Central European Neurosurgery最新文献

{"title":"Meningiomas involving the sphenoid wing outcome after microsurgical treatment--a clinical review of 73 cases.","authors":"Uta Schick","doi":"10.1055/s-0030-1261950","DOIUrl":"https://doi.org/10.1055/s-0030-1261950","url":null,"abstract":"The authors report on 73 meningiomas involving the sphenoid wing in the outer, middle or inner part of the sphenoid ridge or extending to the orbit. Total resection was achieved in 48 % and a good improvement in visual acuity in 58 % . New, postoperative cranial nerve defi cits were seen in 7 patients. The follow-up was relatively short (29.8 mo), which might explain the observed low recurrence rate of 15 % despite the high number of subtotal resections in this series. Only patients with medial (group 3) or sphenoorbital (group 4) meningiomas (23 % ) underwent postoperative radiotherapy. Remarkable is a mortality rate of 3 % in this benign entity and a relatively high, non-visual, permanent morbidity rate of 7 % in group 3 or 4 patients. Overall, this is a large series of sphenoid wing meningiomas worth publishing. We should always keep in mind that the primary surgical goals and principles include at fi rst preservation of quality of life, followed by the preservation of neurological functions. Nevertheless, the resection should be performed as radical as possible to gain a good tumour control. Radiotherapy should be off ered as an eff ective alternative treatment in recurrent tumours.","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0030-1261950","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29209363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rosette-forming glioneuronal tumor of the fourth ventricle.","authors":"N G Rainov, T Wagner, V Heidecke","doi":"10.1055/s-0029-1242760","DOIUrl":"https://doi.org/10.1055/s-0029-1242760","url":null,"abstract":"Introduction & Komori et al. (2002) were the fi rst authors to recognize the existence of a new brain tumor entity, rosette-forming glioneuronal tumor (RGNT) of the fourth ventricle. The authors described 11 cases of this distinctive tumor of the posterior fossa [6] . A few further RGNT cases were published in the following 5 years [1, 2, 4, 5, 8, 10] , eventually leading to the inclusion of RGNT in the 4 th edition of the WHO brain tumor classifi cation as a benign primary brain tumor classifi ed as WHO grade 1 [7, 9] . We describe here the clinical and neuroradiological features of a further patient with RGNT of the fourth ventricle. Our report may contribute to establishing the natural history of these tumors and identifying the best course of treatment.","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0029-1242760","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28892821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of invasion-related extracellular matrix molecules in human glioblastoma versus intracerebral lung adenocarcinoma metastasis.","authors":"I Varga,&nbsp;G Hutóczki,&nbsp;M Petrás,&nbsp;B Scholtz,&nbsp;E Mikó,&nbsp;A Kenyeres,&nbsp;J Tóth,&nbsp;G Zahuczky,&nbsp;L Bognár,&nbsp;Z Hanzély,&nbsp;A Klekner","doi":"10.1055/s-0030-1249698","DOIUrl":"https://doi.org/10.1055/s-0030-1249698","url":null,"abstract":"<p><p>Tumor cell invasion into the surrounding brain tissue is mainly responsible for the failure of radical surgical resection, with tumor recurrence in the form of microdisseminated disease. Extracellular matrix (ECM)-related molecules and their receptors predominantly participate in the invasion process, including cell adhesion to the surrounding microenvironment and cell migration. The extent of infiltration of the healthy brain by malignant tumors strongly depends on the tumor cell type. Malignant gliomas show much more intensive peritumoral invasion than do metastatic tumors. In this study, the mRNA expression of 30 invasion-related molecules (twenty-one ECM components, two related receptors, and seven ECM-related enzymes) was investigated by quantitative reverse transcriptase-polymerase chain reaction. Fresh frozen human tissue samples from glioblastoma (GBM), intracerebral lung adenocarcinoma metastasis, and normal brain were evaluated. Significant differences were established for 24 of the 30 molecules. To confirm our results at the protein level, immunohistochemical analysis of seven molecules was performed (agrin, neurocan, syndecan, versican, matrix metalloproteinase 2 [MMP-2], MMP-9, and hyaluronan). Determining the differences in the levels of invasion-related molecules for tumors of different origins can help to identify the exact molecular mechanisms that facilitate peritumoral infiltration by glioblastoma cells. These results should allow the selection of target molecules for potential chemotherapeutic agents directed against highly invasive malignant gliomas.