Asian Journal of Neurosurgery最新文献

{"title":"Negative Chronotropic Cardiovascular Changes in Lumbar Spine Surgery: A Potential Spinal-Cardiac Reflex?","authors":"Kashif Ali Sultan, Mohammad Ashraf, Attika Chaudhary, Laulwa Al Salloum, Naseeruddin Ghulam, Nazir Ahmed, Hassan Ismahel, Minaam Farooq, Javed Iqbal, Naveed Ashraf","doi":"10.1055/s-0043-1769894","DOIUrl":"https://doi.org/10.1055/s-0043-1769894","url":null,"abstract":"Abstract Cardiovascular changes following lumbar spine surgery in a prone position are exceedingly rare. Over the past 20 years, a total of six cases have been published where patients experienced varying degrees of bradycardia, hypotension, and asystole, which could be attributed to intraoperative dural manipulation. As such, there is emerging evidence for a potential neural-mediated spinal-cardiac reflex. The authors report their experience of negative chronotropy during an elective lumbar spine surgery that coincided with dural manipulation and review the available literature. A 34-year-old male presented with a long-standing history of lower back pain recently deteriorating to bilaterally radiating leg pain, with restricted left leg raise, and numbness at the left L5 dermatomal territory. The patient was an athletic police officer with no comorbidities or past medical history. Magnetic resonance imaging lumbosacral spine revealed spinal stenosis most pronounced at L4/L5 and disc bulges at L3/L4 and L5/S1. The patient opted for lumbar decompression surgery. After an unremarkable comprehensive preoperative workup, including cardiac evaluation (electrocardiogram, echocardiogram), the patient was induced general anesthesia in a prone position. A lumbar incision was made from L2 to S1. When the left L4 nerve root was retracted while removing the prolapsed disc at L4/L5, the anesthetist cautioned the surgeon of bradycardia (34 beats per minute [bpm]), and the surgery was immediately stopped. The heart rate improved to 60 bpm within 30 seconds. When the root was later retracted again, a second episode of bradycardia occurred for 4 minutes with heart rate declining to 48 bpm. The surgery was stopped, and after 4 minutes, the anesthetist administered 600 µg of atropine. The heart rate then rose to 73 bpm within 1 minute. Other potential causes for bradycardia were excluded. The total blood loss was estimated to be 100 mL. He remains well at his 6-month follow-up and has returned to work as normal. Akin to previously published cases, each episode of bradycardia coincided with dural manipulation, which may indicate a possible reflex between the spinal dura mater and the cardiovascular system. Such a rare adverse event may occur even in seemingly healthy, young individuals, and anesthetists should caution the operating surgeon of bradycardias to exclude operative manipulation of the dura as the cause. While this phenomenon is only reported in a handful of lumbar spine surgery cases, it provides evidence for a potential spinal-cardiac physiological reflex in the lumbar spine that may be neural mediated and should be investigated further.","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":"18 2","pages":"404-409"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/03/5f/10-1055-s-0043-1769894.PMC10313433.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9742960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synchronous Posterior and Anterior Pituitary Tumors: A Case Report of a Hypothetic Paracrine Relationship.","authors":"Franco Rubino,&nbsp;Daniel G Eichberg,&nbsp;Ali G Saad,&nbsp;Ricardo J Komotar,&nbsp;Michael E Ivan","doi":"10.1055/s-0043-1768601","DOIUrl":"https://doi.org/10.1055/s-0043-1768601","url":null,"abstract":"<p><p>Tumors of the posterior pituitary are a distinct group of low-grade sellar neoplasms. Furthermore, the coexistence with an anterior pituitary tumor is extremely unlikely and could not be a mere coincidence and could be a paracrine relationship. Here, we present a case of 41-year-old woman with Cushing syndrome and two pituitary masses on magnetic resonance imaging. Histologic examination shows two distinct lesions. The first consisted of a pituitary adenoma with intense adrenocorticotropic hormone immunostaining and the second lesion consisted of a proliferation of pituicytes arranged in vague fascicles or pituicytoma. After a narrative review of the literature, we found that synchronous pituitary adenoma and a thyroid transcription factor 1 (TTF-1) pituitary tumor were only reported eight times in the past. These patients included two granular cell tumors and six pituicytomas and all of them coexisted with pituitary adenomas, seven functioning and one nonfunctioning. We analyze the hypothesis of a possible paracrine relationship for this concomitance, but this exceedingly rare situation is still a matter of debate. To the best of our knowledge, our case represents the ninth case of a TTF-1 pituitary tumor coexisting with a pituitary adenoma.