254 results on '"Supratentorial Tumors"'
Search Results
2. An observational comparative study to evaluate the use of image-guided surgery in the management and outcome of supratentorial intracranial space-occupying lesions
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Ashis Patnaik, N Guruprasad, Arunkumar Sekar, Sumit Bansal, and Rabi N Sahu
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craniotomy ,neuronavigation ,postoperative neurological deficits ,supratentorial tumors ,Pharmacy and materia medica ,RS1-441 ,Analytical chemistry ,QD71-142 - Abstract
Objectives: The objective of this article is to study the effect of neuronavigation on the outcome of surgery for supratentorial tumors, such as the extent of resection, size of craniotomy, and overall morbidity and mortality by comparing with conventional excision. Methods: A total of 50 patients undergoing intracranial surgery for supratentorial space-occupying lesions from 2020 to 2022 were included in the study. One intervention group consisted of patients undergoing surgical resection of supratentorial tumors utilizing image guidance versus the control group, which consisted of patients undergoing surgical excision of supratentorial tumor excision without image guidance. Parameters used to compare the outcome were the extent of resection of the lesions, craniotomy size, and overall morbidity and mortality. Results and Conclusion: There was no significant reduction in craniotomy size or prolongation of operative duration with the use of neuronavigation. There was no significant difference in postoperative hospital stay between the two groups. Neuronavigation-assisted cases did not show any significant reduction in the occurrence of postoperative neurological deficits or any reduction of overall morbidity and mortality.
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- 2024
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3. An observational comparative study to evaluate the use of image-guided surgery in the management and outcome of supratentorial intracranial space-occupying lesions.
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Patnaik, Ashis, Guruprasad, N, Sekar, Arunkumar, Bansal, Sumit, and Sahu, Rabi
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COMPUTER-assisted surgery , *ARACHNOID cysts , *SURGICAL excision , *SCIENTIFIC observation , *CRANIOTOMY ,TUMOR surgery - Abstract
Objectives: The objective of this article is to study the effect of neuronavigation on the outcome of surgery for supratentorial tumors, such as the extent of resection, size of craniotomy, and overall morbidity and mortality by comparing with conventional excision. Methods: A total of 50 patients undergoing intracranial surgery for supratentorial space-occupying lesions from 2020 to 2022 were included in the study. One intervention group consisted of patients undergoing surgical resection of supratentorial tumors utilizing image guidance versus the control group, which consisted of patients undergoing surgical excision of supratentorial tumor excision without image guidance. Parameters used to compare the outcome were the extent of resection of the lesions, craniotomy size, and overall morbidity and mortality. Results and Conclusion: There was no significant reduction in craniotomy size or prolongation of operative duration with the use of neuronavigation. There was no significant difference in postoperative hospital stay between the two groups. Neuronavigation-assisted cases did not show any significant reduction in the occurrence of postoperative neurological deficits or any reduction of overall morbidity and mortality. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Preoperative assessment of optic nerve sheath diameter and heart rate variability to predict intraoperative brain condition in patients with supratentorial tumors: a prospective observational study.
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Krishnakumar, Mathangi, Gopalakrishna, Kadarapura Nanjundaiah, Dhritiman, C., Bhadrinarayan, V., Sundaram, Mouleeswaran, Goyal, Amit, Bhat, Dhananjaya I., and Naik, Shweta S.
- Abstract
Brain relaxation is an important requirement in intracranial neurosurgical procedures and optimal brain relaxation improves the operating conditions. Optic nerve sheath diameter (ONSD) is a non-invasive bedside surrogate marker of intracranial pressure (ICP) status. Elevated ICP is often associated with marked autonomic dysfunction. There is no standard measure to predict intraoperative brain condition non-invasively, considering both anatomical displacement and physiological effects due to raised ICP and brain oedema. This study was aimed to determine the usefulness of heart rate variability (HRV) parameters and ONSD preoperatively in predicting intraoperative brain relaxation in patients with supratentorial tumors undergoing surgery.This prospective observational study was conducted in a tertiary care centre. 58 patients with supratentorial brain tumors undergoing elective surgery were studied. Preoperative clinical presentation, computed tomography (CT) findings, ONSD and HRV parameters were assessed in determining intraoperative brain condition. Intraoperative hemodynamic parameters and brain relaxation score after craniotomy were studied. There was significant difference in CT grade, ONSD and HRV parameters in patients between lax and tight brain. A receiver operating curve was constructed to determine the cut off to predict intraoperative brain bulge. A CT grade more than 2, ONSD of greater than 0.63 cms and ratio of low frequency to high ratio (LF/HF) of more than 1.8 were good predictors of brain bulge. The changes in ONSD and HRV parameters, with the CT findings can be used as surrogate markers of increased ICP to help predict intraoperative brain condition. [ABSTRACT FROM AUTHOR]
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- 2023
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5. Brain relaxation using desflurane anesthesia and total intravenous anesthesia in patients undergoing craniotomy for supratentorial tumors: a randomized controlled study
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Ze Jiang, Youxuan Wu, Fa Liang, Minyu Jian, Haiyang Liu, Hongxun Mei, and Ruquan Han
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Desflurane ,Propofol ,Brain relaxation ,Supratentorial tumors ,Anesthesiology ,RD78.3-87.3 - Abstract
Abstract Background Satisfactory brain relaxation is essential in neurosurgery. Desflurane anesthesia and propofol-based total intravenous anesthesia (TIVA) have different effects on cerebral hemodynamics, potentially contributing to discrepant brain relaxation. The purpose of this study was to compare the effects of desflurane and TIVA on brain relaxation in patients undergoing craniotomy for supratentorial tumors. Methods In this randomized, controlled study, we enrolled patients aged 18–60 years, with ASA I–III, who were scheduled to undergo elective craniotomy for supratentorial tumors. Patients were randomly assigned in a 1:1 ratio to receive desflurane anesthesia or TIVA. The primary outcome was the proportion of satisfactory brain relaxation. Secondary outcomes included emergence and extubation times, recovery of cognitive function and postoperative complications. Results Of 369 patients who were assessed for eligibility, 111 were randomized and 110 were included in the modified intention-to-treat analysis (55 in the desflurane group and 55 in the TIVA group). The proportion of satisfactory brain relaxation was similar between the two groups: 69% in the desflurane group and 73% in the TIVA group (RR: 0.950, 95% CI: 0.748–1.207; P = 0.675). Patients assigned to the desflurane group had shorter emergence (10 [8–13] min vs. 13 [10–20] min, P
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- 2023
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6. Brain relaxation using desflurane anesthesia and total intravenous anesthesia in patients undergoing craniotomy for supratentorial tumors: a randomized controlled study.
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Jiang, Ze, Wu, Youxuan, Liang, Fa, Jian, Minyu, Liu, Haiyang, Mei, Hongxun, and Han, Ruquan
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BRAIN , *ANESTHESIA , *CONFIDENCE intervals , *COGNITION , *SURGICAL complications , *RANDOMIZED controlled trials , *TREATMENT effectiveness , *DESCRIPTIVE statistics , *TACHYCARDIA , *CRANIOTOMY , *SUPRATENTORIAL brain tumors - Abstract
Background: Satisfactory brain relaxation is essential in neurosurgery. Desflurane anesthesia and propofol-based total intravenous anesthesia (TIVA) have different effects on cerebral hemodynamics, potentially contributing to discrepant brain relaxation. The purpose of this study was to compare the effects of desflurane and TIVA on brain relaxation in patients undergoing craniotomy for supratentorial tumors. Methods: In this randomized, controlled study, we enrolled patients aged 18–60 years, with ASA I–III, who were scheduled to undergo elective craniotomy for supratentorial tumors. Patients were randomly assigned in a 1:1 ratio to receive desflurane anesthesia or TIVA. The primary outcome was the proportion of satisfactory brain relaxation. Secondary outcomes included emergence and extubation times, recovery of cognitive function and postoperative complications. Results: Of 369 patients who were assessed for eligibility, 111 were randomized and 110 were included in the modified intention-to-treat analysis (55 in the desflurane group and 55 in the TIVA group). The proportion of satisfactory brain relaxation was similar between the two groups: 69% in the desflurane group and 73% in the TIVA group (RR: 0.950, 95% CI: 0.748–1.207; P = 0.675). Patients assigned to the desflurane group had shorter emergence (10 [8–13] min vs. 13 [10–20] min, P < 0.001) and extubation times (13 [10–18] min vs. 17 [13–23] min, P < 0.001), and better recovery of cognitive function at 15 min after extubation (16 [0–24] vs. 0 [0–20], P = 0.003), but experienced increased postoperative nausea and vomiting (PONV) (16 [29%] vs. 6 [11%] P = 0.017) and tachycardia (22 [40%] vs. 9 [16%], P = 0.006) during recovery. Conclusions: Desflurane anesthesia and TIVA provide similar brain relaxation in patients without intracranial hypertension undergoing elective craniotomy. Desflurane accelerates the recovery from anesthesia but is associated with increased PONV and tachycardia during the recovery period. Trial registration: Clinicaltrial.gov (NCT04691128). Date of registration: December 31, 2020. [ABSTRACT FROM AUTHOR]
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- 2023
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7. Anesthesia for Brain Tumors
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Jain, Varun, Rath, Girija Prasad, Garg, Rakesh, editor, and Bhatnagar, Sushma, editor
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- 2021
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8. High Incidence of Hyponatremia in Patients Operated for Nonsellar/Suprasellar Supratentorial Tumors—A Prospective Observational Study
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Ramesh J. Venkatapura, Sritam S. Jena, Rita Christopher, and Dhananjaya I. Bhat
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supratentorial tumors ,hyponatremia ,neurological deficits ,Anesthesiology ,RD78.3-87.3 - Abstract
Background The incidence of hyponatremia is high in supratentorial tumors. However, most studies of supratentorial tumors have included patients with sellar/suprasellar tumors. It is common knowledge that sellar tumors have higher incidence and severity of hyponatremia. Incidence of hyponatremia is not known if we exclude sellar/suprasellar tumors. Therefore, this study was designed to evaluate the incidence of hyponatremia in supratentorial tumors after excluding sellar/suprasellar tumors. Methods After institutional ethics committee approval and written informed consent, adult patients with supratentorial tumors (nonsellar/suprasellar) were recruited, and data were collected prospectively. In all patients, serum electrolytes were measured every 2 to 3 days. Hyponatremia was defined as serum sodium of
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- 2021
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9. Postoperative intensive care management and residual endocrinopathy of pediatric supratentorial brain tumors: a retrospective cohort study.
