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Microsurgical Anatomy

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https://www.readbyqxmd.com/read/28217397/a5-segment-aneurysm-of-the-anterior-cerebral-artery-imbedded-into-the-body-of-the-corpus-callosum-a-case-report
#1
Fransua Sharafeddin, Ahmad Hafez, Martin Lehecka, Rahul Raj, Roberto Colasanti, Ahmadreza Rafiei, Joham Choque, Behnam R Jahromi, Mika Niemelä, Juha Hernesniemi
BACKGROUND: The A5 segment aneurysms of the anterior cerebral artery are rare, approximately 0.5% of all intracranial aneurysms. They are small with a wide base located in the midline, with the domes mostly projecting upward or backward. CASE DESCRIPTION: The authors describe a unique case of A5 segment aneurysm, with the dome embedded into the body of the corpus callosum. This 41-year-old female was admitted to the neurology department for possible multiple sclerosis investigation...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28191601/the-maxillary-artery-and-its-variants-an-anatomical-study-with-neurosurgical-applications
#2
Jorge E Alvernia, Joaquin Hidalgo, Marc P Sindou, Chad Washington, Gustavo Luzardo, Eddie Perkins, Remi Nader, Patrick Mertens
BACKGROUND: The maxillary artery (MA) has gained attention in neurosurgery particularly in cerebral revascularization techniques, intracranial endonasal approaches and endovascular procedures. OBJECTIVES: To describe and illustrate the anatomy of the MA and its neurosurgical importance in a detailed manner. METHODS: Six cadaveric heads (12 MAs) were injected with latex. The arteries and surrounding structures were dissected and studied using microsurgical techniques...
February 13, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28186451/techniques-and-outcomes-of-microsurgical-management-of-ruptured-and-unruptured-fusiform-cerebral-aneurysms
#3
Sam Safavi-Abbasi, M Yashar S Kalani, Ben Frock, Hai Sun, Kaan Yagmurlu, Felix Moron, Laura A Snyder, Randy J Hlubek, Joseph M Zabramski, Peter Nakaji, Robert F Spetzler
OBJECTIVE Fusiform cerebral aneurysms represent a small portion of intracranial aneurysms; differ in natural history, anatomy, and pathology; and can be difficult to treat compared with saccular aneurysms. The purpose of this study was to examine the techniques of treatment of ruptured and unruptured fusiform intracranial aneurysms and patient outcomes. METHODS In 45 patients with fusiform aneurysms, the authors retrospectively reviewed the presentation, location, and shape of the aneurysm; the microsurgical technique; the outcome at discharge and last follow-up; and the change in the aneurysm at last angiographic follow-up...
February 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28175514/356%C3%A2-microsurgical-anatomy-of-the-brainstem-safe-entry-zones-a-cadaveric-study-with-high-resolution-magnetic-resonance-imaging-and-fiber-tracking
#4
Debraj Mukherjee, Veysel Antar, Bora Gurer, Ulas Cikla, Gabriel Neves, Mehmet Ekici, Tomer Hananya, Aaron S Field, Shahriar M Salamat, Mustafa Kemal Baskaya
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
https://www.readbyqxmd.com/read/28160906/thumb-reconstruction-with-thin-proximal-ulnar-perforator-free-flap
#5
REVIEW
Mario Cherubino, Martina Corno, Luigi Valdatta, Roberto Adani
Soft tissue defects of the thumb with exposure of tendons, periosteum, or neurovascular bundles require a complex reconstruction aimed at restoring both skin coverage and the essential function of pinching and manipulation. When large defects are involved, a free tissue transfer is indicated. The proximal ulnar perforator flap represents an interesting solution without the drawbacks of other more widespread free flaps. This report describes the case of a patient with a squamous cell carcinoma of the thumb that required circumferential resection of the soft tissue of the distal phalanx and the interphalangeal joint...
