Basilar Invagination: Transoral Microsurgical Endoscopically-Controlled Odontoidectomy without Palatotomy in Extreme form of Basilar Invagination.

 Transoral odontoidectomy in the treatment of basilar invagination is surgically challenging. Incision of the soft palate significantly increases rostral exposure of the clivus but is associated with a high incidence of speech and swallowing difficulties after surgery. We present a patient suffering from severe compression of the medulla oblongata due to an extreme form of basilar invagination treated successfully with the resection of dens via a transoral nasopharyngeal approach without palatotomy.

Is Falcine Meningioma a Diffuse Disease of the Falx? Case Series and Analysis of a "Grade Zero" Resection.

Background: Falcine meningiomas have unique characteristics including their high rates of recurrence, association with high grade pathology, increased male prevalence, and potential for diffuse involvement of the falx.

Objective: To address these issues in a substantial series of falcine meningiomas and report on the impact of extent of resection for this distinct meningioma entity.

Methods: Retrospective analysis of characteristics and outcomes of 59 falcine meningioma patients who underwent surgery with the senior author.

Foramen Magnum Meningioma: Microsurgical Endoscopic-Controlled Resection via a Lateral Suboccipital Retrocondylar Approach with Preservation of Posterior Arch of Atlas Integrity.

 Surgical treatment of foramen magnum (FM) meningiomas is challenging due to proximity of the tumor to critical neurovascular structures, namely, the lower brainstem/upper cervical cord, vertebral artery, PICA, and lower cranial nerves. Controversies in microsurgical resection of meningiomas in this location include the necessity for condyle drilling and the need for vertebral artery mobilization. However, a laminectomy or hemilaminectomy of the C1 posterior arch is usually routinely performed.

Spontaneous cerebellar hemorrhage--experience with 57 surgically treated patients and review of the literature.

The treatment of spontaneous cerebellar hemorrhage is still discussed controversially. We analyzed a series of 57 patients who underwent surgical evacuation of a cerebellar hematoma at our department. Preoperative clinical and radiological parameters were assessed and correlated with the clinical outcome in order to identify factors with impact on outcome.

AVM resection after radiation therapy--clinico-morphological features and microsurgical results.

A subgroup of patients initially treated by radiosurgery underwent surgical resection because of recurrent hemorrhage or neurological deterioration. In a retrospective study, we want to analyze the clinical features of these patients and evaluate the effect of microneurosurgery in such rare constellations. Moreover, we hope to find answers about failure of radiation therapy in these cases by correlation of radiobiological and histopathological data.

Decompressive laminoplasty in multisegmental cervical spondylotic myelopathy: bilateral cutting versus open-door technique.

Purpose: The aim of the study was to evaluate patients with multisegmental cervical spondylotic myelopathy (MCM) surgically treated via a dorsal approach. Two different laminoplasty techniques were compared by assessment of enlargement of the spinal canal and the neurological outcome.

Methods: Thirteen patients (mean age 49 years, 11 males) underwent decompressive laminoplasty over a 7-year period.

Anterior clinoidal meningiomas: functional outcome after microsurgical resection in a consecutive series of 106 patients. Clinical article.

Object: In this study, the authors' goal was to analyze a series of patients treated microsurgically for an anterior clinoid process (ACP) meningioma in regard to long-term functional outcome.

Methods: The authors retrospectively analyzed clinical data in a consecutive series of 106 patients who underwent microsurgical treatment for an ACP meningioma at 2 neurosurgical institutions between 1987 and 2005. The main presenting symptoms of the 84 female and 22 male patients (mean age 56 years) were visual impairment in 54% and headache in 28%.

Spinal meningiomas: critical review of 131 surgically treated patients.

This study was undertaken to analyze the functional outcome of surgically treated spinal meningiomas and to determine factors for surgical morbidity. Between January 1990 and December 2006 a total of 131 patients underwent surgical resection of a spinal menigioma. There were 114 (87%) female and 17 (13%) male patients.

