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Petroclival

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https://www.readbyqxmd.com/read/28875113/fully-endoscopic-minimally-invasive-transrectus-capitis-posterior-muscle-triangle-approach-to-the-posterolateral-condyle-and-jugular-tubercle
#1
Wang Mingdong, Juan C Fernandez-Miranda, Roger Neves Mathias, Eric Wang, Paul Gardner, Hong Wang
Background  We evaluated a transrectus capitis posterior muscle triangle approach to the posterolateral foramen magnum, occipital condyles, jugular tubercle, and the fourth ventricle. We also assessed factors that affect the amount of bone removal required. Objective  To evaluate if the proposed approach is as effective as standard open approaches to expose the lateral portion of the foramen magnum. Methods  The proposed minimally invasive fully endoscopic approach was performed in 15 cadaveric specimens using 4-mm (0- and 45-degree) endoscopes...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28862550/voxel-based-lesion-mapping-of-meningioma-a-comprehensive-lesion-location-mapping-of-260-lesions
#2
Ryuichi Hirayama, Manabu Kinoshita, Hideyuki Arita, Naoki Kagawa, Haruhiko Kishima, Naoya Hashimoto, Yasunori Fujimoto, Toshiki Yoshimine
OBJECTIVE In the present study the authors aimed to determine preferred locations of meningiomas by avoiding descriptive analysis and instead using voxel-based lesion mapping and 3D image-rendering techniques. METHODS Magnetic resonance images obtained in 248 treatment-naïve meningioma patients with 260 lesions were retrospectively and consecutively collected. All images were registered to a 1-mm isotropic, high-resolution, T1-weighted brain atlas provided by the Montreal Neurological Institute (the MNI152), and a lesion frequency map was created, followed by 3D volume rendering to visualize the preferred locations of meningiomas in 3D...
September 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28735380/the-midline-suboccipital-subtonsillar-approach-to-the-cerebellomedullary-cistern-how-i-do-it
#3
Stephan Herlan, Florian Roser, Florian H Ebner, Marcos Tatagiba
BACKGROUND: Lesions lateral to the lower brainstem in an area extending from the foraminae of Luschka to the foramen magnum are rare and include different pathologies. There is no consensus on an ideal surgical approach. METHOD: To gain access to this area, we use the midline suboccipital subtonsillar approach (STA). This midline approach with unilateral retraction of the cerebellar tonsil enables entry into the cerebellomedullary cistern. CONCLUSIONS: The STA offers excellent access with a panoramic view of the cerebellomedullary cistern and its structures and therefore can be useful for a number of different pathologies in the lower petroclival area...
July 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28731399/expanding-the-endoscopic-transpterygoid-corridor-to-the-petroclival-region-anatomical-study-and-volumetric-comparative-analysis
#4
Jacob L Freeman, Raghuram Sampath, Steven Craig Quattlebaum, Michael A Casey, Zach A Folzenlogen, Vijay R Ramakrishnan, A Samy Youssef
OBJECTIVE The endoscopic endonasal transmaxillary transpterygoid (TMTP) approach has been the gateway for lateral skull base exposure. Removal of the cartilaginous eustachian tube (ET) and lateral mobilization of the internal carotid artery (ICA) are technically demanding adjunctive steps that are used to access the petroclival region. The gained expansion of the deep working corridor provided by these maneuvers has yet to be quantified. METHODS The TMTP approach with cartilaginous ET removal and ICA mobilization was performed in 5 adult cadaveric heads (10 sides)...