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":"18 2","pages":"377-382"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4e/58/10-1055-s-0043-1768601.PMC10313437.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9742957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Step Ladder Expansive Cranioplasty: A Novel Perspective in Cranial Volume Augmentation Surgery.","authors":"Sudip Kumar Sengupta,&nbsp;Shashivadhanan Sundervadhanan,&nbsp;Tony J Rappai,&nbsp;S M Sudumbrekar,&nbsp;Sankar Prasad Gorthi,&nbsp;Saurabh K Verma","doi":"10.1055/s-0043-1768571","DOIUrl":"https://doi.org/10.1055/s-0043-1768571","url":null,"abstract":"<p><p><b>Background</b>  In face of a refractory raised intracranial pressure (ICP), surgeons most commonly resort to decompressive craniectomy (DC). Procedure leaves an unprotected brain underlying the craniectomy defect and Monro-Kellie doctrine: disrupted. Different variants of hinge craniotomies (HC) have been used with clinical outcomes comparable to DC as single stage alternatives. However, both DC and every variant of HC have a limit to the achievable volume augmentation and all invariably cause a compression of the cerebral cortex and its vasculature at the craniotomy site. We believe both these limitations adversely affect the outcome. <b>Methods</b>  A team of neuroscientists in Indian Armed Forces Medical Services has been working for the last 9 years toward developing a novel surgical technique that can mitigate both these drawbacks. Desired procedure should take the centripetal pressure exerted by the combination of the tensile strength of the scalp (with or, without an underlying bone flap) and atmospheric pressure off the brain surface while achieving an assured augmentation of intracranial volume that can be optimized on a case-to-case basis. We call it a \"step ladder expansive cranioplasty.\" <b>Results</b>  The distance of the parietal eminence was found to have increased by 10.2 mm on the operated side after expansive cranioplasty. <b>Conclusion</b>  From drawing board to bedside, we have made some progress toward our goal, but it is still far away from completion. More studies are required to fill in the gaps in our knowledge necessary to optimize the various parameters of the surgery. Procedure has promise to be of special role in in war and disaster scenarios.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":"18 2","pages":"414-419"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/78/f1/10-1055-s-0043-1768571.PMC10313430.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9744831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral Myiasis Secondary to Burr Hole Evacuation: A Rare Illustrative Case Report.","authors":"Rama Chandra Deo,&nbsp;Abhijit Acharya,&nbsp;Souvagya Panigrahi,&nbsp;Satya Bhusan Senapati,&nbsp;A K Mahapatra,&nbsp;Sumirini Puppala","doi":"10.1055/s-0043-1769895","DOIUrl":"https://doi.org/10.1055/s-0043-1769895","url":null,"abstract":"<p><p>Myiasis (maggot infestation) is a condition in which fly maggots feed off and develop in the tissues of living organisms. Most common in tropical and subtropical regions, human myiasis, is prevalent among individuals in close association of domestic animals and those inhabiting the unhygienic conditions. We, hereby, describe a rare case of cerebral myiasis (17th in the world, 3rd in India) that presented to our institution in Eastern India secondary in the operated site of craniotomy and burr hole few years back. Cerebral myiases are exceedingly rare conditions, especially in high-income countries with only 17 previously published cases with the reported mortality as high as 6 out of 7 cases dying of the disease. We additionally also present a compiled review of previous case literatures to highlight the comparative clinical, epidemiological features and outcome of such cases. Although rare, brain myiasis should be a differential diagnosis of surgical wound dehiscence in developing countries where conditions do exist in this country that permit myiasis. This differential diagnosis should be remembered, particularly when the classic signs of inflammation are not present.