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Nakao Ota, Felix Goehre, Takanori Miyazaki, Yu Kinoshita, Hidetoshi Matsukawa, Takeshi Yanagisawa, Humihiro Sakakibara, Norihiro Saito, Shiro Miyata, Kosumo Noda, Toshiyuki Tsuboi, Hiroyasu Kamiyama, Sadahisa Tokuda, Kyousuke Kamada, Rokuya Tanikawa
BACKGROUND: The application of bypass procedures to the posterior cerebral artery (PCA) in combination with proximal clipping or trapping is a useful option for the treatment of complex posterior circulation aneurysms, especially those of the PCA. Due to its course around the midbrain through various cisterns, different approaches are required to access the PCA. OBJECTIVE: The presented study analyzes a retrospective case series of bypass procedures to the PCA to investigate the relevant treatment strategies and their outcomes...
September 16, 2016: World Neurosurgery
Serdar Ercan, Alba Scerrati, Phengfei Wu, Jun Zhang, Mario Ammirati
OBJECTIVE The subtemporal approach is one of the surgical routes used to reach the interpeduncular fossa. Keyhole subtemporal approaches and zygomatic arch osteotomy have been proposed in an effort to decrease the amount of temporal lobe retraction. However, the effects of these modified subtemporal approaches on temporal lobe retraction have never been objectively validated. METHODS A keyhole and a classic subtemporal craniotomy were executed in 4 fresh-frozen silicone-injected cadaver heads. The target was defined as the area bordered by the superior cerebellar artery, the anterior clinoid process, supraclinoid internal carotid artery, and the posterior cerebral artery...
September 16, 2016: Journal of Neurosurgery
L Pescatori, M Niutta, M P Tropeano, G Santoro, A Santoro
Despite the recent progress in surgical technology in the last decades, the surgical treatment of skull base lesions still remains a challenge. The purpose of this study was to assess the anatomy of the tentorial and cavernous segment of the fourth cranial nerve as it appears in two different surgical approaches to the skull base: subtemporal transtentorial approach and pretemporal fronto-orbito-zygomatic approach. Four human cadaveric fixed heads were used for the dissection. Using both sides of each cadaveric head, we made 16 dissections: 8 with subtemporal transtentorial technique and 8 with pretemporal fronto-orbito-zygomatic approach...
August 22, 2016: Neurosurgical Review
L H Chen, Y Yang, Q Wei, Y J Li, W D Li, J B Gao, B Yu, H Zhao, R X Xu
OBJECTIVE: With the development of modern skull base minimally invasive technology mature and neural radio surgery techniques, it is necessary to re-examine the therapeutic strategy for the treatment of petroclival meningiomas. To sum up the operative experience and methods in microsurgical resection of petroclival meningiomas by the combining trans-subtemporal and suboccipital retrosigmoid keyhole approach. To explore the minimally invasive operation approach of petroclival meningiomas, to raise the removal degree and to improve the postoperative result using this approach...
February 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
G Chen, W W Zhai, Z Q Yu
OBJECTIVE: To investigate varying patterns of intracranial pressure(ICP)after giant meningioma resection and analyze the causes of the variation of ICP in different postoperative phases. METHODS: Clinical data, surgical approachs and the ICP monitoring data of 7 patients with giant meningioma in different positions who were admitted to the First Affiliated Hospital of Soochow University from October 2013 to July 2014 and received microsurgical resection via different approachs were analysed retrospectively...
June 28, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Eric Mason, Jason Van Rompaey, C Arturo Solares, Ramon Figueroa, Daniel Prevedello
Background The petroclival region seats many neoplasms. Traditional surgical corridors to the region can result in unacceptable patient morbidity. The combined subtemporal retrolabyrinthine transpetrosal (posterior petrosal) approach provides adequate exposure with hearing preservation; however, the facial nerve and labyrinth are put at risk. Approaching the petroclival region with an endoscopic endonasal approach (EEA) could minimize morbidity. Objective To provide an anatomical and computed tomography (CT) comparison between the posterior petrosal approach and EEA to the petroclival region...