February 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28137542/developing-the-first-highly-specialized-neurosurgical-center-of-excellence-in-trujillo-peru-work-in-progress-first-four-months-results
#6
Joham Choque-Velasquez, Roberto Colasanti, Virginia Baffigo-Torre, Luisa Estela Sacieta-Carbajo, Jacqueline Olivari-Heredia, Yolanda Falcon-Lizaraso, Juan Huber Mallma-Torres, Humberto Elera-Florez, Juha Hernesniemi
BACKGROUND: Economic, cultural, and geographical reasons usually limit the access to specialized health centers in developing countries, especially in rural areas. Peruvian health system indicators still highlight significant unmet clinical need for neurosurgical patients. Our project is to develop the first highly specialized neurosurgical center in the EsSalud hospital of Trujillo, with the goal to improve the treatment of neurosurgical diseases in that region, thus optimizing their outcomes while decreasing expensive and risky patients transfer to the neurosurgical departments in the capital district...
January 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28109859/microsurgical-anatomy-of-the-hypoglossal-and-c1-nerves-description-of-a-previously-undescribed-branch-to-the-atlanto-occipital-joint
#7
Joe Iwanaga, Christian Fisahn, Fernando Alonso, Daniel DiLorenzo, Peter Grunert, Matthew T Kline, Koichi Watanabe, Rod J Oskouian, Robert J Spinner, R Shane Tubbs
OBJECTIVE: Distal branches of the C1 nerve that travel with the hypoglossal nerve have been well investigated but relationships of C1 and the hypoglossal nerve near the skull base have not been described in detail. Therefore, the aim of this study was to investigate these small branches of the hypoglossal and first cervical nerves by anatomical dissection. METHODS: Twelve sides from six cadaveric specimens were used in this study. To elucidate the relationship among the hypoglossal, vagus, and first and cervical nerve, the mandible was removed and these nerves were dissected under the surgical microscope...
January 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28049512/a-stab-wound-to-the-axilla-illustrating-the-importance-of-brachial-plexus-anatomy-in-an-emergency-context-a-case-report
#8
Diogo Casal, Teresa Cunha, Diogo Pais, Inês Iria, Maria Angélica-Almeida, Gerardo Millan, José Videira-Castro, João Goyri-O'Neill
BACKGROUND: Although open injuries involving the brachial plexus are relatively uncommon, they can lead to permanent disability and even be life threatening if accompanied by vascular damage. We present a case report of a brachial plexus injury in which the urgency of the situation precluded the use of any ancillary diagnostic examinations and forced a rapid clinical assessment. CASE PRESENTATION: We report a case of a Portuguese man who had a stabbing injury at the base of his left axilla...
January 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28039506/microsurgical-anatomy-of-branches-of-musculocutaneous-nerve-clinical-relevance-for-spastic-elbow-surgery
#9
C Thieffry, L Chenin, P Foulon, E Havet, J Peltier
PURPOSE: The neurotomy of musculocutaneous nerve is a treatment for patients who suffer from spastic elbow flexion when medical and reeducative treatments have failed. It consists in sectioning motor branches of musculocutaneous nerve which are destined to the biceps brachii and brachialis muscles, both being the main elbow flexor muscles. The aim of this study was to analyse the distance, where each motor branch arises from the musculocutaneous nerve to both biceps brachii and brachialis muscles, to establish precisely the localisation and length of the necessary incision to reach its branches for surgery...
December 30, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28024974/dual-image-videoangiography-during-intracranial-microvascular-surgery
#10
Alberto Feletti, Xiangdong Wang, Riki Tanaka, Yasuhiro Yamada, Daisuke Suyama, Tsukasa Kawase, Hirotoshi Sano, Yoko Kato
OBJECTIVE: Indocyanine-green videoangiography (ICG-VA) is a precious tool to assess vessels and aneurysm patency during neurovascular surgical procedures. However, ICG-VA highlights vascular structures, which appear white over a black background. Therefore, anatomical relations are sometimes not easy to understand at first glance. The recently developed dual-image videoangiography (DIVA) enables the simultaneous visualization of both light and near-infrared (NIR) fluorescence images of ICG-VA...
