11 results
Intraoperative Fiber-Optic Endoscopy for Ventricular Catheter Insertion
- Philip V. Theodosopoulos, Aviva Abosch, Michael W. McDermott
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 28 / Issue 1 / February 2001
- Published online by Cambridge University Press:
- 02 March 2017, pp. 56-60
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Objective:
Ventricular catheter placement is a common neurosurgical procedure often resulting in inaccurate intraventricular positioning. We conducted a comparison of the accuracy of endoscopic and conventional ventricular catheter placement in adults.
Methods:A retrospective analysis of data was performed on 37 consecutive patients undergoing ventriculo-peritoneal shunt (VPS) insertion with endoscopy and 40 randomly selected, unmatched patients undergoing VPS insertion without endoscopy, for the treatment of hydrocephalus of varied etiology. A grading system for catheter tip position was developed consisting of five intraventricular zones, V1-V5, and three intraparenchymal zones, A, B, C. Zones V1 for the frontal approaches and V1 or V2 for the occipital approaches were the optimal catheter tip locations. Postoperative scans of each patient were used to grade the accuracy of ventricular catheter placement.
Results:Seventy-six percent of all endoscopic ventricular catheters were in zone V1 and 100% were within zones V1-V3. No endoscopically inserted catheters were observed in zones V4, V5 or intraparenchymally. Thirty-eight percent of the conventionally placed catheters were in zone V1, 53% in zones V1-3 and 15% intraparenchymally. There was a statistically significant difference in the percentage of catheters in optimal location versus in any other location, favoring endoscopic guidance (p<0.001).
Conclusion:We conclude that endoscopic ventricular catheter placement provides improved positioning accuracy than conventional techniques.
A Comparison of CT Contrast Enhancement and BUDR Labeling Indices in Moderately and Highly Anaplastic Astrocytomas of the Cerebral Hemispheres
- Michael W. McDermott, Hendrikus G.J. Krouwer, Akio Asai, Satoyuki Ito, Takao Hoshino, Michael D. Prados
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 19 / Issue 1 / February 1992
- Published online by Cambridge University Press:
- 18 September 2015, pp. 34-39
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Contrast enhancement on computerized tomography (CT) scans has been used in directing therapy for presumed intracranial gliomas. However, for moderately anaplastic astrocytomas (MOAAS) and highly anaplastic astrocytomas (HAAS), it provides no information about proliferative potential. The bromodeoxyuridine (BUDR) labeling index (LI), however, indicates proliferative potential, correlating with histologic malignancy and survival. An LI < 1% is a favorable indicator; LI > 5% suggests more aggressiveness. To determine the correlation, if any, between BUDR LI and contrast enhancement, CT scans of 71 patients with cerebral hemisphere tumors labeled with BUDR were retrospectively reviewed. Among 36 MOAAS, the BUDR LI was < 1% in 77% of enhanced tumors and 61% of unenhanced tumors. Among 35 HAAS, it was < 5% in 56% of enhanced tumors and 90% of unenhanced tumors. Therefore, contrast enhancement on CT scans does not always correctly predict proliferative potential in these tumors, and biopsy and labeling studies are recommended before therapy.
Stereotactic Insertion of an Ommaya Reservoir: Technical Note
- Michael W. McDermott, Samuel F. Ciricillo, Philip H. Gutin, Michael S.B. Edwards
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 22 / Issue 3 / August 1995
- Published online by Cambridge University Press:
- 18 September 2015, pp. 235-238
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Background
Stereotactic insertion of catherters into deep-seated tumors or developmental cysts is easily accomplished, but connecting the catheter to an Ommaya reservoir while maintaining catheter position can be difficult. We describe a technique for easy placement of a catheter-Ommaya reservoir construct with one pass.
MethodsStandard stereotactic imaging is performed. The distance from the outer table of the skull to the target point is measured. A catheter-Ommaya reservoir construct is assembled to this length and directed to the target position with a standard Cosman-Robert-Wells (CRW) stereotactic frame.
ResultsUse of this technique placed catheters into tumor or developmental cysts accurately and with no surgical complications in 12 patients.
ConclusionsThis technique is simple, safe, reliable, and requires no special equipment. It avoids the risk of dislodging the catheter when it is being connected to the Ommaya reservoir, reducing the chances of cyst leakage and collapse.
