Journal of neurosurgery
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Journal of neurosurgery · May 2011
Case ReportsSphenoorbital meningioma: surgical technique and outcome.
The aim of this study was to describe the surgical technique used for removal of sphenoorbital meningiomas in the authors' practice and to review the operative outcome. ⋯ In the authors' practice, surgery for sphenoorbital meningiomas consists of resection of the orbital/sphenoid intraosseous, intraorbital, and intradural tumor components. The authors believe that aggressive removal of the orbital/sphenoid intraosseous tumor is critical for a favorable visual outcome and tumor control. Furthermore, satisfactory cosmetic results can be achieved with simple reconstruction techniques as described.
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Journal of neurosurgery · May 2011
Clinicopathological factors related to regrowth of vestibular schwannoma after incomplete resection.
The authors retrospectively analyzed various clinicopathological factors to determine which are related to regrowth during a long-term follow-up period in patients who underwent incomplete vestibular schwannoma (VS) resection. ⋯ Greater residual tumor thickness, based on MR imaging after the initial surgery, and a higher MIB-1 index are both important factors related to postoperative tumor regrowth in patients who have undergone incomplete VS resection. These patients require frequent neuroimaging investigation during follow-up to assure early detection of tumor regrowth.
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Journal of neurosurgery · May 2011
Case ReportsPreservation of the superior petrosal sinus during the petrosal approach.
The petrosal approach is based on sectioning the superior petrosal sinus (SPS) and the tentorium. However, the venous anatomy in certain situations forbids this maneuver. The authors have derived a technique that enables the SPS to be spared during the performance of the petrosal approach. They describe the anatomical basis of this technique and report on 2 cases in which the technique was applied. ⋯ This modification of the petrosal approach involving sparing of the SPS or cutting of the tentorium is an effective means for cases in which the venous anatomy mandates preservation of these structures.
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Journal of neurosurgery · May 2011
Gamma Knife surgery of meningiomas located in the posterior fossa: factors predictive of outcome and remission.
Although numerous studies have analyzed the role of stereotactic radiosurgery for intracranial meningiomas, few studies have assessed outcomes of posterior fossa meningiomas after stereotactic radiosurgery. In this study, the authors evaluate the outcomes of posterior fossa meningiomas treated with Gamma Knife surgery (GKS). The authors also assess factors predictive of new postoperative neurological deficits and tumor progression. ⋯ Gamma Knife surgery offers an acceptable rate of tumor control for posterior fossa meningiomas and accomplishes this with a low incidence of neurological deficits. In patients selected for GKS, tumor progression is associated with age greater than 65 years and decreasing dose to the tumor margin. Clival- or petrous-based locations are predictive of an increased risk of new or worsening neurological deficit following GKS.
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Trigeminal neuralgia (TN) is a form of facial pain that can be debilitating if left untreated. It typically affects elderly adults and is thought to be related to neurovascular compression. It is uncommon in people younger than 30 years of age, with only 1% of cases reportedly occurring in those younger than 20 years of age. The most common cause of compression in young adults is thought to be venous nerve compression either alone or in association with arterial nerve compression. The objective of this study was to review data in cases of TN in which patients were 25 years of age or younger and to identify TN disease characteristics, demographics, clinical features, operative findings, and outcome. ⋯ Trigeminal neuralgia is uncommon in young adults. Patients tend to present with symptoms similar to those in adults: long periods of pain and venous compression, but outcome unfortunately is not as good as that reported in the older population.