Pub Date : 2023-01-05DOI: 10.33962/roneuro-2022-071
G. Popescu, Francesca Paslaru, M.C. Zaharia, M. Popescu, R.M. Gorgan
Background: Neurofibromatosis type 1 (NF1) and neurofibromatosis type 2 (NF2) are rare tumoral suppressor syndromes, triggered by an abnormal mutation in a tumour suppressor gene (TSG) (1). Each of these syndromes represents an orphan disease (by itself), but the tumours encountered in these patients are the most frequent lesions of the nervous system. Between the two of these diseases, NF1 presents a greater risk of malignancy, hence the importance of an accurate diagnosis and distinction between the two pathological entities. The purpose of this paper is to describe our department's practice protocol with neurofibromatosis and review the current literature regarding clinical diagnosis and management of these complex diseases.
Methods: Our paper is a retrospective study that comprehends 25 patients with neurofibromatosis treated in our clinic between 2011 and 2018.
Results: Our study included 16 female patients (64%) and 9 male patients (36%). The mean age at presentation was 48,7 (range 14-72 years). There were 7 cases (28%) of NF1 and 18 cases (72%) of NF2. Seven cases (28%) had a positive family history and 18 patients did not (72%). The most common symptoms at presentation were hearing loss, vertigo, and headache.
Conclusions: Neurofibromatosis is a very complex disease in which the tumours may have an unforeseeable growth pattern. New tumours can grow over the years and the symptoms are unpredictable. Surgical treatment is best to be reserved for symptomatic tumours. Non-surgical procedures are also an important step of the treatment, but further studies are required to decide their effectiveness.
{"title":"Therapeutic advances in treatment of patients with neurofibromatosis type 1 and type 2","authors":"G. Popescu, Francesca Paslaru, M.C. Zaharia, M. Popescu, R.M. Gorgan","doi":"10.33962/roneuro-2022-071","DOIUrl":"https://doi.org/10.33962/roneuro-2022-071","url":null,"abstract":"Background: Neurofibromatosis type 1 (NF1) and neurofibromatosis type 2 (NF2) are rare tumoral suppressor syndromes, triggered by an abnormal mutation in a tumour suppressor gene (TSG) (1). Each of these syndromes represents an orphan disease (by itself), but the tumours encountered in these patients are the most frequent lesions of the nervous system. Between the two of these diseases, NF1 presents a greater risk of malignancy, hence the importance of an accurate diagnosis and distinction between the two pathological entities. The purpose of this paper is to describe our department's practice protocol with neurofibromatosis and review the current literature regarding clinical diagnosis and management of these complex diseases.
 Methods: Our paper is a retrospective study that comprehends 25 patients with neurofibromatosis treated in our clinic between 2011 and 2018.
 Results: Our study included 16 female patients (64%) and 9 male patients (36%). The mean age at presentation was 48,7 (range 14-72 years). There were 7 cases (28%) of NF1 and 18 cases (72%) of NF2. Seven cases (28%) had a positive family history and 18 patients did not (72%). The most common symptoms at presentation were hearing loss, vertigo, and headache.
 Conclusions: Neurofibromatosis is a very complex disease in which the tumours may have an unforeseeable growth pattern. New tumours can grow over the years and the symptoms are unpredictable. Surgical treatment is best to be reserved for symptomatic tumours. Non-surgical procedures are also an important step of the treatment, but further studies are required to decide their effectiveness.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135405113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-05DOI: 10.33962/roneuro-2022-070
Alexandru Vlad Ciurea, Andrei Adrian Popa
Between September 28 and October 1, 2022, took place the 47th National Congress of the Romanian Society of Neurosurgery. It was organized in Iasi, at the Palace of Culture. On this occasion, the 26th Francophone Course and the 4th National Congress of Modern Neuroscience were held. These three events represent the quintessence of all current modern neurosurgical problems. Extremely important topics were disputed which helped to grow the passion in the hearts of young enthusiasts and their mentors.
