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Bin Abdulqader S, Alzhrani G. Endoscopic Endonasal Resection of a Cavernous Malformation of the Third Ventricle: Case Report and Literature Review. J Neurol Surg A Cent Eur Neurosurg 2024; 85:221-226. [PMID: 35644135 DOI: 10.1055/s-0041-1741070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Suprasellar and third ventricle cavernous malformations (CMs) are uncommon. Conventional approaches such as interhemispheric and translamina terminalis approaches are often used to resect these lesions. Here we demonstrate the use of the endoscopic endonasal approach for a third ventricle CM. CASE DESCRIPTION A 31-year-old man presented with progressive symptoms of headache and visual disturbance as well as short-term memory deficit over a 6-month period. Neurologic examination revealed bitemporal hemianopsia. Radiologic images showed a suprasellar lesion extending into the third ventricle as well as obstructive hydrocephalus. The patient was operated on using an endoscopic endonasal approach and histopathology revealed a diagnosis of CM. Transient diabetes insipidus and adrenal insufficiency were reported postoperatively. CONCLUSION This report demonstrates safe resection of a third ventricle CM via the endonasal route.
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Affiliation(s)
- Sarah Bin Abdulqader
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Gmaan Alzhrani
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
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Ajlan A, Basindwah S, Hawsawi A, Alsabbagh B, Alwadee R, Abdulqader SB, Alzhrani G, Orz Y, Bafaqeeh M, Alobaid A, Alyamany M, Farrash F, Alaskar A, Alkhathlan M, Alqurashi A, Elwatidy S. A Prospective Comparison Between Soft Tissue Dissection Techniques in Pterional Craniotomy: Functional, Radiological, and Aesthetic Outcomes. Oper Neurosurg (Hagerstown) 2024; 26:256-267. [PMID: 37815213 DOI: 10.1227/ons.0000000000000929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/04/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Given the complex anatomy of the operative region and individual surgeon preferences, some techniques for soft tissue dissection before pterional craniotomy have gained more popularity than others. This prospective study used subjective and objective measurements to compare the functional, radiological, and aesthetic outcomes of 3 such dissection techniques. METHODS This multicenter prospective cohort study included all patients who underwent elective pterional craniotomy between 2018 and 2020 at 3 centers in Riyadh, Saudi Arabia. All patients underwent 1 of 3 soft tissue dissection techniques: myocutaneous flap, interfascial, and subfascial dissection techniques. Clinical and radiological assessments were performed upon discharge and at the 3- and 6-month follow-ups. RESULTS We included 78 patients, with a mean age of 44.9 ± 16.3 years. Myocutaneous flap, interfascial, and subfascial dissections were performed in 34 (43%), 24 (30%), and 20 patients (25%), respectively. The myocutaneous flap method had the shortest opening ( P = .001) and closure ( P = .005) times; tenderness was more evident in this group than in the others ( P = .05). The frontalis muscle was most affected in the interfascial dissection group ( P = .05). The frontalis nerve function was similar in all groups after 6 months ( P = .54). The incidence of temporomandibular joint dysfunction was highest in the myocutaneous flap group (29%). Decreased temporalis muscle thickness at the 6-month postoperative follow-up was most severe in the subfascial dissection group (12.6%), followed by the myocutaneous flap (11.9%) and interfascial dissection (9.9%) groups, with no significant difference ( P = .85). Temporal hollowing was more prominent in the myocutaneous flap group ( P = .03). Cosmetic satisfaction was highest in the interfascial dissection group, with no significant difference ( P = .4). CONCLUSION This study provides important information for neurosurgeons in weighing the benefits and risks of each technique for their patients.
