Pituitary adenoma consistency affects postoperative hormone function: a retrospective study.

Background: Tumor consistency recently emerged as a key factor in surgical planning for pituitary adenomas, but its impact on postoperative endocrine function is still unclear. Our study aimed to evaluate the impact of tumor consistency on the development of postoperative pituitary deficiencies.

Methods: Single-center, retrospective analysis of consecutive pituitary surgeries performed between January 2017 and January 2021 at Policlinico Umberto I in Rome.

Ruptured Brain Arteriovenous Malformations: Surgical Timing and Outcomes-A Retrospective Study of 25 Cases.

 One important problem in treatment of ruptured brain arteriovenous malformations (bAVMs) is surgical timing. The aim of the study was to understand which parameters affect surgical timing and outcomes the most.  Between January 2010 and December 2018, 25 patients underwent surgery for a ruptured bAVM at our institute.

Fractures and dislocations of the lisfranc tarso-metatarsal articulation: outcome related to timing and choice of treatment.

A Lisfranc injury is when one or more of the metatarsals are displaced from the tarsus. The term is more commonly used to describe an injury to the midfoot, centred on the 2nd tarso-metatarsal joint. These fractures are sometimes easily overlooked, especially if they are part of a polytrauma.

Proposal of Standardization of Closure Techniques After Endoscopic Pituitary and Skull Base Surgery Based on Postoperative Cerebrospinal Fluid Leak Risk Classification.

Postoperative cerebrospinal fluid (CSF) leak still represents the main limitation of endonasal endoscopic surgery. The aim of the study is to classify the risk of postoperative leak and to propose a decision-making protocol to be applied in the preoperative phase based on radiological data and on intraoperative findings to obtain the best closure.One hundred fifty-two patients were treated in our institution; these patients were divided into 2 groups because from January 2013 the closure technique was standardized adopting a preoperative decision-making protocol.

A Survey on Pituitary Surgery in Italy.

Background: Pituitary tumors are a heterogeneous group of lesions that are usually benign. Therefore, a proper understanding of the anatomy, physiology, and pathology is mandatory to achieve favorable outcomes. Accordingly, diagnostic tests and treatment guidelines should be determined and implemented.

Fibrous Pituitary Macroadenomas: Predictive Role of Preoperative Radiologic Investigations for Proper Surgical Planning in a Cohort of 66 Patients.

Objective: The endoscopic technique is in many cases the technique of choice for the removal of pituitary adenomas. Extended endoscopic approaches make it possible to remove lesions with suprasellar and parasellar extension and fibrous consistency. We identify some characteristics that might point to the adoption of an expanded approach in the preoperative phase.

Surgical management of acute subdural hematoma: a comparison between decompressive craniectomy and craniotomy on patients treated from 2010 to the present in a single center.

Background: Acute subdural hematoma represents an important cause of disability and mortality. Its surgical treatment takes advantage of two surgical procedures: craniotomy and decompressive craniectomy, nevertheless the effectiveness of one procedure rather than the other is still debated. This study was conducted to identify which of the surgical procedures could provide better neurological outcome after traumatic acute subdural hematoma; as a secondary endpoint, the study tries to settle preoperative prognostic factors useful to identify the most appropriate surgical technique for every specific patient and kind of trauma.

Giant Cell Ependymoma of Cervicomedullary Junction: A Case Report of a Long-Term Survivor and Literature Review.

Background: Ependymoma accounts for 3%-9% of all neuroepithelial tumors. Giant cell ependymoma (GCE) is a rare and distinct variant, with only 22 cases described in the literature. The 2007 World Health Organization classification first acknowledged this rare subtype.

Isolated Pediatric Intramedullary Schwannoma: Case Report and Review of Literature.

Background: Intramedullary (IM) schwannomas are rare entities representing 0.3%-1% of intramedullary tumors and 1.1% of spinal schwannomas.

Calcified Spinal Meningiomas.

Objective: To analyze outcomes of patients surgically treated for calcified spinal meningiomas and to determine factors associated with surgical morbidity.

Methods: Between January 2000 and June 2013, a total of 54 patients underwent surgical resection of a spinal meningioma: 37 of these cases showed various degrees of calcification, confirmed by histopathologic analysis. The clinical evaluation was performed according to the American Spinal Injury Association Impairment Scale.

True Petroclival Meningiomas: Proposal of Classification and Role of the Combined Supra-Infratentorial Presigmoid Retrolabyrinthine Approach.

Background: The evolution of the surgical treatment of petroclival meningiomas (PMs) has led to a tendency to abandon complex petrous approaches and return to "less-aggressive" skull base approaches.

Objective: To propose a classification of PMs and establish the role of the combined supra-infratentorial presigmoid retrolabyrinthine (CSIPR) approach in the treatment of PMs rigorously matching the anatomical definition.

Methods: A retrospective analysis was conducted of 51 cases of PMs strictly adhering to the anatomical definition who were operated on from January 1990 to December 2011.

Endoscopic endonasal control of the paraclival internal carotid artery by Fogarty balloon catheter inflation: an anatomical study.

