World Neurosurg
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Meta Analysis
Adjuvant Radiosurgery versus Serial Surveillance following Subtotal Resection of Atypical Meningioma: A Systematic Analysis.
Atypical meningioma (AM) is an aggressive subtype of meningioma associated with a high recurrence rates (RR) following surgical resection. Recent studies have compared outcomes of various treatment strategies, but advantages of adjuvant radiosurgery (ARS) over serial surveillance (SS) following subtotal resection (STR) remain unclear. To further elucidate this issue, we systematically analyzed the current literature on AM and compared outcomes of ARS versus SS after STR. ⋯ The data presented here show significant differences in RR and 5-year PFS between ARS and SS, suggesting a potential benefit of ARS. As our understanding of the clinical outcomes of various treatment strategies for AM increases, we also move closer to integrating modalities, such as radiosurgery, into management guidelines.
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Review Case Reports
'Masson's Haemangioma'- An unusual cause of thoracic compressive myelopathy.
Masson hemangioma is a rare pathologic entity characterized by intravascular papillary endothelial hyperplasia. Although benign, this hemangioma grows to form an expansile compressing mass. This lesion is mostly seen in skin and subcutaneous tissue. Occurrence in the central nervous system is rare. Still rarer is a spinal location with only 5 case reports published to date in the literature. ⋯ This rare pathology should be in the differential diagnosis when spinal cord compressive myelopathy is encountered.
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Multicenter Study
5-aminolaevulinic acid-induced fluorescence in primary central nervous system lymphoma.
Diagnosis of primary central nervous system lymphoma (PCNSL) is usually confirmed by brain biopsy and subsequent neuropathologic workup. 5-Aminolevulinic acid (5-ALA)-induced fluorescence has been established for diagnostic and therapeutic purposes in glioma treatment during the last few years and is discussed for use in other cranial tumors. Its role in diagnosis and treatment of PCNSL is still elusive. ⋯ In patients with glioma, the use of 5-ALA is known to be associated with increased extent of resection and survival benefit. Our data and retrospective analysis of a larger patient cohort suggest that the use of 5-ALA in PCNSL should be included in a surgical approach, if this is reconsidered for select patients within a clinical study. In addition, even photodynamic therapy in combination with 5-ALA might be studied.
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Review Case Reports
Nonmissile penetrating head injuries (NPHIs): surgical management and review of the literature.
Nonmissile penetrating head injuries (NPHIs) in the civilian population are rare but potentially fatal. Although numerous cases have been reported in the literature, the surgical management of such injuries is still ambiguous, especially with development of surgical techniques. Here, we report 5 cases of NPHIs managed with different surgical techniques and review the literature on surgical treatment of these injuries to outline the appropriate management for these patients from a neurosurgical perspective. ⋯ NPHIs can be fatal but they can be managed with satisfactory results by proper preoperative imaging evaluation, rapid appropriate surgical management, and accurate postoperative care. Personalized surgical intervention should be undertaken depending on the mechanism and extent of the NPHI.
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Review Case Reports
Unique diagnostic features and surgical strategy for intracranial carotid sympathetic plexus schwannoma: case report and literature review.
Intracranial carotid sympathetic plexus schwannoma (CSPS) is extremely rare; thus differential diagnostic criteria, optimal surgical strategies, and even a precise definition are lacking. Here we describe a case of CSPS and propose a definition and classification for previously reported cases. ⋯ Preoperative diagnosis of petrous apex schwannoma is difficult: characteristic findings such as diplopia, hypacusis, and laterally displaced ICA may help. In addition, assessment of the relationship between the tumor and cavernous sinus could be useful in the determination of the surgical approach. Complete resection with good clinical outcome could be expected using Dolenc's approach (type A) and by the middle fossa extradural approach (type B) for intracavernous and extracavernous CSPS, respectively.