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Petrosal approach

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https://www.readbyqxmd.com/read/28191380/transorbital-approach-for-endovascular-occlusion-of-carotid-cavernous-fistulas-technical-note-and-review-of-the-literature
#1
Ching-Jen Chen, Panagiotis Mastorakos, James P Caruso, Dale Ding, Paul J Schmitt, Thomas J Buell, Daniel M Raper, Avery Evans, Steven A Newman, Mary E Jensen
Carotid-cavernous fistulas (CCFs) pose an anatomically and physiologically challenging problem for clinicians. The most common method of treatment for these lesions is transvenous endovascular embolization via the inferior petrosal sinus or the facial vein. When transvenous access is not possible, an alternate approach must be devised. We describe a case example with bilateral Barrow Type B CCFs, which were inaccessible using the traditional transvenous approach. Hence, a direct transorbital approach, performed under fluoroscopic guidance, was employed to successfully obliterate the CCF...
January 12, 2017: Curēus
https://www.readbyqxmd.com/read/28111701/thrombosis-of-venous-outflows-of-the-cavernous-sinus-possible-aetiology-of-the-cortical-venous-reflux-in-case-of-indirect-carotid-cavernous-fistulas
#2
Thomas Robert, Philippe Sylvestre, Raphaël Blanc, Daniele Botta, Gabriele Ciccio, Stanislas Smajda, Hocine Redjem, Michel Piotin
BACKGROUND: The presence of a cortical venous reflux (CVR) in a carotid-cavernous fistula (CCF) is well described and is considered to be a criterion for urgent treatment. This reflux is often associated with direct/traumatic CCF and the high-flow of the fistula alone explains the reflux. For indirect CCF, the pathophysiology of a CVR is unclear. METHODS: All patients treated endovascularly for an indirect CCF with a cortical venous reflux between 2003 and 2015 were included...
January 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28069628/cushing-s-syndrome-a-practical-approach-to-diagnosis-and-differential-diagnoses
#3
Joseph M Pappachan, Christian Hariman, Mahamood Edavalath, Julian Waldron, Fahmy W Hanna
Diagnosis of Cushing's syndrome (CS) and identification of the aetiology of hypercortisolism can be challenging. The Endocrine Society clinical practice guidelines recommends one of the four tests for initial screening of CS, namely, urinary-free cortisol, late night salivary cortisol, overnight dexamethasone suppression test or a longer low-dose dexamethasone suppression test, for 48 hours. Confirmation and localisation of CS requires additional biochemical and radiological tests. Radiological evaluation involves different imaging modalities including MRI with or without different radio-nuclear imaging techniques...
January 9, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28035290/pathological-location-of-cranial-nerves-in-petroclival-lesions-how-to-avoid-their-injury-during-anterior-petrosal-approach
#4
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/28003168/endoscopic-endonasal-surgery-for-remission-of-cushing-disease-caused-by-ectopic-intracavernous-macroadenoma-case-report-and-literature-review
#5
Maria Koutourousiou, Welby I Winstead
BACKGROUND: Complete surgical resection of an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma is the gold standard of treatment of Cushing disease. Ectopic location of these adenomas is an extremely rare condition that may compromise the diagnosis and surgical success. We present the first case of an ectopic intracavernous ACTH-secreting macroadenoma totally resected with endoscopic endonasal surgery (EES). CASE DESCRIPTION: A 36-year-old woman presented with Cushing syndrome...
December 18, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27916722/unique-diagnostic-features-and-surgical-strategy-for-intracranial-carotid-sympathetic-plexus-schwannoma-case-report-and-literature-review
#6
Hajime Takase, Kohta Araki, Shunsuke Seki, Kana Takase, Hidetoshi Murata, Nobutaka Kawahara
BACKGROUND: Intracranial carotid sympathetic plexus schwannoma (CSPS) is extremely rare; thus differential diagnostic criteria, optimal surgical strategies, and even a precise definition are lacking. Here we describe a case of CSPS and propose a definition and classification for previously reported cases. CASE DESCRIPTION: A 54-year-old man presented with hypacusis and abducens nerve palsy. Radiologic examinations revealed a well-enhanced mass at the right medial temporal base with erosion of the petrous apex and intact perilesional cortical bone...
December 1, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27647276/the-superior-petrosal-sinus-a-review-of-anatomy-embryology-pathology-and-neurosurgical-relevance
#7
REVIEW
Martin M Mortazavi, Marcus A Cox, Erfanul Saker, Sanjay Krishnamurthy, Ketan Verma, Christoph J Griessenauer, Marios Loukas, Rod J Oskouian, R Shane Tubbs
The superior petrosal sinus is located between the middle and posterior cranial fossae and is important during many neurosurgical approaches to the skull base. Using standard search engines, the anatomical and clinical importance of the superior petrosal sinus was investigated. The superior petrosal sinus is important in many neurosurgical approaches and pathological entities. Therefore, it is important for those who operate at the skull base or interpret imaging here to have a good working knowledge of its anatomy, development, and pathological involvement...