OBJECTIVE Neurosurgical management of many vascular and neoplastic lesions necessitates control of the internal carotid artery (ICA). The aim of this study was to investigate the feasibility of achieving control of the ICA through the endoscopic endonasal approach by temporary occlusion with a Fogarty balloon catheter. METHODS Ten endoscopic endonasal paraseptal approaches were performed on cadaveric specimens.

Frontobasal Midline Meningiomas: Is It Right To Shed Doubt on the Transcranial Approaches? Updates and Review of the Literature.

Background: Traditionally, the surgical removal of tuberculum sellae meningioma (TSM) and olfactory groove meningioma (OGM) requires transcranial approaches and microsurgical techniques, but in the last decade endoscopic expanded endonasal approaches have been introduced: transcribriform for OGMs and transtuberculum-transplanum for TSM. A comparative analysis of the literature concerning the two types of surgical treatment of OGMs and TSM is, however, difficult.

Methods: We conducted a literature search using the PubMed database to compare data for endoscopic and microsurgical techniques in the literature.

Combination of pharmacotherapy and lidocaine analgesic block of the peripheral trigeminal branches for trigeminal neuralgia: a pilot study.

Classical trigeminal neuralgia (CTN) is treated predominantly by pharmacotherapy but side effects and unsuccessful occurs. The current study was carried out to evaluate the therapeutic effect of combination of pharmacotherapy and lidocaine block. Thirteen patients with CTN managed with pharmacotherapy were recruited and assigned either to no additional treatment (Group I) or to additional analgesic block (Group II).

Intradural Extramedullary Primary Ependymoma of the Craniocervical Junction Combined with C1 Partial Agenesis: Case Report and Review of the Literature.

Background: Intramedullary ependymomas represent 40%-60% of spinal cord tumors in adults and can be located along the entire spinal cord. Intradural extramedullary (IDEM) ependymomas are very rare with the exception of tumors located at the filum terminale or conus medullaris, with histologic features of myxopapillary ependymomas (World Health Organization grade I).

Case Description: We present the case of a 42-year-old woman with an IDEM ependymoma of the craniocervical junction who experienced neck pain for 5 months.

Two cystic cavernous angiomas after radiotherapy for atypical meningioma in adult woman : case report and literature review.

A correlation between radiation therapy and cavernoma has been suspected since 1994. Since then, only a few cases of radio-induced cavernomas have been reported in the literature (85 patients). Most of them were children, and the most frequent original tumour had been medulloblastoma.

Endoscopic endonasal approaches for cerebrospinal fluid leaks repair.

Objective: A variety of techniques have been described for the repair of cerebrospinal fluid (CSF) leaks at the anterior skull base. Conservative management includes bed rest, avoidance of straining activities, and temporary CSF diversion with serial lumbar punctures or lumbar drains. Surgical repair may be achieved transcranially through a bifrontal craniotomy, extracranially through an external ethmoidectomy or frontal sinusotomy, or transnasally with microscopic or endoscopic visualization.

Postoperative extradural hematomas.

Postoperative extradural hematoma (POEH) is a possible complication after head surgery, often neglected in the literature. In a single surgeon experience we found 13 cases of POEH (0.8%).

Fourth ventricle meningiomas: a rare entity.

Fourth ventricle meningiomas (FVMs) are rare, often misdiagnosed, lesions. To the best of our knowledge, 47 cases have been reported in the literature: we describe our series of three cases treated at our Institution, focusing on some diagnostic tips and intraoperative features of these tumours. Our three patients have a history of headache.

Laminotomy in adults: technique and results.

The objective of this study was to describe step by step our surgical technique of laminotomy and analyze our series with regard to spinal deformities (risk and predisposing factors), postoperative pain and rate of postoperative contusions. Data regarding patients who underwent our technique of laminotomy (N = 40, mean follow-up: 52 ms) (N = 40) between 2002 and 2006 were retrospectively evaluated. The technique used is illustrated in depth.

Endoscopic assistance in the epidural subtemporal approach and Kawase approach: anatomic study.

Background: Few reports exist in the literature about the use of endoscope assistance in the identification of structures in the posterior fossa.

Objective: To asses the advantage of endoscopic assistance in the epidural subtemporal and Kawase approaches by studying anatomic exposure and surgical freedom in the posterior cranial fossa.

Methods: Twelve epidural subtemporal approaches were performed on 6 adult cadaveric heads.

Biochemical remission and recurrence rate of secreting pituitary adenomas after transsphenoidal adenomectomy: long-term endocrinologic follow-up results.

Background: Transsphenoidal surgery is safe and effective in patients with secreting pituitary adenomas; however, variable outcomes have been reported according to the different criteria used to define the biochemical remission of hormone hypersecretion. We report the long-term endocrinologic follow-up results of a large cohort of patients who underwent TSS for secreting pituitary adenomas according to the most recent stringent criteria of cure.

Methods: Two hundred ten consecutive patients were operated on by TSS between 1995 and 2004 for a secreting pituitary adenoma (65 PRL-, 109 GH-, and 36 ACTH-secreting adenomas) and were considered for the study.