Zentralblatt für Neurochirurgie
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Zentralbl. Neurochir. · Feb 2005
Case ReportsMetastatic meningioma WHO grade II of the cervical spine: case report and review of the literature.
The authors report a rare case of metastatic atypical meningioma WHO grade II involving the dorso-lateral region of the cervical spine and causing spinal cord compression in a 76-year-old man. The patient was treated surgically in June 1998 for an atypical parasagittal meningioma in the right frontal lobe. Local recurrence with extension to the left hemisphere required surgical treatment in January 2000, and in December 2000 recurrence caused paraplegia of the lower extremities and paresis of the left arm. ⋯ Surgical subtotal removal of the tumor via hemilaminectomy of the 3 (rd) and 4 (th) cervical vertebrae was performed. After decompression of the cervical spine the paresis of the right arm improved, the paraplegia of the legs and the left arm, existing since December 2000, remained unchanged. Histological findings of the cranial lesions and the metastatic lesion had a similar appearance and were compatible with atypical meningioma (WHO grade II).
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Zentralbl. Neurochir. · Feb 2005
Clinical TrialTechnique and image quality of intraoperative indocyanine green angiography during aneurysm surgery using surgical microscope integrated near-infrared video technology.
To describe the technical integration of indocyanine green (ICG) near-infrared technology into the optical path of the surgical microscope and to report on the image quality achieved by this method. We hypothesized that ICG angiography permits a simple and quick intraoperative assessment of vessel patency and aneurysm occlusion after clip placement. ⋯ ICG angiography using a surgical microscope is valuable for the intraoperative imaging of arterial and venous flow in all visible vessels including small perforating arteries. The simplicity of the method and the speed with which the investigation can be performed indicate that this technique may help to improve the quality and outcome of surgical procedures and reduce the need for intra- or postoperative angiography in selected cases.
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Zentralbl. Neurochir. · Feb 2005
Volumetric analysis of the growth rate of incompletely resected intracranial meningiomas.
Intracranial meningiomas are mostly considered to be slow growing tumors. However, only a few previous reports provide information on the growth rate of these tumors. The aim of this study was to determine the growth rates of intracranial meningiomas after subtotal resection, analysing their relation to radiological appearance and histological features. Results are compared with our previous analysis of growth rates in incidental meningiomas . ⋯ The majority of intracranial meningiomas are slow growing tumors, although the growth rates may vary widely even among benign grade 1 meningiomas. In meningiomas after subtotal surgical resection, the age of the patients seems to present a predictive factor for tumor growth in analogy to our previous observation in incidental meningiomas. Significantly higher relative growth rates were detected in younger patients. Gender does not seem to play a major role as a predictive factor. Radiological features such as calcification or T (2)-signal intensity may provide additional information to predict the growth potential of meningiomas. Close clinical and radiological observation should be performed in young patients harboring tumors with absence of calcification or high T (2)-signal intensities due to the higher growth potential in this patient group.