World Neurosurg
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Review Case Reports
Intraventricular Cavernomas of the Third Ventricle: Report of Two Cases and a Systematic Review of the Literature.
Intraventricular cavernous malformations are relatively rare benign vascular malformations. Patients may be asymptomatic or present with headache, seizure, hemorrhage, or neurologic deficits. We report 2 cases of patients with cavernomas in the third ventricle and at the foramen of Monro. We also performed a systematic review of the literature to examine the clinical features and efficacy of the current standard of care for these lesions. ⋯ The specific location of the cavernoma determines clinical features seen and approach used in surgical resection. Ventriculoperitoneal shunting was not required in most cases, as hydrocephalus improved with removal of the obstruction at the foramen of Monro. Gross total resection appears to be the optimal management strategy in symptomatic patients and leads to a good outcome in most cases.
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Randomized Controlled Trial
Brain arteriovenous malformations located in language area: Surgical outcomes and risk factors for postoperative language deficits.
Case selection for surgical treatment of language-area brain arteriovenous malformations (L-BAVMs) remains difficult. This study aimed to determine the surgical outcomes and risk factors for postoperative language deficits (LDs) in patients with L-BAVMs. ⋯ L-BAVMs located in Geschwind's territory can cause a high incidence of LD. LS involvement and larger nidus size are risk factors for postoperative short- and long-term LD, and preoperative LD is a risk factor for postoperative, long-term LD.
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The premotor cortex (PMC) is known to have a dual role in movement and language processing. Nevertheless, surgical outcomes of brain arteriovenous malformations located in PMC (PMC-BAVMs) have not been well defined. The aim of this study was to determine surgical outcomes and risk factors for neurologic deficits (NDs) after surgery in patients with PMC-BAVMs. ⋯ Varying degrees of motor and language deficits can be induced immediately after resection of PMC-BAVMs. Permanent and long-term severe motor or language deficits are rare. Shorter lesion-to-eloquent fiber distance is a risk factor for short-term NDs. Larger nidus size is a risk factor for short-term and long-term NDs.
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To investigate the prognostic value of preoperative Nurick grade and time with symptoms for gait improvement and recovery in patients with ataxia secondary to cervical myelopathy. ⋯ Patients with a greater preoperative Nurick grade and symptoms for more than 12 months may have significantly lower odds of experiencing gait improvement or gait recovery after surgery for cervical myelopathy. This study's conclusion favors early intervention in patients with cervical myelopathy.
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Radiation-induced malignant peripheral nerve sheath tumors (MPNSTs) are an uncommon late risk of irradiation. We conducted the largest systematic review to date of individual patient data for patients with these tumors. ⋯ The prognosis of radiation-induced and radiation-associated MPNST was worse than that reported for de novo MPNSTs. Surgical complete resection is the mainstay for treatment of radiation-induced and radiation-associated MPNSTs. The risk of incidence of secondary MPNSTs in patients treated with radiotherapy warrants longer follow-up periods.