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Babiker, Amir, Alaqeel, Bothainah, Al-Eyadhy, Ayman, Selayem, Nawaf A, Alissa, Sharifah, Alsofyani, Areej, Masuadi, Emad, Al Juraibah, Fahad, Elwatidy, Sherif, and Maghnie, Mohamad
- Abstract
Endocrinopathy can occur as a postoperative sequel in children treated for supratentorial tumors (STTs). We assessed prediction of a residual hypothalamic/pituitary insufficiency (HPI) in these patients and factors associated with prolonged length of hospital stay (LOS). This is a retrospective cohort study of children who had surgery for STTs in two tertiary centers in Saudi Arabia (2009–2019). We assessed PICU postoperative management and risk of HPI. Data were analyzed using SPSS V24.0 and a logistic regression model for a prediction of a prolonged LOS. Data included 55 children (1–18 years, mean 9.5 ± 4.9 years) who required STT surgeries, 32 (54%) females. Craniopharyngioma (27.3%) was the commonest STTs and 20% of patients had initial symptoms of HPI. PICU management included the use of different types of intravenous fluids (IVFs) and medications such as steroids and desmopressin (DDAVP). An early postoperative DI was reported in 21.8% (n=12/55). Residual HPI included 24 (43.6%) presumed cortisol deficient and 18 (32.7%) central DI patients. Risk factors for postoperative HPI were female gender, age <6 years, headache and preoperative pituitary symptoms. LOS (Median=25.5 ± 12.2 days) was significantly prolonged in patients who required two or more doses of DDAVP [B=13; 95% CI= (1.7–24.3) days] and reduced in patients who had suspected preoperative HPI [B=−19.6; 95% CI= (−31.1, −8.2) days]. Prediction of postoperative HPI in pediatric STTs enhances an early initiation of treatment in PICU and reduces LOS. A meticulous use of IVF and medications supervised by a multidisciplinary team is essential for a favorable outcome. [ABSTRACT FROM AUTHOR]
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- 2022
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10. Corrigendum: Application of and Clinical Research on Enhanced Recovery After Surgery in Perioperative Care of Patients With Supratentorial Tumors
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Jingmi Wu, Weina Zhang, Jie Chen, Hui Fei, Hong Zhu, and Haofen Xie
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supratentorial tumors ,perioperative care ,enhanced recovery after surgery ,surgical treatment ,safe and effective ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2022
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11. High Incidence of Hyponatremia in Patients Operated for Nonsellar/Suprasellar Supratentorial Tumors—A Prospective Observational Study.
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Venkatapura, Ramesh J., Jena, Sritam S., Christopher, Rita, and Bhat, Dhananjaya I.
- Abstract
Background The incidence of hyponatremia is high in supratentorial tumors. However, most studies of supratentorial tumors have included patients with sellar/suprasellar tumors. It is common knowledge that sellar tumors have higher incidence and severity of hyponatremia. Incidence of hyponatremia is not known if we exclude sellar/suprasellar tumors. Therefore, this study was designed to evaluate the incidence of hyponatremia in supratentorial tumors after excluding sellar/suprasellar tumors. Methods After institutional ethics committee approval and written informed consent, adult patients with supratentorial tumors (nonsellar/suprasellar) were recruited, and data were collected prospectively. In all patients, serum electrolytes were measured every 2 to 3 days. Hyponatremia was defined as serum sodium of <135 mEq/L. All the patients were followed up till death or discharge from the hospital. Results A total of 61 patients’ data were analyzed. There were 31 male and 30 female patients with an average age of 44 years. There were 23 meningiomas, 36 gliomas, and 2 other tumors. Forty patients (66%) developed hyponatremia during hospital stay. There were 29 mild cases (serum sodium 131–134 mEq/L), 7 were moderate (serum sodium 126–130 mEq/L), and 4 were severe (serum sodium <126 mEq/L). Three hyponatremic meningioma patients died, of which two had mild hyponatremia and one had severe hyponatremia. Duration of hospital stay was longer in hyponatremic patients. Conclusion The incidence of hyponatremia is high in supratentorial tumor patients after excluding sellar/suprasellar lesions. In the majority of patients, the disturbance is mild. Hyponatremic patients has a longer hospital stay and higher mortality. [ABSTRACT FROM AUTHOR]
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- 2021
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12. Application of and Clinical Research on Enhanced Recovery After Surgery in Perioperative Care of Patients With Supratentorial Tumors
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Jingmi Wu, Weina Zhang, Jie Chen, Hui Fei, Hong Zhu, and Haofen Xie
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supratentorial tumors ,perioperative care ,enhanced recovery after surgery ,surgical treatment ,safe and effective ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
PurposeThis study intends to explore the safety and effectiveness of the concept of enhanced recovery after surgery (ERAS) in the perioperative care of patients with supratentorial tumors.MethodsA total of 151 supratentorial tumor patients were enrolled in this study, and they were divided into control group (n = 75) and observation group (n = 76) according to the random number table method. Patients in the control group received routine neurosurgery care, and patients in the observation group received enhanced recovery after surgery care. The incidence of perioperative complications, postoperative hospital stays, early postoperative eating time, catheter removal time, and time to get out of bed were observed for the two groups of patients, and the quality of postoperative recovery was evaluated.ResultsThere was no statistically significant difference in the basic data of the two groups of patients, such as age, gender, lesion location, and condition (P>0.05), and they were comparable. The observation group’s postoperative eating time, catheter removal time, and time to get out of bed were significantly earlier than those of the control group. Postoperative hospital stays and hospitalization expenses were less than those of the control group. There was a statistically significant difference in postoperative hospital stay between the two groups (P
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- 2021
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13. Application of and Clinical Research on Enhanced Recovery After Surgery in Perioperative Care of Patients With Supratentorial Tumors.
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Wu, Jingmi, Zhang, Weina, Chen, Jie, Fei, Hui, Zhu, Hong, and Xie, Haofen
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MEDICAL research ,PERIOPERATIVE care ,PATIENT care ,HOSPITAL costs ,SURGICAL complications - Abstract
Purpose: This study intends to explore the safety and effectiveness of the concept of enhanced recovery after surgery (ERAS) in the perioperative care of patients with supratentorial tumors. Methods: A total of 151 supratentorial tumor patients were enrolled in this study, and they were divided into control group (n = 75) and observation group (n = 76) according to the random number table method. Patients in the control group received routine neurosurgery care, and patients in the observation group received enhanced recovery after surgery care. The incidence of perioperative complications, postoperative hospital stays, early postoperative eating time, catheter removal time, and time to get out of bed were observed for the two groups of patients, and the quality of postoperative recovery was evaluated. Results: There was no statistically significant difference in the basic data of the two groups of patients, such as age, gender, lesion location, and condition (P>0.05), and they were comparable. The observation group's postoperative eating time, catheter removal time, and time to get out of bed were significantly earlier than those of the control group. Postoperative hospital stays and hospitalization expenses were less than those of the control group. There was a statistically significant difference in postoperative hospital stay between the two groups (P<0.05). Conclusion: Applying the ERAS concept to implement perioperative care for patients with supratentorial tumors is safe and effective. It can not only reduce after-surgical stress and accelerate postoperative recovery, but also shorten hospital stays and reduce hospital costs. It is worthy of clinical application. [ABSTRACT FROM AUTHOR]
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- 2021
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14. Tumors of the Central Nervous System
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Harif, Mhamed, Stefan, Daniela Cristina, Stefan, Daniela Cristina, and Harif, Mhamed
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- 2017
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15. Dexmedetomidine versus labetalol infusions for controlling emergence hypertension in cranial surgeries for supratentorial tumors
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Tarek Ahmed Mostafa Radwan, Naser Ahmed Fadel, Rania Samir Fahmy, and Mahmoud Yahiya Mustafa
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Emergence hypertension ,Labetalol ,Dexmedetomidine ,Cranial surgeries ,Supratentorial tumors ,Anesthesiology ,RD78.3-87.3 - Abstract
Background: Acute hypertension is a common accompaniment during emergence from anesthesia especially in intracranial neurosurgical procedures and may be associated with the development of intracranial hematoma. Although various drugs have been evaluated, management of emergence hypertension in this subset of patients continues to be a challenge for anesthesiologists. Methodology: Seventy-five patients ASA (I-II) scheduled for supratentorial craniotomy under general anesthesia were randomly allocated to one of three groups at the time of dural closure: Group “dex” received dexmedetomidine infusion in a rate of 1 μg/kg/hr, Group “labetalol” received labetalol infusion in a rate of 0.5 mg/kg/hr, and Group “control” a control group where patients received saline infusion at the same rate of dexmedetomidine and labetalol. Hypertensive episodes were managed with nitroglycerin at a dose starting from 1 μg/kg/min if systolic blood pressure exceeded 25% of its preinduction value. Hemodynamic parameters as well as the number of patients, the total dose of nitroglycerin required in each group and the time to extubation were recorded. Results: Dexmedetomidine and labetalol had a significant effect in reducing SBP, MAP, DBP, HR during emergence from anesthesia, with more reduction of the SBP, MAP and DBP in the dexmedetomidine group and of the HR in the labetalol group in comparison with the other two groups. The number of patients needing nitroglycerin was 8 representing 32% of patients in dexmedetomidine group, 5 representing 20% of patients in labetalol group and 22 representing 88% of patients in control group (P value = 0.032). Time to emergence from anesthesia was comparable in the three groups. Conclusion: Both dexmedetomidine and labetalol had favorable effects on hemodynamics at time of emergence from anesthesia in comparison with control group without prolongation of the time of extubation.
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- 2016
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16. Elective versus nonelective brain tumor resections: a 5-year propensity score matching cost comparison analysis
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Frank P.K. Hsu, Kiarash Golshani, Alvin Y. Chan, Jefferson W. Chen, Sumeet Vadera, Elliot H. Choi, Michael Y. Oh, and William C. Wilson
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Male ,medicine.medical_specialty ,Brain tumor ,Insurance Coverage ,Postoperative Complications ,Risk Factors ,Humans ,Medicine ,Economic analysis ,Propensity Score ,health care economics and organizations ,Retrospective Studies ,Supratentorial Tumors ,Cost comparison ,Brain Neoplasms ,business.industry ,General surgery ,Significant difference ,General Medicine ,Length of Stay ,Middle Aged ,medicine.disease ,Elective Surgical Procedures ,Baseline characteristics ,Propensity score matching ,Costs and Cost Analysis ,Female ,business ,Medicaid - Abstract
OBJECTIVE Elective surgical cases generally have lower costs, higher profit margins, and better outcomes than nonelective cases. Investigating the differences in cost and profit between elective and nonelective cases would help hospitals in planning strategies to withstand financial losses due to potential pandemics. The authors sought to evaluate the exact cost and profit margin differences between elective and nonelective supratentorial tumor resections at a single institution. METHODS The authors collected economic analysis data in all patients who underwent supratentorial tumor resection at their institution between January 2014 and December 2018. The patients were grouped into elective and nonelective cases. Propensity score matching was used to adjust for heterogeneity of baseline characteristics between the two groups. RESULTS There were 143 elective cases and 232 nonelective cases over the 5 years. Patients in the majority of elective cases had private insurance and in the majority of nonelective cases the patients had Medicare/Medicaid (p < 0.01). The total charges were significantly lower for elective cases ($168,800.12) compared to nonelective cases ($254,839.30, p < 0.01). The profit margins were almost 6 times higher for elective than for nonelective cases ($13,025.28 vs $2,128.01, p = 0.04). After propensity score matching, there was still a significant difference between total charges and total cost. CONCLUSIONS Elective supratentorial tumor resections were associated with significantly lower costs with shorter lengths of stay while also being roughly 6 times more profitable than nonelective cases. These findings may help future planning for hospital strategies to survive financial losses during future pandemics that require widespread cancellation of elective cases.
