Neurosurgery Clinics of North America
Preface
Epidemiology of Brain Metastases
Key points
Introduction
Shortcomings of the existing literature
Models for reporting of brain metastases
Number and location of brain metastases
Primary tumors that metastasize to the brain
Lung cancer
Breast cancer
Melanoma
Unknown primary cancer
Prognosis and survival of patients with brain metastases
Summary
Initial Approach to Patients with a Newly Diagnosed Solitary Brain Metastasis
Key points
Introduction
Clinical presentation
Imaging
Additional work-up
Prognostic and molecular classifications
Symptom management
Treatment
Case examples
Summary
Initial Approach to the Patient with Multiple Newly Diagnosed Brain Metastases
Key points
Introduction
Tissue diagnostics
Whole-brain radiation therapy
Stereotactic radiosurgery
Surgery
Targeted therapy
Immunotherapy
Summary
The Role of Stereotactic Biopsy in Brain Metastases
Key points
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Introduction
Pathobiology of brain metastases
The role of stereotactic biopsy in brain metastases
Surgical considerations
Clinical case studies
Discussion
Techniques for Open Surgical Resection of Brain Metastases
Key points
Background
Surgical approaches
Tumor resection
Surgical adjuncts
Summary
Laser Ablation for Cerebral Metastases
Key points
Introduction
Systematic review of the available literature
Surgical procedure for laser ablation
Discussion
Summary
Pathological Features of Brain Metastases
Key points
Introduction
Pathogenesis
General aspects
Special aspects
Metastases morphology
Differential diagnosis
Cerebrospinal fluid cytology
Serum Tumor Markers
Pathologist Surgeon Interface
Summary
Whole-Brain Radiation Therapy Versus Stereotactic Radiosurgery for Cerebral Metastases
Key points
Whole-brain radiation therapy
Stereotactic radiosurgery
Future directions and conclusion
Brain Metastasis Recurrence Versus Radiation Necrosis: Evaluation and Treatment
Key points
Introduction
Pathophysiology of radiation necrosis
Incidence of radiation necrosis
Diagnostics
Treatment
Summary
Antiepileptic Drugs in the Management of Cerebral Metastases
Key points
Introduction
Indications for treatment
Choice of therapy
Duration of therapy
Neurology consultation
Limitations and future areas of investigation
Concluding remarks
Chemotherapy for the Management of Cerebral Metastases
Key points
Introduction
History of chemotherapy for cerebral metastasis
Novel delivery systems
Novel agents
Summary
Leptomeningeal Carcinomatosis: Molecular Landscape, Current Management, and Emerging Therapies
Key points
Introduction
Epidemiology
Pathophysiology and molecular landscape
Current treatment and imaging
Emerging therapies
Summary
Immune Therapy for Central Nervous System Metastasis
Key points
Introduction
Systemic immunotherapies
Brain metastasis microenvironment
Immunotherapy for direct treatment of brain metastasis
Immunotherapy and radiation
Adverse effects of immunotherapy
Future directions
Targeting the Tumor Microenvironment in Brain Metastasis
Key points
Introduction
Blood-brain barrier
Astrocytes
Immune cells
Summary
Sellar Metastases: Diagnosis and Management
Key points
Epidemiology
Origin of the primary tumor
Anatomic site of metastases
Manifestations of the disease
Imaging
Management
Prognosis
Management of Skull Base Metastases
Key points
Introduction
Epidemiology of skull base metastases
Clinical presentation of skull base metastases
Management of skull base metastases
Summary