{"title":"Steps towards neuro-excellence","authors":"Alexandru Vlad Ciurea, Andrei Adrian Popa","doi":"10.33962/roneuro-2022-070","DOIUrl":"https://doi.org/10.33962/roneuro-2022-070","url":null,"abstract":"Between September 28 and October 1, 2022, took place the 47th National Congress of the Romanian Society of Neurosurgery. It was organized in Iasi, at the Palace of Culture. On this occasion, the 26th Francophone Course and the 4th National Congress of Modern Neuroscience were held. These three events represent the quintessence of all current modern neurosurgical problems. Extremely important topics were disputed which helped to grow the passion in the hearts of young enthusiasts and their mentors.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135405116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-05DOI: 10.33962/roneuro-2022-076
Razvan Adrian Covache-Busuioc, Horia Petre Costin, Vicentiu Mircea Saceleanu
The posterior inferior cerebellar artery (PICA) has a unique anatomical complexity, which is of great clinical importance and is involved in many pathologies, such as aneurysm, ischemic stroke, neurovascular compression syndrome (NVCS), arteriovenous malformation (AVM) and brain tumour (1).
PICA has a sinuous and variable trajectory, divided into 5 segments. PICA infarction usually manifests lateral bulbar syndrome and is more likely to cause mass effects. PICA frequently compresses the bulb and cranial nerves, resulting in various neurovascular compression syndromes (NVCS) (2).
The ischemic stroke caused by thromboembolism in the PICA segment is accounted for more than 2% of all cases of ischemic stroke (3). Moreover, it tends to be underdiagnosed due to the symptomatology, represented usually by vertigo which mimics a possible peripheral vestibulopathy (4).
{"title":"PICA ischemic stroke","authors":"Razvan Adrian Covache-Busuioc, Horia Petre Costin, Vicentiu Mircea Saceleanu","doi":"10.33962/roneuro-2022-076","DOIUrl":"https://doi.org/10.33962/roneuro-2022-076","url":null,"abstract":"The posterior inferior cerebellar artery (PICA) has a unique anatomical complexity, which is of great clinical importance and is involved in many pathologies, such as aneurysm, ischemic stroke, neurovascular compression syndrome (NVCS), arteriovenous malformation (AVM) and brain tumour (1).
 PICA has a sinuous and variable trajectory, divided into 5 segments. PICA infarction usually manifests lateral bulbar syndrome and is more likely to cause mass effects. PICA frequently compresses the bulb and cranial nerves, resulting in various neurovascular compression syndromes (NVCS) (2).
 The ischemic stroke caused by thromboembolism in the PICA segment is accounted for more than 2% of all cases of ischemic stroke (3). Moreover, it tends to be underdiagnosed due to the symptomatology, represented usually by vertigo which mimics a possible peripheral vestibulopathy (4).","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135405117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-05DOI: 10.33962/roneuro-2022-073
George Popescu, Marius C. Zaharia, Ana-Maria Georghiu, Bogdan-Ionuț David, Ana-Maria Ioniță, Cezar Vijlanescu, Radu M. Gorgan
Background. Even in the 21st century, infections of the central nervous system and their secondary damage still represents a high mortality condition. Furthermore, brain abscesses (BA) are huge public health issues due to their high mortality and morbidity with high financial implications for the health care system.
Material and methods. In this article, we want to present our clinic`s experience in the management of brain abscesses between 2012 and 2021. A 10 years retrospective study was performed in the 4th Neurosurgery Department of “Bagdasar-Arseni” Clinical Emergency Hospital in Bucharest
Results. In the last 10 years, our clinic admitted 46 patients, 10 women and 36 men. The mean age was 47 years old. The most common symptom was headache (42 cases). In 39 cases, patients had solitary abscesses while seven patients presented multiple abscesses. The therapeutic approach was classic surgery in 37 cases. In four cases abscess drainage was performed and in five cases conservative treatment was used. At discharge, 31 patients were healed and seven patients died.
