World Neurosurg
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Patient safety aspects and the residents' role in spine surgery within a structured training program have recently been investigated. The current work deals with residency training safety aspects for cranioplasty (CP), a standard neurosurgical cranial procedure. ⋯ A relatively simple cranial procedure, such as CP, can be safely performed by a supervised neurosurgery resident without increasing complications or compromising patients' outcomes.
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Meningiomas can present during pregnancy as the result of hormonal as well as fluid changes. Foramen magnum meningiomas are particularly rare. We present the first reported case successfully treated during pregnancy. ⋯ Large skull base tumors symptomatic in pregnancy can be safely treated with careful planning and close monitoring.
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Meningiomas are the most common type of benign brain tumor, and the incidence of meningioma in women is more than twofold higher than in men. Several studies have demonstrated that hormones are somehow related to the growth of meningiomas. ⋯ This is the first report of a case in which an LHRH agonist promoted the growth of a pre-existing meningioma. We suggest that patients with a history of meningioma who are receiving LHRH agonist treatment should be closely monitored.
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We report a contemporary consecutive series of 80 patients operated on for benign pituitary macroadenomas, followed endocrinologically for at least 3 months postoperatively. These patients were systematically evaluated preoperatively by high-resolution magnetic resonance imaging designed to detect the position of normal gland relative to the lesion. The rate of preservation of normal pituitary was critically analyzed using this strategy combined with endoscopic transsphenoidal resection. ⋯ The preservation and restoration of hormonal function are essential to assessing the outcome of surgery and to the patient's quality of life. Careful analysis of the anatomy of the pituitary lesions and their effect on the anatomy and physiology of the pituitary gland are crucial to success and allow modern technological advances to provide fewer complications of therapy and improved outcomes for our patients. The benchmarks provided in this article are a stimulus for even better results in the future as we take advantage of technical and conceptual advances and the benefits of multidisciplinary collaboration.
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Retroperitoneal dumbbell lumbar spinal schwannomas (RDLSSs) classified as the Eden type 4 are composed of small intervertebral foramen components and large paravertebral components extending into the retroperitoneal cavity. The surgical management of RDLSSs s remains a great challenge for all neurosurgeons because of the features of tumor. ⋯ The operative plan should be tailored to the features of the RDLSS. Retroperitoneal laparoscopy surgery by the anterior approach can produce safe and effective resection of RDLSSs with minimal postoperative complications. This procedure may be preferred for RDLSSs mainly located in the retroperitoneum without spinal canal extension.