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https://www.readbyqxmd.com/read/29770250/the-usefulness-of-indocyanine-green-during-surgery-for-hypervascular-posterior-fossa-tumors
#1
Takahiro Shinya, Hideki Nagamine, Ken-Ichi Sugawara, Shogo Ishiuchi
Background: Cerebral hemangioblastomas are benign tumors with abundant blood flow that occur mainly in the posterior fossa. Tumor removal en bloc is important in surgical treatment because of the risk of bleeding; however, it is actually rather difficult in practice. Therefore, we propose a surgical strategy for visualizing hypervascular tumors of the posterior fossa utilizing indocyanine green (ICG). Case Description: Case 1 involved a 48-year-old male with a history of von Hippel-Lindau (VHL) disease...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29685409/less-is-more-parahippocampal-resection-or-endoscopic-assistance-in-ambient-cistern-surgery-qualitative-and-quantitative-assessment-of-subtemporal-approach
#2
Leonardo C Welling, Eberval Gadelha Figueiredo, Peter Nakaji, Mariana S Welling, Marcelo D Schafranski, Manoel Jacobsen Teixeira, Robert F Spetzler, Mark C Preul
The ambient cistern is an arachnoid complex that extends from the crural cistern to lateral border of cerebral colliculi. The subtemporal approach has been recognized as the best access to reach pathologies in the ambient cistern, however many disadvantages exist. The present work aims to analyze quantitatively the area of exposure provided by the subtemporal access. The objective is to evaluate if there are advantages of using the neuroendoscope in conventional subtemporal access when compared to the subtemporal access with resection of the parahippocampal gyrus...
April 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29649020/autologous-bone-flap-resorption-years-after-subtemporal-craniotomy
#3
John Oladapo Obafunwa, Emily Hammerl, David Jaskierny, Livia Taylor, Lynette Russell, Karl Reinhard
In Spring of 2012, the partially undressed and skeletonized remains of a homeless adult Hispanic male was found in a fairly open wooded area in Nebraska. The remains showed evidence of extensive pathologies, which included healed traumas and surgeries. Examination of the decedent's medical records revealed that he had a history of kidney and liver problems, alcohol abuse, several traumas including a major head injury that necessitated a craniotomy, and radiological features of neurocysticercosis. The autologous bone flap, which was replaced after the craniotomy, had resorbed significantly away from the edges of the injury...
April 11, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29618068/occipital-artery-to-posterior-cerebral-artery-bypass-using-descending-branch-of-the-lateral-circumflex-femoral-artery-graft-for-treatment-of-fusiform-unruptured-posterior-cerebral-artery-aneurysm-3-dimensional-operative-video
#4
Kristine Ravina, Ian A Buchanan, Robert C Rennert, Ben A Strickland, Joseph N Carey, Jonathan J Russin
Posterior cerebral artery (PCA) aneurysms can be technically challenging lesions due to the intricacy of perforating branches and the relationship to cranial nerves and the brainstem. Fusiform aneurysms of the perimesencephalic segment of the PCA are a rare finding which does not favor direct clip occlusion or reconstruction. In such cases, proximal parent vessel occlusion is an option for aneurysm treatment. Extracranial-intracranial (EC-IC) bypass can be used to revascularize beyond the lesion when considering proximal occlusion...
April 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29614354/bony-dehiscence-of-the-horizontal-petrous-ica-canal-an-anatomic-study-with-surgical-implications
#5
Alexander Spiessberger, Fabian Baumann, Karl Friedrich Kothbauer, Mohammed Aref, Serge Marbacher, Javier Fandino, Edin Nevzati
OBJECTIVE: The cervical carotid segment is routinely used as donor site for high flow bypass procedures. The horizontal petrous segment would offer a shorter graft distance, complete graft protection intracranially and avoid the need for surgical neck exposure. In a morphometric cadaveric study we aim to investigate variations of the petrous carotid anatomy, especially the incidence of bony dehiscence of the roof of the horizontal petrous carotid segment canal, which may facilitate exposure of the vessel and thereby potentially lower the morbidity of high flow bypass procedures...
