World Neurosurg
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Epilepsy is common in patients harboring cavernous malformation (CM), and surgery is reported to be an effective treatment. Small amounts of patients, however, still suffer from seizures after surgery. We analyzed the outcome and predictive factors after cavernoma-related epilepsy (CRE) surgery. ⋯ Surgical treatment results in favorable seizure control in most patients after cavernoma-related epilepsy surgery. Long duration of epilepsy before surgery, high seizure frequency, and drug-resistant epilepsy could have a negative effect on seizure outcome (Engel classification II-IV). Therefore, early surgical resection of the cavernoma after careful presurgical planning is recommended to achieve an optimal result.
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Limited hippocampal radiofrequency thermocoagulation (RFTC) for patients with mesial temporal lobe epilepsy was associated with good short-term seizure control and few complications. We aimed to demonstrate the neuropsychologic outcomes and assess the prognostic factors of long-term seizure control in these patients. ⋯ Limited hippocampal RFTC is a safe stereotactic minimal invasive procedure with good neuropsychological outcome and acceptable efficacy of seizure reduction in appropriately selected patients.
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Central nervous system (CNS) tumors are the most common solid neoplasm in children, 60-70% occurring in the posterior fossa. Surgery is the mainstay of treatment but surgery in the pediatric population is associated with a high risk of perioperative complications. We aimed at analyzing the perioperative complications after posterior fossa surgery in a pediatric population and identifying the associated risk factors. ⋯ Surgery in the posterior fossa in the pediatric population harbors a high risk of complications. Identifying the variables contributing to these complications is important in order to improve surgical management of these patients.
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The role of surgery in primary central nervous system lymphoma (PCNSL) is to allow pathological diagnosis from tumor biopsy. However, PCNSL is often difficult to distinguish from other tumors, particularly glioblastoma (GBM). Quantitative evaluations to facilitate differentiation between PCNSL and GBM would be useful. Here, we investigated the best examinations for exact differentiation of PCNSL from GBM among preoperative examinations, including imaging studies and tumor markers. ⋯ Both β2-MG ≥2.0 mg/dL in CSF and TNR ≥2.4 from 18F-FDG-PET allow quantitative differentiation of PCNSL from GBM, potentially representing clinically useful indicators. These findings could lead to innovative methods for differentiating PCNSL from GBM as well as new treatment strategies for other brain tumors.
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Lesional posterior cortex epilepsy (PCE) is often drug-resistant and may benefit from surgical intervention. In this study, we aimed to identify potential predictive factors associated with seizure recurrence following epilepsy surgery in lesional PCE. ⋯ More than half of the patients (including two cases with bilateral MRI lesions) were seizure-free at long-term follow-up. However, patients with bilateral findings on interictal EEG and gliosis were more likely to have recurrent seizures following surgery. Since lesional PCE is almost always drug-resistant and has a potential for favorable outcomes, epilepsy surgery should be considered early.