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- 2022
17. High Incidence of Hyponatremia in Patients Operated for Nonsellar/Suprasellar Supratentorial Tumors—A Prospective Observational Study
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Rita Christopher, Ramesh J. Venkatapura, Sritam Jena, and Dhananjaya I Bhat
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Supratentorial Tumors ,medicine.medical_specialty ,endocrine system diseases ,hyponatremia ,business.industry ,Incidence (epidemiology) ,nutritional and metabolic diseases ,Institutional ethics ,Critical Care and Intensive Care Medicine ,medicine.disease ,supratentorial tumors ,Anesthesiology and Pain Medicine ,Anesthesiology ,Female patient ,Medicine ,Observational study ,In patient ,RD78.3-87.3 ,Neurology (clinical) ,High incidence ,Radiology ,business ,Hyponatremia ,neurological deficits - Abstract
Background The incidence of hyponatremia is high in supratentorial tumors. However, most studies of supratentorial tumors have included patients with sellar/suprasellar tumors. It is common knowledge that sellar tumors have higher incidence and severity of hyponatremia. Incidence of hyponatremia is not known if we exclude sellar/suprasellar tumors. Therefore, this study was designed to evaluate the incidence of hyponatremia in supratentorial tumors after excluding sellar/suprasellar tumors. Methods After institutional ethics committee approval and written informed consent, adult patients with supratentorial tumors (nonsellar/suprasellar) were recruited, and data were collected prospectively. In all patients, serum electrolytes were measured every 2 to 3 days. Hyponatremia was defined as serum sodium of Results A total of 61 patients’ data were analyzed. There were 31 male and 30 female patients with an average age of 44 years. There were 23 meningiomas, 36 gliomas, and 2 other tumors. Forty patients (66%) developed hyponatremia during hospital stay. There were 29 mild cases (serum sodium 131–134 mEq/L), 7 were moderate (serum sodium 126–130 mEq/L), and 4 were severe (serum sodium Conclusion The incidence of hyponatremia is high in supratentorial tumor patients after excluding sellar/suprasellar lesions. In the majority of patients, the disturbance is mild. Hyponatremic patients has a longer hospital stay and higher mortality.
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- 2021
18. 'Balanced hyperosmolar therapy\' using 3% hypertonic saline - 20% mannitol versus an equiosmolar volume of either 3% hypertonic saline or mannitol 20% in supratentorial tumor resection: A new approach to achieve hemodynamic stability
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Mahmoud K Khames, Samir Ahmed ElKafrawy, and Islam M Kandeel
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Supratentorial Tumors ,business.industry ,Resection ,Hypertonic saline ,03 medical and health sciences ,0302 clinical medicine ,Volume (thermodynamics) ,030202 anesthesiology ,Anesthesia ,medicine ,MANNITOL 20% ,Mannitol ,Hemodynamic stability ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Both 3% hypertonic saline (3% HTS) and 20% mannitol were proven to be effective in relaxing the brain during supratentorial surgeries. This work aimed to study the effect of consecutive use of both drugs on the brain relaxation score and hemodynamic status during such surgeries.Ninety patients scheduled for supratentorial brain surgeries included in this prospective, randomized and double-blind study. Patients were allocated in three groups; HTS group (n=30) received 3 ml/kg 3% NaCl infusion over 30 minutes, HTS/M group (n=30) received mannitol 20% (1.4 ml/kg) as an infusion over 15 minute followed by 1.5 ml/kg 3% NaCl infused over 15 minutes and M group (n=30) received 3.2 ml/kg mannitol 20% infusion over 30 minutes. Brain relaxation was estimated. MAP and serum Na level were recorded at baseline and then at 30, 90 and 150 min. Total fluid intake, total urine output and operative time were recorded. Fluid intake and urine output were the highest with 20% mannitol (p ˂ 0.001). HTS/M and HTS groups showed no significance when satisfactory and fairly brain relaxation scores were added (p=0.862). MAP and CVP were near to baseline in HTS/M group at 30 and 90 min, while at 150 min no significant difference between groups. Serum hyperosmolarity was noticed in all groups at all check points but maximally with HTS group at 30 min (321.1 mOsm/L). Balanced hyperosmolar therapy using 3% HTS and 20% mannitol consecutively resulted in a satisfactory brain relaxation and allowed more hemodynamic stability.
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- 2021
19. Awake Craniotomy pada Biopsi Steriotaktik Tumor Supratentorial di daerah Thalamus Dextra et causa Suspect Thalamic Glioma
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M. Dwi Satriyanto and Siti Chasnak Saleh
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tumor supratentorial ,awake craniotomy ,dexmedetomidin ,propofol ,fentanyl ,supratentorial tumors ,dexmedetomidine ,Anesthesiology ,RD78.3-87.3 - Abstract
Awake craniotomy merupakan suatu prosedur yang banyak digunakan pada kasus-kasus intrakranial dengan berbagai tujuan, yang memungkinkan dapat menentukan lokasi kelainan di otak yang akurat dan meminimalkan risiko cedera neurologis selama tindakan. Peran anaesthesiologist adalah untuk memberikan analgesia dan sedasi yang memadai sambil mempertahankan ventilasi dan stabilitas hemodinamik pada pasien yang sadar dan harus kooperatif selama tindakan berlangsung. Seorang wanita berusia 32 tahun dengan tumor supratentorial at region thalamus dextra et causa suspek thalamic glioma untuk dilakukan tindakan steriotaktik biopsi dengan Awake craniotomy. Pada pemeriksaan ditemukan keluhan sulit berjalan sejak 4 tahun karena sisi tubuh bagian kiri lemah, bicara cedal, mulut mencong ke kanan, kejang pada kepala dan mata sebelah kiri. Pasien dirujuk karena muntah hebat dan sakit kepala hebat 1 minggu terakhir, kesadaran komposmentis, GCS E4M6V5. Paresenerves VI kanan-kiri, parese nerves VII sinistra sentral. Pemeriksaan laboratorium, ECG dan foto thorak tidak didapatkan kelainan, sedangkan pada MSCT kepala didapat kan adanya massa berbatas tidak tegas, dinding tidak teratur dengan kalsifikasi minimal di thalamus kanan disertai edema perifokal kemungkinan suatu low grade astrocytoma dan hydrocephalus obstruksi. Tindakan biopsi steriotaktik terhadap tumor supratentorial ini dilakukan dengan tehnik anestesi awake craniotomy dengan obat dexmedetomidin, propofol dan fentanyl. Pengawasan pasien di ruang pemulihan selama 4 jam.Setelah Modified Aldrete score 9–10, pasien dipindahkan ke ruangan. Awake Craniotomy in Stereotactic Biopsy for Supratentorial Tumors at Thalamus Dextra Region et causa Suspect Thalamic Glioma Awake craniotomy is a procedure that is widely used in intracranial procedures with a variety purposes, which also allows an accurate localization of abnormalities in the brain, and to minimize the risk of neurological injury. Anaesthesiologist role is to provide adequateanalgesia and sedation while maintaining ventilation and hemodynamic stability in patients that still conscious and cooperative during the surgery. A 32years old woman with supratentorial tumor at theright thalamus with suspected thalamic glioma. Stereotactic biopsy was performed under awake craniotomy.She was sufferedwith difficulty in walking for 4 years due to weakness of the left side of the body,slurred talking, and lopsided mouth to the right, withspastic on the head and left eye. She was referred because of severe vomiting and headaches since 1 week, but still fully alert withGCS E4M6V5. She had bilateral nerve VI and central of left nerve VIIpareses. Her laboratory examinations, ECG and thoracic images were normal, whereas MSCT showeda mass with not firm verge, irregular wall with minimal calcification in the right thalamus and perifocaledema, suggested as a low grade astrocytoma and hydrocephalus obstruction. Stereotactic biopsy of supratentorial tumors was performed under awake craniotomy with dexmedetomidine, propofol and fentanyl. The patient was observed at the PACU for 4 hours, and after Modified Aldrete score reached 9–10, the patient was transferred to the ward.
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- 2014
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20. Tumor surgery within cerebral eloquent areas: A two-institutions experience
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Signorelli Francesco, Maduri Rodolfo, Chirchiglia Domenico, and Guyotat Jacques
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electrical stimulation mapping ,functional mapping ,awake surgery ,eloquent areas ,supratentorial tumors ,gliomas ,extent of resection ,Medicine (General) ,R5-920 - Abstract
Introduction: Tumor surgery within eloquent areas represents a formidable challenge and the use of electrical cortico-subcortical stimulation mapping (ESM), allows to localize sensorimotor and language areas and pathways. Our aim is to point out methodological issues of ESM and its impact on outcome at the light of a prospective analysis of a two-institution series of 159 patients with lesions involving eloquent areas with a lengthy follow up. Material and Methods: All patients operated on for lesions involving eloquent areas between May 2000 and May 2010 at the Neurosurgical Department of the Neurological and Neurosurgical Hospital 'P. Wertheimer' in Lyon (France) and at the Neurosurgical Department of the University Hospital in Catanzaro (Italy), were enrolled prospectively in our study. Results: Of 159 consecutive patients, 141 of them underwent surgical removal of the lesion with the aid of electrical cortico-subcortical stimulation mapping integrated in a setting of intraoperative localization of anatomic landmarks for eloquent areas. For the remaining 18 patients ESM was not deemed useful or feasible: 15 patients received a biopsy and 3 patients received tumor debulking under general anesthesia. For patients operated with ESM, it was possible to achieve a gross total removal of the lesion in 67,4% of cases (95 patients). One patient died in the immediate postoperative period for a pulmonary embolism. At a total mean follow-up of 62.8 months 78 patients were alive, 62 of which were recurrence free and had a KPS of 70% or more, while the other 80 patients had a mean survival time of 23.9 months, with a mean high quality survival period (KPS ≥ 70) of21.6 months. Discussion and Conclusion: Intraoperative electrical language and motor mapping, when feasible and indicated, consistently localizes eloquent cortical areas and subcortical pathways and allows to set the tumor resection boundaries according to functional limits, with a favorable impact on survival and quality of life. Integration of neurofunctional data with anatomic landmarks is nonetheless useful to expedite the surgical procedure and improve specificity and sensibility of functional mapping.
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- 2014
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21. Gliome de bas grade avec altération de MYBL1 : observation d’une nouvelle entité tumorale pédiatrique
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Didier Scavarda, Radia Fritih, Clémence Delteil, Dominique Figarella-Branger, Karen Silva, Romain Appay, Pascale Varlet, and Arnault Tauziède-Espariat
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0301 basic medicine ,Supratentorial Tumors ,Pathology ,medicine.medical_specialty ,business.industry ,Angiocentric Pattern ,Astrocytic glioma ,medicine.disease ,3. Good health ,Pathology and Forensic Medicine ,03 medical and health sciences ,Epilepsy ,Diffuse Glioma ,030104 developmental biology ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Glioma ,medicine ,Brain lesions ,MYB ,business - Abstract
Diffuse gliomas with MYB or MYBL1 alterations are rare tumours mostly affecting children or young adults with long-term epilepsy. This category of glioma includes two morphological subtypes. The angiocentric subtype is characterized by an angiocentric pattern of growth and a frequent MYB:QKI fusion. The isomorphic subtype corresponds to a highly differentiated astrocytic glioma with low cellularity, low proliferation and no specific microscopic features. The diagnosis is based on the imaging, demonstrating a supratentorial tumor, associated with the confirmation of a MYB or MYBL1 rearrangement. Here, we report the case of a 7-year-old child who presented a right frontal brain lesion corresponding to an isomorphic diffuse glioma with MYBL1 alteration.
