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Abstract

Craniopharyngiomas are rare tumors with peak incidence between 5–14 and between 65–74 years of age. Treatment of choice is surgical resection, sometimes associated with radiation therapy. Complete tumor resection may be challenging. Radical surgery is particularly risky in older patients. Authors evaluate three cases of large cystic craniopharyngioma in patients in their 7th and 8th decade of life operated with the use of endoscopic technique. The postoperative follow-up period in which out-patient controls with imaging examinations were performed was up to 6 years. Symptoms of intracranial hypertension resolved in all patients in the immediate postoperative period. Visual acuity improved in two patients. No cases of aseptic meningitis have been reported. One patient underwent subsequent radio-therapy. The well-being of the operated patients continued.
Endoscopic transventricular approach to cystic craniopharyngiomas may be a safe and effective approach in older patients, being an alternative to microsurgical procedures.
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Authors and Affiliations

Krzysztof Stachura
1
Ewelina Grzywna
1
Maciej J. Frączek
1

  1. Department of Neurosurgery and Neurotraumatology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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Abstract

B a c k g r o u n d: The anatomy of arteries supplying blood to the brain often varies among the population. It applies particularly to posterior cerebral circulation. The impact of its anatomy variabilities on the formation of intracranial aneurysms has not been determined yet. The aim was to find out if posterior cerebral circulation anatomy variations coexist with basilar artery aneurysms (BAAs). We retrospectively analyzed 27 patients with BAA and a group of 30 patients matched by gender and age but without BAA. In both groups together most (66.67%) of patients were female and the average age was 59.75 ± 10.91. All of the patients had Computed Tomography performed. We assessed the occurrence of BAA, basilar artery (BA) diameter, vertebral artery (VA) diameter, posterior cerebral artery (PCA) diameter, and if patients had hypoplastic VA or PCA.
R e s u l t s: The presence of right VA hypoplasia significantly increased the risk of BAA occurrence (48.15% vs. 16.67%; p = 0.011). The occurrence of hypoplastic VA on either side was significantly associated with the risk of BAA formation (59.26% vs. 26.67%; p = 0.013). Patients with BAA had slightly larger left PCA diameter 1cm after division (1.96 ± 0.51 vs. 1.64 ± 0.42; p = 0.014) in comparison to those without BAA. Additionally, hypoplastic right PCA occurred more often in patients with BAA (22.22% vs. 0%; p = 0.022).
C o n c l u s i o n s: We can conclude that the anatomy of PCA and VA affects the occurrence of BAA. Hypoplastic VA, the presence of wider left PCA and hypoplastic right PCA may be factors that coexist with BAA occurrence.

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Authors and Affiliations

Małgorzata E. Czuba
1
Maciej J. Frączek
1
Katarzyna Ciuk
1
Jakub Polak
1
Piotr Gabryś
1
Paweł Brzegowy
2
Andrzej Urbanik
2

  1. Students’ Scientific Group at Department of Radiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Radiology, Jagiellonian University Medical College, Kraków, Poland

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