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Neurosurgical oncology

J Kim, S Radjadurai, Z Rahman, K Hitos, S Ghattas, L Gomes, C Wong, A Bleasel, M A Dexter
INTRODUCTION: Seizures are an important cause of morbidity in patients with low grade gliomas with approximately 40% of cases drug resistant. The pathogenesis is quite complex and poorly understood. The treatment aims vary between almost purely epilepsy considerations and those that are primarily oncologic. AIM: To determine whether patients who present with seizures and are found to have a low grade glioma have better outcomes when managed through a specialized epilepsy unit compared to the general neurosurgical service...
October 9, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Marion Rapp, Stephanie Schipmann, Kira Hoffmann, Rainer Wiewrodt, Hans-Jakob Steiger, Marcel Kamp, Walter Stummer, Dorothee Wiewrodt, Michael Sabel
Background: Cerebral tumors are associated with high rates of anxiety, depression and reduced health related quality of life. Nevertheless psychooncological screening instruments are neither implemented nor well defined in the daily routine of neurosurgical departments. Therefore, we tried (1) to identify a suitable screening algorithm for neurosurgical patients, (2) to define clinical risk factors for increased distress and (3) to analyze the optimal screening time point. Results: Between October 2013 and January 2015 472 elective neurosurgical in-patients (median age 55...
August 3, 2018: Oncotarget
Musa AlHarbi, Nahla Ali Mobark, Latifa AlMubarak, Rasha Aljelaify, Mariam AlSaeed, Amal Almutairi, Fatmah Alqubaishi, M Emarat Hussain, Ali Abdullah O Balbaid, Amal Said Marie, Lamia AlSubaie, Saeed AlShieban, Nada alTassan, Shakti H Ramkissoon, Malak Abedalthagafi
Primary brain tumors are a leading cause of cancer-related morbidity and mortality in children. Glioblastoma (GBM) is a high-grade astrocytoma that occurs in both children and adults and is associated with a poor prognosis. Despite extensive study in recent years, the clinical management of these tumors has remained largely unchanged, consisting of surgical resection, conventional chemotherapy, and radiotherapy. Although the etiology and genomic drivers in GBM are diverse, constitutional mismatch repair-deficiency (CMMRD) syndrome is a rare, recessively inherited disease with a predisposition to gliomagenesis...
August 13, 2018: Oncologist
Dieter Henrik Heiland, Gerrit Haaker, Ralf Watzlawick, Daniel Delev, Waseem Masalha, Pamela Franco, Marcia Machein, Ori Staszewski, Oliver Oelhke, Nils Henrik Nicolay, Oliver Schnell
INTRODUCTION: Glioblastoma multiforme (GBM) is the most common malignant primary brain tumor in adults with peak incidence in patients older than 65 years. These patients are mostly underrepresented in clinical trials and often undertreated due to concomitant diseases. Recently, different therapeutic approaches for elderly patients with GBM were discussed. To date, there is no defined standard treatment. The aim of the present study is to evaluate the functional and oncological outcome in surgical treatment of elderly patients...
August 3, 2018: Journal of Neuro-oncology
Piotr Kaźmierski, Mirosław Wąsiewicz, Jarosław Chrząstek, Michał Pająk
BACKGROUND: Iatrogenic vascular injuries, due to the particular nature of such pathology, are associated with high morbidity and mortality in the postoperative period. OBJECTIVES: The objective of this study was to present a case of non-classic approach to the therapy of iatrogenic arteriovenous fistula. MATERIAL AND METHODS: We present a case of a 17-year old female patient admitted to the Department of Vascular, General and Oncologic Surgery (Copernicus Memorial Hospital, Łódź, Poland) due to an iatrogenic injury to the common iliac vein and artery, following neurosurgical intervention on the spine...
July 30, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Ann Mansur, Selfy Oswari, Petra Octavian Perdana Wahjoepramono, Muhammad Kusdiansah, Mark Bernstein
OBJECTIVE: This study evaluated the sustainability of teaching awake craniotomy in Indonesia. We explored the factors affecting how awake craniotomy can be taught in a low- to middle-income (LMIC) country and the factors affecting the utilization of awake craniotomy in Indonesia. METHODS: This is a prospective mixed-methods study in Indonesia. A questionnaire was administered to 100 neurosurgeons at a conference on their experience with neuro-oncology, awake craniotomy, and teaching missions...
October 2018: World Neurosurgery
Francesco Acerbi, Francesco Restelli, Camilla De Laurentis, Jacopo Falco, Claudio Cavallo, Morgan Broggi, Julius Höhne, Karl-Michael Schebesch, Marco Schiariti, Paolo Ferroli
BACKGROUND: In recent years several techniques have been proposed with the aim of improving tumors visualization and extent of resection and, among them, the use of photosensitive dyes is gaining great interest. Regarding the application of the two most used dyes, 5-aminolevulinic acid (5-ALA) and sodium fluorescein (SF), there is still a lack of shared and established protocols among different centers. The main objective of the present study was to evaluate the current practice of fluorescence-guided techniques in neuro-oncological surgery in Europe...
