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https://www.readbyqxmd.com/read/29790979/petrosal-meningiomas-factors-affecting-outcome-and-the-role-of-intraoperative-multimodal-assistance-to-microsurgery
#1
Francesco Tomasello, Filippo Flavio Angileri, Alfredo Conti, Antonino Scibilia, Salvatore Cardali, Domenico La Torre, Antonino Germanò
BACKGROUND: Petrous meningiomas (PMs) represent a subset of posterior fossa tumors accounting for ∼8% of all intracranial meningiomas. Surgical treatment of PMs is challenging because of their relationships with vital neurovascular structures of the cerebellopontine angle. OBJECTIVE: To investigate independent pre- and intraoperative predictors of PM surgery outcome. METHODS: We reviewed the surgical and outcome data of patients who underwent microsurgical resection of PMs from 1997 to 2016...
May 22, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29790934/pediatric-pituitary-adenomas-early-and-long-term-surgical-outcome-in-a-series-of-85-consecutive-patients
#2
Lina Raffaella Barzaghi, Marco Losa, Jody Filippo Capitanio, Luigi Albano, Giovanna Weber, Pietro Mortini
BACKGROUND: Young age has been reported as a negative prognostic factor for pituitary adenomas (PAs). They are very uncommon in children and adolescents; therefore, surgical outcomes are poorly described. OBJECTIVE: To report results of microsurgical transsphenoidal approach (MTSA) in pediatric PAs. METHODS: The study retrospectively analyzed 3040 PAs treated in our institute, according to the adenoma subtype and then divided into pediatric (≤18 yr) and adult groups (>18 yr)...
May 22, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29788512/adequacy-of-fixed-dose-heparin-infusions-for-venous-thromboembolism-prevention-after-microsurgical-procedures
#3
Corinne M Bertolaccini, Ann Marie B Prazak, Jayant Agarwal, Isak A Goodwin, W Bradford Rockwell, Christopher J Pannucci
BACKGROUND:  In microvascular surgery, patients often receive unfractionated heparin infusions to minimize risk for microvascular thrombosis. Patients who receive intravenous (IV) heparin are believed to have adequate prophylaxis against venous thromboembolism (VTE). Whether a fixed dose of IV heparin provides detectable levels of anticoagulation, or whether the "one size fits all" approach provides adequate prophylaxis against VTE remains unknown. This study examined the pharmacodynamics of fixed-dose heparin infusions and the effects of real-time, anti-factor Xa (aFXa) level driven heparin dose adjustments...
May 22, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29788336/microsurgical-resection-of-posterior-third-ventricular-pineal-region-papillary-tumor-via-supracerebellar-infratentorial-approach-3-dimensional-operative-video
#4
Sima Sayyahmelli, Ihsan Dogan, Mustafa K Baskaya
The posterior third ventricle and pineal region can harbor different pathologies. The supracerebellar infratentorial approach allows a direct access to the pineal region and posterior third ventricle and provides wide exposure of the arachnoid planes and deep venous system. In this 3-dimensional video, we present a patient with posterior third ventricular/pineal region tumor who underwent microsurgical resection via supracerebellar infratentorial approach. The patient is a 28-year-old woman with history of hydrocephalus who underwent endoscopic third ventriculostomy and biopsy at an outside hospital...
May 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29788334/microsurgical-resection-of-ruptured-large-left-temporo-occipital-arteriovenous-malformation-3-dimensional-operative-video
#5
Chun-Yu Cheng, Rakshith Shetty, Laligam N Sekhar
A 59-yr-old man presented with intraventricular hemorrhage and was found to have a large temporo-occipital arteriovenous malformation (AVM), Spetzler-Martin grade 4. The preoperative intra-arterial digital subtraction angiography (IADSA) showed the AVM was 4 × 4 cm2, had superficial and deep venous drainage, and was fed by multiple branches of the posterior cerebral artery and middle cerebral artery. Preoperative embolization was done in 4 stages. He underwent a left temporo-occipital craniotomy, mastoidectomy, and retrosigmoid craniotomy with a posterior temporal approach...
