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Background: Pituitary apoplexy may occur when a large tumor compresses or outgrows its nutrient supply, resulting in ischemic necrosis and hemorrhage. Although once deemed a neurosurgical emergency, increasing evidence suggests that conservative management of pituitary apoplexy leads to favorable neuro-ophthalmologic and endocrinologic outcomes as well. Spontaneous remission after pituitary apoplexy has been described in functioning pituitary adenomas, but it is a rare occurrence in nonfunctioning tumors., Case Description: We report a man that presented with pituitary apoplexy of a nonfunctioning pituitary macroadenoma that was managed conservatively and treated hormonally for hypopituitarism during a 2-year follow-up period, with serial neuroimaging demonstrating significant tumor volume reduction with almost complete resolution resulting in partial empty sella. In addition, a short literature review was performed pertaining to the management of pituitary apoplexy with emphasis on a more conservative approach., Conclusions: A subset of patients with pituitary apoplexy without altered consciousness and nonprogressive or mild ophthalmologic deficits may be managed conservatively; however, lifelong periodic assessment, preferably by a specialized multidisciplinary pituitary team, is essential until clinical outcomes become clear., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective: In the treatment of degenerative lumbar stenosis, facet-sparing laminectomy with instrumented fusion (FSL) was recently almost totally replaced by less invasive, allegedly equally effective surgical techniques. We performed a long-term comparison between outcomes after Young laminoplasty (YL) as a representative of the less invasive technique and FSL., Methods: From December 4, 2000, to March 11, 2005, 56 patients with a history of neurogenic claudication and radiologically verified absolute lumbar stenosis were surgically treated. After applying inclusion and exclusion criteria, 44 patients were enrolled., Results: Using the Oswestry Disability Index scale, significant improvement on 1-year and 8-year follow-up examinations was noticed in the FSL and YL groups. The Oswestry Disability Index was significantly better in the FSL group compared with the YL group at the 8-year follow-up (27.82 ± 1.918 vs. 40.74 ± 2.163)., Conclusions: FSL is a more invasive and more expensive surgical technique than YL. In a short-term and long-term follow-up comparison, FSL is a more successful operative technique, and the difference increases over time in favor of FSL., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Cavernous malformations are classified as a group of vascular malformations of the central nervous system. Conservative treatment of brainstem cavernomas is accompanied with poor outcome. Surgery ofbrainstem cavernomas still poses a challenge due to the high risk of neurological damage and respectable morbidity. We report a case of complete neurological recovery in a 24-year-old female patient with mesencephalic cavernoma treated surgically. This case highlights that careful microsurgical treatment with the goal of complete cavernoma excision remains the treatment of choice in cases with de novo or recurrent hemorrhage. Intraoperative neurophysiologic monitoring should be used as the gold standard during brainstem cavernoma operations in order to avoid nuclear and long tract damages.