March 31, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29602006/microsurgical-clipping-of-basilar-apex-aneurysms-a-systematic-historical-review-of-approaches-and-their-results
#6
REVIEW
Spiessberger Alexander, Strange Fabio, Fandino Javier, Marbacher Serge
OBJECTIVE: Neck clipping remains a valuable treatment option for basilar apex aneurysms, especially in those with complex morphology, such as incorporation of branching vessels or large size, and young patient age. A number of approaches have proven to give effective exposure for various types of lesion morphologies. Our historic literature review from 1976 to the present systematically compares the outcomes and complications of the key surgical approaches in the treatment of basilar apex aneurysms...
March 27, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29551719/the-tentorial-bridge-to-deep-skull-base-exposure-anatomical-morphometric-study
#7
Ciro A Vasquez, John Thompson, A Samy Youssef
BACKGROUND: Skull base surgeons have adopted splitting the tentorium in order to expand the exposure, minimize brain retraction and combine the supra and infratentorial compartments for resection of large skull base lesions. OBJECTIVE: To describe stepwise techniques for splitting the tentorium to access deeply located skull base lesions and morphometrically assess the gained exposure. METHODS: Surgical exposure was performed through a transylvian, subtemporal, posterior transpetrosal and combined posterior supra/infratentorial - trans-sinus approach...
March 15, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29401427/increasing-the-time-resolution-of-single-molecule-experiments-with-bayesian-inference
#8
Colin D Kinz-Thompson, Ruben L Gonzalez
Many time-resolved single-molecule biophysics experiments seek to characterize the kinetics of biomolecular systems exhibiting dynamics that challenge the time resolution of the given technique. Here, we present a general, computational approach to this problem that employs Bayesian inference to learn the underlying dynamics of such systems, even when they are much faster than the time resolution of the experimental technique being used. By accurately and precisely inferring rate constants, our Bayesian inference for the analysis of subtemporal resolution dynamics approach effectively enables the experimenter to super-resolve the poorly resolved dynamics that are present in their data...
January 23, 2018: Biophysical Journal
https://www.readbyqxmd.com/read/29351686/basilar-artery-ectasia-causing-trigeminal-neuralgia-an-evolved-technique-of-transpositional-suture-pexy
#9
Harminder Singh, Harley Brito da Silva, Mehdi Zeinalizadeh, Turki Elarjani, David Straus, Laligam N Sekhar
BACKGROUND: Microvascular decompression for patients with trigeminal neuralgia (TGN) is widely accepted as one of the modalities of treatment. The standard approach has been retrosigmoid suboccipital craniotomy with placement of a Teflon pledget to cushion the trigeminal nerve from the offending artery, or cauterize and divide the offending vein(s). However, in cases of severe compression caused by a large artery, the standard decompression technique may not be effective. OBJECTIVE: To describe a unique technique of vasculopexy of the ectatic basilar artery to the tentorium in a patient with TGN attributed to a severely ectatic and tortuous basilar artery...
February 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29288394/endoscopic-transorbital-route-to-the-petrous-apex-a-feasibility-anatomic-study
#10
Alberto Di Somma, Norberto Andaluz, Luigi Maria Cavallo, Thomaz E Topczewski, Federico Frio, Rosa Maria Gerardi, Jose Pineda, Domenico Solari, Joaquim Enseñat, Alberto Prats-Galino, Paolo Cappabianca
BACKGROUND: While the subtemporal approach represents the surgical module milestone designed to reach the petrous apex, a novel ventral route, which is the superior eyelid endoscopic transorbital approach, has been proposed to access the skull base. Accordingly, we aimed to evaluate the feasibility of this route to the petrous apex, providing a qualitative and quantitative analysis of this relatively novel pathway. METHODS: Five human cadaveric heads were dissected at the Laboratory of Surgical NeuroAnatomy of the University of Barcelona...