July 21, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28725517/preoperative-embolization-for-skull-base-meningiomas
#5
Kensuke Suzuki, Masaya Nagaishi, Yoshiyuki Matsumoto, Yoshiko Fujii, Yuki Inoue, Yoshiki Sugiura, Koji Hirata, Ryotaro Suzuki, Yosuke Kawamura, Ryuta Nakae, Yoshihiro Tanaka, Akio Hyodo
The results of preoperative embolization for skull base meningiomas were retrospectively evaluated to confirm the efficacy of this procedure. Skull base meningiomas that were treated with preoperative embolization were evaluated in 20 patients. The occluded arteries, embolic materials, treatment time, excision rate, neurologic manifestations, and complications were analyzed. The embolic material was 80% liquid, 30% coils, and 15% particles. The surgery was normally completed within 3 to 5 hours. Blood loss was normally approximately 250 mL, excluding four patients having the following conditions: malignant meningioma, a large tumor located on the medial side of the sphenoidal ridge, the petroclival tumor, and infiltrated tumor into the sigmoid sinus...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28713632/radiographic-assessment-of-the-presigmoid-retrolabyrinthine-approach
#6
Andrew K Wong, Melissa M Stamates, Anita P Bhansali, Michael Shinners, Ricky H Wong
BACKGROUND: Lesions of the petroclival fissure are difficult to access surgically. Both retrosigmoid and presigmoid retrolabyrinthine approaches have been described to successfully treat these complex tumors. The retrosigmoid approach offers quick and familiar access, whereas the presigmoid retrolabyrinthine approach reduces the operative distance and the need for cerebellar retraction. The presigmoid retrolabyrinthine approach, however, is constrained by anatomical limits that can be subject to patient variation...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28683438/gamma-knife-radiosurgery-for-petroclival-meningioma-long-term-outcome-and-failure-pattern
#7
Jin Wook Kim, Dong Gyu Kim, Young-Bem Se, Sung Kwon Kim, Hyun-Tai Chung, Sun Ha Paek, Hee-Won Jung
Total removal of petroclival meningioma is difficult, and aggressive extirpation is often associated with significant surgical morbidity and mortality. The aim of this study was to evaluate the long-term outcome and failure pattern of treatment with Gamma Knife radiosurgery (GKRS) in patients with petroclival meningiomas. Eighty-nine consecutive patients with petroclival meningiomas underwent GKRS between 1998 and 2013. Fifty-eight patients received GKRS as a primary treatment and 31 patients underwent GKRS as a secondary treatment after microsurgery...
2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28541487/tumor-progression-following-petroclival-meningioma-subtotal-resection-a-volumetric-study
#8
Jacob B Hunter, Brendan P O'Connell, Matthew L Carlson, Lola C Chambless, Robert J Yawn, Ray Wang, Akshitkumar Mistry, Reid C Thompson, Kyle D Weaver, George B Wanna
BACKGROUND: One study has investigated postoperative growth rates following subtotal resection of petroclival meningiomas utilizing linear measurements, which are insensitive to the multidimensional complex growth of meningiomas, to estimate tumor volume. OBJECTIVE: To describe petroclival meningioma growth patterns following less-than-complete resection utilizing volumetric analysis and to identify variables associated with tumor progression. METHODS: Patients with surgically resected WHO grade I petroclival meningiomas were retrospectively reviewed (1999-2015)...
May 24, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28435113/microsurgical-and-endoscopic-anatomy-for-intradural-temporal-bone-drilling-and-applications-of-the-electromagnetic-navigation-system-various-extensions-of-the-retrosigmoid-approach
#9
Ken Matsushima, Noritaka Komune, Satoshi Matsuo, Michihiro Kohno
OBJECTIVE: The use of the retrosigmoid approach has recently been expanded by several modifications, including the suprameatal, transmeatal, suprajugular, and inframeatal extensions. Intradural temporal bone drilling without damaging vital structures inside or beside the bone, such as the internal carotid artery and jugular bulb, is a key step for these extensions. This study aimed to examine the microsurgical and endoscopic anatomy of the extensions of the retrosigmoid approach and to evaluate the clinical feasibility of an electromagnetic navigation system during intradural temporal bone drilling...
