Combined simultaneous transcranial and transsphenoidal resection of large-to-giant pituitary adenomas.

Background: While large-to-giant pituitary adenomas (PAs) may be safely removed by experienced surgeons through a single route, the procedure is technically challenging. We present the outcome of a simultaneous combined transcranial and transsphenoidal approach and discuss its applications.

Methods: A retrospective review was conducted on 12 consecutive patients.

False-negative cerebrospinal fluid cryptococcal antigen test due to small-colony variants of Cryptococcus neoformans meningitis in a patient with cystopleural shunt.

This is the first report of a small-colony variant Cryptococcus neoformans isolated from the cerebrospinal fluid of a patient with cystopleural shunt associated chronic meningitis. Cryptococcal antigen testing of the cerebrospinal fluid and the serum were both negative. The atypical morphology and the false-negative test may lead to delay of diagnosis and treatment.

Outcome analysis of patients with craniofacial resection: Hong Kong experience.

Background: The aim of this study was to evaluate the clinical outcome of patients who underwent craniofacial resection for tumour in the anterior skull base at the University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong between January 1993 and June 2003.

Methods: A retrospective review was conducted. The duration of follow up ranged from 1.

Emergency placement of a self-expandable covered stent for carotid artery injury during trans-sphenoidal surgery.

A patient sustained internal carotid artery (ICA) injury during trans-sphenoidal surgery. Bleeding from the resultant pseudo-aneurysm was not fully controlled by surgical packing. Emergency endovascular deployment over the injured ICA segment of a self-expandable covered-stent ('Symbiot' stent), initially designed for use in coronary saphenous vein-graft, was successful in securing haemostasis.

[Auditory brainstem implantation in patient with bilateral acoustic neuromas].

Objective: To restore auditory sensation for patient suffering loss of hearing due to bilateral acoustic neuromas.

Method: One patient of bilateral acoustic neuromas received auditory brainstem implant (ABI) at the same surgery for resection of the second tumor. The retrosigmoid approach was used for resection of the tumor and to exposure the lateral recess of the fourth ventricle for placement of ABI electrode array.

Chronic subdural haematoma and arachnoid cyst in autosomal dominant polycystic kidney disease (ADPKD).

We present the unusual association between chronic subdural haematoma (CSDH), intracranial arachnoid cyst and autosomal dominant polycystic kidney disease (ADPKD) in a 27-year-old man. CSDH is a documented complication of intracranial arachnoid cyst, the incidence of which is increased in patients with ADPKD. Awareness of this association may lead to earlier diagnosis of ADPKD and treatment of its systemic complications, including renal insufficiency, systemic hypertension and previously unsuspected intracranial saccular aneurysm.

Endoscopic-assisted cranionasal resection of olfactory neuroblastoma.

Background: Cranionasal resection was first described in 1997 for the surgical resection of olfactory neuroblastoma. The endoscopic transnasal approach is used in cranionasal resection to replace the more invasive craniofacial resection. It has the advantages of avoiding the facial wound and its associated pain, swelling, and scar.

Metastatic melanoma of the pituitary gland. Case report.

The authors report on the clinical features and imaging studies in a case of metastatic melanoma of the pituitary gland. Cerebral metastatic melanoma and pituitary metastasis from any source are commonly associated with systemic metastasis, whereas pituitary metastatic melanoma without widespread disease dissemination is distinctly rare. This 46-year-old man presented with diabetes insipidus and anterior pituitary dysfunction 5 years after he underwent resection of a cutaneous malignant melanoma of the neck.