World Neurosurg
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Review Meta Analysis
Epidemiology of Idiopathic Normal Pressure Hydrocephalus: A Systematic Review of the Literature.
Idiopathic normal pressure hydrocephalus (iNPH) is an important cause of gait disturbance and cognitive impairment in elderly adults. However, the epidemiology of iNPH is relatively unknown, largely as a result of the paucity of specifically designed population studies. This systematic review aims to assess the prevalence and incidence of iNPH. ⋯ iNPH appears to be extremely underdiagnosed. Properly designed and adequately powered population-based studies are required to characterize the epidemiology of this disease accurately.
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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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Awake craniotomy (AC) in brain lesions has allowed an improvement of both oncologic and functional results. However, intraoperative seizures (IOSs) were reported as a cause of failure of AC. Here, we analyze the incidence, risk factors, and consequences of IOSs in a prospective cohort of 374 ACs without electrocorticography (ECoG). ⋯ AC for intra-axial brain lesion can be safely and reproducibly achieved without ECoG, with a low rate of IOS and excellent functional results, even in patients with preoperative intractable epilepsy.
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Case Reports
Recurrent Natural Killer (NK)-cell lymphoma with Central Nervous System metastasis mimicking cerebellar infarction.
Natural killer cell lymphoma is an uncommon hematologic malignancy, and central nervous system metastasis is rare. The classic magnetic resonance imaging appearance of lymphoma in the brain is T1 hypointense with strong homogeneous gadolinium enhancement, variable T2 signal, and restricted diffusion on diffusion-weighted images. Gadolinium enhancement is an important feature to differentiate lymphoma from infarction. ⋯ Lymphoma can mimic cerebral infarction on computed tomography and magnetic resonance imaging. An imaging appearance of cerebral infarction in a patient with a history of lymphoma should raise suspicions of lymphoma metastasis.
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Endoscopic ventriculostomy is an attractive surgical alternative to ventriculoperitoneal shunt in the treatment of focal hydrocephalus, including trapped temporal horn (TTH). The major concern of this surgical approach is closure of a stoma, the risk of which may be minimized by placement of a stent after ventriculostomy. ⋯ The risk of recurrence of TTH after endoscopic ventriculocisternostomy may be minimized by combining ventriculostomy with stent placement. This surgical procedure would be beneficial, particularly in cases of TTH associated with malignant brain tumors, where the risk of delay or interruption of adjuvant oncologic treatments may negatively impact patient prognosis.