scholarly journals Outcome of Sellar and Suprasellar Brain Tumors with Retractorless Modified Subfrontal Approach

2021 ◽  
Vol 15 (7) ◽  
pp. 1544-1546
Author(s):  
Abdul Rauf ◽  
Hameed Ullah Khan ◽  
Mubarak Hussain
Keyword(s):  
Brain Tumors ◽  
University Hospital ◽  
Olfactory Groove ◽  
Suprasellar Region ◽  
Olfactory Groove Meningioma ◽  
Male Patients ◽  
Magnetic Resonance Imaging Mri ◽  
Subfrontal Approach ◽  
Operation Results

Aim: To determine the outcome of sellar and suprasellar brain tumors with retractorless modified subfrontal approach. Study design: Descriptive/observational study Place and duration of study: Department of Neurosurgery, Liaquat University Hospital Hyderabad/Jamshoro from 1st March 2020 to 28th February 2021. Methodology: Fifty patients of sellar and suprasellar brain tumors age between 15-70 years were enrolled. Patients details demographics age, sex and body mass index were recorded after taking written consent. The inter-hemispheric front-basal technique was used for all patients and the average follow-up time was 6 months. Postoperatively, magnetic resonance imaging (MRI) and computerized tomography (CT) scans in all patients were performed. After 12 hours, the postoperative CT scan was performed to monitor for persistent tumor and hemorrhage cerebral edema following an operation. Results: There were 30 (60%) male patients and 20 (40%) female patients. Mean age of the patients were 28.36±14.88 years with mean BMI 23.16±7.54 kg/m2. Most of the patients 20(40%) were from age group 15-30 years, followed by 31-40 years in 12 (24%) patients. Frequency of pituitary adenoma was found in 22 (44%) cases, craniopharyngioma found in 19 (38.7%) cases, arachnoid cyst found in 4 (8%), keratin flakes in 2 (4%) cases, benign giant cell tumor found in 2 (4%)olfactory groove meningioma in 1 (2%) and epidermoid in 1 (2%) cases. Post operatively 35 (70%) patients were completely recovered, complications found in 13 (26%) patients who were recovered later and frequency of not recovered patients was 2 (4%). According to Karnofsky performance, 16 (32%) patients had scale 30, scale 60 was in 2 (4%) cases, scale 70 in 4 (8%) patients, scale 80 in 19 (38%) and scale 90 in 9 (18%). Conclusion: This retractorless method is very effective and safe in the sellar and suprasellar region for excision of big tumors. This method allows the huge tumor to be removed without serious complication. Keywords: Sub-frontal approach, Sellar, Suprasellar, Brain tumor, Retractorless method

scholarly journals RONC-19. TWO CASES OF RE-IRRADIATION FOR LATE RECURRENT OR RADIATION-INDUCED TUMOR AFTER RADIATION THERAPY FOR PEDIATRIC BRAIN TUMORS

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii459-iii459
Author(s):  
Takashi Mori ◽  
Shigeru Yamaguchi ◽  
Rikiya Onimaru ◽  
Takayuki Hashimoto ◽  
Hidefumi Aoyama
Keyword(s):  
Radiation Therapy ◽  
Brain Tumors ◽  
Tumor Resection ◽  
Intensity Modulated Radiation Therapy ◽  
Late Recurrence ◽  
Pediatric Brain Tumors ◽  
Suprasellar Region ◽  
Radiation Induced ◽  
Pediatric Brain

Abstract BACKGROUND As the outcome of pediatric brain tumors improves, late recurrence and radiation-induced tumor cases are more likely to occur, and the number of cases requiring re-irradiation is expected to increase. Here we report two cases performed intracranial re-irradiation after radiotherapy for pediatric brain tumors. CASE 1: 21-year-old male. He was diagnosed with craniopharyngioma at eight years old and underwent a tumor resection. At 10 years old, the local recurrence of suprasellar region was treated with 50.4 Gy/28 fr of stereotactic radiotherapy (SRT). After that, other recurrent lesions appeared in the left cerebellopontine angle, and he received surgery three times. The tumor was gross totally resected and re-irradiation with 40 Gy/20 fr of SRT was performed. We have found no recurrence or late effects during the one year follow-up. CASE 2: 15-year-old female. At three years old, she received 18 Gy/10 fr of craniospinal irradiation and 36 Gy/20 fr of boost to the posterior fossa as postoperative irradiation for anaplastic ependymoma and cured. However, a anaplastic meningioma appeared on the left side of the skull base at the age of 15, and 50 Gy/25 fr of postoperative intensity-modulated radiation therapy was performed. Two years later, another meningioma developed in the right cerebellar tent, and 54 Gy/27 fr of SRT was performed. Thirty-three months after re-irradiation, MRI showed a slight increase of the lesion, but no late toxicities are observed. CONCLUSION The follow-up periods are short, however intracranial re-irradiation after radiotherapy for pediatric brain tumors were feasible and effective.