May 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29788241/microsurgical-treatment-of-distal-anterior-cerebral-artery-aneurysms-3-dimensional-operative-video
#6
Vijay Agarwal, Daniel L Barrow
Selecting appropriate patient position for surgery must take into consideration a variety of factors. For an interhemispheric approach to distal anterior cerebral artery (DACA) aneurysms, the patient may be positioned with the head either horizontal or vertical with respect to the floor. We preferentially place the patient in the supine position with the shoulder elevated and the head turned parallel to the floor with the side of the approach down and the vertex tilted 45° up. In this way, gravity is utilized to allow the right frontal lobe to fall away from the falx, eliminating the need for retraction...
May 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29788188/importance-of-fenestration-size-for-definitive-treatment-of-a-quadrigeminal-arachnoid-cyst-endoscopic-inspection-of-the-cyst-and-surrounding-anatomy-2-dimensional-operative-video
#7
François Lechanoine, Pietro Spennato, Claudio Ruggiero, Giuseppe Cinalli
Arachnoid cysts are fluid-filled sacs, located between the brain or spinal cord and the arachnoid membrane. Their prevalence in children is between 1% and 3%. Quadrigeminal arachnoid cysts represent 1% to 10% of them and are often associated with hydrocephalus, mostly by an obstructive mechanism, explained by compression of the tectum of the midbrain. When an indication for treatment is retained, 3 surgical options are available: microsurgical excision/fenestration, endoscopic fenestration, and shunt placement...
May 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29788139/microsurgical-resection-of-spinal-cord-hemangioblastoma-2-dimensional-operative-video
#8
Mirza Pojskic, Kenan I Arnautovic
This video demonstrates microsurgical resection of spinal cord hemangioblastoma. Hemangioblastomas are rare, benign, highly vascularized tumors classified as grade I according to World Health Organization classification systems. About 3% of all intramedullary tumors are hemangioblastomas.1,2 Spinal cord hemangioblastomas are either sporadic3,4 or manifestations of von Hippel-Lindau (VHL) disease in 20% to 45% of patients.5,6 A 30-year-old male presented with sudden onset urinary incontinence. Magnetic resonance imaging showed contrast enhancing intramedullary tumor with adjacent cyst in T11, and syringomyelia extending to C1...
May 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29788106/microsurgical-resection-of-a-solitary-spinal-epidural-cavernous-angioma-3-dimensional-operative-video
#9
Guilherme H W Ceccato, Lucélio Henning, Julyana L Prado, Marcio S Rassi, Luis A B Borba
Solitary spinal epidural cavernous angiomas are rare vascular malformations. Surgical excision is the treatment of choice, as these lesions tend to grow or bleed at some point. In this 3-dimensional, narrated video, we present the case of a 61-year-old male who presented with progressive pain in the right paravertebral region secondary to an epidural cavernous angioma located at the T6/T7 level. Under intraoperative neurophysiological monitoring, a laminectomy between T5 and T7 was performed. A reddish, well delimited, and highly vascularized epidural mass was identified and dissected from the adjacent dura and nerve root, and an en bloc total resection was achieved...
May 21, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29787881/a-long-term-follow-up-after-radiosurgery-of-papillary-tumour-of-the-pineal-region-ptpr-two-cases-report-and-review-of-the-literature
#10
Cecilia Fernández-Mateos, Roberto Martinez, Jesús Vaquero
Tumours of the pineal region are rare in adulthood, accounting for approximately 1% of intracranial neoplasms in this age range. Because of their rarity, it has proven to be difficult to establish the optimal therapy. Furthermore, microsurgical total resection in this eloquent location is associated with not low rates of morbidity. We described two patients diagnosed of papillary tumours of the pineal region (PTPR) by stereotactic biopsy and referred for gamma knife radiosurgery after shunting for hydrocephalus...
