World Neurosurg
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The incidence of brain metastases from melanoma is increasing. Several effective treatment options are now available but what can be considered the optimal therapeutic strategy is not yet defined. We evaluated the outcome of patients with brain metastatic melanoma in terms of local control rate, brain distant progression, and overall survival. ⋯ Our data identifier a subset of patients with a more favorable outcome who could take advantage of a more aggressive local approach followed by targeted therapy.
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Case Reports
Was Cavum Septum Pellucidum the cause of intractable seizure in this 17 years old boy with Wilson's disease?
Cavum septum pellucidum (CSP), which is often found incidentally in a few populations, occasionally becomes symptomatic if enlarged significantly. Wilson disease (WD) is an uncommon autosomal recessive inborn defect in copper metabolism characterized by abnormal accumulation of copper in various tissues, particularly in the liver and the brain. Seizure disorder, although rare both in CSP and WD, may happen in a few patients with either of the conditions. ⋯ Symptomatic CSP is a rare disorder, but the coexistence of WD is even rarer. Endoscopic cyst fenestration is a novel procedure that can be successful in properly selected cases. To the best of our knowledge, CSP associated with WD has not been reported in any English literature. We present this case for its rarity along with a relevant literature review.
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To explore quantitatively and qualitatively how the number of gradient directions (NGD) and spatial resolution (SR) affect diffusion tensor imaging (DTI) tractography in patients planned for brain tumor surgery, using routine clinical magnetic resonance imaging protocols. ⋯ This study indicates that, under time constraints of clinical imaging, a higher number of diffusion gradients is more important than spatial resolution for superior DTI probabilistic tractography in patients undergoing brain tumor surgery.
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Surgical treatment of spinal tumors regularly includes spinal instrumentation with pedicle screws. Most modern pedicle screws are made of titanium alloy, which is associated with artifacts on postoperative imaging such as computed tomography and/or magnetic resonance imaging. These artifacts hamper radiation treatment planning and execution and follow-up imaging. Recently, carbon fiber-reinforced polyetheretherketone (CFRP) implants became available for posterior instrumentation with the aim to reduce imaging artifacts by implants. ⋯ Carbon fiber-reinforced PEEK pedicle screws reduce image artifacts on computed tomography and magnetic resonance imaging. Thereby, they are a valuable and feasible option for spinal instrumentations in patients harboring spinal tumors where postoperative imaging and radiation therapy planning are necessary and might be crucial for long-term outcome and overall survival.
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The movements of a neurocysticercosis cyst within the ventricular cavity have been identified rarely. ⋯ Such an intraventricular migration of any kind of tumor has not been recorded in the literature.