Search Results

You are looking at 1 - 6 of 6 items for

  • Author or Editor: Martina Messing-Jünger x
  • Refine by Access: all x
Clear All Modify Search
Restricted access

Michael Sabel, Jörg Felsberg, Martina Messing-Jünger, Eva Neuen-Jacob, and Jürgen Piek

✓ The authors report the case of a man who had suffered a penetrating metal splinter injury to the left frontal lobe at 18 years of age. Thirty-seven years later the patient developed a left-sided frontal tumor at the precise site of the meningocerebral scar and posttraumatic defect. Histological examination confirmed a glioblastoma multiforme adjacent to the dural scar and metal splinters. In addition, a chronic abscess from which Propionibacterium acnes was isolated was found within the glioma tissue. The temporal and local association of metal splinter injury with chronic abscess, scar formation, and malignant glioma is highly suggestive of a causal relationship between trauma and the development of a malignant brain tumor.

Restricted access

A. Martina Messing-Jünger, Javier Ibáñez, Fabio Calbucci, Maurice Choux, Gabriel Lena, Iradj Mohsenipour, and Frank Van Calenbergh

Object

The goal of this study was to assess the effectiveness and handling characteristics of a dura substitute composed of two outer layers of expanded polytetrafluoroethylene (PTFE) and a middle layer consisting of an elastomeric fluoropolymer.

Methods

In a prospective multicenter study, the dura substitute was implanted using a standard technique in 119 patients undergoing cranial or spinal surgery requiring duraplasty. Intraoperative assessments of the dura patch consisted of testing for cerebrospinal fluid (CSF) leakage employing the Valsalva maneuver and a surgeon’s standard evaluation of the handling characteristics of the device. Postoperative assessments conducted during a mean follow-up time of 15.7 months (range 0.3–45.6 months) consisted of physical examinations, routine computed tomography (CT) or magnetic resonance (MR) imaging studies, and histological studies of any removed dura patches.

The mean age of the 119 patients was 40 years (range < 1–81 years). The dura substitute was implanted cranially in 102 patients and spinally in 17. Intraoperative assessment including the Valsalva maneuver led to application of additional sutures in 17 patients. Handling features were rated very good to excellent. Postoperative clinical evaluation resulted in 79 excellent and 18 good results. Imaging studies (MR imaging studies in 69 patients and CT studies in 34 patients) showed no adhesions in 87 patients and minimal adhesions in seven patients (the dura was not visualized in nine patients). Postoperative complications occurred in 12 patients. There were six cases of CSF leakage, three cases of extradural hematoma, one case of arachnoid fibrosis after decompression of a Chiari malformation Type I, and two cases of infection. Eight (7%) of these complications were potentially related to the dura patch.

Conclusions

In a large, multicenter clinical study of the use of an expanded-PTFE–containing dura substitute, the device was found to be easy to handle and implant. No serious dura patch–related intraoperative adverse events were observed. Postoperatively, there were no major sealing problems or long-term complications. In two cases the patch had to be removed due to fibrosis and infection. The three-layer polymer dura substitute appears to be safe and effective in minimizing CSF leakage and adhesion formation, and its use avoids any risk of prion disease transmission.

Restricted access

Eylem Ocal, Eliana E. Kim, Milagros Niquen-Jimenez, Gleice Salibe de Oliveira, Souad Bakhti, Suchanda Bhattacharjee, Giselle Coelho, Wirginia Maixner, Martina Messing-Jünger, Nabila Taghlit, and Nelci Zanon

Pediatric neurosurgery is an ever-evolving field, and at the heart of it are talented and hardworking neurosurgeons who harness technology and research to enhance the standard of neurosurgical care for children. Recent studies have found that female neurosurgeons tend to choose a career focused on pediatric neurosurgery more than other subspecialties. However, the achievements and contributions of women in pediatric neurosurgery are not well known. To address this, an international working group of pediatric neurosurgeons was established from the World Federation of Neurosurgical Societies (WFNS) Women in Neurosurgery (WINS) group and Pediatric Neurosurgery Committee. The working group reviewed the current literature and collected information through personal communications with the global WINS network. Despite the increasing number of women entering neurosurgical training, the number of female pediatric neurosurgeons is still a mere handful worldwide. In this article, the authors summarize the current status of female pediatric neurosurgeons across the globe, highlighting their achievements as well as the gender bias and challenges that they face at every level of progression of their career. A better organized pediatric neurosurgery workforce, with more female representation and mentorship, would encourage future generations of diverse genders toward a career in this field.

