Abstract:
BACKGROUND:Giant and large pituitary adenomas (PA) constitute a specific subset of PAs, with gross total resection (GTR) rates frequently not exceeding 50%. Both an anatomical inaccessibility and an inadequate tumor visualization are thought to play a role. This study analyzes risk factors for postoperative residuals after endoscopic transsphenoidal pituitary surgery for large and giant pituitary adenomas. METHODS:A retrospective analysis of patients with giant and large PA operated between 2015 and 2018 was performed. RESULTS:Forty patients (13 females, 27 males) were included in the analysis (30 large and 10 giant PAs). The mean MRI follow-up time was 5.9 ± 6.54 months. Overall, GTR was achieved in 29 patients (72.5%), subtotal resection in 9 (22.5%), and the inconclusive result was in 2 (5%). Unexpected residuals represented 7 (77.7%) of all 9 residual tumors. The most frequent intraoperative factor associated with unexpected residual tumors was improper identification of residual tumor due to obstruction of view in 2 (28.5%) cases and inability to distinguish normal tissue from tumor in the other two (28.5%). Sub-analysis based on tumor size revealed that with large PAs, GTR was achieved in 25 (83.3%), STR in 4 (13.3%), and inconclusive in 1 (3.3%) patient. In patients with giant PAs, GTR was achieved in 4 (40%), STR in 5 (50%), and inconclusive in 1 (10%). Analysis of preoperative factors showed a significant association of residual tumors with larger suprasellar AP distance (p = 0.041), retrosellar extension (p = 0.007), and higher Zurich Score (p = 0.029). CONCLUSION:Large and giant PAs are challenging lesions with high subtotal resection rates. Suprasellar AP distance, retrosellar extension, and higher Zurich Score seem to be significant predictors of degree of resection in these tumors. Improving the intraoperative ability to distinguish tumor from a normal tissue might further decrease the number of unexpected residuals.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Peto I,Abou-Al-Shaar H,White TG,Abunimer AM,Kwan K,Zavadskiy G,Wagner K,Black K,Eisenberg M,Bruni M,Dehdashti ARdoi
10.1007/s00701-020-04497-1subject
Has Abstractpub_date
2020-10-01 00:00:00pages
2341-2351issue
10eissn
0001-6268issn
0942-0940pii
10.1007/s00701-020-04497-1journal_volume
162pub_type
杂志文章abstract::In the last 3.5 years (up to August 1988) out of 450 patients with surgically treated intracranial aneurysms in 100 cases (22%) acute surgery was performed (up to 72 h after SAH). Patients in grade I-III (WFNS scale) were operated upon. In all the cases there were supratentorial aneurysms. CSF drainage during the oper...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01420184
更新日期:1990-01-01 00:00:00
abstract::Although primary treatment of medulloblastoma is now successful in a high percentage of patients, its secondary manifestations still bear a poor prognosis. Thorough studies of secondary manifestations are therefore pivotal to plan therapeutic approaches for the long-term management of medulloblastoma. Here we describe...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01410612
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abstract:INTRODUCTION:An open collaborative international network has been established which aims to improve inter-centre standards for collection of high-resolution, neurointensive care data on patients with traumatic brain injury. The group is also working towards the creation of an open access, detailed and validated databas...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,多中心研究
doi:10.1007/s00701-003-0066-6
更新日期:2003-08-01 00:00:00
abstract:INTRODUCTION:Glomus jugulare tumours represent a great therapeutic challenge. Previous papers have documented good results from Gamma Knife surgery (GKS) with these tumours. However, the relationship between clinical improvement and tumour shrinkage has never been assessed. MATERIALS AND METHODS:There were 14 patients...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0268-7
更新日期:2009-05-01 00:00:00
abstract:STUDY DESIGN:Retrospective analysis of 357 cases of degenerative disc disease treated by interbody fusion with threaded titanium cages. OBJECTIVE:To determine the safety and efficiency of cervical and lumbar interbody fusions using threaded titanium cages and autogenous bone. SUMMARY OF BACKGROUND DATA:Stabilizing th...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050453
更新日期:2000-01-01 00:00:00
abstract:INTRODUCTION:A 55-year-old man underwent a microvascular decompression procedure for a pharmacoresistant trigeminal neuralgia. Preoperative MRI showed a neurovascular conflict between the Vth nerve root and the superior cerebellar artery. METHODS:Dissection of the intracisternal trigeminal root was undertaken, and a p...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0488-x
更新日期:2010-04-01 00:00:00
abstract:PURPOSE:The present study investigated the incidence of acute rebleeding after successful coil embolization of a ruptured cerebral aneurysm, including clinical outcomes, and possible mechanisms of the events other than coil compaction and/or incomplete embolization. MATERIALS AND METHODS:This study included 591 consec...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0593-x
更新日期:2010-05-01 00:00:00
abstract::The clinical findings and operation results in two series of patients with medial prolapse of an intervertebral disc with total or partial occlusion of the spinal canal are reported. In one of the series (30 patients) symptoms of cauda equina compression, with bladder and rectal disturbances, were present, and in the ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405333
更新日期:1978-01-01 00:00:00
abstract:OBJECTIVE:We compared the electrode positions of subthalamic nucleus (STN) deep brain stimulation (DBS) estimated at the immediate postoperative period with those estimated 6 months after surgery. METHODS:Brain CT scans were taken immediately and 6 months after bilateral STN DBS in 53 patients with Parkinson's disease...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0771-x
更新日期:2010-12-01 00:00:00
abstract::The role of superficial temporal artery--middle cerebral artery (STA-MCA) anastomosis was investigated with an ultrasonic Doppler flowmeter in 3 patients with sphenoid ridge meningiomas and one with a parasellar malignant teratoma, all of which involved the intracranial internal carotid artery. The intraoperative Dopp...
