3DSlicer software assisted microsurgery for parafalcine meningioma through contralateral longitudinal fissure approach / 中国综合临床

Objective:To evaluate the effect of microsurgery for parafalcine meningioma through contralateral longitudinal fissure approach assisted by 3DSlicer software.Methods:From January 2020 to January 2021, 18 patients with parafalcine meningioma in The second hospital of Hebei Medical University were randomly selected as the observation group.The contralateral longitudinal fissure was treated by microsurgery assisted by 3DSlicer software.Before operation, improve the imaging examinations such as brain CT plain and enhancement, magnetic resonance angiography and magnetic resonance venography, establish the models of tumor, superior sagittal sinus and superior cerebral artery by using 3DSlicer software, analyze the positional relationship between tumor and superior sagittal sinus and superior cerebral vein, and remove the tumor by contralateral longitudinal fissure approach.Nineteen patients with parafalx meningioma treated by traditional ipsilateral longitudinal fissure approach from January to December 2019 were selected as the control group.The differences in operation time, intraoperative bleeding, limb muscle strength recovery rate, headache and dizziness relief rate were compared between the two groups.Results:In the observation group, the positional relationship between the reconstructed tumor and the superior cerebral vein above its base was completely consistent with the actual situation during the operation.All patients underwent Simpson grade I resection, and there was no injury to the superior cerebral vein and venous sinus during the operation.The recovery rate of limb muscle strength in the observation group (75%(9/12)) was higher than that in the control group (23%(3/13))( P=0.009). There was no significant difference in the operation time, intraoperative bleeding and the remission rate of headache and dizziness one week after operation in the observation group ( P>0.05). Conclusion:3DSlicer software was helpful for preoperative evaluation of the positional relationship between parafalcine meningioma and the anatomic structures such as superior cerebral vein and superior sagittal sinus.Under the guiding of 3DSlicer software, surgeon removed the tumor totally through the contralateral longitudinal fissure approach, which effectively reduced the operative side injury of the important structures such as superior cerebral vein and functional cerebral cortex, and contributed highly to the recovery of limb muscle strength of patients.

Gorlin Goltz syndrome: a rare case report

Gorlin-Goltz syndrome is uncommon multisystemic disease with an autosomal dominant trait, with complete penetrance and variable expressivity, though sporadic cases have been described. We report a case of 18 years old male patient having features of Gorlin Goltz syndrome. Gorlin-Goltz syndrome is characterized by multiple basal cell nevi or carcinomas, odontogenic keratocysts, palmar and/or plantar pits, calcification of the falx cerebri, and is associated with internal malignancies. It is important to know the major and minor criteria for the diagnosis and early preventive treatment of this syndrome.

Partial duplication of tentorium cerebelli and complete duplication of falx cerebelli / 대한해부학회지

Variations of the dural folds and the dural venous sinuses are infrequently reported in the existing medical literature. Such variations in the posterior cranial fossa may pose difficulties in various analytical and surgical procedures of this region. We present a rare concurrent variation of the falx cerebelli and tentorium cerebelli that was detected during routine dissection of an adult male cadaver. While removing the brain, a partial duplication of tentorium cerebelli was observed below the left half of the tentorium cerebelli and above the left cerebellar hemisphere. This fold did not have any dural venous sinus in it. Further, a complete duplication of falx cerebelli with a single occipital venous sinus within its attached border was also observed. We present the review of literature and discuss the comparative anatomy of this case.

Neurodevelopmental Prognostic Factors in 73 Neonates with the Birth Head Injury / 대한신경손상학회지

