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https://www.readbyqxmd.com/read/28300709/delayed-carotid-pseudoaneurysms-from-iatrogenic-clival-meningeal-branches-avulsion-recognition-and-proposed-management
#1
Rami Almefty, Ian F Dunn, Muhammad Ali Aziz-Sultan, Ossama Al-Mefty
Carotid injury during anterior skull base approaches is promptly recognizable and mandates immediate treatment; likewise, development of pseudoaneurysms after such injuries is anticipated and managed. We report here on the delayed development of a pseudoaneurysm as the result of avulsion of clival meningeal arteries that manifests as unalarming intraoperative bleeding that appears as brisk and arterial but very easily controlled. Immediate postoperative angiography is negative, necessitating repeated angiography to depict the delayed formation...
March 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28291217/-early-postoperative-results-of-surgical-treatment-of-patients-with-anterior-clinoidal-meningiomas
#2
S V Chernov, D A Rzaev, A V Kalinovsky, A B Dmitriev, A R Kasymov, A V Zotov, E V Gormolysova, E K Uzhakova
Resection of anterior clinoidal meningiomas is a challenging task due to their localization, frequent involvement of the major cerebral arteries and cranial nerves, a high risk of postoperative neurological deficits, and low radicalness of surgery. AIM: To evaluate the radicalness of microsurgical removal and a neurological deficit in the early postoperative period in patients with anterior clinoidal meningiomas. MATERIAL AND METHODS: A total of 35 patients with anterior clinoidal meningiomas underwent surgery at the Department of Neurooncology of the Novosibirsk Federal Neurosurgical Center in the period from 2013 to July 2016...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28259671/hybrid-surgery-management-of-giant-hypervascular-tumors-intraoperative-endovascular-embolization-with-microsurgical-resection
#3
Rami O Almefty, Nirav J Patel, Alfred P See, Ian F Dunn, Ossama Al-Mefty, Mohammed Ali Aziz-Sultan
INTRODUCTION: Giant hypervascular intracranial tumors represent a formidable challenge as their size limits surgical control of the blood supply and debulking poses the risk of critical blood loss. Embolization facilitates resection but carries the risk of life-threatening tumor infarction, hemorrhage, or swelling if performed preoperatively. Endovascular intraoperative embolization avoids the fatal risk and allows the surgeon to attend instantly if any complication occurs. CLINICAL PRESENTATION: We report two cases in which combining intraoperative embolization with microsurgical resection in the hybrid operating room was used to safely and successfully remove giant, hypervascular tumors...
March 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28175422/130%C3%A2-skull-base-chordomas-in-children-and-young-adults
#4
M Maher Hulou, Marcio S Rassi, Kaith Almefty, Wenya Linda Bi, Ian F Dunn, Timothy R Smith, Ossama Al-Mefty
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
https://www.readbyqxmd.com/read/28170043/germline-and-somatic-bap1-mutations-in-high-grade-rhabdoid-meningiomas
#5
Ganesh M Shankar, Malak Abedalthagafi, Rachael A Vaubel, Parker H Merrill, Naema Nayyar, Corey M Gill, Ryan Brewster, Wenya Linda Bi, Pankaj K Agarwalla, Aaron R Thorner, David A Reardon, Ossama Al-Mefty, Patrick Y Wen, Brian M Alexander, Paul van Hummelen, Tracy T Batchelor, Keith L Ligon, Azra H Ligon, Matthew Meyerson, Ian F Dunn, Rameen Beroukhim, David N Louis, Arie Perry, Scott L Carter, Caterina Giannini, William T Curry, Daniel P Cahill, Frederick G Barker, Priscilla K Brastianos, Sandro Santagata
Background.: Patients with meningiomas have widely divergent clinical courses. Some entirely recover following surgery alone, while others have relentless tumor recurrences. This clinical conundrum is exemplified by rhabdoid meningiomas, which are designated in the World Health Organization Classification of Tumours as high grade, despite only a subset following an aggressive clinical course. Patient management decisions are further exacerbated by high rates of interobserver variability, biased against missing possibly aggressive tumors...
