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spine, skull Base, vascular

Ken Matsushima, Ryo Hashimoto, Masahide Gondo, Hirokazu Fukuhara, Michihiro Kohno, Hiroyuki Jimbo
BACKGROUND: Incidental durotomy is a relatively common complication in spinal surgeries, and treatment of persistent cerebrospinal fluid (CSF) leakage is still challenging, especially in cases for which "watertight" suturing is inapplicable. The usefulness of a non-vascularized perifascial areolar tissue (PAT) graft was recently emphasized for plastic and skull base surgeries. Its hypervascularity allows for early engraftment and long-term survival, and its flexibility is advantageous in fixing defects of complex shapes in limited surgical spaces...
August 20, 2016: World Neurosurgery
Roberta Rehder, Muhammad Abd-El-Barr, Kristopher Hooten, Peter Weinstock, Joseph R Madsen, Alan R Cohen
PURPOSE: In an era of residency duty-hour restrictions, there has been a recent effort to implement simulation-based training methods in neurosurgery teaching institutions. Several surgical simulators have been developed, ranging from physical models to sophisticated virtual reality systems. To date, there is a paucity of information describing the clinical benefits of existing simulators and the assessment strategies to help implement them into neurosurgical curricula. Here, we present a systematic review of the current models of simulation and discuss the state-of-the-art and future directions for simulation in neurosurgery...
January 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
N V Glagolev
This literature review is devoted to the clinical and pathogenic aspects of the relationship between Chiari type I malformation (CMT) and scoliosis. The view of the clinical presentation development in CMT associated with scoliosis is considered on the basis of both the CSF dynamics disturbances and vascular pathology of the craniovertebral junction. The role of the posterior atlanto-occipital membrane is evaluated. Case reports of the risk factors for scoliosis progression in patients with CMT are presented...
2014: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
R Ortiz, E Domínguez, S López Fernández, M Miguel, F Sánchez Pérez-Grueso, L Martínez, J A Tovar
BACKGROUND/AIM: Neither cervicotomy nor postero-lateral thoracotomy allow safe surgical access to the lower cervical spine and high posterior mediastinum with full control of the vascular and neural structures involved. We report our favorable experience with cervico-sternotomy for accessing this region. PATIENTS AND METHODS: Six patients were operated upon between 1998 and 2011 for either removal of huge cervico-thoracic neural ganglioneuromas (n = 2) or anterior arthrodesis for congenital (n = 2), neuropathic (n = 1) or osteolytic scoliosis (n = 1)...
July 2014: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Megan K Mills, Lubdha M Shah
The perivertebral space extends from the skull base to the mediastinum and is delineated by the deep layer of the deep cervical fascia. The different tissue types, including muscles, bones, nerves, and vascular structures, give rise to the various disorders that can be seen in this space. This article defines the anatomy of the perivertebral space, guides lesion localization, discusses different disease processes arising within this space, and reviews the best imaging approaches.
January 2015: Radiologic Clinics of North America
María Elisa López-Vázquez, Francisco Javier Llamas-Macías, César Nuño-Escobar, Alejandro González-Ojeda, Clotilde Fuentes-Orozco, Michel Dassaejv Macías-Amezcua
BACKGROUND: Paragangliomas of the head and neck are neuroendocrine tumors. They have a low incidence (0.6%), are generally benign, have a poorly defined etiology, and multiple factors have been associated with their origin. Humans and other species living at high altitudes (>2000 m above sea level) are subjected to a relatively chronic hypoxia and there is a high prevalence of the development of carotid body hyperplasia and eventually paragangliomas. This disease is usually seen in patients in their 50s and in their 30s if there is a family history...
May 2014: Cirugia y Cirujanos
Joseph A Osorio, Arnau Benet, Christopher P Hess, Michael W McDermott, Adib A Abla
BACKGROUND: Iatrogenic vertebral artery injury is a rare neurosurgical complication, but it is potentially fatal. The majority of vertebral artery injuries are encountered during cervical spine instrumentation, and craniotomy-related injuries have been encountered during the far-lateral approach. OBJECTIVE: To present the first reported case of iatrogenic vertebral artery injury occurring during retrosigmoid craniotomy, in the setting of an anomalous vertebral artery course within the suboccipital musculature...
