Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Dec 2011
Case ReportsBilateral sphenoorbital hyperostotic meningiomas with proptosis and visual impairment: a therapeutic challenge. Report of three patients and review of the literature.
Bilateral hyperostotic sphenoorbital meningiomas are extremely uncommon. Due to extensive infiltration of the orbits and the frontotemporal skull base, often only a subtotal tumor resection is feasible. Thus far, no treatment algorithms have been suggested for this rare tumor entity. We report on the surgical management of 3 patients. ⋯ In bilateral hyperostotic sphenoorbital meningiomas we propose staged surgery when clinical and radiological progression is observed. Subtotal tumor resection with the aim of optic nerve decompression and subsequent orbital reconstruction provides satisfactory results. The most affected eye should be treated first. In case of additional cavernous sinus infiltration, focal radiation therapy can be considered.
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Clin Neurol Neurosurg · Dec 2011
Temporal lobe pleomorphic xanthoastrocytoma and chronic epilepsy: long-term surgical outcomes.
To review clinical features and surgical outcome in patients with temporal lobe pleomorphic xanthoastrocytomas (PXAs) and intractable epilepsy. ⋯ Temporal lobe pleomorphic xanthoastrocytomas causing chronic intractable epilepsy occur in younger patients, and demonstrate excellent long-term results in seizure improvement and tumor control with surgery. We support the choice between simple lesionectomy and a tailored resection with amygdalohippocampectomy guided by preoperative findings, intraoperative electrocorticography, and the severity and chronicity of the patient's epilepsy.
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Clin Neurol Neurosurg · Dec 2011
A practical approach to the lateral cutaneous nerve of the thigh: an anatomical study.
To study the main anatomical landmarks related to the lateral cutaneous nerve of the thigh (LCN) in the infrainguinal region and to define reliable criteria for identifying the nerve during the surgery and electrophysiological study. ⋯ Despite the symmetry found between the right and left sides, the values of the main anatomic parameters involved in the localization of the LCN presented a great degree of variability. Even so, dissection using the proposed anatomical triangle allows for the localization of the LCN in almost all cases.