Abstract:
OBJECTIVE:The treatment of hypothalamus-invading craniopharyngiomas, based on pediatric experience, is subtotal resection (STR) with radiotherapy. This strategy sometimes leads to uncontrollable tumor progression. In adults, with the use of endoscopic endonasal surgery (EES), does removing the hypothalamic part of the tumor-whenever possible-compromise the outcome of the patients? METHODS:We included adults with craniopharyngioma treated by a first EES in 2008-2016 by senior neurosurgeon (E.J.). Endocrine, ophthalmologic, and hypothalamic data were retrospectively collected, including body mass index (BMI), cognitive and social status, with a systematic follow-up interview. Magnetic resonance imaging scans were graded according to Puget classification: 0, no hypothalamic involvement; 1, hypothalamic displacement; and 2, hypothalamic involvement. Grade 2 tumors were separated into gross total resection (GTR) or STR. RESULTS:We included 22 patients aged 18-79 years. Presenting symptoms were visual (14, 64%), endocrine dysfunction (10, 45%), BMI >30 (8, 36%), and cognitive/psychiatric impairment (9, 41%). Fourteen (64%) were grade 2 craniopharyngiomas. GTR was performed in 14 (64%) patients. Postoperatively, 12/14 (86%) cases improved visually, and 20 (91%) needed hormone replacement therapy. There was no difference in BMI evolution in the GTR versus STR group, cognitive status was stable or improved in all patients except 1; 4/8 patients with STR experienced progression needing adjuvant treatment versus no patient with GTR. CONCLUSIONS:EES GTR of grade 2 craniopharyngiomas does not cause major hypothalamic worsening, in contrast with children operated by cranial approaches. The surgeon's experience is key in deciding when to stop the dissection. Offering GTR whenever possible aims at avoiding tumor progression and radiotherapy.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Apra C,Enachescu C,Lapras V,Raverot G,Jouanneau Edoi
10.1016/j.wneu.2019.06.037subject
Has Abstractpub_date
2019-09-01 00:00:00pages
e803-e811eissn
1878-8750issn
1878-8769pii
S1878-8750(19)31578-5journal_volume
129pub_type
杂志文章abstract:BACKGROUND:The trigeminocerebellar artery (TCA) is a branch of the basilar artery supplying both the trigeminal nerve root and the cerebellar hemisphere. Despite its proximity to the trigeminal nerve, only a few cases of trigeminal neuralgia (TN) caused by TCA compression of the trigeminal nerve have been reported. Mor...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
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journal_title:World neurosurgery
pub_type: 杂志文章
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2020.05.128
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.10.204
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abstract:BACKGROUND:Previous studies compared outcomes of intracranial meningioma surgery in octogenarians with outcomes in younger patients without accounting for different tumor locations and sizes. The aim of the current study was to evaluate outcomes of intracranial meningioma surgery in octogenarians taking into account pa...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.09.001
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Sinus histiocytosis with massive lymphadenopathy, also known as Rosai-Dorfman disease, is a rare condition, classically characterized by painless, massive cervical lymphadenopathy. Histologically, the pathognomonic findings include a dense, mixed inflammatory infiltrate with areas of emperipolesis. Albeit in...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2016.02.121
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Anterior sacral meningocele (ASM) is characterized by a herniation of the dural sac through a bony defect of the anterior sacral wall. Symptoms of ASMs are usually directly related to their mass effect on the adjacent pelvic structures, often causing chronic constipation and urinary disturbances. The low-dys...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.105
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:The best technique for the first attempt at mechanical thrombectomy for acute ischemic stroke is a still matter of debate. In this study, we evaluate the efficacy of a stent-retrieving into an aspiration catheter with proximal balloon (ASAP) technique that uses a series of thrombus extraction by withdrawing t...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.10.004
更新日期:2018-01-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2012.11.053
更新日期:2013-12-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.08.252
更新日期:2019-12-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.01.244
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:The angioarchitecture and presentation of arteriovenous malformations (AVMs) associated with AVM hemorrhage may vary with patient age. Our aim was to determine the influence of patient age at diagnosis on hemorrhage patterns and outcomes. METHODS:A consecutive case series of 267 cases of ruptured AVMs was r...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.05.020
更新日期:2015-10-01 00:00:00
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journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.08.120
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:The present study evaluated the relationships among perioperative hyperchloremic metabolic acidosis (HCA), hyperchloremia, and postoperative acute kidney injury (AKI) in patients who had undergone craniotomy for intracranial hemorrhage (ICH). METHODS:The present retrospective cohort study included adult pat...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.02.015
更新日期:2019-05-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.06.203
更新日期:2019-10-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.08.134
更新日期:2018-12-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2020.07.093
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:The endoscopic approach, chiefly via the maxillary sinus, has growing applications for the lateral skull base, and can be classified into the use of "endonasal" or "sublabial" entry. Although the endonasal transmaxillary approach has been well accepted, it has a limitation with respect to the lateral exposur...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.06.157
更新日期:2020-10-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.07.133
更新日期:2017-11-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.02.153
更新日期:2019-06-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.10.145
更新日期:2020-11-02 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.12.123
更新日期:2020-12-31 00:00:00
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journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.09.132
更新日期:2021-01-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.07.083
更新日期:2020-10-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.02.075
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:The standard freehand method for the insertion of external ventricular drains (EVDs) is associated with high rates of incorrect placement. Use of neuronavigation has been shown to reduce the rates of inaccurately positioned EVDs. We present a novel neuronavigation-based approach for EVD placement using flat ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.192
更新日期:2018-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2019.09.097
更新日期:2020-01-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.03.206
更新日期:2019-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2016.08.124
更新日期:2016-12-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.07.102
更新日期:2020-11-01 00:00:00