We present a 2-dimensional operative video (Video 1) of a suboccipital retrosigmoid approach for an anteromedial tentorial meningioma with a specific focus on the use of a surgical exoscope. The patient is a 50-year-old woman who presented to emergency room with a 6-month history of nausea, dizziness, and gait imbalance secondary to a 2.5-cm homogenously enhancing mass originating from the anteromedial tentorium on the right side with associated brainstem compression.
View Article and Find Full Text PDFNeurosurg Focus Video
January 2024
The authors present an operative video of a supraorbital craniotomy for resection of a suprasellar, supradiaphragmatic craniopharyngioma. The patient is a 62-year-old female who presented with 3 months of blurry vision secondary to a 2.5-cm suprasellar mass causing compression on the optic nerve.
View Article and Find Full Text PDFBackground: Head and Neck Paragangliomas are characterized by having a rich blood supply. Presurgical embolization with Onyx as a neoadjuvant treatment is not a consensus regarding its efficacy and safety. Our study aimed to answer this matter through a single-arm meta-analysis.
View Article and Find Full Text PDFClin Neurol Neurosurg
August 2023
Tuberculum sellae meningiomas are midline anterior skull base tumors and account for approximately 10-15% of all intracranial meningiomas. Clinical presentation of tuberculum sellae meningiomas is mainly characterized by visual deficits due to optic chiasm compression or optic canal invasion. Treatment options for TSM typically involve surgical resection of the tumor.
View Article and Find Full Text PDFClin Neurol Neurosurg
July 2023
Meningiomas that arise in the atria of the lateral ventricles are relatively rare lesions, that pose a unique challenge for surgery due to their deep-seated location and proximity to critical white matter tracts. Size and anatomical variations can affect the best approach for these tumors, with several approaches described to access the atrium including the interhemispheric trans-precuneus, trans-supramarginal gyrus, distal trans-sylvian, supracerebellar trans-collateral sulcus, and finally the trans-intraparietal sulcus approach, which was the choice for this case. Minimally invasive techniques that preserve the surrounding tissue are becoming increasingly popular and are perfectly suited to deep seated lesions.
View Article and Find Full Text PDFObjective: Surgery is the primary treatment for craniopharyngioma with the preservation of hypothalamic function of paramount importance. Infundibular preservation is debated, as maximal resection decreases recurrence rates but causes hypopituitarism. A triphasic response of diabetes insipidus (DI), syndrome of inappropriate antidiuretic hormone secretion (SIADH), and recurrent DI has been described after pituitary surgery, but the impact of infundibular preservation on the triphasic response following craniopharyngioma resection has not been well established.
View Article and Find Full Text PDFSkull base surgery has undergone significant progress following key technological developments. From early candle-lit devices to the modern endoscope, refinements in visualization techniques have made endoscopic skull base surgery (ESBS) a standard practice for treating a variety of conditions. The endoscope has also been integrated with other technologies to enhance visualization, including fluorescence agents, intraoperative neuronavigation with augmented reality, and the exoscope.
View Article and Find Full Text PDFThe pituitary gland plays a vital role in hormonal regulation. Pituitary lesions include tumors, cysts, and inflammatory processes that require multidisciplinary care from endocrinologists, neuro-ophthalmologists, neurosurgeons, and otolaryngologists. Treatment is typically aimed at controlling hormonal hypersecretion, decompressing the optic apparatus, and reducing tumor volume, and surgery is a common first-line approach.
View Article and Find Full Text PDFJ Craniovertebr Junction Spine
August 2020
Background: Despite the various treatment protocols available, survival evaluation is a fundamental criterion for the definition of surgical management; there are still many inconsistencies in the literature on this topic, especially in terms of the value of surgery and its morbidity in patients with very short survival.
Objective: The objective was to analyze the association of clinical, oncological, and surgical factors in the survival of patients undergoing spinal surgery for spinal metastases (SM).
Materials And Methods: A retrospective cohort of forty patients who were surgically treated at our institution for SM between 2010 and 2018 were included in the study.
Study Design: Retrospective cohort.
Objective: Evaluate the epidemiology of surgical patients with spinal metastases, identify the complications, and evaluate their neurological prognoses.
Summary Of Background Data: The development of new oncological treatments and screening tests have increased the survival of oncologic patients, and consequently, the incidence of metastatic lesions of the spine.
Background: The new AOSpine Upper Cervical Classification System (UCCS) was recently proposed by the AOSpine Knowledge Forum Trauma team to standardize the treatment of upper cervical traumatic injuries (UCI). In this context, evaluating its reliability is paramount prior to clinical use.
Objective: To evaluate the reliability of the new AOSpine UCCS.
Objective: Many repair techniques have been proposed to treat large myelomeningocele (MMC), and although effective in many cases, some of these techniques can be complex and time consuming, with complications such as cerebrospinal fluid (CSF) leakage, flap loss, tip necrosis, and wound dehiscence. The purpose of this study was to analyze cases of large skin defects and the methods applied and to report the outcomes of the keystone design perforator island flap (KDPIF) technique for large MMC closure.
Methods: The authors performed a retrospective review of all neonatal patients who had undergone KDPIF for MMC closure in the period from 2013 to 2018.
Rev Assoc Med Bras (1992)
February 2019
Objective: To present the surgical results of patients who underwent axis screw instrumentation, discussing surgical nuances and complications of the techniques used.
Methods: Retrospective case-series evaluation of patients who underwent spinal surgery with axis instrumentation using screws.
Results: Sixty-five patients were included in this study.