Discussions. In BA management, antimicrobial therapy is crucial. Thus, identifying the pathogen is crucial for accurate antimicrobial treatment. Unfortunately, in too many cases, the agent remains unknown and empiric treatment is required. Aspiration of the abscesses proved to be safe and with similar results compared to classic surgery.
Conclusions. Brain abscesses remain a high challenge to manage even in the 21st century. Broad-spectrum antibiotic treatment should be applied as soon as possible until the pathogen is identified and specific treatment will be used.
{"title":"Brain abscess – a still high mortality medical condition","authors":"George Popescu, Marius C. Zaharia, Ana-Maria Georghiu, Bogdan-Ionuț David, Ana-Maria Ioniță, Cezar Vijlanescu, Radu M. Gorgan","doi":"10.33962/roneuro-2022-073","DOIUrl":"https://doi.org/10.33962/roneuro-2022-073","url":null,"abstract":"Background. Even in the 21st century, infections of the central nervous system and their secondary damage still represents a high mortality condition. Furthermore, brain abscesses (BA) are huge public health issues due to their high mortality and morbidity with high financial implications for the health care system.
 Material and methods. In this article, we want to present our clinic`s experience in the management of brain abscesses between 2012 and 2021. A 10 years retrospective study was performed in the 4th Neurosurgery Department of “Bagdasar-Arseni” Clinical Emergency Hospital in Bucharest
 Results. In the last 10 years, our clinic admitted 46 patients, 10 women and 36 men. The mean age was 47 years old. The most common symptom was headache (42 cases). In 39 cases, patients had solitary abscesses while seven patients presented multiple abscesses. The therapeutic approach was classic surgery in 37 cases. In four cases abscess drainage was performed and in five cases conservative treatment was used. At discharge, 31 patients were healed and seven patients died.
 Discussions. In BA management, antimicrobial therapy is crucial. Thus, identifying the pathogen is crucial for accurate antimicrobial treatment. Unfortunately, in too many cases, the agent remains unknown and empiric treatment is required. Aspiration of the abscesses proved to be safe and with similar results compared to classic surgery.
 Conclusions. Brain abscesses remain a high challenge to manage even in the 21st century. Broad-spectrum antibiotic treatment should be applied as soon as possible until the pathogen is identified and specific treatment will be used.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135405115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-05DOI: 10.33962/roneuro-2022-074
Corneliu Toader, Andrei Alexandru Marinescu, Andrei Adrian Popa, Bogdan Gabriel Bratu, Alexandru Vlad Ciurea
Introduction: Intracranial aneurysms consist in abnormal dilatation of the cerebral arteries, most frequently asymptomatic, with symptoms appearing in the case of aneurysm rupture. From an imaging point of view, a cranial CT scan shows the subarachnoid haemorrhage caused by aneurysm rupture and the “gold standard” for aneurysm diagnosis is cerebral angiography.
Case presentation: A 49 years-old female, Ukrainian refugee, presented with a unique comitial crisis and chronic headache. Following an MRI performed in Kiev, it was decided to perform a bilateral carotid and vertebral angiography in our clinic. Clinical and imagistic results showed a giant left middle cerebral artery aneurysm. Postoperative, the patient had a favourable neurological recovery, with no neurological deficits. Additionally, control angiography and CT scan highlight complete occlusion of the aneurysm and no complications.
Conclusions: Cerebral aneurysms represent a high-risk vascular condition that needs a CT scan and angiography to be precisely diagnosed, surgical clipping should be performed as soon as possible.
{"title":"Intracranial aneurysms - a battle against time","authors":"Corneliu Toader, Andrei Alexandru Marinescu, Andrei Adrian Popa, Bogdan Gabriel Bratu, Alexandru Vlad Ciurea","doi":"10.33962/roneuro-2022-074","DOIUrl":"https://doi.org/10.33962/roneuro-2022-074","url":null,"abstract":"Introduction: Intracranial aneurysms consist in abnormal dilatation of the cerebral arteries, most frequently asymptomatic, with symptoms appearing in the case of aneurysm rupture. From an imaging point of view, a cranial CT scan shows the subarachnoid haemorrhage caused by aneurysm rupture and the “gold standard” for aneurysm diagnosis is cerebral angiography.
