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Open access

DNA methylation profiling of a lipomatous meningioma: illustrative case

Zeel Patel, Justin Z. Wang, Zamir Merali, Vikas Patil, Farshad Nassiri, Qingxia Wei, Julio Sosa, Claire Coire, and Gelareh Zadeh

Meningiomas are the most common primary intracranial tumor, comprising approximately one-third of all brain tumors. Symptoms can vary depending on the size and anatomical location of the tumor but can include headaches, seizures, neurological deficits, and behavioral changes. 1 These tumors are identified usually through magnetic resonance imaging (MRI) or computed tomography (CT), often following the development of neurological symptoms or incidentally in asymptomatic patients on imaging obtained for other clinical purposes. 2 While molecular profiling

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Manual superficial temporal artery compression using a circular plastic material for embolization of meningioma: illustrative case

Yoshinobu Horio, Koichi Miki, Dai Kawano, Takaaki Amamoto, Hironori Fukumoto, Hiromasa Kobayashi, Koichiro Takemoto, Takashi Morishita, and Hiroshi Abe

Preoperative embolization for meningioma is performed to reduce intraoperative blood loss, decrease blood transfusions, and shorten the operative time. 1–3 In the case of meningiomas that occur in the high-convexity region or near the superior sagittal sinus, the superficial temporal artery (STA) frequently feeds the tumor, 4 and when embolizing from the middle meningeal artery (MMA), the embolic material may not reach the tumor vessels because of the pressure gradient caused by blood flow from the STA, resulting in inadequate embolization. When embolizing

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Fluorescence and immune-cell infiltration of nonneoplastic, postbrachytherapy brain tissue in 5-ALA–guided resection of recurrent anaplastic meningioma: illustrative case

Rishab Ramapriyan, Victoria E Clark, 1 PhD, Maria Martinez-Lage, Brian Hsueh, 1 PhD, Brian V Nahed, 1 MSc, William T Curry, Bryan D Choi, 1 PhD, Bob S Carter, and 1 PhD

5-Aminolevulinic acid (5-ALA) fluorescence-guided surgery (FGS) has gained prominence in recent years for its utility in high-grade glioma resection, allowing enhanced visualization and tumor removal. 1 The use of 5-ALA for meningioma surgery has also been reported. 2 Mechanistically, 5-ALA is preferentially taken up by cells of certain tumors, including meningiomas, and enters the heme biosynthesis pathway, where it is converted to heme precursor porphyrin PpIX, which then accumulates in cells due to various tumor-specific aberrations, such as altered

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Endoscopic closure of the Eustachian tube orifice for refractory lateral skull base cerebrospinal fluid leak using autologous fat graft: illustrative case

Gautam U. Mehta, Nida Fatima, Gregory P. Lekovic, and William H. Slattery

. Illustrative Case We report the case of a 42-year-old woman who had undergone resection of a large middle cranial fossa meningioma 20 years ago. She presented with a large left middle fossa meningocele ( Fig. 1 ), severe headaches, recent placement of a left myringotomy tube resulting in CSF otorrhea and rhinorrhea, and recurrent meningitis. She was admitted with severe confusion and meningitis and started on broad-spectrum antibiotics. Given the acuity and severity of her clinical presentation, and the urgent need for definitive repair, we recommended a blind sac closure

Open access

Patient-specific virtual reality technology for complex neurosurgical cases: illustrative cases

Diana Anthony, Robert G. Louis, Yevgenia Shekhtman, Thomas Steineke, Anthony Frempong-Boadu, and Gary K. Steinberg

Navigation 1 41, M Rt anterior clinoidal meningioma 3D MP-RAGE MRI postcontrast; CTA w/ & w/o contrast X X X 2 62, M Lt parietal anaplastic oligodendroglioma T1-weighted SPGR MRI w/ & w/o contrast; DTI tractography; axial motor fMRI; CTA isotropic X X X 3 29, M Intradural intramedullary spinal cord cavernoma Axial CT; axial 3D MP-RAGE MRI; sagittal T2-weighted MRI; axial DTI tractography X X X 4 22, M Giant ruptured rt M1 MCA aneurysm CTA w/ contrast X X 5 27, F Lt posterior parieto

