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World Neurosurgery

Hiroshi Yokota, Yuki Ida, Daisuke Wajima, Fumihiko Nishimura, Hiroyuki Nakase
BACKGROUND: A Rathke cleft cyst (RCC) with non-hemorrhagic rupture mimicking pituitary apoplexy has been rarely reported. CASE DESCRIPTION: A 52-year-old woman, previously diagnosed with asymptomatic RCC, came to us with a severe headache, along with visual dysfunction and symptoms of pituitary insufficiency. Fluid-attenuated inversion recovery magnetic resonance imaging demonstrated diffuse hyper-intensity in the cerebral cisterns, while watery clear cerebrospinal fluid was obtained by lumbar puncture...
October 21, 2016: World Neurosurgery
Joham Choque-Velasquez, Roberto Colasanti, George Fotakopoulos, Humberto Elera-Florez, Juha Hernesniemi
BACKGROUND: Multiple intracranial aneurysms treatment is particularly demanding, even more in a developing country where the access to specialized centers may be prevented by different factors. CASE DESCRIPTION: Herein, we report a challenging case regarding the single-stage surgical treatment of seven cerebral aneurysms in a 58-year-old woman from the northern Peruvian Andes. All the aneurysm were successfully and safely clipped through two lateral supraorbital craniotomies...
October 21, 2016: World Neurosurgery
Kuan-Pin Chen, Cheng-Chia Lee, Chia-Lin Liao, Tao-Chieh Yang, Tsung-Lang Chiu, Chain-Fa Su
In this report, we present the results of using upfront gamma knife surgery (GKS) in the management of giant central neurocytoma (volume > 50 ml) without the initial removal of the tumor mass. Two patients underwent GKS for histologically proven central neurocytoma (CNC). Clinical and imaging studies were performed to evaluate the response to treatment. GKS involved delivery doses of 12 or 13 Gy to the tumor margin at the isodose line of 50%. Tumor response to GKS appeared as early as 4-6 months post-GKS, at which point a dramatic reduction in volume was observed...
October 21, 2016: World Neurosurgery
Waeel Ossama Hamouda, Mohammed Aladdin, Sarah Abdulaziz Al-Muammar, Danya Mohammed Khalid Gari
BACKGROUND: Microscopic lumbar discectomy is a common, minimally invasive surgery. A transverse skin incision has sound theoretical cosmetic advantages in comparison to the classic vertical incision. OBJECTIVES: the study aimed to compare transverse and vertical skin incisions for microscopic discectomy regarding cosmetic outcome, postoperative pain and the provided surgical cutaneous inlet. MATERIALS & METHODS: Eighty-six patients were randomly enrolled prospectively in the study, divided among a vertical incision group (V group) and a transverse incision group (T group)...
October 21, 2016: World Neurosurgery
Apar S Patel, Christoph J Griessenauer, Raghav Gupta, Nimer Adeeb, Paul M Foreman, Hussain Shallwani, Justin M Moore, Mark R Harrigan, Adnan H Siddiqui, Christopher S Ogilvy, Ajith J Thomas
INTRODUCTION: Cerebral vasospasm following subarachnoid hemorrhage (SAH) is the single most important cause of neurological decline following successful treatment of the ruptured aneurysm. Here, we report safety and efficacy of non-compliant balloon angioplasty for the treatment of cerebral vasospasm. METHODS: Three major academic institutions in the United States provided data on cerebral vasospasm treated with non-compliant balloon angioplasty between October 2004 and February 2016...
October 21, 2016: World Neurosurgery
Julian Li, Kevin Phan, Ralph Mobbs
OBJECTIVE: Anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF) are commonly used approaches for lumbar spine fusion surgery, each with their own unique advantages and disadvantages. ALIF requires mobilization of the great vessels and peritoneum, while dissection of the psoas muscle in the LLIF technique is associated with post-operative neurological complications in the proximal lower limb. The anterior-to-psoas (ATP) or oblique lumbar interbody fusion (OLIF) technique is the proposed solution to accessing the L1-L5 levels without the issues encountered with ALIF and LLIF...
October 21, 2016: World Neurosurgery
Anna C Lawson McLean, Steffen K Rosahl
OBJECT: Neurofibromatosis type 2 is an autosomal-dominant disorder caused by a defective gene locus 22q12. Patients with NF2 are prone to develop multiple intracranial neoplasms, such as vestibular schwannomas, meningiomas and schwannomas of other cranial nerves. To date, little is known about the growth dynamics of these tumors. The aim of our study was to investigate a) the median growth rate per year, b) the growth-free intervals, and c) the growth patterns of these tumors. METHODS: Patient records from the regional neurofibromatosis center were evaluated for their suitability in this analysis...
