglia function and causes Parkinson’s disease (PD). The pathophysiology of the dopamine-dependent relationship between basal ganglia signaling and motor control, however, is not fully understood. We obtained simultaneous recordings of local field potentials (LFPs) from the subthalamic nucleus (STN) and electromyograms (EMGs) in patients with PD to investigate the impact of dopaminergic state and movement on long-range beta functional connectivity between basal ganglia and lower motor neurons. Methods: Eight PD patients were investigated 3 months after implantation of a deep brain stimulation (DBS)-system capable of recording LFPs via chronically-implanted leads (Medtronic, ACTIVA PC+S®). We analyzed STN spectral power and its coherence with EMG in the context of two different movement paradigms (tonic wrist extension vs. alternating wrist extension and flexion) and the effect of levodopa (L-Dopa) intake using an unbiased data-driven approach to determine regions of interest (ROI). Results: Two ROIs capturing prominent coherence within a grand average coherogram were identified. A trend of a dopamine effect was observed for the first ROI (50–150 ms after movement start) with higher STN-EMG coherence in medicated patients. Concerning the second ROI (300–500 ms after movement start), an interaction effect of L-Dopa medication and movement task was observed with higher coherence in the isometric contraction task compared to alternating movements in the medication ON state, a pattern which was reversed in L-Dopa OFF. Discussion: L-Dopa medication may normalize functional connectivity between remote structures of the motor system with increased upper beta coherence reflecting a physiological restriction of the amount of information conveyed between remote structures. This may be necessary to maintain simple movements like isometric contraction. Our study adds dynamic properties to the complex interplay between STN spectral beta power and the nucleus’ functional connectivity to remote structures of the motor system as a function of movement and dopaminergic state. This may help to identify markers of neuronal activity relevant for more individualized programming of DBS therapy. KW - Parkinson’s disease KW - subthalamic nucleus KW - deep brain stimulation KW - local field potentials KW - dopamine KW - movement Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-201540 VL - 13 IS - 223 ER - TY - JOUR A1 - Löhr, Mario A1 - Kessler, Almuth F. A1 - Monoranu, Camelia-Maria A1 - Grosche, Jens A1 - Linsenmann, Thomas A1 - Ernestus, Ralf-Ingo A1 - Härtig, Wolfgang T1 - Primary brain amyloidoma, both a neoplastic and a neurodegenerative disease: a case report JF - BMC Neurology N2 - Background Scattered extracellular deposits of amyloid within the brain parenchyma can be found in a heterogeneous group of diseases. Its condensed accumulation in the white matter without evidence for systemic amyloidosis is known as primary brain amyloidoma (PBA). Although originally considered as a tumor-like lesion by its space-occupying effect, this condition displays also common hallmarks of a neurodegenerative disorder. Case presentation A 50-year-old woman presented with a mild cognitive decline and seizures with a right temporal, irregular and contrast-enhancing mass on magnetic resonance imaging. Suspecting a high-grade glioma, the firm tumor was subtotally resected. Neuropathological examination showed no glioma, but distinct features of a neurodegenerative disorder. The lesion was composed of amyloid AL λ aggregating within the brain parenchyma as well as the adjacent vessels, partially obstructing the vascular lumina. Immunostaining confirmed a distinct perivascular inflammatory reaction. After removal of the PBA, mnestic impairments improved considerably, the clinical course and MRI-results are stable in the 8-year follow-up. Conclusion Based on our histopathological findings, we propose to regard the clinicopathological entity of PBA as an overlap between a neoplastic and neurodegenerative disorder. Since the lesions are locally restricted, they might be amenable to surgery with the prospect of a definite cure. KW - amyloidoma KW - neurooncology KW - brain tumor KW - neurodegenerative disease KW - neurovascular unit Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-200341 VL - 19 ER -