scholarly journals Bilateral Simultaneous Quadriceps Tendon Rupture in a 24-Year-Old Obese Patient: A Case Report and Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Fahad H. Abduljabbar ◽  
Abdulaziz Aljurayyan ◽  
Bayan Ghalimah ◽  
Lawrence Lincoln
Keyword(s):  
Case Report ◽  
Knee Injuries ◽  
Quadriceps Tendon ◽  
Knee Extension ◽  
Delayed Treatment ◽  
Basketball Game ◽  
Tendon Ruptures ◽  
Male Patients ◽  
Magnetic Resonance Imaging Mri

Introduction. Simultaneous bilateral quadriceps tendon ruptures (SBQTR) are uncommon knee injuries and most frequently occur in male patients, over 50 years of age. It can be associated with one or more predisposing risk factors like obesity, steroids use, and hyperparathyroidism. The main focus of this paper is to review SBQTR in obese patients. Case Report. We are reporting the youngest patient in the literature to date, a 24-year-old obese male patient, who presented to the emergency department complaining of bilateral knee pain and inability to walk after a fall during a basketball game. His clinical examination revealed the presence of a palpable suprapatellar gap and loss of knee extension bilaterally. Magnetic resonance imaging (MRI) confirmed that both of his quadriceps tendons were ruptured. A day after his diagnosis, the patient underwent successful operative repair followed by rehabilitation. At the two-year follow-up, the patient had full strength of both quadriceps muscles with no extension lag. Conclusion. The diagnosis of SBQTR can be challenging. Early diagnosis and treatment are associated with better functional outcome compared to delayed treatment. Physicians should have a high index of clinical suspicion in order not to miss such an injury and achieve favourable outcomes.

scholarly journals Silk Vista Baby Is a Safe and Technically Feasible Flow Diverting Stent for Distal Aneurysm Treatment

2021 ◽  
Vol 12 ◽  
Author(s):  
Vladimir Gavrilovic ◽  
Annarita Dapoto ◽  
Nicola Marotti ◽  
Andrea Pellegrin ◽  
Alessandro Pauro ◽  
...  
Keyword(s):  
Case Series ◽  
Flow Diverter ◽  
Side Branch ◽  
University Hospital ◽  
Complete Occlusion ◽  
Magnetic Resonance Imaging Mri ◽  
The University ◽  
Santa Maria ◽  
Flow Diverting Stent

Background and Purpose: Flow diverting stents are designed to divert blood flow from the aneurysm sac, allowing for eventual occlusion following endovascular therapy. This case series reports clinical experience using the Silk Vista Baby (SVB, Balt Extrusion, Montmorency, France), a flow diverter (FD) designed to treat intracranial aneurysms in small, distal vessels.Methods: All patients who underwent treatment with SVB at the University Hospital “Santa Maria della Misericordia” of Udine between July 2018 and September 2020 were retrospectively identified. Baseline patient and aneurysm characteristics, intraprocedural technical outcomes, periprocedural complications, modified Rankin Scale (mRS) at discharge, magnetic resonance imaging (MRI) results at 3-month follow-up, and angiographic results at 6-month follow-up were collected.Results: A total of 18 patients (55.6% [10/18] male; mean age 62.6 years, range: 42–77 years) were retrospectively identified, receiving treatment for 22 aneurysms. Most patients were symptomatic (14/18, 77.8%) and approximately half had subarachnoid hemorrhage (10/18, 55.6%). Sufficient aneurysm coverage was achieved in 88.9% (16/18) of patients with a single device. Mortality did not occur (0/18, 0%); adverse device-related events included side branch occlusion (1/18, 5.6%) and in-stent thrombosis (1/18, 5.6%). At discharge, 77.8% (14/18) had an mRS of 0. In most cases, patients showed complete occlusion (10/15, 66.7%) or a small aneurysmal remnant (3/15, 20.0%) upon MRI; upon angiography, most showed complete occlusion (10/13, 76.9%) or only a small aneurysmal remnant (2/13, 15.4%).Conclusion: This case series showed that the SVB FD is safe and feasible to use in patients with aneurysms in small, distal vessels. Additional randomized, prospective studies with larger cohorts are needed for the SVB.

