World Neurosurg
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Review Case Reports
Integrated genomic characterization of a pineal parenchymal tumor of intermediate differentiation.
Pineal parenchymal tumors of intermediate differentiation (PPTIDs) are rare lesions. The differential diagnosis and management strategy for PPTIDs can be challenging because of the variable prognostic and pathologic characteristics of these tumors. ⋯ Pineal parenchymal tumors reflect a broad spectrum of malignancy potential and prognoses, which mandate better understanding of the disease mechanism for rational therapeutic strategies. We present a case of PPTID and report several mutations and chromosomal abnormalities previously unrecognized in this tumor subtype. Review of the literature highlights a need for surgical resection followed by adjuvant chemoradiation. Further investigation of these novel variants may improve understanding of the pathogenesis underlying pineal parenchymal tumors.
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Review Biography Historical Article
Music and Medicine: the tragic case of Gershwin's brain tumor and the challenges of Neurosurgery in the first half of the 20th century.
Although neurosurgery has gone through moments of great renewal in recent decades, at the beginning of the 20th century it was still dealing with the unfathomable mysteries of the nervous system and its disorders. Historical insight improves understanding of the great personalities of the past and allows us to look at the efforts of pioneering surgeons with greater awareness. ⋯ This article presents the tragic case of Gershwin's brain tumor. Through his story, it is possible to get an idea of the difficulties with which the great neuroscientists and surgeons of the past approached the human nervous system and its pathologic manifestations. The first part of this article deals with the evolution of Gershwin's disease over the years and the subsequent brain surgery. In the second part, general considerations on the most striking symptoms experienced by the composer are reported, as well as a description of the different hypotheses on the nature of Gershwin's tumor.
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To examine the literature on risk factors for cerebral vasospasm (CV), one of the most serious complications following aneurysmal subarachnoid hemorrhage (SAH), with special reference to the definition of CV. ⋯ Severe SAH evident on computed tomography scan appears to be a definite risk factor for CV after SAH, followed by cigarette smoking, hypertension, and left ventricular hypertrophy on electrocardiogram. To understand the pathogenesis of CV, further studies on the relationships between risk factors, especially factors not related to the severity of SAH, and angiographic vasospasm grade are necessary.
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The authors introduce a new fusion technique using 2 three-dimensional digital subtraction angiography images acquired by a flat-panel detector angiographic system to understand the detailed angioarchitecture of complex cerebral and spinal vascular malformations. ⋯ A fusion technique using two three-dimensional digital subtraction angiography is beneficial for preoperative planning and successful treatment in cases of complex cerebral and spinal vascular malformations.
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Despite a wide range of surgical procedures, an unresolved debate remains regarding which attempt is optimal for the treatment of colloid cysts in the third ventricle. In this article, we present a new combination of stereotactic and endoscopic techniques. ⋯ The techniques we describe for removal of colloid cysts are safe and effective, even for recurrent cases, and they provide 100% total resection, favorable cognitive outcomes, low risk of recurrence, and low risk of morbidity. The disadvantages of this method are a longer time for surgery and the need for more complex instrumentation compared with conventional endoscopic resection.