 Case presentation: A 49 years-old female, Ukrainian refugee, presented with a unique comitial crisis and chronic headache. Following an MRI performed in Kiev, it was decided to perform a bilateral carotid and vertebral angiography in our clinic. Clinical and imagistic results showed a giant left middle cerebral artery aneurysm. Postoperative, the patient had a favourable neurological recovery, with no neurological deficits. Additionally, control angiography and CT scan highlight complete occlusion of the aneurysm and no complications.
 Conclusions: Cerebral aneurysms represent a high-risk vascular condition that needs a CT scan and angiography to be precisely diagnosed, surgical clipping should be performed as soon as possible.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135405118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-21DOI: 10.33962/roneuro-2021-071
G. Iacob, R. Roşiu, M. Luchian, G. Simion
Background: Primary hydatid disease in the muscle is extremely rare, resulting in either the spread of cysts spontaneously or after operations for hydatidosis in distant regions. Methods: Report of an unusual case of primary hydatid cyst in the gluteus muscle, behaving as enlarging soft-tissue tumour, with a review of the literature. Results: Magnetic resonance imaging revealed an intramuscular cyst in the gluteus muscle; and no cyst existed in any other location. The cyst was excised totally, and the diagnosis of muscular cystic hydatidosis was confirmed by histopathologic examination. In follow-up of two years after the operation, there has been no recurrence in either patient. Conclusion: The involvement of the gluteus maximus muscle without the evidence of hepatic or pulmonary disease is rare, characterized by slow development, but a major local extension must be considered in the differential diagnosis of a cystic mass with well-defined margins in the extremities of individuals from endemic regions. Physical examination, serology results and radiological findings should be interpreted with care, especially in hydatid cyst endemic countries. Surgery is still the treatment of choice, with total cyst excision.
{"title":"Giant, primary, hydatid cyst of the gluteal region","authors":"G. Iacob, R. Roşiu, M. Luchian, G. Simion","doi":"10.33962/roneuro-2021-071","DOIUrl":"https://doi.org/10.33962/roneuro-2021-071","url":null,"abstract":"Background: Primary hydatid disease in the muscle is extremely rare, resulting in either the spread of cysts spontaneously or after operations for hydatidosis in distant regions. \u0000Methods: Report of an unusual case of primary hydatid cyst in the gluteus muscle, behaving as enlarging soft-tissue tumour, with a review of the literature. \u0000Results: Magnetic resonance imaging revealed an intramuscular cyst in the gluteus muscle; and no cyst existed in any other location. The cyst was excised totally, and the diagnosis of muscular cystic hydatidosis was confirmed by histopathologic examination. In follow-up of two years after the operation, there has been no recurrence in either patient. \u0000Conclusion: The involvement of the gluteus maximus muscle without the evidence of hepatic or pulmonary disease is rare, characterized by slow development, but a major local extension must be considered in the differential diagnosis of a cystic mass with well-defined margins in the extremities of individuals from endemic regions. Physical examination, serology results and radiological findings should be interpreted with care, especially in hydatid cyst endemic countries. Surgery is still the treatment of choice, with total cyst excision.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46586293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-21DOI: 10.33962/roneuro-2021-067
H. Berceanu, S. Groppa, H. Pleș
