World Neurosurg
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The tuberculum sellae is a relatively common location for meningiomas. We assessed our experience with the use of transcranial resection, which, although criticized for its more invasive nature compared with endonasal approaches, may be the ideal approach in selected patients with tuberculum sellae meningiomas (TSMs). ⋯ In most patients undergoing a frontotemporal approach, a GTR/Simpson grade I resection with manageable and self-limiting surgical complications, a good 6-month GOS in most patients, and improved to stable vision were seen at follow-up. Various treatment approaches can be considered for TSM resection, but the ability to decompress the optic canal and achieve a GTR makes the frontotemporal approach attractive in many cases.
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Case Reports
Occipital intraosseous hemangioma over torcula: unusual presentation with raised intracranial pressure.
Hemangiomas of the bone are benign, uncommon, slow-growing lesions accounting for <1.0% of all bony neoplasms. Intraosseous occipital hemangiomas are rare, and occipital hemangiomas presenting with features of raised intracranial tension are, with only 2 cases reported to date. ⋯ Although these are benign lesions, they can have a varied clinical presentation. An understanding of the different clinical presentations and surgical nuances in excising such tumors can lead to early diagnosis and good patient outcome.
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This report provides the first representative images of an intracranial osteochondroma with a cystic component mimicking cystic meningioma. A 40-year-old male presented at our outpatient clinic with decreased sensation in his right upper extremity. Preoperative computed tomography showed a tumor with a cystic meningioma-like appearance and prominent calcifications. ⋯ Intracranial osteochondroma is also a rare, benign tumor that can mimic meningioma when presenting in the dural convexity. Our report describes the joint capsule-like appearance of a convex cystic osteochondroma including a calcified cap, bonelike structure, and fluid-containing intracapsular space. The tumor was evaluated by imaging and pathologic studies.
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Increasing experience with intraventricular neuroendoscopic procedures shows good results in the combination of endoscopic third ventriculostomy (ETV) and tumor biopsy. Other possible combinations are mainly presented in subgroups in the literature. Here, we present our experience with combined intraventricular procedures within 1 setting over the last 2 decades. ⋯ A combination of different intraventricular endoscopic procedures is safe and reliable, bearing similar risks of morbidities and mortality to single neuroendoscopic procedures. This study is one of the largest series in the literature and has similar low complication rates to others. Fornix contusion is the most frequent intraoperative complication in these patients. However, obvious clinical correlation is rare.
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Anatomic variations of the anterior communicating artery (ACOM) complex have been shown to influence ACOM aneurysm morphology. It is not known whether these variations predispose unruptured ACOM aneurysms to grow over time. ⋯ We identify several anatomic characteristics that may be associated with increased risk of ACOM aneurysm growth. These data could influence management strategies of unruptured ACOM aneurysms.