July 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28377283/the-combined-transpetrosal-approach-anatomic-study-and-literature-review
#10
REVIEW
M Burhan Janjua, James P Caruso, Jeffrey P Greenfield, Mark M Souweidane, Theodore H Schwartz
The combined petrosal approach is an essential technique for the skull base neurosurgeon. In this manuscript, the authors provide a brief history of the development of this approach, technical instruction with consideration of important landmarks, and a literature review of the broad range of clinical applications for this approach. The combined petrosal approach was performed bilaterally in 6 cadaveric injected specimens. The relationship of middle and posterior fossa dura, venous sinuses, cranial nerves (CNs), and the vascular anatomy were studied...
July 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28338439/stereotactic-radiosurgery-in-the-treatment-of-parasellar-meningiomas-long-term-volumetric-evaluation
#11
Or Cohen-Inbar, Athreya Tata, Shayan Moosa, Cheng-Chia Lee, Jason P Sheehan
OBJECTIVE Parasellar meningiomas tend to invade the suprasellar, cavernous sinus, and petroclival regions, encroaching on adjacent neurovascular structures. As such, they prove difficult to safely and completely resect. Stereotactic radiosurgery (SRS) has played a central role in the treatment of parasellar meningiomas. Evaluation of tumor control rates at this location using simplified single-dimension measurements may prove misleading. The authors report the influence of SRS treatment parameters and the timing and volumetric changes of benign WHO Grade I parasellar meningiomas after SRS on long-term outcome...
March 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28330424/tentorial-meningioma-supplied-by-a-marginal-tentorial-artery-arising-from-the-superior-cerebellar-artery-anatomic-and-technical-considerations
#12
Stéphanie Lenck, Kentaro Watanabe, Jean-Pierre Saint-Maurice, Moujahed Labidi, Marc-Antoine Labeyrie, Sébastien Froelich, Emmanuel Houdart
Background and importance The marginal tentorial artery runs over the free edge of the tentorium. Different origins have been described, always involving branches of the carotid artery. We report the superior cerebellar artery as an unknown origin of this artery. We developed our strategy in a case of a tentorial meningioma mainly supplied by this artery. Clinical presentation A 53-year-old man was admitted in our institution for the surgical treatment of a large tentorial and petroclival meningioma. A 2D conventional angiogram was insufficient to detect the tumoral blush...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28223248/endoscopic-intradural-subtemporal-keyhole-approach-with-neuronavigational-assistance-to-the-suprasellar-petroclival-and-ventrolateral-brainstem-regions-an-anatomic-study
#13
Zhemin Ding, Qing Wang, Xiaojie Lu, Xinwei Qian
OBJECTIVE: The purposes of this study were to evaluate the feasibility of a purely endoscopic intradural approach to the suprasellar, petroclival, and ventrolateral brainstem regions through a subtemporal keyhole and to assess the value of neuronavigational assistance in the Kawase approach. METHODS: Twenty endoscopic intradural subtemporal keyhole approaches were performed on 10 cadaveric heads. An intradural Kawase approach and a navigation-assisted intradural Kawase approach were then carried out on a random side of each specimen...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28203025/-trigemino-cardiac-reflex-in-skull-base-surgery
#14
H Z Duan, Y Zhang, L Li, J Y Zhang, Z Q Yi, S D Bao
OBJECTIVE: To explore the mechanism, clinical features, and prognosis of Trigemino-cardiac reflex (TCR) during skull base operations. METHODS: A retrospective analysis was performed on 291 patients with skull base disease from Jan. 2009 to Oct. 2015 in Peking University First Hospital. By reviewing the patients' operative data and anaesthetic electrical record, and we picked out all the patients who suffered from TCR during the operation and analyzed their surgical procedures, clinical features, influence factors, and prognosis...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28202836/-pre-and-intra-operative-supporting-technology-for-brain-tumors-4-transpetrosal-approach-for-petroclival-tumors
#15
Takeo Goto
No abstract text is available yet for this article.