Meningiomas of the falcotentorial junction: selection of the surgical approach according to the tumor type.

Background: We retrospectively analyzed a series of patients harboring a FT meningioma with regard to clinical presentation, surgical technique, and follow-up results.

Methods: Clinical data in a consecutive series of 13 patients treated for a meningioma of the FT junction were retrospectively reviewed. Tumors were classified into 4 types according to their dural origin and tumor extent as depicted from preoperative MRI.

The impact of subarachnoid hemorrhage on regional cerebral blood flow and large-vessel diameter in the canine model of chronic vasospasm.

Objective: The aim of this study was to correlate changes in regional cerebral blood flow (rCBF) to the degree of cerebral vasospasm in the canine two-hemorrhage model of subarachnoid hemorrhage (SAH).

Methods: SAH was induced in 13 adult beagle dogs using the two-hemorrhage model. Eleven beagle dogs served as controls.

Foramen magnum meningiomas: clinical outcome after microsurgical resection via a posterolateral suboccipital retrocondylar approach.

Objective: We analyzed a consecutive series of patients operated for a foramen magnum (FM) meningioma located on the ventral aspect of the medulla oblongata via a posterolateral suboccipital retrocondylar approach with regard to long-term surgical outcome.

Methods: Clinical data in a consecutive series of 25 patients experiencing a meningioma attached to dura of the anterior or anterolateral FM rim were retrospectively reviewed.

Results: The most common symptoms of the 19 women and six men (mean age, 59.

Dural involvement in primary extradural meningiomas of the cranial vault.

Object: The authors retrospectively analyzed a consecutive series of patients with cranial vault primary extradural meningioma (PEM), with particular regard to the tumor's dural involvement. The pertinent literature was reviewed.

Methods: Clinical data were retrospectively obtained in a consecutive series of 16 patients treated for a PEM at two institutions between 1992 and 2004.

Tuberculum sellae meningiomas: functional outcome in a consecutive series treated microsurgically.

Objective: The objective of this study was to analyze a series of patients harboring a tuberculum sellae meningioma with regard to clinical presentation and long-term functional outcome.

Methods: Data in a consecutive series of 62 patients harboring a tuberculum sellae meningioma treated microsurgically between 1990 and 2003 were retrospectively reviewed.

Results: The mean age of the 46 women and 16 men enrolled in the study was 53 years (range = 29-81 years).

Spinal intradural juxtamedullary cysts in the adult: surgical management and outcome.

Objective: Intradural nonneoplastic cysts compressing the spinal cord are rare lesions. We retrospectively analyzed a series of patients harboring this entity with regard to clinical and radiological features, surgical management, and follow-up results.

Methods: In a retrospective study, we reviewed the medical charts, radiological investigations, and follow-up data of 11 women and 10 men (mean age, 43.

Tentorial meningiomas: clinical results in 81 patients treated microsurgically.

Objective: Even during the microsurgical era, tentorial meningiomas present a formidable surgical challenge when tumor involves critical neurovascular structures. We report our experience with tentorial meningioma with regard to clinical presentation, diagnostic workup, microsurgical technique, complications, and follow-up results.

Methods: In a retrospective study, we reviewed the medical charts, neuroimaging data, and follow-up data of patients treated microsurgically for tentorial meningioma in our department between January 1989 and June 2002.

Meningiomas of the posterior petrous bone: functional outcome after microsurgery.

Object: The aim of this study was to analyze a subgroup of patients harboring cerebellopontine angle meningiomas originating from the posterior petrous bone in regard to clinical presentation, surgical anatomy, complications, and long-term functional postoperative results.

Methods: Data in a series of 51 patients with meningiomas of the posterior petrous bone who had undergone microsurgical treatment at the authors' institution between 1989 and 2002 were retrospectively reviewed. The patient population consisted of 46 women and five men with a mean age of 53 years (range 22-70 years).