Neurosurg Focus
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The optimal treatment of craniopharyngioma in children remains a challenge. The use of complete excision to minimize recurrence continues to be controversial because of the risk of postoperative morbidity and death. Advances in skull base approaches, modern microsurgical techniques, neuroimaging, and hormone replacement therapy, however, have allowed safe gross- or near-total resection in the majority of cases. ⋯ In this review, the authors focus on commonly used skull base approaches for the surgical management of craniopharyngioma. They discuss the relative indications, advantages, disadvantages, and complications associated with each approach. Illustrative cases and intraoperative videos are presented.
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Comparative Study Clinical Trial
Endoscopic management of pediatric brain tumors.
Primary endoscopic procedures for children with intraventricular brain tumors include endoscopic tumor biopsy and endoscopic tumor removal. The simultaneous treatment of hydrocephalus with endoscopic third ventriculostomy (ETV) or endoscopic septostomy increases the appeal of a minimally invasive endoscopic approach. ⋯ Endoscopic surgery in children with intraventricular brain tumors is an effective and safe method for sampling of the lesion and, in select cases, its resection. This minimally invasive technique should be considered in situations in which the patient might thereby avoid a more conventional procedure, given the high rate of success and low morbidity associated with endoscopic management.
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Review Historical Article
Prizes, lectures, and awards of the American Association of Neurological Surgeons/Congress of Neurological Surgeons Section on Tumors.
An important goal of the Section on Tumors of the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) since its founding in 1985 has been to foster both education and research in the field of brain tumor treatment. As one means of achieving this, the Section awards a number of prizes, research grants, and named lectures at the annual meetings of the AANS and CNS. After a brief examination of similar honors that were given in recognition of pioneering work by Knapp, Cushing, and other early brain tumor researchers, the authors describe the various awards given by the AANS/CNS Section on Tumors since its founding, their philanthropic donors, and the recipients of the awards. The subsequent career of the recipients is briefly examined, in terms of the rate of full publication of award-winning abstracts and achievement of grant funding by awardees.
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Review Historical Article
The transsphenoidal approach. A historical perspective.
Over the last century, the transsphenoidal approach has evolved into the first-line method of treatment for sellar as well as select groups of parasellar and suprasellar lesions. The journey to its current popularity has been marked by controversy and near abandonment in the late 1920s, followed by its renaissance in the late 1960s. ⋯ The transsphenoidal procedures now performed stem from an array of modifications and refinements accumulated through nearly 100 years of medical and surgical evolution. This era's critical innovations and neurosurgical personalities are the topic of this historical overview.
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Review Biography Historical Article
Early evolution of neurological surgery: conquering increased intracranial pressure, infection, and blood loss.
At the end of the 19th century, the early evolution of the specialty of neurological surgery was restricted by complications related to infection, increased intracranial pressure, and excessive intraoperative blood loss. These complications often caused mortality rates of 30 to 50%. ⋯ Cushing's later development of the "silver clip" and incorporation of electrosurgical techniques facilitated safe resection of brain tumors previously assumed to be inoperable. These pivotal accomplishments paved the way for the establishment of our specialty.