World Neurosurg
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Choroid plexus papilloma (CPP) in the third ventricle is a rare benign intracranial tumor. ⋯ Young children have a small total blood volume and fragile cardiovascular status. Therefore, it is critical to preserve the venous system and to ligate the feeding artery before extirpation of the tumor. The surgical approach to the third ventricular CPPs should be tailored to individual children based on tumor size, location, and vascularity.
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To determine whether various clinical factors are related to long-term outcomes of patients with sporadic cerebellar hemangioblastomas. ⋯ The solid configuration observed on preoperative images of sporadic cerebellar hemangioblastomas is one of the most important clinical factors related to both immediate and long-term outcomes after surgery.
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Lateral ventricular trigone meningioma is relatively rare and surgical resection is the main treatment strategy. It is a challenge to achieve total resection without any complication. We analyzed a series of cases using literature review. ⋯ Surgical resection, using the trans-sulcal approach with intraoperative ultrasound assistance, can achieve a high rate of total resection and a low rate of complication, promising a good prognosis. The management technique and the perioperative treatment have to be individualized.
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Distal posterior inferior cerebellar artery aneurysms: clinical features and outcome of 80 patients.
Aneurysms of the posterior inferior cerebellar artery (PICA) distal to its origin are rare. Beside their rarity, their treatment is challenged by a high proportion of fusiform aneurysms, torturous course of PICA, and often severe bleeding. Our aim is to represent the characteristics of these aneurysms and their treatment, as well as to analyze outcome. ⋯ Microsurgery is a feasible treatment for distal PICA aneurysms. Despite the challenge of often severe hemorrhage, wide-necked aneurysms, and some risk for laryngeal palsy, most patients surviving the initial stage return to normal life. Because of the greater number of rebleedings than for aneurysms at other locations, immediate treatment is crucial.
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Cerebral revascularization has been used in treating difficult skull base tumors when the preservation of the involved native arteries is deemed challenging, and the patients are at risk of developing vascular complications. We aimed to evaluate a recent series of patients who needed high flow cerebral bypasses as part of the surgical treatment strategies for their difficult skull base tumors; to assess current indications and the results of such treatments. ⋯ High flow bypass for cerebral revascularization is a good surgical option for treating certain difficult skull base tumors. High rate of graft patency and low risk of perioperative stroke can be achieved in experienced hands with concurrent high rate of gross total resection of the tumor and good clinical outcome of the patients.