OBJECTIVE: The objective of this study was to reinterpret the neurodevelopmental prognostic factors that are associated with birth head injury by performing a long-term follow-up. METHODS: Seventy-three neonates with head injuries were retrospectively analyzed after a duration of 10.0±7.3 years to determine the correlations between perinatal factors, including gender, head circumference, gestational age, body weight, and mode of delivery, and head injury factors from radiologic imaging with social, fine motor, language, and motor developmental quotients. RESULTS: There was a statistically significant difference between perinatal factors and head injury factors with respect to head circumference, body weight, gestational age, mode of delivery, Apgar scores at 1 min, cephalohematoma, subdural hemorrhage, subarachnoid hemorrhage, and hypoxic injury, but no direct correlation by regression analysis was observed between perinatal factors and developmental quotients. Of the head injury factors, falx hemorrhage showed a significant indirect relationship with the language and motor developmental quotients. Mode of delivery, subgaleal hematoma, cephalohematoma, greenstick skull fracture, epidural hemorrhage (EDH), tentorial hemorrhage, brain swelling, and hypoxic injury showed an indirect relationship with social development. CONCLUSION: In terms of perinatal factors and head injury factors, mode of delivery, subgaleal hematoma, cephalohematoma, greenstick skull fracture, EDH, tentorial hemorrhage, falx hemorrhage, brain swelling, and hypoxic injury displayed an indirect relationship with long-term development, and therefore these factors require particular attention for perinatal care.

Effects of minimally invasive tumor resection under microscope on symptoms improvement, Simpson classification and prognosis in patients with sagittal sinus and falx cerebri meningioma / 中国基层医药

Objective To analyze the effects of minimally invasive tumor resection under microscope on symptoms improvement,Simpson classification and prognosis in patients with sagittal sinus and falx cerebri meningioma.Methods From December 2012 to December 2016,123 patients with parasagittal and falx meningioma in the People 's Hospital of Shanxi Province were randomly divided into two groups according to the digital table.The control group (61 cases) underwent conventional craniotomy,and the study group (62 cases) performed minimally invasive tumor resection.The symptoms improvement,Simpson classification and postoperative recurrence were compared between the two groups.Results The operation time between the two groups had no statistically significant difference (t =1.13,P ＞ 0.05).The intraoperative blood loss in the study group was (119.05 ± 26.94) mL,which was lower than (172.05 ±27.43) mL in the control group (t =10.81,P ＜ 0.01).The postoperative symptoms improvement of movement of limbs (3.22％),epilepsy (4.65 ％),sensory dysfunction (1.61％) in the study group were significantly better than those in the control group (14.75％,31.15％,27.87％) (x2 =5.02,6.34,4.14,all P ＜ 0.05).The Simpson classification of tumor resection rate in the study group was better than that in the control group(x2 =12.23,P ＜0.01).The incidence rates of complications such as epilepsy(0.00％) and intracranial hemorrhage(1.61％),and recurrence rate(0.00％) in the study group were lower than those in the control group(26.23％,27.87％,27.87％)(x2 =4.05,4.14,4.65,all P ＜ 0.05).Conclusion Minimally invasive tumor resection under the microscope can effectively improve clinical symptoms of patients with sagittal sinus and falx cerebri meningioma,which can improve tumor resection rate,effectively reduce the incidence of postoperative complications and recurrence rate.

Chondroma of the Cerebral Falx: Case Report of a Very Rare Intracranial Tumor / Condroma da foice do cérebro: relato de caso de um tumor intracraniano muito raro

Chondromas are a benign cartilaginous tumor that account for approximately 0.5% of primary intracranial tumors. They usually arise from the synchondrosis of the skull base, being rarely reported elsewhere (dura convexity, falx, or even intraparenchymal). Because they are very rare tumors sharing clinical behavior and imagiological similarities with the much more common meningioma, the clinical diagnosis is frequently mistaken after an initial imaging workup. The authors present a case of a 48-year-old woman, with frequent headaches and an extra-axial tumor arising from the anterior falx, initially diagnosed as a meningioma.

Condromas são tumores cartilaginosos benignos que correspondem por aproximadamente 0,5% dos tumores primários intracranianos. Eles geralmente surgem da sincondrose da base do crânio, sendo raramente registrados em outros locais como a convexidade dural, a foice, até mesmo no parênquima cerebral. Por serem tumores muito raros que compartilham comportamento clínico e imagiológico com meningiomas, o diagnóstico é frequentemente confundido após exame de imagem inicial. Os autores apresentam o caso de uma mulher de 48 anos, com cefaleia frequente e um tumor extra-axial ascendendo da foice anterior, inicialmente diagnosticado como um meningioma.

