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Brain tumor surgery

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https://www.readbyqxmd.com/read/29454130/abscess-within-a-glioblastoma-mimicking-a-matryoshka-doll
#1
Kislay Kishore, Manish Beniwal, Shilpa Rao, K V L N Rao, Vikas Vazhayil, Dwarkanath Srinivas, Sampath Somanna
BACKGROUND: Abscess co-existing within a brain tumor is a rare entity. Case reports in literature primarily consist of sellar pathology and parenchymal lesions including meningioma, glioma, and metastases. We report a case of glioblastoma with an intra-tumoral abscess in a middle-aged lady with no prior invasive procedure or systemic focus of infection. CASE DESCRIPTION: A 45-year old lady presented with new onset generalized seizures and rapidly progressive left hemiparesis...
February 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29452315/technical-aspects-of-awake-craniotomy-with-mapping-for-brain-tumors-in-a-limited-resource-setting
#2
Rafael Teixeira Magalhaes Leal, Bruno Mendonça Barcellos, Jose Alberto Landeiro
BACKGROUND: Brain tumor surgery near or within eloquent regions is increasingly common and is associated with a high risk of neurological injury. Awake craniotomy with mapping has been shown to be a valid method to preserve neurological function while increasing the extent of resection. However, the technique used varies greatly among centers. Most count on professionals such as neuropsychologists, speech therapists, neurophysiologists or neurologists to help in intraoperative patient evaluation...
February 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29451456/clival-meningocele-causing-bilateral-hearing-loss-in-a-child-due-to-superficial-siderosis-of-the-central-nervous-system-case-report
#3
Stephen J Johans, Kevin N Swong, Daniel J Burkett, Michael P Wemhoff, Sean M Lew, Chirag R Patel, Anand V Germanwala
Superficial siderosis (SS) of the CNS is a rare and often unrecognized condition. Caused by hemosiderin deposition from chronic, repetitive hemorrhage in the subarachnoid space, it results in parenchymal damage in the subpial layers of the brain and spinal cord. T2-weighted MRI shows the characteristic hypointensity of hemosiderin deposition, classically occurring around the cerebellum, brainstem, and spinal cord. Patients present with progressive gait ataxia and sensorineural hearing impairment. Although there have been several studies, case reports, and review articles over the years, the clear pathophysiology of subarachnoid space hemorrhage remains to be elucidated...
February 16, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29451454/efficacy-of-intraoperative-ultrasonography-in-neurosurgical-tumor-resection
#4
Jared F Sweeney, Heather Smith, AmiLyn Taplin, Eric Perloff, Matthew A Adamo
OBJECTIVE Intraoperative ultrasonography (IOUS) is a widely accessible imaging modality that provides real-time surgical guidance with minimal identified risk or additional operative time. A recent study by the authors found a strong correlation between IOUS and postoperative MRI findings when evaluating the extent of tumor resection, suggesting that IOUS might have significant clinical implications. The objective of this study was to expand on results from the previous study in order to provide more evidence on the usage of IOUS in the determination of gross-total resection (GTR) in both adult and pediatric patients with brain tumors...
February 16, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29451451/critical-assessment-of-pediatric-neurosurgery-patient-parent-educational-information-obtained-via-the-internet
#5
Michael Garcia, Christopher Daugherty, Bertha Ben Khallouq, Todd Maugans
OBJECTIVE The Internet is used frequently by patients and family members to acquire information about pediatric neurosurgical conditions. The sources, nature, accuracy, and usefulness of this information have not been examined recently. The authors analyzed the results from searches of 10 common pediatric neurosurgical terms using a novel scoring test to assess the value of the educational information obtained. METHODS Google and Bing searches were performed for 10 common pediatric neurosurgical topics (concussion, craniosynostosis, hydrocephalus, pediatric brain tumor, pediatric Chiari malformation, pediatric epilepsy surgery, pediatric neurosurgery, plagiocephaly, spina bifida, and tethered spinal cord)...