May 19, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29783013/multiple-hereditary-exostoses-with-tetraparesis-due-to-cervical-spine-osteochondroma
#11
Ali Akhaddar, Mohamed Zyani, Issam Rharrassi
This is a case report about a 34-year-old man with hereditary multiple exostoses presented with gradual tetraparesis. Neuroimaging evaluation revealed an important posterior spinal cord compression by a C3 bony formation. Following posterior microsurgical decompression, the patient recovered nearly completely. Histopathological examination of the intraspinal lesion confirmed the diagnosis of benign osteochondroma. The patient returned to a normal life without evidence of recurrence at 2-year follow-up.
May 18, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29781851/the-international-fellowship-program-in-microsurgery-at-uppsala-university-hospital-a-paragon-throughout-europe
#12
Holger Jan Klein
Personal reports with valuable information on plastic surgery fellowships from all over the world are about to accumulate in recent years. Whereas some institutions have rightly become widely renowned for their excellent microsurgery fellow training in Taiwan, Canada, United States, and Australia, less is known about European fellowships focusing on reconstructive microsurgery. As former fellow at the Department of Plastic and Maxillofacial Surgery at Uppsala University Hospital, Sweden, the author hereby presents a survey on a unique and exemplary 6-month microsurgical fellowship offering hands-on training, academic education, and not last personal development to ambitious candidates who pursue a career in reconstructive microsurgery...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29780229/long-term-follow-up-of-motor-function-deterioration-following-microsurgical-resection-of-middle-third-parasagittal-and-falx-meningioma
#13
Ashraf Ahmad Elzarief, Mohamed Fouad Ibrahim
Background: Incidence of parasagittal meningioma varies in literature; it ranges from 16.8% to 25.6% of intracranial meningioma. Parafalcine meningioma accounts for about 8.5% of intracranial meningioma. Based on their relation to the superior Sagittal sinus and falx, these tumors had been classified into 3 groups; anterior third located between crista galli and coronal suture, middle third located between coronal and lambdoid sutures, and posterior third located posterior to lambdoid suture...
2018: The Egyptian journal of neurology, psychiatry and neurosurgery
https://www.readbyqxmd.com/read/29779186/mastoid-foramen-mastoid-emissary-vein-and-clinical-implications-in-neurosurgery
#14
Martin Hampl, David Kachlik, Katerina Kikalova, Roxane Riemer, Matej Halaj, Vlastimil Novak, Premysl Stejskal, Miroslav Vaverka, Lumir Hrabalek, David Krahulik, Ondrej Nanka
BACKGROUND: Mastoid emissary vein is especially important from the neurosurgical point of view, because it is located in variable number in the area of the occipitomastoid suture and it can become a source of significant bleeding in surgical approaches through the mastoid process, especially in retrosigmoid craniotomy, which is used for approaches to pathologies localized in the cerebellopontine angle. Ideal imaging method for diagnosis of these neglected structures when planning a surgical approach is high-resolution computed tomography...
May 20, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29778597/microsurgical-clipping-of-ruptured-anterosuperior-projecting-anterior-communicating-artery-aneurysms-how-i-do-it
#15
Feng Xu, Nicholas C Bambakidis
In anterosuperior-projecting anterior communicating artery (ACoA) aneurysms, the aneurysm dome usually adheres to one or both proximal A2 segment, which may present technical difficulties. This video demonstrates microsurgical clipping of a ruptured anterosuperior-projecting AComA aneurysm. A 52-year-old male presented with a Hunt-Hess grade II subarachnoid hemorrhage (SAH). Computed tomography showed SAH in the basal cisterns, sylvian and interhemispheric fissures. Angiography demonstrated a wide-necked AComA aneurysm projecting anterosuperiorly...
May 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29777279/-flap-coverage-using-the-posterior-gluteal-thigh-flap
#16
REVIEW
M K Boyce, T R Mett, R Ipaktchi, P M Vogt
OBJECTIVE: Defect coverage of the sacral, trochanteric or ischial region with durable tissue (gluteal thigh flap). INDICATIONS: Decubital ulcers of the sacral, trochanteric or ischial region after exhaustion of conservative measures. CONTRAINDICATIONS: Moribund or palliative patients who do not benefit from defect coverage and are likely to suffer a life-threatening complication. Noncompliant patients, who cannot follow the postoperative recommendations or protocols in regard to positioning or recurrence prevention...