Microsurgical treatment of sagittal sinus, falx meningioma experience (report of 30 cases) / 中国基层医药

Objective To investigate the effects of surgical method on the falx paraneoplastic parasagittal meningiomas.Methods 30 cases of surgical treatment in sagittal sinus and falx meningioma patients with imaging data,surgical approach,microsurgical resection of the tumor method and efficacy were analyzed.Results 30 patients resected by Simpson standard,Ⅰ grade resection 23 cases,Ⅱ grade resection in 7 cases,no operative mortality.1-5 years of follow-up,2 patients relapsed,all secondary surgical cure.Conclusion To be familiar with microscopic neuroanatomical relationship,using microsurgical resection of the superior sagittal sinus,falx meningioma,tumor removal rate can be increased to reduce the important functional areas of damage,reduce complications and improve quality of life of patients.

Microsurgical treatment of meningioma in the cerebral falx and sagittal sinus / 中国基层医药

Objective To review the clinical efficacy and surgical methods of microsugical treatment for the meningioma in the cerebral falx and sagittal sinus .Methods The clinical date and microsurgery techniques of 8 pa-tients with meningioma in the cerebral falx and sagittal sinus treated by microsurgery were analyzed retrospectively . Results 7 tumors were totally removed ,including Simpson grade Ⅰin 5 cases and Simpson Ⅱin 2 cases and 1 ca-ses subtotally resection.The follow-up from 6 months to 4 years,the tumor recurred in.Conclusion The total tumor resection by microsurgery ,and effective treatment of cerebral falx and sagittal sinus in operation ,and protection of im-portant brain eloquent veins are important reasons for influence outcomes .

Multifocal Calcifications of the Falx Cerebri and Dura Presenting as Hot Spots in the Skull on Bone Scintigraphy / 핵의학분자영상

A 49-year-old woman with invasive ductal carcinoma of the right breast underwent Tc-99m MDP bone scintigraphy for an evaluation of skeletal metastases. Multiple focal hot spots in the midline and left frontoparietal skull region were observed. The plain radiographs revealed the typical findings of the calcification of the falx cerebri and dura. These findings might be mistaken for metastases of the skull in cancer patients. Therefore, a radiographic correlation is essential when multifocal hot spots in the skull are observed in cancer patients.

Cavernous Angioma in the Falx Cerebri: A Case Report

Intracranial cavernous angiomas are benign vascular malformations and can be divided into intra-axial and extra-axial lesions. Extra-axial cavernous angiomas are relatively rare and usually arise in relation to the dura mater and mimick meningiomas. We report a case of cavernous angioma that occured in the falx cerebri of a 22-yr-old female patient with the special focus on neuroradiologic findings. This is the fourth case of cavernous angioma in the falx cerebri reported in the literature to our knowledge.

Interhemispheric Chronic Subdural Hematoma Showing Falx Syndrome: Case Report

Chronic subdural hematoma can be seen frequently in the cerebral convexity, however, it is rare in the interhemispheric space. It develops usually in patients with blood clotting disturbance, history of head trauma, chronic alcoholic abuse. When its volume becomes large, falx syndrome showing hemiparesis which is more prominent in the leg than in the arm or an isolated paresis of one leg, can be noticed. The interhemispheric chronic subdural hematoma can be managed by the conservativel treatment or surgical evacuation of hematoma. Decision on the treatment modality depends on the clinical course. Conservative management is the treatment of choice for patients without disturbances of consciousness and other neurological deficits. However, early surgical treatment is necessary in patients with progressive neurological deterioration. The authors report a case of chronic subdural hematoma in interhemispheric space which was managed by medical treatment.

Falcine Mesenchmal Chondrosarcoma

We experienced a case of falcine mesenchymal chondrosarcoma in a 22-year-old pregnant woman. Cartilage cell tumors within the cranium are very rare, only less than 0.2% of all intracranial tumors. Because a few examples of mesenchymal chondrosarcoma in this locttion have been reported, we reviewed previous reports cases, to determine the natural history of intracranial chondrosarcomas. The distinguishing features of this rare tumor are compared with previous cases of itracranial tumors derived from cartilage.

A Case of Oligodendroglioma Attached to the Leptomeninges and Falx Cerebri

We have experienced a case of oligodendroglioma which was similar to a falx meningioma. The oligodendroglioma arose in the medial surface(paracentral lobule) of the right frontal lobe and firmly attached to the falx cerebri. The tumor was found in early life(16 year old) and it had no roentgenographic calcification. So histological confirmation was possible after the operation. We report this uncommon oligodendroglioma with a review of literatures.