Editorial for Brain Sciences Special Issue: "Advances in Skull Base Tumor Surgery: The Practical Pearls".

The field of skull base surgery is unique; it involves the adequate and coordinated multidisciplinary interaction of multiple specialties, such as otorhinolaryngology, maxillofacial surgery, ophthalmology, neuro-anesthesiology, oncology, radiation oncology, neurophysiology, and neurosurgery [...

Toward a Frontierless Collaboration in Neurosurgery: A Systematic Review of Remote Augmented and Virtual Reality Technologies.

Objective: Augmented reality (AR) and virtual reality (VR) technologies have been introduced to neurosurgery with the goal of improving the experience of human visualization. In recent years, the application of remote AR and VR has opened new horizons for neurosurgical collaboration across diverse domains of education and patient treatment. Herein, we aimed to systematically review the literature about the feasibility of this technology and discuss the technical aspects, current limitations, and future perspectives.

Giant primary intracranial multi-fossa leiomyosarcoma involving the frontal sinus, ethmoid air cells, anterior fossa, middle fossa, and intraventricular space: A case report and literature review.

Background: Leiomyosarcomas (LMSs) is a type of sarcoma that arises from smooth muscle and generally presents in the abdomen. Although intracranial LMS has been identified before, most reported presentations have been in immunocompromised patients. Here, we present an intracranial LMS in an immunocompetent patient.

Isolated cervical osteomyelitis in a patient with no primary source of infection - A case report and review of the literature.

Background: Cervical vertebral osteomyelitis (CVO) is a rare pathology that leads to progressive osseous degradation and eventual loss of bone putting the patient at risk of devastating neurological injury in the event of bony collapse or instability. formerly called is rare, but within the last two decades has been an increasingly reported cause of osteomyelitis. The majority of vertebral osteomyelitis cases have been reported in patients with a history of prior invasive procedures where direct contamination at the time of procedure was suspected as the underlying etiology.

Percutaneous high cervical spinal cord stimulation for refractory trigeminal neuralgia.

Background: Trigeminal neuralgia (TN) is a debilitating pain that affects the dermatomes associated with the trigeminal nerve (V1, V2, and V3). Unfortunately, many medical treatments and surgical procedures fail to sufficiently modulate the pain associated with this condition.

Case Description: This study presents two extreme cases of refractory TN (RTN) that progressed to atypical facial pain and describes successful mitigation of the neuralgia of said cases by percutaneous implantation of upper cervical spinal cord stimulation (SCS).

Staged Strategies to Deal with Complex, Giant, Multi-Fossa Skull Base Tumors.

Given the complex and multifaceted nature of resecting giant tumors in the anterior, middle, and, to a lesser extent, the posterior fossa, we present two example strategies for navigating the intricacies of such tumors. The foundational premise of these two approaches is based on a two-stage method that aims to improve the visualization and excision of the tumor. In the first case, we utilized a combined endoscopic endonasal approach and a staged modified pterional, pretemporal, with extradural clinoidectomy, and transcavernous approach to successfully remove a giant pituitary adenoma.

Immunoglobulin G4-related disease of the cavernous sinus with orbit invasion - A case report.

Background: Immunoglobulin G4-related disease (IgG4-RD) is a rare systemic disease of unknown etiology. It is characterized by tissue infiltration caused by IgG4 plasma cells and sclerosing inflammation of various body organs. At present, there are very few reported cases of IgG4-RD invasion of cavernous sinus and the orbit.

The use of exoscope combined with tubular retractor system for minimally invasive transsulcal resection of an ventricular atrium atypical choroid plexus papilloma: Three-dimensional operative video.

Background: Choroid plexus papilloma represents 1-4% of pediatric brain tumors, mostly located in the ventricular atrium.[1] Intraventricular tumors represent a challenge due to the poor visualization of the surgical field and damage to surrounding structures.[2] Use of tubular retraction reduces cerebrovascular trauma to the surrounding parenchyma by distributing pressure uniformly, allowing less invasive corticotomy, and more stability on surgical corridors that allow the surgeon to use both hands and external visualization devices.