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Affiliation(s)
- Abdulrazag Ajlan
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh , Saudi Arabia
| | - Sarah Basindwah
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh , Saudi Arabia
| | - Aysha Hawsawi
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh , Saudi Arabia
| | - Badriah Alsabbagh
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh , Saudi Arabia
| | - Rawan Alwadee
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh , Saudi Arabia
| | | | - Gmaan Alzhrani
- Department of Neurosurgery, King Fahad Medical City, Riyadh , Saudi Arabia
| | - Yasser Orz
- Department of Neurosurgery, King Fahad Medical City, Riyadh , Saudi Arabia
| | - Mohammed Bafaqeeh
- Department of Neurosurgery, King Fahad Medical City, Riyadh , Saudi Arabia
| | - Abdullah Alobaid
- Department of Neurosurgery, King Fahad Medical City, Riyadh , Saudi Arabia
| | - Mahmoud Alyamany
- Department of Neurosurgery, King Fahad Medical City, Riyadh , Saudi Arabia
| | - Faisal Farrash
- Division of Neurosurgery, Department of Neuroscience, King Faisal Hospital and Research Center, Riyadh , Saudi Arabia
| | - Abdulaziz Alaskar
- College of Medicine, Prince Sattam Bin Abdulaziz University, Riyadh , Saudi Arabia
| | - Malak Alkhathlan
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh , Saudi Arabia
| | - Ashwag Alqurashi
- Division of Neurosurgery, Department of Surgery, King Saud University Medical City, Riyadh , Saudi Arabia
| | - Sherif Elwatidy
- Division of Neurosurgery, Department of Surgery, College of Medicine, King Saud University, Riyadh , Saudi Arabia
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Bin Abdulqader S, Al Yamany M, Alobaid A, Alzhrani G. Left far-lateral approach for resection of a large foramen magnum meningioma encasing the dominant vertebral artery: 2-Dimensional operative video. Interdisciplinary Neurosurgery 2023. [DOI: 10.1016/j.inat.2022.101693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Abdulqader SB, Elahi BN, Alshoumer A, Alzhrani G. Neurenteric cyst of the dorsal craniocervical junction in an adult: A case report and operative video. Surg Neurol Int 2022; 13:291. [PMID: 35855161 PMCID: PMC9282773 DOI: 10.25259/sni_331_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Neurenteric cysts (NCs) are rarely located in the dorsal craniocervical junction (CCJ). Case Description: Here, we present a case and show the surgical video of a 24-year-old man with a history of neck pain, progressive hemiparesis, and difficulty swallowing. Radiological images revealed an intradural extramedullary lesion at the dorsal CCJ. Posterior approach with C1–C2 laminectomy for resection of the lesion was performed with significant improvement in symptoms postoperatively. Histopathological examination confirmed the diagnosis of NC. Conclusion: This case demonstrates a rare location of a NC in an adult patient. Complete excision of the cyst wall and its content is the recommended treatment option.
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Affiliation(s)
- Sarah Bin Abdulqader
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City,
| | - Basim Noor Elahi
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City,
| | - Azhar Alshoumer
- Department of Pathology, Division of Neuropathology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Gmaan Alzhrani
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City,
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Bin Abdulqader S, Alzhrani G. Middle Fossa Approach for Resection of a Meckel's Cave Dermoid Cyst: 2-Dimensional Operative Video. Interdisciplinary Neurosurgery 2022. [DOI: 10.1016/j.inat.2022.101501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Alotaibi FS, Ntyl SR, Almuhaini TS, Bin Abdulqader S, Alotaibi NM, Soulami L, Bafaquh M, Al Yamany M, Alturki AY, Alzhrani G, Orz Y, Alobaid A. How Reliable Is the Intraoperative Computed Tomography Angiography in Assessing Complete Surgical Resection of Cerebral Arteriovenous Malformations? Oper Neurosurg (Hagerstown) 2021; 21:445-451. [PMID: 34432882 DOI: 10.1093/ons/opab306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 07/02/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Digital subtraction angiography (DSA) is still considered the gold standard test to evaluate arteriovenous malformation's (AVM) residual after microsurgical resection. OBJECTIVE To evaluate the safety and reliability of intraoperative computed tomography angiography (iCTA) as an immediate method of evaluating the surgical results of AVM resection. METHODS We performed a retrospective review for all cases of cerebral AVMs at our institute from January 2015 to April 2020 who underwent surgical resection of cerebral AVM and had iCTA. All included patients underwent a postoperative DSA, and the results were compared with iCTA. RESULTS Twenty-eight cases were included. All cases showed complete resection (100%) in the iCTA, and the results were consistent with the postoperative DSA results. The sensitivity of iCTA was 100%. The added operative time ranged from 25 to 30 min. There were no complications related to the use of iCTA. CONCLUSION Intraoperative assessment of AVMs surgical results with an iCTA is safe and reliable. The sensitivity of iCTA following AVM resection merits further investigations.
