Microvascular decompression in trigeminal neuralgia

Trigeminal neuralgia, like other rhizopathies, has defied categorization, clarification in pathology and effective treatment, despite several efforts, in several disciplines. The different rhizopathies like trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia, tinnitus, spasmodic torticollis, etc., all share a common pathology i.e., a vascular compression of the cranial nerve at the root entry zone. A comprehensive description of the features of trigeminal neuralgia and the surgical management with microvascular decompression is detailed in this article. Microvascular decompression is a relatively safe surgery and complications are very unlikely in dexterous hands

overview in stereotactic radiosurgery

Efficacy and utilization of radiation as a mode of management in neurosurgical lesions has increased radically as a consequence of improvements in appreciation of the concept of stereotaxis, progress in medical imaging, computer technology, and advanced delivery devises. [19.22] Primary management alternative in patients with cerebellopontine angle lesions, skull base tumours, meningiomas, paragangliomas, AVMs etc., is increasingly being used as also in secondary management of recurrent or planned residual disease patients where a part of the lesion is deliberately left behind to avoid loss of function and prevent iatrogenic injury. [22] Contemporary understanding with adequate and proper information of this resource along with understanding the controversies regarding the use of radiation of the management of several lesions in paramount. This article is intended to provide a concise basic introduction of the technology available and the pertinent applications in the management for several lesions with a basic understanding of the advantages and disadvantages of various available devices and the outcome in using various methods based on review of available literature

Postoperative mental functions in patients with frontal meningiomas

The meninges [dura mater, arachnoid, pia mater] are the site of numerous pathological lesions including inflammation and neoplasm Meningiomas are the most frequently observed lesions and the most common of primary meningeal tumours. Over the years, meningiomas has been histologically classified and some entities have been added to the cadre of meningioma variants, while others have been designated as other types of tumours. The 200 revision of the World Health Organisation [WHO] grading system provided diagnostic guidelines. Most meningiomas are biologically benign and correspond to the WHO grade. However, certain meningiomas have an increased tendency to recur or follow an aggressive clinical behavior and are assigned an WHO grade and have a substantially increased incidence of recurrence. Rhabdoid meningioma, papillary meningioma and anaplastic meningioma corresponding to WHO grade have an even higher incidence of recurrence and may be associate with systemic metastasis or brain invasion. There is some information regarding the nature of mental deficits caused by intracranial meningiomas. In this study the authors examined the mental functioning of patients with frontal meningiomas. Twenty-one patients with frontal meningiomas were examined for various neurological symptoms after surgery. Observed neurological symptoms were memory deficits [verbal and fungal], attention and executive functions. The time period between onset of the effect on mental functions of meningioma and postoperative observations ranged from 2-3 months. Postoperative findings revealed a few or no differences in memory or executive functions, although, a postoperative improvement in attentional function was observed. The results of the study indicate that the surgical removal of frontal meningiomas does not impair patients' mental functioning