</p>","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0030-1249698","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28928279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vein of Labbé mimicking an occipital epidural hematoma.","authors":"J Ros de San Pedro,&nbsp;B Cuartero Pérez,&nbsp;J Zamorro Parra,&nbsp;B Torregrosa Sala","doi":"10.1055/s-0030-1252007","DOIUrl":"https://doi.org/10.1055/s-0030-1252007","url":null,"abstract":"Ros de San Pedro J et al. Vein of Labb é Mimicking an Occipital ... Cen Eur Neurosurg 2010; 71: 226 – 230 Introduction ▼ The vein of Labb é (VL) or inferior anastomotic vein is defi ned as a cortical cerebral vein that connects the middle superfi cial vein, which is located in the sylvian fi ssure, and the transverse sinus [18, 22] . This vessel is of prime importance since it participates in draining the posterior part of both the temporal and parietal lobes [2, 16] . The VL is not commonly seen on computed tomography (CT) studies [25, 26] due to its similar density to brain tissue, its close anatomical relation to the temporal bone, and its relatively small caliber. Furthermore, VL is rarely implicated in post-traumatic complications. Thus, VL is not usually kept in mind by either neurosurgeons or radiologists when analyzing CT scan images, even after head trauma. We report the case of a mild head trauma patient, whose urgent CT scan showed an image compatible with an occipital epidural hematoma. After thorough radiological and clinical analysis the initial diagnosis of extradural hematoma was ruled out, while a prominent and looped VL was disclosed as being responsible for the false image on CT.","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0030-1252007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28995652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary optic nerve sheath meningiomas: a follow-up study.","authors":"U Schick,&nbsp;C Jung,&nbsp;W E Hassler","doi":"10.1055/s-0029-1246136","DOIUrl":"https://doi.org/10.1055/s-0029-1246136","url":null,"abstract":"<p><strong>Objective: </strong>The management of optic nerve sheath meningiomas (ONSM) remains controversial, but includes surgery, radiotherapy and plain observation. We present a follow-up study and treatment modalities based on our classification system.</p><p><strong>Patients and methods: </strong>A retrospective analysis was performed of 90 patients with optic nerve sheath meningiomas who were treated between 1991 and 2008 (n=65 surgery only, n=5 radiation only, n=18 surgery and postoperative radiation, n=2 observation). Follow-up data was available, ranging from 6 to 220 months with a median of 45.8 months.</p><p><strong>Results: </strong>Our classification system differentiates between intraorbital (type 1), intracanalicular or intrafissural (type 2), and intraorbital and intracranial (type 3) ONSMs. Thirty-seven tumors demonstrated extension through the optic canal (type 2a). 41 further tumors reached the chiasm (type 3a) or contralateral side (type 3b). Visual acuity was not significantly influenced by surgery but did become worse with a longer duration of preoperative symptoms and a longer follow-up period. Radiotherapy improved vision in 4 and preserved vision in 16 out of 23 cases.</p><p><strong>Conclusions: </strong>Loss of vision in optic nerve sheath meningiomas is a question of time. Radiotherapy should be offered for intraorbital ONSM. Surgery with decompression of the optic canal and intracranial tumor resection is still favored for tumors with intracanalicular and intracranial extension.</p>","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0029-1246136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28691625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clear cell meningeoma of the brainstem in a 3.5-year-old child: case report and review of the literature.","authors":"H Taha,&nbsp;M Schirmer","doi":"10.1055/s-0029-1220939","DOIUrl":"https://doi.org/10.1055/s-0029-1220939","url":null,"abstract":"Taha H, Schirmer M. Clear Cell Meningeoma of the Brainstem ... Cen Eur Neurosurg 2010; 71: 148 – 15","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0029-1220939","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28925475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral hydrocephalus due to idiopathic anomaly of foramen of Monro, treated successfully with endoscopic technique. Report of three cases.","authors":"G Sharifi,&nbsp;O Rezaee,&nbsp;A Jahanbakhshi","doi":"10.1055/s-0029-1220713","DOIUrl":"https://doi.org/10.1055/s-0029-1220713","url":null,"abstract":"Introduction & Unilateral hydrocephalus of the lateral ventricles may result from a unilateral occlusion of the foramen of Monro (FOM). Causative agents may be either neoplastic (subependymal giant cell astrocytoma, hypothalamic glioma), infl ammatory conditions (bacterial ventriculitis, brain abscess and intraventricular hemorrhage), congenital (choroid plexus cyst, atresia of foramen of Monro, choroid plexus hypertrophy), vascular such as AV malformation of the choroid plexus [4, 16] and basilar artery aneurysm or ectasia [8] , or iatrogenic (unilateral shunt overdrainage) [1] . Of the mentioned pathologies, colloid cyst is the most common [7] . Idiopathic occlusion of the foramen of Monro as an etiology for unilateral hydrocephalus is an extremely rare phenomenon with – to our knowledge – only twenty patients described in the English literature so far [7, 12, 13, 17] . We present three patients with unilateral hydrocephalus due to idiopathic occlusion of the FOM, who underwent endoscopic fenestration of the septum pellucidum to make a communication between two ventricles.","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0029-1220713","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28970189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved outcome in shunted iNPH with a combination of a Codman Hakim programmable valve and an Aesculap-Miethke ShuntAssistant.","authors":"J Lemcke,&nbsp;U Meier","doi":"10.1055/s-0029-1241179","DOIUrl":"https://doi.org/10.1055/s-0029-1241179","url":null,"abstract":"<p><strong>Introduction: </strong>Low pressure valves with ventriculoperitoneal shunts have been proven to lead to good outcomes in the treatment of idiopathic normal pressure hydrocephalus. However, overdrainage complications are often seen with low opening pressures. Efforts have been made to obtain good outcomes without overdrainage complications by decreasing the hydrostatic pressure component using special valve constructions. The aim of this study was to ascertain whether it is possible to optimise outcome with the implantation of both an adjustable valve and a gravitational unit.