Dumitru Bagdasar, who is indisputably considered as the founder of neurosurgery on the Romanian territory during the interwar period, was born in Ro?ie?ti, the former F?lciu County, in 1893. In 1913, after having completed his primary and secondary education, he enrolled at the Faculty of Medicine of Bucharest and, in the summer of 1916, at the end of his third university year, he transferred to the Medical Military Institute. From 1916 to 1918, D. Bagdasar dealt with the whole array of illnesses arising from the world conflict, including firearm-related injuries to the nervous system. After the war, he was transferred to the Neurology Clinic of the Colentina Hospital where, under the supervision of Professor Gheorghe Marinescu, he elaborated and completed his doctoral dissertation entitled: Contribu?iuni la studiul Sindromului Parkinsonian-postencefalitic (Contributions to the Study of Postencephalitic Parkinsonism), which he defended in 1922. From 1922 to 1926, at the Military Hospital of Bucharest, he completed his neurology internship under the guidance of the eminent neurologist Dumitru Noica and his initiation to surgery under Professor Mihail Butoianu. In 1927, after giving up his military contract, he was transferred to the Jimbolia Hospital by the Ministry of Health to work as an attending neuropsychiatrist. At the end of the same year, with a recommendation from Professor Nicolae Paulescu, he earned a neurosurgery specialisation scholarship under Professor Harvey Cushing in Boston. There, under the guidance of Professor Cushing and Doctor Bailey, he wrote two papers: Le traitement Chirurgical des gommes cérébrales and Intracranial Chordoblastoma, which were published in prestigious medical journals. In 1929, he returned to the Jimbolia Hospital where, in 1930, he performed his first neurosurgical procedures. At the end of 1931, he transferred to the Cern?u?i Hospital, again as a neuropsychiatrist, and in the following two years he performed a number of 149 operations on the central nervous system, which are described in the surgical reports written by Doctor Bagdasar himself. In 1934, he transferred to Bucharest, where he performed neurosurgical procedures in two hospitals (Emergency Hospital and Central Hospital) and, at the end of the same year, he was tenured as an attending neurosurgeon at the Central Hospital, following a contest organised by the Ministry of Health. From 1935, he worked primarily in the aforementioned hospital but he also performed operations in other hospitals (Emergency, Col?ea, Military etc.). Alongside his surgical activity, he was also interested in the histopathology of the operated tumours, he wrote scientific papers based on his own case reports, participated in medical congresses (Bucharest, Bern, Chisinau etc.) and became interested in the social-political issues of the time..., joining the Communist Party in 1943. In 1940, just before the outburst of World War II, he wrote Acute craniocerebral trauma and
Dumitru Bagdasar出生于罗马尼亚，他无疑被认为是两次世界大战期间罗马尼亚境内神经外科学的奠基人。前F?1893年。1913年，在完成初等和中等教育后，他进入布加勒斯特医学院学习，1916年夏天，在大学第三学年结束时，他转到军事医学学院。从1916年到1918年，D. Bagdasar治疗了世界冲突引起的一系列疾病，包括与枪支有关的神经系统损伤。战争结束后，他被调到科伦蒂纳医院的神经病学诊所，在那里，在乔治·马里内斯库教授的指导下，他详细编写并完成了题为《贡献?他在1922年为《脑后帕金森病研究贡献》进行了辩护。从1922年到1926年，他在布加勒斯特的军事医院，在著名的神经学家Dumitru Noica的指导下完成了他的神经病学实习，并在Mihail Butoianu教授的指导下开始了外科手术。1927年，在放弃军事合同后，他被卫生部调到金博利亚医院，担任主治神经精神病医生。同年年底，在Nicolae Paulescu教授的推荐下，他获得了波士顿Harvey Cushing教授的神经外科专业奖学金。在那里，在库欣教授和贝利医生的指导下，他写了两篇论文:《Le traitement Chirurgical des gommes csamrsambrales》和《颅内脊索母细胞瘤》，发表在著名医学期刊上。1929年，他回到了Jimbolia医院，1930年，他在那里进行了第一次神经外科手术。1931年底，他转到欧洲核子研究中心。在接下来的两年中，他对中枢神经系统进行了149次手术，这些情况在Bagdasar医生本人所写的手术报告中有所描述。1934年，他转到布加勒斯特，在两家医院(急救医院和中心医院)进行神经外科手术，同年年底，在卫生部组织的一次竞赛之后，他被任命为中心医院的主治神经外科医生。从1935年起，他主要在上述医院工作，但也在其他医院做手术(急诊，Col?例如，军事等)。除了他的手术活动，他也对手术肿瘤的组织病理学感兴趣，他根据自己的病例报告撰写科学论文，参加医学大会(布加勒斯特，伯尔尼，基希讷乌等)，并对当时的社会政治问题感兴趣……他于1943年加入中国共产党。1940年，就在第二次世界大战爆发之前，他写了《急性颅脑创伤》，并发表在《医学问题》杂志上。R ?《战争医学问题》。在战争期间，由于他在神经外科手术方面有十多年的经验，他协助伤员(包括军人和平民)，同时也作为所谓的“黄金团队”(C. Arseni, I. Ionescu, Irina Ogrezeanu-Ionescu)的一员，在罗马尼亚和邻近国家甚至在巴勒斯坦管理常见的神经外科病例。1945年，他被任命为卫生部长，同年年底，他成为罗马尼亚第一位神经外科教授。不幸的是，他的生命在1946年7月16日突然结束，原因是可能由原发性肺癌引起的转移性脑瘤。
