Other Nerve Sheath Tumors of Brain and Spinal Cord.

The three main types of nerve sheath tumors are schwannomas, neurofibromas and perineuriomas. Multiple neurofibromas throughout the body are the hallmark of Neurofibromatosis type 1 (NF1). Spinal nerve sheath tumors are classified in the group of intradural extramedullary spinal cord tumors, in which they are the most common type (25-30%).

Schwannomas of Brain and Spinal Cord.

Schwannomas are benign tumors originating from the Schwann cells of cranial or spinal nerves. The most common cranial schwannomas originate from the eight cranial nervevestibular schwannomas (VS). VS account for 6-8% of all intracranial tumors, 25-33% of the tumors localized in the posterior cranial fossa, and 80-94% of the tumors in the cerebellopontine angle (CPA).

Perioperative seizure in patients undergoing brain mapping under awake craniotomy for language-related eloquent region gliomas: a prospective study.

Background: Awake craniotomy (AC) is standard of care for lesions of eloquent brain areas. One important complication during AC is occurrence of intraoperative seizure (IOS), reported to occur among 3.4-20% of the patients.

Changes in Cognitive Functioning After Surgical Resection of Language-related, Eloquent-area, High-grade Gliomas Under Awake Craniotomy.

Background: Dominant-hemisphere tumors, especially gliomas, as infiltrative tumors, frequently affect cognitive functioning. Establishing a balance between extensive resection, which is proven to result in longer survival, and less extensive resection, in order to maintain more cognitive abilities, is challenging.

Objective: To evaluate changes in cognitive functioning before and after surgical resection of language-related, eloquent-area, high-grade gliomas under awake craniotomy.

Elderly Patients with Frontobasal and Suprasellar Meningiomas: Safety and Efficacy of Tumor Removal via Frontolateral Approach.

Objective: Many neurosurgeons prefer conservative treatments in the elderly because of higher rates of mortality and morbidity after surgery. We aim to evaluate safety and efficacy of surgery in elderly patients with frontobasal and suprasellar meningiomas with a simple operative procedure, the frontolateral approach.

Methods: Retrospective analysis was made in consecutive patients with meningiomas operated via frontolateral approach.

Imaging features and classification of peritumoral edema in vestibular schwannoma.

Background: Peritumoral edema (PTE) is rarely present in patients with vestibular schwannomas (VS). We studied the correlation between radiological tumor characteristics and the presence of edema, describe its magnetic resonance imaging features and classify the different edema patterns.

Methods: We analysed 605 consecutive patients treated for VS at our Institute.

The Significance of Intraoperative Magnetic Resonance Imaging in Resection of Skull Base Chordomas.

Background: Skull base chordoma can be a challenging surgical entity because of its invasive nature.

Objective: In this study, the role of intraoperative magnetic resonance imaging (iMRI) to optimize the resection of skull base chordomas is evaluated.

Methods: We performed a retrospective analysis of operated patients with skull base chordomas in the setting of iMRI.

Nervus intermedius dysfunctions after vestibular schwannoma surgery: a prospective clinical study.

Objective: The purpose of this prospective study was to evaluate the dysfunction of the nervus intermedius (NI) after vestibular schwannoma (VS) surgery. The authors present a clinically feasible method for this purpose.

Methods: In this prospective study, the authors included 30 patients who underwent surgery at the International Neuroscience Institute between May 2014 and February 2017 for resection of VS.

Evaluation of Olfactory Outcome After Frontolateral Approach for Treatment of Suprasellar Tumors.

Objective: We present the findings of our prospective study assessing olfactory function outcome in patients undergoing a frontolateral approach for the resection of suprasellar lesions.

Methods: Eighteen consecutive patients (7 females, 11 males) surgically treated at our institute for suprasellar tumors were included in this prospective study. Olfactory function was evaluated at the admission and 14 days after the surgery using the standard 12-item "Sniffin' Sticks" screening (SSS) test.

Efficiency and Safety of Autologous Fat Grafts in Reconstructing Skull Base Defects After Resection of Skull Base Meningiomas.

Background: Reconstruction of the skull base after resection of skull base meningiomas is of paramount importance. Here we describe a safe and effective method of skull base reconstruction using autologous free fat grafts.

Methods: In this retrospective analysis of patients operated for skull base meningioma from 2007 to 2014.

Microsurgical management of vestibular schwannoma after failed previous surgery.

OBJECTIVE Microsurgical treatment of recurrent vestibular schwannoma (VS) is difficult and poses specific challenges. The authors report their experience with 53 cases of surgically treated recurrent VS. Outcome of these tumors was compared to that of primarily operated on VS.

Efficacy of microsurgical tumor removal for treatment of patients with intracanalicular vestibular schwannoma presenting with disabling vestibular symptoms.

OBJECTIVE The aim of this study was to analyze the efficacy and risks of microsurgery via the hearing-preserving retrosigmoid approach in patients with intracanalicular vestibular schwannoma (VS) suffering from disabling vestibular symptoms, with special attention to vertigo. METHODS This is a retrospective analysis of 19 patients with intracanalicular VS and disabling vestibular dysfunction as the main or only symptom (Group A). All of the patients reported having had disabling vertigo attacks.