February 16, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29449898/targeted-therapy-of-brain-metastases-latest-evidence-and-clinical-implications
#6
REVIEW
Rodica Di Lorenzo, Manmeet S Ahluwalia
Brain metastases (BM) occur in 20-40% of patients with cancer and 60-75% of patients with BM become symptomatic. Due to an aging population and advances in the treatment of primary cancers, patients are living longer and are more likely to experience complications from BM. The diagnosis of BM drastically worsens long-term survival rates, with multiple metastases being a poor prognostic factor. Until recently, the mainstay of treatment consisted of stereotactic radiosurgery (SRS), surgical resection, whole brain radiation therapy (WBRT), or a combination of these modalities...
December 2017: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/29441722/the-growing-importance-of-lesion-volume-as-a-prognostic-factor-in-patients-with-multiple-brain-metastases-treated-with-stereotactic-radiosurgery
#7
David M Routman, Shelly X Bian, Kevin Diao, Jonathan L Liu, Cheng Yu, Jason Ye, Gabriel Zada, Eric L Chang
Stereotactic Radiosurgery (SRS) is considered standard of care for patients with 1-3 brain metastases (BM). Recent observational studies have shown equivalent OS in patients with 5+ BM compared to those with 2-4, suggesting SRS alone may be appropriate in these patients. We aim to review outcomes of patients treated with SRS with 2-4 versus 5+ BM. This analysis included consecutive patients from 1994 to 2015 treated with SRS. Of 1017 patients, we excluded patients with a single BM and patients without adequate survival data, resulting in 391 patients...
February 14, 2018: Cancer Medicine
https://www.readbyqxmd.com/read/29440926/local-anesthetics-for-brain-tumor-resection-current-perspectives
#8
REVIEW
Jan-Willem Potters, Markus Klimek
This review summarizes the added value of local anesthetics in patients undergoing craniotomy for brain tumor resection, which is a procedure that is carried out frequently in neurosurgical practice. The procedure can be carried out under general anesthesia, sedation with local anesthesia or under local anesthesia only. Literature shows a large variation in the postoperative pain intensity ranging from no postoperative analgesia requirement in two-thirds of the patients up to a rate of 96% of the patients suffering from severe postoperative pain...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/29440379/targeting-the-cmet-pathway-augments-radiation-response-without-adverse-effect-on-hearing-in-nf2-schwannoma-models
#9
Yingchao Zhao, Pinan Liu, Na Zhang, Jie Chen, Lukas D Landegger, Limeng Wu, Fu Zhao, Yanxia Zhao, Yanling Zhang, Jing Zhang, Takeshi Fujita, Anat Stemmer-Rachamimov, Gino B Ferraro, Hao Liu, Alona Muzikansky, Scott R Plotkin, Konstantina M Stankovic, Rakesh K Jain, Lei Xu
Neurofibromatosis type II (NF2) is a disease that needs new solutions. Vestibular schwannoma (VS) growth causes progressive hearing loss, and the standard treatment, including surgery and radiotherapy, can further damage the nerve. There is an urgent need to identify an adjunct therapy that, by enhancing the efficacy of radiation, can help lower the radiation dose and preserve hearing. The mechanisms underlying deafness in NF2 are still unclear. One of the major limitations in studying tumor-induced hearing loss is the lack of mouse models that allow hearing testing...
February 9, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29434840/autophagy-activation-promotes-bevacizumab-resistance-in-glioblastoma-by-suppressing-akt-mtor-signaling-pathway
#10
He Huang, Jian Song, Zheng Liu, Li Pan, Guozheng Xu
Glioblastomas are the most common primary and malignant brain tumors. The standard therapy includes surgery and radiotherapy plus chemotherapy, with additional bevacizumab to block the angiogenesis in tumors. However, the ever-growing tolerance of glioblastomas to chemotherapeutic drugs impairs the clinical outputs of tumor treatment. The present study investigated the tolerance of glioblastomas to bevacizumab. Although bevacizumab resulted in direct anti-proliferation and pro-apoptosis effects on glioblastoma cells via downregulating the anti-apoptotic proteins and upregulating the pro-apoptotic proteins, tolerance was also encountered that was mainly caused by autophagy induction in tumor cells...
