World Neurosurg
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Postoperative visual recovery in patients with pituitary adenoma can be influenced by the duration of symptoms, age, and tumor volume. Diffusion tensor imaging (DTI) allows visualization of white matter structure along with quantitative information. The aims of our study were to predict the visual recovery process in the early and long-term periods and to define the parameters affecting the recovery course. ⋯ DTI can assess and predict visual recovery after endoscopic transsphenoidal surgery of patients with pituitary macroadenomas causing chiasmal compression. FA values lower than or MD values greater than the cutoff values of the specific period reflect poor prognosis. Tumor volume was found to be the featured parameter that affects visual recovery. The postoperative first year is the most prominent interval evaluating the prognosis of visual recovery.
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We report a rare case of hemorrhagic cavernous sinus hemangioma with sudden onset of abducens palsy. ⋯ For treatment of cavernous sinus hemangioma, stereotactic radiosurgery should be considered as primary or adjuvant treatment in the very early phase after removal, to avoid early recurrence.
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Case Reports
Primary Obstruction of the Foramen of Luschka: Anatomy, Histology, and Clinical Significance.
The foramen of Luschka is a natural aperture between the fourth ventricle and the subarachnoid space at the cerebellopontine angle. Membranous closure of this foramen is referred to as primary obstruction. Available information about this variant and its role in the development of the cysts of the posterior fossa is contradictory. ⋯ The rhomboid lip is a remnant of the roof of the fourth ventricle. Imperforation of the foramen of Luschka results in a pouch in the cerebellopontine angle that contains choroid plexus (Bochdalek's flower basket) and communicates with the fourth ventricle. This pouch has the potential to grow to a diverticulum and cause clinical symptoms. Based on our clinical observations, detailed radiologic and surgical-anatomic criteria were proposed to support the differential diagnosis of a diverticulum of the foramen of Luschka. Treatment strategies were also suggested.
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Clinical and molecular factors are essential to define the prognosis in patients with glioblastoma (GBM). O6-methylguanine-DNA methyltransferase (MGMT) methylation status, age, Karnofsky Performance Status (KPS), and extent of surgical resection are the most relevant prognostic factors. Our investigation of the role of gender in predicting prognosis shows a slight survival advantage for female patients. ⋯ Survival was consistently longer among MGMT methylated females compared with males. Gender can be considered as a further prognostic factor.
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The purpose of this study was to perform a survival analysis of patients with high-grade multicentric gliomas and to assess the influence of various prognostic factors on overall survival (OS). ⋯ This comprehensive analysis of multicentric glioma patients revealed that age younger than 54 years, surgical resection, and radiotherapy were significantly associated with improved survival and were independent prognostic factors for OS. Radiotherapy and radiotherapy combined with chemotherapy were independent prognostic factors for surgical patients' OS as well.