September 19, 2016: Neurosurgical Review
https://www.readbyqxmd.com/read/27647023/bypass-revascularization-applied-to-the-posterior-cerebral-artery
#8
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
https://www.readbyqxmd.com/read/27593848/indocyanine-green-videoangiographic-guided-cannulation-of-the-superior-ophthalmic-vein-for-endovascular-treatment-of-carotid-cavernous-fistulas
#9
Francesco Acerbi, Giuseppe FARAGò, Morgan Broggi, Claudio Cavallo, Michela Ranieri, Valentina Caldiera, Elisa Ciceri, Paolo Ferroli
Backgorund Direct exposure and cannulation of superior ophthalmic vein (SOV) provides an alternative access to reach the cavernous sinus for carotid-cavernous fistula (CCF) embolization, when classic transvenous routes through inferior petrosal sinus (IPS) or facial vein are not feasible. We have used indocyanine green (ICG) videoangiography to study intraoperatively the flow inside the SOV in two cases of indirect CCF. In this paper we report the operative technique and the result of ICG videoangiographic-guided cannulation of the SOV for endovascular treatment of CCF...
July 15, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27586179/orbital-approaches-for-treatment-of-carotid-cavernous-fistulas-a-systematic-review
#10
Kevin Phan, Joshua Xu, Vannessa Leung, Ian Teng, Sharaf Sheik-Ali, Monish Maharaj, Ralph Mobbs, Prashanth J Rao
Carotid cavernous fistulas (CCFs) are abnormal connections between the carotid arteries and the cavernous sinus. CCFs often present with double vision, reduced visual acuity and conjunctivitis. Deteriorating ocular symptoms due to abnormal fistula drainage can potentially cause permanent blindness, and so urgent interventional treatment is necessary. Transvenous embolization of the fistula is the primary treatment option for the majority of patients with symptomatic CCFs. Orbital approaches are considered to be risky compared to the traditional approach via the inferior petrosal sinus, and is thus used as a secondary option...
August 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27468633/endoscopic-facial-nerve-surgery
#11
REVIEW
Daniele Marchioni, Davide Soloperto, Alessia Rubini, João Flávio Nogueira, Mohamed Badr-El-Dine, Livio Presutti
Tympanic facial nerve segment surgery has been traditionally performed using microscopic approaches, but currently, exclusive endoscopic approaches have been performed for traumatic, neoplastic, or inflammatory diseases, specially located at the geniculate ganglion, greater petrosal nerve, and second tract of the facial nerve, until the second genu. The tympanic segment of the facial nerve can be reached and visualized using an exclusive transcanal endoscopic approach, even in poorly accessible regions such as the second genu and geniculate ganglion, avoiding mastoidectomy, bony demolition, and meningeal or cerebral lobe tractions, with low complication rates using a minimally invasive surgical route...
October 2016: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27453800/novel-techniques-in-epilepsy-management-venous-pacing-and-capture-of-electrical-activity-in-the-primate-cortex
#12
Prakriti Gaba, Christopher V DeSimone, Benhur D Henz, Paul A Friedman, Charles J Bruce, David R Holmes, Malini Madhavan, Krithika Vasudevan, Douglas Wahnschaffe, Steven Berhow, Andrew J Danielsen, Dorothy J Ladewig, Susan B Mikell, Susan B Johnson, Scott H Suddendorf, Tomas Kara, Gregory A Worrell, Samuel J Asirvatham
OBJECTIVE: Pharmacotherapy for epilepsy is limited with 30% of patients refractory to this approach of suppressing seizures. Current surgical options are invasive and carry significant morbidities including infection, bleeding, and the potential for deleterious neurocognitive effects. As a result, there is a burgeoning need for innovation to develop safer and efficacious interventions. METHODS: Four distinct catheters (2 existing: Cardima catheter, Standard EPT Blazer catheter; 2 new prototypes: balloon catheter, basket catheters) were tested in 12 baboons (21-30 kg, 100% male)...