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Affiliation(s)
- Fahad Saud Alotaibi
- Department of Adult Neurosurgery, National Neuroscience Institute, King Fahad Medical City Riyadh, Saudi Arabia.,Faculty of Medicine, Al-Imam Mohammed bin Saud University, Riyadh, Saudi Arabia
| | - Sondous Raid Ntyl
- Faculty of medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Tafla Saleh Almuhaini
- Faculty of medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Sarah Bin Abdulqader
- Department of Adult Neurosurgery, National Neuroscience Institute, King Fahad Medical City Riyadh, Saudi Arabia
| | - Naif M Alotaibi
- Department of Adult Neurosurgery, National Neuroscience Institute, King Fahad Medical City Riyadh, Saudi Arabia.,Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Lahbib Soulami
- Neuronavigation & Intraoperative Surgical Imaging Unit, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammad Bafaquh
- Department of Adult Neurosurgery, National Neuroscience Institute, King Fahad Medical City Riyadh, Saudi Arabia
| | - Mahmoud Al Yamany
- Department of Adult Neurosurgery, National Neuroscience Institute, King Fahad Medical City Riyadh, Saudi Arabia
| | - Abdulrahman Y Alturki
- Department of Adult Neurosurgery, National Neuroscience Institute, King Fahad Medical City Riyadh, Saudi Arabia
| | - Gmaan Alzhrani
- Department of Adult Neurosurgery, National Neuroscience Institute, King Fahad Medical City Riyadh, Saudi Arabia
| | - Yasser Orz
- Department of Adult Neurosurgery, National Neuroscience Institute, King Fahad Medical City Riyadh, Saudi Arabia
| | - Abdullah Alobaid
- Department of Adult Neurosurgery, National Neuroscience Institute, King Fahad Medical City Riyadh, Saudi Arabia
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Bin Abdulqader S, Alluhaybi AA, Alotaibi FS, Almalki S, Ahmad M, Alzhrani G. Spheno-orbital juvenile psammomatoid ossifying fibroma: a case report and literature review. Childs Nerv Syst 2021; 37:3251-3255. [PMID: 33404728 DOI: 10.1007/s00381-020-05004-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
Ossifying fibroma (OF) is an uncommon benign fibro-osseous lesion. Based on its clinical, morphological, and radiological features, OF is further divided into cemento-ossifying fibroma (COF), juvenile psammomatoid ossifying fibroma (JPOF), and juvenile trabecular ossifying fibroma (JTOF). JPOF rarely involves the cranial base, with limited reports published on spheno-orbital JPOF. In this paper, we report a case of JPOF of the greater wing of the sphenoid bone and lateral orbital wall in an 11-year-old child and show a surgical video. Although rare, JPOF should be considered in the differential diagnosis of fibro-osseous lesions of the spheno-orbital region.
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Affiliation(s)
- Sarah Bin Abdulqader
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, As Sulimaniyah, Riyadh, 12231, Saudi Arabia
| | - Abdulelah A Alluhaybi
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, As Sulimaniyah, Riyadh, 12231, Saudi Arabia
| | - Fahad S Alotaibi
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, As Sulimaniyah, Riyadh, 12231, Saudi Arabia
| | - Salman Almalki
- Anatomic Pathology Department, Pathology and Clinical Laboratory Medicine Administration, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Maqsood Ahmad
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, As Sulimaniyah, Riyadh, 12231, Saudi Arabia
| | - Gmaan Alzhrani
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, As Sulimaniyah, Riyadh, 12231, Saudi Arabia.
