Publications by authors named "Juan Leonardo Serrato-Avila"

Article Synopsis
  • * A total of 42 brainstems were analyzed, revealing a significant increase in surgical exposure from 42 mm² to 159.6 mm² after QLC resection, aiding in procedures involving the pons and cerebellum.
  • * After evaluating 59 patients who underwent this surgery, it was found that while some experienced temporary side effects like ataxia, all symptoms resolved within a year, and overall patient outcomes improved.
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Article Synopsis
  • The cerebellar interpeduncular region, especially the middle cerebellar peduncle (MCP) and interpeduncular sulcus (IPS), is crucial for surgery due to various vascular and tumor-related issues.
  • A study was conducted using cadaveric heads and human brainstems to analyze the surface and vascular anatomy of these areas to identify safer surgical entry points.
  • Findings suggest that accessing the middle thirds of the IPS and MCP is safer than the upper and lower thirds, as they have fewer blood vessels and important nerve tracts crossing through them.
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Article Synopsis
  • This study investigates the "safe entry zones" (EZs) in the brainstem, which are crucial for accessing brainstem pathologies during surgery.
  • The research involved analyzing 26 human brainstems to define safe working areas and distances for various EZs based on key brain structures.
  • Results showed that the transolivary EZ has the largest safe working area, while the supracolicular EZ is identified as the most effective route for accessing specific brain regions like the midbrain tectum and fourth ventricle.
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Cavernous malformations (CM) affect approximately 0.5% of the population, with only a limited portion being located in the optic nerve and chiasma. The clinical presentation is determined by their locations.

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Objective: The cerebellar interpeduncular region (CIPR) is a gate for dorsolateral pontine and cerebellar lesions accessed through the supracerebellar infratentorial approach (SCITa), the occipital transtentorial approach (OTa), or the subtemporal transtentorial approach (STa). The authors sought to compare the exposures of the CIPR region that each of these approaches provided.

Methods: Three approaches were performed bilaterally in eight silicone-injected cadaveric heads.

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Background: Intracranial aneurysms are common vascular malformation occurring in 1-2% of the population and accounting for 80-85% of nontraumatic subarachnoid hemorrhages. About 10% of the ruptured aneurysm causing subarachnoid hemorrhage (SHA) develop intraventricular hemorrhage (IVH). In this scenario, the external ventricular drain (EVD) is a usual treatment for IVH.

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Background: Atypical teratoide/rhabdoid tumor is a very rare and aggressive disease that primarily presents in pediatric patients. To the best of our knowledge, the initial presentation of this type of tumor with ganglioglioma-like differentiation is rare in the literature.

Case Report: We present the case of a 9-month-old patient with left facial paralysis.

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Background: Giant brain aneurysms account for approximately 5% of all intracranial aneurysms, often presenting with intraluminal thrombosis that causes a mass effect in surrounding neural structures. Although its exact growing mechanism remains unknown, they have to be treated. Despite the most recent advances in neurosurgical fields, the best treatment modality remains unknown and surgery of giant superior cerebellar artery (SCA) aneurysms still is a challenge even for the most experienced neurosurgeons, due to their deep location, surrounding perforating vessels, and intraluminal thrombosis.

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Objective: In this article, we describe a new safe entry point for the posterolateral pons.

Methods: To show the adjacent anatomy and measure the part of the interpeduncular sulcus that can be safely accessed, we first performed a review of the literature regarding the pons anatomy and its surgical approaches. Thereafter, 1 human cadaveric head and 15 (30 sides) human brainstems with attached cerebellums were bilaterally dissected with the fiber microdissection technique.

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Late radiation necrosis is a rare entity presenting in 2.2% to 9% of radiation-treated arteriovenous malformations (AVMs). It occurs by a mean of 3 years following treatment.

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Objective: To present an alternative cost-effective hemostatic agent (HA) for cranial surgery and to describe the technique to produce it.

Methods: This HA has been used in 3 reference centers over the last year during 230 procedures, including different types of pathology, such as skull base, oncology, vascular, and trauma, either for endoscopic or open approaches. This agent was made from a low-cost and worldwide-available gelatin foam which was mixed with saline solution in 2 syringes and connected by a 3-way stopcock, making a useful hemostatic paste.

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Introduction And Objectives: The irreducible neuroaggressive disorder (IND) is a well-described entity known to be associated with impulsive and aggressive behavior. While various studies have assessed available pharmacological and non-pharmacological treatment regimens, patients with IND continue to pose a major threat to themselves and society. While targeted stereotactic therapy for IND has gained traction in recent years, there is a paucity of information describing comparative effectiveness of different validated anatomic regions.

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