October 21, 2016: World Neurosurgery
Anand Veeravagu, Amy Li, Lawrence M Shuer, Atman M Desai
BACKGROUND: Osteochondromas are the most frequent benign bone tumors, but only rarely occur along the spinal column and even more rarely induce symptoms from spinal cord compression. CASE DESCRIPTIONS: We report two adult patients, both with a history of hereditary multiple exostoses, who presented with cervical myelopathy secondary to osteochondromas. The first patient is a 22-year-old male with numbness and weakness of his right upper limb and neck pain. Radiological images revealed a bony tumor arising from the C3 lamina with evidence of severe spinal cord compression...
October 21, 2016: World Neurosurgery
Jaya Uppal, Stanislaw Sobotka, Arthur L Jenkins
BACKGROUND: Multiple causes outside the spine can mimic spinal back pain. Endometriosis is an important gynecological disorder, which commonly affects the lower region of the female pelvis and less frequently the spine and soft tissues. The lumbosacral trunk is vulnerable to pressure from any abdominal mass originating from the uterus and the ovaries. Therefore symptoms of endometriosis include severe reoccurring pain in the pelvic area as well as lower back and abdominal pain. CASE DESCRIPTION: We report on a 39 year old gymnast with cyclic sciatica and back pain, whose initial presentation initially led to a spinal fusion at L4/5 and L5/S1, but that procedure did not change her symptoms...
October 21, 2016: World Neurosurgery
Michele Bailo, Nicola Boari, Filippo Gagliardi, Alberto Franzin, Martina Piloni, Alfio Spina, Marco Gemma, Antonella Del Vecchio, Angelo Bolognesi, Pietro Mortini
OBJECT: Complete vestibular schwannomas (VS) removal is not always achievable without any risk of disabling postoperative complications, especially in terms of facial nerve function. Moreover, even after gross total removal a relevant rate of recurrence has been reported. The aim of this study is to validate Gamma Knife radiosurgery (GKRS) as an effective strategy to treat tumor's regrowth after previous surgery. METHODS: Ninety patients treated with GKRS for VS after previous microsurgery were included in the present study...
October 21, 2016: World Neurosurgery
Daniel Dubinski, Sae-Yeon Won, Jürgen Konczalla, Jan Mersmann, Christof Geisen, Eva Herrmann, Volker Seifert, Christian Senft
OBJECTIVE: Rupture of an intracranial aneurysm usually presents with an acute onset, requires multidisciplinary intensive care treatment, and the overall death and disability rates are high. The ABO blood type is known to play an important role in hemostasis, thrombosis and vascular NO response. The aspect of ABO blood type in onset, clinical progress and outcome after SAH are to date largely unexplored. We conducted this study to elucidate the association of ABO blood type on the occurrence and outcome of aneurysmal SAH...
October 21, 2016: World Neurosurgery
Dorota Tassigny, Basel Abu-Serieh, Daniella Tsague Fofe, Jacques Born, Germain Milbouw
BACKGROUND AND IMPORTANCE: Syringomyelia is a progressive cerebrospinal fluid disorder which can lead to irreversible spinal cord injury. To date, the optimal management of syringomyelic cavities remains controversial. Multiple studies have emphasized the importance of the cranio-cervical decompression or shunting procedures. However, excepted for syrinx related to Arnold Chiari malformation, nearly half of patients need to be re-operated. The purpose of the present study was to describe a simple and efficient surgical technique and to report the long-term radio-clinical outcomes...
October 21, 2016: World Neurosurgery
Peng Li, Zhenmin Wang, Qiangyi Zhou, Shiwei Li, Jing Zhang, Ying Wang, Xingchao Wang, Bo Wang, Fu Zhao, Pinan Liu, Zhijun Yang
BACKGROUND: Vision is extremely important for patients with hearing loss due to neurofibromatosis type 2 (NF2). Tumors adjacent to the anterior visual pathway can potentially impair the vision. To date, only a few case reports and small-series studies have been reported. OBJECTIVE: To evaluate the clinical features of tumors adjacent to the anterior visual pathway in a large series of NF2 patients. METHODS: Seventy-three patients with potentially vision-impairing tumors were carefully screened from among 467 NF2 patients...
October 21, 2016: World Neurosurgery
Leonardo Lima, Justin Sharim, Rebecca Levin-Epstein, Stephen Tenn, Alisson R Teles, Tania Kaprealian, Nader Pouratian
OBJECTIVE: To evaluate the efficacy of postoperative fractionated stereotactic radiosurgery (FSRS) and hypofractionated stereotactic radiotherapy (SRT) to large surgical cavities following gross-total resection of brain metastases. METHODS: A retrospective analysis of 41 patients who had received tumor-bed FSRS (5 fractions) or SRT (10 fractions) following resection of brain metastasis between 2005 to 2015 was performed. All resection cavities were treated with a frameless LINAC-based system...