June 2016: Journal of Neurological Surgery. Part B, Skull Base
Zhou Xu, Xingruo Zeng, Daofeng Tian, Qianxue Chen
AIM: To study and summarize our experience with the subtemporal transtentorial approach for resection of petroclival tumors. MATERIAL AND METHODS: Twenty-eight patients who suffered from petroclival tumors and underwent tumor resection via a subtemporal transtentorial approach between October 2010 and July 2013 were retrospectively reviewed. RESULTS: Total resection was performed in 22 cases, at a rate of 78.57%, subtotal resection in 5 cases, and large portion resection in 1 case...
2016: Turkish Neurosurgery
Aneta Neskoromna-Jędrzejczak, Katarzyna Bogusiak, Aleksander Przygoński, Dariusz Timler
Number of deaths related with injuries suffered as a result of experienced traumas is increasing. Penetrating traumas of the facial skeleton occur relatively rarely and much more often concern rather children than adults. Epidemiology relating this kind of trauma differs depending on the region of the world. In Poland, gunshot injuries as well as traumas caused by explosions of firecrackers or fireworks amount only to a slight percentage among all facial skeleton traumas, and the most common reason for penetrating traumas lies in accidents or assault with the use of sharp, narrow and long objects that easily enter bones of the facial skeleton...
January 1, 2016: Polski Przeglad Chirurgiczny
Xingdong Wang, Enxi Xu, Hengzhu Zhang, Lei She, Xiaodong Wang, Zhengcun Yan
OBJECTIVE: To study the endoscope anatomy of the petroclival and ventrolateral brainstem regions via the intradural subtemporal keyhole Kawase approach and discuss the feasibility and indications of this approach to the regions. MATERIALS AND METHODS: Craniotomy procedures performed via the intradural subtemporal keyhole Kawase approach were simulated on 16 sides of 8 adult cadaveric heads fixed by formalin, and the related anatomical structures were observed through the 0-degree endoscope or alternatively 30-degree one...
May 2016: Journal of Craniofacial Surgery
Mikail Inal, Nuray Bayar Muluk, Veysel Burulday, Mehmet Hüseyin Akgül, Mehmet Faik Ozveren, Umut Orkun Çelebi, Gökçe Şimşek, Birsen Ünal Daphan
OBJECTIVES: The aim of this paper was a retrospective investigation of calcification at the petroclival region using Multi-slice Computed Tomography (MSCT). METHODS: One hundred thirty skull bases were reviewed. The images were acquired with a 64 slice CT (MSCT). At first images were taken at the axial plane; and then coronal and sagittal reconstructions of raw data were performed. Later investigations were carried out on these 3-dimensional images (3-D imaging)...
April 2016: Journal of Cranio-maxillo-facial Surgery
Hussein Kheshaifati, Faisal Al-Otaibi, Maher Alhejji
BACKGROUND: Oculomotor nerve palsy can result as a manifestation of diabetic mellitus or aneurysmal compression. Vascular loop compression is a very rare etiology of oculomotor nerve palsy. Here, we present a case report of microvascular decompression for oculomotor nerve palsy. CASE DESCRIPTION: We present a 16-year-old male patient, otherwise healthy, who presented with right oculomotor nerve palsy for a period of 1 year. Aneurysmal compression and intracranial lesion were ruled out by cerebral angiogram and magnetic resonance imaging...
April 2016: World Neurosurgery
Kai J Miller, Gerwin Schalk, Dora Hermes, Jeffrey G Ojemann, Rajesh P N Rao
The link between object perception and neural activity in visual cortical areas is a problem of fundamental importance in neuroscience. Here we show that electrical potentials from the ventral temporal cortical surface in humans contain sufficient information for spontaneous and near-instantaneous identification of a subject's perceptual state. Electrocorticographic (ECoG) arrays were placed on the subtemporal cortical surface of seven epilepsy patients. Grayscale images of faces and houses were displayed rapidly in random sequence...
January 2016: PLoS Computational Biology
Pattana Wangaryattawanich, Lakshmi S Chavali, Komal B Shah, Bhanu Gogia, Raul F Valenzuela, Franco DeMonte, Ashok J Kumar, L Anne Hayman
Magnetic resonance (MR) venography and computed tomographic (CT) venography are suited for displaying the convexity veins that drain the medial and lateral surfaces of the brain hemispheres. However, such is not the case for the bridging veins of the skull base. Technical factors prevent contrast material-enhanced MR or CT images obtained in standard axial, coronal, and sagittal planes from fully displaying the curved pathways of these clinically important venous structures. This limitation can be overcome by using a reconstruction technique that depicts these venous structures and their interconnections...
