World Neurosurg
-
Review Multicenter Study
Endoscopic endonasal management of rare sellar lesions: clinical and surgical experience on 78 cases and review of the literature.
In the present study we aim to provide further definition of a group of rare sellar diseases treated by the endoscopic endonasal approach. ⋯ Endoscopic endonasal approaches offer some specific benefits in the treatment of these patients.
-
Review Meta Analysis
Safety and Efficacy of Surgical and Endovascular Treatment for Distal Anterior Cerebral Artery Aneurysms: A Systematic Review and Meta-analysis.
Aneurysms of the distal anterior cerebral artery (DACA) are rare, representing between 1% and 9% of all intracranial aneurysms. The best treatment strategy for these aneurysms continues to be debated. ⋯ Our meta-analysis showed that both treatment modalities are technically feasible and effective with sufficient long-term aneurysm occlusion and acceptable recurrence/rebleed rates. Surgical treatment is associated with superior angiographic outcomes. There were no substantial differences in procedure-related morbidity and mortality. These findings are important because they suggest that therapy of DACA aneurysms should be performed on a selective, case-by-case basis to maximize patient benefits.
-
Review Historical Article
Meningeal preservation in a child mummy from Ancient Egypt.
Over many centuries, the ancient Egyptians developed a method of preserving bodies so they would remain lifelike. Mummification of bodies was originally a natural process in Egypt, and it evolved to a sophisticated embalming system to preserve the individual for the afterlife. ⋯ One of them was a 6-8 old-year male child with a damaged skull that allowed us to see the meningeal structures covering the entire cranial vault, in absence of brain remains. This finding in a child mummy is exceptional, as reflected in the specialized literature.
-
Facial nerve schwannomas are rare, benign, nerve-sheath tumors. They can occur in any segment of the facial nerve and often clinically and radiographically mimic the common vestibular schwannoma when extending into the cerebellopontine angle. The optimal treatment strategy for intracranial facial nerve schwannomas remains controversial. ⋯ Treatment for intracranial facial nerve schwannomas depends on clinical presentation, tumor size, preoperative facial, and hearing function. Conservative management is recommended for asymptomatic patients with small tumors. Stereotactic radiosurgery may be an option for smaller and symptomatic tumors with good facial function. If tumor is large or the patient has facial paralysis, surgical resection should be indicated. If preservation of the facial nerve is not possible, total resection with nerve grafting should be performed for those patients with facial paralysis, whereas subtotal resection is best for those patients with good facial function.
-
Unruptured intracranial aneurysms (UIAs) have become an issue of greater significance as their detection rates have increased over the years. We present the overall experience of microsurgical clipping of unruptured aneurysms by a single surgeon over a period of more than 16 years. ⋯ Surgical clipping is effective and can provide a good long-term outcome. The most commendable consequence that it provides is a better long-term occlusion rate. The experience of the individual surgeon is important for a superior and enduring overall outcome. An increase in the rate of coiling in recent years has affected the outcome rate after surgery that calls for further evaluation.