Neurosurgery
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Silent corticotrophic adenomas (SCAs) stain adrenocorticotropic hormone (ACTH)+ without causing Cushing's disease. SCAs are reportedly more aggressive, but information comes from small series. ⋯ In the largest series to date, SCAs exhibited comparable size, but increased cavernous sinus invasion and progression/recurrence versus HNAs. SCAs exhibit deficient pro-opiomelanocortin to ACTH conversion. Close follow-up is warranted for SCAs.
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Case Reports
Stereotactic radiosurgical salvage treatment for locally recurrent esthesioneuroblastoma.
Esthesioneuroblastoma (ENB) is a rare malignant neuroendocrine tumor considered to be radiation sensitive. Local recurrence may be treated in a variety of ways, including stereotactic radiosurgery (SRS); however, little information on its effectiveness is available. ⋯ SRS appears to be a reasonable and safe option for treatment of intracranial recurrence of ENB.
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Review Meta Analysis
The role of radiosurgery to the tumor bed after resection of brain metastases.
Optimal postoperative management paradigm for brain metastases remains controversial. ⋯ Our systematic review supports the use of radiosurgery as a safe and effective strategy for adjuvant treatment of brain metastases, particularly when gross total resection has been achieved. With all limitations of comparisons between studies, no increase in local recurrence or decrease in overall survival compared with rates with adjuvant whole-brain radiation therapy was found.
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Giant middle cerebral artery (MCA) aneurysms pose management challenges. ⋯ Giant MCA aneurysms are challenging lesions. EC-IC bypass with parent vessel occlusion can provide a durable form of treatment with acceptable rates of morbidity and mortality.