December 23, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28017747/complications-and-their-managements-of-large-intracranial-vestibular-schwannoma-via-retrosigmoid-approach
#11
Xiang Huang, Ming Xu, Jian Xu, Liangfu Zhou, Ping Zhong, Mingyu Chen, Kaiyuan Ji, Huiyu Chen, Ying Mao
OBJECTIVE: To investigate the common complications from the microsurgical treatment of large intracranial vestibular schwannoma (VS) via suboccipital retrosigmoid approach and to propose strategies for minimizing such complications. METHODS: We selected all large unilateral VS patients from the collected database (1999-2013) who underwent microsurgical resection as their initial treatment for histopathologically confirmed VS. Tumors larger than 30 x 20 mm were defined as large...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27986388/-3d-anatomy-of-cerebellar-peduncles-based-on-fibre-microdissection-and-a-demonstration-with-tractography
#12
Ruben Rodríguez-Mena, José Piquer-Belloch, José Luis Llácer-Ortega, Pedro Riesgo-Suárez, Vicente Rovira-Lillo
OBJECTIVE: To perform an anatomical and radiological study, using fibre microdissection and diffusion tensor tractography (DTT), to demonstrate the three-dimensionality of the superior, middle and inferior cerebellar peduncles. MATERIAL AND METHODS: A total of 15 brain-stem, 15 cerebellar hemispheres, and 5 brain hemispheres were dissected in the laboratory under the operating microscope with microsurgical instruments between July 2014 and July 2015. Brain magnetic resonance imaging was obtained from 15 healthy subjects between July and December of 2015, using diffusion-weighted images, in order to reproduce the cerebellar peduncles on DTT...
December 13, 2016: Neurocirugía
https://www.readbyqxmd.com/read/27973959/three-dimensional-digitalized-virtual-planning-for-saphenous-artery-flap-a-pilot-study
#13
Yuan Z Zhang, Shu Z Wen, Hui Q Zhang, Ya G Li, Jian M Zhao, Yong Yang
OBJECTIVE: Since the 1970s, research and applications on flap and muscle flap had solved many problems in microsurgical reconstruction. However, the traditional flap design is completely dependent on two-dimensional (2D) images. The purpose of this study was to discuss the methods in the visualization of saphenous artery flap by digitalized technique and its applications by digitalized technique. METHODS: Two adult fresh cadaver specimens, one male and one female, were subject to radiographic computerized tomography (CT) scanning before and after perfused with lead oxide-gelatine mixture, whose collimation are 0...
December 2016: Comput Assist Surg (Abingdon)
https://www.readbyqxmd.com/read/27867120/transforaminal-resection-of-cervical-dumbbell-schwannomas-in-patients-with-additional-tumors
#14
Ji Zhang, Xiang-Heng Zhang, Zi-Feng Wang, You-Ping Li, Zheng-Quan Zhu, Ji-Cheng Sun, Zheng-He Chen, Shao-Yong Wu, Ke Sai, Jian Wang, Yong-Gao Mou, Zhong-Ping Chen
BACKGROUND: It is rare for 2 primary tumors to occur simultaneously in a patient. Management of cervical dumbbell schwannomas (CDSs) with concurrent tumors (CTs) requires a specific neurosurgical strategy. The primary objective of this study is to investigate surgical strategies for CDSs with CTs while preserving as much of the mechanically relevant bone structures as possible. METHODS: Twelve patients with concurrent CTs and CDSs were identified from 3 medical centers...
November 17, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27859787/microsurgical-anatomy-of-the-oculomotor-nerve
#15
REVIEW
Hae Kwan Park, Hyung Keun Rha, Kyung Jin Lee, Chung Kee Chough, Wonil Joo
The oculomotor nerve supplies the extraocular muscles. It also supplies the ciliary and sphincter pupillae muscles through the ciliary ganglion. The nerve fibers leave the midbrain through the most medial part of the cerebral peduncle and enter the interpeduncular cistern. After the oculomotor nerve emerges from the interpeduncular fossa, it enters the cavernous sinus slightly lateral and anterior to the dorsum sellae. It enters the orbit through the superior orbital fissure, after exiting the cavernous sinus, to innervate the extraocular muscles...