Restricted access

Jan Boström, Gisela Janßen, Martina Messing-Jünger, Jörg U. Felsberg, Eva Neuen-Jacob, Volkher Engelbrecht, Hans-Gerd Lenard, Wolfgang J. Bock, and Guido Reifenberger

✓ The authors report on an 11-year-old boy in whom proptosis of the eye caused by a benign intraosseous xanthofibroma of the left orbital wall became clinically apparent at the age of 4 years. Two years later he developed bilateral papilledema, at which time computerized tomography and magnetic resonance studies revealed multiple enhancing intracranial lesions. The largest mass was located in the left middle fossa; other lesions were located at the tentorium cerebelli, in both lateral ventricles, near the superior sagittal sinus, and extracranially near the left jugular vein. The mass in the left middle fossa was resected and diagnosed as juvenile xanthogranuloma (JXG). Thirty months later, the patient again became symptomatic, exhibiting behavioral abnormalities and a decrease in mental powers. At that time, the two remaining lesions in both lateral ventricles had grown enough to cause trapping of the temporal horns and raised intracranial pressure. These lesions were successively resected and histopathologically confirmed to be JXGs. However, resection of the second intraventricular lesion was complicated by postoperative bilateral amaurosis, presumably caused by postdecompression optic neuropathy. According to a review of the literature, fewer than 20 patients with JXG involving the central nervous system have been reported. The patient described in this report is the first in whom multiple intracranial JXGs developed in the absence of cutaneous manifestations. Although JXGs are biologically benign lesions, the treatment of patients with multifocal and/or progressive intracranial manifestations is problematic.

Restricted access

Rebecca A. Reynolds and John C. Wellons III

Restricted access

Frank Willi Floeth, Dirk Pauleit, Hans-Jörg Wittsack, Karl Josef Langen, Guido Reifenberger, Kurt Hamacher, Martina Messing-Jünger, Karl Zilles, Friedrich Weber, Walter Stummer, Hans-Jakob Steiger, Gabriele Woebker, Hans-Wilhelm Müller, Heinz Coenen, and Michael Sabel

Object. The purpose of this study was to determine the predictive value of [18F]fluoroethyl-l-tyrosine (FET)—positron emission tomography (PET) and magnetic resonance (MR) spectroscopy for tumor diagnosis in patients with suspected gliomas.

Methods. Both FET-PET and MR spectroscopy analyses were performed in 50 consecutive patients with newly diagnosed intracerebral lesions supposed to be diffuse gliomas on contrast-enhanced MR imaging. Lesion/brain ratios of FET uptake greater than 1.6 were considered positive, that is, indicative of tumor. Results of MR spectroscopy were considered positive when N-acetylaspartate (NAA) was decreased in conjunction with an absolute increase of choline (Cho) and an NAA/Cho ratio of 0.7 or less. An FET lesion/brain ratio, an NAA/Cho ratio, and signal abnormalities on MR images were compared with histological findings in neuronavigated biopsy specimens.

The FET lesion/brain ratio and the NAA/Cho ratio were identified as significant independent predictors for the histological identification of tumor tissue. The accuracy in distinguishing neoplastic from nonneoplastic tissue could be increased from 68% with the use of MR imaging alone to 97% with MR imaging in conjunction with FET-PET and MR spectroscopy. Sensitivity and specificity for tumor detection were 100 and 81% for MR spectroscopy and 88 and 88% for FET-PET, respectively. Results of histological studies did not reveal tumor tissue in any of the lesions that were negative on FET-PET and MR spectroscopy. In contrast, a tumor diagnosis was made in 97% of the lesions that were positive with both methods.

Conclusions. In patients with intracerebral lesions supposed to be diffuse gliomas on MR imaging, FET-PET and MR spectroscopy analyses markedly improved the diagnostic efficacy of targeted biopsies.