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Matthew L. Carlson, Oystein Vesterli Tveiten, Colin L. Driscoll, Frederik K. Goplen, Brian A. Neff, Bruce E. Pollock, Nicole M. Tombers, Marina L. Castner, Monica K. Finnkirk, Erling Myrseth, Paal-Henning Pedersen, Morten Lund-Johansen and Michael J. Link

Previous attempts to ascertain which treatment strategy ultimately provides the best quality of life for patients with small-to medium-sized VSs have been severely hampered by small numbers, short follow-up, potentially important selection biases, lack of a disease-specific quality of life analysis, and no nontumor control group for comparison. 9 After an extensive review of the recent literature, Gauden and colleagues concluded that since most studies have relied on the 36-Item Short Form Health Survey (SF-36) and have reported outcomes in disparate ways, no strong

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Andrew S. Little, Daniel Kelly, John Milligan, Chester Griffiths, Gail Rosseau, Daniel M. Prevedello, Ricardo Carrau, Heidi Jahnke, Charlene Chaloner, Judith O'Leary, Kristina Chapple, Peter Nakaji and William L. White

P atient -reported QOL end points are becoming increasingly important clinical metrics to supplement traditional objective outcome measures. Quality of life is a measure of a patient's sense of well being and includes multiple domains, such as emotions, pain, functional status, and social interactions. Endonasal skull base surgery is gaining popularity as an alternative to conventional open approaches, partially because of the perception of decreased approach-related morbidity and improved QOL. 1 , 19 Because these approaches exploit the nasal corridor and

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Philippe Schucht, Fadi Ghareeb and Hugues Duffau

G liomas within the central cerebral region pose a surgical challenge because damage to either the precentral or the postcentral gyrus can result in severe motor or sensory deficits. These deficits tend to be permanent and have grave repercussions on patients' quality of life and overall survival times. 21 Most LGGs (WHO Grade II gliomas; 54%) are located in the frontal lobe, and approximately 1 in 10 are located within the central region. 11 Patients with LGG tend to live several years after diagnosis; surgery helps to further extend survival times. 6

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François Proust, Olivier Martinaud, Emmanuel Gérardin, Stéphane Derrey, Sophie Levèque, Sandrine Bioux, Eléonore Tollard, Erick Clavier, Olivier Langlois, Olivier Godefroy, Didier Hannequin and Pierre Fréger

coiling; focal encephalomalacia was noted on a greater number of MR images after microsurgical treatment. If global efficiency, language, and visual memory were similar in the 2 groups, the proportion of verbal memory defects was significantly higher after microsurgical clipping than with endovascular coiling. Quality of Life Quality of life constitutes a criterion of evaluation that describes the daily life tasks in physical, psychological, and social fields of health. 58 This information was provided by patients and their close relatives or caregivers and

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A. Henriette Paulsen, Tryggve Lundar and Karl-Fredrik Lindegaard

: Compliance in quality of life data: a Norwegian experience . Stat Med 17 : 623 – 632 , 1998 13 Kulkarni AV , Rabin D , Drake JM : An instrument to measure the health status in children with hydrocephalus: the Hydrocephalus Outcome Questionnaire . J Neurosurg 101 : 2 Suppl 134 – 140 , 2004 14 Laurence KM , Coates S : The natural history of hydrocephalus. Detailed analysis of 182 unoperated cases . Arch Dis Child 37 : 345 – 362 , 1962 15 Lindquist B , Carlsson G , Persson EK , Uvebrant P : Behavioural problems and autism in

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Joseph Bampoe, Paul Ritvo and Mark Bernstein

Quality-of-life assessments in neurooncology are becoming more relevant with the proliferation of intensive research into brain tumors and their therapy. In this review, the authors examined several aspects and problems associated with the past, present, and future applications of quality-of-life assessments in neurooncology.

The inadequacy of the almost exclusive use of physical functioning assessments, image-documented tumor response to therapy, and patient survival time as endpoints when evaluating therapeutic regimens is becoming increasingly apparent. In therapies in which outcome using traditional endpoints are only marginally different, specific (neurological) toxicity and social and psychological outcomes must be evaluated as well to determine valid treatment options. Also becoming widely accepted is the consideration of patient values of specific health states in justifying treatment resources. There is ongoing research in brain tumor patients to address these issues.

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Vinícius M. P. Guirado, Mario A. Taricco, Moacyr R. C. Nobre, Euro B. Couto Júnior, Eduardo S. C. Ribas, Alexandre Meluzzi, Roger S. Brock, Mario R. Pena Dias, Rodrigo Rodrigues and Manoel J. Teixeira

T he evaluation of the patient's own perception about the effect of the disease on his or her quality of life (QOL) is an important aspect when measuring outcomes of any treatment, including neurosurgical procedures. Most often, the neurosurgical literature reflects only the surgeon's point of view about the disease and limitations it implies for the patient. 10 , 13 , 15 , 17–20 , 24–26 , 29 , 31 , 35 , 38 , 42 , 45 , 47 , 49 , 52 , 53 , 55 , 57–59 , 63 , 64 , 70–76 , 80 , 89 Also, studies usually focus on morbidity and mortality instead of other

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Martin Barth, Claudius Thomé, Peter Schmiedek, Christel Weiss, Hidetoshi Kasuya and Peter Vajkoczy

classified as good [25–30], moderate [15–24], and bad [0–14]). 2) Quality of life was determined in the context of a detailed interview with the patient and his/her nearest relative and the use of a standardized questionnaire that included the following parameters: degree of anxiety and oblivion (range 1 [not present] to 4 [severe]), the HDRS (range 0–9 [no/slight depression present], 10–13 [mild depression], 14–17 [mild/ moderate depression], and > 17 [moderate/severe depression]), and the SF-36. The SF-36 consists of 8 health-related domains: Physical Functioning, Role

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Andrew S. Little, Daniel F. Kelly, John Milligan, Chester Griffiths, Daniel M. Prevedello, Ricardo L. Carrau, Gail Rosseau, Garni Barkhoudarian, Heidi Jahnke, Charlene Chaloner, Kathryn L. Jelinek, Kristina Chapple and William L. White

, Schwartz TH : A prospective study of postoperative symptoms in sinonasal quality-of-life following endoscopic skull-base surgery: dissociations based on specific symptoms . Int Forum Allergy Rhinol 3 : 664 – 669 , 2013 4 Cappabianca P , Cavallo LM , Colao A , de Divitiis E : Surgical complications associated with the endoscopic endonasal transsphenoidal approach for pituitary adenomas . J Neurosurg 97 : 293 – 298 , 2002 5 Charalampaki P , Ayyad A , Kockro RA , Perneczky A : Surgical complications after endoscopic transsphenoidal

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Barbara Zarino, Elisa Verrua, Emanuele Ferrante, Elisa Sala, Giulia Carosi, Claudia Giavoli, Andreea L. Serban, Giulia Del Sindaco, Martina A. Sirtori, Giulio A. Bertani, Paolo Rampini, Giorgio G. Carrabba, Maura Arosio, Anna Spada, Marco Locatelli and Giovanna Mantovani

P ituitary tumors account for 15% of all brain tumors, and autopsy and radiological studies have revealed pituitary lesions in 15%–30% of healthy individuals. 13 , 40 In addition to neural comorbidities common to most pituitary lesions (e.g., visual deficits and abnormalities in pituitary secretions), several studies have highlighted a potential reduction in health-related quality of life (HRQOL) and neuropsychological impairment in these patients, even in the absence of hormone deficits or excess. 15 , 16 , 19 , 23 , 31 , 36 , 40 The objectives of a