Intracranial lipomas are rare benign tumour that is slow growing, generally asymptomatic, most frequently located in the midline areas and are usually an incidental finding on imaging and therefore cases are not frequently reported. This study reports a case of a patient with quadrigeminal plate lipoma presenting with obstructive hydrocephalous and the 6th cranial nerve palsy that was successfully treated with ventriculo-peritoneal shunting without addressing the lesion. Key words: Lipoma, quadrigeminal plate, the 6th cranial nerve palsy, hydrocephalus ABSTRACTArticle history:
The purpose of this article is to advocate standard skull base technique for removing the clinoidal meningioma and to delineate the technique's advantages that aid in achieving an improved extent of tumor resection and enhancing the patients' overall outcome, specially their visual outcome. Methods: A retrospective analysis was performed on 10 consecutive patients with clinoidal meningiomas who underwent surgical resection at the Bangabandhu Sheikh Mujib Medical University and other private clinics between May 2013 and July 2016. A standard pterional craniotomy technique consisting of extradural anterior clinoidectomy, coupled with optic canal unroofing and optic nerve sheath opening was used in all patients. All patients had thorough preoperative and postoperative ophthalmological evaluations. The follow-up period ranged from 6 to 42 months. Results: Total resection was achieved in 5 (50.0%) of the 10 patients in this series. The majority of the patients with preoperative visual impairment experienced significant visual improvement 7 of 10 patients; 70.0%). Conclusion: In the majority of patients with clinoidal meningiomas, total resection may be achieved with minimal complications. For large tumors encasing the optic nerve and internal carotid artery, or for those tumors causing preoperative visual impairment, use of the cranial base technique delineated in this study may lead to significant improvement in the patients' visual and overall outcomes.
(1) Background: Meningiomas are usually benign encapsulated intracranial tumors with well-defined borders that offer a high chance of cure with complete removal. The aim of this study was to evaluate the association between preoperative MRI features and surgical plane of cleavage. (2) Materials and Methods: This was a cross-sectional observational study conducted in the Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University. Data were recorded from 48 study participants with confirmed intracranial meningioma and analyzed by IBM SPSS (version 23). (3) Results: The highest incidence of intracranial meningioma was observed in the third decade of life of our study participants. The female to male ratio was 1.82:1. The most common location of meningiomas was convexity (29.16%), sphenoid wing (22.91%), parasagittal (20.83%), and falcine (14.58%). Most of the patients (68.8%) had medium-sized tumors, and 75.0% exhibited hyperintense signal change in the tumor parenchyma on T2-weighted imaging. One-third (33.3%) of patients were characterized as no edema, focal edema, and lobar/hemispheric edema. There was no statistically significant association between tumor size and types of surgical cleavage plane. Different signal intensities of tumor parenchyma, as well as types of peritumoral edema, showed no statistically significant association with surgical cleavage plane (p > 0.05). (4) Conclusion: There was no association among the size of the tumor, extent of peritumoral edema, the intensity of the tumor on T2-weighted images, and the types of surgical cleavage plane. Future studies with larger sample sizes are required to find out more precise findings.
The beginning of Neurosurgery is not very new in Bangladesh. Prof.Rashiduddin Ahmed established the first Neurosurgery unit in the then Institute of Postgraduate Medical Research (IPGMR) with only six beds in 1970. The first generation neurosurgeons left the field of neurosurgery in the safe hands of their disciples. There was a rapid progression of neurosurgery further both in private and in government level after 2000.In 1997 the first MS (Neurosurgery) course was started in IPGMR which was replaced by a 5-year residency course under Bangabandhu Sheikh Mujib Medical University (BSMMU) in 2010. Till now over 154 candidates are the active members of Bangaldesh Society of Neurosurgeons and are practicing independent neurosurgery. It is a very popular course and at present there are about 89 residents in various phases of the course in 4 institutions under BSMMU. With the available investigations, diagnostic facilities, operative facilities and good neuroanesthesia; now neurosurgeons also developed their skills in vascular neurosurgery, pediatric neurosurgery, endoscopic neurosurgery, spinal stabilization procedures, stereotactic neurosurgery and stem cell therapy. We are also hopeful that, very soon we would be able to achieve and develop our standard of neurosurgery to an international level by our determination and continuous effort, and by suitable and update learning, teaching and training. Bang. J Neurosurgery 2019; 8(2): 57-62
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