Durectomy and reconstruction for the treatment of a recurrent spinal meningioma

2006 ◽  
Vol 5 (1) ◽  
pp. 76-78 ◽  
Author(s):  
Eric M. Horn ◽  
Vivek R. Deshmukh ◽  
Gregory P. Lekovic ◽  
Curtis A. Dickman
Keyword(s):  
Dura Mater ◽  
Complete Resection ◽  
Fascia Lata ◽  
Gait Ataxia ◽  
The Novel ◽  
Resonance Imaging ◽  
Spinal Meningioma ◽  
Thoracic Spinal ◽  
Spinal Meningiomas ◽  
Extensive Involvement

✓ The management of spinal meningiomas with extensive involvement of the dura mater is controversial. The principal difficulty in performing a resection is the potential for complications associated with this approach. The authors present the case of a pregnant 35-year-old woman in whom bilateral lower-extremity numbness, weakness, gait ataxia, and myelopathy developed. Magnetic resonance imaging showed a recurrent thoracic meningioma with extensive infiltration of the dura mater. Durectomy, complete resection, and reconstruction were performed. The patient has not experienced a recurrence 21 months after her treatment. This case illustrates that thoracic spinal meningiomas with extensive dural involvement can be resected safely with a complete durectomy. The novel dural reconstruction involving the implantation of a fascia lata and bovine pericardium allograft is an effective way to reconstruct the dura to create an adequate barrier to cerebrospinal fluid.

scholarly journals Thoracic meningioma with ossification: Case report

2021 ◽  
Vol 12 ◽  
pp. 505
Author(s):  
Daniel Buchanan ◽  
Nikolay L. Martirosyan ◽  
Wei Yang ◽  
Russell I. Buchanan
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Rare Case ◽  
Complete Resection ◽  
Case Description ◽  
Spinal Meningioma ◽  
Thoracic Myelopathy ◽  
Punctate Calcification ◽  
Spinal Meningiomas ◽  
Intradural Extramedullary

Background: The incidence of spinal meningiomas is 0.33/100000 population, and ossified spinal meningiomas are even less commonly encountered. Case Description: A 64-year-old male presented with a progressive T4-level thoracic myelopathy. MR imaging revealed an intradural extramedullary mass that significantly compressed the spinal cord. The accompanying CT demonstrated hyperdensities within the lesion consistent with punctate calcification vs. ossification (i.e. consistent with histological bone formations within tumor). The patient underwent complete resection of the tumor resulting in a full recovery of neurological function within 6 postoperative weeks. The pathological specimen showed findings consistent with an ossified spinal meningioma. Conclusion: Here, we identified a rare case of an ossified thoracic T4 meningioma occurring in a 64-year-old male.

scholarly journals Spinal meningiomas: surgical management and outcome

2003 ◽  
Vol 14 (6) ◽  
pp. 1-7 ◽  
Author(s):  
Oren N. Gottfried ◽  
Wayne Gluf ◽  
Alfredo Quinones-Hinojosa ◽  
Peter Kan ◽  
Meic H. Schmidt
Keyword(s):  
Magnetic Resonance Imaging ◽  
Functional Outcomes ◽  
Surgical Techniques ◽  
Functional Improvement ◽  
Resonance Imaging ◽  
Single Institution ◽  
Spinal Meningioma ◽  
Spinal Meningiomas ◽  
Operative Microscope ◽  
Analyze Data

Advances in imaging and surgical technique have improved the treatment of spinal meningiomas; these include magnetic resonance imaging, intraoperative ultrasonography, neuromonitoring, the operative microscope, and ultrasonic cavitation aspirators. This study is a retrospective review of all patients treated at a single institution and with a pathologically confirmed diagnosis of spinal meningioma. Additionally the authors analyze data obtained in 556 patients reported in six large series in the literature, evaluating surgical techniques, results, and functional outcomes. Overall, surgical treatment of spinal meningiomas is associated with favorable outcomes. Spinal meningiomas can be completely resected, are associated with postoperative functional improvement, and the rate of recurrence is low.

Top-Ten Tips for Imaging the Brachial Plexus with Ultrasound and MRI

2019 ◽  
Vol 23 (04) ◽  
pp. 405-418 ◽  
Author(s):  
James F. Griffith ◽  
Radhesh Krishna Lalam
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Brachial Plexus ◽  
Muscle Denervation ◽  
Resonance Imaging ◽  
Neural Injury ◽  
Clinical Indications ◽  
Magnetic Resonance Imaging Mri ◽  
High Level ◽  
Extensive Involvement

AbstractWhen it comes to examining the brachial plexus, ultrasound (US) and magnetic resonance imaging (MRI) are complementary investigations. US is well placed for screening most extraforaminal pathologies, whereas MRI is more sensitive and accurate for specific clinical indications. For example, MRI is probably the preferred technique for assessment of trauma because it enables a thorough evaluation of both the intraspinal and extraspinal elements, although US can depict extraforaminal neural injury with a high level of accuracy. Conversely, US is probably the preferred technique for examination of neurologic amyotrophy because a more extensive involvement beyond the brachial plexus is the norm, although MRI is more sensitive than US for evaluating muscle denervation associated with this entity. With this synergy in mind, this review highlights the tips for examining the brachial plexus with US and MRI.

