Using the Arcuate Eminence-Trigeminal Notch Line to Localize the Anterior Wall of the Internal Auditory Canal in a Subtemporal Approach: An Anatomical Study.

 This article aims to describe the regional anatomy of the anterior end of the arcuate eminence, the lateral end of the trigeminal notch, and the line connecting the two (i.e., the arcuate eminence-trigeminal notch line [ATL]) and to determine whether the ATL could be used as a landmark for localizing the internal auditory canal (IAC).

Monitoring of intracranial venous sinus pressure and prevention for venous air embolism during operation with semi-sitting position.

Background: Venous air embolism (VAE) during craniotomy operation with semi-sitting position is closely related to intracranial venous pressure. The objective of current study was to explore the relationship between intracranial venous pressure and VAE during operation with semi-sitting position.

Methods: Between April 2018 and January 2019, 25 patients with vestibular schwannoma and 1 patient with posterior fossa meningioma received operation under semi-sitting position.

Trigeminal Schwannomas in Middle Fossa Could Breach into Subdural Space: Report of 4 Cases and Review of Literature.

Objective: The objectives of this study were to report 4 cases diagnosed with trigeminal schwannomas (TS), among whom tumor in epidural space of middle fossa broke through dura mater into subdural space, and to analyze the potential reason for recurrence of TS in middle fossa after surgical removal by endoscopic endonasal approach (EEA) or interdural approach.

Methods: The information of 4 patients diagnosed with TS who were surgically treated was retrospectively analyzed and the selection of approaches, surgical strategies, and potential reason for recurrence after middle fossa TS removal by EEA and interdural approach were discussed.

Results: During last 10 years, 43 patients with TS received surgical treatment at Xuan Wu Hospital of Capital Medical University, among whom 1 patient with TS extending from middle fossa to infratemporal fossa was first treated by EEA, then the tumor recurred and the patient underwent a second operation via a frontotemporal subdural approach.

Endoscopic Approach to Remove Intra-extracranial Tumors in Various Skull Base Regions: 10-year Experience of a Single Center.

Background: Some problems have been found in the usually adopted combined approach for the removal of intra-extracranial tumors in skull base. Herein, we described a pure endoscopic transnasal or transoral approach (ETA) for the removal of intra-extracranial tumors in various skull base regions.

Methods: Retrospectively, clinical data, major surgical complications, pre- and postoperative images, and follow-up information of a series of 85 patients with intra-extracranial tumors in various skull base regions who were treated by surgery via ETA in our skull base center during the past 10 years were reviewed and analyzed.

Usefulness of intraoperative electromyographic monitoring of oculomotor and abducens nerves during skull base surgery.

Background: Intraoperative neurophysiologic monitoring of the extraocular cranial nerve (EOCN) is not commonly performed because of technical difficulty and risk, reliability of the result and predictability of the postoperative function of the EOCN.

Methods: We performed oculomotor nerve (CN III) and abducens nerve (CN VI) intraoperative monitoring in patients with skull base surgery by recording the spontaneous muscle activity (SMA) and compound muscle action potential (CMAP). Two types of needle electrodes of different length were percutaneously inserted into the extraocular muscles with the free-hand technique.

Trigeminal neuralgia caused by a dilated superior cerebellar artery and a draining vein of cerebellar arteriovenous malformations: a case report and review of the literature.

Trigeminal neuralgia (TN) secondary to arterivenous malformations (AVMs) is relatively rare. We here report on a case of TN caused by cerebellar AVMs that was successfully treated by total AVMs resection in conjunction with microvasecular decompression (MVD) in one stage. In addition, we perform a review of the literature about the treatment of TN caused by cerebellar AVMs.

Identification of cranial nerves near large vestibular schwannomas using superselective diffusion tensor tractography: experience with 23 cases.

Background: The preservation of the facial nerve (FN) and acoustic function in large vestibular schwannoma (VS) surgery is challenging because of nerve course uncertainties and morphological deviations. Preoperative diffusion tensor tractography (DTT) has been proposed to predict the FN location. This study was conducted to evaluate the effectiveness of this technique for identifying the FN, cochlear nerve (CN) and trigeminal nerve (TN) in large VSs.

[Early experience of resection of meningiomas in anterior skull base with intra-extracranial extension via a pure endoscopic endonasal approach].

Objective: The early experience of treating anterior skull base meningiomas with intra-extracranial extension via pure endoscopic endonasal approach (EEA) was presented, the safety, feasibility and preliminary treatment outcomes were investigated.

Methods: Eight patients with intra-extradural meningiomas who were admitted from October 2006 to October 2010 were operated on via EEA in one stage in Xuanwu hospital. In this study, the operative technique was described, the degree of resection, complications and the early clinical outcomes were discussed.

Cerebral vasculopathy in a Chinese family with neurofibromatosis type I mutation.

Neurofibromatosis type I (NF1) is a hereditary, autosomal dominant, neurocutaneous syndrome that is attributed to NF1 gene mutation. NF1 has been associated with scoliosis, macrocephaly, pseudoarthrosis, short stature, mental retardation, and malignancies. NF1-associated vasculopathy is an uncommon and easily-overlooked presentation.

The pterional transsylvian transtentorial approach to ventrolateral pontine cavernomas: indications and techniques.

Objective: The authors describe a pterional transsylvian transtentorial approach to the ventrolateral pons based on its clinical application to cavernomas.

