Independent association of extent of resection with survival in patients with malignant brain astrocytoma.

Object: With recent advances in the adjuvant treatment of malignant brain astrocytomas, it is increasingly debated whether extent of resection affects survival. In this study, the authors investigate this issue after primary and revision resection of these lesions.

Methods: The authors retrospectively reviewed the cases of 1215 patients who underwent surgery for malignant brain astrocytomas (World Health Organization [WHO] Grade III or IV) at a single institution from 1996 to 2006.

Outcome of Chiari-associated syringomyelia after hindbrain decompression in children: analysis of 49 consecutive cases.

Objective: Chiari I malformation is complicated by syringomyelia in many cases. Hindbrain decompression remains first-line surgical treatment; however, the incidence, time course, and predictors of syrinx resolution remain unclear. We set out to determine predictors of syrinx improvement after hindbrain decompression for Chiari I- associated syringomyelia.

Persistent outpatient hyperglycemia is independently associated with decreased survival after primary resection of malignant brain astrocytomas.

Objective: Patients with malignant brain astrocytomas are at high risk for developing hyperglycemia secondary to frequent corticosteroid administration. Several clinical studies have shown that hyperglycemia is associated with poor outcome in multiple disease states. Furthermore, hyperglycemia augments in vitro astrocytoma growth, whereas hypoglycemia attenuates in vitro astrocytoma cell growth.

Association of preoperative depression and survival after resection of malignant brain astrocytoma.

Background: Clinical depression has been shown to negatively influence the morbidity and mortality of multiple disease states. It remains unclear if clinical depression affects survival after surgical management of malignant brain astrocytoma. We set out to determine whether patients with a diagnosis of clinical depression before surgery experienced decreased survival independent of treatment modality or degree of disability.

Intraoperative ultrasonography as a guide to patient selection for duraplasty after suboccipital decompression in children with Chiari malformation Type I.

Object: Indications for duraplasty in treatment of Chiari malformation Type I (CM-I) remain unclear. In the present study, the authors evaluate their surgical experience to determine whether intraoperative ultrasonography is effective in the selection of patients with CM-I who can be adequately treated with craniectomy alone without duraplasty.

Methods: The authors reviewed the records of 256 children who underwent first-time hindbrain decompression for CM-I.

Suboccipital decompression for Chiari malformation-associated scoliosis: risk factors and time course of deformity progression.

Object: Chiari malformation Type I (CM-I) is often associated with scoliosis. It remains unclear which subgroups of patients are most likely to experience progression of spinal deformity after cervicomedullary decompression. The authors' goal was to determine the time frame of curvature progression and assess which patient subgroups are at greatest risk for progression of spinal deformity after surgery.

Correlation of hindbrain CSF flow and outcome after surgical decompression for Chiari I malformation.

Objective: Many patients with symptomatic Chiari I malformation experience symptom recurrence after surgical decompression. Improved radiographic predictors of outcome are needed to better select patients most likely to benefit from surgical intervention. We examined whether ventral or dorsal cerebrospinal fluid (CSF) flow dynamics assessed by cine phase-contrast MRI scans could predict response to posterior fossa decompression for Chiari I malformation.

Aceruloplasminemia: an inherited neurodegenerative disease with impairment of iron homeostasis.

In 1987, Miyajima et al. first characterized an autosomal recessive, adult-onset neurodegenerative disorder resembling Parkinson's disease associated with near-absent circulating serum ceruloplasmin levels. Coined "familial apoceruloplasmin deficiency", they described a patient with a presenting triad of diabetes mellitus, retinal degeneration, and neurodegeneration with blepharospasm.