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- 2021
22. Demographic and histopathologic profile of pediatric brain tumors: A hospital-based study
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Harshil C Shah, Bhushan P Ubhale, and Jaimin K Shah
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Astocytomas ,cerebellum ,epidemiologic profile ,supratentorial tumors ,World Health Organization ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Very few hospital-based or population-based studies are published in the context to the epidemiologic profile of pediatric brain tumors (PBTs) in India and Indian subcontinent. Aim: To study the demographic and histopathologic profile of PBTs according to World Health Organization 2007 classification in a single tertiary health care center in India. Materials and Methods: Data regarding age, gender, topography, and histopathology of 76 pediatric patients (0–19 years) with brain tumors operated over a period of 24 months (January-2012 to December-2013) was collected retrospectively and analyzed using EpiInfo 7. Chi-square test and test of proportions (Z-test) were used wherever necessary. Results: PBTs were more common in males (55.3%) as compared to females (44.7%) with male to female ratio of 1.23:1. Mean age was 10.69 years. Frequency of tumors was higher in childhood age group (65.8%) when compared to adolescent age group (34.2%). The most common anatomical site was cerebellum (39.5%), followed by hemispheres (22.4%). Supratentorial tumors (52.6%) were predominant than infratentorial tumors (47.4%). Astrocytomas (40.8%) and embryonal tumors (29.0%) were the most common histological types almost contributing more than 2/3rd of all tumors. Craniopharyngiomas (11.8%) and ependymomas (6.6%) were the third and fourth most common tumors, respectively. Conclusion: Astrocytomas and medulloblastomas are the most common tumors among children and adolescents in our region, which needs special attention from the neurosurgical department of our institute. Demographic and histopathologic profile of cohort in the present study do not differ substantially from that found in other hospital-based and population-based studies except for slight higher frequency of craniopharyngiomas.
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- 2015
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23. The effects of COVID-19 pandemic on pediatric neurosurgery practice and training in a developing country
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Farideh Nejat, Keyvan Tayebi Meybodi, and Zohreh Habibi
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Pediatric neurosurgery ,Neurosurgery ,Clinical Neurology ,Developing country ,COVID pandemic ,Iran ,Pediatrics ,Neurosurgical Procedures ,03 medical and health sciences ,Ventriculoperitoneal shunts ,0302 clinical medicine ,Health care ,Pandemic ,medicine ,Humans ,Training ,Pediatrics, Perinatology, and Child Health ,030212 general & internal medicine ,Developing Countries ,Practice ,Supratentorial Tumors ,SARS-CoV-2 ,business.industry ,General surgery ,COVID-19 ,General Medicine ,Pediatrics, Perinatology and Child Health ,Original Article ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Purpose COVID-19 pandemic has influenced all aspects of societies, with the healthcare being the most affected field. All specialties including neurosurgery are involved, and due to resource limitations, the number of elective surgeries in subspecialized filed has substantially decreased. Herein, we report our practice experience in pediatric neurosurgery in a tertiary hospital during pandemic, and the effects of pandemic on educational issues. Methods All the patients on whom any kind of neurosurgical operation was performed from March to June 2020 were retrospectively collected, and also from the same period in the previous year. Results A total of 111 patients underwent surgery in this period. This figure was 159 patients during the same period in 2019. The total number of surgical cases reduced by 31% compared to the last year. While ventriculoperitoneal shunts and supratentorial tumor were more frequent, there was a considerable reduction in subspecialized educational surgeries like neural tube defects and craniosynostoses. Conclusion CVID-19 pandemic changed all scopes of medical practice and training. Considering the limitation in the available resources, the number of educational cases may decrease in subspecialized disciplines like pediatric neurosurgery. If pandemic continues, alternative measures should be taken to compensate for the shortcoming in technical and practical training.
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- 2020
24. Investigating dynamic susceptibility contrast-enhanced perfusion-weighted magnetic resonance imaging in posterior fossa tumors: differences and similarities with supratentorial tumors
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Matia Martucci, Massimo Benenati, A Infante, Cesare Colosimo, Antonia Ramaglia, Annibale Botto, Giammaria Marziali, Antonio Marrazzo, Pamela Guadalupi, and Simona Gaudino
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Adult ,Adolescent ,Brain tumor ,Contrast Media ,Infratentorial Neoplasms ,Infratentorial ,Supratentorial ,Brain tumors ,030218 nuclear medicine & medical imaging ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Dynamic susceptibility contrast MRI (DSC) ,medicine ,Humans ,Gliomas ,Radiology, Nuclear Medicine and imaging ,Child ,Grading (tumors) ,Aged ,Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA ,Neuroradiology ,Aged, 80 and over ,Perfusion-weighted MRI (PWI) ,Supratentorial Tumors ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Primary central nervous system lymphoma ,Supratentorial Neoplasms ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,Perfusion-Weighted Magnetic Resonance Imaging ,medicine.disease ,Diffusion Magnetic Resonance Imaging ,030220 oncology & carcinogenesis ,business ,Nuclear medicine - Abstract
To assess the accuracy of dynamic susceptibility contrast-enhanced perfusion-weighted magnetic resonance imaging in glioma grading and brain tumor characterization of infratentorial tumors, and to investigate differences from supratentorial tumors. This retrospective study, approved by the institutional review board, included 246 patients with brain tumors (184 supratentorial, 62 infratentorial), grouped by tumor type: high-grade gliomas (HGG), low-grade gliomas (LGG), metastases (Met), and primary central nervous system lymphoma (PCNSL). Relative cerebral blood volume (rCBV) and mean percentage of signal recovery (PSR) were calculated. For statistical analyses, lesions were grouped by location and histology. Differences were tested with Mann–Whitney U tests. From ROC curves, we calculated accuracy, sensitivity, specificity, PPV, and NPV, for rCBV and PSR. For infratentorial tumors, rCBV was highly accurate in differentiating HGG from LGG (AUC = 0.938). Mean PSR showed high accuracy in differentiating PCNSL and HGG from Met (AUC = 0.978 and AUC = 0.881, respectively). Infratentorial and supratentorial tumors had similarly high rCBV in HGG, high mean PSR in PCNSL, and low mean PSR in Met. The main differences were the optimum threshold rCBV values (3.04 for supratentorial, 1.77 for infratentorial tumors) and the mean PSR, which was significantly higher in LGG than in HGG in supratentorial (p = 0.035), but not infratentorial gliomas. Using infratentorial rCBV threshold values for supratentorial tumors decreased the sensitivity and specificity. rCBV and mean PSR were useful in grading and differentiating infratentorial tumors. Proper cutoff values were important in the accuracy of perfusion-weighted imaging in posterior fossa tumors.
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- 2020
25. Desmoplastic Infantile Ganglioglioma: A Case Report of a Rare Supratentorial Tumor
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Priti Kapoor, Vishal Singh, and Ojaswi Khandediya
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Supratentorial Tumors ,Pathology ,medicine.medical_specialty ,business.industry ,Medicine ,Desmoplastic infantile ganglioglioma ,business - Published
- 2020
26. Anestesia untuk Kraniotomi Tumor Supratentorial
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Diana Christine Lalenoh, Hermanus Lalenoh, and Nancy Margareta Rehatta
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anestesi ,neuroproteksi farmakologik ,neuroproteksi non farmakologik ,tumor supratentorial ,anesthesia ,non-pharmacological neuroprotection ,pharmacological neuroprotection ,supratentorial tumors ,Anesthesiology ,RD78.3-87.3 - Abstract
Tumor supratentorial tersering pada orang dewasa adalah glioma (36%), meningioma (32.1%), dan adenoma pituitary (8.4%). Sekitar separuh dari tumor tersebut adalah ganas. Mayoritas tumor tumor tersebut (80%) adalah supratentorial. Untuk seluruh tumor primer, rata-rata usia terdeteksi adanya tumor otak adalah 57 tahun. Angka pasti insidens metastase tumor otak tidak diketahui namun diperkirakan cukup rendah. Dari sekitar 25% pasien yang meninggal karena kanker, ditemukan adanya metastase dari tumor sistem saraf pusat (SSP) pada otopsi. Ada lima sumber keganasan yang sering metastase ke otak yaitu kanker payudara, kanker kolorektal, kanker paru, dan melanoma. Enam persen dari pasien dengan komplikasi tersebut muncul dalam 1 tahun setelah terdeteksi adanya tumor primer. Lima jenis kanker tersebut yang sering menyebabkan metastase otak pada sekitar 37.000 kasus di Amerika Serikat. Jurnal Neuroanestesia Indonesia 17 Dilaporkan keberhasilan penanganan anestesi pada seorang pasien, wanita 56 tahun, dengan berat badan 65 kg. Pasien tersebut didiagnosis sebagai Space Occupaying Lession (SOL) kanan DD/Meningioma. Pasien dilakukan operasi kraniotomi untuk pengeluaran tumor. Tekanan darah saat masuk kamar operasi 176/100 mmHg, laju nadi 98 kali / menit, laju napas 20 kali / menit, suhu badan 370 C, dan GCS E4V5M6. Pasien diinduksi dengan Fentanyl 100 μg, Propofol 100 mg, fasilitas intubasi dengan Rocuronium 40 mg, Lidokain 70 mg, dan pemeliharaan dengan Sevofluran dan Oksigen serta Propofol kontinyu, dan penambahan fentanyl dan rokuronium intermiten. Infus terpasang dua jalur. Operasi berlangsung selama tujuh jam dua puluh menit. Dengan terpasang nasal kanul dan oksigen 3 liter/menit, pasien dipindahkan ke ICU. Pasien dirawat selama satu hari di ICU, kemudian dipindahkan ke ruangan. Setelah lima hari pasien dirawat di ruangan kemudian pasien dipulangkan dan rawat jalan dengan dokter bedah saraf. Anestesi untuk tumor supratentorial membutuhkan suatu pengertian mengenai patofisiologi dari penekanan tekanan intrakranial (TIK) lokal maupun secara keseluruhan; pengaturan dan pemeliharaan perfusi intraserebral; bagaimana menghindari akibat pengaruh sekunder dari sistemik terhadap otak. Persiapan perioperatif yang cermat dan terstruktur sangat penting pada penanganan anestesi untuk tumor supratentorial, yang meliputi persiapan pasien preoperasi, persiapan kelengkapan obat, alat, dan monitoring, serta perencanaan pelaksanaan anestesi sampai dengan pananganan pasca operasi. Anesthesia For Craniotomy Supratentorial Tumor The common supratentorial tumors in adults are glioma (36%), meningioma (32.1%), and adenoma pituitary (8.4%). Approximately half of these tumors are malignant. The majority of them ( 80%) are supratentorial. For the entire primary tumor, the average age when a brain tumor was detected is 57 years old. The exact number of metastatic brain tumor incidence is unknown, but it is assumed quite low. The existence of metastatic tumor of the central nervous system (SSP) is found at the autopsy of around 25% of patients who died of cancer. There are five sources of malignancy which often cause metastasis to the brain, namely breast cancer, colorectal cancer, lung cancer, and melanoma. In six percent of patients, these complications appeared within a year after the primary tumor is detected. These five cancers frequently cause the brain metastases in approximately 37.000 cases in the United States. It is reported the successful handling of anesthesia on a woman 56 years old, weighing 65 kg. This patient was diagnosed with Space Occupying Lession (SOL) right DD / Meningioma. Craniotomy surgery was performed for tumor expenditure. At the time she entered the operating room, her blood pressure was 176/100 mmHg, pulse rate beats / minute, respiratory rate 20 times / minute, body temperature of 37o C, and GCS E4V5M6. She was induced with Fentanyl 100 mg, 100 mg Propofol; intubation facilities are Rocuronium 40 mg, Lidocaine 70 mg, maintenance with Inhalan Sevoflurane and Oxygen, along with continuous Propofol, the addition of Fentanyl and intermittent Rocuronium. Infusion was attached in two pathways.The surgery lasted seven hours and twenty minutes. With nasal cannula and oxygen 3 liters / minute attached, the patient was transferred to ICU. She was treated for one day in ICU, before moved into a ward. After stay in the ward for five days, she was discharged and became an outpatient of neurosurgeon. Anesthesia for supratentorial tumor requires an understanding of pathophysiology of intracranial pressure (ICP) suppression locally and entirely; setting up and maintenance of intracerebral perfusion; how to avoid secondary effects of a systemic effect on the brain. Accurate and structured perioperative preparation is critical for handling of anesthesia for supratentorial tumors, which includes the preparation of the patient pre-surgery, completeness preparation of drugs, devices, and monitoring, as well as planning the implementation of the anesthesia until post-surgery tendance.
