A phase II, open-label, single-arm trial of pembrolizumab for recurrent meningioma and solitary fibrous tumor.

Background: Atypical and anaplastic meningiomas account for 20% of all meningioma cases. Solitary fibrous tumor (SFT) is a type of soft tissue sarcoma with similar attributes to meningioma. For patients with refractory or recurrent disease after previous surgery or radiotherapy, there is no effective treatment.

Stem the blood flow: beneficial impact of bevacizumab on survival of subventricular zone glioblastoma patients.

Purpose: Angiogenesis is a crucial step in tumorigenesis of glioblastoma (GBM). Bevacizumab, an anti-vascular endothelial growth factor drug, is approved for second-line therapy for GBM. Glioma stem cells, presumably the cell of origin of GBM, take an active role in angiogenesis.

Significant Systemic Insulin Resistance is Associated With Unique Glioblastoma Multiforme Phenotype.

Background: Some glioblastoma multiforme (GBM) are characterized by the presence of gemistocytes (GCs), a unique phenotype of reactive astrocytes. Certain GCs can be identified as neoplastic cells but these cells were also found to be associated with diabetes in non-neoplastic lesions of the central nervous system. Our aim was to find a correlation between insulin - resistance metabolic features and the presence of GCs in patients with newly diagnosed GBM.

Supratentorial hemangioblastoma: correlation between phenotype, gender and vascular territory affected.

Supratentorial hemangioblastomas are rare, vascular lesions. The presence of peri-tumoral cysts and edema has meaningful clinical, diagnostic and therapeutic implications. Nevertheless, the pathogenesis of both cyst and edema formation is not fully understood.

[THERAPEUTIC OPTIONS FOR BRAIN OLIGOMETASTASES: COMPARISON BETWEEN SURGICAL RESECTION, STEREOTACTIC RADIOSURGERY, WHOLE BRAIN RADIATION THERAPY AND COMBINED MODULES IN RELATION TO SURVIVAL, FUNCTION AND OTHER CONSIDERATIONS].

Brain metastases (BM) are a leading cause of morbidity and mortality in patients with systemic cancer. In the last two decades, an enormous improvement in controlling extra-cranial disease has been achieved, positively affecting the overall survival of patients. However, this has led to an increased number of patients who live long enough to develop BM.

Deep, spontaneous intracerebral hemorrhages: Clinical differences and risk factors associated with anterior versus posterior circulation.

Background: spontaneous intracerebral hemorrhages (ICH) in different anatomical locations are considered different clinical entities, associated with different vascular etiologies. However, such a distinction between deep ICH in the posterior vs. the anterior circulation is not well documented.

Neuropsychological assessments and cognitive profile mostly associated with shunt surgery in idiopathic normal pressure hydrocephalus patients: diagnostic and predictive parameters and practical implications.

Background: Cognitive decline is a well-documented feature of idiopathic normal pressure hydrocephalus (iNPH) that can be reversible following cerebrospinal fluid tap tests (CSF-TT). The current gold standard for selecting iNPH patients for shunt surgery is measurable improvement in gait tests following CSF-TT. However, the diagnostic significance and predictive role of pre-surgical cognitive evaluations in probable iNPH patients is still controversial.

Gemistocytes in newly diagnosed glioblastoma multiforme: Clinical significance and practical implications in the modern era.

Background: Gemistocytes (GCs) in low grade gliomas are associated with rapid growth and worse prognosis. However, their clinical significance in glioblastomas (GBM) is a matter of debate.

Aim Of Study: To investigate the clinical significance of the presence of GCs in newly-diagnosed GBM patients in the modern era.

Minimally Invasive Intracerebral Hematoma Evacuation Using a Novel Cost-Effective Tubular Retractor: Single-Center Experience.

Background: Spontaneous intracerebral hematoma (ICH) is a common disease with a dismal overall prognosis. Recent development of minimally invasive ICH evacuation techniques has shown promising results. Commercially available tubular retractors are commonly used for minimally invasive ICH evacuation yet are globally unavailable.

Deep versus Superficial Spontaneous Cerebellar Hemorrhages: Separated Vascular Etiologies with Different Clinical Consequences.

Background: Spontaneous cerebellar hemorrhage (CH) is a critical neurosurgical event. It is usually categorized as a homogenous group under the general term of deep/nonlobar intracerebral hemorrhage. However, increasing evidence suggests it is composed of 2 subgroups, separated from each other by their anatomic location (deep vs.

Height in adolescence as a risk factor for glioma subtypes: a nationwide retrospective cohort study of 2.2 million subjects.

Background: Gliomas manifest in a variety of histological phenotypes with varying aggressiveness. The etiology of glioma remains largely unknown. Taller stature in adulthood has been linked with glioma risk.

Multicentric non-enhancing lesions in glioblastoma: A retrospective study.

Glioblastoma (GBM) typically presents as a single lesion. Multicentric GBM are defined as well separated lesions on MRI (enhancing and non-enhancing). Multicentric GBM with non-enhancing lesions (MNE-GBM) are rarely described in literature.

A Review of the Neurosurgical Management of Brain Metastases During Pregnancy.

Objective: Patients with pregnancy-associated secondary brain tumors (PASBT) are challenging to manage. Because no guidelines for the management of such patients currently exist, we performed a systematic review of the literature using PRISMA guidelines with a discussion of management from a neurosurgeon's perspective.