July 17, 2018: Journal of Neurosurgical Sciences
Jang W Yoon, Wen Jiang, James T Rutka, Yuhui Huang, Betty Y S Kim
Significant advances in the design and understanding of the materials and systems of 1-100 nm have provided unprecedented tools to probe, diagnose, and treat diseases at the molecular level with greater efficiency and accuracy. In particular, optical and chemical properties of nanomaterials are being exploited to improve the effectiveness of neuro-oncological and neurosurgical interventions. Modern nanotechnology-driven clinical applications may have significant impact on management of brain tumors.
2018: Progress in Neurological Surgery
Francesco Acerbi, Ignazio G Vetrano, Tommaso Sattin, Jacopo Falco, Camilla de Laurentis, Costanza M Zattra, Lorenzo Bosio, Zefferino Rossini, Morgan Broggi, Marco Schiariti, Paolo Ferroli
OBJECTIVE The best management of veins encountered during the neurosurgical approach is still a matter of debate. Even if venous sacrifice were to lead to devastating consequences, under certain circumstances, it might prove to be desirable, enlarging the surgical field or increasing the extent of resection in tumor surgery. In this study, the authors present a large series of patients with vascular or oncological entities, in which they used indocyanine green videoangiography (ICG-VA) with FLOW 800 analysis to study the patient-specific venous flow characteristics and the management workflow in cases in which a venous sacrifice was necessary...
July 2018: Neurosurgical Focus
Yachun Li, Patra Charalampaki, Yong Liu, Guang-Zhong Yang, Stamatia Giannarou
PURPOSE: Probe-based confocal laser endomicroscopy (pCLE) enables in vivo, in situ tissue characterisation without changes in the surgical setting and simplifies the oncological surgical workflow. The potential of this technique in identifying residual cancer tissue and improving resection rates of brain tumours has been recently verified in pilot studies. The interpretation of endomicroscopic information is challenging, particularly for surgeons who do not themselves routinely review histopathology...
August 2018: International Journal of Computer Assisted Radiology and Surgery
Alexandre Roux, Céline Botella, Megan Still, Marc Zanello, Frédéric Dhermain, Philippe Metellus, Johan Pallud
BACKGROUND: There is no consensus concerning the management of adult patients with posterior fossa metastasis-associated obstructive hydrocephalus, especially regarding surgical procedures. A literature review was performed to assess the surgical strategy in the management of patients with metastatic brain tumor. METHODS: A literature search was conducted of PubMed in November 2017 to identify all studies concerning brain metastases and obstructive hydrocephalus in English...
September 2018: World Neurosurgery
Ali Inal, Hilmi Kodaz, Hatice Odabas, Ayse Ocak Duran, Mehmet Metin Seker, Mevlide İnanc, Emin Tamer Elkıran, Yusuf Gunaydın, Serkan Menekse, Turkan Ozturk Topcu, Zuhat Urakcı, Didem Tastekin, Mehmet Bilici, Sener Cihan, Caglayan Geredeli, Emel Sezer, Dogan Uncu, Erkan Arpacı, Banu Ozturk, Oznur Bal, Mukremin Uysal, Ozgur Tanrıverdi, Mahmut Gumus, Bala Basak Oven Ustaalioglu, Ali Suner, Suna Cokmert, İlhan Hacıbekiroglu, Kubra Aydın, Abdurrahman Isıkdogan
Purpose: Almost half of all patients diagnosed with non-small cell lung cancer (NSCLC) have distant metastases at presentation. One-third of patients with NSCLC will have brain metastases. Without effective treatment, the median survival is only 1 month. However, it is difficult to treat brain metastases with systemic chemotherapy since the agents have difficulty crossing the blood-brain barrier. Therefore, it is important to estimate the patient's survival prognosis. The aim of this study was to analyze prognostic factors for survival in Turkish patients who received chemotherapy after cranial irradiation for NSCLC with brain metastases...
April 2018: Journal of Cancer Research and Therapeutics
Alessandro Perin, Tommaso Francesco Galbiati, Cecilia Casali, Federico Giuseppe Legnani, Luca Mattei, Francesco Ugo Prada, Marco Saini, Andrea Saladino, Nicole Riker, Francesco DiMeco
BACKGROUND AND IMPORTANCE: Mesencephalic tectal gliomas represent a subset of midbrain tumors, which are more frequent in children than in adults. They usually become symptomatic when causing hydrocephalus by occluding the aqueduct. Because of their slow progression, due to their benign histology, they are characterized by a relatively good prognosis, although hydrocephalus might jeopardize patients' prognosis. Treatment is usually represented by cerebrospinal fluid diversion associated or not with biopsy...
June 5, 2018: Operative Neurosurgery (Hagerstown, Md.)