December 2014: Neurosurgery
Ludo F M Beenen, Joanne C Sierink, Saskia Kolkman, C Yung Nio, Teun Peter Saltzherr, Marcel G W Dijkgraaf, J Carel Goslings
BACKGROUND: For the evaluation of severely injured trauma patients a variety of total body computed tomography (CT) scanning protocols exist. Frequently multiple pass protocols are used. A split bolus contrast protocol can reduce the number of passes through the body, and thereby radiation exposure, in this relatively young and vitally threatened population. PURPOSE: To evaluate three protocols for single pass total body scanning in 64-slice multidetector CT (MDCT) on optimal image quality...
July 2015: Acta Radiologica
A Zimmer, W Reith
Temporal bone fractures are mostly due to high-energy head trauma with high rates of concurrent intracranial and cervical spine injuries and belong to the wider spectrum of lateral skull base trauma. Given that the temporal bone represents the most complex bone structure in the human body, containing a multitude of vital neurovascular structures, variable clinical presentations may arise from such fractures, ranging from asymptomatic courses to serious consequences, such as conductive and/or sensorineural hearing loss, vascular and/or cranial nerve injury as well as cerebrospinal fluid leakage...
April 2014: Der Radiologe
Brandon Robert Bruns, Ronald Tesoriero, Joseph Kufera, Clint Sliker, Adriana Laser, Thomas M Scalea, Deborah M Stein
BACKGROUND: Blunt cerebrovascular injury (BCVI) is reported to occur in approximately 2% of blunt trauma patients, with a stroke rate of up to 20%. Guidelines for BCVI screening are based on clinical and radiographic findings. We hypothesized that liberal screening of the neck vasculature, as part of initial computed tomographic (CT) imaging in blunt trauma patients with significant mechanisms of injury, identifies BCVI that may go undetected. METHODS: As per protocol, patients at risk for significant injuries undergo a noncontrast head CT scan followed by a multislice CT scan (40-slice or 64-slice) incorporating an intravenous contrast-enhanced pass from the circle of Willis through the pelvis (whole-body CT [WBCT] scan)...
March 2014: Journal of Trauma and Acute Care Surgery
Nickalus R Khan, Clinton J Thompson, Douglas R Taylor, Garrett T Venable, R Matthew Wham, L Madison Michael, Paul Klimo
OBJECT: Bibliometrics is defined as the study of statistical and mathematical methods used to quantitatively analyze scientific literature. The application of bibliometrics in neurosurgery is in its infancy. The authors calculate a number of publication productivity measures for almost all academic neurosurgeons and departments within the US. METHODS: The h-index, g-index, m-quotient, and contemporary h-index (hc-index) were calculated for 1225 academic neurosurgeons in 99 (of 101) programs listed by the Accreditation Council for Graduate Medical Education in January 2013...
March 2014: Journal of Neurosurgery
Nicolai El Hindy, Adrian Ringelstein, Michael Forsting, Ulrich Sure, Oliver Mueller
BACKGROUND: We are the first to report one-staged resection of a spinal metastasis from malignant cranial hemangiopericytoma after preoperative Onyx™-20 embolization by direct percutaneous puncture.Spinal metastases from cranial hemangiopericytoma are extremely rare. Surgical morbidity of these highly vascularized tumours results mainly from excessive blood loss. Preoperative embolization of hyper vascular tumours has been used to reduce intraoperative blood loss for a long time. To avoid complications from arterial catheter intervention, direct percutaneous puncture has been advocated as a safe and effective alternative...
2013: World Journal of Surgical Oncology
M J Moravan, A L Petraglia, J Almast, G A Yeaney, M C Miller, G Edward Vates
Intraosseous hemangiomas are benign vascular tumors that are encountered most commonly in vertebrae and rarely in the skull. When presenting in the skull, they are commonly found in the calvarium in frontal and parietal bones and seldom in the skull base. We encountered a patient with an incidental finding on magnetic resonance imaging (MRI) of an enhancing lesion in the clivus. Here we report an unusual location of a clival intraosseous hemangioma. A 62 year old man worked up for carpal tunnel syndrome had imaging of his cervical spine that revealed an enhancing clival lesion, which extended into the left occipital condyle...