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Percheron-like artery infarction after transsphenoidal surgery: illustrative case

Lennart W. Sannwald, Andrea von Helden, Hans-Joachim Wagner, Dag Moskopp, and Mats L. Moskopp

Transsphenoidal surgery is an established procedure avoiding both craniotomy and direct manipulation of brain tissue by use of a transnasal approach to skull base lesions such as pituitary adenomas, skull base meningiomas, metastases, and craniopharyngiomas. Over the last decades, the transsphenoidal approach has enjoyed increasing popularity for surgery of the sellar region as it helps avoiding brain retraction and causes few severe complications such as cerebrospinal fluid fistula, postoperative meningitis, and injury to the internal carotid artery. However

Open access

Extended reality platform for minimally invasive endoscopic evacuation of deep-seated intracerebral hemorrhage: illustrative case

Thomas C. Steineke and Daniela Barbery

endoscopic neurosurgery . Interdiscip Neurosurg . 2017 ; 8 : 17 – 22 . 28451520 10.1016/j.inat.2017.01.003 16 Jean WC , Singh A . Expanded endoscopic endonasal transtuberculum approach for tuberculum sellae meningioma: operative video with 360-degree fly-through and surgical rehearsal in virtual reality: 2-dimensional operative video . Oper Neurosurg (Hagerstown) . 2020 ; 19 ( 2 ): E179 – E180 . 10.1093/ons/opaa017 17 Jean WC . Virtual reality surgical rehearsal and 2-dimensional operative video of a paramedian supracerebellar

Open access

Tumor characteristics guiding selection of channel-based versus open microscopic approaches for resection of atrial intraventricular meningiomas: patient series

Jeffrey J Feng, Stephanie K Cheok, Mark S Shiroishi, and Gabriel Zada

The atrium is by far the most common location of intraventricular meningiomas (80%), which account for 0.5%–3.0% of all meningiomas. 1 Atrial intraventricular meningiomas (AIMs) often grow insidiously until they reach a relatively large size 2 , 3 (>3 cm), often leaving resection as the main treatment modality available, as stereotactic radiosurgery (SRS) is often reserved for smaller tumors with diameters <3 cm. 1 , 4 , 5 When resection is indicated, several approach options are available to the neurosurgeon. Microsurgical resection through a transsulcal

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Intracranial solitary fibrous tumor in a 15-year-old girl: illustrative case

Kuan Lu, Xiaoqing Qu, Jingcheng Jiang, Quanjun Zheng, Yongsheng Ao, and Lihua Qiu

mesenchyme. 5–7 SFT is often located in the intracranial region outside of the brain, commonly presenting as lesions near the skull base, sagittal sinus, falx cerebri, and tentorium cerebelli. 5 , 8 The location of SFT within the brain is comparable to that of meningioma. Our case corresponds with previous reports of SFT in the areas of the transverse sinus and tentorium cerebelli. Most SFTs are indeed solitary, but instances of multiple lesions can occur. In terms of malignancy, intracranial SFTs are regarded as borderline tumors, with the majority of cases

Open access

Intraosseous meningioma, a rare presentation of a common brain tumor: illustrative case

Sherif Elwatidy, Abdulaziz Alanazi, Rahaf F. Alanazi, and Khulood K. Alraddadi

Meningioma, also known as meningeal tumor, is a benign tumor that is typically slow growing. 1 , 2 It originates from the arachnoid cap cells from a highly metabolic active subtype that is involved in cerebrospinal fluid (CSF) resorption. 1 , 2 It is estimated to account for between 13% and 26% of all intracranial tumors, whereas extradural meningiomas constitute from 1% to 2% of all meningiomas. 2 Intraosseous meningioma is a subgroup of meningioma that arises in the skull. It can occur at any location of the skull, with the orbital cavity and