Clinical neurology and neurosurgery
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The primary treatment of meningiomas is surgery which can be curative if the tumor is completely removed. For parasagittal, lateral sphenoid wing and olfactory groove meningiomas, gross-total resection should be the goal. Tuberculum and diaphragma sella meningiomas can be resected through the subfrontal or the pterional approaches. ⋯ Stereotactic radiosurgery can be used as an alternative treatment to surgery either as a first-line treatment or at recurrence. Various conventional radiotherapy techniques can be employed for residual tumor post surgery or at recurrence. Chemotherapy has modest activity and is reserved for selected cases.
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Clin Neurol Neurosurg · Apr 2010
Comparative StudyLow field intraoperative MRI-guided surgery of gliomas: a single center experience.
The aim of this article is to report on our experience in using a low field intraoperative MRI (iMRI) system in glioma surgery and to summarize the hitherto use and benefits of iMRI in glioma surgery. ⋯ Low field iMRI is a helpful tool in modern neurosurgery and facilitates brain tumor resection to a maximum safe extent. Its use translates into a better prognosis for these patients with devastating tumors. Future studies covering the use of iMRI will need to be conducted in a prospective, randomized fashion to prove the true benefit of iMRI in glioma surgery.
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Clin Neurol Neurosurg · Apr 2010
Comparative StudyShort-course whole-brain radiotherapy (WBRT) for brain metastases due to small-cell lung cancer (SCLC).
Many patients with brain metastases due to SCLC have a poor survival prognosis. The most common treatment is whole-brain radiotherapy (WBRT). This retrospective study compares short-course WBRT with 5x4Gy in 1 week to standard WBRT with 10x3Gy in 2 weeks. ⋯ In patients with brain metastases due to SCLC, short-course WBRT with 5x4Gy provided similar outcomes as 10x3Gy and appears preferable, particularly for patients with poor estimated survival.
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Clin Neurol Neurosurg · Apr 2010
Differential diagnosis of intracranial ring enhancing cystic mass lesions--role of diffusion-weighted imaging (DWI) and diffusion-tensor imaging (DTI).
To evaluate the contribution of DWI and DTI to the differential diagnosis of cerebral ring enhancing lesions by describing DWI and ADC (apparent diffusion coefficient) findings and measuring the two DTI parameters mean diffusivity (MD) and fractional anisotropy (FA). ⋯ The findings of reduced diffusion compared to NAWM and increased FA within a ring enhancing cyst strongly indicate a cerebral abscess. In contrast, the majority of neoplastic cysts revealed high diffusion and low FA. Reduced diffusion is also found in a very small number of tumour cysts, but in these low FA refers to a non-infectious origin and thus helps distinguishing from infectious abscess.