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- 2012
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27. Corrigendum: Application of and Clinical Research on Enhanced Recovery After Surgery in Perioperative Care of Patients With Supratentorial Tumors.
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Wu, Jingmi, Zhang, Weina, Chen, Jie, Fei, Hui, Zhu, Hong, and Xie, Haofen
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ENHANCED recovery after surgery protocol ,PERIOPERATIVE care ,MEDICAL research ,CLINICAL medicine ,PATIENT care - Abstract
Supratentorial tumors, perioperative care, enhanced recovery after surgery, surgical treatment, safe and effective Keywords: supratentorial tumors; perioperative care; enhanced recovery after surgery; surgical treatment; safe and effective EN supratentorial tumors perioperative care enhanced recovery after surgery surgical treatment safe and effective 1 2 2 05/02/22 20220428 NES 220428 In the original article, there was a mistake in B Tables 1 b and B 2 b as published. [Extracted from the article]
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- 2022
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28. Sporadic supratentorial hemangioblastoma with meningeal affection: A case report and literature review
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Marta Claramonte, Juan Francisco Sánchez-Ortega, Mónica Martín, and Juan Calatayud-Pérez
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Von Hippel-Lindau disease ,medicine.medical_specialty ,Supratentorial Tumors ,Vascular imaging ,recurrence ,business.industry ,Meninges ,supratentorial hemangioblastoma ,Review Article ,medicine.disease ,medicine.anatomical_structure ,Frontal lobe ,Hemangioblastoma ,medicine ,Surgery ,Neurology (clinical) ,Radiology ,Von Hippel–Lindau disease ,business ,Sinus (anatomy) ,After treatment - Abstract
Background: Hemangioblastomas are vascular tumors, of benign behavior, that originate in the central nervous system. Supratentorial hemangioblastomas are extremely rare and are generally associated with Von Hippel-Lindau disease (VHL). The involvement of structures by contiguity, such as blood vessels or meninges, is something exceptional. There are few references in the literature of supratentorial hemangioblastomas with meningeal involvement and most of them are described in reports or small case series. Methods: We performed a systematic review of the literature to observe the characteristics of patients with supratentorial hemangioblastomas with meningeal involvement. In addition, we present the case of a 43-year-old male patient with a sporadic supratentorial hemangioblastoma with both, meningeal and vascular involvement that recurred years after treatment. Results: The patients presented supratentorial tumors with meningeal involvement, we had a 1.2:1 ratio male-female distribution. The mean age was 50 years. Most tumors were located in the cerebral hemispheres, the lobe affected most frequently was the frontal lobe. About 67% of the cases were sporadic and only 21% were related to VHL disease. There were three cases of recurrence after surgery. Conclusion: Supratentorial hemangioblastomas are extremely rare lesions. It is rare for supratentorial hemangioblastomas to invade adjacent structures such as blood vessels or meninges, however, when this happens, it is recommended a preoperative vascular imaging study, especially in parasagittal hemangioblastomas where superior longitudinal sinus may be involved. In these cases, en bloc surgical resection is difficult and the probability of recurrence is higher. Although clinical trials and studies with a greater casuistry are necessary to establish guidelines for the management of supratentorial hemangioblastomas, nowadays, contribution of new cases is useful for understanding this pathology.
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- 2021
29. Dexmedetomidine versus labetalol infusions for controlling emergence hypertension in cranial surgeries for supratentorial tumors.
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Radwan, Tarek Ahmed Mostafa, Fadel, Naser Ahmed, Fahmy, Rania Samir, and Mustafa, Mahmoud Yahiya
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Background Acute hypertension is a common accompaniment during emergence from anesthesia especially in intracranial neurosurgical procedures and may be associated with the development of intracranial hematoma. Although various drugs have been evaluated, management of emergence hypertension in this subset of patients continues to be a challenge for anesthesiologists. Methodology Seventy-five patients ASA (I-II) scheduled for supratentorial craniotomy under general anesthesia were randomly allocated to one of three groups at the time of dural closure: Group “dex” received dexmedetomidine infusion in a rate of 1 μg/kg/hr, Group “labetalol” received labetalol infusion in a rate of 0.5 mg/kg/hr, and Group “control” a control group where patients received saline infusion at the same rate of dexmedetomidine and labetalol. Hypertensive episodes were managed with nitroglycerin at a dose starting from 1 μg/kg/min if systolic blood pressure exceeded 25% of its preinduction value. Hemodynamic parameters as well as the number of patients, the total dose of nitroglycerin required in each group and the time to extubation were recorded. Results Dexmedetomidine and labetalol had a significant effect in reducing SBP, MAP, DBP, HR during emergence from anesthesia, with more reduction of the SBP, MAP and DBP in the dexmedetomidine group and of the HR in the labetalol group in comparison with the other two groups. The number of patients needing nitroglycerin was 8 representing 32% of patients in dexmedetomidine group, 5 representing 20% of patients in labetalol group and 22 representing 88% of patients in control group ( P value = 0.032). Time to emergence from anesthesia was comparable in the three groups. Conclusion Both dexmedetomidine and labetalol had favorable effects on hemodynamics at time of emergence from anesthesia in comparison with control group without prolongation of the time of extubation. [ABSTRACT FROM AUTHOR]
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- 2016
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30. Repetitive navigated transcranial magnetic stimulation (rnTMS) to facilitate recovery of motor deficits after supratentorial tumour resection – interim analysis
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Heike Schneider, Tizian Rosenstock, Thomas Picht, Jan Reuther, Peter Vajkoczy, and Melina Engelhardt
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medicine.medical_specialty ,Supratentorial Tumors ,business.industry ,General Neuroscience ,medicine.medical_treatment ,Biophysics ,Neurosciences. Biological psychiatry. Neuropsychiatry ,610 Medical sciences ,Medicine ,Interim analysis ,Resection ,Transcranial magnetic stimulation ,ddc: 610 ,medicine ,Neurology (clinical) ,Radiology ,business ,RC321-571 - Abstract
Objective: Surgical resection of motor eloquent tumors poses the risk of causing postoperative motor deficits which leads to significantly reduced quality of life in these patients. Thus, development of treatment strategies to facilitate postoperative rehabilitation of motor deficits is crucial. The[for full text, please go to the a.m. URL], 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie
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- 2021
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31. Application of and Clinical Research on Enhanced Recovery After Surgery in Perioperative Care of Patients With Supratentorial Tumors
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Jie Chen, Haofen Xie, Weina Zhang, Hong Zhu, Hui Fei, and Jingmi Wu
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medicine.medical_specialty ,Cancer Research ,perioperative care ,surgical treatment ,supratentorial tumors ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Enhanced recovery after surgery ,RC254-282 ,Original Research ,Supratentorial Tumors ,business.industry ,Incidence (epidemiology) ,Significant difference ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,safe and effective ,Perioperative ,Surgery ,Clinical research ,Oncology ,enhanced recovery after surgery ,030220 oncology & carcinogenesis ,Perioperative care ,Neurosurgery ,business ,030217 neurology & neurosurgery - Abstract
PurposeThis study intends to explore the safety and effectiveness of the concept of enhanced recovery after surgery (ERAS) in the perioperative care of patients with supratentorial tumors.MethodsA total of 151 supratentorial tumor patients were enrolled in this study, and they were divided into control group (n = 75) and observation group (n = 76) according to the random number table method. Patients in the control group received routine neurosurgery care, and patients in the observation group received enhanced recovery after surgery care. The incidence of perioperative complications, postoperative hospital stays, early postoperative eating time, catheter removal time, and time to get out of bed were observed for the two groups of patients, and the quality of postoperative recovery was evaluated.ResultsThere was no statistically significant difference in the basic data of the two groups of patients, such as age, gender, lesion location, and condition (P>0.05), and they were comparable. The observation group’s postoperative eating time, catheter removal time, and time to get out of bed were significantly earlier than those of the control group. Postoperative hospital stays and hospitalization expenses were less than those of the control group. There was a statistically significant difference in postoperative hospital stay between the two groups (PConclusionApplying the ERAS concept to implement perioperative care for patients with supratentorial tumors is safe and effective. It can not only reduce after-surgical stress and accelerate postoperative recovery, but also shorten hospital stays and reduce hospital costs. It is worthy of clinical application.
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- 2021
32. Hub biomarkers for the diagnosis and treatment of glioblastoma based on microarray technology
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Liang Xia, Bing Wu, Caixing Sun, Ya-lan Dong, Li-weng Li, Kai Jing, Kai Cui, Shuyuan Zhang, Yang-fan Zou, and Jin-hui Chen
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Male ,Cancer Research ,Bioinformatics ,Brain tissue ,Malignancy ,Gene Expression Omnibus database ,03 medical and health sciences ,0302 clinical medicine ,Biomarkers, Tumor ,Medicine ,Humans ,Gene Regulatory Networks ,Protein Interaction Maps ,RC254-282 ,030304 developmental biology ,0303 health sciences ,Supratentorial Tumors ,business.industry ,Hub gene ,Brain Neoplasms ,Gene Expression Profiling ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Middle Aged ,medicine.disease ,Prognosis ,Original Article (Technical Edit) ,Survival Rate ,Differentially expressed genes ,Oncology ,030220 oncology & carcinogenesis ,Case-Control Studies ,Gene chip analysis ,Cancer research ,Female ,business ,Glioblastoma ,Transcriptome ,Follow-Up Studies - Abstract
Background: Glioblastoma (GBM) is the most common clinical intracranial malignancy worldwide, and the most common supratentorial tumor in adults. GBM mainly causes damage to the brain tissue, which can be fatal. This research explored potential gene targets for the diagnosis and treatment of GBM using bioinformatic technology. Methods: Public data from patients with GBM and controls were downloaded from the Gene Expression Omnibus database, and differentially expressed genes (DEGs) were identified by Gene Expression Profiling Interactive Analysis (GEPIA) and Gene Expression Omnibus 2R (GEO2R). Construction of the protein–protein interaction network and the identification of a significant module were performed. Subsequently, hub genes were identified, and their expression was examined and compared by real-time quantitative (RT-q)PCR between patients with GBM and controls. Results: GSE122498 (GPL570 platform), GSE104291 (GPL570 platform), GSE78703_DMSO (GPL15207 platform), and GSE78703_LXR (GPL15207 platform) datasets were obtained from the GEO. A total of 130 DEGs and 10 hub genes were identified by GEPIA and GEO2R between patients with GBM and controls. Of these, strong connections were identified in correlation analysis between CCNB1, CDC6, KIF23, and KIF20A. RT-qPCR showed that all 4 of these genes were expressed at significantly higher levels in patients with GBM compared with controls. Conclusions: The hub genes CCNB1, CDC6, KIF23, and KIF20A are potential biomarkers for the diagnosis and treatment of GBM.