scholarly journals Child's Craniopharyngiomas About 11 Cases and Review of the Literature

2021 ◽  
Vol 3 (5) ◽  
pp. 14-18
Author(s):  
T. Mesbahi ◽  
A. Rafiq ◽  
L. Panu ◽  
O. Jamal ◽  
A. Naja
Keyword(s):  
University Hospital ◽  
Endocrine Disorders ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Slow Evolution ◽  
Magnetic Resonance Imaging Mri ◽  
Visual Disturbances

Craniopharyngioma is a benign and rare intracranial tumor. In children, the clinic is characterized by the semiological, neurological, ophthalmological, and endocrine tripod. Medical imaging, represented by computed tomography (CT) and especially magnetic resonance imaging (MRI), has revolutionized the approach to the diagnosis of the latter. It has a slow evolution and likely to recur late. Thus, prolonged clinical-radiological follow-up is important to affirm a cure. The aim of this study is to highlight the epidemiological, clinical, paraclinical, therapeutic and evolutionary characteristics of craniopharyngiomas in children. This work consisted of a retrospective study of 11 pediatric cases of this tumor collected in the Neurosurgery Department of the IBN ROCHD University Hospital in Casablanca between January 2011 and January 2017. In this series, the child's craniopharyngiomas accounted for a rate of 45.8% of all these tumors. The average age of our patients was 9.09 years, with a sex ratio of 0.37. The average time to diagnose was 10 months. The picture was dominated by 100% visual disturbances, signs of intracranial hypertension at 63.63% and endocrine disorders at 36.36%. The lesion was intra and suprasellar seat in 91% of cases and suprasellar seat in 9%. Tumor size was less than 4cm in 54.53% of cases. Hydrocephalus is observed in 27.27% of cases. The fronto-pterrional modus operandi was the most used 72% of cases. Total exeresis was achieved in 9.1% of cases. Overall trends were favorable in 72% of cases without noting mortality. Tumor progressive recovery was observed in 9.1% of cases, but there were no recurrences. Given its location, the treatment of craniopharyngioma can lead to significant consequences in children affecting the long-term quality of life, hence the importance of post-operative follow-up and multidisciplinary management.

The outcome of bilateral subfrontal approach of large olfactory groove meningioma

2015 ◽  
Vol 28 (1) ◽  
pp. 93
Author(s):  
YasserBahgat El-Sisi ◽  
MagdyEl Sayed Rashed ◽  
AdelMahmoud Hanafy ◽  
EssamEl-Din Gaber Saleh ◽  
HossamAbd Al Hakin El Noomany ◽  
...  
Keyword(s):  
Olfactory Groove ◽  
Olfactory Groove Meningioma ◽  
Subfrontal Approach

Gender-affirming hormone therapy associated with multiple meningiomas and atypical histology in a transgender woman

2021 ◽  
Vol 14 (7) ◽  
pp. e242813
Author(s):  
Christopher Paul Millward ◽  
Eleri Phillips ◽  
Andrew Folusho Alalade ◽  
Catherine Elizabeth Gilkes
Keyword(s):  
Hormone Therapy ◽  
Cyproterone Acetate ◽  
Tumour Growth ◽  
High Dose ◽  
Mri Scan ◽  
Who Grade ◽  
Olfactory Groove ◽  
Olfactory Groove Meningioma ◽  
And Gender

We present a 69-year-old transgender woman who underwent gender-affirming surgery in 1998 and gender-affirming hormone therapy (cyproterone acetate (CPA) and estradiol) since this time. Following an MRI scan to investigate tremor in 2013, an incidental left anterior clinoid and right petrous meningioma were identified. Subtotal surgical resection was achieved for the anterior clinoid meningioma (WHO grade 1, meningothelial subtype). At follow-up in 2016, an olfactory groove meningioma and left greater wing of sphenoid meningioma were identified. By 2017, both tumours, along with the petrous meningioma, demonstrated significant growth. In 2018, clinical decline was evident and MRI demonstrated further tumour growth. Surgery was scheduled and the olfactory groove meningioma was completely resected (WHO grade 2, chordoid subtype). Hormones were stopped, after which regression of the petrous meningioma was observed. This case demonstrates an association between high-dose CPA and estradiol and the development, growth and regression of meningiomas in a transgender woman.

scholarly journals Endoscopic management of periventricular and intraventricular arachnoid cysts

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Ahmed Abdel Aziz Fayed ◽  
Tamer Ibrahim ◽  
Tarek Rayan
Keyword(s):  
Posterior Fossa ◽  
Single Case ◽  
Arachnoid Cysts ◽  
Endoscopic Management ◽  
Increased Intracranial Pressure ◽  
Surgical Time ◽  
Suprasellar Region ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri

