Symptomatic Vessel Narrowing Caused by Spontaneous Rupture of Craniopharyngioma Cyst —Case Report—

Shida, Naoki; Nakasato, Nobukazu; Mizoi, Kazuo; Kanaki, Masaya; Yoshimoto, Takashi

doi:10.2176/nmc.38.666

Cited by 42 publications

(37 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…7 It has long been recognized that leakage of cystic fluid can lead to local inflammation, and this has been modeled by injection of cystic fluid into the brain of rats, which induces an inflammatory response and an increase in GFAP expression. 47,53,54 Expression of a number of inflammatory mediators, such as IL6, IL1A, tumor necrosis factor (TNF), and α-defensins 1-3, has been identified in cystic fluid, generating interest in the use of immunomodulators for the treatment of cysts. 34,38,40 The histopathological similarities between ACP and odontogenesis and frequently cystic odontogenic tumors such as ameloblastoma and calcifying odontogenic cyst has also been recognized, but the molecular biology of these similarities and links remains relatively underexplored.…”

Section: Molecular Pathology Of Tumor Cystsmentioning

confidence: 99%

Molecular pathology of adamantinomatous craniopharyngioma: review and opportunities for practice

Apps¹,

Martinez-Barbera²

2016

FOC

View full text Add to dashboard Cite

Since the first identification of CTNNB1 mutations in adamantinomatous craniopharyngioma (ACP), much has been learned about the molecular pathways and processes that are disrupted in ACP pathogenesis. To date this understanding has not translated into tangible patient benefit. The recent development of novel techniques and a range of preclinical models now provides an opportunity to begin to support treatment decisions and develop new therapeutics based on molecular pathology. In this review the authors summarize many of the key findings and pathways implicated in ACP pathogenesis and discuss the challenges that need to be tackled to translate these basic science findings for the benefit of patients.

show abstract

Section: Molecular Pathology Of Tumor Cystsmentioning

confidence: 99%

Molecular pathology of adamantinomatous craniopharyngioma: review and opportunities for practice

Apps¹,

Martinez-Barbera²

2016

FOC

View full text Add to dashboard Cite

show abstract

“…Furthermore, secondary injury related to immediate or delayed vasospasm has been reported after craniopharyngioma surgery as well. 22,28,29 Vasospasm may be related to subarachnoid hemorrhage caused by tumor dissection. However, it has also been hypothesized that the caustic nature of cystic craniopharyngioma fluid may also result in vasospasm.…”

Section: Learning Curve In Craniopharyngioma Surgerymentioning

confidence: 99%

The learning curve in endoscopic endonasal resection of craniopharyngiomas

Kshettry

Do²,

Elshazly

et al. 2016

FOC

View full text Add to dashboard Cite

OBJECTIVE There is a paucity of literature regarding the learning curve associated with performing endoscopic endonasal cranial base surgery. The purpose of this study was to determine to what extent a learning curve might exist for endoscopic endonasal resection in cases of craniopharyngiomas. METHODS A retrospective review was performed for all endoscopic endonasal craniopharyngioma resections performed at Thomas Jefferson University from 2005 to 2015. To assess for a learning curve effect, patients were divided into an early cohort (2005–2009, n = 20) and a late cohort (2010–2015, n = 23). Preoperative demographics, clinical presentation, imaging characteristics, extent of resection, complications, tumor control, and visual and endocrine outcomes were obtained. Categorical variables and continuous variables were compared using a 2-sided Fisher's exact test and t-test, respectively. RESULTS Only the index operation performed at the authors' institution was included. There were no statistically significant differences between early and late cohorts in terms of patient age, sex, presenting symptoms, history of surgical or radiation treatment, tumor size or consistency, hypothalamic involvement, or histological subtype. The rate of gross-total resection (GTR) increased over time from 20% to 65% (p = 0.005), and the rate of subtotal resection decreased over time from 40% to 13% (p = 0.078). Major neurological complications, including new hydrocephalus, meningitis, carotid artery injury, or stroke, occurred in 6 patients (15%) (8 complications) in the early cohort compared with only 1 (4%) in the late cohort (p = 0.037). CSF leak decreased from 40% to 4% (p = 0.007). Discharge to home increased from 64% to 95% (p = 0.024). Visual improvement was high in both cohorts (88% [early cohort] and 81% [late cohort]). Rate of postoperative panhypopituitarism and permanent diabetes insipidus both increased from 50% to 91% (p = 0.005) and 32% to 78% (p = 0.004), which correlated with a significant increase in intentional stalk sacrifice in the late cohort (from 0% to 70%, p < 0.001). CONCLUSIONS High rates of near- or total resection and visual improvement can be achieved using an endoscopic endonasal approach for craniopharyngiomas. However, the authors did find evidence for a learning curve. After 20 cases, they found a significant decrease in major neurological complications and significant increases in the rates of GTR rate and discharge to home. Although there was a large decrease in the rate of postoperative CSF leak over time, this was largely attributable to the inclusion of very early cases prior to the routine use of vascularized nasoseptal flaps. There was a significant increase in new panhypopituitarism and diabetes insipidus, which is attributable to increase rates of intentional stalk sacrifice.

show abstract

“…Note that rupture of these lesions has resulted in meningitis and vasospasm. 14,20 Arachnoid cysts have also been associated with other intracranial tumors, as in the patient in Case 1.…”

Section: Discussionmentioning

confidence: 92%

Arachnoid cysts: spontaneous resolution distinct from traumatic rupture

Bristol¹,

Albuquerque²,

McDougall³

et al. 2007

FOC

View full text Add to dashboard Cite

✓Although many arachnoid cysts are discovered incidentally and require no intervention, a small subset has been known to rupture. Note that rupture can occur either spontaneously or in association with trauma. Based on a review of the literature on ruptured arachnoid cysts, it appears that patients with middle fossa cysts are more likely to experience symptomatic traumatic rupture than those with cysts in other locations. Middle fossa cysts are more commonly associated with hemispheric subdural collections and hematomas than are any other cysts. The authors report on two representative cases illustrating the distinct presentation, imaging characteristics, and management of these cysts.

show abstract

Symptomatic Vessel Narrowing Caused by Spontaneous Rupture of Craniopharyngioma Cyst —Case Report—

Cited by 42 publications

References 10 publications

Molecular pathology of adamantinomatous craniopharyngioma: review and opportunities for practice

Molecular pathology of adamantinomatous craniopharyngioma: review and opportunities for practice

The learning curve in endoscopic endonasal resection of craniopharyngiomas

Arachnoid cysts: spontaneous resolution distinct from traumatic rupture

Contact Info

Product

Resources

About