Meningiomas

The treatment of choice for meningiomas is complete surgical excision of the tumor, its dural attachments and any abnormal bone. For CPA meningiomas, this may be accomplished by any of the standard approaches described for acoustic neuroma excision, depending upon the hearing status and the precise location of the tumor. Complete macroscopic surgical excision is usually achieved in this group of patients. This objective is only accomplished in about 70 of patients with non-acoustic neuroma like...

Neurosurgery

Jallo GI, Woo HH, Meshki C, Epstein FJ, Wisoff JH. Arachnoid cysts of the cerebellopontine angle diagnosis and surgery. Neurosurgery 1997 40 31-8. 8. Maceri DR, Fox CM. Audiological assessment of the acoustic neuroma patient. Techniques in Neurosurgery 1997 3 89-94. 9. Gardner G, Robertson JH. Hearing preservation in unilateral acoustic neuroma surgery. Ann Otol Rhinol Laryngol 1988 97 55-66. 10. Bederson JB, von Ammon K, Wichmann WW, Yarsagil MG. Conservative treatment of patients with...

Results of Acoustic Neuroma Surgery

The objective of acoustic neuroma surgery is the total removal of the neoplasm with minimal morbidity and mortality. Objective recording of cranial nerve function, CSF leak rates, meningitis incidence and quality-of-life assessments can assess morbidity. Extent of tumor removal can be determined intraoperatively, and recurrence can be monitored with MRI scans. In the modern era, total tumor removal should be achieved. This was the case in 99.6 of patients with unilateral tumors in Cambridge....

Treatment Strategies in Patients with Acoustic Neuromas

When considering the management of a patient with an acoustic neuroma, several factors preside. The size of the tumor is of paramount importance. In the Cambridge series of 473 patients presenting between 1983 and 1995, 47 of tumors were large (more than 2.5 cm), 32 medium (1.5-2.5 cm) and 21 small (less than 1.5 cm). Large tumors may cause the life-threatening complications of symptomatic hydro-cephalus, and direct mass effect. We advocate initial insertion of a ventriculoperitoneal shunt, or,...

Extracranial Cerebrovascular Disease Pathogenesis

Most ischemic strokes in the past were attributed to intracranial vessel occlusion. This was recognized by C. Miller Fisher, who found a clinicopathological association between athero-matous disease of the cervical carotid artery and an increase in the risk of stroke 5 hence, the importance of the extracranial cerebral vascula-ture as a source of ischemic disease. The recent contributions from molecular biology, as well as improved vascular imaging, have increased our understanding of the...