Abstract Introduction The most successful surgical management of periventricular and intraventricular cysts is still a matter of debate. Up to the early 1990s, open cyst fenestration and cystoperitoneal shunts were the only options available. Recently, different endoscopic approaches to these lesions have gained popularity. Methods Eighteen endoscopic procedures were performed for the treatment of arachnoid cysts in 18 patients. Sylvian fissure arachnoid cysts were excluded from this study. Ten of them were females and eight were males with their ages ranging from 6 months to 50 years with a mean of 16 years. All patients were prospectively observed. Results Seven of the arachnoid cysts were in the suprasellar region, 5 in the quadrigeminal region, 2 in the posterior fossa, 2 parietal, and 2 intraventricular. Seventeen cases (94%) had hydrocephalus. The main presenting manifestations were those of increased intracranial pressure. All fenestrations were done in the lateral ventricle except for the 2 cases with posterior fossa arachnoid cysts, the fenestrations were done to the fourth ventricle. Endoscopic ventriculocytostomies (VC) were performed in 14 cases without operative complications and no stents were placed. Endoscopic cystocisternostomies (C) were done in all suprasellar cases. Endoscopic cystoventriculostomies (CV) were done in 4 cases. The mean surgical time was 1 h. The mean follow-up period was 15 months. Symptoms improved in 17 cases. Seventeen cases demonstrated a significant decrease of the cysts’ size in the postoperative computed tomography (CT) and magnetic resonance imaging (MRI). A single case developed a complication in the form of subdural hygroma which required no intervention and was managed conservatively. Conclusion Endoscopic management of periventricular and intraventricular arachnoid cysts is a useful safe option in the management of arachnoid cysts related to the ventricular system.

scholarly journals The novel dynamic MPFL-reconstruction technique: cheaper and better?

2021 ◽  
Author(s):  
Hauke Horstmann ◽  
Roman Karkosch ◽  
Annika Berg ◽  
Christoph Becher ◽  
Maximilian Petri ◽  
...  
Keyword(s):  
Hospital Setting ◽  
University Hospital ◽  
Mpfl Reconstruction ◽  
Reconstruction Technique ◽  
Complication Rates ◽  
Pain Level ◽  
Registration Number ◽  
Male Patients ◽  
Patellar Stability

Abstract Purpose Reconstruction of the medial patellofemoral ligament (MPFL) is an established procedure to restore patellar stability. Aim of this study is to evaluate the results of a dynamic MPFL reconstruction technique in a large university hospital setting. Methods Two hundred and thirteen consecutive patients with 221 knees were surgically treated for recurrent lateral patellar dislocation. All patients obtained dynamic reconstruction of the MPFL with detachment of the gracilis tendon at the pes anserinus while maintaining the proximal origin at the gracilis muscle. Patellar fixation was performed by oblique transpatellar tunnel transfer. Follow-up data including Kujala and BANFF score, pain level as well as recurrent patella instability were collected at a minimum follow-up of 2 years. Results Follow-up could be obtained from 158 patients (71%). The mean follow-up time was 5.4 years. Mean pain level was 1.9 ± 2.0 on the VAS. Mean Kujala score was 78.4 ± 15.5. Mean BANFF score was 62.4 ± 22.3. MPFL-reconstructions that were performed by surgeons with a routine of more than ten procedures had a significantly shorter surgical time 52.3 ± 17.6 min. Male patients yielded higher satisfaction rates and better clinical scores compared to females. Complications occurred in 27.2% of procedures, 20.9% requiring revision surgery of which were 9.5% related to recurrent patellar instability. 78% of all patients indicated they would undergo the procedure again. Conclusion Dynamic MPFL reconstruction presents a reproducible procedure with increased complication rates, inferior to the results of static reconstruction described in the literature. Despite, it appears to be an efficient procedure to restore patellar stability in a large university hospital setting, without the necessity for intraoperative fluoroscopy. Trial registration The study was registered in ClinicalTrials.gov with the registration number NCT04438109 on June 18th 2020.

Preferences and Utilities for Health States after Treatment of Olfactory Groove Meningioma: Endoscopic vs Open

2016 ◽  
Vol 77 (S 01) ◽  
Author(s):  
Christopher Yao ◽  
Alyssa Kahane ◽  
David Goldstein ◽  
Gelareh Zadeh ◽  
John De Almeida
Keyword(s):  
Health States ◽  
Olfactory Groove ◽  
Olfactory Groove Meningioma
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