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- 2021
33. A Rare ıntracranial Mass of Childhood; Menengioma
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Rüştü Turkay, Türkan Ikizceli, Nurdan Gocgun, Yildiray Savas, and Behice Kaniye Yilmaz
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pediatric brain tumors,atypical meningioma,supratentorial tumors,childhood tumors ,medicine.medical_specialty ,Supratentorial Tumors ,Pediatrik beyin tümörleri,Atipik menenjiyom,Supratentoryal tümörler,Çocukluk çağı tümörleri ,business.industry ,Atypical meningioma ,medicine ,Medicine ,Radiology ,business ,Tıp ,Intracranial mass - Abstract
Meningioma is the most common extra parenchymal brain tumor in adults, originating from arachnoid cap cells in the brain, and is very rare in childhood. As pediatric meningiomas are rare, they have different and challenging epidemiological, radiological, and histopathological features than adults. We aimed to share a very rare case of meningioma in a 7-year-old girl presenting with sudden vision loss and seizures in the light of the literature., Menenjiyom, erişkinlerde beyindeki araknoid kapakhücrelerinden kaynaklanan en yaygın ekstra parankimal beyin tümörüdür veçocukluk çağında çok nadirdir. Pediatrik menenjiyomlar nadir olduğu içinyetişkinlere göre farklı epidemiyolojik, radyolojik ve histopatolojiközelliklere sahiptirler. Bu yazıda, ani görme kaybı ve nöbetler ile başvuran 7yaşında bir kız çocuğunda nadir görülen bir menenjiyom olgusunu literatür eşliğindesunulmuştur.
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- 2020
34. Clinical Experience with Frameless Neuronavigation Guided Biopsy for Intracranial Space Occupying Lesion
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Suraj Thulung, Binit Aryal, Munu Napit, Dinuj Shrestha, Suresh Bishokarma, and Subash Lohani
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medicine.medical_specialty ,Supratentorial Tumors ,Neuronavigation ,medicine.diagnostic_test ,Tumor size ,business.industry ,Biopsy ,lcsh:Surgery ,lcsh:RD1-811 ,medicine.disease ,Intracranial space-occupying lesion ,lcsh:RC321-571 ,Hematoma ,Frameless ,Histological diagnosis ,medicine ,Histopathology ,Radiology ,business ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry - Abstract
Biopsy is mandatory for histological diagnosis of non-resectable brain tumors. Of various techniques, neuronavigation guided biopsy provides intraoperative real-time reference and allows biopsy from multiple trajectories. The aim of this study is to assess the efficacy and accuracy of frameless neuronavigation biopsy. We retrospectively reviewed the medical archives of patients with intracranial space occupying lesion who underwent frameless neuronavigation biopsy at our institute between 2016 to 2018. All operations were performed under general anesthesia. Data were analyzed by SPSS version 20. P value of
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- 2019
35. Postoperative navigated transcranial magnetic stimulation to predict motor recovery after surgery of tumors in motor eloquent areas
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Philippe Schucht, Chantal Zbinden, Katharina Lutz, Annetta Redmann, Andreas Raabe, Alberto Consuegra, Kathleen Seidel, and Levin Häni
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Brain mapping ,050105 experimental psychology ,Resection ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Physiology (medical) ,medicine ,Humans ,0501 psychology and cognitive sciences ,610 Medicine & health ,Neuronavigation ,Retrospective Studies ,Postoperative Care ,Supratentorial Tumors ,Rehabilitation ,Brain Neoplasms ,business.industry ,05 social sciences ,Motor Cortex ,Recovery of Function ,Middle Aged ,Evoked Potentials, Motor ,Transcranial Magnetic Stimulation ,Sensory Systems ,Surgery ,Transcranial magnetic stimulation ,Neurology ,Tumor surgery ,Motor recovery ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Intraoperative neurophysiological monitoring - Abstract
Objective To know whether motor deficits after tumor surgery are transient is reassuring for the patient and crucial for planning rehabilitation and adjuvant treatment. We analyze the value of postoperative MRI navigated transcranial magnetic stimulation (nTMS) compared to intraoperative MEP monitoring in predicting recovery of motor function. Methods Retrospective series of nTMS mappings within 14 days after surgery for supratentorial tumors (09/2014–05/2018). All patients with motor deficits of Medical-Research-Council-Grade (MRCS) 0–4- were included. Results We performed nTMS mapping on average 3.8 days after surgery and recorded nTMS MEP in 11 of 13 patients. Motor strength recovered to at least MRCS 4 within one month if postoperative nTMS elicited MEPs (positive predictive value 90.9%). If nTMS did not elicit MEPs, the patient did not recover (negative predictive value 100%). Intraoperative MEP and postoperative nTMS were equally predictive for long-term motor recovery. In cases of intraoperative MEP alteration/signal loss, but a positive postoperative nTMS mapping, 2/3 patients demonstrated a good motor recovery. Conclusion nTMS may predict long-term motor recovery of patients suffering from severe motor deficits directly after resection of tumors located in motor eloquent areas. Significance In cases of intraoperative MEP alterations, postoperative nTMS may clarify the potential for motor recovery.
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- 2019
36. Feasibility of hippocampal dose‑volume parameters associated with memory decline in intensity‑modulated radiotherapy for supratentorial tumors
- Author
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Masahide Anada, Toru Shibata, Shohei Kozai, Toshifumi Kinoshita, Shigeo Takahashi, and Takamasa Nishide
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Cancer Research ,Supratentorial Tumors ,business.industry ,medicine.medical_treatment ,Planning target volume ,Retrospective cohort study ,Articles ,Hippocampal formation ,Corpus callosum ,Radiation therapy ,Clinical Practice ,Oncology ,medicine ,Intensity modulated radiotherapy ,business ,Nuclear medicine - Abstract
The purpose of the present retrospective study was to evaluate the feasibility of hippocampal dose-volume parameters associated with memory decline for intensity-modulated radiotherapy (IMRT). In total, 18 patients who underwent IMRT for supratentorial tumors were analyzed. Prescribed doses of IMRT in 30 fractions were 60 Gy to planning target volume (PTV) 1 of the local area and 48-51 Gy to PTV2 of the extended local area. Based on previous literature, the present study investigated dose-volume parameters of the bilateral hippocampi: D(40%) of 13.1 Gy, D(50%) of 29.6 Gy, and V(55Gy) of 5.0%. It was evaluated which of the parameters was most achievable, and unfavorable factors that interfere with reaching these parameters were identified. As a result, D(40%) of 13.1 Gy, D(50%) of 29.6 Gy and V(55Gy) of 5.0% were achieved in 17, 67 and 33% of patients, respectively. For D(50%) of 29.6 Gy, PTV2 ≥500 cc (P=0.004) and tumor in temporal/corpus callosum/basal ganglia (P=0.009) were significant unfavorable factors. In conclusion, D(50%) of 29.6 Gy was most achievable. In daily clinical practice, it should be primarily attempted to achieve D(50%) of 29.6 Gy of the bilateral hippocampi.
- Published
- 2021
37. Assessment of caregiver burden in patients undergoing in- and out-patient neurosurgery
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Lawrence Li, Lashmi Venkatraghavan, KokWeng Leong, Mark Bernstein, and Rebecca Moga
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Adult ,Male ,medicine.medical_specialty ,Canada ,medicine.medical_treatment ,Population ,Neurosurgery ,Caregiver Burden ,Single Center ,03 medical and health sciences ,0302 clinical medicine ,Cost of Illness ,Physiology (medical) ,Surveys and Questionnaires ,Medicine ,Humans ,In patient ,education ,Craniotomy ,Aged ,Supratentorial Tumors ,education.field_of_study ,business.industry ,General Medicine ,Caregiver burden ,Middle Aged ,Neurology ,Caregivers ,030220 oncology & carcinogenesis ,Emergency medicine ,Surgery ,Observational study ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Diskectomy - Abstract
The objective of this study is to describe the caregiver burden, as well as the financial burden among caregivers after inpatient and outpatient neurosurgical patients. In this single center, observational study, adult patients undergoing elective inpatient or outpatient neurosurgery (supratentorial tumor resection or lumbar microdiscectomy) and his/her caregiver were recruited for the study. Bakas Caregiving Outcome Scale (BCOS) was used to assess caregiver burden and data was collected from preoperative period until post-operative day (POD) 30. Cost burden was assessed by a cost diary from day of surgery till POD 7. Forty-eight patient-caregiver pairs (21 inpatient craniotomies, 7 outpatient craniotomies, and 20 outpatient microdiscectomies) completed the study. BCOS values were in the negative impact range (60) on POD1 in craniotomy group and improved to positive impact range (60) after POD3. Median BCOS score remained at 60 in outpatient microdiscectomy. 56% of caregiver had at least 1 day of loss of income and 20% lost income throughout first 8 days. Median Cost (in Canadian dollars) associated with caregiving ranged from C$57 to C$250 amongst different groups. We concluded that caring for patients after craniotomy is psychologically demanding which leads to an increase in caregiver burden. In addition, there is a cost burden for the care givers in the form of missed workdays and additional direct expenses. Further studies are needed to recognize this problem and address the burden among the caregivers in the neurosurgical population.
- Published
- 2020
38. An unusual location for a choroid plexus papilloma: the pineal region.
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Sasani, Mehdi, Solmaz, Bilgehan, Oktenoglu, Tunc, and Ozer, Ali
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CHOROID plexus , *CENTRAL nervous system , *CEREBRAL ventricles , *MAGNETIC resonance imaging , *BRAIN surgery , *TUMORS - Abstract
Purpose: Choroid plexus papillomas (CPP) are rare benign neoplasms of the central nervous system that occur most often in children during the first decade of life. They occur most often in the lateral ventricle. It is extremely rare for a CPP to occur in the pineal region. We describe the case of a child with a CPP located in the pineal region, who was initially diagnosed with obstructive hydrocephalus by cranial computed tomography (CT). Methods: A 9-year-old female patient presented with complaints of visual disturbance, nausea, and vomiting. Magnetic resonance imaging (MRI) showed a poor contrast-enhanced pineal-localized lesion. Anatomical variations within the patient caused her surgery to proceed using a supratentorial-occipital interhemispheric approach. Results: The tumor was totally removed, and a histological examination revealed the tumor to be a typical CPP. The patient received follow-up neurological and ophthalmologic examinations at 3, 6, 9, 12, 24, and 36 months postoperatively, which demonstrated her progressive improvement. Conclusions: CPPs may have a wide range of locations and resulting symptoms. However, the pineal region is a rarely encountered location, particularly for pediatric patients. It is of great value to correctly differentiate neoplasms such as germ cell tumors, pineocytomas, meningiomas, and astrocytomas, so that patients receive the correct diagnosis and treatment approach. [ABSTRACT FROM AUTHOR]
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- 2014
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39. cIMPACT-NOW update 7: advancing the molecular classification of ependymal tumors
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Cynthia Hawkins, Thomas E. Merchant, Maryam Fouladi, Kenneth Aldape, Sriram Venneti, Kristian W. Pajtler, David N. Louis, Richard J. Gilbertson, David W. Ellison, David Capper, and Mark R. Gilbert
- Subjects
0301 basic medicine ,Ependymoma ,Myxopapillary ependymoma ,Pathology ,medicine.medical_specialty ,Posterior fossa ,Reviews ,Pathology and Forensic Medicine ,Central Nervous System Neoplasms ,03 medical and health sciences ,0302 clinical medicine ,Molecular classification ,Ependyma ,medicine ,Humans ,CNS TUMORS ,Supratentorial Tumors ,business.industry ,Brain Neoplasms ,General Neuroscience ,Supratentorial Neoplasms ,Glioma ,Subependymoma ,medicine.disease ,030104 developmental biology ,Mycn amplification ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Advances in our understanding of the biological basis and molecular characteristics of ependymal tumors since the latest iteration of the World Health Organization (WHO) classification of CNS tumors (2016) have prompted the cIMPACT-NOW group to recommend a new classification. Separation of ependymal tumors by anatomic site is an important principle of the new classification and was prompted by methylome profiling data to indicate that molecular groups of ependymal tumors in the posterior fossa and supratentorial and spinal compartments are distinct. Common recurrent genetic or epigenetic alterations found in tumors belonging to the main molecular groups have been used to define tumor types at intracranial sites; C11orf95 and YAP1 fusion genes for supratentorial tumors and two types of posterior fossa ependymoma defined by methylation group, PFA and PFB. A recently described type of aggressive spinal ependymoma with MYCN amplification has also been included. Myxopapillary ependymoma and subependymoma have been retained as histopathologically defined tumor types, but the classification has dropped the distinction between classic and anaplastic ependymoma. While the cIMPACT-NOW group considered that data to inform assignment of grade to molecularly defined ependymomas are insufficiently mature, it recommends assigning WHO grade 2 to myxopapillary ependymoma and allows grade 2 or grade 3 to be assigned to ependymomas not defined by molecular status.