January 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Omar Choudhri, Michael T Lawton
The middle tentorial incisural space, located lateral to the midbrain and medial to the temporal lobe, contains the ambient cistern through which courses the third, fourth, and fifth cranial nerves, posterior cerebral artery (PCA), superior cerebellar artery, and the choroidal arteries. Arteriovenous malformations (AVMs) in this compartment are supplied by the thalamogeniculate and posterior temporal branches of the PCA, and drain into tributaries of the basal vein of Rosenthal. We present a case of an AVM in this middle tentorial incisural space that persisted after embolization and radiosurgery, and was microsurgically resected through a subtemporal approach...
January 2016: Neurosurgical Focus
Oriela Rustemi, Renato Scienza, Alessandro Della Puppa
Intracranial dural arteriovenous fistulas (dAVF) with cervical perimedullary drainage, Cognard V, are a surgically challenging rare entity. In this video we show the disconnection of a right tentorial Cognard V dAVF, done through a subtemporal transtentorial approach with the application of indocyanine green video angiography. A 47-year-old man presented with severe tetraparesis. Only partial embolization was possible. An osteoplastic frontotemporal craniotomy was performed to obtain a wide view along with CSF release to safely mobilize the temporal lobe...
January 2016: Neurosurgical Focus
M Yashar S Kalani, Ting Lei, Nikolay L Martirosyan, Mark E Oppenlander, Robert F Spetzler, Peter Nakaji
The mesial temporal lobe can be approached via a pterional or orbitozygomatic craniotomy, the subtemporal approach, or transcortically. Alternatively, the entire mesial temporal lobe can be accessed using a lateral supracerebellar transtentorial (SCTT) approach. Here we describe the technical nuances of patient positioning, craniotomy, supracerebellar dissection, and tentorial disconnection to traverse the tentorial incisura to arrive at the posterior mesial temporal lobe for a cavernous malformation. The SCTT approach is especially useful for lesions in the dominant temporal lobe where an anterolateral approach may endanger language centers or the vein of Labbé...
January 2016: Neurosurgical Focus
Thomas Robert, Alexander G Weil, Sami Obaid, Hosam Al-Jehani, Michel W Bojanowski
Large tumors located on the upper surface of the tentorium, extending to the posterior edge of the tentorial incisura and affecting the posterior temporo-mesial region, are challenging to reach without damaging the surrounding brain. Typically, these lesions are approached through a subtemporal or a transcortical transtemporal corridor. To avoid temporal lobe transgression or retraction, and venous drainage compromise, we use a supracerebellar transtentorial (SCTT) approach which gives a direct exposure to the posterior temporo-medial region and the posterior incisural space...
January 2016: Neurosurgical Focus
Xun Ye, Xingju Liu, Xiaofeng Deng, Fuxin Lin, Shuo Wang, Dong Zhang, Yuanli Zhao, Yong Cao, Yan Zhang, Rong Wang, Mingqi Yang, Jizong Zhao
OBJECTIVE: A retrospective study was conducted to analyze the clinical data of patients treated by retractorless surgery and explore the clinical feasibility and practical application of this strategy. METHODS: A total of 194 patients undergone retractorless surgery in Beijing Tiantan Hospital from Nov 2013 to Oct 2014 were retrospectively reviewed. Complications related to microsurgical approaches, disease types, neurological function score and intraoperative compression or stretching were analyzed...
July 7, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Peng-Fan Yang, Hui-Jian Zhang, Jia-Sheng Pei, Qiao Lin, Zhen Mei, Zi-Qian Chen, Yan-Zeng Jia, Zhong-Hui Zhong, Zhi-Yong Zheng
OBJECT The objectives of this study were to describe a novel minimal-access subtemporal approach for selective resection of the amygdala and hippocampus in patients with medically refractory mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis, and to analyze the related outcomes. METHODS The authors analyzed data from all cases involving patients with unilateral MTLE due to hippocampal sclerosis who were treated with selective amygdalohippocampectomy via the posterior subtemporal approach through a relatively small craniotomy, without a neuronavigation system, at their institution during the period from September 2010 to September 2012...
July 2016: Journal of Neurosurgery
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