February 2018: Oncology Letters
https://www.readbyqxmd.com/read/29432943/functional-based-resection-does-not-worsen-quality-of-life-in-patients-harboring-a-diffuse-low-grade-glioma-involving-eloquent-brain-regions-a-prospective-cohort-study
#11
Jun Muto, Edouard Dezamis, Odile Rigaux-Viode, Sophie Peeters, Alexandre Roux, Marc Zanello, Charles Mellerio, Xavier Sauvageon, Pascale Varlet, Catherine Oppenheim, Johan Pallud
OBJECTIVE: We assessed the impact of surgery on postoperative cognitive function and ability to work in adult patients harboring a diffuse low-grade glioma involving eloquent brain regions and having a functional-based maximal surgical resection using intraoperative corticosubcortical mapping under awake conditions. METHODS: We prospectively included 39 consecutive diffuse IDH-mutant low-grade glioma patients without preoperative and adjuvant oncological treatment and assessed preoperative (mean 24...
February 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29428980/bone-flap-salvage-in-acute-surgical-site-infection-after-craniotomy-for-tumor-resection
#12
David J Wallace, Michael J McGinity, John R Floyd
Craniotomy surgical site infections are an inherent risk and dreaded complication for the elective brain tumor patient. Sequelae can include delays in resumption in adjuvant treatments for multiple surgeries if staged cranioplasty is pursued. Here, the authors review their experience in operative debridement of surgical site infections with single-stage reimplantation of the salvaged craniotomy bone flap. A prospectively maintained database of a single surgeon's neuro-oncology patients from 2009 to 2017 (JRF) was queried to identify 11 patients with surgical site infection after craniotomy for tumor resection...
February 10, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29427211/treatment-with-5-azacitidine-delay-growth-of-glioblastoma-xenografts-a-potential-new-treatment-approach-for-glioblastomas
#13
Tobias Kratzsch, Susanne Antje Kuhn, Andreas Joedicke, Uwe Karsten Hanisch, Peter Vajkoczy, Jens Hoffmann, Iduna Fichtner
PURPOSE: Glioblastoma multiforme (GBM) is the most lethal primary brain tumor in adults. The epigenetically active ribonucleoside analog 5-azacitidine is a new therapy option that changes tumor cell chromatin, which is frequently modified by methylation and deacetylation in malignant gliomas. METHODS: In vitro, we analyzed cell viability, cell apoptosis, and migration of human GBM cells. In vivo, we established subcutaneous and intracerebral GBM mouse models originating from U87MG, U373MG, and primary GBM cells as well as one patient-derived xenograft...
February 9, 2018: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/29424334/reactive-gliosis-mimicking-tumor-recurrence-a-case-series-documenting-mri-abnormalities-and-neuropathological-correlates
#14
Hugh Kearney, Jane Cryan, Alan Beausung, Seamus Looby, Francesca M Brett
The aim of this study is to identify, in our center, all cases of foreign-body reactions to hemostatic agents or other prostheses resulting in a radiological suspicion of tumor recurrence. We interrogated our internal database to identify all such cases and systematically evaluated the MRI brain scans of patients: (i) at the time of initial tumor diagnosis, (ii) postoperatively, (iii) and at the time of suspected tumor recurrence. In addition, we reviewed each patient's operative notes and reviewed the histology of all cases following a second surgical intervention...
February 9, 2018: Clinical Neuropathology
https://www.readbyqxmd.com/read/29414911/with-a-little-help-from-my-friends-the-role-of-intraoperative-fluorescent-dyes-in-the-surgical-management-of-high-grade-gliomas
#15
REVIEW
Rosario Maugeri, Alessandro Villa, Mariangela Pino, Alessia Imperato, Giuseppe Roberto Giammalva, Gabriele Costantino, Francesca Graziano, Carlo Gulì, Francesco Meli, Natale Francaviglia, Domenico Gerardo Iacopino
High-grade gliomas (HGGs) are the most frequent primary malignant brain tumors in adults, which lead to death within two years of diagnosis. Maximal safe resection of malignant gliomas as the first step of multimodal therapy is an accepted goal in malignant glioma surgery. Gross total resection has an important role in improving overall survival (OS) and progression-free survival (PFS), but identification of tumor borders is particularly difficult in HGGS. For this reason, imaging adjuncts, such as 5-aminolevulinic acid (5-ALA) or fluorescein sodium (FS) have been proposed as superior strategies for better defining the limits of surgical resection for HGG...