Ossified Thoracic Spinal Meningioma: Report of Two Cases

2004 ◽  
Vol 51 (4) ◽  
pp. 389
Author(s):  
Seung Eun Chung ◽  
Sang Ho Lee ◽  
Tae Hong Kim ◽  
Hyeon Seon Park ◽  
Dae Yong Kim
Keyword(s):  
Spinal Meningioma ◽  
Thoracic Spinal

scholarly journals Relationship between Magnetic Resonance Imaging and Pathologic Findings in Spinal Meningiomas.

1999 ◽  
Vol 48 (2) ◽  
pp. 651-655
Author(s):  
Hirofumi Matsumoto ◽  
Mitsuhiro Takashita ◽  
Tomoji Yatsuka ◽  
Hirofumi Taira ◽  
Yasuo Higuma ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Pathologic Findings ◽  
Spinal Meningiomas

scholarly journals Cinematic rendering of a burst sagittal suture caused by an occipito-frontal gunshot wound

2021 ◽  
Author(s):  
Dominic Gascho ◽  
Michael J. Thali ◽  
Rosa M. Martinez ◽  
Stephan A. Bolliger
Keyword(s):  
Gunshot Wound ◽  
Three Dimensional ◽  
The Novel ◽  
Sagittal Suture ◽  
Resonance Imaging ◽  
Cinematic Rendering ◽  
Reconstruction Methods ◽  
Dimensional Reconstruction ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

AbstractThe computed tomography (CT) scan of a 19-year-old man who died from an occipito-frontal gunshot wound presented an impressive radiating fracture line where the entire sagittal suture burst due to the high intracranial pressure that arose from a near-contact shot from a 9 mm bullet fired from a Glock 17 pistol. Photorealistic depictions of the radiating fracture lines along the cranial bones were created using three-dimensional reconstruction methods, such as the novel cinematic rendering technique that simulates the propagation and interaction of light when it passes through volumetric data. Since the brain had collapsed, depiction of soft tissue was insufficient on CT images. An additional magnetic resonance imaging (MRI) examination was performed, which enabled the diagnostic assessment of cerebral injuries.

Presigmoid transpetrous approach (partial petrosectomy) combined with subtemporal transtentorial approach for petroclival meningioma

2021 ◽  
Vol 3 (3) ◽  
Author(s):  
Fernando Palacios ◽  
◽  
Manuel Lazón ◽  
Eduardo Romero ◽  
Rommel Rodriguez
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Intraoperative Complications ◽  
Brain Magnetic Resonance Imaging ◽  
Complete Resection ◽  
Neurosurgical Procedures ◽  
Resonance Imaging ◽  
Petroclival Meningioma ◽  
Skull Base Neoplasms ◽  
Petroclival Meningiomas

Introduction: Petroclival meningiomas constitute 3 to 10% of meningiomas of the posterior fossa, they originate in the petroclival fissure, in the upper part of the clivus, petrosal apex, and medial to the trigeminal nerve. Resection of these tumors is a neurosurgical challenge. The combined partial petrosectomy approach associated with a sub-temporal approach is a technique described by various authors; however, its performance is considered highly complex. We report the case of a petroclival meningioma operated successfully in our hospital using a combined presigmoid and subtemporal transtentorial transpetrosal approach. Clinical case: 33-year-old female patient with a clinical picture of headache, nausea, and gait disturbance. Brain magnetic resonance imaging showed a large right petroclival tumor (4.2x3.9x3.8cm) that displaced the brainstem and secondary hydrocephalus. The hydrocephalus was treated with a ventricular peritoneal shunt. Then, the tumor was resected using a combined presigmoid and subtemporal transpetrosal approach, a technique that allowed adequate exposure of the tumor, achieving complete resection, without intraoperative complications. Postoperative evolution was favorable, with no sequelae. Conclusion: The combined presigmoid and transtentorial subtemporal transpetrous approach for petroclival meningiomas is an effective and feasible technique to perform in our environment. The support of technology such as Neuronavigation, the ultrasonic aspirator, intraoperative monitoring, and adequate experience in skull base surgery are fundamental factors for the success of this surgery. Keywords: Meningioma, Skull Base Neoplasms, Craniotomy, Neurosurgical Procedures. (Source: MeSH NLM)