May 17, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29775768/canine-pet-dog-tumor-microsurgery-and-intratumoral-concentration-and-safety-of-metronomic-chlorambucil-for-spontaneous-glioma-a-phase-i-clinical-trial
#17
R Timothy Bentley, Stephanie A Thomovsky, Margaret A Miller, Deborah W Knapp, Aaron A Cohen-Gadol
INTRODUCTION: Metronomic (daily low-dose) chlorambucil requires further study before implementation in human glioma. OBJECTIVE: Investigate the distribution and safety of metronomic chlorambucil in naturally occurring canine glioma. METHODS: Eight client-owned (pet) dogs with newly diagnosed spontaneous glioma were prospectively enrolled. Chlorambucil was administered preoperatively at 4 mg/m2 q 24hr for ≥ 3 days, and continued postoperatively until death or dose-limiting adverse events...
May 15, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29775161/surgical-treatment-of-middle-cluneal-nerve-entrapment-neuropathy-technical-note
#18
Juntaro Matsumoto, Toyohiko Isu, Kyongsong Kim, Naotaka Iwamoto, Daijiro Morimoto, Masanori Isobe
OBJECTIVE The etiology of low-back pain (LBP) is heterogeneous and is unknown in some patients with chronic pain. Superior cluneal nerve entrapment has been proposed as a causative factor, and some patients suffer severe symptoms. The middle cluneal nerve (MCN) is also implicated in the elicitation of LBP, and its clinical course and etiology remain unclear. The authors report the preliminary outcomes of a less invasive microsurgical release procedure to address MCN entrapment (MCN-E). METHODS The authors enrolled 11 patients (13 sites) with intractable LBP judged to be due to MCN-E...
May 18, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29775147/intraoperative-cochlear-nerve-mapping-with-the-mobile-cochlear-nerve-compound-action-potential-tracer-in-vestibular-schwannoma-surgery
#19
Nobuyuki Watanabe, Takuya Ishii, Kazuhiko Fujitsu, Shogo Kaku, Teruo Ichikawa, Kosuke Miyahara, Tomu Okada, Shin Tanino, Yasuhiro Uriu, Yuichi Murayama
OBJECTIVE The authors describe the usefulness and limitations of the cochlear nerve compound action potential (CNAP) mobile tracer (MCT) that they developed to aid in cochlear nerve mapping during vestibular schwannoma surgery (VSS) for hearing preservation. METHODS This MCT device requires no more than 2 seconds for stable placement on the nerve to obtain the CNAP and thus is able to trace the cochlear nerve instantaneously. Simultaneous bipolar and monopolar recording is possible. The authors present the outcomes of 18 consecutive patients who underwent preoperative useful hearing (defined as class I or II of the Gardner-Robertson classification system) and underwent hearing-preservation VSS with the use of the MCT...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29774873/-application-of-intraoperative-mri-combined-with-neuronavigation-in-microsurgical-resection-for-insular-glioma
#20
Quanwei Zhou, Li Xia, Kejun He, Sheng Yan, Xiaoping Xu, Xixi Li, Zhengsong Huang, Nu Zhang
To evaluate the value of intraoperative magnetic resonance imaging (iMRI) combined with neuronavigation for the resection of insular gliomas.
 Methods: From August 2014 to October 2017 in the First Hospital Affiliated to Sun Yat-sen University, clinical data of 41 patients with insular glioma, who underwent the surgery assisted with 3.0T iMRI and neuronavigation, were analyzed retrospectively, and the resection extent, complications and prognosis were evaluated.
 Results: Subtotal tumor resection was achieved in 21 patients and partial resection was done in 20 after iMRI scanning...
April 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
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