September 2012: Journal of Neurosurgical Sciences
C Zhu, H G Zhu, Z Y Zhang, L Z Wang, J W Zheng, W M Ye, Y He, Y A Wang
OBJECTIVES: To investigate the clinical symptoms, computed tomography (CT) features and treatments of intraosseous venous malformations (IVM) that occur in the facial bone. METHODS AND RESULTS: Eleven patients with facial IVM were treated with two surgical techniques, excision (n = 4) or curettage (n = 7). No recurrence was encountered at follow-up (45.8 ± 16.0 months). Postoperative deformities were left in two paediatric patients who were treated with excision...
August 2013: Phlebology
Irene Monjas-Cánovas, Elena García-Garrigós, Juan J Arenas-Jiménez, Javier Abarca-Olivas, Francisco Sánchez-Del Campo, Juan R Gras-Albert
INTRODUCTION AND OBJECTIVES: Our aim was to study the radiological anatomy of the ethmoidal arteries. METHODS: A descriptive study was performed including CT images of 20 cadaver heads. The specimens were perfused with a radiopaque material and various anatomical parameters were analysed. RESULTS: The anterior ethmoidal artery was found in 95% (38/40) of cases. It originated from the ophthalmic artery in 87.5% (34/40) of nasal cavities. In six cases, normal variants were found...
September 2011: Acta Otorrinolaringológica Española
J C Tonn, C Schichor, O Schnell, S Zausinger, E Uhl, D Morhard, M Reiser
Intraoperative computed tomography (iCT) has gained increasing impact among modern neurosurgical techniques. Multislice CT with a sliding gantry in the OR provides excellent diagnostic image quality in the visualization of vascular lesions as well as bony structures including skull base and spine. Due to short acquisition times and a high spatial and temporal resolution, various modalities such as iCT-angiography, iCT-cerebral perfusion and the integration of intraoperative navigation with automatic re-registration after scanning can be performed...
2011: Acta Neurochirurgica. Supplement
Karl Schaller, Marc Kotowski, Vitor Pereira, Daniel Rüfenacht, Philippe Bijlenga
OBJECTIVE: We aimed at the integration of recent flat panel technology in a joint interventional suite for neurosurgeons and neuroradiologists. METHODS: A Flat Panel system, allowing for intraoperative performance of 2D and 3D DSA, for automated segmentation of vascular structures, and for performance of computed tomography, was connected with a surgical microscope and neuronavigation. All surgical and neurointerventional cases were monitored and stored in a prospective data base...
2011: Acta Neurochirurgica. Supplement
C Pizzoni, C Sarandria, E Pierangeli
Clear-cell meningioma (CCM) is a rare subtype of meningioma which occurs at a younger age and has a higher recurrence rate than other subtypes (WHO grade II). CCM usually occur in younger patients and is located in the posterior fossa and spine. The authors report the first case of olfactory groove mixed clear-cell meningioma. A 66-year-old woman was admitted to the SS. Annunziata Hospital (Taranto, Italy) in January 2007 with a two-year history of subtle changes in personality and mental function. On neurologic examination she presented a loss of sense of smell...
September 2009: Journal of Neurosurgical Sciences
N Samprón, M Arrazola, E Urculo
INTRODUCTION: Cranio-cervical instability is, in some cases, the main surgical concern in posterior skull base tumors. We report on a case in which a solitary plasmacytoma of the skull base presented with cranio-cervical instability. Vertebral artery was injured during surgery. The surgical anatomy is reviewed, with emphasis in vascular complications avoidance. CASE REPORT: A 66 year-old woman was diagnosed of a cranial base solitary plasmacytoma and treated with radio and chemotherapy with complete remission...
October 2009: Neurocirugía
Jae Il Lee, Young Zoon Kim, Eun Hee Lee, Kyu Hong Kim
Although adenoid cystic carcinoma (ACC) of the lacrimal gland is a rarely encountered orbital tumor, it invades intracranially more frequently than carcinomas of other glands in the head and neck. A 52-year-old man underwent orbital exenteration and resection of intracranially extended tumor via a fronto-orbito-zygomatic approach in combination with a transfacial approach. Histopathologically, the tumor showed perineural, vascular, and lymphatic invasion. Additionally, he received radiotherapy (60 Gy) and adjuvant systemic cisplatin and 5-fluorouracil chemotherapy due to residual tumor in the orbit and systemic metastases (lung, ribs, and spines)...
October 2008: Journal of Korean Neurosurgical Society
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