February 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28124175/preoperative-simulation-of-the-running-course-of-the-abducens-nerve-in-a-large-petroclival-meningioma-a-case-report-and-literature-review
#16
REVIEW
Kaichuang Yang, Fusao Ikawa, Shumpei Onishi, Manish Kolakshyapati, Masaaki Takeda, Satoshi Yamaguchi, Minoru Ishifuro, Yuji Akiyama, Mizuki Morishige, Kaoru Kurisu
One of the most important and useful pieces of information in the preoperative evaluation of a large petroclival meningioma is the running course of the abducens nerve. The abducens nerve is small and has a long intracranial course, making it prone to compression by the tumor at various anatomical points. In relatively large tumors, it is difficult to confirm the entire course of the abducens nerve, even by heavy T2-thin slice imaging. We report a case of successful preoperative estimation of the course of the abducens nerve that aided in its complete preservation during the resection of a large petroclival tumor...
April 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28109858/radiologic-dilemma-in-an-extra-axial-petroclival-lesion-low-grade-versus-high-grade
#17
Madhivanan Karthigeyan, Chirag Kamal Ahuja, Debjyoti Chatterjee, Pravin Salunke
BACKGROUND: Radiologic differentiation between a low-grade and high-grade lesion is crucial when deciding extent of resection and prognostication. Occasionally, imaging features can be confusing between the 2 lesions. We report a case that presented such a radiologic dilemma. The lesion appeared benign and extra-axial on routine magnetic resonance imaging sequences. However, subtle clinical and imaging clues pointed to a high-grade lesion. CASE DESCRIPTION: A 27-year-old woman presented with multiple cranial nerve palsies, gait ataxia, and features of increased intracranial pressure...
April 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28042016/spontaneous-intraventricular-hemorrhage-a-rare-presentation-of-a-skull-base-mesenchymal-chondrosarcoma
#18
Altaf Ali Laghari, Gohar Javed, Muhammad Faheem Khan, Syed Ijlal Ahmed, Karim Rizwan Nathani, Riyasat Ahmed
BACKGROUND: Chondrosarcomas are very rare malignant, slow-growing tumors that develop in or near the petroclival region of the brain. We report a very rare case in which the tumor originated from left petrous bone and induced intraventricular hemorrhage leading to an acute comatose presentation. CASE DESCRIPTION: A 28-year-old man initially presented to the outpatient department with a 1-month history of headache, vomiting, vertigo, and left facial numbness. A lesion at the cerebellopontine angle with extension into the middle cranial fossa was demonstrated on computed tomography and magnetic resonance imaging...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28035290/pathological-location-of-cranial-nerves-in-petroclival-lesions-how-to-avoid-their-injury-during-anterior-petrosal-approach
#19
Hamid Borghei-Razavi, Ryosuke Tomio, Seyed-Mohammad Fereshtehnejad, Shunsuke Shibao, Uta Schick, Masahiro Toda, Kazunari Yoshida, Takeshi Kawase
Objectives Numerous surgical approaches have been developed to access the petroclival region. The Kawase approach, through the middle fossa, is a well-described option for addressing cranial base lesions of the petroclival region. Our aim was to gather data about the variation of cranial nerve locations in diverse petroclival pathologies and clarify the most common pathologic variations confirmed during the anterior petrosal approach. Method A retrospective analysis was made of both videos and operative and histologic records of 40 petroclival tumors from January 2009 to September 2013 in which the Kawase approach was used...
February 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27965073/outcomes-of-endonasal-and-lateral-approaches-to-petroclival-meningiomas
#20
Maria Koutourousiou, Juan C Fernandez-Miranda, Francisco Vaz-Guimaraes Filho, John R de Almeida, Eric W Wang, Carl H Snyderman, Paul A Gardner
OBJECTIVE: Transpetrosal approaches for the treatment of petroclival meningiomas are often associated with substantial morbidity and long recovery. With the goal of early clinical improvement, we have used less invasive surgical approaches for petroclival meningiomas. METHODS: We retrospectively reviewed 32 patients with petroclival meningiomas. Eleven patients (34.4%) were managed with lateral approaches (retrosigmoid or far lateral approach), 17 (53.1%) with anterior midline approaches (endoscopic endonasal approach [EEA]), and 4 (12...
March 2017: World Neurosurgery
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