Modified Lateral Supraorbital Craniotomy with Posterior Orbitotomy and Anterior Clinoidectomy for Resection of a Midline Planum and Tuberculum Sellae Meningioma.

The patient is a 51-year-old woman who had been experiencing syncope and near-syncopal events for at least 10 years with an otherwise benign neurological exam. Magnetic resonance imaging revealed an extra-axial mass consistent with a midline planum and tuberculum sellae meningioma, for which the patient opted to have resected. We demonstrate how performing a posterior orbitotomy with anterior clinoidectomy can enhance a lateral supraorbital craniotomy.

Epidermoid Cyst with Bilateral Premedullary Involvement Resected from Left Far-Lateral Approach.

The patient is a 51-year-old woman with an epidermoid cyst extending bilaterally along the clivus and cerebellopontine angles from the level of the cisterna magna to the prepeduncular cistern. Her presenting symptoms included hearing loss, tinnitus, and imbalance for 4 months. Near-complete resection of the epidermoid cyst was achieved via a left far-lateral approach.

Mixed Gangliocytoma-Pituitary Adenoma: A Systematic Review of Diagnostic Features, Clinical Management, and Surgical Outcomes.

Objective: Mixed gangliocytoma-pituitary adenomas (MGPAs) are very rare sellar neoplasms. Contemporary understanding of their natural history, clinical characteristics, optimal management strategies, and prototypical outcomes remains poorly understood.

Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Embase, Web of Science, and Cochrane were searched to include studies of patients with histologically confirmed mixed gangliocytomas.

Anatomical Step-by-Step Dissection of Complex Skull Base Approaches for Trainees: Lateral Supraorbital Approach with Expanded Indications.

 The lateral supraorbital (LSO) approach is a less-invasive alternative to the pterional craniotomy that provides rapid transsylvian access. Establishing familiarity with the LSO technique and its features as compared with other anterolateral approaches is an important component of advanced skull base training. We present a step-by-step demonstration of the LSO approach using cadaveric dissection in a manner that is digestible for trainees at various levels.

DSA Quantitative Analysis and Predictive Modeling of Obliteration in Cerebral AVM following Stereotactic Radiosurgery.

Background And Purpose: Stereotactic radiosurgery is a key treatment modality for cerebral AVMs, particularly for small lesions and those located in eloquent brain regions. Predicting obliteration remains challenging due to evolving treatment paradigms and complex AVM presentations. With digital subtraction angiography (DSA) being the gold standard for outcome evaluation, radiomic approaches offer potential for more objective and detailed analysis.

A taxonomy for cerebellar cavernous malformations: subtypes of cerebellar lesions.

Objective: An anatomical taxonomy has been established to guide surgical approach selection for resecting brainstem and deep and superficial cerebral cavernous malformations (CMs). The authors propose a novel taxonomy for cerebellar CMs, introduce 6 distinct neuroanatomical subtypes, and assess their clinical outcomes.

Methods: This bi-institutional, 2-surgeon cohort study included 143 cerebellar CMs that were microsurgically treated over a 25-year period.

Profound Pneumocephalus and Low-Pressure Hydrocephalus Triggered by Ventriculoperitoneal Shunt Placement after Resection, Fat Graft Reconstruction, and Radiotherapy for a Malignant Skull Base Schwannoma.

 Tension pneumocephalus is a rare postoperative complication, typically presenting with mental status changes or rapid neurological decline after craniotomy. We report a complex case of tension pneumocephalus triggered by graft retraction after ventriculoperitoneal (VP) shunt placement.  A 39-year-old woman with a recurrent left trigeminal cavernous sinus schwannoma, status post one prior resection, two stereotactic radiosurgery treatments, and one course of fractionated radiotherapy, underwent radical resection with orbital exenteration and abdominal fat free graft reconstruction followed by adjuvant radiotherapy for malignant transformation.

Systematic reviews and meta-analyses in the cerebrovascular space: essential domains for readers.

Introduction: Systematic Review and Meta-Analysis (SRMAs) in neurosurgery have significantly increased. With approximately 1 million patients affected by cerebrovascular disease annually, interpreting SRMAs necessitates a systematic approach. The objective of this review is to identify and describe four essential domains for SRMA interpretation.

The power of social media: broader Twitter outreach and higher Altmetric scores significantly amplify neurosurgical citation reach.