Methods: Consecutive patients in their database with brain stem cavernomas who underwent surgical removal from April 2009 to December 2012 were retrospectively analyzed. Four patients who underwent anterolateral pontine cavernoma removal via the pterional transsylvian transtentorial approach were included in the current study.

Randomized controlled trial of symptomatic middle cerebral artery stenosis: endovascular versus medical therapy in a Chinese population.

Background And Purpose: To investigate the efficacy and safety of percutaneous transluminal angioplasty and stenting (PTAS) for symptomatic middle cerebral artery stenosis compared with standard medical treatment in a low-risk Chinese population.

Methods: A prospective, randomized, controlled, single-center clinical trial was conducted comparing PTAS with medical treatment for symptomatic middle cerebral artery stenosis (≥70%). Patients were enrolled according to 1:1 enroll ratio (PTAS: medical).

Resection of anterior cranial base meningiomas with intra- and extracranial involvement via a purely endoscopic endonasal approach.

Objective: The complete resection of anterior cranial base meningiomas with intra- and extracranial involvement is always challenging. We describe our experience of treating such meningiomas via a purely endoscopic endonasal approach (EEA).

Methods: Eight patients with intra- and extradural meningiomas were operated via EEA.

A novel intravital method to evaluate cerebral vasospasm in rat models of subarachnoid hemorrhage: a study with synchrotron radiation angiography.

Precise in vivo evaluation of cerebral vasospasm caused by subarachnoid hemorrhage has remained a critical but unsolved issue in experimental small animal models. In this study, we used synchrotron radiation angiography to study the vasospasm of anterior circulation arteries in two subarachnoid hemorrhage models in rats. Synchrotron radiation angiography, laser Doppler flowmetry-cerebral blood flow measurement, [(125)I]N-isopropyl-p-iodoamphetamine cerebral blood flow measurement and terminal examinations were applied to evaluate the changes of anterior circulation arteries in two subarachnoid hemorrhage models made by blood injection into cisterna magna and prechiasmatic cistern.

Fascin expression in skull base chordoma: correlation with tumor recurrence and dura erosion.

Skull base chordomas are invasive tumors, with high rate of local recurrence even when totally extracted. The aggressive biological behavior in chordoma remains unclear. The purpose of this study was to investigate the relationship between fascin expression and tumor biological behavior in skull base chordoma.

[Intracranial aneurysms in childhood and adolescence].

Objective: To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in childhood and adolescence.

Methods: From our dedicated aneurysmal patient databank, the investigators reviewed 39 consecutive children and adolescents with 44 intracranial aneurysms. There were 24 boys and 15 girls.

Management and prognosis of symptomatic patients with intramedullary spinal cord cavernoma: clinical article.

Object: The authors conducted a study to assess the clinical pattern, radiological features, therapeutic strategies, and long-term outcomes in patients with intramedullary spinal cord cavernomas (ISCCs) based on a large case series.

Methods: This retrospective study identified 96 patients (60 males, 36 females) surgically (81 cases) or conservatively (15 cases) treated for ISCCs between May 1993 and November 2007. Each diagnosis was based on MR imaging and spinal angiography evidence.

Intracranial aneurysms in adolescents.

Purpose: Intracranial aneurysms are extremely uncommon in adolescents. This study was undertaken to assess the clinical and radiological characteristics and clarify the choice of therapeutic strategies of intracranial aneurysms in adolescents with age range from 15 to 18 years.

Methods: From our dedicated aneurysmal databank between October 1985 and July 2008, we reviewed 16 consecutive adolescents who had 20 intracranial aneurysms.

Xe-CT and transcranial doppler in symptomatic vasospasm subarachnoid hemorrhage patients under euvolemic treatment without sedation.

Background: Delayed cerebral ischemia from cerebral arterial vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) is associated with significant morbidity and mortality. Early recognition of the cerebral arterial vasospasm and institution of appropriate treatment can reduce the consequences.

Aim: We investigated the association of transcranial Doppler (TCD) and Xe-CT with the characteristics of symptomatic vasospasm secondary to aneurysmal subarachnoid hemorrhage (SAH) in patients who underwent euvolemic treatment without sedation.

Ruptured intrameatal AICA aneurysms--a report of two cases and review of the literature.

Background: Aneurysms of the distal part of the anterior-inferior cerebellar artery (AICA) are rare. Most are located in the cerebellopontine angle close to the internal auditory meatus. To our knowledge, only 13 patients with the aneurysm located inside the internal auditory meatus have been reported in the literature.

The clinical features and treatment of pediatric intracranial aneurysm.

Purpose: Intracranial aneurysms are relatively rare in the pediatric population. The objective of this study was to highlight the clinical and radiological features and the therapeutic outcome and clarify the choice of therapeutic strategies for pediatric intracranial aneurysms.

Materials And Methods: Twenty-four consecutive children (age View Article and Find Full Text PDF

Correlation between carotid intraplaque hemorrhage and clinical symptoms: systematic review of observational studies.

Background And Purpose: We sought to investigate the association between carotid intraplaque hemorrhage (IPH) and ipsilateral symptoms of cerebral ischemia.

Methods: A search was performed for clinical observational studies comparing the incidence of IPH between symptomatic and asymptomatic patients. Odds ratios (ORs) for IPH as a factor in the pathogenesis of neurologic events were calculated and combined by a meta-analysis.