April 1, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/28048264/su-d-207b-02-early-grade-classification-in-meningioma-patients-combining-radiomics-and-semantics-data
#6
T Coroller, W Bi, M Abedalthagafi, A Aizer, W Wu, N Greenwald, R Beroukhim, O Al-Mefty, S Santagata, I Dunn, B Alexander, R Huang, H Aerts
PURPOSE: The clinical management of meningioma is guided by its grade and biologic behavior. Currently, diagnosis of tumor grade follows surgical resection and histopathologic review. Reliable techniques for pre-operative determination of tumor behavior are needed. We investigated the association between imaging features extracted from preoperative gadolinium-enhanced T1-weighted MRI and meningioma grade. METHODS: We retrospectively examined the pre-operative MRI for 139 patients with de novo WHO grade I (63%) and grade II (37%) meningiomas...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/27399409/130%C3%A2-skull-base-chordomas-in-children-and-young-adults
#7
M Maher Hulou, Marcio S Rassi, Kaith Almefty, Wenya Linda Bi, Ian F Dunn, Timothy R Smith, Ossama Al-Mefty
INTRODUCTION: Skull base chordomas are rare tumors, with less than 5% occurring in patients younger than 20 years of age. Current understanding and a consensus management strategy for pediatric chordomas remain lacking. We investigated the clinical and radiological features of chordomas in young patients, with an emphasis on surgical outcomes and predictors of survival following our management protocol of radical surgical resection with adjuvant high-dose radiotherapy. METHODS: Data from 31 patients, age 22 years or younger, referred to the senior author (OAM) from 1993 to 2008 were reviewed...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27341050/transtentorial-transcollateral-sulcus-approach-to-the-ventricular-atrium-an-endoscope-assisted-anatomical-study
#8
Yasser Jeelani, Abdulkerim Gokoglu, Tomer Anor, Ossama Al-Mefty, Alan R Cohen
OBJECTIVE Conventional approaches to the atrium of the lateral ventricle may be associated with complications related to direct cortical injury or brain retraction. The authors describe a novel approach to the atrium through a retrosigmoid transtentorial transcollateral sulcus corridor. METHODS Bilateral retrosigmoid craniotomies were performed on 4 formalin-fixed, colored latex-injected human cadaver heads (a total of 8 approaches). Microsurgical dissections were performed under 3× to 24× magnification, and endoscopic visualization was provided by 0° and 30° rigid endoscope lens systems...
April 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27090972/endoscope-assisted-microsurgical-approach-to-the-posterior-and-posterolateral-incisural-space
#9
Roberta Rehder, Marcos Perocco Luiz da Costa, Ossama Al-Mefty, Alan R Cohen
OBJECTIVE: Despite recent technological advances, direct approaches to the posterolateral incisural space remain surgical challenges. The choice of the operative route depends on the exact location and extent of the target lesion as well as individual preferences. The extreme lateral infratentorial supracerebellar approach to treat pathologies located in the ambient cistern and posterior incisural space is a technically feasible route in selected cases. In this cadaveric study, we demonstrate the benefits of endoscope-assisted microsurgical maneuvers using the extreme lateral supracerebellar infratentorial approach...
July 2016: World Neurosurgery
https://www.readbyqxmd.com/read/26871376/letter-to-the-editor-cadaveric-csf-reconstitution-model-for-neuroendoscopic-intraventricular-procedures
#10
LETTER
Emad Aboud, Ossama Al-Mefty
No abstract text is available yet for this article.
April 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/26476700/pre-operative-image-based-segmentation-of-the-cranial-nerves-and-blood-vessels-in-microvascular-decompression-can-we-prevent-unnecessary-explorations
#11
Parviz Dolati, Alexandra Golby, Daniel Eichberg, Mohamad Abolfotoh, Ian F Dunn, Srinivasan Mukundan, Mohamed M Hulou, Ossama Al-Mefty
OBJECTIVES: This study was conducted to validate the accuracy of image-based pre-operative segmentation using the gold standard endoscopic and microscopic findings for localization and pre-operative diagnosis of the offensive vessel. PATIENTS AND METHODS: Fourteen TN and 6 HS cases were randomly selected. All patients had 3T MRI, which included thin-sectioned 3D space T2, 3D Time of Flight and MPRAGE Sequences. Imaging sequences were loaded in BrainLab iPlanNet and fused...
