Medial Pontine Area: A Safe Entry to the Brainstem as a Cut Above the Rest.

Aim: To examine the fiber-based anatomy of the medial pontine area (MPA), one of the most commonly used brainstem (BS) safe entry zones in neurosurgery.

Material And Methods: According to the protocol of Klingler and Ludwig, six BSs were kept in 10% formalin solution for at least 2 months. After removing the arachnoid mater, pia mater, and vascular structures, the samples were frozen at -16°C for at least 2 weeks.

Improving the Visualization of Superior Longitudinal Fascicule-2 and Superior Longitudinal Fascicule -3 Using Photoshop Filters.

Background And Objectives: Several studies are currently exploring the anatomical origins of superior longitudinal fascicule (SLF) 2 and SLF-3, which are components of the frontoparietal network. This study aimed to achieve optimum visualization of the anatomical corridors of these fibers using Photoshop filters.

Methods: Four postmortem brain hemispheres were dissected in accordance with the method proposed by Klingler and Ludwig.

Dentate Nucleus: Connectivity-Based Anatomic Parcellation Based on Superior Cerebellar Peduncle Projections.

Objective: Projections from the dentate nucleus (DN) follow a certain organized course to upper levels. Crossing and noncrossing fibers of the dentatorubrothalamic (DRT) tract terminate in the red nucleus and thalamus and have various connections throughout the cerebral cortex. We aimed to establish the microsurgical anatomy of the DN in relation to its efferent connections to complement the increased recognition of its surgical importance and also to provide an insight into the network-associated symptoms related to lesions and microsurgery in and around the region.

Observational Case Analysis of Neonates With Large Cephalohematoma.

Introduction Cephalohematomas in the newborn period are related to the accumulation of blood between the bone and periosteum as a result of a series of adverse conditions during labor. The optimal approach to cephalohematoma cases is still unclear. In this study, we aimed to present the follow-up data of 94 newborns with a cephalohematoma size of >50 mm and a higher risk of ossification.

Endoscopic Untethering of Tight Filum Terminale: An Operative Technique.

Aim: To demonstrate the various technical advantages of minimally invasive endoscopic untethering of tight filum terminale for the treatment of tethered cord syndrome (TCS).

Material And Methods: In five pediatric cases of TCS, we performed untethering by using the endoscopic technique. The age of the patients were 6, 7, 8, 9, and 12 years old.

Minimally Invasive Approach Toward Percutaneous Direct Pars Repair: An Observational Study.

Background: Spondylolysis refers to a defect of the vertebral pars interarticularis. Percutaneous direct pars repair using a minimally invasive technique was performed in a group of young patients to maintain their spinal segment movement and to restore their normal anatomy. The aim of this study was to present the clinical, functional, and radiologic outcomes of pars defects that were repaired percutaneously via the minimally invasive technique.

Comparison of Two Minimally Invasive Techniques with Endoscopy and Microscopy for Extraforaminal Disc Herniations.

Objective: Extraforaminal disc herniations are extraordinary herniations because they are located outside the foraminal bony borders and compress the root exiting at the corresponding level, whereas in median or paramedian herniations, the root 1 level below is compressed. Percutaneous endoscopic discectomy (PED) and microscopic extraforaminal discectomy (MEFD) are 2 popular contemporary techniques that have been performed extensively for these herniations since the 1970s.

Methods: In this study, we retrospectively analyzed 118 patients who underwent either PED (66 patients) or MEFD (52 patients).

Effect of perioperative aspirin use on hemorrhagic complications in elective craniotomy for brain tumors: results of a single-center, retrospective cohort study.

Objective: In daily practice, neurosurgeons face increasing numbers of patients using aspirin (acetylsalicylic acid, ASA). While many of these patients discontinue ASA 7-10 days prior to elective intracranial surgery, there are limited data to support whether or not perioperative ASA use heightens the risk of hemorrhagic complications. In this study the authors retrospectively evaluated the safety of perioperative ASA use in patients undergoing craniotomy for brain tumors in the largest elective cranial surgery cohort reported to date.

