Monitoring optic nerve function during craniotomy

1976 ◽  
Vol 44 (1) ◽  
pp. 29-31 ◽  
Author(s):  
Moshe Feinsod ◽  
John B. Selhorst ◽  
William F. Hoyt ◽  
Charles B. Wilson
Keyword(s):  
Pituitary Adenoma ◽  
Optic Nerve ◽  
Surgical Removal ◽  
Evoked Responses ◽  
Nerve Function ◽  
Normal Vision ◽  
Content Type ◽  
Visual Evoked Responses ◽  
Normal Latency ◽  
Fine Print

✓ During surgical removal of a pituitary adenoma, conduction in the anterior visual pathways was monitored by continuous recording of visual evoked responses (VER). The method employed a scleral contact lens with an embedded flashing diode for delivery of visual stimuli. Evoked potentials of nearly normal latency, amplitude, and form were recorded from occipital scalp electrodes immediately after the optic nerves were decompressed. Restoration of the VER was correlated with restoration of normal vision.

Transsphenoidal decompression of the optic nerve and chiasm

1977 ◽  
Vol 46 (6) ◽  
pp. 717-722 ◽  
Author(s):  
Edward R. Laws ◽  
James C. Trautmann ◽  
Robert W. Hollenhorst
Keyword(s):  
Pituitary Adenoma ◽  
Optic Nerve ◽  
Transsphenoidal Surgery ◽  
Visual Loss ◽  
Sella Turcica ◽  
Recent Experience ◽  
Content Type ◽  
Visual Status ◽  
Fine Print

✓ A review of recent experience with transsphenoidal surgery for lesions in and about the sella turcica establishes the value of this approach for the management of patients with visual loss. The lesions encountered consisted of pituitary adenoma in 45 cases, craniopharyngioma in 10 cases, and miscellaneous tumors involving the sella in the remaining seven cases. Sixty of the 62 patients in this series had quantitative determination of preoperative and postoperative visual status; after surgery, vision was improved in 81%, unchanged in 11%, and worse in 5%. Two patients (3%) died during the immediate postoperative period before their visual status could be evaluated.

Head injury in the champanzee

1973 ◽  
Vol 39 (2) ◽  
pp. 167-177 ◽  
Author(s):  
Frank S. Letcher ◽  
Paul G. Corrao ◽  
Ayub K. Ommaya
Keyword(s):  
Head Injury ◽  
Loss Of Consciousness ◽  
Evoked Responses ◽  
Irreversible Loss ◽  
Content Type ◽  
Visual Evoked Responses ◽  
Photic Driving ◽  
Electroencephalogram Eeg ◽  
Marked Suppression ◽  
Fine Print

✓ The effect of experimental head injury on the electroencephalogram (EEG) and cortical evoked response was studied in 11 awake, moderately restrained chimpanzees. As a base for comparison with injury effects, the waking and sleeping electroencephalogram (EEG) and the somatic and visual evoked responses (SER and VER) were investigated first. Unusually high voltage occipital waves and a propensity for photic driving characterized the EEG. Controlled blows to the occiput in 10 animals produced reversible depression of consciousness in only four. In those four, the EEG and SER were affected differently immediately after the injury; the SER showing marked suppression while the early EEG was unaffected. Recovery of the SER and of consciousness paralleled each other. With injuries causing prolonged or irreversible loss of consciousness, the later EEG showed depression or large amplitude slow waves, which became isoelectric if the blow was fatal.

Gamma knife radiosurgery in the management of cavernous sinus meningiomas

2000 ◽  
Vol 93 (supplement_3) ◽  
pp. 68-73 ◽  
Author(s):  
Pierre-Hugues Roche ◽  
Jean Régis ◽  
Henry Dufour ◽  
Henri-Dominique Fournier ◽  
Christine Delsanti ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Tumor Growth ◽  
Gamma Knife ◽  
Cavernous Sinus ◽  
Gamma Knife Radiosurgery ◽  
Surgical Removal ◽  
Content Type ◽  
Cavernous Sinus Meningioma ◽  
The Mean ◽  
Fine Print

