Objective: To evaluate the additional diagnostic value of diffusion and perfusion MRI in the differentiation of glioblastoma multiforme (GBM) and solitary brain metastasis. Patients and methods: This retrospective study included 24 patients with histologically proven brain tumors who underwent conventional MRI with analysis of diffusion (DWI) and perfusion (PWI) MRI findings of each tumor. The Apparent Diffusion Coefficient (ADC) values were calculated in the minimum (ADC-MIN), mean (ADC-MEAN), and maximum (ADC-MAX) in all the tumors and the peritumoral regions. The PWI data was expressed as maximum regional cerebral blood volume (rCBV) of the tumors and peritumoral regions. Results: After adding diffusion and perfusion to conventional MRI findings, we found that the accuracy of differentiation between glioblastoma multiforme (GBM) and solitary metastasis increased from 70% to 90%. Results: There is a significant difference in DWI signal intensity between GBM and metastatic tumors (P 0.05). The ADC values of GBM were lower than that of metastatic tumors. On perfusion MRI, the maximum rCBV of the peritumoral region (rCBVP) of GBM was higher than that of brain metastases (P 0.001). Conclusion: The addition of diffusion and perfusion to the MRI protocol increases the accuracy of differentiation between GBM and solitary brain metastasis and should be considered routinely.

Objective: To evaluate the additional diagnostic value of diffusion and perfusion MRI in the differentiation of glioblastoma multiforme (GBM) and solitary brain metastasis. Patients and methods: This retrospective study included 24 patients with histologically proven brain tumors who underwent conventional MRI with analysis of diffusion (DWI) and perfusion (PWI) MRI findings of each tumor. The Apparent Diffusion Coefficient (ADC) values were calculated in the minimum (ADC-MIN), mean (ADC-MEAN), and maximum (ADC-MAX) in all the tumors and the peritumoral regions. The PWI data was expressed as maximum regional cerebral blood volume (rCBV) of the tumors and peritumoral regions. Results: After adding diffusion and perfusion to conventional MRI findings, we found that the accuracy of differentiation between glioblastoma multiforme (GBM) and solitary metastasis increased from 70% to 90%. Results: There is a significant difference in DWI signal intensity between GBM and metastatic tumors (P 0.05). The ADC values of GBM were lower than that of metastatic tumors. On perfusion MRI, the maximum rCBV of the peritumoral region (rCBVP) of GBM was higher than that of brain metastases (P 0.001). Conclusion: The addition of diffusion and perfusion to the MRI protocol increases the accuracy of differentiation between GBM and solitary brain metastasis and should be considered routinely.

Objective: To evaluate the additional diagnostic value of diffusion and perfusion MRI in the differentiation of glioblastoma multiforme (GBM) and solitary brain metastasis. Patients and methods: This retrospective study included 24 patients with histologically proven brain tumors who underwent conventional MRI with analysis of diffusion (DWI) and perfusion (PWI) MRI findings of each tumor. The Apparent Diffusion Coefficient (ADC) values were calculated in the minimum (ADC-MIN), mean (ADC-MEAN), and maximum (ADC-MAX) in all the tumors and the peritumoral regions. The PWI data was expressed as maximum regional cerebral blood volume (rCBV) of the tumors and peritumoral regions. Results: After adding diffusion and perfusion to conventional MRI findings, we found that the accuracy of differentiation between glioblastoma multiforme (GBM) and solitary metastasis increased from 70% to 90%. Results: There is a significant difference in DWI signal intensity between GBM and metastatic tumors (P 0.05). The ADC values of GBM were lower than that of metastatic tumors. On perfusion MRI, the maximum rCBV of the peritumoral region (rCBVP) of GBM was higher than that of brain metastases (P 0.001). Conclusion: The addition of diffusion and perfusion to the MRI protocol increases the accuracy of differentiation between GBM and solitary brain metastasis and should be considered routinely.

Objective: To evaluate the additional diagnostic value of diffusion and perfusion MRI in the differentiation of glioblastoma multiforme (GBM) and solitary brain metastasis. Patients and methods: This retrospective study included 24 patients with histologically proven brain tumors who underwent conventional MRI with analysis of diffusion (DWI) and perfusion (PWI) MRI findings of each tumor. The Apparent Diffusion Coefficient (ADC) values were calculated in the minimum (ADC-MIN), mean (ADC-MEAN), and maximum (ADC-MAX) in all the tumors and the peritumoral regions. The PWI data was expressed as maximum regional cerebral blood volume (rCBV) of the tumors and peritumoral regions. Results: After adding diffusion and perfusion to conventional MRI findings, we found that the accuracy of differentiation between glioblastoma multiforme (GBM) and solitary metastasis increased from 70% to 90%. Results: There is a significant difference in DWI signal intensity between GBM and metastatic tumors (P 0.05). The ADC values of GBM were lower than that of metastatic tumors. On perfusion MRI, the maximum rCBV of the peritumoral region (rCBVP) of GBM was higher than that of brain metastases (P 0.001). Conclusion: The addition of diffusion and perfusion to the MRI protocol increases the accuracy of differentiation between GBM and solitary brain metastasis and should be considered routinely.

Abstract Objective: To discusses the surgical treatment of prolapsed lumber intervertebral disc in adolescents and its long-term results (PLID). Background: PLID is very rare in adolescence. Heavy lifting and trauma are the main causes; back pain and radicular pain are the most common clinical presentations, and surgical treatment gives satisfactory outcome after failure of conservative treatment. Methods: During period from January 2014-January 2019 twenty patients between 14 - 20 years old underwent for lumbar disc surgery in Neurosurgery department, Hadramawt University, Yemen, 18 patients were males while 2 were females. Results: Twenty patients 18 males (80%) while 2 females (20%) all patients have low back pain (100%), unilateral sciatica in (90%), bilateral sciatica in (10%) and sphincter disturbance in (10%). The most common affected level is L4/5 represent (80%) while L5/S1 (20%), partial lumbar laminectomy in (40%) and microdiscectomy and fenestration in (60%). Complication rate was (15%) and recurrence only (5%). Conclusion: PLID in adolescence is very rare; back pain and sciatica were the main clinical presentation. Meticulous surgical procedures give satisfactory outcome and excellent result.

Background Colloid cyst is a benign rare lesion that originates in the third ventricle. Headache, vomiting, visual deterioration, and memory deficits are the most common presenting symptoms. Endoscopic excision of colloid cyst is one of the recent advances in the field of minimally invasive neurosurgery. Aim The aim was to assess the efficacy and safety of the endoscope for excision of the colloid cyst. Patients and methods In this study, we review our experience in 14 patients who presented to us in two University Hospitals in south of Egypt in 2 years (2016 and 2017). The authors used LOTTA ventriculoscope with HOPKINS wide-angle straightforward telescope 6°. Results Of fourteen patients, 13 (92.9%) improved completely postoperatively, and only one (7.1%) patient who had visual deterioration did not improve after surgery. Total to near-total excision was done in 11 (78.6%) patients, and evacuation of the cyst with partial excision was done in three (21.4%) patients. Conclusion Endoscopic excision of third ventricular colloid cyst is a safe minimally invasive approach that can be used in patients who present with colloid cyst without the need to do cerebrospinal fluid diversion (shunt).

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