World Neurosurg
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Intracranial lymphoplasmacyte-rich meningioma (LPRM) is rarely reported because of its extremely low incidence, and current understanding of this disease is poor. We analyzed the incidence and clinical, radiologic, pathologic, and prognostic features of intracranial LPRMs. ⋯ Intracranial LPRM is a rare subtype of meningioma with no gender difference and low recurrence. Long-term survival is expected, although tumors located in the skull base and bone destruction are independent risk factors of poor long-term outcomes. Microsurgical treatment of skull base LPRM remains a formidable challenge because of poorly defined borders and critical neurovascular structure encasement. Radical tumor resection, which induces severe neurologic deficits, is unnecessary.
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Spinal cord tanycytic ependymomas (TEs) rarely are reported because of extremely low incidence. Understanding of this disease is therefore poor. The aim of this study was to analyze the incidence and clinical, radiologic, pathologic, and prognostic features of spinal cord TEs. ⋯ Spinal cord TE is a rare subtype of ependymomas with low recurrence. Long-term survival can be expected, although poorly defined tumor border is an independent predictor of long-term outcomes. Microsurgical treatment of spinal cord TEs remains a formidable challenge due to the poorly defined border and critical neurovascular structures encasement. It is unnecessary for radical tumor resection at the cost of severe neurologic deficits.
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Intraoperative monitoring of cochlear nerve action potential (CNAP) has been used in patients with small vestibular schwannoma (<15 mm) to preserve cochlear nerve function. We performed surgery for a larger vestibular schwannoma under CNAP monitoring with the aim of preserving cochlear nerve function, and compared the data with findings from 10 patients with hemifacial spasm who underwent microvascular decompression surgery. ⋯ CNAP monitoring is extremely useful for preserving the function of the unseen cochlear nerve during vestibular schwannoma surgery.
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Arteriovenous malformations (AVMs) of the superior cerebellar vermis and dural arteriovenous fistulas (dAVFs) draining into tentorial venous structures are uncommon lesions. Various surgical approaches and positions have been used to gain access. ⋯ Our series shows that for superior vermian AVMs or dAVFs with retrograde transverse sinus or torcula venous drainage, the supracerebellar infratentorial approach in a modified vertex tilt-up park bench position is a safe and effective surgical approach.
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To investigate predictors of recurrence and moderate to severe complications after burr-hole surgery for chronic subdural hematoma (cSDH). ⋯ Recurrence after cSDH surgery is more often encountered in patients with radiologically more extensive disease reflected by bilateral hematoma and large hematoma diameter. On the other hand, moderate to severe complications are more often seen in patients in a worse clinical condition, reflected by decreased level of consciousness and more comorbidities.