December 2015: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/26323607/a-prognostic-cytogenetic-scoring-system-to-guide-the-adjuvant-management-of-patients-with-atypical-meningioma
#12
Ayal A Aizer, Malak Abedalthagafi, Wenya Linda Bi, Margaret C Horvath, Nils D Arvold, Ossama Al-Mefty, Eudocia Q Lee, Lakshmi Nayak, Mikael L Rinne, Andrew D Norden, David A Reardon, Patrick Y Wen, Keith L Ligon, Azra H Ligon, Rameen Beroukhim, Ian F Dunn, Sandro Santagata, Brian M Alexander
BACKGROUND: The appropriate use of adjuvant therapy in patients with gross totally resected atypical meningioma requires an accurate assessment of recurrence risk. We sought to determine whether cytogenetic/genetic characterization may facilitate better estimation of the probability of recurrence. METHODS: We first analyzed our clinical database, including high-resolution DNA copy number data, to identify 11 common copy number aberrations in a pilot cohort of meningiomas of all grades...
February 2016: Neuro-oncology
https://www.readbyqxmd.com/read/26308667/extent-of-resection-and-overall-survival-for-patients-with-atypical-and-malignant-meningioma
#13
Ayal A Aizer, Wenya Linda Bi, Manjinder S Kandola, Eudocia Q Lee, Lakshmi Nayak, Mikael L Rinne, Andrew D Norden, Rameen Beroukhim, David A Reardon, Patrick Y Wen, Ossama Al-Mefty, Nils D Arvold, Ian F Dunn, Brian M Alexander
BACKGROUND: The prognosis for patients with atypical and malignant meningioma is guarded; whether the extent of resection is associated with survival-based outcomes in this population remains poorly defined. This study investigated the association between gross total resection (GTR) and all-cause mortality in patients with atypical and malignant meningioma. METHODS: The Surveillance, Epidemiology, and End Results program was used to identify 575 and 64 patients betweens the ages of 18 and 70 years who were diagnosed with atypical and malignant meningioma, respectively, between 2004 and 2009...
December 15, 2015: Cancer
https://www.readbyqxmd.com/read/26253325/brachytherapy-in-the-treatment-of-recurrent-aggressive-falcine-meningiomas
#14
Hussam Abou Al-Shaar, Kaith K Almefty, Mohammad Abolfotoh, Nils D Arvold, Phillip M Devlin, David A Reardon, Jay S Loeffler, Ossama Al-Mefty
Recurrent aggressive falcine meningiomas are uncommon tumors that recur despite receiving extensive surgery and radiation therapy (RT). We have utilized brachytherapy as a salvage treatment in two such patients with a unique implantation technique. Both patients had recurrence of WHO Grade II falcine meningiomas despite multiple prior surgical and RT treatments. Radioactive I-125 seeds were made into strands and sutured into a mesh implant, with 1 cm spacing, in a size appropriate to cover the cavity and region of susceptible falcine dura...
September 2015: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/26251815/fibrin-glue-injection-for-cavernous-sinus-hemostasis-associated-with-cranial-nerve-deficit-a-case-report
#15
Daryoush Tavanaiepour, Sarah Jernigan, Mohamad Abolfotoh, Ossama Al-Mefty
Fibrin glue injection has been used to control intraoperative cavernous sinus (CS) venous bleeding. There have been no reported complications related to this maneuver. We present a case where a patient developed a sensory trigeminal nerve deficit after injection of fibrin glue into the posterior CS during resection of a petrosal meningioma. We believe that this deficit was due to the compression of the trigeminal ganglion similar to balloon compression procedures. Although fibrin glue injection may achieve satisfactory cavernous sinus homeostasis, the volume and rate of injection should be kept in mind to avoid a compressive lesion on traversing cranial nerves and surrounding structures, or retrograde filling of the venous tributaries...
