Glioblastoma multiforme (GBM) is the most aggressive and lethal form of brain cancer. 1 The currently recommended treatment guideline consists of maximal surgical resection with adjuvant radiotherapy and temozolomide (TMZ) chemotherapy. However, GBM patients still have a poor prognosis with a 5-year survival rate less than 10%. 1 GBM-associated vertebral metastases are extremely rare. 2 Here, we report a rare case of thoracic vertebral metastases in the absence of intracranial recurrence.On May 28, 2020, a 25-year-old man with an average medical history was admitted to our hospital complaining of intermittent dizziness and headache for 2 months, in addition to a progressively decreased left vision for 3 months. Neurological examination revealed cognitive decline and left vision loss (only light perception).Preoperative brain magnetic resonance imaging (MRI) showed an irregular mass measuring 87 mm × 58 mm × 60 mm in the left frontotemporal lobe (Figure 1A). The tumor presented a hypointense signal on the T1-weighted sequence and a hyperintense signal on the T2weighted sequence. The left ventricle was compressed significantly,

BackgroundPatients with ischemic cerebrovascular diseases are more likely to suffer from intracranial aneurysms, and their surgical treatment has a growing controversy in this condition. The current case series was aimed at exploring surgical treatment and perioperative management of intracranial aneurysms in Chinese patients with ischemic cerebrovascular diseases.MethodsMinimally invasive surgical approach through small pterion or inferolateral forehead was applied in 31 patients. Anti-platelet drugs were withdrawn 1 week before surgical operation. Systolic blood pressure was controlled to be more than 110 mmHg and increased by 20% after the clipping of intracranial aneurysms. Branches of external carotid artery were spared to ensure collateral circulation. Temporary blocking was minimized and ischemic time was shortened during surgical operation.ResultsPatients had an average age of 66 (46–78) years, and proportion of males was 39% (12 males). There were 35 unruptured intracranial aneurysms with a diameter more than 5 mm. There were 20 posterior communicating and anterior choroidal aneurysms (57%), seveb middle cerebral aneurysms (20%), and eight anterior communicating aneurysms (23%), with 21 lobular aneurysms (60%). Twenty-nine patients had normal neurological function (Glasgow Outcome Scale [GOS] 5), one patient with mild neurological defect (GOS 4), and one patient with severe neurological defect (GOS 3) at discharge. Meanwhile, there were 26 patients with modified Rankin Scale (MRS) 0–1, 4 patient with MRS 2, and one patient with MRS 3 at discharge. There were four patients lost during the follow-up. During the follow-up, 26 patients had normal neurological function (GOS 5), and one patient with severe neurological defect (GOS 3). Meanwhile, there were 25 patients with MRS 0–1, one patient with MRS 2, and one patient with MRS 3. All patients had no recurrence of intracranial aneurysms after operation.ConclusionsThe current case series found that minimally invasive surgical approach and intraoperative monitoring, supplemented by effective management of cerebrovascular perfusion, circulation and coagulation, can promote the treatment of intracranial aneurysms and prevent the development of cerebral ischemia and aneurysm rupture in Chinese patients with ischemic cerebrovascular diseases. Future studies with large sample size will be needed to confirm the results from the current case series.