World Neurosurg
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To examine recurrence rates in patients undergoing microsurgical excision of colloid cysts of the third ventricle with long-term serial clinical and imaging follow-up and to identify risk factors for cyst recurrence. ⋯ Periodic imaging surveillance is essential after excision of third ventricular colloid cysts to detect asymptomatic recurrences because these lesions may recur several years after presumed total or near-total excision. Recurrences associated with clinical symptoms or demonstrated growth on serial follow-up require intervention; however, reoperation may be cautiously deferred in patients with stable asymptomatic recurrences.
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Calcification in pituitary adenomas is a rare occurrence and its differential diagnosis typically includes other sellar masses. Common calcifications in pituitary adenomas are classified into 2 morphological forms: capsular (eggshell-like) and multiple small nodular calcifications located within the adenoma. Also, there is a pituitary stone term. This study aims to present the results of calcified pituitary adenoma case series who underwent endoscopic endonasal approach (EEA) and the clinical, histopathological characteristics and surgical outcomes of these cases. ⋯ Preoperative radiological evaluation, intraoperative classification of calcification, and postoperative histopathological assessments are crucial in the treatment of calcified adenomas. Bases on these findings, the EEA, with its advantages, is an approach that can be effectively used in the management of these calcified adenomas.
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We describe a case of a 57-year-old woman presenting initially with diplopia who later developed retro-orbital and retroauricular pain. Examination showed right abducens nerve palsy and subsequent right trigeminal nerve hyperesthesia. Neuroimaging revealed a well-defined mass confined to the right cavernous sinus, with high T2 signal intensity and homogeneous enhancement on postgadolinium T1-weighted images. ⋯ CSH is a rare benign extra-axial tumor, which is highly vascularized, and is frequently misdiagnosed as meningioma or schwannoma. The combination of very high T2 signal intensity and progressive centripetal contrast enhancement highly suggest CSH diagnosis. Given the significant risk of bleeding and mortality associated with surgical intervention, it is crucial to recognize CSH preoperatively to plan a meticulous surgical approach.
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Cavernous malformations are low-flow fragile vascular lesions prone to extralesional bleeding that can occur in the cerebral hemispheres, the brainstem, or the spinal cord. This paper reports the case of a 32-year-old right-handed man with acute-onset headaches associated with right-sided tinnitus, right-sided hemianesthesia, and binocular diplopia related to cranial nerve IV palsy. Neuroimaging displayed left-sided isolated cavernous malformation of the inferior tectal plate, with evidence of extralesional bleeding. ⋯ At the 3-month follow-up consultation, symptoms had improved aside from diplopia, which required wearing prism eyeglasses. Tectal cavernous malformations account for 18% of midbrain cavernomas. It was explained that surgical excision using the supracerebellar infratentorial approach would be performed within 2 months after a second extralesional bleeding episode causing disabling symptoms.
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Lumbar spinal stenosis often necessitates surgical intervention, with preoperative musculoskeletal health significantly influencing postoperative outcomes. This prospective cohort study investigates the sex-specific impact of preoperative musculoskeletal characteristics on postoperative leg pain in elderly patients undergoing lumbar surgery. ⋯ These findings highlight the need for sex-specific preoperative assessments to improve surgical outcomes, suggesting that targeted preoperative interventions to enhance musculoskeletal health could benefit female patients undergoing lumbar surgery.