World Neurosurg
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Case Reports
Gliosarcoma in Cerebellopontine Angle with Rapid Tumor Growth and Intratumoral Hemorrhage: Case Report.
Gliosarcoma is a relatively rare and bimorphous brain tumor, predominantly located in the brain lobe. Here, we report a rare case of gliosarcoma presenting radiologically in the cerebellopontine angle (CPA) region. ⋯ Although rare, gliosarcoma should be considered in the differential diagnosis of CPA tumors, especially if it is associated with rapid tumor growth or intratumoral hemorrhage.
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To assess if modern management of extracranial malignant diseases has prolonged the survival times for patients with more than 2 brain metastases (BM). ⋯ Both the median and 10% survival times have increased in recent years among patients with more than 2 BM treated with GKS. Both linear and exponential regressions accurately expressed the increase in both median and 10% survival times during the years 1990-2010. Findings from other published data support the observation of longer survival times among patients treated more recently, independent of the patients being treated with GKS or with whole-brain radiation therapy with or without radiosurgery. Thus, earlier findings of short survival times for patients with multiple BM are no longer valid, at least not for patients deemed suitable for radiosurgery. Aggressive management is thus warranted for these patients.
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The objective of the current study was to compare the clinical features and outcomes between younger and older patients with skull base chordoma (SBC). ⋯ In younger patients, there were more SBCs located in the occipitocervical regions, and younger patients tended to undergo more aggressive resection. The tumor signal intensity of younger patients with SBC was higher in T2 images but lower in enhanced T1 images. A younger age was a favorable factor for a longer progression-free survival and a good neurologic status at follow-up.
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The anterior inferior cerebellar artery-posterior inferior cerebellar artery (AICA-PICA) common trunk anomaly is reportedly one of the most common vessel variants in the posterior circulation, but reports of hemifacial spasm (HFS) associated with AICA-PICA common trunk are very rare. In the present study, we describe methods of microvascular decompression (MVD) for HFS caused by AICA-PICA common trunk compression. ⋯ Reports concerning decompression methods of AICA-PICA common trunk anomaly are very rare. The tortuosity of the common trunk and perforators from the offending vessel make the usual repositioning of the offending artery much more difficult, and adequate decompression techniques are required for successful MVD.
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Somatosensory evoked potential (SSEP) monitoring is performed to examine postoperative clinical findings when a monitoring event was noted intraoperatively and to ascertain the alarm threshold for intraoperative neural damage. ⋯ Compared with the traditional SSEP baseline before skin incision, the baseline acquired after spine exposure results in more accurate monitoring. A >60% decrease in SSEP amplitude could be a more suitable alarm threshold.