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pub_type: 杂志文章
doi:10.1007/BF01406817
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:Close relatives (CR) of patients with severe traumatic brain injury (TBI) and high-grade subarachnoid hemorrhage (SAH) suffer extraordinary distress during the treatment: Distress may lead to persisting mental illness symptoms within the spectrum of post-traumatic stress disorder (PTSD), anxiety disorders, a...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
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更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Pituitary transposition preserving gland function is possible when approaching superior clival region tumors. Clinical experience along with detailed anatomical knowledge makes this technique safe and effective. METHOD:We present a step by step description of our technique based on the most recent anatomica...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-04012-1
更新日期:2019-10-01 00:00:00
abstract::The review of the literature on Cheyne-Stokes respiratory periods reveals enormous variation of the opinions expressed. The original description concerned periodicity characterized by rhythmic changes of respiratory phases and respiratory pauses in a relation of 60 : 15 seconds. In the respiratory phase there were 30 ...
journal_title:Acta neurochirurgica
pub_type: 历史文章,杂志文章,评审
doi:10.1007/BF01809226
更新日期:1978-01-01 00:00:00
abstract:BACKGROUND:The microsurgical unilateral laminotomy (MUL) technique for bilateral decompression of lumbar spinal stenosis (LSS) is a less destabilizing alternative to laminectomy and leads to good short-term outcomes. However, little is known about the long-term results including predictive factors. METHODS:Medical rec...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2804-6
更新日期:2016-06-01 00:00:00
abstract::Primary spinal cord oligodendrogliomas are rare tumours. Only 3 holocord cases have been reported in the literature. We present a primary intramedullary "holocord" oligodendroglioma in a 13 year-old male. Scoliosis was the initial symptom. Neurological deterioration prompted MRI, which demonstrated the lesion. Total r...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
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更新日期:1991-01-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3138-8
更新日期:2017-05-01 00:00:00
abstract::Fourteen cases of midline vertebro-basilar trunk aneurysms were operated on by four routes of surgical approach: middle fossa anterior transpetrosal approach (ATP), presigmoid transpetrosal approach (PTP), conventional lateral suboccipital approach (LSO) or suboccipital transcondylar approach (STC). There was no morta...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01420302
更新日期:1996-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2019-05-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2018-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s00701-013-1830-x
更新日期:2013-11-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-04007-y
更新日期:2019-10-01 00:00:00
abstract::An association between fibromuscular dysplasia (FMD) and intracranial aneurysms has been proposed but the occurrence of multiple aneurysms on the trunk of basilar artery (BA) associated with FMD has not been previously reported. ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-003-0163-6
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Vestibular schwannoma (VS) is a benign tumor originating from the vestibulocochlear nerve. The optimal treatment strategy is debated, since surgery may result in iatrogenic facial nerve injury. We report the results of VS surgery in a population-based unselected cohort in a center with access to Cyber Knife ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-04055-4
更新日期:2020-01-01 00:00:00
abstract::Microvascular decompression (MVD) has come to stay as an effective way of treating hemifacial spasm. But it remains to be seen how much each of the electrophysiological monitoring techniques (intra-operative) are contributing to its increased efficacy. Their role as indicators for re-exploration or recurrence is to be...
journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章
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更新日期:2001-01-01 00:00:00
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journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
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更新日期:2009-02-01 00:00:00
abstract::A total of 39 patients suffering from clinical instability of the lumbar spine after microdiscectomy were evaluated for their long-term outcome. Included there were 21 (54%) male and 18 (46%) female patients with a mean age of 55 years. All had been operated on for a virgin single-level lumbar disc herniation between ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
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更新日期:1998-01-01 00:00:00
abstract::In this paper the results of measurements of ultrasound velocity in, and density of, a number of normal and pathological tissues are given. From the results it can be concluded that intracranial pathological regions will often be detectable with ultrasound techniques, but is is not possible with any degree of certaint...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
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更新日期:1979-01-01 00:00:00