Objective: The authors sought to quantify the role of social media-related academic activity through use of the Altmetric score (a composite score based on social media attention from a variety of sources) and investigate its potential impact on the number of citations received at 3 years postpublication (articles published between January 2019 and December 2019).

Methods: Articles published in the top 12 neurosurgical journals according to Google Scholar (based on 5-year Web of Science impact factors, 2017-2021) were identified. Data collected included days since publication, Altmetric scores, and total number of tweets (posts), and 3-year citations were obtained from Google Scholar.

Spontaneous resolution of traumatic cervical epidural hematoma: illustrative case.

Background: Cervical epidural hematomas are rare and can arise for many reasons. Patients typically present with pain and/or symptoms of spinal cord compression. Prompt surgical decompression is typically pursued when deficits are present in an effort to improve long-term neurological outcomes.

Clinical Research Primer for Medical Students: Overview and Illustrative Experiences.

 The ability to participate in clinical scholarship is a foundational component of modern evidence-based medical practice, empowering improvement across essentially every aspect of clinical care. In tandem, the need for comprehensive exposure to clinical research has been identified as a critical component of medical student training and preparation for residency that is underserved by traditional undergraduate medical education models. The goal of the current work was to provide guidelines and recommendations to assist novice medical students in taking ownership of their research education.

Arteriovenous malformations in the cerebellopontine angle: assessment of the "backdoor resection" technique and microsurgical results in 38 patients.

Objective: Posterior fossa arteriovenous malformations (AVMs) represent 7% to 15% of all intracranial AVMs and are associated with an increased risk of hemorrhage, morbidity, and mortality compared with supratentorial AVMs, thus prompting urgent and definitive treatment. Cerebellopontine angle (CPA) AVMs are a unique group of posterior fossa AVMs incorporating characteristics of brainstem and cerebellar lesions, which are particularly amenable to microsurgical resection. This study reports the clinical, radiological, operative, and outcome features of patients with CPA AVMs in a large cohort.

Transcirculation retrograde placement of a Pipeline embolization device for treatment of a vertebrobasilar junction aneurysm.

Transcirculation catheterization, also known as the retrograde approach, involves the navigation of a catheter or other endovascular device from one arterial circulation to the other (right to left, or anterior to posterior).1-4 We present a case of a complex vertebrobasilar junction aneurysm previously treated by bilateral vertebral artery deconstruction, precluding antegrade access (video 1). Following the creation of a protective occipital artery to posterior inferior cerebellar artery (PICA) bypass, the patient was treated with transcirculation placement of a Pipeline embolization device (PED).

Microsurgical Resection of Brainstem Cavernous Malformations in Older Adults: A Multicenter, 30-Year Experience.

Background And Objectives: Microsurgical resection is the only curative intervention for symptomatic brainstem cavernous malformations (BSCMs), but the management of these lesions in older adults (≥65 years) is not well described. This study sought to address this gap by examining the safety and efficacy of BSCM resection in a cohort of older adults.

Methods: Records of patients who underwent BSCM resection over a 30-year period were reviewed retrospectively.

Acute Macrocystic Thoracic Schwannoma: Systematic Review and Illustrative Case Example.

Background: Schwannomas are benign peripheral nerve sheath tumors arising from myelinating Schwann cells. Although macrocystic changes are regularly encountered in schwannoma variants such as vestibular nerve tumors, they are exceedingly rare among spinal neoplasms.

Methods: Case report and systematic review of 4 databases (Ovid Medline, PubMed, Science Direct, and SCOPUS) from inception to present.

Genetically Distinct Oligosarcoma Arising from Oligodendroglioma: Systematic Review & Illustrative Case Example.

Background: Oligosarcoma is a rare central nervous system (CNS) neoplasm that may arise following oligodendroglioma resection, which demonstrates a unique genetic profile and aggressive clinical phenotype. We present a systematic review and illustrative case example emphasizing the clinical and prognostic features of this unusual and unfavorable neuro-oncologic disease.

Methods: Systematic literature review and illustrative case report.

Sex differences in patients with and without high-risk factors associated with aneurysmal subarachnoid hemorrhage.

Background: Controversy remains regarding the appropriate screening for intracranial aneurysms or for the treatment of aneurysmal subarachnoid hemorrhage (aSAH) for patients without known high-risk factors for rupture. This study aimed to assess how sex affects both aSAH presentation and outcomes for aSAH treatment.

Method: A retrospective cohort study was conducted of all patients treated at a single institution for an aSAH during a 12-year period (August 1, 2007-July 31, 2019).