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- 2020
40. 5-Aminolevulinic Acid-Guided Surgery for Recurrent Supratentorial Pediatric Neoplasms
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Jason Labuschagne
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Male ,medicine.medical_specialty ,Malignancy ,Neurosurgical Procedures ,03 medical and health sciences ,0302 clinical medicine ,Tumor margin ,Biopsy ,medicine ,Humans ,Child ,Pathological ,Neuronavigation ,Fluorescent Dyes ,Supratentorial Tumors ,medicine.diagnostic_test ,business.industry ,Brain Neoplasms ,Significant difference ,Off-Label Use ,medicine.disease ,Magnetic Resonance Imaging ,Levulinic Acids ,Tumor recurrence ,Surgery ,Treatment Outcome ,030220 oncology & carcinogenesis ,Child, Preschool ,Female ,Neurology (clinical) ,Neoplasm Recurrence, Local ,business ,030217 neurology & neurosurgery ,Pediatric population - Abstract
Background The use of 5-aminolevulinic acid (5-ALA) in pediatric neuro-oncology is considered off-label, and little data are available on its use in tumor recurrence surgery. Here we present our experience with 5-ALA fluorescence-guided surgery for recurrent supratentorial tumors in the pediatric population. Methods Eleven pediatric patients presenting with recurrence of a supratentorial high-grade malignancy (5 glioblastoma [GBM], 6 non-GBM) underwent 5-ALA–assisted surgery. Biopsy specimens were obtained from pathological and normal-appearing areas of the tumor margin. Results From the margin of the tumor displaying solid fluorescence, a total of 36 samples were obtained. All of these histological samples were found to harbor tumor cells. From areas of vague enhancement, a total of 49 histological samples were taken, of which 38 samples (77%) harbored tumor cells. There was no significant difference in the percentage of biopsy-positive vague fluorescent areas between the GBM cases (80%) and non-GBM cases (75%). A total of 59 biopsy specimens were taken from the tumor margin that appeared completely negative for fluorescence. On analysis, 24 (40.7%) of these specimens demonstrated tumor cells. There was no significant difference in the number of false-negative biopsies between the GBM group (40%) and the non-GBM group (41%). Conclusions The positive predictive value of solid fluorescence is high in recurrent disease but is substantially lower in areas of vague fluorescence. The rate of false-negative fluorescence is high. 5-ALA should be considered as an adjuvant in revision surgery with the aforementioned caveats in mind.
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- 2020
41. Predicting short-term outcomes following supratentorial tumor surgery
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Kaitlyn Shultz, Eric Winter, Ryan Dimentberg, Ian F. Caplan, Neil R. Malhotra, Jang W. Yoon, Gregory Glauser, Scott D. McClintock, Debanjan Haldar, and H. Isaac Chen
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Male ,medicine.medical_specialty ,Patient Readmission ,Neurosurgical Procedures ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Aged ,Retrospective Studies ,Supratentorial Tumors ,Hospital readmission ,business.industry ,Confounding ,Supratentorial Neoplasms ,General Medicine ,Perioperative ,Emergency department ,Length of Stay ,Middle Aged ,Prognosis ,Patient Discharge ,Surgery ,Treatment Outcome ,Quartile ,030220 oncology & carcinogenesis ,Tumor surgery ,Female ,Neurology (clinical) ,Neurosurgery ,business ,030217 neurology & neurosurgery - Abstract
Objectives The LACE+ index risk prediction tool has not been successfully used to predict short-term outcomes after neurosurgery. This study assessed the ability of LACE+ to predict 30-day (30D) adverse outcomes after supratentorial brain tumor surgery. Patients and methods LACE+ scores were retrospectively calculated for consecutive patients (n = 624) who received surgery for supratentorial tumors at one multi-center health system (2017–2019). Coarsened exact matching was employed to control for confounding variables. Outcomes including unplanned hospital readmission, emergency department visits, and death were compared for patients with different LACE+ score quartiles (Q1, Q2, Q3, Q4). Results 134 patients were matched between Q1 and Q4; 152 patients between Q2 and Q4; 192 patients between Q3 and Q4. LACE+ score was not found to predict readmission within 30D of discharge for Q1 vs Q4 (p = 0.239), Q2 vs Q4 (p = 0.336), or Q3 vs Q4 (p = 0.739). LACE + score also did not predict 30D risk of emergency department visits for Q1 vs Q4 (p = 0.210), Q2 vs Q4 (p = 0.839), or Q3 vs Q4 (p = 0.167). LACE + did predict death within 30D of surgery for Q3 vs Q4 (1.04 % vs 7.29 %, p = 0.039), but not for Q1 vs Q4 (p = 0.625) or Q2 vs Q4 (p = 0.125). Conclusion LACE + may not be suitable for characterizing short-term risk of certain perioperative events in a patient population undergoing supratentorial brain tumor surgery.
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- 2020
42. Experience of fully awake craniotomy for supratentorial lesions: a single-institution study
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Erdal Coskun, Serkan Civlan, Emrah Egemen, Eyup Baykara, Batuhan Bakirarar, and Fatih Yakar
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Quality of life ,Adult ,Male ,medicine.medical_specialty ,Weakness ,Adolescent ,Tumor resection ,Anesthesia, General ,Karnofsky performance status ,Metastasis ,Young Adult ,Postoperative Complications ,medicine ,Humans ,In patient ,Wakefulness ,Single institution ,Aged ,Aged, 80 and over ,Supratentorial Tumors ,business.industry ,Supratentorial Neoplasms ,Middle Aged ,Surgery ,Awake craniotomy ,Quality of Life ,Female ,Histopathology ,Neurology (clinical) ,medicine.symptom ,business ,Craniotomy - Abstract
Aim In patients with poor medical conditions, awake procedures can help avoid the complications of general anesthesia. We aim to report and discuss our experience of awake craniotomy for the treatment of supratentorial lesions. Material and methods We included patients who underwent awake craniotomy for supratentorial tumors between 2007 and 2018. A bipolar stimulation probe was used for patients with eloquent area lesions. The demographic features, presenting symptoms, comorbidities, localization, histopathology, pre- and postoperative Karnofsky performance status, mean operation length, mean length of hospital stay, and intraoperative and postoperative complications were recorded. Results We included 250 patients (age, 53.5 ± 15.3 years; range, 15-90 years; 105 females and 145 males) mostly with metastasis (46%). The tumor resection rate was 90 ± 3.6%. Of 30 patients (12%) who experienced an increase in weakness, 26 experienced improvements within three days, and the remainder had permanent symptoms. Intraoperative and postoperative seizures occurred in three (1.2%) and seven (2.8%) patients, respectively, which were controlled by antiepileptic drugs. Dysphasia occurred intraoperatively in seven patients (2.8%) but improved in a month. The mean follow-up duration was 31.8 ± 11.9 months (range, 7-70 months). No mortality was seen during hospitalization. Conclusion Awake procedures are a good option in supratentorial lesions to avoid the complications of general anesthesia in patients with a poor medical condition. To obtain maximal tumor resection and maintain a patient\'s quality of life, neurosurgeons should opt for awake craniotomy often.
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- 2020
43. Ganglioglioma desmoplásico infantil
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Jorge Wladimir Junqueira Bizzi, Mario Ferreira Coutinho, Ligia Maria Barbosa Coutinho, and Carlos Eduardo da Silva
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Lesion ,Pathology ,medicine.medical_specialty ,Supratentorial Tumors ,medicine.anatomical_structure ,business.industry ,Dura mater ,medicine ,Desmoplastic infantile ganglioglioma ,medicine.symptom ,business - Abstract
O ganglioglioma desmoplásico infantil (GDI) é um tumor raro, que pertence ao grupo dos tumores mistos neurogliais, descrito pela primeira vez por VandenBerg, em l98716: São tumores supratentoriais, volumosos, apresentando freqüentemente envolvimento leptomeníngeo. O exame anatomopatológico evidencia intensa desmoplasia, com diferenciação astrocítica e ganglionar, bem como o teste imunoistoquímico apresenta resultado positivo para “glial fibrillary acidic protein” (GFAP). São relatados dois casos de GDI e discutidos os aspectos clínicos e terapêuticos dos referidos casos.
- Published
- 2018
44. Comparison of stereotactic and ultrasound-guided biopsy of solid supratentorial tumor: A preliminary report
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GD Satyarthee, BhawaniS Sharma, V. S. Mehta, and P.S. Chandra
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Pathology ,medicine.medical_specialty ,Stereotactic biopsy ,030218 nuclear medicine & medical imaging ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Hematoma ,Biopsy Site ,Biopsy ,medicine ,Fixation (histology) ,Computerized tomography guided stereotactic biopsy ,Supratentorial Tumors ,medicine.diagnostic_test ,supratentorial brain lesions ,business.industry ,General Medicine ,medicine.disease ,operating-time ,ultrasound-guided biopsy ,Ultrasound-Guided Biopsy ,Original Article ,Radiology ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Introduction: The computed tomography (CT) guided stereotactic biopsy (STB) is considered as method of choice for biopsy of intracranial mass lesions. However, it's disadvantages are frame fixation, time requirement for transportation between CT scan suit to the operation theater with added much higher equipment cost in the relatively resource scarred developing country. Ultrasound-guided biopsy (USGB) is relatively simpler, economical, less time consuming, and real-time procedure. Clinical Materials and Methods: Thirty-seven consecutively admitted patients with supratentorial brain tumors, who underwent biopsy of the lesion using CT compatible stereotactic and ultrasound-guided (USGB) procedure formed cohort of the study. Based on location and size of the lesions, the cases were divided into two groups, superficial and deep. Twenty-two patients underwent ultrasound-guided biopsy and 15 with STB. Results: The diagnostic yield of STB was 93% and 91% for ultrasound-guided biopsy. The mean operation time of STB group was 149.00 min and 94 min for USGB, which was statistically significant. Two cases in each group developed hematoma; however, one case in USGB group needed surgical evacuation. The real-time monitoring detected two hematoma intraoperatively, which were further also confirmed on postoperative CT scan head. Conclusions: The ultrasound-guided biopsy procedure (USGB) was simple, relatively shorter time-consuming procedure and equally efficacious and utilizing economical equipment and can act as a safer alternative to CT STB process for biopsy of the intracranial mass lesion. Furthermore, USGB also provided intra-operative real-time monitoring, which provided clue for close monitoring in the postoperative period after completion of biopsy to look for development of fresh hematoma development not only at the biopsy site but also along the biopsy track and adjoining area. Perhaps, a longer period of ultrasonic monitoring following the procedure would be of greater help to detect hematoma formation, which is one of the most common complications of the biopsy procedure.
