World Neurosurg
-
Resection of the T1 contrast-enhancing portion of glioblastoma multiforme (GBM) has been shown to increase patient survival, although whether GBM resection beyond these boundaries has an additional survival benefit is not clear. In this study, we examined the effect of resecting the enhancement and a margin of brain tissue surrounding the enhancement in patients with GBM of the temporal lobe. ⋯ Achieving SMR substantially improved survival in patients with temporal lobe GBM compared with GTR of the enhancement alone.
-
We describe the technique for surgical "transaneurysmal" embolectomy in a patient with subarachnoid hemorrhage and multiple cerebral aneurysms who manifested large-vessel occlusion during coil embolization. ⋯ Transaneurysmal thrombectomy may be useful and safe for large-vessel occlusion just distal to cerebral aneurysms.
-
Spinal epidural lymphoma with compressive myelopathy is a rarely found condition. The aims of this study are to describe the clinical features and to analyze its treatment outcome and prognostic factors. ⋯ Spinal epidural lymphoma with compressive myelopathy is a serious disease in children necessitating urgent treatment. Preserved motor power is a meaningful prognostic factor of neurologic improvement. Treatment should be individualized based on the patient's neurologic condition.
-
Limited information is available on the natural history and etiology of cystic formation after stereotactic radiosurgery (SRS) for brain metastases (BM). We aimed to characterize the natural history of cyst formation after SRS of BM and analyze potential risk factors. ⋯ In our experience with 1106 SRS-treated cases of BM, cyst formation was a rare phenomenon. However, 1 in 3 patients who underwent >4 rounds of SRS sustained cyst formation. A high proportion (78%) of SRS-associated cysts progressively expanded and required medical or surgical treatment.
-
Transient focal magnetic resonance imaging (MRI) abnormalities after status epilepticus (SE) are rarely seen in patients with benign brain tumors, and the underlying mechanism is still unknown. We report a rare case of cerebral cavernous malformation with transient focal MRI abnormalities around the tumor and accumulation of 11C-methionine on positron emission tomography (PET) after SE. These findings mimicked those of a glioma because the MRI and methionine PET findings were similar. We also speculate about the cause of this phenomenon in relation to pathologic findings of this case. ⋯ This case suggests that transient focal MRI abnormalities after SE may indicate reversible cortical brain edema. Accumulation of 11C-methionine on PET could occur in the corresponding lesion even if no malignant tumor is present. Because distinguishing transient MRI abnormalities after SE from a glioma is difficult, repeated imaging studies should be performed in patients with brain tumor-related seizures.