{"title":"Unpublished data on the founder of Romanian Neurosurgery – Professor Dumitru Bagdasar","authors":"H. Berceanu, S. Groppa, H. Pleș","doi":"10.33962/roneuro-2021-067","DOIUrl":"https://doi.org/10.33962/roneuro-2021-067","url":null,"abstract":"Dumitru Bagdasar, who is indisputably considered as the founder of neurosurgery on the Romanian territory during the interwar period, was born in Ro?ie?ti, the former F?lciu County, in 1893. In 1913, after having completed his primary and secondary education, he enrolled at the Faculty of Medicine of Bucharest and, in the summer of 1916, at the end of his third university year, he transferred to the Medical Military Institute. From 1916 to 1918, D. Bagdasar dealt with the whole array of illnesses arising from the world conflict, including firearm-related injuries to the nervous system. After the war, he was transferred to the Neurology Clinic of the Colentina Hospital where, under the supervision of Professor Gheorghe Marinescu, he elaborated and completed his doctoral dissertation entitled: Contribu?iuni la studiul Sindromului Parkinsonian-postencefalitic (Contributions to the Study of Postencephalitic Parkinsonism), which he defended in 1922. From 1922 to 1926, at the Military Hospital of Bucharest, he completed his neurology internship under the guidance of the eminent neurologist Dumitru Noica and his initiation to surgery under Professor Mihail Butoianu. In 1927, after giving up his military contract, he was transferred to the Jimbolia Hospital by the Ministry of Health to work as an attending neuropsychiatrist. At the end of the same year, with a recommendation from Professor Nicolae Paulescu, he earned a neurosurgery specialisation scholarship under Professor Harvey Cushing in Boston. There, under the guidance of Professor Cushing and Doctor Bailey, he wrote two papers: Le traitement Chirurgical des gommes cérébrales and Intracranial Chordoblastoma, which were published in prestigious medical journals. In 1929, he returned to the Jimbolia Hospital where, in 1930, he performed his first neurosurgical procedures. At the end of 1931, he transferred to the Cern?u?i Hospital, again as a neuropsychiatrist, and in the following two years he performed a number of 149 operations on the central nervous system, which are described in the surgical reports written by Doctor Bagdasar himself. In 1934, he transferred to Bucharest, where he performed neurosurgical procedures in two hospitals (Emergency Hospital and Central Hospital) and, at the end of the same year, he was tenured as an attending neurosurgeon at the Central Hospital, following a contest organised by the Ministry of Health. From 1935, he worked primarily in the aforementioned hospital but he also performed operations in other hospitals (Emergency, Col?ea, Military etc.). Alongside his surgical activity, he was also interested in the histopathology of the operated tumours, he wrote scientific papers based on his own case reports, participated in medical congresses (Bucharest, Bern, Chisinau etc.) and became interested in the social-political issues of the time..., joining the Communist Party in 1943. In 1940, just before the outburst of World War II, he wrote Acute craniocerebral trauma and","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42939962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-21DOI: 10.33962/roneuro-2021-069
G. Popescu, F. Paslaru, A. Paslaru, M. Apostol, M. Zaharia, T. Corneliu, M. Mitrica, M. Popescu, R. M. Gorgan
