Surgical treatment and prognosis of adult patients with brainstem gliomas.

The paper presents 47 adult patients who were surgically treated due to brainstem gliomas. Thirteen patients presented with contrast-enhancing Grades III and IV gliomas, according to the WHO classification, 13 patients with contrast-enhancing tumours originating from the glial cells (Grade I; WHO classification), 9 patients with diffuse gliomas, 5 patients with tectal brainstem gliomas and 7 patients with exophytic brainstem gliomas. During the surgical procedure, neuronavigation and the diffusion tensor tractography (DTI) of the corticospinal tract were used with the examination of motor evoked potentials (MEPs) and somatosensory evoked potentials (SSEPs) with direct stimulation of the fundus of the fourth brain ventricle in order to define the localization of the nuclei of nerves VII, IX, X and XII.

Surgical treatment of adult patients with thalamic tumors with the aid of tractography, fMRI, transcranial electrical stimulation and direct electrical stimulation of the subcortical white matter.

The aim of investigation was to assess treatment outcomes in adult patients with thalamic tumors, operated on with the aid of tractography (DTI) and monitoring of motor evoked potentials (MEPs) generated due to transcranial electrical stimulation (TES) and direct electrical stimulation (DES) of the subcortical white matter. 38 subsequent patients with thalamic tumors were operated on using tractography (DTI)-integrated neuronavigation, transcranial electrical stimulation (TES) and direct electrical stimulation (DES). The volumetric method was used to calculate pre- and postoperative tumor volume.

Early Detection of Malignant Transformation in Resected WHO II Low-Grade Glioma Using Diffusion Tensor-Derived Quantitative Measures.

Objective: Here, we retrospectively investigate the value of voxel-wisely plotted diffusion tensor-derived (DTI) axial, radial and mean diffusivity for the early detection of malignant transformation (MT) in WHO II glioma compared to contrast-enhanced images.

Materials And Methods: Forty-seven patients underwent brain magnetic resonance imaging follow-up between 2006-2014 after gross-tumor resection of intra-axial WHO II glioma. Axial/Mean/Radial diffusivity maps (AD/MD/RD) were generated from DTI data.

Assessment of explicit and implicit linguistic impairments in patients with aphasia after resection of tumour of the left cerebral hemisphere. Preliminary results.

Background And Purpose: Classical definitions of aphasia des-cribe deficits of different language levels (syntactic, semantic, phonologic) hindering the ability to communicate. Recent studies indicate, however, that impairment of particular aspects of linguistic competencies in aphasia differs in severity. Contemporary approach to the aphasic symptoms presents them as disturbed access of linguistic representations to the awareness system.

The use of functional magnetic resonance imaging in reducing a risk of postoperative neurological deficits in the patients with brain tumour.

Background And Purpose: The purpose of the study was to compare the results of operative treatment of tumours located in the sensory-motor cortex guided with functional magnetic resonance imaging (fMRI) combined with the neuro-na-vigation system to the results of classical operative treatment.

Material And Methods: The studied group comprised 28 pa-tients with a tumour located in the sensory-motor cortex area who underwent surgery guided with fMRI and the neuro-na-vigation system. A control group comprised 30 patients with the same clinical diagnosis, operated on without functional neuronavigation.

Transcranial color-coded Doppler assessment of cerebral arteriovenous malformation hemodynamics in patients treated surgically or with staged embolization.

Objective: The etiology of hemodynamic disturbances following embolization or surgical resection of arteriovenous malformations (AVMs) has not been fully explained. The aim of the study was the assessment of the selected hemodynamic parameters in patients treated for cerebral AVMs using transcranial color-coded Doppler sonography (TCCS).

Materials And Methods: Forty-six adult patients (28 males, 18 females, aged 41 ± 13 years, mean ± SD) diagnosed with AVMs who were consecutively admitted to the Department of Neurosurgery between 2000 and 2012 treated surgically or with staged embolization were enrolled in the study.

Reoperations of patients with low-grade gliomas in eloquent or near eloquent brain areas.

Background And Purpose: Reoperations of patients with recurrent low-grade gliomas (LGG) are not always recommended due to a higher risk of neurological deficits when compared to initial surgery. The purpose of the present study was to evaluate surgical outcomes of patients operated on for recurrent LGG.

