World Neurosurg
-
Meningeal hemangiopericytoma (HPC) is a rare, aggressive central nervous system tumor that tends to invade locally and to metastasize, and has a high rate of recurrence. ⋯ Strategies combining adjuvant radiation with tumor resection seemed to hinder tumor progression, but had no effect on OS or the development of metastases. Greater extent of resection was associated with increased OS (log-rank, P < .05). Anaplastic HPC was associated with reduced OS and with reduced recurrence interval (log-rank, P < .05).
-
Case Reports
Concentric craniotomy: removal of tumor involving the skull and the intracranial space.
Removal of a tumor involving both the intracranial space and the skull presents technical challenges. This is especially so if there is a potential for significant hemorrhage due to a hemangioma or a significant attachment to the brain as with a meningioma. ⋯ The technique we describe, a concentric craniotomy, transforms a difficult operation with the potential for significant hemorrhage into a more standard removal of a convexity tumor.
-
Microvascular decompression (MVD) is an established surgical therapy for patients with idiopathic trigeminal neuralgia (TN). The role of MVD in patients with definite or suspected multiple sclerosis (MS) remains controversial. ⋯ Facial pain outcomes after MVD in patients with suspected MS-related TN are poor compared with outcomes for patients with idiopathic TN. This study provides further support that many patients with MS-related TN have pain that is centrally mediated, reducing the effectiveness of procedures performed on the trigeminal root, ganglion, or divisions.
-
I considered this commitment, assigned to me for 2013, a prestigious form of recognition, and I have tried to give this distinguished auditorium the sense of the work that has been evolving throughout my years of neurosurgery. Since the late 1970s, surgery via a transsphenoidal approach had been used in our medical school to treat pituitary adenomas. ⋯ This is a team of people who refuse to remain where they are, with respect for and always in favor of better outcomes for patients. This attitude has permitted the development of an efficient system of care and has made Naples a center of excellence for pituitary and skull base surgery.
-
This study was undertaken primarily to investigate the possible prognostic values of several cell-cycle regulators for the prediction of functioning pituitary adenoma (FPA) recurrence after surgical resection by immunohistochemically analyzing tumor samples obtained by surgical resection. ⋯ Our findings indicate that p16, pRB protein, and cyclin D1 are associated with recurrence FPA after surgical resection.