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Microsurgical Anatomy

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https://www.readbyqxmd.com/read/29301049/treatment-of-an-anterior-inferior-cerebellar-artery-aneurysm-with-microsurgical-trapping-and-in-situ-posterior-inferior-cerebellar-artery-to-anterior-inferior-cerebellar-artery-bypass-case-report
#1
Bryan S Lee, Alex M Witek, Nina Z Moore, Mark D Bain
BACKGROUND: Anterior inferior cerebellar artery (AICA) aneurysms are rare lesions whose treatment can involve microsurgical and/or endovascular techniques. Such treatment can be challenging and may carry a significant risk of neurological morbidity. OBJECTIVE: To demonstrate a case involving a complex AICA aneurysm that was treated with a unique microsurgical approach involving trapping the aneurysm and performing in Situ bypass from the posterior inferior cerebellar artery (PICA) to the distal AICA...
December 30, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29258935/low-retrosigmoid-infratonsillar-approach-to-lateral-medullary-lesions
#2
Baran Bozkurt, M Yashar S Kalani, Kaan Yağmurlu, Evgenii Belykh, Mark C Preul, Peter Nakaji, Robert F Spetzler
OBJECTIVE: In our study, we comprehensively detail the technique of the low retrosigmoid approach to the lateral medullary area, including the inferior cerebellar peduncle, postolivary sulcus, pontomedullary sulcus, and inferior olivary nucleus, as well as the lateral recess of the fourth ventricle. METHODS: Four formalin-fixed, silicone-injected, cadaveric human heads were examined under the operating microscope to demonstrate the pertinent descriptive anatomy using the low retrosigmoid approach in a stepwise manner...
December 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29166460/microsurgical-treatment-of-basilar-tip-aneurysms-is-it-still-acceptable
#3
Felix Hendrik Pahl, Matheus Fernandes de Oliveira, José Marcus Rotta
OBJECTIVE: Basilar tip aneurysms (BTAs) have a complex anatomy, making them difficult to treat. We describe our surgical results for BTAs. METHODS: From 2004 to 2015 (12 years), a total of 25 small BTAs and two giant BTAs were treated in the Hospital do Servidor Público Estadual de São Paulo. RESULTS: In 23 patients harboring aneurysms positioned anteriorly or straight, all aneurysms were clipped (complete exclusion in all on follow-up angiography)...
October 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/29166425/anatomy-of-the-sphenopalatine-artery-and-its-implications-for-transnasal-neurosurgery
#4
M Eordogh, A Grimm, I Gawish, L Patonay, R Reisch, H R Briner, G Baksa
BACKGROUND: The knowledge of sinonasal vasculature is inevitable in transnasal neurosurgery. We performed an anatomical study on the sphenopalatine artery from the perspective of skull base procedures. METHODOLOGY: To analyse the anatomical landmarks of the sphenopalatine artery, arterial skull corrosion casts (26 head halves) underwent endoscopic transnasal phantom surgery. Furthermore, we performed microsurgical dissection on formaldehyde-fixated cadavers with arterial perfusion (14 head halves) as well as studied Cone Beam CT-scans of anonymised patients and cadavers (115 head sides)...
November 22, 2017: Rhinology
https://www.readbyqxmd.com/read/29165672/trans-sylvian-approach-to-microvascular-decompression-for-trigeminal-neuralgia-in-syndromic-cranial-base-settling
#5
Mrityunjoy Sarkar, Ashok Pillai
BACKGROUND AND IMPORTANCE: The lateral suboccipital approach for microvascular decompression (MVD) of the trigeminal nerve has become a standard-of-care over the past several decades. Syndromic cranial base settling, a rare but known cause for trigeminal neuralgia (TN), poses significant dilemmas in clinical management. In such cases, distorted anatomy may render surgery via the suboccipital approach difficult or even impossible. CLINICAL PRESENTATION: A 34-yr-old male with osteogenesis imperfecta and severe basilar invagination suffered from TN that was refractory to medication and stereotactic radiosurgery...
November 18, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29148902/microsurgical-anatomy-and-approaches-around-the-lateral-recess-with-special-reference-to-entry-into-the-pons
#6
Osamu Akiyama, Ken Matsushima, Maximiliano Nunez, Satoshi Matsuo, Akihide Kondo, Hajime Arai, Albert L Rhoton, Toshio Matsushima
OBJECTIVE The lateral recess is a unique structure communicating between the ventricle and cistern, which is exposed when treating lesions involving the fourth ventricle and the brainstem with surgical approaches such as the transcerebellomedullary fissure approach. In this study, the authors examined the microsurgical anatomy around the lateral recess, including the fiber tracts, and analyzed their findings with respect to surgical exposure of the lateral recess and entry into the lower pons. METHODS Ten cadaveric heads were examined with microsurgical techniques, and 2 heads were examined with fiber dissection to clarify the anatomy between the lateral recess and adjacent structures...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29068930/lymphatic-territories-lymphosomes-in-the-rat-an-anatomical-study-for-future-lymphatic-research
#7
Hiroo Suami, Mario F Scaglioni
BACKGROUND: Understanding the precise anatomy in experimental animals is crucial for correct design of research projects. Rats are commonly used for scientific research in plastic surgery because of their availability in academic institutions, moderate cost, and sizable vessels for microsurgical procedures. In past publications about rat anatomy, lymphatic mapping has been limited and incomplete. The aim of this study was to comprehensively map the superficial lymphatic system in the rat...