Microsurgical Gross Total Resection of a WHO Grade II Cerebellopontine Angle Ependymoma in an Adult.

Infratentorial ependymomas that arise in the fourth ventricle and extend into the cerebellopontine angle (CPA) through the foramina of Luschka are well described. However, a primary CPA location of an ependymoma is distinctly uncommon. In this video, we present a 46-year-old man with episodes of dizziness, left-sided tinnitus, imbalance, double vision, and nausea.

Surgical outcomes of decompressive laminectomy by transspinous approach for degenerative lumbar spinal stenosis.

Objective: To assess clinical and radiographical outcomes of transspinous decompression technique for the treatment of degenerative central lumbar spinal stenosis.

Methods: The single-centre, non-randomised interventional, prospective, observational study was conducted Neurosurgery Clinic of Mazhar Osman Research and Training Hospital for Psychiatry and Neurology, Istanbul, Turkey from May 2013 and May 2016 and comprised adult patients with refractory symptoms from degenerative central lumbar spinal stenosis who underwent lumbar spinous processsplitting laminectomy. Pre- and post-operative Oswestry Disability Index score, visual analogue scale for overall pain, maximum walking distance and anteroposterior diameter of the spinal canal on magnetic resonance imaging were assessed on follow up examination.

Frontal lobe intracerebral schwannoma mimicking metastatic lesion in a patient with papillary thyroid carcinoma.

Intracerebral schwannomas are quite rare. Due to their rarity and lack of pathognomonic imaging features, intracerebral schwannoma may be overlooked in the initial differential diagnosis of an intra-axial mass with heterogeneous ring enhancement, such as a high-grade glioma, metastasis or lymphoma. Here, we present a 21-year-old woman with prior diagnosis of papillary thyroid carcinoma and recent history of seizures who had a heterogeneously ring-enhancing left frontal lobe mass.

Is a Unilateral Surgical Approach Effective in Patients with Bilateral Leg Pain with Unilateral Lumbar Disc Herniation? A Prospective Nonrandomized Clinical and Surgical Study.

Objective: To examine the surgical results of unilateral lumbar discectomy in patients with bilateral leg pain and discuss short- and long-term outcomes within the limits of lumbar decompression.

Methods: We analyzed 60 patients with unilateral disc herniation who underwent unilateral lumbar discectomy and hemipartial laminectomy between 2014 and 2017. Group 1 (30 patients) had bilateral leg pain and unilateral lumbar disc herniation.

Gross Total Resection of Chordoid Glioma of the Third Ventricle via Anterior Interhemispheric Transcallosal Transforaminal Approach at Two Stages.

Suprasellar tumors in particular tumors located in the retrochiasmatic area and anterior third ventricle are challenging cases in terms of optimal surgical exposure. Several approaches have been described including transsylvian, translamina terminalis, endoscopic endonasal, and anterior interhemispheric. Each approach has advantages and disadvantages.

Microsurgical Resection of Tuberculum Sellae Meningioma via Pterional Craniotomy with Extradural Anterior Clinoidectomy and Optic Unroofing.

Microsurgical treatment of suprasellar tumors, in particular tuberculum sellae meningiomas, poses significant challenge. These tumors are surrounded by vital neurovascular structures, such as optic apparatus, pituitary stalk, internal carotid artery and its branches, and anterior cerebral arteries. In large and complex cases, early identification and decompression of these structures may facilitate safer dissection and resection.

Hypertrophic Olivary Degeneration: Neurosurgical Perspective and Literature Review.

Background: Hypertrophic olivary degeneration (HOD) occurs because of posterior fossa or brainstem lesions that disrupt the dentato-rubro-olivary tract, well known as the Guillain-Mollaret triangle. Clinical and radiologic hallmarks of this condition are palatal myoclonus and T2 hyperintensity of the inferior olivary complex on magnetic resonance imaging (MRI), respectively. Because symptomatic HOD can complicate the recovery of patients with posterior fossa or brainstem lesions, the purpose of this study is to evaluate clinical and imaging findings of patients with HOD.