February 7, 2018: Brain Sciences
https://www.readbyqxmd.com/read/29412496/characterization-of-active-and-infiltrative-tumorous-subregions-from-normal-tissue-in-brain-gliomas-using-multiparametric-mri
#16
Anahita Fathi Kazerooni, Mahnaz Nabil, Mehdi Zeinali Zadeh, Kavous Firouznia, Farid Azmoudeh-Ardalan, Alejandro F Frangi, Christos Davatzikos, Hamidreza Saligheh Rad
BACKGROUND: Targeted localized biopsies and treatments for diffuse gliomas rely on accurate identification of tissue subregions, for which current MRI techniques lack specificity. PURPOSE: To explore the complementary and competitive roles of a variety of conventional and quantitative MRI methods for distinguishing subregions of brain gliomas. STUDY TYPE: Prospective. POPULATION: Fifty-one tissue specimens were collected using image-guided localized biopsy surgery from 10 patients with newly diagnosed gliomas...
February 7, 2018: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29409926/rapid-intraoperative-in-situ-synthetic-cranioplasty
#17
Christopher C Young, Brian W Hanak, Anoop P Patel, Laligam N Sekhar
BACKGROUND: Craniectomy is a frequently performed neurosurgical procedure and coverage of the cranial defect is necessary for protection of the underlying brain, cosmesis, and patient satisfaction. We report a new technique for intraoperative in-situ synthetic cranioplasty to allow for one-step resection of skull osteoma and reconstruction of cranial defect. Strategies of intraoperative cranioplasty are reviewed. METHOD: A 48-year-old man presents with a suspected benign osteoma over his forehead...
January 30, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29408716/scanning-fiber-endoscope-improves-detection-of-5-ala-induced-protoporphyrin-ix-fluorescence-at-the-boundary-of-infiltrative-glioma
#18
Evgenii Belykh, Eric J Miller, Danying Hu, Nikolay L Martirosyan, Eric C Woolf, Adrienne C Scheck, Vadim A Byvaltsev, Peter Nakaji, Leonard Y Nelson, Eric J Seibel, Mark C Preul
OBJECTIVE: Fluorescence-guided surgery with protoporphyrin IX (PpIX) as a photodiagnostic marker is gaining acceptance for resection of malignant gliomas. Current wide-field imaging technologies do not have sufficient sensitivity to detect low PpIX concentrations. We evaluated a scanning fiber endoscope (SFE) for detection of PpIX fluorescence in gliomas and compared it with an operating microscope (OPMI) equipped with fluorescence module and a benchtop confocal laser scanning microscope (CLSM)...
January 31, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29408648/when-are-complications-following-brain-tumor-surgery-detected
#19
Heidi Heitmann Viken, Ida Amalie Iversen, Asgeir Jakola, Lisa Millgård Sagberg, Ole Solheim
OBJECTIVE: To optimize follow-up and surveillance routines after intracranial surgery, knowledge about when complications occur is needed. We sought to explore when postoperative complications are detected after brain tumor surgery, and assess the severity of these. METHODS: We did a retrospective review of hospital records in 1291 adult patients undergoing elective craniotomy for intracranial tumors between 2008-2016 at our institution. Medical history, comorbidity, registered outcomes within 30 days and time of detection of complications were registered...
January 30, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29400585/fatal-collision-are-wireless-headsets-a-risk-in-treating-patients
#20
Cindy Sage, Lennart Hardell
Wireless-enabled headsets that connect to the internet can provide remote transcribing of patient examination notes. Audio and video can be captured and transmitted by wireless signals sent from the computer screen in the frame of the glasses. But using wireless glass-type devices can expose the user to a specific absorption rates (SAR) of 1.11-1.46 W/kg of radiofrequency radiation. That RF intensity is as high as or higher than RF emissions of some cell phones. Prolonged use of cell phones used ipsilaterally at the head has been associated with statistically significant increased risk of glioma and acoustic neuroma...
February 5, 2018: Electromagnetic Biology and Medicine
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