Ewa Izycka-Swieszewska, Ewa Bien, Joanna Stefanowicz, Edyta Szurowska, Ewa Szutowicz-Zielinska, Magdalena Koczkowska, Dawid Sigorski, Wojciech Kloc, Wojciech Rogowski, Elzbieta Adamkiewicz-Drozynska
This study presents a unique series of malignant supratentorial gliomas in children previously cured from non-CNS primary cancer. On neuroimaging these tumors were not specific, so the patients were suspected of cerebral recurrence of their primary neoplasm: leukemia in four children and sarcoma in one child. Histologically, the group contained four glioblastomas and one anaplastic astrocytoma. Three patients underwent neurosurgical resection, while the other two underwent stereotactic diagnostic biopsy only...
2018: BioMed Research International
Jonathan Roth, Jehuda Soleman, Dimitris Paraskevopoulos, Robert F Keating, Shlomi Constantini
PURPOSE: Incidental pediatric brain tumors (IPBT) are increasingly being diagnosed. Currently, there is no consensus regarding the need and timing of their treatment. In the current study, we identify trends among pediatric neurosurgeons and oncologists with regard to IPBT management and approval of growth hormone replacement therapy (GHRT). METHODS: A questionnaire presenting six different cases of IPBT was emailed to all members of several leading societies in pediatric neurosurgery and oncology...
July 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Claudio Cavallo, Camilla De Laurentis, Ignazio G Vetrano, Jacopo Falco, Morgan Broggi, Marco Schiariti, Paolo Ferroli, Francesco Acerbi
INTRODUCTION: Sodium Fluorescein (SF) is a green, water-soluble dye with the capacity to accumulate in cerebral areas as a result of damaged blood-brain barrier (BBB); this property allows SF to concentrate specifically at the tumor site of various types of brain neoplasms, making the tumor tissue more clearly visible. EVIDENCE ACQUISITION: A literature search (1947-2018) was conducted with the keywords "fluorescein neurosurgery", "YELLOW neurosurgery", "fluorescein brain tumor", "YELLOW brain tumor"...
May 22, 2018: Journal of Neurosurgical Sciences
Hany Osman, Joseph Georges, Deena Elsahy, Eyas M Hattab, Steven Yocom, Aaron A Cohen-Gadol
Intraoperative neurosurgical histopathologic diagnoses rely on evaluation of rapid tissue preparations such as frozen sections and smears with conventional light microscopy. Although useful, these techniques are time consuming and therefore cannot provide real-time intraoperative feedback. In vivo molecular imaging techniques are emerging as novel methods for generating real-time diagnostic histopathologic images of tumors and their surrounding tissues. These imaging techniques rely on contrast generated by exogenous fluorescent dyes, autofluorescence of endogenous molecules, fluorescence decay of excited molecules, or light scattering...
July 2018: World Neurosurgery
Assaf Berger, Rotem Tellem, Michal Arad, Uri Hochberg, Tal Gonen, Ido Strauss
Pain is one of the most common symptoms among cancer patients, and particularly in those who suffer from metastatic or terminal disease. There is great importance in delivering good pain management to these patients in order to alleviate their suffering, improve their functional status and their overall quality of life. In most cases, pain management is based on pharmacotherapy with opioids and other medications. However, there are selected patients for whom pharmacotherapy does not achieve acceptable pain relief or is associated with marked side effects...
February 2018: Harefuah
A García-Baizán, A Tomás-Biosca, P Bartolomé Leal, P D Domínguez, R García de Eulate Ruiz, S Tejada, J L Zubieta
OBJECTIVE: To report our experience in the use of 3 tesla intraoperative magnetic resonance imaging (MRI) in neurosurgical procedures for tumors, and to evaluate the criteria for increasing the extension of resection. MATERIAL AND METHODS: This retrospective study included all consecutive intraoperative MRI studies done for neuro-oncologic disease in the first 13 months after the implementation of the technique. We registered possible immediate complications, the presence of tumor remnants, and whether the results of the intraoperative MRI study changed the surgical management...
March 2018: Radiología
Desmond A Brown, Benjamin T Himes, Brittny T Major, Benjamin F Mundell, Ravi Kumar, Bruce Kall, Fredric B Meyer, Michael J Link, Bruce E Pollock, John D Atkinson, Jamie J Van Gompel, W Richard Marsh, Giuseppe Lanzino, Mohamad Bydon, Ian F Parney
OBJECTIVE: To determine adverse event rates for adult cranial neuro-oncologic surgeries performed at a high-volume quaternary academic center and assess the impact of resident participation on perioperative complication rates. PATIENTS AND METHODS: All adult patients undergoing neurosurgical intervention for an intracranial neoplastic lesion between January 1, 2009, and December 31, 2013, were included. Cases were categorized as biopsy, extra-axial/skull base, intra-axial, or transsphenoidal...
January 2018: Mayo Clinic Proceedings
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