World Neurosurg
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Central nervous system (CNS) tumors are the most common cause of cancer-related death in children. Little is known about the demographics and treatment of pediatric brain tumors in low- and middle-income countries (LMICs). ⋯ We present the first operative series of childhood CNS tumors in Nepal. Children often had delayed diagnosis and treatment of a tumor, despite symptoms. More comprehensive data are required to develop improved treatment and management algorithms in the context of a given country's demographics and medical capabilities for childhood CNS tumors.
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Multicenter Study
Clinical, Pathological, and Surgical Outcomes for Adult Pineoblastomas.
Pineoblastomas are uncommon primitive neuroectodermal tumors that occur mostly in children; they are exceedingly rare in adults. Few published reports have compared the various aspects of these tumors between adults and children. ⋯ Although this series is small, the data suggest that pineoblastomas in adults have a less aggressive clinical course than in children.
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Case Reports Comparative Study
Endoscopic endonasal transclival resection of a brain stem cavernoma: a detailed account of our technique in comparison with the literature.
To report a technique of endoscopic transclival resection of a hemorrhagic brainstem cavernous malformation manifesting in the ventral pons. ⋯ Successful endoscopic, endonasal, transclival resection of a brainstem cavernous malformation was described. This patient experienced improvement in neurologic symptoms after surgery without morbidity. Technologic advances in endoscopic skull base approaches provide access to lesions of the brainstem that previously required more invasive approaches. The endonasal transclival approach provides the most direct route to ventral pontine lesions. Early intervention in brainstem cavernous malformation is indicated and should be performed with an individualized approach taking into consideration the possible complications.
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Surgery is a well-established and safe treatment option for focal drug resistant epilepsy. However, difficulties are often encountered in diagnosing mesial cortical lesions. The aim of this study was to evaluate the usefulness and overall complication rate of subdural interhemispheric electrodes (IHEs) as part of an invasive presurgical evaluation of epilepsy patients. ⋯ Implantation of IHE for the preoperative evaluation of epilepsy patients is an established surgical procedure with an acceptable complication profile. The benefits delivered from IHE can positively influence final seizure outcome in the challenging group of extratemporal resections due to interhemispheric lesions. Thus IHEs demonstrate a useful diagnostic utility for the presurgical evaluation of selected epilepsy patients.
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We describe a rare case of a rapidly recurring benign meningial-based perineurioma. Clinical, radiologic, and pathologic features of a rapidly recurring falxial perineurioma are described; the perineurioma was discovered incidentally in an 86-year-old woman. ⋯ The pathologic examination confirmed the diagnosis of a perineurioma (World Health Organization grade I). Follow-up magnetic resonance tomography 5 months later due to neurologic deterioration revealed an abnormally rapidly growing and extensive local tumor recurrence. Due to the mass effect, reoperation was performed and adjuvant radiation of 20 Gy to the tumor bed was implemented thereafter. Meningeal-based perineuriomas of the central nervous system are extremely rare, and literature on proper management is scarce. Although histologic classification reveals a benign lesion, follow-up may be considered for this type of tumor.