Multidomain and long-term cognitive evaluation in malignant glioma patients.

We performed longitudinal evaluations of the neurocognitive status in glioma patients to describe possible variations over the course of illness. Glioma patients underwent a complete battery of standardized neuropsychological tests pre-radiotherapy at 6, 12 and 24 months. We enrolled 130 patients, 67.

Comorbidities in elderly patients with glioblastoma: a field-practice study.

Aim: This single-center study evaluated the effect of comorbidities on progression-free and overall survival in elderly patients with glioblastoma multiforme (GBM).

Patients & Methods: Comorbid conditions were identified in each patient with the modified version of the cumulative illness rating scale (CIRS).

Results:  Total of 118 patients with GBM were enrolled.

The role of surgical resection in patients with brain metastases.

Purpose Of Review: Treatment of brain metastases represent a critical issue and different options have to be considered according to patients and tumour characteristics; in recent years, new therapeutic strategies have been proposed. In this review, we discuss the role of surgical resection on the basis of patient selection, new surgical techniques and the use of intraoperative adjuncts. The integration with postoperative whole brain radiotherapy will be also outlined because alternative treatment options are currently available.

Endoscopic Reconstruction of CSF Pathways in Ventricular Tumors.

Neuroendoscopy is now considered to be a minimally invasive surgical approach for expanding lesions bulging into the ventricle, and it is also considered to be a relevant tool for performing biopsy procedures, fenestration of cystic walls, or for performing tumor removal in selected cases. Furthermore, the use of neuroimaging and the accurate follow-up of brain tumor patients have allowed the documentation of tumoral and pseudotumoral cystic areas that cause the obstruction of cerebrospinal fluid (CSF) pathways. Neuroendoscopic procedures enable the fenestration of cystic lesions, in addition to enabling third ventriculostomy or septostomy to restore CSF pathways.

Surgery of malignant gliomas: advances and perspectives.

Purpose Of Review: One of the most controversial issues in the combined treatment of malignant gliomas is the role of surgical resection, even though the relevance of surgery in obtaining tissue diagnosis and alleviating clinical symptoms is well defined; more debated is the importance of radical surgery in improving the patient final outcome. This review aims to present an overview of the recommendations for surgical treatment of malignant gliomas, and to describe the potential role of locoregional treatments.

Recent Findings: An increasing series of data are being collected in favour of radical surgical removal, with the support of intraoperative imaging and fluorescence guide.

Neuroendoscopic biopsy of ventricular tumors: a multicentric experience.

Object: Although neuroendoscopic biopsy is routinely performed, the safety and validity of this procedure has been studied only in small numbers of patients in single-center reports. The Section of Neuroendoscopy of the Italian Neurosurgical Society invited some of its members to review their own experience, gathering a sufficient number of cases for a wide analysis.

Methods: Retrospective data were collected by 7 centers routinely performing neuroendoscopic biopsies over a period of 10 years.

Cooperative study by the Italian neuroendoscopy group on the treatment of 61 colloid cysts.

Objects: Microsurgical resection, stereotactic aspiration and VP shunt have for years been the choice options for the treatment of colloid cysts of the third ventricle. Recently, endoscopic approaches have aroused increasing interest and gained acceptance. Although safer, this minimally invasive approach is considered less efficacious than microsurgery.

Epilepsy and gliomas: incidence and treatment in 119 patients.

One hundred and nineteen consecutive patients affected by supratentorial gliomas were studied in order to determine the incidence of seizure at diagnosis, the occurrence of subsequent seizures and the efficacy of anticonvulsant treatment. The overall incidence of seizures as presentation symptom was 52% (62 patients). Preoperative seizures were present in 83% of patients affected by low-grade astrocytoma, in 46% of patients affected by anaplastic astrocytoma and in 36% of patients affected by glioblastoma.

A simple method for stereotactic microsurgical excision of small, deep-seated cavernous angiomas.

Eight patients underwent microsurgical excision of small, deep-seated cavernous angiomas (maximum diameter, 0.9 to 2 cm; distance from cortical surface, 3.5 to 6.