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Alluhaybi AA, Abdulqader SB, Altuhayni K, AlTurkstani A, Kabbani A, Ahmad M. Preoperative trans-arterial embolization of a giant scalp congenital hemangioma associated with cardiac failure in a premature newborn. J Int Med Res 2021; 48:300060520977589. [PMID: 33296609 PMCID: PMC7731708 DOI: 10.1177/0300060520977589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Scalp congenital hemangiomas are a rare, but well-known, vascular malformation in infants. These hemangiomas are usually benign, but occasionally these are associated with cardiac complications and disfigurement. Giant hemangiomas that are associated with high-output heart failure require intervention because they have a high mortality rate and do not respond to medical therapy. We report here a case of a premature newborn who was diagnosed with a giant scalp hemangioma associated with cardiac failure. The newborn underwent successful arterial feeder embolization of the superficial temporal artery. He then underwent surgical excision 14 days after embolization. We believe that preoperative embolization of a giant scalp hemangioma in newborns is a safe measure for alleviating underlying cardiac failure and minimizing the risk of intraoperative bleeding.
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Affiliation(s)
- Abdulelah A Alluhaybi
- Pediatric Neurosurgery Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Sarah Bin Abdulqader
- Pediatric Neurosurgery Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Khalid Altuhayni
- Pediatric Neurosurgery Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdulellah AlTurkstani
- Pediatric Neurosurgery Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Aseel Kabbani
- Pediatric Neurosurgery Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Maqsood Ahmad
- Pediatric Neurosurgery Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
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Al-Shudifat ARM, Kahlon B, Bin Abdulqader S, Almutairi W, Alsumali K, Aldhfyan Y, Al-Abdallat L. Outcome of Severe Traumatic Brain Injury at KSMC: Functional Outcomes of ICP Monitor Insertion-Two Years' Experience. Open Access Emerg Med 2021; 13:155-159. [PMID: 33880070 PMCID: PMC8052127 DOI: 10.2147/oaem.s288262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/09/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate functional outcomes of severe traumatic brain injuries after insertion of intracranial pressure (ICP) monitor at King Saud Medical City (KSMC) and their correlation to each other. Patients and Methods A retrospective observational study for all adult patients (age >18 years) who were diagnosed with severe head injury and underwent ICP insertion at KSMC. Patients diagnosed between 2017 and 2019 were included. Data for measured outcomes, Glasgow outcome scale (GOS), Karnofsky Performance Score (KPS) and length of stay (LOS) and prognostic factors, data like: age, gender and primary Glasgow coma score (GCS) was obtained from patients' files and direct communication with patients or their caregivers. We also compared patients who underwent ICP monitoring alone with those who underwent ICP with decompressive craniectomy (DC). Follow-up period ranged from 6-24 months. Results Seventy-four patients were included in this cohort study. Outcome measurements for patients with decompression and ICP were lower than those with ICP alone. KPS and GOS showed strong correlation (p<0.01) in whole cohort and in both subgroups (ICP alone and ICP with DC). KPS showed significant correlation with length of stay (p=0.026). Conclusion ICP monitoring is valid tool in management of severely head injured patients. Patients who underwent DC had a worse outcome. KPS can be used as alternative tool to measure functional outcome in severe traumatic brain injury.
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Affiliation(s)
- Abdul Raman M Al-Shudifat
- Department of Neurosurgery, School of Medicine, The University of Jordan, Amman, Jordan.,Department of Neurosurgery, King Saud Medical City (KSMC), Riyadh, Saudi Arabia
| | - Babar Kahlon
- Department of Neurosurgery, King Saud Medical City (KSMC), Riyadh, Saudi Arabia
| | | | - Wajab Almutairi
- Department of Neurosurgery, King Saud Medical City (KSMC), Riyadh, Saudi Arabia
| | - Khairiah Alsumali
- Department of Neurosurgery, King Saud Medical City (KSMC), Riyadh, Saudi Arabia
| | - Yazeed Aldhfyan
- Department of Neurosurgery, King Saud Medical City (KSMC), Riyadh, Saudi Arabia
| | - Laith Al-Abdallat
- Department of Neurosurgery, School of Medicine, The University of Jordan, Amman, Jordan
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Bin Abdulqader S, Almutairi OT, Alhussinan MA, Elarjani T, Albathi A, Alturki AY, Bafaquh M. A bibliometric analysis of the most-cited articles on craniospinal epidural hematoma. Turk Neurosurg 2021; 32:560-570. [PMID: 34169996 DOI: 10.5137/1019-5149.jtn.31889-20.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM Epidural hematoma (EDH) is a commonly encountered neurosurgical condition. Numerous articles have been published on EDH. Bibliometric analysis studies the chronological trends and ranks the most impactful articles in a given field. The aim of this paper is to analyze the most-cited articles on cranial and spinal EDH. MATERIAL AND METHODS A title-specific search was performed on the Scopus database using the term "epidural hematoma" in June 2020, with no publication date restrictions. The top 100 most-cited articles were collected, reviewed, and analyzed. RESULTS A total of 2165 articles were published on EDH from 1949 to 2020, and the top 100 most-cited ones were published between 1966 and 2014, receiving an average citation of 84.7 per paper. Most papers were published in Neurosurgery and Journal of Neurosurgery (JNS). 48% of the most-cited articles on EDH originated from the United States of America (USA). Notably, studies on spinal EDH represented 75% of the most-cited articles in our review. The most-cited article on EDH was published by Lawton et al. in 1995, receiving a total of 412 citations at an annual citation rate of 16.4%. CONCLUSION This report identifies the most influential publications on EDH as well as the publications trends over the last 70 years. Recognition of the most impactful work is an important tool for clinicians and researchers as it can reflect the enormous changes in the clinical practice. This report can serve as a guide for developing evidence-based practices and identifying areas of research inadequacy.