</p><p><strong>Materials and methods: </strong>Between July 2003 and July 2006, 42 patients underwent ventriculoperitoneal shunt surgery with a Codman Hakim programmable valve (Codman, Johnson & Johnson, Raynham, USA) and a Miethke ShuntAssistant (Miethke Gmbh, Potsdam, Germany). These patients were followed up for a period between 2 years (35 patients) and 4 years (18 patients) after surgery.</p><p><strong>Results: </strong>The systematic re-programming of the valves from 100 mmH(2)O to 70 mmH(2)O and then to 50 mmH(2)O after 3 months allowed the brain to adapt to the implanted valve without the complication of overdrainage. The responder rates were 86% after two years and 83% after four years. Overdrainage was seen in 3% of the cases, mechanical complications occurred in 6%.</p><p><strong>Conclusion: </strong>Our results indicate that the combination of a Codman Hakim programmable valve with a Miethke ShuntAssistant could improve outcomes in shunted iNPH. This finding has yet to be proven in a larger, prospective randomized trial.</p>","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0029-1241179","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28908175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intramuscular infiltrating lipoma of the longus colli muscle. a very rare cause of neck structures compression.","authors":"A Pichierri,&nbsp;N Marotta,&nbsp;A Raco,&nbsp;R Delfini","doi":"10.1055/s-0029-1241189","DOIUrl":"https://doi.org/10.1055/s-0029-1241189","url":null,"abstract":"medially and on the right side of the prevertebral retropharyngeal space from C2 to C5. The mass showed irregular and lobulated edges only at its inferior pole, with clearly visible margins in the other areas; it presented with an overt adipose intensity ( ● ▶ Fig. 1 ). The mass was responsible for the compression of the esophagus and pharynx, which were dislocated anteriorly and towards the left. The trachea was also displaced enough to be aff ected by a reduction in the air column volume at the level of the epiglottis. Furthermore, the lesion dislocated the vasculoner vous axis of the neck anteriorly and laterally. General endotracheal anesthesia was performed. Intubation was carried out with the assistance of a fi broscope because of the stenotic and displaced course of the upper airways. We planned a right anterior retropharyngeal approach. The skin was incised two centimeters below the angle of the right mandible and the incision continued along the anterior edge of the homolateral sternocleidomastoid muscle for eight centimeters. Once the fascia of the right longus colli muscle was reached, it was incised to access the lesion that bulged among the fi bers of the muscle. The lesion was easily dissected in its superior and deeper portions, but a cleavage plan was less evident at its lower pole. So, after the removal of the great part of the lesion, wide excision of the muscle was performed inferiorly ensuring that no residual tumor was left. The procedure resulted in complete removal of the lesion. Introduction & Lipomas are the most common benign soft tissue mesenchymal tumors. They are usually located in the subcutaneous layer without infi ltrating adjacent tissues [12] . Infi ltrating lipomas, by contrast, are uncommon entities that characteristically infi ltrate skeletal muscles with a propensity for local recurrence if they are incompletely excised [1] . These infi ltrating lesions can be subclassifi ed into intermuscular and intramuscular lipomas [5, 11, 12] . We describe the case of a large intramuscular lipoma of the right longus colli muscle located at the level of C2-C5. Although other reports of retropharyngeal space lipomas exist [7, 13, 18, 20, 24] , ours seems to be the fi rst case of a longus colli intramuscular lipoma described in the English literature since 1988 [7] .","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0029-1241189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28892822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based indications for ICP recording after head injury. A review.","authors":"R J Firsching,&nbsp;B Voellger","doi":"10.1055/s-0030-1248256","DOIUrl":"https://doi.org/10.1055/s-0030-1248256","url":null,"abstract":"<p><p>The indication for invasive intracranial pressure (ICP) recording in comatose patients after head injury is a matter of discussion. In this review the evidence-based data are analysed. Monitoring appears useful especially in sedated patients, but there is no study which provides evidence of its overall benefit for the patient. The decision for or against ICP monitoring must therefore be based on weighing the potential benefits versus the risk for the individual patient according to the personal experience and judgement of the attending neurosurgeon.</p>","PeriodicalId":51241,"journal":{"name":"Central European Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0030-1248256","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28946749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}