Acta neurochirurgica
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Acta neurochirurgica · Jan 2010
Determinants of postoperative visual recovery in suprasellar meningiomas.
Suprasellar meningiomas usually present with visual deterioration, including decreased visual acuity and/or visual field defects. Suprasellar meningiomas have a close relationship with the optic apparatus, arteries of the anterior circulation, pituitary stalk and hypothalamus, which makes safe surgical resection a challenge especially with dissection around an already compromised optic apparatus. In this report 21 patients operated on for a suprasellar meningioma over a 4-year period are reviewed. Postoperative outcome and visual recovery are evaluated, including analysis of its determinants. ⋯ The extent and duration of visual symptoms, size of the tumor and vascular adherence were prognostic factors affecting visual recovery after microsurgical resection of suprasellar meningiomas.
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Acta neurochirurgica · Jan 2010
Case ReportsImage-guided cranial osteoma resection and bioceramic porous hydroxyapatite custom-made reconstruction in a one-step surgical procedure. Technical notes and illustrative case.
Removal of a large cranial tumour and reconstruction of the consequent bone defect in the same surgical setting is an ordinary procedure. A custom-made hydroxyapatite ceramic reconstruction of a cranial bone defect is a modern option that currently needs a preoperative stage of studying the bone defect and designing the implant. Consequently, if a reconstructive hydroxyapatite-based procedure after a cranial tumour resection is the aim, a two-stage surgery is necessary. The authors investigated the possibility of performing this procedure in a one-step surgery by the use of a neuronavigation system. ⋯ Surgical removal of a cranial bone tumour and optimal reconstruction with a custom-made hydroxyapatite ceramic implant is an appealing procedure that can be carried out in a one-step surgery by means of an intraoperative image-guidance system.