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Petrosal approach

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https://www.readbyqxmd.com/read/28927220/intraspinosum-middle-meningeal-artery-ligation-a-simple-technique-to-control-bleeding-in-the-middle-fossa-during-the-anterior-transpetrosal-approach
#1
Shunsuke Shibao, Hamid Borghei-Razavi, Kazunari Yoshida
BACKGROUND: Although the greater superficial petrosal nerve (GSPN) is an important landmark of the anterior transpetrosal approach (ATPA), bleeding from the interdural space around the foramen spinosum (FS), the GSPN, and the foramen ovale impedes the identification of the GSPN, during epidural dissection in the ATPA. OBJECTIVE: To describe the technique of intraspinosum middle meningeal artery (MMA) ligation, which enables us to control bleeding from the interdural space...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28885117/the-interperiosteodural-concept-applied-to-the-jugular-foramen-and-its-compartmentalization
#2
Florian Bernard, Ilyess Zemmoura, Jean Philippe Cottier, Henri-Dominique Fournier, Louis-Marie Terrier, Stéphane Velut
OBJECTIVE The dura mater is made of 2 layers: the endosteal layer (outer layer), which is firmly attached to the bone, and the meningeal layer (inner layer), which directly covers the brain and spinal cord. These 2 dural layers join together in most parts of the skull base and cranial convexity, and separate into the orbital and perisellar compartments or into the spinal epidural space to form the extradural neural axis compartment (EDNAC). The EDNAC contains fat and/or venous blood. The aim of this dissection study was to anatomically verify the concept of the EDNAC by focusing on the dural layers surrounding the jugular foramen area...
September 8, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28664026/transarterial-sinus-embolization-for-a-dural-arteriovenous-fistula-in-a-sinus-of-the-lesser-sphenoid-wing-a-case-report
#3
Tomoaki Murakami, Hajime Nakamura, Takeo Nishida, Tomohiko Ozaki, Katsunori Asai, Tomoki Kidani, Yoshinori Kadono, Toshiki Yoshimine
Dural arteriovenous fistula (DAVF) in a sinus of the lesser sphenoid wing (SLSW) is rarely reported. Here, we report a case of an isolated SLSW DAVF treated by coils placed into the sinus through the feeding artery. A 68-year-old man was admitted to our hospital with headache. Magnetic resonance images and an angiogram showed a varix in the right middle cranial fossa. A DAVF, consisting of three main feeders and the isolated SLSW, was diagnosed based on the angiogram findings. Retrograde leptomeningeal venous drainage to the deep middle cerebral vein was observed...
April 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28651592/anatomic-comparison-of-veins-of-labb%C3%A3-between-autopsy-digital-subtraction-angiography-and-computed-tomographic-venography
#4
Qiong Fang, Anhong Jiang, Wei Tao, Lin Xin
OBJECTIVE: The drainage portion of the vein of Labbé varies, and it is difficult to predict whether the operation is likely to damage this vein. The aim of this study was to correlate the microanatomy of the vein of Labbé with digital subtraction angiography (DSA) and computed tomographic venography (CTV), in order to provide a basis for the preservation of the vein of Labbé during a supratentorial surgical approach. METHODS: A total of 30 human cadavers (60 sides) and 61 living patients (110 sides) were examined in this study...
June 26, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28614036/an-individualized-approach-to-the-evaluation-of-cushing-syndrome
#5
REVIEW
Susmeeta T Sharma
Cushing syndrome (CS) is caused by chronic exposure to excess glucocorticoids. Early recognition and treatment of hypercortisolemia can lead to decreased morbidity and mortality. The diagnosis of CS and thereafter, establishing the cause can often be difficult, especially in patients with mild and cyclic hypercortisolism. Surgical excision of the cause of excess glucocorticoids is the optimal treatment for CS. Medical therapy (steroidogenesis inhibitors, medications that decrease adrenocorticotropic hormone [ACTH] levels or glucocorticoid antagonists) and pituitary radiotherapy may be needed as adjunctive treatment modalities in patients with residual, recurrent or metastatic disease, in preparation for surgery, or when surgery is contraindicated...
June 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28604185/cavernous-sinus-dural-arteriovenous-fistula-treated-by-facial-vein-direct-puncture-case-report-and-review-of-the-literature
#6
Atsushi Matsumoto, Masanobu Okauchi, Atsushi Shindo, Masahiko Kawanishi, Takashi Tamiya
Introduction In case of cavernous sinus dural arteriovenous fistula (CSDAVF), transvenous embolization (TVE) of the cavernous sinus (CS) via the inferior petrosal sinus (IPS) is generally performed. However, various approach routes have been reported when the accessibility of the IPS is challenging. We herein report a case of CSDAVF treated by TVE with direct puncture of the facial vein. Case report A 70-year-old woman who suffered from tinnitus, chemosis, diplopia and bruit was referred to our hospital. Digital subtraction angiography (DSA) demonstrated CSDAVF...
