Closed Stereotactic Needle Biopsy of Brainstem Small Cell Glioblastoma: A Case Report and Literature Review.

Glioblastoma is the deadliest and most common of the malignant primary brain tumors that can occur in adults. In contrast, brainstem gliomas are extremely uncommon in adults; however, their precise incidence is not known, due to the difficult nature of obtaining tissue from the brainstem provoking low biopsy and resection rates. In this case report, we have examined a 34-year-old female who was diagnosed with pontomedullary small cell glioblastoma following a successful biopsy of the brainstem lesion.

Initial experience with the use of an expandable titanium cage as a vertebral body replacement in patients with tumors of the spinal column: a report of 95 patients.

Objective: Vertebral body resection to treat spine tumors necessitates reconstruction to maintain spinal stability. The durability of reconstruction may be a challenge in cancer patients as treatment with chemotherapy and/or radiation coupled with poor nutritional status may compromise bone quality. We present a series of patients who underwent implantation of an expandable titanium cage (ETC) for reconstruction after vertebral body resection for primary or metastatic spine tumors.

A model for neurosurgical humanitarian aid based on 12 years of medical trips to South and Central America.

The pediatric neurosurgical mission trips led by physicians at Virginia Commonwealth University (VCU) Health Systems began in 1996 with the formation of Medical Outreach to Children, founded by 1 of the authors (J.D.W.

Cerebral acid-base homeostasis after severe traumatic brain injury.

Object: Brain tissue acidosis is known to mediate neuronal death. Therefore the authors measured the main parameters of cerebral acid-base homeostasis, as well as their interrelations, shortly after severe traumatic brain injury (TBI) in humans.

Methods: Brain tissue pH, PCO2, PO2, and/or lactate were measured in 151 patients with severe head injuries, by using a Neurotrend sensor and/or a microdialysis probe.

Association between elevated brain tissue glycerol levels and poor outcome following severe traumatic brain injury.

Object: Glycerol is considered to be a marker of cell membrane degradation and thus cellular lysis. Recently, it has become feasible to measure via microdialysis cerebral extracellular fluid (ECF) glycerol concentrations at the patient's bedside. Therefore the aim of this study was to investigate the ECF concentration and time course of glycerol after severe traumatic brain injury (TBI) and its relationship to patient outcome and other monitoring parameters.

Glioblastoma multiforme causing calvarial destruction: an unusual manifestation revisited.

This report describes invasion of overlying calvaria and soft tissues by a high-grade glioma without macroscopic evidence of dural involvement. The initial radiologic examinations demonstrated a heterogeneous mass in the right frontoparietal region with both extra- and intra-axial components. Inward displacement of the adjacent dura initially prompted consideration for extra-axial lesions such as metastatic lesions, lymphoma, or an aggressive meningioma.

Diagnosis of Erdheim-Chester disease by using computerized tomography-guided stereotactic biopsy of a caudate lesion. Case report.

The authors present the case of a 27-year-old woman with Erdheim-Chester disease (ECD) and extensive intracranial involvement, in whom the initial diagnosis of ECD was established based on computerized tomography (CT)-guided stereotactic biopsy of a caudate lesion. Erdheim-Chester disease is a rare non-Langerhans cell histiocytosis of unknown origin that is clinically characterized by bone pain, diabetes insipidus, and exophthalmos. The radiological hallmarks of the disease include symmetrical sclerosis of the long bones with epiphysial sparing and increased tracer uptake in lesions seen on scintigraphic imaging.

Clinical trials in traumatic brain injury: lessons for the future.

Thus far, none of the neuroprotective drugs that have been tested to reduce or prevent secondary ischemic brain damage have been shown clear benefit. We will attempt to identify factors that may be responsible for some of these failures. We also will give our thoughts on how to prevent these pitfalls in the usefulness and criteria for use of animal models for traumatic brain injury to depict human head injury are discussed.

The importance of brain temperature in patients after severe head injury: relationship to intracranial pressure, cerebral perfusion pressure, cerebral blood flow, and outcome.

Brain temperature was continuously measured in 58 patients after severe head injury and compared to rectal temperature, intracranial pressure, cerebral blood flow, and outcome after 3 months. The temperature difference between brain and rectal temperature was also calculated. Mild hypothermia (34-36 degrees C) was also used to treat uncontrollable intracranial pressure (ICP) above 20 mm Hg when other methods failed.

Relationship between brain temperature, brain chemistry and oxygen delivery after severe human head injury: the effect of mild hypothermia.

We studied brain temperature and the effect of mild hypothermia in 58 patients after severe head injury (SHI). Brain tissue oxygen tension (ptiO2), carbon dioxide tension (ptiCO2), tissuie pH (pHti) and temperature (T.br) were measured using a multiparameter probe.