Clinical Pearls Pituitary tumors present in various ways as a result of excess or deficient secretion of pituitary hormones or extrinsic compression on the pituitary stalk or adjacent structures. Approximately 75% of pituitary adenomas are functioning tumors; of these, half…
Clinical Pearls Comprehensive knowledge of the complex anatomy of the cerebellopontine (CP) angle is a prerequisite for achieving good surgical results. The crucial neurovascular structures should be identified as early as possible during surgery, which enables their preservation and guides…
Clinical Pearls The pineal region is bordered posteriorly by the tentorial apex, inferiorly by the culmen of the cerebellar vermis, superiorly by the splenium of the corpus callosum, and anteriorly by the third ventricle, quadrigeminal plate, and midbrain tectum. Pineal…
Clinical Pearls Meningiomas are the most common primary brain tumors, and the knowledge of these tumors and their management has evolved over the years. With better and more affordable radiologic investigations and changes to the World Health Organization classification grading,…
Clinical Pearls A metastatic brain tumor means that the patient has stage IV cancer, with median survival of less than 1 year. When a patient presents with a new brain metastasis, without a known primary site, the chance of finding…
Clinical Pearls High-grade gliomas are malignant brain tumors with a median survival of 14 months with maximal therapy, and they are considered incurable. Mainstays of therapy include maximal safe surgical resection combined with adjuvant radiation and chemotherapy. Although previously controversial,…
Open full size image Overview The term low-grade glioma (LGG) is used to describe World Health Organization (WHO) grade II gliomas, including diffuse astrocytomas, oligodendrogliomas, and oligoastrocytomas. Unlike high-grade gliomas, LGGs tend to grow slowly, but persistently, at roughly 3.5 mm…
Clinical Pearls The clinician must be alert for any evidence of underlying neurologic disease, including asymmetrical abdominal reflexes, abnormalities on neurologic examination, or a cavovarus foot deformity. On radiographs, hyperkyphosis over the apex of the curvature, an unusual curve pattern,…
Clinical Pearls A detailed history and neurologic exam can be used to isolate the level at which the underlying pathology originated. Understanding the presenting symptoms can help one to appreciate the significance of the extent of degeneration present and therefore…
Clinical Pearls Degeneration in the spine is a naturally occurring process that can be understood through the “three-joint complex,” which is composed of the intervertebral disk and the two dorsal articulating joints. Degeneration of any one joint leads to degeneration…