November 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29053071/prevention-of-postoperative-visual-field-defect-after-the-occipital-transtentorial-approach-anatomical-study
#8
Satoshi Matsuo, Serhat Baydin, Abuzer Güngör, Erik H Middlebrooks, Noritaka Komune, Koji Iihara, Albert L Rhoton
OBJECTIVE A postoperative visual field defect resulting from damage to the occipital lobe during surgery is a unique complication of the occipital transtentorial approach. Though the association between patient position and this complication is well investigated, preventing the complication remains a challenge. To define the area of the occipital lobe in which retraction is least harmful, the surface anatomy of the brain, course of the optic radiations, and microsurgical anatomy of the occipital transtentorial approach were examined...
October 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28985669/establishment-of-next-generation-neurosurgery-research-and-training-laboratory-with-integrated-human-performance-monitoring
#9
Antonio Bernardo
Quality of neurosurgical care and patient outcomes are inextricably linked to surgical and technical proficiency and a thorough working knowledge of microsurgical anatomy. Neurosurgical laboratory-based cadaveric training is essential for the development and refinement of technical skills before their use on a living patient. Recent biotechnological advances including 3-dimensional (3D) microscopy and endoscopy, 3D printing, virtual reality, surgical simulation, surgical robotics, and advanced neuroimaging have proved to reduce the learning curve, improve conceptual understanding of complex anatomy, and enhance visuospatial skills in neurosurgical training...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28973523/endoscopic-approach-of-the-insula-through-the-anterior-middle-temporal-gyrus-a-feasibility-study-in-the-laboratory
#10
Francesco Corrivetti, Sébastien Froelich, Emmanuel Mandonnet
BACKGROUND: Insular glioma surgery still represents a challenge. Nonetheless, advances in microsurgical anatomy and brain mapping techniques have allowed an increase in the extent of resection with acceptable morbidity rates. Transsylvian and transcortical approaches constitute the main surgical corridors, the latter providing considerable advantages and a high degree of reliability. Nevertheless, both surgical corridors yield remarkable difficulties in reaching the most posterior insular region...
July 25, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28973522/variations-of-occipital-artery-posterior-inferior-cerebellar-artery-bypass-anatomic-consideration
#11
Ken Matsushima, Satoshi Matsuo, Noritaka Komune, Michihiro Kohno, J Richard Lister
BACKGROUND: Advances in diagnosis of posterior inferior cerebellar artery (PICA) aneurysms have revealed the high frequency of distal and/or dissecting PICA aneurysms. Surgical treatment of such aneurysms often requires revascularization of the PICA including but not limited to its caudal loop. OBJECTIVE: To examine the microsurgical anatomy involved in occipital artery (OA)-PICA anastomosis at various anatomic segments of the PICA. METHODS: Twenty-eight PICAs in 15 cadaveric heads were examined with the operating microscope to take morphometric measurements and explore the specific anatomy of bypass procedures...
July 7, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28958929/effectiveness-of-the-3d-monitor-system-for-medical-education-during-neurosurgical-operation
#12
Masahiko Wanibuchi, Katsuya Komatsu, Yukinori Akiyama, Takeshi Mikami, Nobuhiro Mikuni
BACKGROUND: Three-dimensional (3D) graphics are used in the medical field, especially during surgery. Although 3D monitoring is useful for medical education, its effectiveness needs to be objectively evaluated. The aim of this study was to investigate the efficacy of 3D monitoring in the surgical education of medical students. METHODS: A questionnaire on high-definition 3D monitoring was given to fifth-year medical students in a six-year program. Sixty-four students wore polarized glasses and observed a microsurgical operation through a 3D monitor...
September 25, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28945853/dr-albert-l-rhoton-jr-s-time-at-the-mayo-clinic-the-beginnings-of-a-remarkable-career
#13
Tarek Rayan, Matthew L Carlson, David G Piepgras, Michael J Link, Jamie J Van Gompel
Dr Albert L. Rhoton Jr became the focal point of neurosurgery's evolution in understanding the intricate and complex microanatomy of the human brain over the last 4 decades. His pioneering work on cadaveric specimens proved to be a pivotal endeavor in the pursuit to better understand the complex microsurgical anatomy of cranial surgery. This paper details his early career at the Mayo Clinic in Rochester, Minnesota. A comprehensive review and synthesis of data acquired from the institutional historical archives including the Annual Reports to the Executive Committee, the Reports to the Board of Directors, the MAYOVOX Newsletter, the illustration archives of the Mayo Clinic Division of Creative Media, staff biographies, curriculum vitae, personal interviews, as well as full-text journal articles, and book publications was performed...