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Affiliation(s)
- Sarah Bin Abdulqader
- National Neuroscience Institute King Fahad Medical City, Department of Neurosurgery, Riyadh, Kingdom of Saudi Arabia
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Abdulqader SB, Almujaiwel N, Alshakweer W, Alzhrani G. High-grade spheno-orbital meningioma in patients with systemic lupus erythematosus: Two case reports and literature review. Surg Neurol Int 2020; 11:367. [PMID: 33194300 PMCID: PMC7656016 DOI: 10.25259/sni_583_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/09/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Spheno-orbital meningiomas (SOMs) are often benign. The association of meningioma and systemic lupus erythematosus (SLE) is rarely discussed in the literature. Here, we report two patients with high-grade, SOMs with a prolonged history of SLE and review the literature. Case Description: The first case is a 52-year-old female patient with a 15-year history of SLE diagnosis who was referred to our center with a 1-year history of proptosis and excessive tearing of the left eye. This patient was operated for the left SOM with histopathological diagnosis of the World Health Organization (WHO) Grade III rhabdoid meningioma. The second case is a 36-year-old female patient with a 12-year history of SLE diagnosis who presented to our clinic with a 5-year-history of progressive right eye proptosis and occasional headaches. She was operated for the right SOM with histopathological diagnosis of the WHO Grade II chordoid meningioma. Conclusion: Rhabdoid and chordoid SOMs are uncommon and no previous report discussed their occurrence in patients with SLE. The association of high-grade meningiomas and SLE deserves further exploration.
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Affiliation(s)
- Sarah Bin Abdulqader
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Wafa Alshakweer
- Department of Pathology and Clinical Laboratory Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Gmaan Alzhrani
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
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12
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Bin Abdulqader S, Al-Ajlan Z, Albakr A, Issawi W, Al-Bar M, Recinos PF, Alsaleh S, Ajlan A. Endoscopic transnasal resection of optic pathway pilocytic astrocytoma. Childs Nerv Syst 2019; 35:73-81. [PMID: 30338361 DOI: 10.1007/s00381-018-3994-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 10/10/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE Optic pathway gliomas (OPGs) are low-grade neoplasms that primarily affect children. The management of OPGs remains controversial. Reports on the use of the endoscopic endonasal approach (EEA) in OPGs are extremely limited, and no such reports exist on its utility for pediatric OPGs. Here, we report our results and experience with OPGs treated with the EEA. METHODS We retrospectively reviewed the medical records of OPG patients who were treated surgically via the EEA at our institutions from 2015 to 2017. Data on the demographics, clinical presentation, surgical complications, clinical outcomes, radiological imaging, and visual outcomes were recorded for each patient. RESULTS Four cases were identified, with visual disturbances being the predominant complaint. The mean patient age was 15.5 years. Three cases showed normal preoperative hormonal profiles, but one patient had hypothyroidism. All tumors identified in this study were World Health Organization grade I pilocytic astrocytomas. Surgical complications included hypopituitarism in two patients, meningitis in two patients, cerebrospinal fluid leak in one patient, and transient diabetes insipidus in one patient. No patient experienced worsening neurological or visual symptoms postoperatively. CONCLUSIONS Although our data are preliminary, the EEA provides a direct corridor to OPG with acceptable results in terms of tumor resection and visual outcomes. Hypothalamic-pituitary axis dysfunction remains a limitation of any treatment modality for OPGs and should be considered whenever possible. Definitive conclusions are pending as the learning curve of this approach is steep. Further work is needed to understand patient selection for such an approach.