The anterior incisural width as a preoperative indicator for intradural space evaluation: An anatomical investigation.

Background: The opticocarotid triangle (OCT) and the carotico-oculomotor triangle (COT) are two anatomical triangles used in accessing the interpeduncular region. Our objective is to evaluate if the anterior incisural width (AIW) is an indicator to predict the intraoperative exposure through both triangles.

Methods: Twenty sides of 10 cadaveric heads were dissected and analyzed.

Combined petrosal approach for resection of petroclival chondrosarcoma: Microsurgical 2-D video.

Background: Petroclival lesions pose a significant neurosurgical challenge due to involvement or close proximity to important neurovascular structures. Chondrosarcomas are rare lesions that can affect these areas.

Case Description: A 24-year-old male with 3 months history of poor coordination, imbalance, left-sided face hypoesthesia, facial palsy House-Brackmann Grade 2, and 6 cranial nerve palsy with diplopia.

High flow bypass for right giant cavernous internal carotid artery aneurysm with fibromuscular dysplasia of cervical internal carotid artery: microsurgical 2-D video.

Background: It is well known that intracranial aneurysms can be associated to fibromuscular dysplasia (FMD). Nevertheless, it is not clear the best treatment strategy when there is an association of giant symptomatic cavernous carotid aneurysm with extensive cervical internal carotid artery (ICA) FMD.

Case Description: We present the case of 63 year-old right-handed female with hypothyroidism, 1 month history of right-sided pulsatile headache and visual disturbances with feeling of fullness sensation and blurry vision.

Retractorless interhemispheric transtentorial approach for large lesions in the posterior incisural space.

Background: Surgical resection of lesions in the posterior incisural space presents a significant surgical challenge, which may result in postoperative visual complications and other neurological deficits. We, therefore, describe a retractorless interhemispheric transtentorial approach that avoids surrounding brain structures with positive outcomes and no complications or visual damage.

Case Description: We present four cases of lesions in the posterior incisural space that was treated with a retractorless interhemispheric transtentorial approach.

Current Open Surgical Indications for Revascularization in Cerebral Ischemia.

Cerebral revascularization was pioneered half a century ago. Gradual improvements in microsurgical instrumentation and training in microsurgical techniques have allowed significant changes that improved outcomes in neurosurgery, extrapolating this knowledge to other neurosurgical diseases (brain tumor, aneurysms, and skull base tumor surgery). But the popularity of cerebral bypass procedures was followed by their decline, given the lack of clear benefit of bypass surgery in chronic cerebrovascular ischemia after the EC-IC bypass studies.

Microsurgical Technique for Basilar Apex Aneurysm Clipping: Two-Dimensional Video.

We present the case of a 57-year-old female with hypertension, current smoker status, and recent headaches. Imaging studies showed an unruptured 8-mm basilar apex wide neck aneurysm located 4 mm above posterior clinoid (Figure 1) with a 3-mm anterior communicant artery aneurysm. No contraindications were encountered for endovascular treatment, although after we evaluated endovascular and surgical options, surgical clipping was considered also a safe and favorable option based on anterior projection of aneurysm, height of the basilar artery bifurcation, small and elongated posterior communicant artery, and available space between posterior clinoid and basilar artery (4 mm).

Stimulation and Neuromodulation in the Treatment of Epilepsy.

Invasive brain stimulation technologies are allowing the improvement of multiple neurological diseases that were non-manageable in the past. Nowadays, this technology is widely used for movement disorders and is undergoing multiple clinical and basic science research for development of new applications. Epilepsy is one of the conditions that can benefit from these emerging technologies.

Biocompatible Amniotic Sac Implant Maintains a Scar-Free Brain Surface During Recurrent Glioma Surgery.

Background: Dissection of brain surface adhesions during recurrent glioma surgery carries a risk of injury to cortical vessels and important surface vessels. We present our experience with the use of BioD film, a biocompatible amniotic membrane implant, to help prevent postoperative adhesions. We describe a novel method for preventing postoperative adhesions after high-grade glioma surgery using BioD film.