Brain oedema and intracranial hypertension treatment by GLIAS.

The authors present their results regarding the use of a buffered solution of glycerol 30%-sodium ascorbate 20% (GLIAS) for the treatment of brain oedema and intracranial hypertension. GLIAS was perfused intravenously in 80 patients with several types of brain oedema. In every patients serum and urinary osmolarity, diuresis, main blood and urine parameters, and ICP were monitored.

Multicentric gliomas. Report of seven cases.

Multifocal gliomas fall into four main categories: diffuse, multiple, multicentric and multiple-organ. Multicentric gliomas are uncommon lesions of the central nervous system. Even more so are multicentric gliomas lying both above and below the tentorium (16 cases to date, as far we know).

The effects of pipecuronium bromide on intracranial pressure and cerebral perfusion pressure.

Twenty patients with expansive pathologic intracranial lesions, who were anesthetized with thiopental, nitrous oxide in oxygen, and fentanyl and mechanically ventilated to ensure normocarbia, received pipecuronium bromide 70 microg/kg i.v. Intracranial pressure (ICP), heart rate, arterial pressure, central venous pressure (CVP), EKG, and end-tidal CO2 were simultaneously recorded for 5 min before and for 15 min after administration of the muscle relaxant.

Pulmonary embolism in neurosurgical patients.

We report the outcome of a retrospective study on the frequency of pulmonary embolism during the hospital stay in a series of 7,250 neurosurgical patients. Of 4,500 patients who underwent surgery 25 (0.55%) developed pulmonary embolism at some point after the operation while 5 of the 2,750 patients not operated on (0.

Tumors of the lateral ventricles.

Tumors are only rarely found in the lateral ventricles. Although various oncotypes of these tumors differ in growth rate and invasiveness they present the same clinical pattern with the same diagnostic and surgical problems. Thus we can consider them as a group.

Molecular organization of oncogenes and potentially oncogenic regulatory genes in primary human brain tumors.

We review here results obtained from a wide screening of 72 primary human brain tumors, in order to investigate the molecular organization of proto-oncogenes and potentially oncogenic genes. We demonstrated alterations in the restriction pattern of c-sis oncogene in 1 anaplastic astrocytoma and in 1 endotheliomatous meningioma, and amplifications of c-myc oncogene in 2 endotheliomatous meningiomas. In the same screening of primary brain tumors, we have recently published evidences for a specific alteration in the restriction pattern of estrogen receptor gene sequences which code for the DNA binding domain of the protein.

Chronic damage after spinal trauma in rat: neurophysiological and ultrastructural investigations.

A group of 10 rats underwent spinal trauma by epidural spinal compression according to Tator's procedure. After 4 months from injury cortical and spinal SEP were recorded, and the spinal injured tract was examined by electronic microscope. We studied morphologic and functional changes showed after some months behind the trauma.

Intra-extracranial thrombosis of the internal carotid artery associated with meningioma.

Cases of internal carotid artery occlusion associated with an intracranial tumor are rare. The authors report two cases of complete occlusion of the internal carotid artery. In one case the thrombosis was probably caused by direct compression of the carotid siphon by a large meningioma arising from the inner third of the sphenoid wing.

Altered restriction pattern of the putative DNA binding domain of estrogen receptor or related genes in primary human meningiomas.

We analyzed by restriction mapping the genomic organization of the estrogen receptor gene in several primary human brain tumors in order to investigate the possible relationships between the development of these tumors and gonadal steroid hormones. In 5 out of 23 meningiomas the Eco RI restriction of genomic DNAs revealed 6 invariant normal fragments of 6.5, 4.

Considerations on a case of intranasal cerebral ectopia.

The Authors report a case of intranasal cerebral ectopia; the problems concerning the nosographic and diagnostic definition of this condition as well as the differences from other similar pathologies with the same location (such as meningoencephalocele and nasal glioma) are discussed. Particular attention is payed to the various surgical techniques that can be used in these cases.