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Affiliation(s)
| | - Ziyad Al-Ajlan
- Department of Neurosurgery, King Saud University, Riyadh, Saudi Arabia
| | | | - Wisam Issawi
- Department of Neurosurgery, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed Al-Bar
- Department of Neurosurgery, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Pablo F Recinos
- Department of Neurosurgery, Cleveland Clinic Foundation, 9500 Euclid Avenue/CA-5, Cleveland, OH, 44195, USA.,Minimally Invasive Cranial Base and Pituitary Surgery Program, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic Foundation, 9500 Euclid Avenue/CA-5, Cleveland, OH, 44195, USA
| | - Saad Alsaleh
- Department of Otolaryngology-Head and Neck Surgery, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrazag Ajlan
- Department of Neurosurgery, King Saud University, Riyadh, Saudi Arabia. .,Department of Neurosurgery, Stanford University School of Medicine, 300 Pasteur Drive, Palo Alto, Stanford, CA, 94305, USA.
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13
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Ajlan AM, Abdulqader SB, Achrol AS, Aljamaan Y, Feroze AH, Katznelson L, Harsh GR. Diabetes Insipidus following Endoscopic Transsphenoidal Surgery for Pituitary Adenoma. J Neurol Surg B Skull Base 2017; 79:117-122. [PMID: 29868315 DOI: 10.1055/s-0037-1604363] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 06/14/2017] [Indexed: 12/27/2022] Open
Abstract
Objectives Pituitary adenoma (PA), among the most commonly encountered sellar pathologies, accounts for 10% of primary intracranial tumors. The reported incidence of postoperative diabetes insipidus (DI) is highly variable. In this study, we report our experience with DI following endoscopic transsphenoidal surgery (TSS) for PAs, elucidating the risk factors of postoperative DI, the likelihood of long-term DI, and the impact of DI on the length of stay (LOS). Methods The study included 178 patients who underwent endoscopic resection of PAs. Early DI was defined as that occurring within the first postoperative week. The mean follow-up was 36 months. Long-term DI was considered as DI apparent in the last follow-up visit. Results Of the 178 patients included in the study, 77% of the tumors were macroadenomas. Forty-seven patients (26%) developed early DI. Long-term DI was observed in 18 (10.1%) of the full cohort. Age younger than 50 years was significantly associated with a higher incidence of long-term DI ( p = 0.02). Macroadenoma and gross total resection were significantly associated with higher incidence of early DI ( p = 0.05 and p = 0.04, respectively). The mean LOS was 4 days for patients with early postoperative DI and 3 days for those without it. Conclusion The reported incidence of postoperative DI is significantly variable. We identified age younger than 50 years a risk factor for developing long-term postoperative DI. Gross total surgical resection and tumor size (> 1 cm) were associated with development of early DI. Early DI increased the LOS on average by 1 day.
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Affiliation(s)
- Abdulrazag M Ajlan
- Department of Neurosurgery, Stanford University, Palo Alto, California, United States.,Department of Neurosurgery, King Saud University, Riyadh, Saudi Arabia
| | | | - Achal S Achrol
- Department of Neurosurgery, Stanford University, Palo Alto, California, United States
| | - Yousef Aljamaan
- College of Medicine, University of Dammam, Dammam, Saudi Arabia
| | - Abdullah H Feroze
- Department of Neurosurgery, Stanford University, Palo Alto, California, United States
| | - Laurence Katznelson
- Department of Neurosurgery, Stanford University, Palo Alto, California, United States.,Department of Medicine, Stanford University, Palo Alto, California, United States
| | - Griffith R Harsh
- Department of Neurosurgery, Stanford University, Palo Alto, California, United States
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