April 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29281055/resection-of-a-midbrain-cavernous-malformation-via-far-posterior-subtemporal-approach-to-the-dorsolateral-brainstem-2-dimensional-operative-video
#11
Abdulrahman Y Alturki, Alejandro Enriquez-Marulanda, Ajith J Thomas, Christopher S Ogilvy
No abstract text is available yet for this article.
December 21, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29273691/neuropsychological-outcome-after-subtemporal-versus-transsylvian-approach-for-selective-amygdalohippocampectomy-in-patients-with-mesial-temporal-lobe-epilepsy-a-randomised-prospective-clinical-trial
#12
Viola Lara Vogt, Daniel Delev, Alexander Grote, Johannes Schramm, Marec von Lehe, Christian Erich Elger, Juri-Alexander Witt, Christoph Helmstaedter
OBJECTIVE: To compare the effects of different surgical approaches for selective amygdalohippocampectomy in patients with pharmacoresistant mesial temporal lobe epilepsy with regard to the neuropsychological outcome and to replicate an earlier study employing a matched-pair design. METHOD: 47 patients were randomised to subtemporal versus transsylvian approaches. Memory, language, attentional and executive functions were assessed before and 1 year after surgery...
December 22, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29191541/subtemporal-interdural-surgical-approach-for-giant-facial-nerve-neurinomas
#13
Atul Goel, Shashi Ranjan, Abhidha Shah, Survendra Rai, Sandeep Gore, Pralhad Dharurkar
OBJECTIVE: The management issues of 15 cases of giant and dumbbell-shaped facial neurinomas that extended both in the middle and posterior cranial fossa are reported. MATERIAL AND METHODS: During the period 2002 to June 2017, we surgically treated 15 cases of giant and dumbbell shaped facial neurinomas: 10 males and 5 females ranging from 17-59 years (average 34.2 years). Average duration of facial nerve weakness before seeking surgical relief was 49.46 months. Fourteen patients had varying degrees of hearing disturbance...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29121249/surgical-management-of-anterolateral-and-posteromedial-incisural-tentorial-meningioma
#14
Andrea Talacchi, Antonio Biroli, Stefano Medaglia, Francesca Locatelli, Mario Meglio
BACKGROUND: Tentorial meningiomas are a broad and consistent category of tumors but their definition is still unclear and their classification uncertain. OBJECTIVE: To report the clinical and surgical characteristics of tentorial hiatus meningiomas based on a revised classification of tentorial meningiomas. METHODS: We reviewed the records of 14 patients who had undergone microsurgical removal of incisural tentorial meningioma. Two tumor subgroups, anterolateral (AL) and posteromedial (PM), were distinguished according to their site of attachment: the middle third and the posterior third of the tentorial free margin, respectively...
November 7, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29097332/tentorial-meningiomas-reappraisal-of-surgical-approaches-and-their-outcomes
#15
Anil Nanda, Devi Prasad Patra, Amey Savardekar, Tanmoy K Maiti, Subhas K Konar, Christina Notarianni, Bharat Guthikonda, Shyamal C Bir
INTRODUCTION: Tentorial meningiomas are notorious for their critical location. Selection of a suitable approach that exposes the multi-compartmental growth of tumor is important for a complete and safe resection. This paper discusses about various operative approaches and their overall surgical outcome. METHODS: We retrospectively reviewed our 41 patients with tentorial meningiomas. They were classified according to modified Yasargil's classification. The symptomatic improvement and progression free survival (PFS) were analyzed at follow-up...