Method: Systematic review of the literature using PRISMA guidelines from 1999 to 2018.

Acute Presentation of Normal Pressure Hydrocephalus After Transcatheter Aortic Valve Implantation: A Novel Interaction Between the First and Third Circulations.

Background: Idiopathic normal pressure hydrocephalus (iNPH) negatively affects gait and cognition abilities and urine continence in the elderly. It is associated with systemic hypertension, although the exact pathophysiology is still unknown. A correlation to increased intracranial pulsatility and decreased compliance was suggested.

Height as a risk factor in meningioma: a study of 2 million Israeli adolescents.

Background: Meningiomas are the most common primary central nervous system tumors. Potential risk factors include obesity, height, history of allergy/atopy, and autoimmune diseases, but findings are conflicting. This study sought to assess the role of the different risk factors in the development of meningioma in adolescents/young adults.

Fulminant presentation of a SMARCB1-deficient, anterior cranial fossa tumor in adult.

Background: Malignant atypical teratoid rhabdoid tumor (ATRT) usually develops in children. ATRTs are rare in adults, with only one case in the literature describing involvement of the anterior skull base. These primary intracranial tumors are characterized molecularly as SMARCB1 (INI1) deficient.

[IS ROUTINE CT SCAN NECESSARY AFTER THE REMOVAL OF BENIGN BRAIN TUMORS?].

Aims: Determine if early CT evaluation is justified in patients operated on for benign brain tumors.

Background: Researchers have recently questioned the common practice of referring all patients after cranial surgery for CT scans to rule out silent complications.

Methods: The cohort included 257 consecutive patients who underwent surgical removal of a benign brain tumor in the years 2011-2016.

Chiari I malformation and pregnancy: a comprehensive review of the literature to address common questions and to guide management.

Background: The optimal management of Chiari I malformation during pregnancy remains uncertain. Labor contractions, which increase intracranial pressure, and neuraxial anesthesia both carry the theoretical risk of brainstem herniation given the altered CSF dynamics inherent to the condition. Mode of delivery and planned anesthesia, therefore, require forethought to avoid potentially life-threatening complications.

[DIFFUSE LOW GRADE GLIOMA: PERSONALIZED ADAPTATION OF SURGICAL RESECTION IN AN ERA OF TARGETED ONCOLOGICAL THERAPY].

Diffuse low grade glioma (DLGG) is a primary, infiltrative brain tumor which grows slowly but steadily and eventually undergoes malignant transformation into a high grade glioma. Today, it is hard to generalize the treatment approaches for DLGG. Due to different genetic and clinical variables, there is a large gap in the treatment provided to different patients.

Granular cell tumor of the infundibulum: a systematic review of MR-radiography, pathology, and clinical findings.

Introduction: Granular cell tumors (GCTs) of the infundibulum are rare in practice and literature, resulting in a lack of evidence-based standard of care. We present two characteristic cases from our institution and perform a systematic review of the existing literature to further elucidate the presentation of this tumor and guide management.

Methods: A systematic literature search was conducted according to PRISMA guidelines, yielding 42 total individual reported GCTs suitable for evaluation.

Spinal meningiomas: 61 cases with predictors of early postoperative surgical outcomes.

Background: Spinal meningiomas are benign, well-circumscribed and slowly-growing intradural tumors that compress the spinal cord. Hereby, a retrospective review of 61 spinal meningioma cases evaluated in terms of demographic, clinical, pathological and radiological features to predict the early postoperative functional outcomes.

Methods: Patients' records and MRI images of all the histologically confirmed spinal meningioma cases that underwent surgical resection at two university hospitals from January 2005 to June 2016 were retrospectively reviewed.

Subependymal Giant Cell Astrocytoma: Associated Hyperproteinorrhachia Causing Shunt Failures and Nonobstructive Hydrocephalus - Report of Successful Treatment with Long-term Follow-up.

Subependymal giant cell astrocytomas (SEGAs) are histologically benign tumors most frequently associated with tuberous sclerosis complex (TSC). Despite their benign histopathological appearance, they may cause unfavorable outcomes due to their intraventricular location. Rarely, SEGA may be associated with hyperproteinorrhachia (high levels of proteins in the cerebrospinal fluid [CSF]), which causes malresorptive, communicating hydrocephalus; certainly, this scenario makes shunt obstruction likely in this patient population.

Proposal of a new radiological classification system for spinal meningiomas as a descriptive tool and surgical guide.

Objectives: 1) To provide neurosurgeons and radiologists with a new quantitative and anatomical method to describe spinal meningiomas (SM) consistently. 2) To provide a guide to the surgical approach needed and amount of bony resection required based on the proposed classification. 3) To report the distribution of our 58 cases of SM over different Stages and Subtypes in correlation to the surgical treatment needed for each case.

Accelerated growth of hemangioblastoma in pregnancy: the role of proangiogenic factors and upregulation of hypoxia-inducible factor (HIF) in a non-oxygen-dependent pathway.

Hemangioblastomas (HBs) are benign, highly vascular tumors, often characterized by loss of function of the von Hippel-Lindau (vHL) gene. They are the most common central nervous system tumor observed in vHL syndrome. Loss of function of the vHL gene creates a "pseudo-hypoxic" state, causing overactivation of hypoxia-inducible factor (HIF) and vascular endothelial growth factor (VEGF)-related pathways.