World Neurosurg
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As spinal dural arteriovenous fistulae (SDAVF) are rare and their clinical presentation is non-specific, they are often overlooked during diagnostic evaluations. Typical magnetic resonance imaging (MRI) findings are intramedullary T2-weighted signal hyperintensity and perimedullary flow voids. There are few reports on the characteristic signs of the cauda equina. We assessed the significance of a new imaging parameter, the cauda equina occupation ratio (CEOR), for the evaluation of SDAVF. ⋯ The preoperative CEOR was larger in patients with SDAVF than in the controls. It normalized after successful occlusion of the fistula. Our findings indicate that the CEOR is a useful parameter for the pre- and postoperative evaluation of SDAVF.
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To investigate the influence of Modified clivoaxial angle (MCAA) on the surgical planning and outcome in adult patients with Chiari malformation type I (CMI). ⋯ MCAA may play a role in guiding the surgical treatment and predicting the prognosis in adult CMI patients. The larger the MCAA, the less invasive surgery is preferred with higher CCOS. PFDD should be the first choice in patients with mild or no VCMC (MCAA>138°) and RT in patients with moderate VCMC (127°
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Most of the meningiomas are classified as WHO grade I and adjuvant radiation therapy (RT) is commonly recommended for subtotal resections with documented progressive regrowth of lesions with venous sinus involvement. We investigated if recurrence of grade I meningiomas was influenced by adjuvant RT. ⋯ Adjuvant RT does not seem to be a pivotal criterion to reduce recurrence rate in patients with grade I meningioma even when venous sinuses are involved.
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A 61-year-old man was admitted complaining of myelopathy and back pain for 3 months. A 15-mm hemangioma with calcification was noted on magnetic resonance imaging (MRI) and computed tomography (CT). Intraoperatively, the mass was hard with ill-defined demarcation. ⋯ After surgery, the patient's symptoms recovered without severe neurologic deficit. Hemangioma calcificans, a variant of cavernous hemangioma with full calcification and ossification, is an extremely rare disease in the spine and brain. Here we report a rare case of intramedullary cavernous hemangioma with calcification of the spinal cord.
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Stereotactic radiosurgery (SRS) has been increasingly applied for malignant meningiomas as an alternative to conventionally fractioned radiation therapy. We performed a retrospective analysis of an institutional patient cohort with malignant meningiomas treated by image-guided-SRS. ⋯ Although the real boundaries of efficacy of SRS have to be further evaluated in a prospective trial, it appears that aggressive treatment by high-dose single or multisession SRS of recurring malignant meningiomas provides satisfactory local control rates.