Clinical and neuroradiological red flags in differential diagnosis of pituitary metastases and PitNETs (adenomas): a surgeon's experience and systematic literature review.

Introduction: Pituitary metastases (PMs) are rare malignancy manifestations, generally deemed to have an extremely poor prognosis. Differential diagnosis from primary pituitary lesions is often difficult, as their features can mimic those of pituitary neuroendocrine tumours (PitNETs). This study aimed to report a single surgeon's experience in managing PMs and to gather the existing evidence on their clinical and neuroradiological presentation to build a model of 'red flags' that help raise the suspicion of PMs in the context of sellar lesions.

SUPRAORBITAL AND ENDONASAL APPROACHES: TAILORING SURGICAL TECHNIQUES FOR TUBERCULUM SELLAE MENINGIOMAS BASED ON PREOPERATIVE GRADING SYSTEMS.

Background Tuberculum sellae meningiomas (TSM) tend to compress the optic apparatus and an ideal surgical route, whether transcranial or endonasal, is still debated. Another issue is if the minimally invasive supraorbital (SO) approach offers the same results compared to the more invasive craniotomy. Aiming to guide approach selection, preoperative grading systems have been described.

Eagle syndrome: An updated review.

Background: This work aims to review the current literature and our experience on vascular Eagle syndrome (ES) that can present misleading clinical presentations and better understand the possible therapeutic strategies.

Methods: We reviewed the existing literature on PubMed from January 1, 2017, to December 31, 2022, including the sequential keywords " AND ," " AND ," " AND ," " AND ," and " AND ."

Results: 38 vascular ES cases, including our experience, were analyzed.

Modified percutaneous biopsy of the spine: improvement of the technique.

Purpose: Biopsy of the spine can be performed by open surgery or percutaneous needle sampling. The first has the highest diagnostic yield while the second is a less invasive procedure with lower rate of complications and shorter hospitalization time. We described a modified technique of percutaneous biopsy using semi-rigid grasping forceps that may offer the advantages of both, open and minimally invasive surgery.

Deep brain stimulation of the dentato-rubro-thalamic tract in a case of Holmes tremor: a constrained spherical deconvolution (CSD)-guided procedure.

Deep brain stimulation (DBS) is an established treatment for movement disorders, including Holmes tremor (HT). HT is a rest and action tremor that occurs as a late symptom of brainstem lesions such as stroke. Unfortunately, it is frequently refractory to medical treatment, hence DBS surgery may be a good option.

Brainstem haemorrhage as a rare complication of burr hole craniostomy.

Aim Evacuation through burr hole craniostomy is the most common type of chronic subdural hematoma surgical treatment, with a morbidity rate of 0-9%. Methods Here we present a case of 66-year-old Caucasian woman with bilateral hemispheric chronic subdural hematoma and left transtentorial uncal herniation. Bilateral burr hole craniostomy with gradual and simultaneous evacuation was performed and subdural drains were placed with daily strict monitoring of drained fluid.

Isolated intracranial myeloid sarcoma: report of a case and review of the literature.

Myeloid sarcoma is a rare malignant tumor of primitive myeloid cell origin often associated with hematologic disorders. The central nervous system is rarely involved and differentiating between myeloid sarcoma and other tumors is not possible on imaging. Here we present the rare case of an isolated intracranial myeloid sarcoma, initially misdiagnosed radiologically as a meningioma, treated with surgical total resection and subsequent chemotherapy, with no signs of any hematological disorder at follow up.

Postoperative Functional Preservation of Facial Nerve in Cystic Vestibular Schwannoma.

Objective: To retrospectively analyze clinical and surgical data of a consecutive series of 26 patients with unilateral cystic vestibular schwannomas.

Methods: Tumors were classified as type A (central cyst) and type B (peripheral cyst) and as small (tumor diameter <3 cm) and large (tumor diameter >3 cm). All patients underwent microsurgical removal via retrosigmoid approach.

Hypertrophic Pachymeningitis and Hydrocephalus-The Role of Neuroendoscopy: Case Report and Review of the Literature.

Background: Hypertrophic pachymeningitis (HP) is a rare primary or secondary inflammatory disorder that manifests with thickening of dura mater involving predominantly the tentorium and falx in the focal form. Hydrocephalus has not been reported in association with secondary HP.

Case Description: A 61-year-old woman presented with intracranial HP of the posterior fossa secondary to Wegener granulomatosis not responsive to corticosteroid therapy.

Heart rate variability is differentially altered in multiple sclerosis: implications for acute, worsening and progressive disability.

Background: Sympathovagal imbalance has been associated with poor prognosis in chronic diseases, but there is conflicting evidence in multiple sclerosis.

Objectives: The objective of this study was to investigate the autonomic nervous system dysfunction correlation with inflammation and progression in multiple sclerosis.

Methods: Heart rate variability was analysed in 120 multiple sclerosis patients and 60 healthy controls during supine rest and head-up tilt test; the normalised units of low frequency and high frequency power were considered to assess sympathetic and vagal components, respectively.