Material And Methods: Sixteen patients who had surgery for recurrent LGG out of 68 LGG patients who underwent surgery at the Department of Neurosurgery in Sosnowiec, Poland between 2005 and 2011 were enrolled in the study.

Meningiomas of the anterior portion of the craniovertebral junction: immediate and late outcome following surgical removal using a partial transcondylar approach.

Background And Purpose: The partial transcondylar approach (PTA) is an alternative to the suboccipital approach in the surgical treatment of meningiomas of the anterior portion of the craniovertebral junction (APCVJ). The purpose of this study is to present our results of treatment of these meningiomas using PTA.

Material And Methods: Fourteen patients (11 women, 3 men) with meningioma of the APCVJ were included in the study.

The assessment of prognostic factors in surgical treatment of low-grade gliomas: a prospective study.

Objective: A prospective volumetric analysis of extent of resection (EOR) was carried out to assess surgical outcomes in adults diagnosed with hemispheric low grade gliomas (LGGs).

Materials And Methods: 68 consecutive patients diagnosed with LGGs were enrolled in the study. Pre- and post-operative tumor volumes and EOR were measured based on FLAIR MRI.

Fibre integrity and diffusivity of the pyramidal tract and motor cortex within and adjacent to brain tumour in patients with or without neurological deficits.

Background: Assessment of the relationship between preoperative neurological deficits and diffusion tensor imaging (DTI) parameters in patients with brain tumour within/adjacent to pyramidal tract and motor cortex. Evaluation of the difference in fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in patients with low and high grade gliomas.

Material And Methods: 20 patients with supratentorial brain tumours were divided into two groups: I with preoperative neurological deficits and II without preoperative neurological deficits.

Early and long-term results of the treatment of jugular paragangliomas using different ranges of surgical approach.

Background And Purpose: The applied approach to the jugular foramen is a combination of the juxtacondylar approach with the subtemporal fossa approach type A. The purpose of this study is to present our results of treatment of jugular paragangliomas using the aforementioned approach.

Material And Methods: Twenty-one patients (15 women, 6 men) with jugular paragangliomas were included in the study.

A case of carotid body paraganglioma and haemangioblastoma of the spinal cord in a patient with the N131K missense mutation in the VHL gene.

The article describes paraganglioma case in woman with von Hippel-Lindau disease. She was found to be a carrier of a rare germline mutation in the VHL gene (393C>A; N131K). The patient developed large, untypical for von Hippel-Lindau disease, carotid body paraganglioma at the common carotid artery bifurcation.

Rare primary tumours of the hypothalamus in adults: clinical course and surgical treatment.

Background And Purpose: The paper presents the operative technique and the results of treatment of adult patients with primary tumours of the hypothalamus, including rare ones. The aim of the study was to show the possibility of safe surgical treatment of rare tumours of the hypothalamus through a bifrontal basal interhemispheric trans-lamina terminalis approach.

Material And Methods: Five patients with tumours of the hypothalamus were operated on in the Neurosurgical Clinic in Sosnowiec between 1990 and 2008.

Medial sphenoid ridge meningiomas: early and long-term results of surgical removal using the fronto-temporo-orbito-zygomatic approach.

Background And Purpose: The fronto-temporo-orbito-zygomatic approach (FTOZA) is an alternative to the pte-rional approach in surgical resection of meningiomas of the medial part of the lesser wing of the sphenoid bone. The purpose of this study is to present our results of treatment of these meningiomas using the FTOZA.

Material And Methods: Thirty patients (19 women, 11 men) with a central skull base tumour were included in the study.

Differentiation between brain tumor recurrence and radiation injury using perfusion, diffusion-weighted imaging and MR spectroscopy.

Background: Differentiation between tumor recurrence/vital tumor tissue and radionecrosis based on conventional diagnostic imaging is impossible because of the likeness of the images. In such circumstances advanced MRI techniques (PWI, DWI, 1HMRS) seem to be helpful. The aim of our study was to evaluate the diagnostic effectiveness of PWI, DWI and 1HMRS in the differentiation of the tumor recurrence from radiation related injury.

Direct and remote outcome after treatment of tumours involving the subtemporal fossa and related structures with the extended subtemporal approach.

Background And Purpose: The aim of the study was to present our results of the surgical treatment of subtemporal fossa tumours and surrounding regions using the extended subtemporal approach.