Optic nerve mobilization to enhance the exposure of the pituitary stalk during craniopharyngioma resection: early experience.

OBJECT Preservation of the pituitary stalk and its vasculature is a key step in good postoperative endocrinological outcome in patients with craniopharyngiomas. In this article, the authors describe the surgical technique of medial optic nerve mobilization for better inspection and preservation of the pituitary stalk. METHODS This operative technique has been applied in 3 patients.

Endoscope-assisted retrosigmoid infralabyrinthine approach to jugular foramen tumors.

Objective: Removal of jugular foramen (JF) tumors usually requires extensive skull base approaches and is frequently associated with postoperative morbidities such as lower cranial nerve injury. The endoscope-assisted retrosigmoid infralabyrinthine approach is a relatively new approach to tumors extending into the bony canal of the JF. The authors present their experience with this approach.

Surgical Treatment of Jugular Foramen Schwannoma: Surgical Treatment Based on a New Classification.

Background: Surgery plays a crucial role in the management of jugular foramen schwannomas (JFSs). Still, it remains challenging, particularly in cases of tumor growth inside the bony canal of the jugular foramen (JF).

Objective: To present our recent experience with surgical treatment of JFSs, with particular focus on the efficacy and safety of the endoscope-assisted retrosigmoid infralabyrinthine and transcervical approaches for tumors extending through the JF bony canal.

Assessment of quantitative corticospinal tract diffusion changes in patients affected by subcortical gliomas using common available navigation software.

Objective: The aim of this study is to analyze the quantitative DTI parameters of the CST in patients suffering from subcortical gliomas affecting the CST using generally available navigation software.

Methods: A retrospective study was conducted on 22 subjects with diagnosis of primary cerebral glioma and preoperative motor deficits. Exclusion criteria were: involvement of motor cortex, lesion involving both hemispheres, previous surgical treatment.

Prognostic Significance of Peritumoral Edema in Patients With Vestibular Schwannomas.

Background: Peritumoral edema (PTE) in skull base meningiomas correlates to the absence of an arachnoid plane and difference in outcome. In vestibular schwannomas (VS), PTE and its significance for microsurgery and outcome have never been systematically evaluated.

Objective: To evaluate whether PTE correlates with tumor characteristics, the presence of an arachnoid plane, and outcome.

Combined endonasal and sublabial endoscopic transmaxillary approach to the pterygopalatine fossa and orbital apex.

Background: The pterygopalatine fossa (PPF) and inferomedial orbital apex are difficult regions for open neurosurgical access. The traditional extensive anterior approach (transfacial or transmandibular) and lateral/posterolateral (transcranial) approach were used to access the PPF. The combined endonasal and sublabial transmaxillary approach is a less invasive access route for these lesions.

Prevention of venous thromboembolic complications with and without intermittent pneumatic compression in neurosurgical cranial procedures using intraoperative magnetic resonance imaging. A retrospective analysis.

Object: To evaluate the introduction of intraoperative and postoperative pneumatic compression additionally to the use of compression stockings, low molecular weight heparin-LMWH and early mobilization, a retrospective study in cranial neurosurgery using intraoperative MRI was performed.

Methods: A retrospective analysis of 207 neurosurgical patients using intraoperative MRI was performed. A group of 86 patients was treated with the additional use of intraoperative and postoperative pneumatic compression until mobilization out of bed.

Comparison of Direct Side-to-End and End-to-End Hypoglossal-Facial Anastomosis for Facial Nerve Repair.

Background: The hypoglossal facial anastomosis (HFA) is the gold standard for facial reanimation in patients with severe facial nerve palsy. The major drawbacks of the classic HFA technique are lingual morbidities due to hypoglossal nerve transection. The side-to-end HFA is a modification of the classic technique with fewer tongue-related morbidities.

The peculiar cystic vestibular schwannoma: a single-center experience.

Objective: The operative management of cystic vestibular schwannoma is more challenging. In this study, we focus on the peculiarity of cystic vestibular schwannoma in terms of management and outcome. We evaluated a homogenous series of consecutive patients with cystic vestibular schwannomas who were operated on with a similar technique and via the same surgical approach.

Endoscope-assisted retrosigmoid intradural suprameatal approach for surgical treatment of trigeminal schwannomas.

Background: Trigeminal schwannomas are the most common intracranial nonvestibular schwannomas, and the dumbbell-shaped subtype is the most challenging.

Objective: To evaluate the efficiency and safety of the endoscope-assisted retrosigmoid intradural suprameatal approach (EA-RISA) for dumbbell trigeminal schwannomas and to compare EA-RISA with classic RISA.

Methods: A retrospective study of all patients with trigeminal schwannomas was performed with a focus on dumbbell tumors.

Operative management of patients with radiosurgery-related trigeminal neuralgia: analysis of the surgical morbidity and pain outcome.

Object: Trigeminal neuralgia (TGN) occurring after radiosurgical treatment of cerebellopontine or petroclival tumors may be very difficult to control. Our aim was to determine the efficacy of neurosurgical treatment in regards to pain control and to evaluate the procedure-related complication and morbidity rates.

Methods: Retrospective study of a series of operated patients with radiosurgery-induced TGN.