World Neurosurg
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Case Reports
Collision of craniopharyngioma and pituitary adenoma: comprehensive review of an extremely rare sellar condition.
The collision of pituitary adenoma and craniopharyngioma is extremely rare and thus there remains a paucity of data. ⋯ Most craniopharyngiomas were adamantinomatous. There are 2 types of collisions: separated and admixed. Tumor control, overall survival, and endocrinologic remission are more challenging to achieve than for solitary tumors, but gross total resection of both tumors is important for satisfactory tumor control.
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Glioblastoma multiforme (GBM) is the most common primary malignant brain tumor in adults, with an increased incidence among the elderly. However, the optimal treatment strategy in elderly patients remains unclear. This study seeks to investigate the effect of patient selection and treatment strategies on survival trends in these patients. ⋯ In an analysis of 104,456 patients with GBM, all treatment modalities were found to be used less frequently in elderly patients. Increasing age and poor performance status were associated with worsened survival. Gross total resection was associated with the greatest survival benefit, and chemotherapy and radiotherapy also improved survival outcomes. These treatment options improved outcomes regardless of performance status. Although maximal treatment strategies may improve survival in elderly patients with GBM, these treatment strategies must be balanced against patient-specific factors and quality-of-life concerns.
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Case Reports
Limited Intradural Anterior Petrosectomy for Upper Basilar Aneurysms: A Technical Note.
The extradural anterior petrosectomy is a widely used skull base approach to the upper petroclival region, basilar trunk, and ventral pons. However, there is significant procedure-related morbidity and a complete petrosectomy is required, as the intradural structures are not in view at the time of drilling. We describe an intradural anterior petrosectomy for aneurysms of the basilar trunk and anterior inferior cerebellar artery with intraoperative photographs and artwork to illustrate the approach. ⋯ The intradural anterior petrosectomy allows limited drilling of the petrous apex and provides sufficient exposure of upper basilar artery aneurysms.
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The pedicled nasoseptal flap (NSF) is the mainstay for endoscopic skull base reconstruction. We present a novel technique using a semirigid chondromucosal NSF that improves the reinforcement and protection of intracranial structures. ⋯ The composite chondromucosal NSF is a reliable reconstruction option for select ventral cranial base reconstruction cases with the potential to improve the protection of intracranial structures. Additional surgical cases and longer follow-up are required for a better assessment of long-term outcomes.
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We studied chemotherapy-related cognitive impairment via resting state (RS)-functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) in 19 cases of patients with early breast cancer. White matter neuropsychological test treatment were carried out before and after chemotherapy, RS-fMRI, and DTI evaluation. In RS-fMRI with regional homogeneity (ReHo) reflects brain activity. ⋯ This prospective study on resting state and RS-fMRI functional magnetic resonance DTI study DTI sequence combination chemotherapy for breast cancer-related cognitive disorders supports the "chemo brain" point of view. Chemotherapy can cause memory decline, accompanied by a partial area of the brain and white matter integrity in brain activity changes. Prompt clinical treatment RS-fMRI and DTI have potential applications in assessing chemotherapy-related cognitive impairment.