October 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28987834/subtemporal-approach-for-gross-total-resection-of-retrochiasmatic-craniopharyngiomas-our-experience-on-30-cases
#16
Grzegorz Zieliński, Emir Ahmed Sajjad, Łukasz Robak, Andrzej Koziarski
BACKGROUND: Surgical treatment of retrochiasmatic craniopharyngiomas is associated with higher rates of complications, mortality, failure of complete removal, and recurrence compared with craniopharyngiomas located elsewhere. These tumors lie behind the optic chiasm and when large can extend upward into the third ventricle and downward along the brain stem, making their adequate exposure challenging. Most of the proposed techniques either use a translamina terminalis route or require wide bony exposures...
January 2018: World Neurosurgery
https://www.readbyqxmd.com/read/28954709/visual-field-defects-following-different-resective-procedures-for-mesiotemporal-lobe-epilepsy
#17
Barbara Schmeiser, Moritz Daniel, Evangelos Kogias, Daniel Böhringer, Karl Egger, Shan Yang, Niels Alexander Foit, Andreas Schulze-Bonhage, Bernhard Jochen Steinhoff, Josef Zentner, Wolf Alexander Lagrèze, Nikolai Johannes Gross
INTRODUCTION: One of the most common side effects of mesiotemporal lobe resection in patients with medically intractable epilepsy are visual field defects (VFD). While peripheral defects usually remain unnoticed by patients, extended VFD influence daily life activities and can, in particular, affect driving regulations. This study had been designed to evaluate frequency and extent of VFD following different surgical approaches to the mesiotemporal area with respect to the ability to drive...
September 24, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28885086/enlarging-pediatric-ectopic-rathke-s-cleft-cyst-in-the-prepontine-cistern-case-report
#18
Takamasa Kamei, Masahiro Nonaka, Yoshiko Uemura, Yasuo Yamanouchi, Yumiko Komori, Ryoichi Iwata, Junichi Takeda, Tetsuo Hashiba, Kunikazu Yoshimura, Akio Asai
Rathke's cleft cyst is a cystic disease that occurs in the sella turcica or, occasionally, in the suprasellar area. An ectopic Rathke's cleft cyst is extremely rare, and its nature is less well understood. The authors report the case of a 14-year-old girl who presented with a growing cystic lesion in the prepontine cistern, immediately behind the dorsum sellae. Preoperative imaging and intraoperative investigation showed part of the cyst wall continuing into the dorsum sellae, to the pituitary gland. The cisternal portion of the cyst wall was totally resected via a right subtemporal approach...
November 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28867323/endoscopic-middle-cranial-fossa-reconstruction-with-a-subtemporal-keyhole
#19
Fuminari Komatsu, Masaaki Imai, Akihiro Hirayama, Naokazu Hayashi, Shinri Oda, Masami Shimoda, Mitsunori Matsumae
BACKGROUND: Skull base reconstruction is an essential technique for repairing cerebrospinal fluid (CSF) leakage. A reliable method for middle cranial fossa (MCF) reconstruction with minimal invasiveness has not been reported. An initial case of endoscopic MCF reconstruction with a subtemporal keyhole is described. CASE DESCRIPTION: A 57-year-old man developed severe meningitis and was diagnosed with spontaneous CSF leakage from bone defects on the tegmen tympani...
December 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28841124/the-epitrigeminal-approach-to-the-brainstem
#20
Georgios Andrea Zenonos, David Fernandes-Cabral, Maximiliano Nunez, Stefan Lieber, Juan Carlos Fernandez-Miranda, Robert Max Friedlander
OBJECTIVE Surgical approaches to the ventrolateral pons pose a significant challenge. In this report, the authors describe a safe entry zone to the brainstem located just above the trigeminal entry zone which they refer to as the "epitrigeminal entry zone." METHODS The approach is presented in the context of an illustrative case of a cavernous malformation and is compared with the other commonly described approaches to the ventrolateral pons. The anatomical nuances were analyzed in detail with the aid of surgical images and video, anatomical dissections, and high-definition fiber tractography (HDFT)...
August 25, 2017: Journal of Neurosurgery
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