Lymphocytic Adenohypophysitis
- Michael W. McDermott, Donald E. Griesdale, Kenneth Berry, G. Edward Wilkins
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 15 / Issue 1 / February 1988
- Published online by Cambridge University Press:
- 18 September 2015, pp. 38-43
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Lymphocytic adenohypophysitis (LAH) is an uncommon disorder in the spectrum of pituitary disease. Twenty-three cases proven by biopsy or at autopsy have been reported since 1962. We report 2 further cases and review the etiology, immunology and pathology of the disease. The diagnosis should be considered in afemale patient who presents during the post-partum period with the clinical picture of a non-functional or prolactin cell pituitary adenoma and evidence of hypopituitarism.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
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- 05 August 2015
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- 27 April 2015, pp ix-xxx
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Contributors
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- By Jean Marie Abraham, Catherine Ayoub, Jessica Dym Bartlett, Karen L. Bierman, Paula A. Braveman, Robert H. Bruininks, Frances A. Campbell, Rachel Chazan-Cohen, Peggy Chen, Alyssa Crawford, Katina D’Onise, Celene E. Domitrovich, Greg J. Duncan, Susan Egerter, Michelle M. Englund, Temitope O. Erinosho, Kevin D. Frick, Michael K. Georgieff, Scott D. Gest, Bernard Guyer, Momoko Hayakawa, Ariel Kalil, Pinar Karaca-Mandic, Samuel A. Kleiner, Narayana Kocherlakota, John W. Lynch, Sai Ma, Laurie T. Martin, Robyn A. Mcdermott, Robin E. Mockenhaupt, Robert L. Nix, Helen Raikes, Arthur J. Reynolds, Arthur J. Rolnick, Sharon Rolnick, Lawrence J. Schweinhart, Amy Susman-Stillman, Judy A. Temple, Jim Thorp, Dianne S. Ward, Janet A. Welsh, Barry White, Sung J. Choi Yoo, Kathleen M. Ziol-Guest
- Edited by Arthur J. Reynolds, University of Minnesota, Arthur J. Rolnick, University of Minnesota, Judy A. Temple, University of Minnesota
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- Health and Education in Early Childhood
- Published online:
- 05 February 2015
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- 19 February 2015, pp xiii-xiv
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In Situ Cranioplasty for Hyperostosing Meningiomas of the Cranial Vault
- Orin Bloch, Michael W. McDermott
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- Canadian Journal of Neurological Sciences / Volume 38 / Issue 1 / January 2011
- Published online by Cambridge University Press:
- 02 December 2014, pp. 59-64
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Objective:
Hyperostosis of the bone overlying meningiomas has been reported in up to 50% of cases. The skull becomes infiltrated by meningothelial tumor cells, necessitating removal of the hypertrophied bone to achieve a complete tumor resection. Unfortunately, aesthetic reconstruction of large bony defects can pose a significant challenge intra-operatively. Custom cranioplasty implants are very expensive and can only be fabricated after the bony defect exists, requiring a second surgery for implantation. Although numerous composite materials exist to repair the defects at the time of tumor resection, the challenge is to create an implant that fits appropriately without shifting and approximates the natural curvature of the skull. We have developed a technique for an “in situ cranioplasty” using a composite construct with strength in compression and tension.
Technique:After the skull is reshaped by shaving down part of the hyperostotic bone, titanium mesh is molded to the surface of the skull and screwed into the surrounding normal bone. The bone flap is then removed by drilling a trough at the outer margin of the tumor-involved skull and removing a ring of normal surrounding bone. The central portion of tumor involved skull is then craniectomized. The mesh can be reapplied and the full thickness of the central bone can be reconstructed with polymethylmethacrylate, yielding a solid construct perfectly matched to the patient's natural head shape.
Conclusion:This novel technique yields a sturdy, aesthetic, and cost-effective result which can be used to address any cranial vault defect at the time of tumor resection.
Pre-Operative Factors Affecting Resectability of Giant Intracranial Meningiomas
- Alfredo Quiñones-Hinojosa, Tania Kaprealian, Kaisorn L. Chaichana, Nader Sanai, Andrew T. Parsa, Mitchel S. Berger, Michael W. McDermott
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 36 / Issue 5 / September 2009
- Published online by Cambridge University Press:
- 02 December 2014, pp. 623-630
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Objective:
Larger intracranial tumors require extended operating times and may be associated with increased perioperative complications. There are few reports describing the experience of resecting large meningiomas ≥5cm in a variety of locations. As a group, it remains largely unknown whether these relatively rare lesions are amenable to radical resection, and what factors influence their resectability.
Methods:Sixty-seven patients undergoing surgery for a large intracranial meningioma (≥5cm in the longest dimension) between 1998 and 2004 were retrospectively reviewed. The surgeries were performed at a single institution University of California at San Francisco. Predictors of resectability were assessed via multivariate logistical regression analysis.
Results:Thirty-nine (58%) patients underwent gross total resection (GTR) (Simpson grades I/II). There were no cases of perioperative mortality. At last follow-up, symptoms improved in 39 (58%) patients, remained unchanged in 20 (30%), and were aggravated in 8 (12%). In the multivariate model for all large meningiomas, age>45 years [OR(95%CI);0.127 (0.026-0.616),p=0.01] and superior sagittal sinus involvement [OR(95%CI);0.160 (0.026-0.976),p=0.05] were negative predictors of GTR, while preoperative embolization [OR(95%CI);8.087(1.719-38.044),p=0.008] was positively associated with GTR. For only supratentorial meningiomas, superior sagittal sinus involvement [OR (95%CI);0.077 (0.010-0.571),p=0.01] and preoperative embolization [OR(95%CI);10.492(1.961-56.135),p=0.006] were independently associated with GTR.