October 21, 2016: World Neurosurgery
Dennis T Lockney, Sasha Vaziri, Frank Walch, Paul Kubilis, Dan Neal, Gregory J A Murad, Maryam Rahman
BACKGROUND: Prophylactic use of anti-epileptic drugs (AEDs) for patients undergoing brain tumor surgery is common practice despite lack of clear evidence. We hypothesized that prophylactic AED (pAED) use did not affect seizure rates in brain tumor patients who underwent craniotomy for tumor resection. METHODS: A retrospective review was performed of 606 patients who underwent surgery for brain tumors from 2006-2013 at the University of Florida, excluding patients with pre-existing seizure condition prior to tumor diagnosis...
October 21, 2016: World Neurosurgery
Bedjan Behmanesh, Matthias Setzer, Juergen Konczalla, Patrick Harter, Johanna Quick-Weller, Lioba Imoehl, Kea Franz, Florian Gessler, Volker Seifert, Gerhard Marquardt
BACKGROUND: Primary intramedullary spinal cord glioblastoma are very rare tumors of the spinal cord. They imply a very poor prognosis since complete surgical resection is not possible due to the infiltrative growth of these tumors. The aim of this study is to present our data achieved with an aggressive multimodality treatment. METHODS: We retrospectively reviewed our clinical database. All patients with histologically proven intramedullary spinal cord glioblastoma treated in our department were included in this study...
October 21, 2016: World Neurosurgery
Marco Skardelly, Christian Rother, Susan Noell, Felix Behling, Thomas V Wuttke, Jens Schittenhelm, Sotirios Bisdas, Christoph Meisner, Sabine Rona, Ghazaleh Tabatabai, Florian Roser, Marcos Soares Tatagiba
OBJECTIVE: Well-defined risk factors for the identification of meningioma patients who might benefit from preoperative or early postoperative seizure prophylaxis are unknown. We investigated and quantified risk factors to determine individual risks of seizure occurrence in meningioma patients. METHODS: A total of 634 adult meningioma patients were included in this retrospective cohort study. Patient gender and age, tumor location, grade and volume, usage of antiepileptic drugs (AEDs) and extent of resection were determined...
October 21, 2016: World Neurosurgery
Zenghui Qian, Xin Feng, Huibin Kang, Xiaolong Wen, Wenjuan Xu, Fei Zhao, Chuhan Jiang, Zhongxue Wu, Youxiang Li, Aihua Liu
BACKGROUND: Recent studies have reported the use of stent-assisted coiling (SAC) for wide-necked aneurysms in patients with acute subarachnoid hemorrhage (SAH). This study attempted to determine whether it is safe and efficient to use SAC for wide-necked aneurysms during post-SAH days 4-10. METHODS: We reviewed 126 consecutive patients with ruptured wide-necked aneurysms who underwent SAC. The patients were classified into the early cohort (SAC was performed within post-SAH days 0-3) and late cohort (SAC was performed within post-SAH days 4-10)...
October 21, 2016: World Neurosurgery
Lukas Andereggen, Janine Frey, Robert H Andres, Marwan El-Koussy, Jürgen Beck, Rolf W Seiler, Emanuel Christ
OBJECTIVE: In men with prolactinomas, an impaired bone density is the principle consequence of hyperprolactinemia-induced hypogonadism. While dopamine (DA-) agonists are the first-line approach in prolactinomas, surgery can be considered in selected cases. In the present study, we aimed to investigate on the long-term control of hyperprolactinemia, hypogonadism and bone health comparing primary medical and surgical therapy in men who had not had prior DA-agonist treatment. METHODS: Retrospective case-note study of 44 consecutive men with prolactinomas and no prior DA-agonists managed in a single tertiary referral center...
October 20, 2016: World Neurosurgery
Chao Liu, Yue Zhou
OBJECTIVE: To compare the clinical outcomes of patients with recurrent lumbar disc disease undergoing percutaneous endoscopic lumbar discectomy and minimally invasive transforaminal lumbar Interbody fusion at a single clinic. METHODS: Between January 2008 to January 2014, 401 consecutive patients with first time of recurrent lumbar disc herniation which were treated with PELD or MIS-TLIF. The data collected prospectively for analysis were clinical and radiographic results after revision surgery and complications...
October 20, 2016: World Neurosurgery
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