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Joshua R. Dusick, Felice Esposito, Daniel F. Kelly, Pejman Cohan, Antonio DeSalles, Donald P. Becker and Neil A. Martin

T he transsphenoidal route has been the favored approach for resection of most intrasellar tumors for longer than three decades. 46, 48 For many nonadenomatous suprasellar tumors, however, the transcranial route, taken either by performing a pterional or subfrontal approach, has continued to be used by a majority of neurosurgeons. More recently, a modification of the transsphenoidal approach that allows additional exposure of the suprasellar space has been followed for various pathological conditions such as tuberculum sellae meningiomas, craniopharyngiomas

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Joshua G. Kouri, Michael Y. Chen, Joseph C. Watson and Edward H. Oldfield

remained free from neurological or endocrinological deficits. No residual tumor was detected on immediate postoperative MR images or on follow-up MR images obtained 12 months postoperatively ( Fig. 4 ). Discussion We recently reported on the use of a modified transsphenoidal approach in the treatment of 10 patients with pituitary adenomas involving the pituitary stalk. 28 In a subsequent technical note, Kato, et al., 17 described application of this approach to the resection of other types of suprasellar tumors. The four cases discussed in the present report provide

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Ashish Suri, Karanjit Singh Narang, Bhawani Shankar Sharma and Ashok Kumar Mahapatra

blindness, which may be uniocular or binocular, and if left untreated may progress to binocular blindness. Blindness is usually caused by optic nerve atrophy due to tumor compression, which is generally regarded as irreversible. 8 Our study focuses on this subset of patients with suprasellar tumors who presented with either uniocular or binocular blindness. We have tried to analyze the factors that may affect the visual outcome after surgery in these patients. This study is the largest in the existing medical literature to evaluate the factors affecting visual outcome

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Mohamadreza Hajiabadi, Madjid Samii and Rudolf Fahlbusch

vivo. 17 Displacement, edema, and microstructural damage of tracts can be evaluated by DTI, 23 but the validity and reliability of these techniques, especially in the visual pathway system, are not yet clear. 12 , 14 , 26 Visual pathway fiber tractography may serve as a way to broaden our anatomical-functional understanding and provide better visualization of the optic pathway. In this preliminary study, we attempted to define preoperative, intraoperative, and postoperative alterations of the visual pathway fibers in 25 patients with suprasellar tumors using DTI

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Hussam Metwali, Mario Giordano, Katja Kniese and Rudolf Fahlbusch

, 8 , 9 , 11 , 17 , 22 , 32 , 37 In this study, we focused on the intraoperative change in the FA and the volume of the optic chiasma after its decompression in patients harboring suprasellar tumors that were treated under intraoperative MRI control. We correlated the change of the FA and the volume of the optic chiasma to the improvement of the visual status. To the best of our knowledge, this is the first study to discuss the significance of the intraoperative changes in the FA and the volume of the optic chiasma as very early predictors of the visual outcome. We

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Richard C. Schneider, Fred C. Kriss and Harold F. Falls

anterior cerebral arteries, the right more than left. Operation After preoperative steroid preparation, a right frontal osteoplastic craniotomy was performed. A suprasellar tumor pressed on the inferior surface of the chiasm; elevation of the right optic nerve showed a groove formed by the right anterior cerebral artery as it compressed the optic tract. The capsule of the pituitary tumor was firm; the tumor itself was soft, cystic, and hemorrhagic, probably secondary to radiation therapy. A blue, dome-shaped lesion, 1 cm in diameter, was identified on the

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Ronald Brisman and Jerry Mendell

records of more than 1000 patients with brain tumors seen at the Neurological Institute of New York between 1958 and 1968. Results The results are summarized in Table 1 . Autopsy studies showed 15 patients with suprasellar tumors. The low percentage of autopsied suprasellar tumors in this series (15 of 223) may reflect the relatively benign nature of these lesions (pituitary adenomas, craniopharyngiomas, epidermoid). These patients often live for many years and then may die in other hospitals from nontumor-related causes. Five of these (33.3%) had

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Giulio Maira, Carmelo Anile, Alessio Albanese, Daniel Cabezas, Flaminia Pardi and Andrea Vignati

C raniopharyngiomas grow from remnants of the Rathke pouch. They can be located inside the sella turcica and from there may grow above it, with symmetrical or asymmetrical suprasellar expansion. Exclusively suprasellar tumors involve the infundibulum and the suprasellar cisterns or may be found solely in the third ventricle. Approximately one third of all craniopharyngiomas reported in the literature involve the pituitary fossa. 3, 6, 24, 28, 29, 31, 33, 36, 37, 43 When this neoplasm is located either completely or partially within an enlarged sella, TSS is

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William A. Fletcher, Richard K. Imes and William F. Hoyt

extends from tumors with tubular thickening of the optic nerves and chiasm to massive multilobular growths. It is the diversity of these tumors that confounds attempts to generalize about their long-term behavior and response to treatment. Our findings indicate that three CT patterns of chiasmal gliomas are diagnostic: tubular thickening of the optic nerve and chiasm, a suprasellar tumor with contiguous optic nerve expansion, and a suprasellar tumor with optic tract involvement. The diagnosis of globular chiasmal gliomas without optic nerve or tract involvement cannot

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Pineal and suprasellar germinomas

Results of radiation treatment

R. Derek T. Jenkin, W. John K. Simpson and Colin W. Keen

, Sheline GE , et al : Radiation therapy for pineal and suprasellar tumors. (In preparation) Wara WM, Fellows CF, Sheline GE, et al: Radiation therapy for pineal and suprasellar tumors. (In preparation) 29. Ward A , Spurling RG : The conservative treatment of third ventricle tumors. J Neurosurg 5 : 124 – 130 , 1948 Ward A, Spurling RG: The conservative treatment of third ventricle tumors. J Neurosurg 5: 124–130, 1948