Microsurgical removal of supratentorial and cerebellar cavernous malformations: what has changed? A single institution experience.

Background: Features associated with a safe surgical resection of cerebral cavernous malformations (CMs) are still not clear and what is needed to achieve this target has not been defined yet.

Methods: Clinical presentation, radiological features and anatomical locations were assessed for patients operated on from January 2008 to January 2018 for supratentorial and cerebellar cavernomas. Supratentorial CMs were divided into 3 subgroups (non-critical vs.

Single Versus Double Hadad-Bassagasteguy Flap in Expanded Endoscopic Skull-Base Surgery.

The reconstruction of dural defects, after endoscopic removal of skull-base lesions, remains challenging when a large defect or a high flow intraoperative cerebrospinal fluid (CSF) leak is observed. The aim of this study is to describe our preliminary experience with a double Hadad-Bassagasteguy (H-B) flap technique for skull-base repair, comparing its efficacy with the use of a single H-B flap in our series. A retrospective chart review was conducted on patients who underwent exclusive endoscopic endonasal skull-base surgery at our Referral Skull Base Center from December 2014 to January 2018.

Recurrent oligodendroglioma with changed 1p/19q status.

We report a case of oligodendroglioma that had consistent histopathological features as well as a distinct change in 1p/19q status in the second recurrence, after temozolomide chemotherapy and radiotherapy. The first tumor recurrence had oligodendroglial morphology, IDH1 R132H and TERT promoter mutations, and 1p/19q codeletion detected by fluorescent in situ hybridization (FISH). Copy number analysis, assessed by next-generation sequencing, confirmed 1p/19q codeletion, and disclosed loss of heterozygosity (LOH) of chromosomes 4 and 9 and chromosome 11 gain.

Endoscopic Endonasal Surgery of Clival Chordomas: Preliminary Results.

Chordomas are rare malignant tumors, often affecting the clival region. Traditionally, they are removed via craniotomic approach but the introduction of the endoscopic endonasal technique (EEA) allowed to control this area. This article shows a series of patients affected by clival chordomas treated with endoscopic approach.

Expanded Endoscopic Approach for Anterior Skull Base Tumors: Experience of a Multidisciplinary Skull Base Team.

The aim of this study is to describe the experience of a multidisciplinary skull base team with transnasal endoscopic surgery for anterior cranial base tumors.A retrospective chart review was conducted on patients who underwent an exclusive expanded transnasal approach to the anterior skull base in the period from December 2014 to November 2015. Data on patient demographics, tumor characteristics, surgical information, imaging, and postoperative complications were collected and analyzed.

Intraoperative Measurement of Arterial Blood Flow in Aneurysm Surgery.

Intraoperative flowmetry (IF) has been recently introduced during cerebral aneurysm surgery in order to obtain a safer surgical exclusion of the aneurysm. This study evaluates the usefulness of IF during surgery for cerebral aneurysms and compares the results obtained in the joined surgical series of Verona and Padua to the more recent results obtained at the neurosurgical department of Verona.In the first surgical series, between 2001 and 2010, a total of 312 patients were submitted to IF during surgery for cerebral aneurysm at the neurosurgical departments of Verona and Padua: 162 patients presented with subarachnoid hemorrhage (SAH) whereas 150 patients harbored unruptured aneurysms.

Endoscopic transnasal surgery of clival lesions: our experience.

Background: The clivus is a region characterized by complex anatomy, with vascular and neural structures that are located in close proximity. Different pathologies can affect this area, and traditional surgical approaches were open approaches. Recently, the endoscopic transnasal technique has been introduced, and currently represents a good alternative for the surgical management of these lesions.

Late deterioration of neurologic function in patients surgically treated for spinal dural arteriovenous fistulas.

Background: A limited number of reports on the long-term neurologic outcome of patients with SDAVFs treated by surgery and/or embolization are available in the literature. The aim of our study is to neurologically evaluate these patients at 2 different follow-up stages, after surgery, to demonstrate a possible late neurologic deterioration after an initial improvement.

Methods: Between January 1987 and May 2002, 29 patients with SDAVFs were operated on at the Verona Department of Neurosurgery.

Conservative treatment of an atlantoaxial degenerative articular cyst: case report.

Background: Atlantoaxial degenerative articular cysts are rare lesions that can cause extradural compression of the cervicomedullary junction. When symptomatic, they usually require surgical treatment. We report an unusual case of spontaneous regression of an atlantoaxial degenerative articular cyst after conservative treatment with an external cervical brace along with a systemic therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids.

Comparison of different infratentorial-supracerebellar approaches to the posterior and middle incisural space: a cadaveric study.

Object: The purpose of this investigation was to describe and compare through cadaveric dissection the microsurgical exposure afforded by the median, paramedian, and extreme-lateral infratentorial-supracerebellar approaches to the posterior and middle incisural space.

Methods: The median, paramedian, and extreme-lateral infratentorial-supracerebellar approaches were performed in 10 embalmed cadaveric heads by using standard microneurosurgical methods; each approach was executed a minimum of five times. The dissections were performed in a stepwise fashion, comparing the exposure afforded by each surgical route and highlighting the relationships among the targeted neurovascular structures.