Single-step resection and reconstruction of orbito-fronto-temporal pathologies using a PMMA CAD-implant.

Background: Resection of bone infiltrating meningiomas of the sphenoid plane and the orbital walls is a highly challenging neurosurgical procedure. In this study, the authors present 11 cases of fronto-orbital and sphenoid wing meningioma which were subjected to tumor resection and cranioplasty using a pre-designed CAD PMMA-implant in one single staged procedure.

Methods: Eleven cases were prospectively analyzed from January 2011 to December 2018.

Bisulfite profiling of the MGMT promoter and comparison with routine testing in glioblastoma diagnostics.

Background: Promoter methylation of the DNA repair gene O-methylguanine-DNA methyltransferase (MGMT) is an acknowledged predictive epigenetic marker in glioblastoma multiforme and anaplastic astrocytoma. Patients with methylated CpGs in the MGMT promoter benefit from treatment with alkylating agents, such as temozolomide, and show an improved overall survival and progression-free interval. A precise determination of MGMT promoter methylation is of importance for diagnostic decisions.

Surviving a Self-inflicted Transorbital Pen Intrusion to the Cerebellum: Case Report.

Background:  Although intracranial traumas by penetrating foreign objects are not absolute rarities, the nature of trauma, the kind of object, and its trajectory make them a one of a kind case every time they occur. Whereas high-velocity traumas mostly result in fatalities, it is the low-velocity traumas that demand an individualized surgical strategy.

Methods:  We present a case report of a 33-year-old patient who was admitted to our department with a self-inflicted transorbital pen injury to the brain.

Reaching the sellar region endonasally - One or both nostrils? A pilot study in body donors.

Introduction: The purpose of this study was to evaluate the effect of posterior septectomy size on surgical exposure and surgical freedom during the endoscopic transsphenoidal approach to the sellar and parasellar region.

Methods: A mononostril and binostril approach to the sellar region was performed on 4 formalin-fixed cadaveric heads. Predefined anatomical structures were identified.

Intracranial Pressure-Guided Shunt Valve Adjustments with the Miethke Sensor Reservoir.

Background: Telemetric intracranial pressure (ICP) monitoring seems to be a promising therapy-supporting option in shunt-treated patients. Benefits become obvious when headaches are unspecific and clinical symptoms cannot be related to possible overdrainage or underdrainage. In this study, we evaluated a new telemetric device to individually adjust shunt valves according to ICP measurements.

Confocal Laser Endomicroscopy in Neurosurgery-An Alternative to Instantaneous Sections?

Objective: Intraoperative distinction of brain tumor from surrounding brain is a crucial challenge in neuro-oncologic surgery. We directly compared confocal laser endomicroscopy (CLE) findings with intraoperative instantaneous sections by the neuropathologist in a blinded fashion.

Methods: The imaging device comprises a rigid endoscope with Hopkins rod lenses and a red wave length laser with a scanning depth of 80 μm.

Telemetric Intracranial Pressure Monitoring with the Raumedic Neurovent P-tel.

Background: Devices enabling long-term intracranial pressure monitoring have been demanded for some time. The first solutions using telemetry were proposed in 1967. Since then, many other wireless systems have followed but some technical restrictions have led to unacceptable measurement uncertainties.

Aqueductal stenting with an intra-catheter endoscope--a technical note.

Introduction: Aqueductoplasty as well as aqueductal stenting is an accepted therapy option in short-segment aqueductal stenosis and isolated fourth ventricle. Over the years, different techniques with only slight modifications by using a conventional neuroendoscope with a working sheath to introduce different instruments have been presented. In summary, the use of Fogarty balloon catheters or flexible endoscopes to pass the narrowed aqueduct is recommended.

Confocal laser endomicroscopy in neurosurgery: a new technique with much potential.

Technical innovations in brain tumour diagnostic and therapy have led to significant improvements of patient outcome and recurrence free interval. The use of technical devices such as surgical microscopes as well as neuronavigational systems have helped localising tumours as much as fluorescent agents, such as 5-aminolaevulinic acid, have helped visualizing pathologically altered tissue. Nonetheless, intraoperative instantaneous frozen sections and histological diagnosis remain the only method of gaining certainty of the nature of the resected tissue.