August 9, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28931254/cavernomas-and-arteriovenous-malformations-in-the-mesial-temporal-region-microsurgical-anatomy-and-approaches
#14
Alvaro Campero, Pablo Ajler, Carlos Rica, Albert Rhoton
BACKGROUND: The mesial temporal region (MTR) is located deep in the temporal lobe and it is surrounded by important vascular and nervous structures that should be preserved during surgery. OBJECTIVE: To describe microsurgical anatomy and approaches to the MTR in relation to cavernomas and arteriovenous malformations (AVMs). METHODS: Five formalin-fixed and red silicone-embedded heads of adult cadavers were used for this study. Between January 2003 and June 2014, 7 patients with cavernomas and 6 patients with AVMs in the MTR underwent surgery...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28927223/microsurgical-anatomy-and-the-effects-of-gravity-retraction-with-the-supracerebellar-infratentorial-approach-two-companion-cases-3-dimensional-operative-video
#15
Omar Choudhri, Michael T Lawton
No abstract text is available yet for this article.
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28922882/microsurgical-anatomy-of-the-interfascial-vein-its-significance-in-the-interfascial-dissection-of-the-pterional-approach
#16
Alvaro Campero, Pablo Ajler, Martín Paíz, Ramiro López Elizalde
BACKGROUND: The pterional approach (PA), together with its variants, is still one of the most common methods used by surgeons to reach the anterior and middle cranial base. A highly important technical detail during a PA is the preservation of the frontotemporal branch of the facial nerve, which can be achieved through an interfascial dissection. OBJECTIVE: To describe the anatomy of the interfascial vein (IFV), highlighting its recognition as a significant anatomic reference to perform an interfascial dissection (IFD)...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28919562/operative-management-of-distal-anterior-cerebral-artery-aneurysms-through-a-mini-anterior-interhemispheric-approach
#17
Alejandro Monroy, Edgar Nathal, Albert L Rhoton
BACKGROUND: Distal anterior cerebral artery (DACA) aneurysms, also referred to as pericallosal artery aneurysms, are present in 1.5 to 9% of all intracranial aneurysms. This study aims to describe the importance of the microsurgical anatomy of the DACA and demonstrate the surgical nuances for handling DACA aneurysms, with a minimally invasive surgical technique METHODS: We retrospectively and descriptively analyzed a series of aneurysm cases performed at the National Institute of Neurology and Neurosurgery-Mexico City...
September 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28879904/a-neurosurgical-perspective-to-approaches-to-the-orbit-a-cadaveric-study
#18
S Balaji Pai, M N Nagarjun
Neurosurgeons are getting increasingly involved in surgery for orbital tumours. The various approaches to the orbit can be challenging. The authors have demonstrated on cadavers the various approaches to the orbit which are required to be mastered by the neurosurgeon. The superior approaches which include the transcranial, supraorbital and the hybrid approaches are the most commonly utilized surgical approaches by the neurosurgeon for excision of orbital pathologies. The lateral orbitotomy is an elegant approach for excision of the tumours lateral to the optic Nerve and lacrimal gland tumours...
September 2017: Neurology India
https://www.readbyqxmd.com/read/28879421/the-history-of-rhoton-s-lab
#19
REVIEW
Toshio Matsushima, J Richard Lister, Ken Matsushima, Evandro de Oliveira, Erdener Timurkaynak, David A Peace, Shigeaki Kobayashi
The work performed in Dr. Rhoton's Lab, represented by over 500 publications on microneurosurgical anatomy, greatly contributed to improving the level of neurosurgical treatment throughout the world. The authors reviewed the development and activities of the Lab over 40 years. Dr. Albert L. Rhoton Jr., the founder of, and leader in, this field, displayed great creativity and ingenuity during his life. He devoted himself to perfecting his study methodology, employing high-definition photos and slides to enhance the quality of his published papers...
September 6, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28868200/the-open-access-video-collection-project-hernesniemi-s-1001-and-more-microsurgical-videos-of-neurosurgery-a-legacy-for-educational-purposes
#20
Joham Choque-Velasquez, Danil A Kozyrev, Roberto Colasanti, Peeraphong Thiarawat, Patcharin Intarakhao, Behnam Rezai Jahromi, Juha Hernesniemi
BACKGROUND: Neurosurgical educational programs and courses are helpful to improve the quality of training. Moreover, nowadays, online activities may represent a very useful tool to globally enhance neurosurgical education. The "Hernesniemi's 1001 and more microneurosurgical videos" project aims to show the microsurgical style developed by the senior author and his TEAMs in more than 40 years of experience. METHODS: More than 1100 high-definition videos of microneurosurgical operations performed by the senior author were carefully edited...
2017: Surgical Neurology International
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