Neuroendoscopic management of posterior third ventricle ependymoma with intraaqueductal and fourth ventricle extension: a case report and review of the literature.

Introduction: Posterior third ventricle ependymomas with intraaqueductal extension are relatively infrequent lesions. Its surgical management represents a formidable technical challenge and includes a wide variety of approaches. Minimally invasive surgery including the endoscopic management can play a crucial role to obtain an optimal clinical outcome.

Trans-eyebrow supraorbital approach in large suprasellar craniopharyngioma surgery in adults: analysis of optic nerve length and extent of tumor resection. Original article.

Background: One of the main drawbacks in the surgery of large craniopharyngiomas is the presence of a prefixed optic chiasm. Our main objective in this study is to compare the predictive value of the optic nerve length and optic chiasm location on large craniopharyngiomas' extent of resection.

Method: We retrospectively studied 21 consecutive patients with large craniopharyngiomas who underwent tumor resection through the trans-eyebrow supraorbital approach.

Relative value of magnetic resonance spectroscopy, magnetic resonance perfusion, and 2-(18F) fluoro-2-deoxy-D-glucose positron emission tomography for detection of recurrence or grade increase in gliomas.

In a consecutive series of 26 previously operated patients diagnosed with cerebral glioma, magnetic resonance spectroscopy (MRS), 2-((18)F) fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), and perfusion MRI (MRP), were performed at follow-up to distinguish recurrence from radiation necrosis, and to identify tumour upgrading. Discrepancy between techniques was observed in 9 cases. The positive predictive value (PPV) and the negative predictive value (NPV) of each technique to detect the presence of high grade glioma was: MRI, PPV=50%; MRS, PPV=91.

Endoscopic biopsy of foramen of Monro and third ventricle lesions guided by frameless neuronavigation: usefulness and limitations.

Objectives: To describe our institution experience regarding the usefulness and limitations of frameless neuronavigation in the endoscopic biopsy of foramen of Monro and third ventricle lesions.

Methods: We report our experience with 22 patients harbouring intraventricular lesions located in the region of the foramen of Monro or the third ventricle who underwent endoscopic biopsy guided by the neuronavigation system. Nine lesions were located on the posterior aspect of the third ventricle or at the pineal region, and thirteen lesions were located at the foramen of Monro or anterior third ventricle region.

Pain improvement in patients with syringomyelia and Chiari I malformation treated with suboccipital decompression and tonsillar coagulation.

Pain experienced by patients who have syringomyelia associated with Chiari I malformation (SACM) includes headache, cervicalgia and radiculalgia. We studied the correlation of clinical and imaging factors with the evolution of pain and surgical outcome at 12 months. We performed a prospective study of 13 patients who presented with SACM and who underwent suboccipital decompression, C1 laminectomy, tonsillar coagulation and duraplasty.

[Endoscopy-assisted surgery of the sellar region].

Objective: To evaluate the usefulness of endoscopic assisted surgery of pituitary adenomas in transesphenoidal surgery, and in surgery of craneopharyngiomas using either minimally invasive approaches to the cranial base or transventricular approaches.

Material And Methods: We present our preliminary experience in eleven patients operated of sellar region tumor by endoscopic assisted resection: 6 pituitary adenoma via transesphenoidal approach, 4 craneopharyngiomas 3 through supraciliar approach and 1 by transcortical transventricular approach, and 1 suprasellar cyst.

Results: By using the 30 degrees optic the use of endoscope allowed complete resection, confirmed by postoperative MRI, of all six pituitary macroadenomas providing control of resection of supraselar remnants.

Endoscopic resection of cavernoma of foramen of Monro in a patient with familial multiple cavernomatosis.

Intraventricular cavernomas are extremely infrequent and only 11 cases of cavernous hemangioma to occur at the foramen of Monro have been reported in the literature. This 56 years old patient was admitted with progressive and intractable headache of 10 days of evolution. He was known to suffer familial multiple cavernomatosis.

Giant occipital intradiploic epidermoid cyst associated with iatrogenic puncture.

The origin of cranial epidermoid cysts (EC) remains controversial, and although generally considered to be congenital, acquired origin has been reported. EC represent 0.2 to 1.

Surgical removal after first bleeding of an arteriovenous malformation previously obliterated with radiosurgery: case report.

Background: Radiosurgery has been widely used to treat cerebral AVMs, providing angiographic evidence of obliteration of the malformation in 80% to 95% of patients, after a latency period of 2 to 5 years.

Case Description: We describe a case of hemorrhage, 6 years after radiosurgery and 4 years after complete angiographic obliteration of an AVM that had not previously bled and that persisted angiographically, obliterated after bleeding.

Results: Several treatment options have been reported for patients with completely obliterated AVMs that bled, including conservative treatment, repeated radiosurgery, and open surgery with resection of AVM remnants.

Early surgical treatment of middle cerebral artery aneurysms associated with intracerebral haematoma.

Objective: Patients with haematoma secondary to middle cerebral artery aneurysm often require urgent surgical treatment consisting of evacuation of the haematoma and aneurysmal clipping.

Methods: . We present our experience over 5 years with 12 patients who underwent surgery before the first 8h of bleeding.

[Association between cerebral infarction and malignant glioma].

Introduction: It is very rare for cerebral infarction to be the first symptom of an intracranial tumour. Only three cases have been reported in which cerebral infarction is thought to have been caused by the arterial compromise triggered by incipient high grade gliomas that are not yet visible in radiological tests.

Case Report: A 46-year-old male with no relevant medical history or cardiovascular risk factors who presented with acute hemiplegia on the right-hand side of the body and a significantly impaired level of consciousness.

[Multiseptated arachnoid cyst treated with fenestration after valvular insufficiency in an adult. ].

Treatment of symptomatic arachnoid cysts is based on two procedures: cyst fenestration versus derivation of CSF. Multiseptated cysts represent a very special group. We present the case of a 75 year old woman with a symptomatic multiseptated arachnoid cyst, developing subacute bleeding in one of the cavities.

[Cauda syndrome due to spinal stenosis and diskytis in two different spinal levels. Diagnosis using myelo-TC].

We report a case of a 75 year old man presenting with paraparesis, urinary incontinence and saddle anesthesia evolving after several months and severe lumbalgia and bad general status which developed fewdays before admission. CT-scan showed spondilosis with lytic lesion at L5-S1 level. MR1 was not performed because the patient had a pacemaker.

[Posterior fossa venous epidural hematoma. Based on 2 cases].

We present two rare cases of posterior fossa epidural hematoma (PFEH) due to occipital fracture and tearing of transverse sinus. One of the patients showed supratentorial and infratentorial extension, which is found in half of the PFEH cases. Both cases experienced clinical worsening within 48 h of the head injury, with control CT showing increase of haematoma volume.

[Cerebral neuroblastomas: diagnosis and treatment].

Aims: To review the literature on cerebral neuroblastomas (CN), including their anatomopathological filiation, clinical characteristics together with those they display in imaging studies, and the different therapeutic options with their prognosis.

Method: Cerebral neuroblastomas belong to the group of primitive neuroectodermal tumours (PNET), also known as cerebral meduloblastomas or supratentorial PNET. They originate in the supratentorial compartment and histologically they are in the WHO grade IV.