Object. The authors sought to assess the functional tolerance and tumor control rate of cavernous sinus meningiomas treated by gamma knife radiosurgery (GKS). Methods. Between July 1992 and October 1998, 92 patients harboring benign cavernous sinus meningiomas underwent GKS. The present study is concerned with the first 80 consecutive patients (63 women and 17 men). Gamma knife radiosurgery was performed as an alternative to surgical removal in 50 cases and as an adjuvant to microsurgery in 30 cases. The mean patient age was 49 years (range 6–71 years). The mean tumor volume was 5.8 cm3 (range 0.9–18.6 cm3). On magnetic resonance (MR) imaging the tumor was confined in 66 cases and extensive in 14 cases. The mean prescription dose was 28 Gy (range 12–50 Gy), delivered with an average of eight isocenters (range two–18). The median peripheral isodose was 50% (range 30–70%). Patients were evaluated at 6 months, and at 1, 2, 3, 5, and 7 years after GKS. The median follow-up period was 30.5 months (range 12–79 months). Tumor stabilization after GKS was noted in 51 patients, tumor shrinkage in 25 patients, and enlargement in four patients requiring surgical removal in two cases. The 5-year actuarial progression-free survival was 92.8%. No new oculomotor deficit was observed. Among the 54 patients with oculomotor nerve deficits, 15 improved, eight recovered, and one worsened. Among the 13 patients with trigeminal neuralgia, one worsened (contemporary of tumor growing), five remained unchanged, four improved, and three recovered. In a patient with a remnant surrounding the optic nerve and preoperative low vision (3/10) the decision was to treat the lesion and deliberately sacrifice the residual visual acuity. Only one transient unexpected optic neuropathy has been observed. One case of delayed intracavernous carotid artery occlusion occurred 3 months after GKS, without permanent deficit. Another patient presented with partial complex seizures 18 months after GKS. All cases of tumor growth and neurological deficits observed after GKS occurred before the use of GammaPlan. Since the initiation of systematic use of stereotactic MR imaging and computer-assisted modern dose planning, no more side effects or cases of tumor growth have occurred. Conclusions. Gamma knife radiosurgery was found to be an effective low morbidity—related tool for the treatment of cavernous sinus meningioma. In a significant number of patients, oculomotor functional restoration was observed. The treatment appears to be an alternative to surgical removal of confined enclosed cavernous sinus meningioma and should be proposed as an adjuvant to surgery in case of extensive meningiomas.

Visual changes after gamma knife surgery for optic nerve tumors

2005 ◽  
Vol 102 (Special_Supplement) ◽  
pp. 143-146 ◽  
Author(s):  
Yang Kwon ◽  
Jun Seok Bae ◽  
Jae Myung Kim ◽  
Do Hee Lee ◽  
Soon Young Kim ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Gamma Knife ◽  
Gamma Knife Surgery ◽  
Optic Glioma ◽  
Content Type ◽  
Nerve Sheath ◽  
Optic Nerve Sheath Meningioma ◽  
Optic Nerve Tumors ◽  
Visual Changes ◽  
Fine Print

✓ Tumors involving the optic nerve (optic glioma, optic nerve sheath meningioma) are benign but difficult to treat. Gamma knife surgery (GKS) may be a useful treatment. The authors present data obtained in three such cases and record the effects of GKS.

Pituitary adenoma producing growth hormone and adrenocorticotropin: a histological, immunocytochemical, electron microscopic, and in situ hybridization study

1998 ◽  
Vol 88 (6) ◽  
pp. 1111-1115 ◽  
Author(s):  
Kalman Kovacs ◽  
Eva Horvath ◽  
Lucia Stefaneanu ◽  
Juan Bilbao ◽  
William Singer ◽  
...  
Keyword(s):  
Growth Hormone ◽  
In Situ Hybridization ◽  
Pituitary Adenoma ◽  
Immunoelectron Microscopy ◽  
Secretory Granules ◽  
Cell Types ◽  
Content Type ◽  
Separate Cell ◽  
Fine Print

✓ The authors report on the morphological features of a pituitary adenoma that produced growth hormone (GH) and adrenocorticotropic hormone (ACTH). This hormone combination produced by a single adenoma is extremely rare; a review of the available literature showed that only one previous case has been published. The tumor, which was removed from a 62-year-old man with acromegaly, was studied by histological and immunocytochemical analyses, transmission electron microscopy, immunoelectron microscopy, and in situ hybridization. When the authors used light microscopy, the tumor appeared to be a bimorphous mixed pituitary adenoma composed of two separate cell types: one cell population synthesized GH and the other ACTH. The cytogenesis of pituitary adenomas that produce more than one hormone is obscure. It may be that two separate cells—one somatotroph and one corticotroph—transformed into neoplastic cells, or that the adenoma arose in a common stem cell that differentiated into two separate cell types. In this case immunoelectron microscopy conclusively demonstrated ACTH in the secretory granules of several somatotrophs. This was associated with a change in the morphological characteristics of secretory granules. Thus it is possible that the tumor was originally a somatotropic adenoma that began to produce ACTH as a result of mutations that occurred during tumor progression.

Aneurysm-induced third nerve palsy

1972 ◽  
Vol 36 (5) ◽  
pp. 548-551 ◽  
Author(s):  
Iftikhar A. Raja
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Functional Recovery ◽  
Poor Prognosis ◽  
Nerve Palsy ◽  
Nerve Function ◽  
Content Type ◽  
Third Nerve Palsy ◽  
Carotid Ligation ◽  
Third Nerve ◽  
Fine Print

✓ Forty-two patients with aneurysm-induced third nerve palsy are described. After carotid ligation, 58% showed satisfactory and 42% unsatisfactory functional recovery. In some patients the deficit continued to increase even after carotid ligation. Early ligation provided a better chance of recovery of third nerve function. Patients in whom third nerve palsy began after subarachnoid hemorrhage had a poor prognosis. No relationship was noted between the size of the aneurysm and the recovery of third nerve function.