July 2015: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/26140492/-live-cadavers-for-training-in-the-management-of-intraoperative-aneurysmal-rupture
#16
Emad Aboud, Ghaith Aboud, Ossama Al-Mefty, Talal Aboud, Stylianos Rammos, Mohammad Abolfotoh, Sanford P C Hsu, Sebastian Koga, Adam Arthur, Ali Krisht
OBJECT: Intraoperative rupture occurs in approximately 9.2% of all cranial aneurysm surgeries. This event is not merely a surgical complication, it is also a real surgical crisis that requires swift and decisive action. Neurosurgical residents may have little exposure to this event, but they may face it in their practice. Laboratory training would be invaluable for developing competency in addressing this crisis. In this study, the authors present the "live cadaver" model, which allows repetitive training under lifelike conditions for residents and other trainees to practice managing this crisis...
November 2015: Journal of Neurosurgery
https://www.readbyqxmd.com/read/26008603/descriptive-epidemiology-of-world-health-organization-grades-ii-and-iii-intracranial-meningiomas-in-the-united-states
#17
Varun R Kshettry, Quinn T Ostrom, Carol Kruchko, Ossama Al-Mefty, Gene H Barnett, Jill S Barnholtz-Sloan
BACKGROUND: Because World Health Organization (WHO) grades II and III meningiomas are relatively uncommon, there is limited literature on the descriptive epidemiology of these tumors, and the existing literature predates the 2000 WHO classification revisions. Our purpose was to provide a modern, population-based study of the descriptive epidemiology of WHO II and III meningiomas in the United States. METHODS: The Central Brain Tumor Registry of the United States (CBTRUS) was queried for intracranial meningiomas categorized by WHO grade for the 2004--2010 study period...
August 2015: Neuro-oncology
https://www.readbyqxmd.com/read/26008142/the-expanding-spectrum-of-disease-treated-by-the-transnasal-transsphenoidal-microscopic-and-endoscopic-anterior-skull-base-approach-a-single-center-experience-2008-2015
#18
David J Cote, Robert Wiemann, Timothy R Smith, Ian F Dunn, Ossama Al-Mefty, Edward R Laws
INTRODUCTION: The transsphenoidal approach was initially developed in neurosurgical practice as an operative approach to the pituitary gland. The introduction of the operating endoscope has improved the versatility of the transsphenoidal approach, broadening the spectrum of lesions that can be treated effectively with this operative strategy. METHODS: We performed a retrospective review of all patients who underwent transnasal, transsphenoidal operations at Brigham and Women's Hospital from April 2008 to February 2015 and categorized each case by pathologic diagnosis...
October 2015: World Neurosurgery
https://www.readbyqxmd.com/read/25909571/the-combined-microscopic-endoscopic-technique-for-radical-resection-of-cerebellopontine-angle-tumors
#19
Mohammad Abolfotoh, Wenya Linda Bi, Chang-Ki Hong, Kaith K Almefty, Abraham Boskovitz, Ian F Dunn, Ossama Al-Mefty
OBJECT: The combined microscopic and endoscopic technique has shown significant advantages in the management of various lesions through different approaches. Endoscopic-assisted techniques have frequently been applied to cerebellopontine angle (CPA) surgery in the context of minimally invasive craniotomies. In this paper the authors report on the use of the endoscope in the CPA as a tool to increase the extent of resection, minimize complications, and preserve the function of the delicate CPA structures...
November 2015: Journal of Neurosurgery
https://www.readbyqxmd.com/read/25839925/utility-of-dynamic-computed-tomography-angiography-in-the-preoperative-evaluation-of-skull-base-tumors
#20
Wenya Linda Bi, Patrick A Brown, Mohammad Abolfotoh, Ossama Al-Mefty, Srinivasan Mukundan, Ian F Dunn
OBJECT: The anatomical complexity of skull base tumors mandates detailed preoperative planning for safe resection. In particular, the location of critical vascular and bony structures can influence the surgical approach. Traditional methods, such as MRI, MR angiography and/or venography (MRA/MRV), CT angiography and/or venography (CTA/CTV), and digital subtraction angiography, each have their limitations. One alternative that combines the benefits of both detailed anatomy compatible with intraoperative image guidance and visualization of the vascular flow is the 320-detector row dynamic volume CTA/CTV...
July 2015: Journal of Neurosurgery
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