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Neurosurgical Forum: Letters to the Editor To The Editor Kiyoshi Takagi , M.D. Takamitsu Fujimaki , M.D. Teikyo University Tokyo, Japan 1325 1326 Abstract Object. The goal of this study was to determine the frequency of enlargement of unruptured intracranial aneurysms by using serial magnetic resonance (MR) angiography and to investigate whether aneurysm characteristics and demographic factors predict changes in aneurysm size. Methods. A retrospective review of MR angiograms obtained in 57

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Neurosurgical Forum: Letters to the Editor To The Editor Martin Hasselblatt , M.D. Institute of Neuropathology Münster, Germany 574 574 Abstract Object. The goal of this study was to determine the relationship between aneurysm size and the volume of subarachnoid hemorrhage (SAH). Methods. One hundred consecutive patients who presented with acute SAH, which was diagnosed on the basis of a computerized tomography (CT) scan within 24 hours postictus and, subsequently, confirmed to be aneurysmal in origin by

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William F. McCormick and Gaston J. Acosta-Rua

I n view of the many publications dealing with saccular intracranial aneurysms, it is somewhat surprising that few give details of the size of the aneurysms. The majority of authors have either totally ignored this aspect of the problem or have merely given the extremes in size of the aneurysms in their series. The study we are reporting documents the size of all “major” intracranial aneurysms encountered in an autopsy series, demonstrates the influence of perfusion under pressure and fixation on the size of the aneurysms, examines the correlation between

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Stephen L. Nutik and Michael J. Babb

V estibular schwannomas (acoustic neuromas) are slow-growing, benign tumors. Sometimes, a course of observation with serial scans is undertaken rather than surgical treatment. 2, 5, 7, 9, 19–22, 27, 29 Patients selected for tumor surveillance are usually older and have smaller lesions in which the growth may prove to be too slow to have a clinical impact during the patient's lifetime. Decisions about this type of management could benefit from a better understanding of the conditions that influence tumor size and growth and their relationship to patient age

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Stephen T. Magill, Jacob S. Young, Ricky Chae, Manish K. Aghi, Philip V. Theodosopoulos and Michael W. McDermott

Radiographic findings, including brain invasion, bone invasion, and peritumoral edema in the surrounding brain, have also been associated with higher-grade meningiomas. 22 However, to our knowledge no study has shown that size is independently associated with tumor grade. Interestingly, in our experience we anecdotally observed that larger tumors tended to be higher grade. Thus, we performed a retrospective study to evaluate whether tumor size was associated with tumor grade. Methods Study Design, Setting, Size, and Participants We performed a retrospective chart review of

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Masahito Fujimoto, Eiji Yoshino, Norihiko Mizukawa and Kimiyoshi Hirakawa

I t is well known that the neurological symptoms of brain tumor may progress during pregnancy. Two major reasons for this deterioration have been suggested: acceleration of the tumor growth caused by the hormonal changes during pregnancy, 1 and vascular engorgement in the tumor caused by the hemodynamic changes of pregnancy leading to an increase in tumor fluid content. 8 Reports documenting actual changes in tumor size after delivery are rare. Only one case was found in the literature, in which midline displacement of the pericallosal artery was shown by

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Neurosurgical Forum: Letters to the editor To The Editor Michael Scott , M.D. Philadelphia, Pennsylvania 133 133 The ability to accurately describe the size of a tumor at operation varies from neurosurgeon to neurosurgeon, depending on his vision, judgment, and occasionally on his tendency to exaggerate. Rarely does he minimize its size. “Huge” and ‘“massive” are not uncommon superlatives. Some neurosurgeons, possibly for Freudian reasons prefer various fruits to describe the size, for example: that of a

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Michael Y. Chen, Alan Hoffer, Paul F. Morrison, John F. Hamilton, Jeffrey Hughes, Kurt S. Schlageter, Jeongwu Lee, Brandon R. Kelly and Edward H. Oldfield

G ene therapy in solid tissues requires transfection of a therapeutic gene into a clinically useful volume of tissue. This is particularly challenging in the CNS because of the BBB. Findings in previous studies have demonstrated that intrathecal, intraventricular, intravascular, and acute parenchymal injections can distribute virus-sized vectors only to limited volumes of brain tissue in small animals. 25, 28, 30 Intrathecal and intraventricular injections deposit therapeutic agents directly into CSF, which has several limitations. Both of these delivery

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Kazunori Arita, Kaoru Kurisu, Atsushi Tominaga, Fusao Ikawa, Koji Iida, Selji Hama and Haruyuki Watanabe

R econstruction of the sella turcica at the end of transsphenoidal surgery is generally performed using a piece of bony nasal septum. However, when a bone splint of adequate size is not available, materials such as hydroxyapatite 9, 13 or silicone 4 are used. Unfortunately, various problems may arise when using these materials, such as difficulties involved in trimming and fitting, 13 the possibility of tumorigenesis, 2, 6–8, 12 foreign body granuloma, 5 or autoimmune disease. 1 To circumvent these problems, we have devised a size-adjustable sellar plate

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Changing Size of an Aneurysm

Report of a Case

Sidney A. Hollin and Sidney W. Gross

Follow-up arteriography without intervening surgery usually demonstrates no change or occasionally an increase in the size of an intracranial aneurysm. 2, 18 Only a few cases have been recorded in which the aneurysm did not fill after repeat angiography. 2, 9, 10, 17 These “spontaneous cures” are presumably the result of intra-aneurysmal thrombosis or an actual decrease in the size of the sac. Marguth and Schiefer 17 described a case in which the second angiogram, carried out 15 years later, failed to visualize the aneurysm. Höök and Norlén 10 reported a