Meningiomas are common neoplasms of the central nervous system, comprising between 24 and 30% of primary intracranial tumours, most commonly affecting females in their middle age or later adult life [1] [2]. Meningiomas are classified as benign, atypical or anaplastic meningiomas depending mostly on histopathological criteria known to be associated with worse prognosis in terms of tumour progression, recurrence risk after surgery and overall survival. The 2016 edition of the World Health Organization (WHO) classification of Central Nervous System (CNS) tumours recognizes brain invasion as an independent criterion for diagnosing an atypical grade II meningioma [3]. Meningioma grading based on the WHO classification of CNS tumours thoroughly impacts therapeutic management and tumour prognosis. Aggressive meningiomas, a different phenotype of tumours, characterized by rapid growth and involvement of adjacent brain tissue, blood vessels and bone, was not previously listed as an independent entity in the WHO classification of meningothelial-cell tumours. Regarding the increasing importance of tumour grading in meningioma treatment strategies, the authors here provide an overview of clinicopathological and radiographic features, surgical management and long-term prognosis of this novel meningothelial tumour entity, the aggressive meningioma. In particular, we aimed to describe pre-, intra- and postoperative methods for recognizing aggressive meningiomas and explore the implications of this diagnosis on both surgical strategies and adjuvant therapy.
{"title":"Clinicopathological features, imaging characteristics and surgical management in a novel tumour entity - aggressive meningiomas","authors":"G. Popescu, F. Paslaru, A. Paslaru, M. Apostol, M. Zaharia, T. Corneliu, M. Mitrica, M. Popescu, R. M. Gorgan","doi":"10.33962/roneuro-2021-069","DOIUrl":"https://doi.org/10.33962/roneuro-2021-069","url":null,"abstract":"Meningiomas are common neoplasms of the central nervous system, comprising between 24 and 30% of primary intracranial tumours, most commonly affecting females in their middle age or later adult life [1] [2]. \u0000Meningiomas are classified as benign, atypical or anaplastic meningiomas depending mostly on histopathological criteria known to be associated with worse prognosis in terms of tumour progression, recurrence risk after surgery and overall survival. The 2016 edition of the World Health Organization (WHO) classification of Central Nervous System (CNS) tumours recognizes brain invasion as an independent criterion for diagnosing an atypical grade II meningioma [3]. Meningioma grading based on the WHO classification of CNS tumours thoroughly impacts therapeutic management and tumour prognosis. \u0000Aggressive meningiomas, a different phenotype of tumours, characterized by rapid growth and involvement of adjacent brain tissue, blood vessels and bone, was not previously listed as an independent entity in the WHO classification of meningothelial-cell tumours. \u0000Regarding the increasing importance of tumour grading in meningioma treatment strategies, the authors here provide an overview of clinicopathological and radiographic features, surgical management and long-term prognosis of this novel meningothelial tumour entity, the aggressive meningioma. In particular, we aimed to describe pre-, intra- and postoperative methods for recognizing aggressive meningiomas and explore the implications of this diagnosis on both surgical strategies and adjuvant therapy.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42836872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-21DOI: 10.33962/roneuro-2021-083
V. Aleksić, Jovan Prelić, Matija Radojević, R. Ćulafić
Schwannomas are the most common benign tumours affecting the peripheral nervous system. They represent a benign proliferation of Schwann cells. Schwannomas and other peripheral nerve sheath tumours are common in the head and neck, spine, thorax, abdominal wall, and retroperitoneum. However, localization in hand is exceptional. We present a 22-years-old female patient diagnosed and operated on for schwannoma of the digital nerve (dorsal cutaneous branch originating from the palmar cutaneous branch of ulnar nerve). In the case of a palpable hand mass, one of the possible diagnoses is schwannoma, and since the operative technique is somewhat specific with tumour enucleation and internal neurolysis, it is necessary to preoperatively keep in mind schwannoma in the differential diagnosis.
