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Jacques J. Lara-Reyna, Rafael Uribe-Cardenas, Imali Perera, Nicholas Szerlip, Anastasios Giamouriadis, Nicole Savage, Therese Haussner, and Mark M. Souweidane

recurrence is unknown. It is hypothesized that the endoscopic removal of recurrent colloid cysts might pose more challenges and less success due to a distorted anatomy, capsule adherence, indistinct cyst margins, and scar formation. These findings may ultimately translate into higher rates of complications or recurrence. A focused analysis on a cohort of patients undergoing secondary endoscopic removal of a recurrent colloid cyst would provide information to guide current clinical practice. It was our aim to analyze our experience using an endoscopic approach in patients

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Ulrich Hubbe, Pamela Franco-Jimenez, Jan-Helge Klingler, Ioannis Vasilikos, Christoph Scholz, and Evangelos Kogias

S urgery for recurrent lumbar disc herniation (LDH) is accompanied by higher morbidity rate compared with primary herniation surgery. Epidural scar tissue increases the risk of dural tear and nerve root injury. 19 , 23 , 45 , 50 The majority of surgeons prefer the use of standard open microdiscectomy to treat recurrent LDH, 5 , 46 , 47 since wider exposure is assumed to provide for more convenient recognition of anatomical landmarks and tissue manipulation. The limited operating window of minimally invasive approaches has been regarded as a discouraging

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Jason M. Hoover, Macaulay Nwojo, Ross Puffer, Jay Mandrekar, Fredric B. Meyer, and Ian F. Parney

-free and overall survival for patients with diffuse gliomas of all types and grades. 18 , 19 , 23 , 27 Resection is also a common component of the management of recurrent gliomas. 3 , 5 , 8 This has clear advantages in appropriately selected patients such as those with mass effect and good performance status who are good surgical candidates. Cytoreduction may have survival benefits for patients with recurrent gliomas as well, but this is less clear, as survival data after multiple surgeries have seldom been reported. Balancing potential benefits and risks is a key

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Darryl Lau, Stephen T. Magill, and Manish K. Aghi

G lioblastoma is the most common primary malignant brain tumor among adults and unfortunately is also the most aggressive. It is a diffusely infiltrative and, almost always, recurrent brain tumor. The prognosis associated with glioblastoma is poor with median survival of 13–16 months even after resection and adjuvant chemotherapy. 63 , 97 While the pathological diagnosis of glioblastoma is characterized by frequent mitosis, palisading nuclei, necrosis, and neovascularization, molecular and genetic studies have revealed glioblastoma to be heterogeneous and

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Nicolaas A. Bakker, J. Marc C. Van Dijk, Steven Immenga, Michiel Wagemakers, and Jan D. M. Metzemaekers

I diopathic trigeminal neuralgia (TN) is a disabling disorder characterized by sudden attacks of unilateral facial pain. Microvascular decompression (MVD) is the method of choice to definitively cure the condition if medical treatment fails to provide sufficient relief. Although the success rates of MVD tends to reduce over time, in the majority of patients (up to 70%) long-term relief (10–15 years) can be achieved with minimal morbidity and mortality. 2 , 10 This also implies that a significant proportion of patients suffers recurrent TN after MVD, a

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Martin J. Rutkowski, Patrick M. Flanigan, and Manish K. Aghi

salivary cortisol. The dexamethasone-suppressed corticotropin-releasing hormone stimulation test may be used for equivocal cases of CD. 30 Because cortisol levels often fluctuate, and results sometimes vary across multiple measurements even in the same patient, repeat testing is recommended. 30 , 40 , 57 Dynamic MRI of the pituitary gland may be used to identify recurrent ACTH-secreting pituitary adenomas. Bilateral inferior petrosal sinus sampling is typically not used to evaluate recurrent CD because the venous drainage of the pituitary gland lateralizes

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Cecilia L. Dalle Ore, Darryl Lau, Jessica L. Davis, Michael M. Safaee, and Christopher P. Ames

J uvenile ossifying fibroma (JOF) is a rare benign tumor that typically occurs in the craniofacial bones of children and young adults. 13 , 14 There are only 2 published cases of JOF or ossifying fibroma involving the spinal column, 29 , 44 and there are no reports in the literature of a recurrent ossifying fibroma involving the spinal column. While malignant transformation of these tumors has not been described, they can grow rapidly and display locally aggressive behavior, causing destruction of surrounding structures. 13 A high propensity for local

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Stephen T. Magill, Cecilia L. Dalle Ore, Michael A. Diaz, Daara D. Jalili, David R. Raleigh, Manish K. Aghi, Philip V. Theodosopoulos, and Michael W. McDermott

increased risk of disease progression, with shorter overall survival and increased need for continued reoperations and radiotherapy. 6 , 18 , 19 Adjuvant radiation therapy provides longer progression-free survival and overall survival in patients with recurrent meningiomas as compared to surgery alone. 18 , 32 The best management of recurrent meningiomas remains unclear and a source of debate. 26 When considering repeat surgery as an option for management of a recurrence, it is important to consider the complication profile associated with reoperation. While the

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Roxanna M. Garcia, Taemin Oh, Tyler S. Cole, Benjamin K. Hendricks, and Michael T. Lawton

separation plane. This interplay between tissue sensitivity and extreme eloquence makes it difficult, if not impossible, to avoid leaving a remnant on occasion. The largest institutional surgical case series by a single neurosurgeon reported a rate of residual or recurrent BSCM of 11% (29 of 260 patients). 4 The natural history and management of residual or recurrent BSCMs are poorly described in the literature. 4 , 8–10 Current findings suggest that completely resected BSCMs do not recur de novo in the same location, which implies that some residual BSCM or remnants are

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Pepijn O. Sun, Ruud W. Selles, Miguel C. Jansen, Harm P. Slijper, Dietmar J. O. Ulrich, and Erik T. Walbeehm

% and 31%. 1 , 4 , 16 , 19 , 21 Five percent to 10% of patients with recurrent and persistent symptoms require revision surgery. 19 , 21 , 23 The outcome of revision surgery for recurrent and persistent CTS is less successful than that of primary surgery; the systematic review and meta-analysis of Soltani et al. 21 reported no improvement of symptoms after repeat decompression with neurolysis in up to 47% and after flap surgery in up to 37%. Furthermore, patients who do have improvement often have residual symptoms after revision surgery. 2 , 3 , 23 In order to