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Glioblastomas and brain metastases are highly proliferative brain tumors with short survival times. Previously, using (13)C-NMR analysis of brain tumors resected from patients during infusion of (13)C-glucose, we demonstrated that there is robust oxidation of glucose in the citric acid cycle, yet glucose contributes less than 50% of the carbons to the(More)
BACKGROUND The incidence of severe, chronic postoperative headache in patients undergoing elective surgery for unruptured aneurysms is unknown. In addition, no clear risk factors have been identified for the development of postoperative headache. OBJECTIVE To evaluate intradural drilling of the anterior clinoid process as a mechanism for the development(More)
PURPOSE To test the efficacy of triple-refocusing MR spectroscopy (MRS) for improved detection of 2-hydroxyglutarate (2HG) in brain tumors at 3T in vivo. METHODS The triple-refocusing sequence parameters were tailored at 3T, with density-matrix simulations and phantom validation, for enhancing the 2HG 2.25-ppm signal selectivity with respect to the(More)
OBJECTIVE The goal of this study was to analyze the natural history of symptomatic brainstem cavernomas (medulla, pons, or midbrain) and outcome after surgical resection. METHODS We retrospectively analyzed clinical data of all patients who presented to our institution with symptomatic brainstem cavernomas between 1995 and 2007 (n = 44). RESULTS After a(More)
OBJECT Anterolateral cavernomas of the pons have been surgically removed via a variety of approaches, commonly retrosigmoid or transventricular. The goal in this study was to evaluate the presigmoid approach as an alternative. METHODS Clinical data were reviewed in 9 patients presenting with anterolateral pontine cavernomas between 1999 and 2007. (More)
Vestibular schwannomas account for ~;80% of cerebellopontine angle (CPA) tumors, with meningiomas being the second most common tumor of the CPA. The occurrence of both a schwannoma and a meningioma in the cerebellopontine angle is rare. After obtaining Institutional Review Board approval, we present a case of a concurrent vestibular schwannoma and(More)
Intracranial or brain arteriovenous malformations (BAVMs) are some of the most interesting and challenging lesions treated by the cerebrovascular neurosurgeon. It is generally believed that the combination of BAVMs and intracranial aneurysms (IAs) is associated with higher hemorrhage rates at presentation and higher rehemorrhage rates and thus with a more(More)
Foramen magnum meningiomas (FMMs) are slow growing, most often intradural and extramedullary tumors that pose significant challenges to the skull base neurosurgeon. The indolent clinical course of FMMs and their insidious onset of symptoms are important factors that contribute to delayed diagnosis and relative large size at the time of presentation.(More)
INTRODUCTION Atypical meningiomas (World Health Organization [WHO] grade II) represent a therapeutic challenge given their high recurrence rate and greater mortality compared with WHO grade I meningiomas. Traditionally, treatment has entailed attempts at gross total resection with radiation therapy reserved for residual disease or recurrences. METHODS We(More)
OBJECT Neurosurgical patients often have mildly prolonged prothrombin time (PT) or international normalized ratio (INR). In the absence of liver disease this mild prolongation appears to be due to the use of very sensitive PT reagents. Therefore, the authors performed relevant coagulation factor assays to assess coagulopathy in such patients. They also(More)