January 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/27715436/midline-and-off-midline-infratentorial-supracerebellar-approaches-to-the-pineal-gland
#16
Satoshi Matsuo, Serhat Baydin, Abuzer Güngör, Koichi Miki, Noritaka Komune, Ryota Kurogi, Koji Iihara, Albert L Rhoton
OBJECTIVE A common approach to lesions of the pineal region is along the midline below the torcula. However, reports of how shifting the approach off midline affects the surgical exposure and relationships between the tributaries of the vein of Galen are limited. The purpose of this study is to examine the microsurgical and endoscopic anatomy of the pineal region as seen through the supracerebellar infratentorial approaches, including midline, paramedian, lateral, and far-lateral routes. METHODS The quadrigeminal cisterns of 8 formalin-fixed adult cadaveric heads were dissected and examined with the aid of a surgical microscope and straight endoscope...
October 7, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27685096/visualization-of-vascular-and-parenchymal-regeneration-after-70-partial-hepatectomy-in-normal-mice
#17
Chichi Xie, Weiwei Wei, Andrea Schenk, Lars Ole Schwen, Sara Zafarnia, Michael Schwier, Felix Gremse, Isabel Jank, Olaf Dirsch, Uta Dahmen
A modified silicone injection procedure was used for visualization of the hepatic vascular tree. This procedure consisted of in-vivo injection of the silicone compound, via a 26 G catheter, into the portal or hepatic vein. After silicone injection, organs were explanted and prepared for ex-vivo micro-CT (µCT) scanning. The silicone injection procedure is technically challenging. Achieving a successful outcome requires extensive microsurgical experience from the surgeon. One of the challenges of this procedure involves determining the adequate perfusion rate for the silicone compound...
September 13, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27677522/the-paramedian-supracerebellar-transtentorial-approach-to-the-posterior-fusiform-gyrus
#18
Anthony M T Chau, Filippo Gagliardi, Adam Smith, Nicholas R Pelzer, Fiona Stewart, Pietro Mortini, Samer K Elbabaa, Anthony J Caputy, Cristian Gragnaniello
BACKGROUND: The posterior fusiform gyrus lies in a surgically challenging region. Several approaches have been described to access this anatomical area. The paramedian supracerebellar transtentorial (SCTT) approach benefits from minimal disruption of normal neurovascular tissue. The aim of this study was to demonstrate its application to access the posterior fusiform gyrus. METHODS: Three brains and six cadaveric heads were examined. A stepwise dissection of the SCTT approach to the posterior fusiform gyrus was performed...
November 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27667106/-microsurgery-treatment-of-midline-deep-brain-lesions-clinical-analysis-of-25-cases
#19
G Chen, W W Zhai, Z Q Yu
Objective: To explore experience and methods in the microsurgical treatment of midline deep brain lesions. Methods: The clinical data of patients with midline deep brain lesions were retrospectively analyzed. The clinical manifestation, imaging findings, lesion locations, surgical procedures, pathological diagnosis and follow-up results were summarized and analyzed. All the lesions were located deeply in the brain midline: corpus callosum (n=1), thalamus and basal ganglia (n=6), lateral ventricle (n=4), the third ventricle (n=2), pineal region (n=8), brainstem and fourth ventricle region (n=4)...
September 13, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27651974/successful-deep-inferior-epigastric-perforator-flap-harvest-despite-preoperative-therapeutic-subcutaneous-heparin-administration-into-the-abdominal-pannus
#20
Joseph W Duncumb, Kana Miyagi, Parto Forouhi, Charles M Malata
Abdominal free flaps for microsurgical breast reconstruction are most commonly harvested based on the deep inferior epigastric vessels that supply skin and fat via perforators through the rectus muscle and sheath. Intact perforator anatomy and connections are vital for subsequent optimal flap perfusion and avoidance of necrosis, be it partial or total. The intraflap vessels are delicate and easily damaged and it is generally advised that patients should avoid heparin injection into the abdominal pannus preoperatively as this may compromise the vascular perforators through direct needle laceration, pressure from bruising, haematoma formation, or perforator thrombosis secondary to external compression...
2016: Case Reports in Surgery
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