World Neurosurg
-
The Woven EndoBridge (WEB) device is an innovative tool for endovascular treatment of wide-necked bifurcation aneurysms. Numerous studies of primary aneurysm treatment with the WEB device have been reported. We analyzed the safety and efficacy of WEB embolization for recurrent and residual aneurysms. ⋯ The results of the present study have indicated that WEB embolization of previously treated aneurysms is reasonably safe. However, careful aneurysm selection could be necessary to achieve adequate mid-term occlusion rates.
-
Giant sacral schwannomas are rare and difficult to treat. Unexpected neurologic deficits after surgery and tumor recurrence should be considered when surgery is performed. We attempt to remove the tumors via piecemeal total or subtotal excision, leaving parts of the capsule adjacent to nerves to preserve the nerves. This study aimed to present the cases of giant sacral schwannoma at our institutions as well as review the relevant literature and to discuss surgical management. ⋯ Adopting an appropriate surgical approach based on the location of the tumor is important. Piecemeal total or subtotal excision, with parts of the capsule adjacent to nerves left behind may help achieve a good outcome, avoiding a postoperative neurologic deficit.
-
The surgical resection of large supracerebellar hemangioblastomas (SHBs) is exceptionally challenging due to their vascularity and deep anatomic location and is associated with a high risk of postoperative complications and mortality. Access to the posterior incisural space can be achieved by either an infratentorial supracerebellar approach or occipital transtentorial approach (OTA). However, the optimal surgical strategy has not yet been established. Here, we report 2 cases of large SHBs that were successfully and safely resected via a unilateral OTA with multimodal assistance. ⋯ The combination of an OTA with preoperative embolization and endoscopic assistance may reduce the intraoperative risk and contribute to improved outcome in patients with such clinically challenging tumors.
-
This paper reports the case of a giant saddle area lymphoid epithelial carcinoma as reference for clinical diagnosis and treatment. The clinical data of 1 patient who suffered from giant saddle area lymphoid epithelial carcinoma that invaded the bilateral cavernous sinus and surrounding internal carotid artery, slope, nasopharynx, oropharynx, sphenoid sinus, and ethmoid sinus were retrospectively analyzed. The treatment process and relevant literature were summarized. ⋯ Giant saddle area lymphoid epithelial carcinoma is rare. Surgical removal should be selected as the initial treatment, and postoperative radiotherapy is indispensable for lymphoid epithelial carcinoma of the skull base and sinus.
-
Uganda has one of the largest unmet neurosurgical needs in the world, but has seen major improvements in neurosurgery-largely centered at Mulago National Referral Hospital (MNRH). This study implements the first long-term follow-up and outcomes analysis of central nervous system tumor patients in Uganda. ⋯ We show evidence for improved overall survival with surgical care at MNRH. In addition, phone interviews as a method of measuring health outcomes provided an effective means of follow-up, showing that most patients do seek follow-up care.