{"title":"Schwannoma of the digital nerve","authors":"V. Aleksić, Jovan Prelić, Matija Radojević, R. Ćulafić","doi":"10.33962/roneuro-2021-083","DOIUrl":"https://doi.org/10.33962/roneuro-2021-083","url":null,"abstract":"Schwannomas are the most common benign tumours affecting the peripheral nervous system. They represent a benign proliferation of Schwann cells. Schwannomas and other peripheral nerve sheath tumours are common in the head and neck, spine, thorax, abdominal wall, and retroperitoneum. However, localization in hand is exceptional. We present a 22-years-old female patient diagnosed and operated on for schwannoma of the digital nerve (dorsal cutaneous branch originating from the palmar cutaneous branch of ulnar nerve). In the case of a palpable hand mass, one of the possible diagnoses is schwannoma, and since the operative technique is somewhat specific with tumour enucleation and internal neurolysis, it is necessary to preoperatively keep in mind schwannoma in the differential diagnosis.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47982365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-21DOI: 10.33962/roneuro-2021-072
F. Urian, G. Iacob, A. V. Ciurea
Considering the rising tendency in the application of lumbar spine devices, a rigorous selection of candidates for lumbar spinal fusion must follow the benefit of the patient in terms of a better outcome than classical techniques or conservatory treatment. We pulled essential information from scientific sources regarding the clinical results of patients who underwent fusion surgery to sift patients who do better from fusion. We found out that imagistic proof of instability such as spondylolisthesis associated with lumbar spinal stenosis and refractory pain takes the most from spinal fusion procedures. Oswestry disability index improvement along with restoring the function and reduction of pain remained the postoperative desires of a successful fusion. Clinical amelioration with bracing test prior to intervention was a predictor of better results after fusion. Exclusion criteria like psychiatric disorders and prior lumbar spine surgery were highlighted since studies demonstrated that they are bad predictors of outcome in spinal fusion surgery. Laminectomy was nowhere implemented in the literature as to be urgently fused since only about 20% of patients manifest instability after this classical procedure. Iatrogenic segmental instability after laminectomy, radiologically proven should be a candidate for spinal fusion. These procedures have high costs and high rates of complications putting the patient’s functional status and quality of life at uncertainty since there is still a lot of debate in this area of spinal neurosurgery.
{"title":"Important controversies in lumbar spine surgery: which patients benefit from lumbar spinal fusion and who should be fused?","authors":"F. Urian, G. Iacob, A. V. Ciurea","doi":"10.33962/roneuro-2021-072","DOIUrl":"https://doi.org/10.33962/roneuro-2021-072","url":null,"abstract":"Considering the rising tendency in the application of lumbar spine devices, a rigorous selection of candidates for lumbar spinal fusion must follow the benefit of the patient in terms of a better outcome than classical techniques or conservatory treatment. We pulled essential information from scientific sources regarding the clinical results of patients who underwent fusion surgery to sift patients who do better from fusion. \u0000We found out that imagistic proof of instability such as spondylolisthesis associated with lumbar spinal stenosis and refractory pain takes the most from spinal fusion procedures. Oswestry disability index improvement along with restoring the function and reduction of pain remained the postoperative desires of a successful fusion. Clinical amelioration with bracing test prior to intervention was a predictor of better results after fusion. Exclusion criteria like psychiatric disorders and prior lumbar spine surgery were highlighted since studies demonstrated that they are bad predictors of outcome in spinal fusion surgery. \u0000Laminectomy was nowhere implemented in the literature as to be urgently fused since only about 20% of patients manifest instability after this classical procedure. Iatrogenic segmental instability after laminectomy, radiologically proven should be a candidate for spinal fusion. These procedures have high costs and high rates of complications putting the patient’s functional status and quality of life at uncertainty since there is still a lot of debate in this area of spinal neurosurgery.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41788084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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