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":"18 2","pages":"410-413"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ce/82/10-1055-s-0043-1769895.PMC10313439.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9744826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracapsular Resection of Pituitary Adenomas: A Systematic Review.","authors":"Kenny S Seng, Oliver Ryan M Malilay","doi":"10.1055/s-0043-1761237","DOIUrl":"10.1055/s-0043-1761237","url":null,"abstract":"<p><p>There is considerable variation in the surgical techniques for transsphenoidal excision of pituitary tumors. Recently, an extracapsular method has been developed that involves using the tumor pseudocapsule as a dissection plane to increase the extent of resection. This review assessed the outcomes of this new approach as compared with standard transsphenoidal surgery. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE/PubMed, the US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP; apps.who.int/trialsearch), and LILACS databases for relevant literature and checked reference lists of relevant articles. Randomized controlled trials and prospective and retrospective cohort studies comparing extracapsular and intracapsular resection of pituitary tumors were included in the review. Five cohort studies with 1,588 participants were included. Extracapsular resection was associated with a higher likelihood of complete excision (relative risk [RR] 1.31, 95% confidence interval [CI] 1.01-1.70, <i>p</i>  = 0.04) and endocrinologic remission (RR 1.26, 95% CI 1.03-1.54, <i>p</i>  = 0.02). Because there was a significant risk of bias and substantial heterogeneity, the estimates of effect may not be robust. In patients with pituitary adenomas undergoing transsphenoidal excision, extracapsular resection may be associated with higher rates of complete excision and endocrinologic remission, but the evidence is not strong. Hence, randomized controlled trials to determine the magnitude of benefit and identify an improvement in progression-free or overall survival are warranted.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":"18 1","pages":"5-11"},"PeriodicalIF":0.0,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/36/10-1055-s-0043-1761237.PMC10089741.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9359989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential of Satellite Sign for Prediction of Hematoma Expansion in Small Spontaneous Hematoma within 7 Days' Follow-Up.","authors":"Dittapong Songsaeng,&nbsp;Wassana Peuksiripibul,&nbsp;Jitladda Wasinrat,&nbsp;Chulaluck Boonma,&nbsp;Patnaree Wongjaroenkit","doi":"10.1055/s-0043-1764327","DOIUrl":"https://doi.org/10.1055/s-0043-1764327","url":null,"abstract":"<p><p><b>Background</b>  Hematoma expansion (HE) is the most important modifiable predictor that can change the clinical outcome of intracerebral hemorrhage (ICH) patients. The study aimed to investigate the potential of satellite sign for prediction of HE in spontaneous ICH patients who had follow-up non-contrast computed tomography (NCCT) within 7 days after the initial CT scan. <b>Methods</b>  We retrospectively reviewed data and NCCT from 142 ICH patients who were treated at our hospital at Bangkok, Thailand. All included patients were treated conservatively, had baseline NCCT within 12 hours after symptom onset, and had follow-up NCCT within 168 hours after baseline NCCT. HE was initially estimated by two radiologists, and then by image analysis software. Association between satellite sign and HE was evaluated. <b>Results</b>  HE occurred in 45 patients (31.7%). Patients with HE had significantly higher activated partial thromboplastin time ( <i>p</i>  = 0.001) and baseline hematoma volume ( <i>p</i>  = 0.001). The prevalence of satellite sign was 43.7%, and it was significantly independently associated with HE ( <i>p</i>  = 0.021). The sensitivity, specificity, and accuracy of satellite sign for predicting HE was 57.8, 62.9, and 61.3%, respectively. From image analysis software, the cutoff of greater than 9% relative growth in hematoma volume on follow-up NCCT had the highest association with satellite sign ( <i>p</i>  = 0.024), with a sensitivity of 55%, specificity of 64.6%, and accuracy of 60.5%. <b>Conclusion</b>  Satellite sign, a new NCCT predictor, was found to be significantly associated with HE in Thai population. With different context of Thai population, HE was found in smaller baseline hematoma volume. Satellite sign was found more common in lobar hematoma. Further studies to validate satellite sign for predicting HE and to identify an optimal cutoff in Thai population that is correlated with clinical outcomes are warranted.