Different Approaches in Skull Base Surgery Carry Risks for Different Types of Complications.

Complications are not uncommon in the complex field of skull base surgery. The intrinsic relationship of lesions in this region to important neurovascular structures, dura mater, and bone may lead to significant morbidity and mortality. The evolution of endoscopic endonasal surgery has had a significant impact on this field as a less invasive option for treatment of selected lesions, but major morbidity may still occur; moreover, endoscopic approaches have been associated with higher rates of some specific complications, such as cerebrospinal fluid leaks.

Intracranial Meningiomas Decrease in Volume on Magnetic Resonance Imaging After Discontinuing Progestin.

Background: The behavior of meningiomas under influence of progestin therapy remains unclear.

Objective: To investigate the relationship between growth kinetics of intracranial meningiomas and usage of the progestin cyproterone acetate (PCA).

Methods: This study prospectively followed 108 women with 262 intracranial meningiomas and documented PCA use.

The Importance of Long Term Follow Up After Endoscopic Pituitary Surgery: Durability of Results and Tumor Recurrence.

Introduction: Endoscopic endonasal approach (EEA) has become the preferred surgical approach for resection of pituitary adenomas in most centers. This technique has a number of advantages such as improved visualization and maneuverability, when compared to microscopic transsphenoidal approach. However, the long-term results of this approach are still scarce.

Management of Giant Pituitary Adenomas: Role and Outcome of the Endoscopic Endonasal Surgical Approach.

Giant adenomas represent a significant surgical challenge. Although traditionally several transcranial and transsphenoidal microscopic approaches have had a central role in their management, in the last 2 decades here have been increasing reports of the endoscopic endonasal approach for giant adenomas, citing its improved resection rates and lower complication profile. However, its role as the preferred approach has not been fully established and there is currently a paucity of evidence-based recommendations available in the literature.

Pituitary Apoplexy: Results of Surgical and Conservative Management Clinical Series and Review of the Literature.

Objective: Pituitary apoplexy is associated with visual, cranial nerve, and endocrine dysfunction. In this article, the results of surgical and conservative management of pituitary apoplexy in a single center are evaluated and a review of the literature is presented.

Methods: A retrospective analysis was made of patients with pituitary apoplexy who underwent surgery or conservative management at our center between January 2007 and June 2017.

Extended Endoscopic Approach for Resection of Craniopharyngiomas.

 Extended endoscopic approaches are useful for resection of selected craniopharyngiomas. Midline, extraventricular, and predominantly cystic lesions are good candidates for endoscopic resection. In this video, we demonstrate the endoscopic endonasal resection of a large suprasellar craniopharyngioma and discuss the nuances of the surgical technique.

Results of a Policy of Fast Tapering of Steroids After Resection Surgery in Glioblastoma.

Background: Corticosteroids are routinely used to treat brain tumors. Although steroids have an immediate clinical benefit, their use can lead to a number of relevant complications, and a negative association with overall survival has been shown in glioblastoma (GBM) patients. There is no evidence in the literature regarding the ideal dose.

Prognostic value of ventricular wall fluorescence during 5-aminolevulinic-guided surgery for glioblastoma.

Background: The meaning of the ventricular wall fluorescence during 5-aminolevulinic (5-ALA)-guided surgery in patients with glioblastoma (GBM) is still unknown. The authors studied the association between ventricle fluorescence, clinical outcome and survival, and described the histopathological findings of selective biopsies from the ventricular wall.

Methods: One hundred and forty patients diagnosed of GBM underwent fluorescence-guided surgery (FGS); 65 of them were naive GBM and ventricle fluorescence during surgery was annotated prospectively.