Meetings of the Scientific Society of the Rybinsk Doctor's Section

1926 ◽  
Vol 22 (12) ◽  
pp. 1405-1405
Keyword(s):  
Dura Mater ◽  
Hand Function ◽  
Parietal Bone ◽  
Fascia Lata ◽  
Fatty Tissue ◽  
Scientific Society ◽  
The Right ◽  
Epileptiform Seizures

Dr. Bronnikov reported a case of Jackson's epilepsy treated operatively. A patient after being wounded with a hammer of the parietal bone first suffered paralysis of the right arm and difficulty in speaking, and after 2 months he had epileptiform seizures every 6 days. In the 4th month, he underwent surgery to remove fragments of the internal lamina pressing on the dura mater, and the defect was closed with a piece of fascia lata with fatty tissue. The patient was demonstrated 3 months after the operation; he had no seizures, his speech was normal, and his hand function had been restored.

EXTENT OF RESECTION AND SURVIVAL IN GLIOBLASTOMA MULTIFORME

Neurosurgery ◽  
2008 ◽  
Vol 62 (3) ◽  
pp. 564-576 ◽  
Author(s):  
◽  
Walter Stummer ◽  
Hanns-Jürgen Reulen ◽  
Thomas Meinel ◽  
Uwe Pichlmeier ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Scale Score ◽  
Aminolevulinic Acid ◽  
Residual Tumor ◽  
Complete Resection ◽  
Karnofsky Performance Scale ◽  
Resonance Imaging ◽  
Treatment Bias ◽  
Karnofsky Performance Scale Score ◽  
Performance Scale

Abstract OBJECTIVE The influence of the degree of resection on survival in patients with glioblastoma multiforme is still under discussion. The highly controlled 5-aminolevulinic acid study provided a unique platform for addressing this question as a result of the high frequency of “complete” resections, as revealed by postoperative magnetic resonance imaging scans achieved by fluorescence-guided resection and homogeneous patient characteristics. METHODS Two hundred forty-three patients with glioblastoma multiforme per protocol from the 5-aminolevulinic acid study were analyzed. Patients with complete and incomplete resections as revealed by early magnetic resonance imaging scans were compared. Prognostic factors that might cause bias regarding resection and influence survival (e.g., tumor size, edema, midline shift, location, age, Karnofsky Performance Scale score, National Institutes of Health Stroke Scale score) were used for analysis of overall survival. Time to reintervention (chemotherapy, reoperation) was analyzed further to exclude bias regarding second-line therapies. RESULTS Treatment bias was identified in patients with complete (n = 122) compared with incomplete resection (n = 121), i.e., younger age and less frequent eloquent tumor location. Other factors, foremost preoperative tumor size, were identical. Patients without residual tumor survived longer (16.7 versus 11.8 mo, P < 0.0001). In multivariate analysis, only residual tumor, age, and Karnofsky Performance Scale score were significantly prognostic. To account for distribution bias, patients were stratified for age (>60 or ≤60 yr) and eloquent location. Survival advantages from complete resection remained significant within subgroups, and age/eloquent location were no longer unevenly distributed. Reinterventions occurred marginally earlier in patients with residual tumor (6.7 versus 9.5 mo, P = 0.0582). CONCLUSION Treatment bias was demonstrated regarding resection and second-line therapies. However, bias and imbalances were controllable in the cohorts available from the 5-aminolevulinic acid study so that the present data now provide Level 2b evidence (Oxford Centre for Evidence-based Medicine) that survival depends on complete resection of enhancing tumor in glioblastoma multiforme.

scholarly journals Two out of three of octogenarians benefitted from delayed resection of spinal meningiomas

2021 ◽  
Vol 12 ◽  
pp. 593
Author(s):  
Ville Vasankari ◽  
Roel Hubert Louis Haeren ◽  
Mika Niemela ◽  
Miikka Korja
Keyword(s):  
Elderly Patients ◽  
Surgical Resection ◽  
Case Description ◽  
Delayed Surgery ◽  
Thoracic Spinal ◽  
Spinal Meningiomas

Background: Can elderly patients with thoracic meningioma and severe paraparesis benefit from delayed surgery? Case Description: Two out of three octogenarians with severe preoperative paraparesis (all wheelchair-bound) were able to walk again following delayed (60–120 days from onset of deficit) surgical resection of thoracic spinal meningiomas. Conclusion: Two out of three octogenarians with thoracic meningiomas causing severe paraparesis benefitted from the delayed (i.e. from 60 to 289 days) surgical resection of their tumors.

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