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":"18 1","pages":"45-52"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/48/d8/10-1055-s-0043-1764327.PMC10089762.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9359988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic Supraclinoid Internal Carotid Artery Pseudoaneurysm associated with Carotid-Cavernous Fistula and Contralateral Anterior Cerebral Artery Pseudoaneurysm Treated by Surgical Trapping with High-Flow Bypass and A3-A3 Bypass: A Case Report and Literature Review.","authors":"Gahn Duangprasert,&nbsp;Sasikan Sukhor,&nbsp;Thanapum Kaewprasert,&nbsp;Dilok Tantongtip","doi":"10.1055/s-0043-1761239","DOIUrl":"https://doi.org/10.1055/s-0043-1761239","url":null,"abstract":"<p><p>Traumatic pseudoaneurysms of the supraclinoid internal carotid artery (ICA) are uncommon, particularly associated with carotid-cavernous fistulas (CCF) or multiple traumatic aneurysms. This report describes a patient with a ruptured left ICA dissecting pseudoaneurysm that caused a direct CCF and a right anterior cerebral artery (ACA) pseudoaneurysm. To eliminate the aneurysm and fistula, we followed the universal bypass strategy by performing an ICA trapping with high-flow bypass, followed by an ACA trapping with A3-A3 side-to-side bypass. Herein, we report the first successful surgical trapping and revascularization of supraclinoid ICA pseudoaneurysm associated with a direct carotid-cavernous fistula.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":"18 1","pages":"184-190"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1a/64/10-1055-s-0043-1761239.PMC10089730.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9674884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study of Intraoperative Fluorescein and Indocyanine Green Videoangiography for Ruptured Cerebral Aneurysms Clipping: A Single Centre Study of 30 Cases.","authors":"Deepak Kumar Singh,&nbsp;Gaurav Sharma,&nbsp;Vipin Kumar Chand,&nbsp;Mohammad Kaif,&nbsp;Kuldeep Yadav","doi":"10.1055/s-0042-1751006","DOIUrl":"https://doi.org/10.1055/s-0042-1751006","url":null,"abstract":"<p><p><b>Aim</b>  This study assesses the application of microscope integrated videoangiography techniques in aneurysm clipping surgery using Indocyanine Green and Fluorescein fluorophores and evaluates merits and demerits of each technique. <b>Materials and Methods</b>  Total 30 patients of cerebral aneurysmal clipping were included. Standard microsurgical procedures were done. After clipping, we administered a 25 mg bolus intravenous dose of indocyanine green with microscope focused through the INFRARED 800 camera module, followed by administration of 60 mg bolus intravenous dose of fluorescein with microscope focused through the yellow 560 module and images were assessed. <b>Results</b>  The average aneurysm size was 17 mm. In 12 patients (40%), FL-VA allowed better assessment of perforating arteries (seven cases) or distal branches (three cases) or both (two cases), when compared with ICG-VA. In one case of MCA (M1) aneurysm, ICG-VA showed no fluorescent signal in one of the distal trunks whereas FL-VA showed normal signal. In one case of ACOM aneurysm, perforators were missed on ICG-VA but were seen on FL-VA. FL-VA was able to identify inadequate aneurysm clipping in one case. In two patients, FL-VA provided the advantage of real-time manipulation of the vessels to expose the vessels and aneurysms of interest. Fluorescein detected all the perforators that were visible under white light (68/68) whereas ICG was able to detect 56 (82.35%) perforators ( <i>p</i> -value< 0.05). <b>Conclusion</b>  Intraoperative ICG and Fluorescein videoangiography recognize inadequate occlusion of aneurysm, decreased flow in branches or perforators. When various study parameters were considered such as ability to assess small size perforators, branching vessels, adequacy of aneurysmal clipping, and useful information on repeat imaging, FL-VA was found superior to ICG-VA.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":"18 1","pages":"25-29"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1e/8d/10-1055-s-0042-1751006.PMC10089731.