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adults. They consist of well differentiated neoplastic neurons and astrocytes. The neurons have characteristic nuclear and nucleolar features, abundant cytoplasm and argyrophilic neuritic processes. Their expression of neuronal markers like synaptophysin and neurofilament proteins also serves to identify these abnormal neurons. Most gangliogliomas grow slowly and have an indolent course.

Ependymomas (Figs 29.5 and 29.6) are the most common intramedullary neoplasms in adults [12,13], while in children they account for only 12% of all intramedullary tumors. Ependymomas typically have a central location in the cord. They occur throughout the spinal axis. They are well delineated from the surrounding spinal cord and often have rostral and caudal non-neoplastic cysts that cap the tumor poles. Virtually all of them are histologically benign.

Myxopapillary ependymomas (Fig. 29.7) are a subgroup of ependymomas with characteristic microcystic histologic features. Their typical location is the conus-cauda region [14]. Located in the filum, they may grossly enlarge the filum and displace the nerve roots laterally and anteriorly. In spite of their benign histology, a small percentage of them tend to sub-arachnoid dissemination.

Hemangioblastomas account for 3-7% of intramedullary spinal cord tumors. They occur throughout the spinal canal. Spinal cord heman-gioblastomas are mostly sporadic, but up to 25% of the patients have von Hippel-Lindau disease.

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