Material And Methods: Twenty-five patients (10 women, 15 men) with subtemporal fossa tumours were included in the study. The neurological and performance status of the patients were assessed before and after surgery as well as at the conclu-sion of treatment.

Direct and remote outcome after treatment of tumours involving the central skull base with the extended subfrontal approach.

Background And Purpose: To present our results of the surgical treatment of central skull base tumours using the extended subfrontal approach (ESA).

Material And Methods: Twenty-six patients (8 women, 18 men) with central skull base tumours were included in the study. The neurological and performance status of the patients was assessed before and after surgery as well as at the conclusion of treatment.

[Lateral approach to the cavernous sinus and its surroundings--analysis of surgical technique based on cadaver simulations].

Background And Purpose: The paper aims to present individual stages of a surgical approach to the cavernous sinus (CS) and its surroundings.

Material And Methods: Twelve simulations of a surgical approach to the CS and its surroundings were performed in non-fixed cadavers. The subsequent stages of simulation were recorded in photographs and drawings.

Direct and remote outcome after treatment of tumours involving the cavernous sinus and its surroundings.

Background And Purpose: The aim of this study was to present results obtained by the authors after surgical treatment of tumours involving the cavernous sinus (CS) and its surroundings.

Material And Methods: Thirty-eight patients (23 females and 15 males) with tumours of the CS and its surroundings were included in the study. The neurological condition of patients and their ability to perform activities of daily living were evaluated prior to treatment, postoperatively and after completion of therapy.

Surgical approaches to pathological lesions of the middle cerebellar peduncle and the lateral part of the pons - clinical observation.

Background And Purpose: Pathological lesions of the middle cerebellar peduncle include tumours, arteriovenous malformations, cavernous angiomas and spontaneous haematomas. Because of the very low incidence of these lesions, surgical approaches to the middle cerebellar peduncle are not commonly known. The authors decided to present their own experience based on five cases operated on at the authors' institution.

[Operative treatment of the intramedullary tumors with the methylprednisolone usage--preliminary report].

Unlabelled: The aim of the study was to assess the intermediate results of the intramedullary tumors treatment with neuroprotection including the methyvlprednisolone (MP) usage.

Material And Method: In the 1995-2003 period 33 patients with intramedullary tumors were operated on in Department of Neurosurgery in Sosnowiec. They were 10 females and 23 males in the age range of 11-61 years.

[Cerebral aneurysms in patients with the occlusion of the brachiocephalic vessels].

Cerebral aneurysms coexistent with iatrogenic (after surgical ligation or occlusion) or idiopathic (due to atheromatosis) occlusion of an extracranial cerebral artery are very rare. The occlusion of the brachiocephalic vessels leads to the formation of a collateral circulation at two levels: the circle of Willis and the connections between collaterals of the extracranial cerebral arteries. The authors discuss different types of collateral arterial pathways as well as hemodynamic abnormalities in the case of the occlusion of the brachiocephalic vessels, particularly internal carotid artery or the innominate artery occlusion.

Color Doppler sonographic evaluation of collateral circulation in patients with cerebral aneurysms and the occlusion of the brachiocephalic vessels.

Objective: The objective of this study was to assess the collateral circulation and blood flow velocity in arteries forming collateral circulation in patients with cerebral aneurysms and the occlusion of the brachiocephalic vessels.

Methods: Between 1989 and 2004 we examined a group of seven consecutive patients with diagnosed cerebral aneurysm and occlusion of the extracranial artery by means of cerebral angiography, transcranial color-coded sonography (TCCS) and color Doppler sonography of extracranial arteries. The Doppler examination results achieved in this group were compared with the Doppler results of 40 healthy subjects from a control group.

[Occipitocervical fixation in the surgical treatment of pathologies of the craniovertebral junction].

Background And Purpose: New surgical approaches to the tumors of the skull base necessitate removal of certain bone structures of the base. In the case of the transcondylar far-lateral approach, the whole occipital condyle and lateral mass of C1 are removed resulting in iatrogenic instability. Consequently, an occipitocervical fixation is needed.

[Treatment of deep brain arteriovenous malformations].

Background And Purpose: The results of the treatment of patients with deep, supratentorial arteriovenous malformations (AVMs) located in medial hemisphere or intraventricularly are presented.

Material And Methods: The paper presents the results of treatment of 17 patients. AVMs were located in the trigonum of the lateral ventricle in 4 cases (23.