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9660230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resting-State Functional MRI/PET Profile as a Potential Alternative to Tri-Modality EEG-MR/PET Imaging: An Exploratory Study in Drug-Refractory Epilepsy.","authors":"Sandhya Mangalore,&nbsp;Sameer Peer,&nbsp;Sunil Kumar Khokhar,&nbsp;Rose Dawn Bharath,&nbsp;Karthik Kulanthaivelu,&nbsp;Jitender Saini,&nbsp;Sanjib Sinha,&nbsp;Vyasaraj Kalya Kishore,&nbsp;Ravindranadh Chowdary Mundlamuri,&nbsp;Ajay Asranna,&nbsp;Vishwanath Lakshminarayanapuram Gopal,&nbsp;Raghavendra Kenchaiah,&nbsp;Arivazhagan Arimappamagan,&nbsp;Nishanth Sadashiva,&nbsp;Malla Bhaskara Rao,&nbsp;Anita Mahadevan,&nbsp;Jamuna Rajeswaran,&nbsp;Keshav Kumar,&nbsp;Kandavel Thennarasu","doi":"10.1055/s-0043-1760852","DOIUrl":"https://doi.org/10.1055/s-0043-1760852","url":null,"abstract":"<p><p><b>Objective</b>  The study explores whether the epileptic networks associate with predetermined seizure onset zone (SOZ) identified from other modalities such as electroencephalogram/video electroencephalogram/structural MRI (EEG/VEEG/sMRI) and with the degree of resting-state functional MRI/positron emission tomography (RS-fMRI/PET) coupling. Here, we have analyzed the subgroup of patients who reported having a seizure on the day of scan as postictal cases and compared the findings with interictal cases (seizure-free interval). <b>Methods</b>  We performed independent component analysis (ICA) on RS-fMRI and 20 ICA were hand-labeled as large scale, noise, downstream, and epilepsy networks (Epinets) based on their profile in spatial, time series, and power spectrum domains. We had a total of 43 cases, with 4 cases in the postictal group (100%). Of 39 cases, 14 cases did not yield any Epinet and 25 cases (61%) were analyzed for the final study. The analysis was done patient-wise and correlated with predetermined SOZ. <b>Results</b>  The yield of finding Epinets on RS-fMRI is more during the postictal period than in the interictal period, although PET and RS-fMRI spatial, time series, and power spectral patterns were similar in both these subgroups. Overlaps between large-scale and downstream networks were noted, indicating that epilepsy propagation can involve large-scale cognition networks. Lateralization to SOZ was noted as blood oxygen level-dependent activation and correlated with sMRI/PET findings. Postoperative surgical failure cases showed residual Epinet profile. <b>Conclusion</b>  RS-fMRI may be a viable option for trimodality imaging to obtain simultaneous physiological information at the functional network and metabolic level.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":"18 1","pages":"53-61"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/3c/10-1055-s-0043-1760852.PMC10089745.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9660229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Grade Astrocytoma Causing Dural and Calvarial Destruction.","authors":"Hatim Belfquih,&nbsp;Badr Slioui,&nbsp;Mohamed Amine Azami,&nbsp;Ali Akhaddar","doi":"10.1055/s-0043-1764325","DOIUrl":"https://doi.org/10.1055/s-0043-1764325","url":null,"abstract":"<p><p>Most of the literature on intra-axial lesions causing calvarial and dural destruction comes from case reports for glioblastoma, lymphoma, metastasis, and aggressive meningioma. Destruction of dura and calvaria by low-grade gliomas is extremely uncommon; cases reported so far have been mostly oligodendrogliomas. This article describes the unusual case of a 23-year-old male patient with a left-sided intra and extracranial tumor involving the frontal lobe, destroying the overlying dura and calvaria, who underwent maximal safe resection. Histopathology showed the tumor to be a low-grade astrocytoma. The calvarial thinning or remodeling caused by low-grade gliomas is thought to result from their chronic mass effect, by displacing the overlying layer of cerebrospinal fluid and transmitting brain pulsations directly to the inner table of the skull. Pressure thinning of the inner table of the skull may be caused by Pacchionian granulations close to the midline. Although this is extremely uncommon, magnetic resonance imaging may include low-grade astrocytoma in the differential diagnosis in such cases.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":"18 1","pages":"223-227"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/0f/10-1055-s-0043-1764325.PMC10089756.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9660698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}