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- 2017
45. Intraoperative neurophysiological monitoring of the cortico-spinal tract in image-guided mini-invasive neurosurgery.
- Author
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Cordella, Roberto, Acerbi, Francesco, Broggi, Morgan, Vailati, Davide, Nazzi, Vittoria, Schiariti, Marco, Tringali, Giovanni, Ferroli, Paolo, Franzini, Angelo, and Broggi, Giovanni
- Subjects
- *
NEUROPHYSIOLOGIC monitoring , *NEUROSURGERY , *SPINAL cord , *ANESTHESIA , *TRANSCRANIAL magnetic stimulation , *IMMUNE response - Abstract
Abstract: Objective: To evaluate the role of intraoperative neurophysiological monitoring in image-guided mini-invasive neurosurgery. Methods: Twenty-one patients were operated under general anaesthesia with the aid of multimodal intraoperative neurophysiological monitoring to remove supratentorials tumors closely related to the cortico-spinal tract. Pre-operative assessment included fMRI scans and tractography that were uploaded into the intraoperative neuro-navigation system. Monitoring consisted in simultaneously recording EEG, electrocorticography, transcranial and direct motor evoked potentials (tMEP and dMEP), somatosensory evoked potentials and subcortical stimulation during the whole procedures. Results: The recording of all the electrophysiological signals was possible in all procedures. SSEP guided the positioning of the strip electrode over the motor cortex (N20 phase inversion) that was used to evoke dMEP and monitor the lower limb motor responses; subcortical stimulation to unveil the spatial relationship between the tumors and motor fibers. Four patients had transient worsening of the symptoms, but only two had a long-term worsening, although not severe, of the pre-op clinical status. Conclusions: Intraoperative neurophysiology has a great value in mini-invasive neurosurgery, especially because the motor cortex is not exposed, consequently it cannot be directly mapped. This report describes a valuable scheme making use of as many electrophysiological signals as possible to constantly monitor the motor functions. Significance: A useful method to monitor motor functions in mini-invasive neurosurgery was described. [Copyright &y& Elsevier]
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- 2013
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46. Effective and safe mannitol administration in patients undergoing supratentorial tumor surgery: A prospective, randomized and double blind study
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Fatis Altindas, Ozlem Korkmaz Dilmen, Esra Sultan Karabulut, Eren Fatma Akcil, Serdar Köksal, and Yusuf Tunali
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Adult ,Male ,medicine.medical_specialty ,Placebo ,Double blind study ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,Furosemide ,030202 anesthesiology ,Humans ,Medicine ,Mannitol ,Blood osmolarity ,In patient ,Prospective Studies ,Supratentorial Tumors ,business.industry ,Supratentorial Neoplasms ,General Medicine ,Middle Aged ,Diuretics, Osmotic ,Surgery ,Clinical trial ,Treatment Outcome ,Elective Surgical Procedures ,Anesthesia ,Female ,Neurology (clinical) ,business ,Craniotomy ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Objectives Although osmotic diuresis with mannitol is commonly used to provide brain relaxation, there is no consensus regarding its optimal dose and combination with loop diuretics. The aim of the present study is to evaluate the effects of mannitol and combination of furosemide with different doses of mannitol on brain relaxation and on blood electrolytes, lactate level, urine output, fluid balance and blood osmolarity in patients undergoing supratentorial tumor surgery. Patients and methods This prospective, randomized, double blind, placebo-controlled study included 51 patients (ASA I–III) scheduled for elective supratentorial craniotomy. Different doses and combinations of diuretics were administered after the bone flap removal. The Group 1 received mannitol at 0.5 g kg−1 and furosemide at 0.5 mg kg−1, the Group 2 received mannitol at 1 g kg−1 and furosemide at 0.5 mg kg−1, and the Group 3 received mannitol at 0.5 g kg−1 and placebo. The primary end-point of the present study is to evaluate the effects of mannitol and combination of furosemide with different doses of mannitol on brain relaxation and the secondary end-points are to evaluate their effects on blood electrolytes, lactate level, urine output, fluid balance and blood osmolarity. Results This study shows that mannitol alone (0.5 g kg−1), and the combinations of furosemide (0.5 mg kg−1) with different doses of mannitol (0.5 g kg−1–1 g kg−1) provides adequate brain relaxation. However, administration of furosemide with low or high doses of mannitol may cause reduction in the sodium and chloride levels as well as rise in the lactate level. Moreover it may cause high urine output and negative intra-operative fluid balance. Conclusion Administration of 0.5 g kg−1 mannitol provides adequate brain relaxation without causing systemic side effects in patients undergoing supratentorial tumor surgery. This study is registered to clinical trials (Clinical Trials.gov identifier NCT02712476).
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- 2017
47. Desmoplastic Noninfantile Ganglioglioma: Report of a Case.
- Author
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Qaddoumi, Ibrahim, Ceppa, Eugene P., Mansour, Asem, Sughayer, Maher A., and Tihan, Tarik
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TUMORS in children ,SUPRATENTORIAL brain tumors ,SURGICAL excision ,GAIT disorders in children ,RADIOGRAPHY ,ONCOLOGY - Abstract
Desmoplastic infantile ganglioglioma is a rare superficial supratentorial tumor that occurs within the first two years of life. Despite the worrisome radiological and histological appearance, the tumors are often curable following gross total resection. Tumors with similar characteristics are exceedingly rare in the noninfantile population. We present a six-year-old boy with seizures, weakness, and unsteady gait. Radiographic imaging confirmed a very large, solid and cystic mass in the right temporal-parietal region. Pathological examination demonstrated a tumor with severe desmoplasia identical to those reported as ‘desmoplastic infantile ganglioglioma.’ This case adds to the limited data available for desmoplastic gangliogliomas in the noninfantile population. It is not clear, yet likely, that the noninfantile form of this neoplasm is biologically similar to the infantile form. It is also unclear whether the desmoplastic noninfantile ganglioglioma has characteristics similar to classical ganglioglioma. This rare case highlights the remarkable versatility of glioneuronal tumors in children. [ABSTRACT FROM AUTHOR]
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- 2006
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48. Geographically Remote Cerebral Venous Sinus Thrombosis in Patients with Intracranial Tumors
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Ashok R. Asthagiri, Daniel M.S. Raper, David Schiff, and Alicia Zukas
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Adult ,Male ,medicine.medical_specialty ,Intraoperative MRI ,Sinus Thrombosis, Intracranial ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Surgical site ,medicine ,Humans ,In patient ,Cerebral venous sinus thrombosis ,Aged ,Retrospective Studies ,Supratentorial Tumors ,medicine.diagnostic_test ,Brain Neoplasms ,business.industry ,Supratentorial Neoplasms ,Postoperative complication ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,Treatment Outcome ,030220 oncology & carcinogenesis ,Female ,Neurology (clinical) ,Radiology ,Glioblastoma ,Complication ,business ,Craniotomy ,Magnetic Resonance Angiography ,030217 neurology & neurosurgery - Abstract
Cerebral venous sinus thrombosis (CVST) related to intracranial tumors has most commonly been recognized as an operative complication related to local operative factors such as retraction or direct venous injury. CVST may also be caused by tumor-related factors such as local mass effect but rarely occurs geographically remote from the site of the tumor. We report 6 cases treated at our institution of intracranial supratentorial tumors associated with CVST. In each case, the CVST was remote from the surgical site. In 3 cases CVST was noted at the time of resection, and 3 cases occurred in a delayed fashion. Each case is discussed in detail, and the utility of intraoperative magnetic resonance imaging in the early diagnosis of this complication is highlighted.
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- 2017
49. Supratentorial Tumors in Pediatric Patients
- Author
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Carlos A. Zamora, Izlem Izbudak, and Thierry A.G.M. Huisman
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Diagnostic Imaging ,Ependymoma ,medicine.medical_specialty ,Supratentorial region ,Neuroimaging ,03 medical and health sciences ,0302 clinical medicine ,Glioma ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Child ,Medical attention ,Supratentorial Tumors ,business.industry ,Brain ,Supratentorial Neoplasms ,Astrocytoma ,General Medicine ,medicine.disease ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Neurology (clinical) ,Radiology ,Differential diagnosis ,business ,030217 neurology & neurosurgery - Abstract
The breadth of tumors that can arise in the supratentorial brain in children is extensive. With the exception of those that result in seizures and the highly malignant histologies, supratentorial tumors may come to medical attention later compared with infratentorial tumors, as they are less commonly associated with ventricular obstruction. This article presents an overview of the neuroimaging characteristics of these entities, with particular attention to relevant features that may aid in narrowing the differential diagnosis, including correlation with demographics and clinical presentation.
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- 2017
50. Early results of stroke-like supratentorial tumors surgical treatment
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A.A. Oblyvach, Y.Yu. Freidman, T.I. Makeeva, O.M. Goncharuk, and A.O. Kaminskiy
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Supratentorial Tumors ,medicine.medical_specialty ,business.industry ,Group ii ,Neurosciences. Biological psychiatry. Neuropsychiatry ,supratentorial tumors, cerebrovascular accident, surgical treatment, early results of treatment ,medicine.disease ,Surgery ,Metastasis ,Lesion ,Early results ,Quality of life ,medicine ,medicine.symptom ,business ,Surgical treatment ,Stroke ,RC321-571 - Abstract
Objective – to study early results of surgical treatment in 176 patients with supratentorial tumors (ST) with a stroke-like course. Materials and methods. The results of surgical treatment of 176 patients with stroke-like tumors were studied. They were treated at the urgent neurosurgery clinic of the Kyiv Emergency Hospital during the period from 2008 to 2015. The age of the patients was 20-70 years, the average age was (53.7 ± 13.4) years. There were 104 (59.1 %) men, 72 (40.9 %) women. Intracerebral tumors were diagnosed in 156 (88.6 %) cases, metastasis was observed in 35 (19.9%), 20 (11.4 %) patients have extracranial tumors Patients were divided into two groups depending on cerebrovascular accident: the group I – 103 patients had hemorrhagic type of cerebrovascular accident, the group II – 73 patients had ischemic type of cerebrovascular accident. In early postoperative period, CT and/or MRI was performed in all cases to detect postoperative complications and evaluate the radicality of surgical resection. An ophthalmologic review before and after surgery was performed. Results. Total resection was achieved in 68 (38.6 %) patients, near total – in 82 (46.6 %), subtotal – in 26 (14.8 %). All 176 patients had less than 70 points of Karnovsky scale before surgery, after treatment the number of this patients decreased to 36 (20.5 %) patients. Improvement of quality life was noted in regression of neurological deficits, restoration of functional disorders, high degree of social adaptation. Conclusions. The main criteria of successful surgical treatment of tumors with stroke-like course. is the survival of patients with radical surgical resection and satisfactory quality of life in the postoperative period. Factors that influence the removal of the tumors with stroke-like course are size of the lesion, its localization, and the histological characteristics of the tumors. Therapeutic tactics in patients with tumors with stroke-like course should be based on an individual approach. Adequate surgical removal of the tumors and hematomas evacuation improve the quality of life in most patients (79.5 %).
- Published
- 2017
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