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Microsurgical Anatomy

Zakir Sakçı, Elif Fidan, Yunus Yaşar, Mehmet Reşid Önen, Hikmet Uluğ, Sait Naderi
No abstract text is available yet for this article.
March 13, 2018: World Neurosurgery
Silky Chotai, Yi Liu, Songtao Qi
The lesions involving cavernous sinus (CS) and lateral sellar region includes tumors, vascular lesions, infection, inflammation, and trauma. Tumors associated with CS cause significant distortion of the microanatomy posing an additional surgical challenge to the neurosurgeons. The surgical approach and microsurgical anatomy with respect to the origin and growth of the tumor within the CS region have not been comprehensively described in recent years. We conducted a review of literature concerning CS and associated tumors, complied through MEDLINE/OVID and using cross-references of articles on PubMed with the keywords cavernous sinus, CS tumors, pituitary adenoma, meningioma, schwannoma, chordoma, CS hemangiomas, extradural, interdural, intradural, skull base, gamma knife radiosurgery, endoscopic endonasal approach...
January 2018: Asian Journal of Neurosurgery
Ali Tayebi Meybodi, Michael T Lawton
Brain arteriovenous malformations (bAVM) are challenging lesions. Part of this challenge stems from the infinite diversity of these lesions regarding shape, location, anatomy, and physiology. This diversity has called on a variety of treatment modalities for these lesions, of which microsurgical resection prevails as the mainstay of treatment. As such, outcome prediction and managing strategy mainly rely on unraveling the nature of these complex tangles and ways each lesion responds to various therapeutic modalities...
February 23, 2018: Journal of Neurosurgical Sciences
Ke Tang, Yaqun Zhao, Xiaodong Yuan
No abstract text is available yet for this article.
February 23, 2018: Journal of Neurosurgery
Roberto Herrera, Héctor Rojas, Ariel Estramian, Julieta Gómez, José Luis Ledesma, José Pablo, Julián Pastore
Background: Craniocervical junction pathology is infrequent in daily neurosurgical practice. In general, most of these lesions are of traumatic or rheumatic origin. Atlantoaxial instability of inflammatory origin (Grisel syndrome) is a rare entity of which only 16 adult cases have been reported in the literature. This pathology is characterized by the development of an osteolytic lesion at the level of the atlantoaxial joint after an infectious event, usually of the upper airways. Case Description: We present the case of a 76-year-old patient who attended our office for clinical symptoms of spinal instability secondary to an osteolytic lesion, with involvement of C1 and C2...
2018: Surgical Neurology International
Toshio Matsushima, Ken Matsushima, Shigeaki Kobayashi, J Richard Lister, Jacques J Morcos
Dr. Albert L. Rhoton Jr. was a pioneer of the study of microneurosurgical anatomy. Championing this field over the past half century, he produced more than 500 publications. In this paper, the authors review his body of work, focusing on approximately 160 original articles authored by Rhoton and his microneuroanatomy fellows. The articles are categorized chronologically into 5 stages: 1) dawn of microneurosurgical anatomy, 2) study of basic anatomy for general neurosurgery, 3) study for skull base surgery, 4) study of the internal structures of the brain by fiber dissection, and 5) surgical anatomy dealing with new advanced surgical approaches...
February 2, 2018: Journal of Neurosurgery
M A Shkarubo, A N Shkarubo, G F Dobrovolsky, G A Polev, I V Chernov, D N Andreev, V V Karnaukhov, K V Koval
INTRODUCTION: Thorough understanding of the central nervous system anatomy is a fundamental part of a neurosurgeon's training. Development of novel neurosurgical approaches and optimization of existing ones directly depend on the comprehensive study of topographic anatomy of the head and neck using cadaveric specimens. Staining the vessels of the arterial and venous systems of a cadaveric specimen aids the detailed understanding of the vascularization of anatomical structures of the brain...
January 22, 2018: World Neurosurgery
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.)
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
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
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
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.)
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
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
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
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
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.)
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.)
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 6-year program. Sixty-four students wore polarized glasses and observed a microsurgical operation through a 3D monitor...
January 2018: World Neurosurgery
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
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