June 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28479521/the-retrolabyrinthine-presigmoid-approach-to-the-anterior-cerebellopontine-region-expanding-the-limits-of-trautmann-triangle
#7
Fernando Alonso, Simone E Dekker, James Wright, Christina Wright, Andrea Alonso, Margaret Carmody, R Shane Tubbs, Nicholas C Bambakidis
OBJECTIVE: The anatomic area exposed through exposure of Trautmann triangle may not be sufficient. We studied the additional exposure provided by skeletonizing the sigmoid sinus (SS). METHODS: In 5 human cadaveric heads, thin-cut computed tomography images of 2 sides of the temporal bone were obtained for a total of 10 sides. The estimated surgical working angle was calculated based on the relationship of the SS to the posterior semicircular canal (PSC), superior petrosal sinus, and jugular bulb on imaging...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28377283/the-combined-transpetrosal-approach-anatomic-study-and-literature-review
#8
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/28374616/treatment-of-barrow-type-b-carotid-cavernous-fistulas-with-flow-diverter-stent-pipeline
#9
Carlos Castaño, Sebastián Remollo, Rosa García-Sort, Carlos Domínguez, Mikel Terceño
Background Carotid cavernous fistulas (CCFs) Barrow type 'B' are dural shunts between the meningeal branches of the internal carotid artery and the cavernous sinus. The symptoms include vision deterioration, ophthalmoplegia with diplopia, exophthalmos, conjunctival injection, chemosis, ocular bruit, seizures, or neurological deficit. Endovascular treatment remains the gold standard for treatment through the transvenous or transarterial routes. The transvenous approaches have been proved to be the first option...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28260292/-anatomy-and-management-of-superior-petrosal-vein-in-microvascular-decompression-for-trigeminal-neuralgia
#10
Y M Yang, Z W Wang, Z Cui, H Z Jiang, C Sha, Q G Yuan, H W Xie, D M Wang
Objective: To investigate the characteristics of superior petrosal vein (SPV) and its influence on the surgical field in microvascular decompression (MVD) for trigeminal neuralgia (TN), and to analyze the effect of the surgical treatment of SPV on the surgical approach, indication and prognosis. Methods: The clinical data of 280 patients with trigeminal neuralgia between Jan. 2013 and Jun. 2016 were collected, including the trunks and the branches of SPV, intraoperative electrocoagulation status, the surgery outcome and complications...
February 21, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28191380/transorbital-approach-for-endovascular-occlusion-of-carotid-cavernous-fistulas-technical-note-and-review-of-the-literature
#11
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
#12
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...
May 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28069628/cushing-s-syndrome-a-practical-approach-to-diagnosis-and-differential-diagnoses
#13
REVIEW
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...
April 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
#14
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
#15
REVIEW
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...
February 2017: 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
#16
REVIEW
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...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27647276/the-superior-petrosal-sinus-a-review-of-anatomy-embryology-pathology-and-neurosurgical-relevance
#17
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
#18
Nakao Ota, Felix Goehre, Takanori Miyazaki, Yu Kinoshita, Hidetoshi Matsukawa, Takeshi Yanagisawa, Fumihiro 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. Because of 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...
December 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
#19
Francesco Acerbi, Giuseppe Farago, Morgan Broggi, Claudio Cavallo, Michela Ranieri, Valentina Caldiera, Elisa Ciceri, Paolo Ferroli
Direct exposure and cannulation of the superior ophthalmic vein (SOV) provides an alternative access to reach the cavernous sinus for carotid-cavernous fistula (CCF) embolization, when classic transvenous routes through the 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...
2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27586179/orbital-approaches-for-treatment-of-carotid-cavernous-fistulas-a-systematic-review
#20
REVIEW
Kevin Phan, Joshua Xu, Vannessa Leung, Ian Teng, Sharaf Sheik-Ali, Monish Maharaj, Ralph Mobbs, Prashanth J Rao
BACKGROUND: 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 caused by abnormal fistula drainage can cause permanent blindness, and so urgent interventional treatment is necessary. Transvenous embolization of the fistula is the primary treatment option for most patients with symptomatic CCFs. Orbital approaches are considered to be risky compared with the traditional approach via the inferior petrosal sinus and are thus used as a secondary option...
December 2016: World Neurosurgery
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