ABSTRACT
PURPOSE: Cranial irradiation can lead to long-term neurological complications, in particular memory disorders. The aim of this prospective study is to evaluate the impact of irradiation of benign skull base tumours located near the hippocampi on autobiographical memory. PATIENTS AND METHODS: From 2016 to 2019, patients with cavernous sinus meningioma or pituitary adenoma treated with normofractionated irradiation were included. Patients underwent full neuropsychological assessment at baseline, 1year and 2years post-treatment. Neuropsychological tests were converted to Z-Score for comparability. RESULTS: Twelve of the 19 patients included had a complete neuropsychological evaluation at 2years and were analysed. On the "TEMPau" test, no significant difference in autobiographical memory was found at 2years, regardless of the period of autobiographical memory. The mean hippocampal dose had no impact on the variation in autobiographical memory. There was no significant cognitive impairment in the other domains assessed, such as attention, anterograde memory, working memory and executive functions. Autobiographical memory was independent of these other cognitive domains, which justifies its specific study. CONCLUSION: Radiotherapy to the skull base for a benign pathology does not lead to significant cognitive impairment. Longer follow-up would be needed to confirm these results.
ABSTRACT
Cardiac myxoma is the most common benign heart tumor. Cardiac myxoma can be a sporadic lesion (93of cases) and usually occurs in women over 30 years. Complete surgical removal of the myxoma and its cardiac attachement is usually curative. The frequency of recurrences in cardiac myxomas was varies between 3for sporadic cases and 22for cases of Carney complex. Recurrence has been related to incomplete excision multifocality and embolism of tumor fragments. We report a case with multiple brain metastases revealed by mycotic aneurysm and seizure intractable
Subject(s)
Brain , Case Reports , Myxoma , Neoplasm MetastasisABSTRACT
Objective : With the life expectancy in the industrial nations increasing over the last two decades; the number of patients older than 70 years with spinal tumors and; especially; meningiomas is rising. Our objective is to assess the outcome of surgically treated spinal meningiomas in patients in their eighth or ninth decade of life and to analyze the possible role of some prognostic factors. Patients and methods : Twenty seven consecutive patients over 70 years of age (mean age; 78.3 years) were operated on for spinal meningiomas between 1995 and 2005 in Bordeaux's Neurosurgery Departement. The preoperative neurologic status of the patients was graded with the Solero score; and the general health conditions were staged according to the American Society of Anesthesiology classification. Tumor were removed totally in 26 cases and subtotally removed in one. The follow-up period ranged from 12 to 81 months (mean; 27.1 months). Results: There was no operative mortality; and morbidity was not significant. Although not significant; neurologic outcome was better in patients with a low preoperative Solero score than those with a high one (P 0.01). Clinical outcome was not influenced by the preoperative general health conditions according to American Society of Anesthesiology classification (p0.07). Clinical outcome was influenced by the duration of symptoms before surgery (p0.05). No recurrence was observed during the follow-up period. Conclusion: Neurologic outcome following surgery was favorable in the vast majority of patients; with no mortality or significant morbidity. Surgery is the only treatment in elderly patients with symptomatic spinal meningiomas; even for those with a poor preoperative neurologic condition. Whenever there is an acceptable risk from an anesthesiological point of view