Zentralblatt für Neurochirurgie
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Zentralbl. Neurochir. · Feb 2007
Neurosurgical management of previously coiled recurrent intracranial aneurysms.
Endovascular treatment of cerebral aneurysms with detachable coils has proven to be a save and effective treatment. But long-term recurrence due to aneurysm regrowth or coil compaction has been reported in up to thirty percent of cases. Therefore a growing number of previously coiled aneurysms have to be retreated by coiling or, in some circumstances, by clipping. We present a consecutive series of ten patients who underwent surgical clipping for recurrent aneurysms after primary coil embolization. ⋯ Clipping of previously coiled aneurysms is a unique problem for vascular neurosurgeons. In most cases clipping is feasible. Clipping should still be considered as a definite treatment option in previously coiled recurrent aneurysms. Results in this small series were good.
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Zentralbl. Neurochir. · Feb 2007
11C-Methionine positron emission tomography for preoperative evaluation of suggestive low-grade gliomas.
The treatment regimen for cerebral gliomas is different, depending on the histological grade of the lesion. The therapeutic strategy for anaplastic gliomas and glioblastomas is more aggressive, including microsurgical removal, radiation and chemotherapy. The management for low-grade gliomas is still under discussion, operation or "wait and see" tactics are possible options. Therefore the diagnostic imaging procedures are crucial for further treatment planning. Although most of the low-grade gliomas appear as hypointense lesions without contrast medium (CM) enhancement on magnetic resonance images, in some cases lesions without CM enhancement can be anaplastic tumours as well. 11C-Methionine positron emission tomography (MET-PET) was performed for preoperative evaluation of non or low CM enhancing intracerebral lesions, so-called suggestive low-grade gliomas. ⋯ According to the results of this study, we find MET-PET to be a helpful tool for pretreatment evaluation of non-CM enhancing, suggestive low-grade intracerebral lesions. MET-PET adds valuable information for the decision-making for surgery or stereotactic biopsy.