World Neurosurg
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Extracranial metastases from atypical meningioma are not usually found; they are sometimes found in lung, bone or scalp, but atypical meningioma in the liver is extremely rare. ⋯ We have analyzed the cytological findings of a metastastic meningioma with particular focus on pathological and immunohistochemical assessment. These results could improve the knowledge of surgeons about meningioma types and guide them to solve clinical incidents.
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Limited studies exist to support the safety of performing neuromodulation surgeries in patients whose anticlotting medication has been held. Here, we assess the safety of performing deep brain stimulation (DBS) in this patient population. ⋯ We found no increased risk of complications in patients routinely on anticlotting medication undergoing DBS lead placement. We show that our protocol was successful in balancing increased risks of bleeding and of thromboembolic events in this patient group.
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Case Reports
Cerebrospinal Fluid Spread in a Child with Pleomorphic Xanthoastrocytoma: A Report with Cytopathological Evidence.
Pleomorphic xanthoastrocytoma (PXA), a relatively uncommon, World Health Organization grade II tumor of astrocytic origin, occurs in children and in general carries good prognosis. The recently identified anaplastic PXA (grade III) type shows poor outcome. Rarely, these said tumors can display an aggressive clinical course with features of leptomeningeal spread. Such cases are mostly seen in adults, with rare instances reported in the pediatric age group. ⋯ The case is an indicator of the need for craniospinal screening protocol in patients with PXA, especially the anaplastic variety, both at the time of initial diagnosis and follow-up.
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The purpose of this study was to test the application of diffusion tensor imaging (DTI) in patients with hemifacial spasm (HFS), to make more accurate diagnoses before surgery and to judge the degree of recovery more accurately after surgical microvascular decompression. To our knowledge, this is the first study to test the validity of DTI for diagnosis and postsurgical evaluation of HFS. ⋯ The use of DTI improves diagnosis and treatment of HFS.
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Over the past 2 decades, management of idiopathic normal pressure hydrocephalus (iNPH) has evolved significantly. In the current study, we sought to evaluate the national prevalence and management trends of iNPH in the United States using a national database. ⋯ We have summarized the national prevalence of iNPH, trends in its management over the previous decade and trends by region and hospital type.