Conclusions:This study evaluated a subset of large intracranial meningiomas ≥5cm. The results indicate that GTR can be achieved in the majority of cases with limited morbidity and mortality, where symptoms will likely improve and recurrences seldom occur. This study may provide useful insights for patients undergoing surgery for large intracranial meningiomas.
Renal Cell Carcinoma Metastatic to the Choroid Mimicking Intraventricular Meningioma
- Alfredo Quinones-Hinojosa, Edward F. Chang, Saad A. Khan, Michael T. Lawton, Michael W. McDermott
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 31 / Issue 1 / February 2004
- Published online by Cambridge University Press:
- 02 December 2014, pp. 115-120
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Background:
Metastatic renal cell carcinoma to the choroid plexus is a rare condition and can be easily confused with meningioma.
Methods:A 61-year-old female presented with progressive neurologic deterioration and MRI findings of obstructive hydrocephalus and a homogeneously contrast enhancing 3 cm oval mass in the trigone of the left lateral ventricle.
Results:Despite radiologic, intraoperative gross features, and frozen pathology all consistent with meningioma, the final pathology revealed metastatic renal cell carcinoma.
Conclusion:Renal cell carcinoma metastatic to the choroid plexus can mimic intraventricular meningioma. We present a review of the literature and comparison of the radiological features of meningiomas and metastatic renal cell carcinoma. We also discuss the use of an under-utilized technique, the contralateral transcallosal approach, in the surgical treatment of this intraventricular lesion.
Sex Steroid and Growth Factor Profile of a Meningioma Associated with Pregnancy
- Justin S. Smith, Alfredo Quiñones-Hinojosa, Miranda Harmon-Smith, Andrew W. Bollen, Michael W. McDermott
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 32 / Issue 1 / February 2005
- Published online by Cambridge University Press:
- 02 December 2014, pp. 122-127
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Background:
Increased growth of meningiomas during pregnancy as well as postpartum clinical regression of symptoms have been reported but remain poorly understood. A better understanding of the factors that contribute to these observations, including potential factors associated with pregnancy, could enable design of more effective adjuvant therapies.
Methods:We describe the presentation of a meningioma during the immediate postpartum period. Serial imaging demonstrated subsequent rapid decrease in size of the tumour prior to any intervention. The lesion was resected, and the tissue was subjected to immunostaining for gene products associated with pregnancy, including estrogen receptor (ER), progesterone receptor (PR), platelet-derived growth factor receptor B (PDGFRB), fibroblastic growth factor receptor 2 (FGFR-2), epidermal growth factor receptor (EGFR) and human placental lactogen (hPL).
Results:The lesion proved to be an atypical fibroblastic meningioma grade II (WHO). Immunostaining demonstrated significant staining for PR, PDGFRB, and FGFR-2. No specific staining for ER, EGFR, or hPL was identified.
Conclusion:Although clinical regression of meningioma following pregnancy is well-recognized, imaging data are much less abundant. This report provides clear clinical and imaging documentation of a meningioma associated with pregnancy. In addition, the growth factor profile of this tumour suggests the importance of PR, PDGFRB, and FGFR-2 as potential therapeutic targets.
List of Contributors
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- By Ralph Adolphs, Bernard J. Baars, John A. Bargh, Jesse M. Bering, David F. Bjorklund, Joseph E. Bogen, Rebekah Bradley, Wallace Chafe, Michael C. Corballis, Diego Cosmelli, Jean-Marie Danion, Richard J. Davidson, Steven W. Day, Georges Dreyfus, John D. Dunne, Stan Franklin, Helena Hong Gao, Lisa Geraci, Deborah E. Hannula, J. Allan Hobson, Caroline Huron, John F. Kihlstrom, Asher Koriat, Uriah Kriegel, Jean-Philippe Lachaux, Charles D. Laughlin, Antoine Lutz, Drew McDermott, Katharine McGovern, Keith Oately, Suparna Rajaram, Henry L. Roediger III, Edmund T. Rolls, Daniel L. Schachter, William Seager, Daniel J. Simons, Scott D. Slotnick, Henry Stapp, Petra Stoerig, Ron Sun, Evan Thompson, C. Jason Throop, Rebecca Todd, Carlo Umiltà, David E. Warren, Joel Weinberger, Drew Westen, Dan Zahavi, Philip David Zelazo
- Edited by Philip David Zelazo, University of Toronto, Morris Moscovitch, University of Toronto, Evan Thompson, University of York
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- The Cambridge Handbook of Consciousness
- Published online:
- 05 June 2012
- Print publication:
- 14 May 2007, pp -
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