June 2016: Journal of Neurology & Neurophysiology
https://www.readbyqxmd.com/read/27399507/309%C3%A2-middle-fossa-approach-to-lateralized-pontine-cavernomas-in-children
#13
Mark Calayag, Reid Hoshide, David D Gonda, Hal S Meltzer, Takanori Fukushima, Michael L Levy
INTRODUCTION: Hemorrhagic cavernous malformations involving the lateral pontine region require complex surgical considerations to maximize complete resection of the cavernoma and associated hemorrhage while minimizing morbidity. We describe our experience through the middle fossa rhomboid approach in 8 children with cavernomas involving the pons, with lateralized hemorrhages extending through the pontine parenchyma. METHODS: Eight children underwent this approach over a 10-year period at Rady Children's Hospital of San Diego...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27312392/the-analysis-of-the-petrosal-vein-to-prevent-venous-complications-during-the-anterior-transpetrosal-approach-in-the-resection-of-petroclival-meningioma
#14
Katsuhiro Mizutani, Masahiro Toda, Kazunari Yoshida
BACKGROUND: The anterior transpetrosal approach (ATPA) has been used in the resection of petroclival meningioma (PCM) for more than 20 years. Although PCM sometimes involves the petrosal vein and its preservation has been an important issue, the precise risk of petrosal vein sacrifice and subsequent venous complications associated with the use of the ATPA in patients with PCM has not yet been elucidated. METHODS: We used computed tomographic (CT) digital subtraction venography (DSV) in the retrospective analysis of the petrosal vein and its tributaries in patients with PCM before and after surgery...
September 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27300453/extended-suboccipital-retrosigmoid-surgical-approach-is-effective-for-resection-of-petrous-apex-meningioma
#15
Hua Cui, Cai-Fang Zhou, Ying-Hui Bao, Ming-Sheng Wang, Yong Wang
OBJECTIVE: The aim of this study was to evaluate the clinical features, treatment strategies, and outcomes of patients presented with petrous apex meningiomas. METHODS: In this retrospective clinical study, 17 patients with petrous apex meningiomas were treated microsurgically via an extended suboccipital retrosigmoid approach. Data regarding the general characteristics of the patients, surgical management, and surgery-related outcomes were obtained by reviewing patients' medical records...
July 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27298011/transvenous-microguidewire-looping-technique-for-breach-of-ipsilateral-inferior-petrosal-sinus-occlusions-en-route-to-cavernous-sinus-dural-arteriovenous-fistulas
#16
Young Dae Cho, Jong Kook Rhim, Dong Hyun Yoo, Hyun-Seung Kang, Jeong Eun Kim, Won-Sang Cho, Moon Hee Han
BACKGROUND AND PURPOSE: Transarterial access to dural arteriovenous fistulas (dAVFs) has been popularized by device improvements and novel embolic materials. However, this approach is limited in the cavernous sinus (CS) because of related complications and low cure rates. Although a transvenous approach, via ipsilateral inferior petrosal sinus (IPS), may be more suitable for CS-dAVFs, microcatheter delivery is occasionally impeded by ipsilateral IPS occlusion. Described herein is a microguidewire looping method to breach such occlusions, thus enabling access to CS lesions...
October 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27188642/study-of-changing-intracranial-venous-drainage-patterns-in-petroclival-meningioma
#17
Kazuhide Adachi, Motoharu Hayakawa, Kohei Ishihara, Tukasa Ganaha, Shinya Nagahisa, Mituhiro Hasegawa, Yuichi Hirose
OBJECTIVE: To elucidate venous drainage patterns to avoid damage to the venous drainage route in the middle cranial fossa and superior petrosal sinus when employing the transpetrosal approach. METHODS: Venous drainage patterns were assessed using three-dimensional computed tomography venography in 22 hemispheres of petroclival meningioma (PCM) cases from patients who underwent primary surgery and 40 hemispheres of control cases. Intracranial venous drainage patterns were compared between control cases and PCM cases...
August 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27175318/subtemporal-retrolabyrinthine-posterior-petrosal-versus-endoscopic-endonasal-approach-to-the-petroclival-region-an-anatomical-and-computed-tomography-study
#18
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
https://www.readbyqxmd.com/read/27161456/microsurgical-resection-of-petroclival-tumors-via-the-subtemporal-transtentorial-approach
#19
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
https://www.readbyqxmd.com/read/27075862/quantitative-analysis-of-surgical-exposure-and-surgical-freedom-to-the-anterosuperior-pons-comparison-of-pterional-transtentorial-orbitozygomatic-and-anterior-petrosal-approaches
#20
Jung-Shun Lee, Alba Scerrati, Jun Zhang, Mario Ammirati
Surgical approaches to the pons lump together different areas of the pons, such as the anterosuperior and the anteroinferior pons. These areas are topographically different, and different approaches may be best suited for one or the other area. We evaluated the exposure of the anterosuperior pons using different surgical approaches. We quantify the surgical exposure and surgical freedom to the anterosuperior pons afforded by the pterional transtentorial (PT), the orbitozygomatic with anterior clinoidectomy (OZ), and the anterior petrosal (AP) approaches...
October 2016: Neurosurgical Review
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