World Neurosurg
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Preoperative endovascular embolization of atypical hemangiomas of the spine can reduce intraoperative blood loss. One frequent concern raised about embolizing these tumors is a possible association with arteries feeding the spinal cord, such as the artery of Adamkiewicz. This study aimed to elucidate a relationship between spinal levels affected by atypical spinal hemangiomas and radiculomedullary arteries. ⋯ In this study, spinal levels affected by atypical hemangiomas requiring surgery were associated with radiculomedullary arteries. When performing preoperative embolization, great care must be taken to identify and preserve arteries supplying the spinal cord.
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Imaging to visualize nerves around tumors preoperatively could help the surgeon to plan the surgery and excise the tumor with preservation or improvement in patients' quality of life. In the present prospective study, we attempted to correlate the preoperative cranial nerves (i.e., trigeminal, abducens, facial, and vestibulocochlear diffusion tensor tractography and anatomic magnetic resonance imaging [MRI] findings) with intraoperative findings during cerebellopontine angle (CPA) tumor surgery. ⋯ The modified technical parameters proposed could lead to better preservation of cranial nerve function, especially for patients with large tumors. To the best of our knowledge, the present study is the first systematic study of relevant cranial nerves in 40 patients with demonstration of the vestibulocochlear bundle by preoperative MRI in the most common CPA tumors using advanced MRI sequences such as diffusion tensor tractography and capturing the data in a multiplanar format.
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The effect of intraoperative magnetic resonance imaging (iMRI) on tumor control during endoscopic transsphenoidal surgery (TSS) for nonfunctioning pituitary adenomas (NFPAs) has not yet been completely characterized. The present study assessed the effect of the iMRI findings on gross total resection (GTR) and progression-free survival at a mean follow-up of 62 ± 9.4 months. ⋯ High-field iMRI can increase the GTR rate in endoscopic TSS for NPFAs. The increased GTR rate was associated with longer progression-free survival. Cavernous sinus invasion, tumor size, and surgical history were important predictors of GTR in patients with NFPA.
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The vast majority of cerebellopontine angle tumors are benign with a favorable prognosis. Metastatic tumors occurring in the cerebellopontine angle are extremely rare. Herein, we report a case of colon carcinoma metastasis to the bilateral internal auditory canals. ⋯ Clinicians should be aware of metastatic tumors in the internal auditory canals. Comprehensive clinicoradiologic evaluation should be highlighted. A history of malignancy and rapidly progressive hearing loss and facial palsy may suggest the diagnosis of metastasis to the internal auditory canal. The definitive diagnosis still depends on histopathologic examination.
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Previous studies showed that several variants located around the IRX family may have functional roles in the development of adolescent idiopathic scoliosis (AIS). However, there was lack of knowledge concerning the target gene of the region on 5p13.3 and the role of IRX genes in the etiology of AIS. This study aimed to validate the relationship between the IRX family and AIS in a large-scale general population and to further investigate the target gene of the region, which was associated with AIS. ⋯ Our large-scale case control study validated that the IRX1 gene could be the disease-associated gene of AIS. The variant rs12517904 of the IRX1 gene is functionally associated with the development of AIS in the Chinese population. The role of IRX1 in the onset of AIS is worthy of further investigation.