Preoperative and postoperative cognitive functioning in patients with frontal meningiomas

2003 ◽  
Vol 98 (1) ◽  
pp. 21-31 ◽  
Author(s):  
Oliver Tucha ◽  
Christian Smely ◽  
Michael Preier ◽  
Georg Becker ◽  
Geraldine M. Paul ◽  
...  
Keyword(s):  
Executive Functions ◽  
Cognitive Functioning ◽  
Time Course ◽  
Lesion Size ◽  
Test Battery ◽  
Surgical Removal ◽  
Specific Information ◽  
Content Type ◽  
Before And After ◽  
Fine Print

Object. There is presently no specific information available concerning the nature and course of cognitive deficits caused by intracranial meningiomas. In this prospective study the authors examined the cognitive functioning of patients with frontal meningiomas. Methods. Fifty-four patients with frontal meningiomas were examined neuropsychologically before and after neurosurgery. The test battery consisted of standardized instruments including those assessing memory, attention, visuoconstructive abilities, and executive functions. The time period between pre-and postoperative assessment ranged from 4 to 9 months. The patients' performance was compared with the results in 54 healthy adults who were also assessed twice by using the same test battery in a period ranging from 4 to 9 months. In addition, the effect on cognition of meningioma lateralization, localization, lesion size, edema, brain compression, time course, and the occurrence of preoperative seizures was analyzed. Conclusions. Except in the case of working memory, comparisons of pre- and postoperative assessments of cognition revealed no differences in memory, visuoconstructive abilities, or executive functions, although a postoperative improvement in attentional functions was observed. The results of this study indicate that the surgical removal of frontal meningiomas does not impair patients' cognitive functioning. Furthermore, improvements in attentional functions may occur in these patients.

Hemangiopericytoma of the spinal canal

1978 ◽  
Vol 49 (6) ◽  
pp. 914-920 ◽  
Author(s):  
Darrell J. Harris ◽  
Victor L. Fornasier ◽  
Kenneth E. Livingston
Keyword(s):  
Endothelial Cells ◽  
Differential Diagnosis ◽  
High Risk ◽  
Spinal Canal ◽  
Vertebral Column ◽  
Soft Tissues ◽  
Surgical Removal ◽  
Vascular Neoplasm ◽  
Content Type ◽  
Fine Print

✓ Hemangiopericytoma is a vascular neoplasm consisting of capillaries outlined by an intact basement membrane that separates the endothelial cells of the capillaries from the spindle-shaped tumor cells in the extravascular area. These neoplasms are found in soft tissues but have rarely been shown to involve the spinal canal. This is a report of three such cases. Surgical removal of the tumor from the spinal canal was technically difficult. A high risk of recurrence has been reported but in these three cases adjunctive radiotherapy appeared to be of benefit in controlling the progression of the disease. These cases, added to the six cases in the literature, confirm the existence of hemangiopericytoma involving the vertebral column with extension into the spinal canal. This entity should be included in the differential diagnosis of lesions of the spinal canal. The risk of intraoperative hemorrhage should be anticipated.

Surgical removal of bilateral papillomas of the choroid plexus of the lateral ventricles with resolution of hydrocephalus

1979 ◽  
Vol 50 (5) ◽  
pp. 677-681 ◽  
Author(s):  
Steven K. Gudeman ◽  
Humbert G. Sullivan ◽  
Michael J. Rosner ◽  
Donald P. Becker
Keyword(s):  
Cerebrospinal Fluid ◽  
Choroid Plexus ◽  
Large Volume ◽  
Surgical Removal ◽  
Tumor Removal ◽  
Content Type ◽  
Lateral Ventricles ◽  
Csf Diversion ◽  
Csf Production ◽  
Fine Print

✓ The authors report a patient with bilateral papillomas of the choroid plexus of the lateral ventricles with documentation of cerebrospinal fluid (CSF) hypersecretion causing hydrocephalus. Special attention is given to the large volume of CSF produced by these tumors (removal of one tumor reduced CSF outflow by one-half) and to the fact that CSF diversion was not required after both tumors were removed. Since tumor removal alone was sufficient to stop the progression of hydrocephalus, we feel that this case supports the concept that elevated CSF production by itself is sufficient to cause hydrocephalus in patients with papillomas of the choroid plexus.

Intrasellar epidermoid cyst

1983 ◽  
Vol 58 (3) ◽  
pp. 411-415 ◽  
Author(s):  
James E. Boggan ◽  
Richard L. Davis ◽  
Greg Zorman ◽  
Charles B. Wilson
Keyword(s):  
Pituitary Adenoma ◽  
Epidermoid Cyst ◽  
Cystic Lesions ◽  
Sellar Region ◽  
Content Type ◽  
Fine Print

✓ The authors report the uncomplicated removal of an intrasellar epidermoid cyst that on presentation mimicked a pituitary adenoma. Current controversies regarding the differentiation of this cyst from other cystic lesions of the sellar region are reviewed.

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