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Anatomic Dissection of Arachnoid Membranes Encircling the Pituitary Stalk on Fresh, NonâFormalin-Fixed Specimens: Anatomoradiologic Correlations and Clinical Applications in Craniopharyngioma Surgery
No full textBackground The anatomy of the arachnoid membranes and cisternal spaces around the pituitary stalk has not been yet exhaustively described and understood. In this study, we performed a detailed anatomic study on fresh, non–formalin-fixed cadavers of the arachnoid membranes encircling the pituitary stalk and correlate our anatomic findings with magnetic resonance imaging (MRI). Methods Ten fresh, non–formalin-fixed, non–silicon-injected adult cadaveric heads were analyzed in this study. The membrane and cisterns that were studied for our study were as follows: 1) the diaphragma sellae and its dural components; 2) the basal arachnoid membrane; 3) the Liliequist membrane with its diencephalic and mesencephalic portion; 4) the medial carotid membrane; 5) the chiasmatic cistern; and 6) the pituitary stalk. MRI examinations of the sellar region were performed in 15 healthy volunteers (9 men, mean age 40 years; and 6 women mean age, 37 years) to visualize the arachnoid membrane encircling the pituitary stalk. MRI examinations were performed with a 3-T unit. A 3-dimensional constructive interference in steady state pulse magnetic resonance sequence was used. Results All the membranes examined were visualized clearly in all the dissections performed. Their 3-dimensional organization around the pituitary stalk was clarified and confirmed by MRI. Conclusions Our study gives a detailed description of the pituitary stalk arachnoid sheets on fresh, non–formalin-fixed cadavers. This technique allowed us to clearly identify a funnel-shaped arachnoid collar encircling the pituitary stalk and delimiting a distinct cisternal space belonging to the stalk itself
In Reply to the Letter to the Editor Regarding “Anatomic Dissection of Arachnoid Membranes Encircling the Pituitary Stalk on Fresh Non-Formalin-Fixed Specimens: Anatomoradiologic Correlations and Clinical Applications in Craniopharyngioma Surgery”
No full textBreast cancer
No full textBreast cancer is the second leading cause of brain metastasis in the world. Several patient- and tumor-related characteristics have been identified as risk factors for developing brain metastases. Treatment is based on local and/or systemic therapies, tailored to breast cancer brain metastases-specific prognostic factors
Brain metastases from renal cell carcinoma
No full textBrain metastasis is a major cause of morbidity and mortality in renal cancer patients. Treatment of metastatic renal cancer is difficult because most of RCCs are resistant to several therapeutic strategies: main studies support surgery as a therapeutic option in patients with good performance status, limited systemic disease, single brain metastasis but also in some patients with a limited number of metastases; on the other side, use of whole brain radiotherapy is still controversial
Melanoma and cutaneous neoplasia
No full textMelanoma is the third most frequent cause of metastatic CNS malignancies after lung, breast and unknown primary site metastases. Surgical resection and radiotherapy have been the conventional treatment for brain metastasis from melanoma. Stereotactic radiosurgery is another modality of treatment that delivers highly conformal radiation to a metastasis target in a high dose per fraction fashion
Vertebroplasty and delayed subdural cauda equina hematoma: Review of literature and case report
Full text linkVertebroplasy is considered an alternative and effective treatment of painful oncologic spine disease. Major complications are very rare, but with high morbidity and occur in less than 1% of patients who undergo vertebroplasty. Spinal subdural hematoma (SDH) is an extremely rare complication, usual developing within 12 h to 24 h after the procedure. We report the case of a tardive SDH in an oncologic patient who underwent VP for Myxoid Liposarcoma metastasis. Trying to explain the pathogenesis, we support the hypothesis that both venous congestion of the vertebral venous plexus of the vertebral body and venous congestion due to a traumatic injury can provoke SDH. To our best knowledge, only 4 cases of spinal subdural hematoma following a transpedicular vertebroplasty have been previously described in International literature and only one of them occurred two weeks after that surgical procedures. Percutaneous verteboplasty is a well-known treatment of pain oncologic spine disease, used to provide pain relief and improvement of quality life and is considered a simple surgical procedure, involving a low risk of complications, but related to high morbidity, such as SDH. Therefore it has to be performed by experienced and skilled surgeons, that should also recognize possible risk factors, making SDH more risky
Endoscopic interlaminar approach for intracanal L5-S1 disc herniation: Classification of disc prolapse in relation to learning curve and surgical outcome
No full textThree-Dimensional Anatomy of the White Matter Fibers of the Temporal Lobe: Surgical Implications
No full textFull endoscopic transforaminal endoscopic approach for symptomatic lumbar disc herniation, our experience
No full textAssociation between spontaneous intracranial epidural hematoma and craniofacial infections: a systematic literature review
Full text linkBackground: Spontaneous and nontraumatic epidural hematoma (SEDH) is a rare entity. Etiology is various, including vascular malformations of the dura mater, hemorrhagic tumors, and coagulation defects. The association between SEDH and craniofacial infections is rather unusual. Methods: We performed a systematic review of the available literature using the PubMed, Cochrane Library, and Scopus research databases. Literature research was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We exclusively included studies reporting demographic and clinical data, published until October 31, 2022. We also report one case from our experience. Results: A total of 18 scientific publications, corresponding to 19 patients, met the inclusion criteria for the qualitative and quantitative analysis. Patients were mostly adolescents, with a clear male predominance. SEDHs frequently occurred in the frontal area, usually near the site of the infection. Surgical evacuation was the treatment of choice with good postoperative outcomes. Endoscopy of the involved paranasal sinus should be achieved as soon as possible to remove the cause of the SEDH. Conclusion: SEDH may occur as a rare and life-threatening complication of craniofacial infections; therefore, prompt recognition and treatment are mandatory
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