BACKGROUND: Meningiomas are the type of central nervous system tumours, derived from the cells of the arachnoid membrane that are well constrained from surrounding tissues, mainly no infiltrating neoplasm with benign features. Meningiomas consist about 15-20% of all primary intracranial neoplasms. AIM: The evaluation of the outcome of the operatively treated meningiomas in relation with the Karnofsky performance score, survival, recurrence, type of the surgical excision, histological type, mitotic count (MC), localisation and volume of the lesion METHODS: In this article 40 operatively treated patients are reviewed for the outcome of the operation about the Karnofsky performance score, survival, recurrence, type of the surgical excision, histological type, mitotic count (MC), localisation and volume of the lesion. RESULTS: Association/interconnection between the mitotic count grade I and the regrowth of meningioma have been verified. Association/interconnection between the mitotic count grade I and the regrowth of meningioma have been verified. Association/interconnection between the mitotic count grade I and the regrowth of meningioma have been established. CONCLUSION: Gender, age and Karnofsky performance score have predictive value in the treatment of different types of meningiomas. The magnitude of surgical resection is associated with the regrowth of a tumour. The mitotic count in different types of meningiomas presents significant feature in the appearance of meningioma recurrence. The surgical resection and the quality and quantity of patient’s survival have a significant relation to the mitotic count of the meningiomas. There is no connection between the size and the localisation of a tumour related to different values of the mitotic count.
BACKGROUND: The transnasal transsphenoidal endoscopic approach to the sella turcica is an overwhelming alternative to the microscopic approach for the past few decades assuming into prominence as a new technique, reaching nearly gold standard for this pathology. The endoscopic approach to the pituitary has redefined accurate visualization of the sella. The panoramic view afforded by the endoscope is unparalleled as compared with the traditional conical view of the microscope. AIMS: This study aims to compare both endoscopic and microscopic technologies, including advantages and disadvantages through the results of endocrine outcome. SETTINGS AND DESIGN: Our retrospective/prospective study included 46 microscopically and 39 endoscopically treated patients during the period of 2010–2018. Tumors were classified according to the diameter and clinical outcomes were evaluated. RESULTS: Our retrospective/prospective study included 46 microscopically and 39 endoscopically treated patients during the period of 2010–2018. Tumors were classified according to the diameter, hormone activity and clinical outcomes were evaluated. Comparison results revealed more efficacious and effective endocrine control and reestablishing the endocrine homeostasis utilizing the endoscopic technique, especially in secretory active macroadenomas. Further, the extension of the resection, which was better in endoscopic approach undouptedly contributed to better endocrine control of the disease. Complication rate, including endocrine, was lower following endoscopy compared with microsurgery. CONCLUSION: This technique evidenced to have a statistically significant reduction in operative time and length of hospital stay, as well as more radical safe resection and complication control. There is also a trend toward improved endocrine outcomes and rate of return of visual defects. These two approaches are still comparable with eloquent advantages and disadvantages, formulated as balanced dialectics. In addition, the use of endoscopes, including multilocular polifilament 3D endoscope, facilitates extended approaches, reaching a delicate skull base lesions that are suprasellar, retrosellar, and parasellar, which permits visualization beyond the abilities of the microscope.
Gliomas are the most common primary intracranial brain neoplasms composing almost 80% of all cancerous brain tumours. Glioblastoma is the most common malignant brain tumour in the adult population and accounts in about 15% of all intracranial neoplasms. This observational analytical study gives a better overview of the current state of glial tumours in North Macedonia from 2021 to 2022 with special reference to glioblastomas.Epidemiological and statistical analysis of glial and other brain tumours in a specific time period with special reference to glioblastomas.This research is an observational statistical analysis that takes place on the Institute for Pathology in the Medical Faculty of ''Ss. Cyril and Methodius'' University in Skopje using the digital data base of patients that had undergone surgery in the University Clinic of Neurosurgery and were diagnosed at the Institute of Pathology during the time period 2021-2022.In the period from 2021 and 2022, at the Institute of Pathology were diagnosed 106 (62%) glioblastomas out of which classic glioblastoma histomorphology confined 85 (80.19%) cases; 9 (8.49%) glioblastomas showed oligodendroglial component, 5 (4.72%) cases were gliosarcomas and 4 (3.77%) cases were diagnosed as giant cell glioblastomas. Three (2.83%) cases showed glioblastoma histomorphology with radionecrosis.The results of this descriptive statistical analysis show that glial tumours, especially glioblastomas as most prevalent malignant tumour type deserves greater scientific attention which beside the impact on their diagnostic complexity, will expand the knowledge of this pathology field and strongly reflect on future scientific and diagnostic work.When it comes to global statistics, we can conclude that Republic of North Macedonia follows the global trends regarding the incidence of glioblastoma associated with gender and age. Our results show that glioblastoma is more prevalent in males than females with the ratio male to female being 1.2:1, and this tumour is more prevalent in patients older than 55 years with the average age of diagnosis being 61 years.
BACKGROUND:Premature fusion of the metopic suture results in a type of craniosynostosis known as trigonocephaly. The treatment of trigonocephaly is surgical and is likely to remain so. Surgical methods and techniques for correction of craniosynostosis-related skull deformities have evolved, and a single best procedure is yet to be presented.CASE REPORT:Here we present a technical remark in a case of open cranial vault reconstruction.CONCLUSION:Although the literature, in general, prefers barrel stave (radial) frontal bone osteotomies, a technique with longitudinal frontal bone osteotomies were performed, without fixation of the bony flaps, frontal bone or supraorbital arch, with a quite satisfactory result.
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