External Auditory Canal Transillumination-Guided Middle Fossa Approaches: An Anatomical Feasibility Study.

Background And Objectives: The middle fossa approaches are tremendously versatile for treating small vestibular schwannomas, selected petroclival meningiomas, midbasilar trunk aneurysms, and lesions of the petrous bone. Our aim was to localize the internal acoustic canal and safely drill the petrous apex with these approaches. This study demonstrates a new method to locate the internal acoustic canal during surgery in the middle fossa.

Virtual anatomical atlas of the deep brain nuclei.

This study aims to improve understanding of the anatomy of the deep brain nuclei relevant to deep brain stimulation as well as stereotactic lesioning procedures, including radio frequency, high-focused ultrasound, and radiosurgery. We created interactive, three-dimensional virtual models from cadaveric dissections and radiological segmentation. We used five brain specimens (ten hemispheres) obtained from routine autopsies, prepared according to Klingler's method.

Can Qualitative Cervical Tractography Predict Clinical Findings as Effectively as It Aids Surgical Planning Today?

Aim: To investigate cervical spinal tractography (CST) and diffusion tensor imaging findings in patients with intramedullary cervical spinal cord (CSC) tumors and to evaluate the association between qualitative diffusion tensor tractography (DTT) findings and neurological examination findings (NEF).

Material And Methods: Neuroradiology case records were retrospectively evaluated to identify patients with intramedullary CSC tumors who underwent cervical spinal DTT. Conventional magnetic resonance imaging (MRI) and DTT were performed using a 3.

Comparative Assessment of Thermal Damage Induced by Bipolar Forceps in a Bovine Liver.

Background And Objectives: Bipolar electrocautery systems in neurosurgical procedures may induce thermal damage to adjacent tissues, especially neural tissues. Therefore, it is crucial to control thermal spread from the tips of bipolar forceps into adjacent tissues. The goal of this study was to compare the thermal damage induced in unintended adjacent tissues during coagulation with 6 different bipolar forceps.

Microsurgical anatomy and the inner architecture of the retrocommissural portion of the hippocampal formation demonstrated through fiber microdissection.

Objective: An understanding of the complex nomenclature and 3D spatial relations between the cortical and white matter components of the retrocommissural portion of the hippocampal formation is essential for a successful outcome when performing surgery in the mediobasal temporal region. The goal of this study was to clarify the nomenclature related to the retrocommissural portion of the hippocampal formation and to provide a detailed description of its topography and inner structure from a relevant surgical perspective. This description can serve as an anatomical reference for approaching lesions in the mediobasal temporal region.

Medical management of chronic subdural hematoma with low-dose hydrocortisone: a case series.

Chronic subdural hematomas (cSDH) are often managed with a burr-hole craniostomy and drainage, but surgery is associated with elevated mortality, morbidity, and recurrence. Despite reports of steroid use for such patients, its efficacy and feasibility are still debated. We present our patient series treated with low-dose hydrocortisone.

The comprehensive evaluation of oral and fecal microbiota in patients with acromegaly.

Purpose: The alteration of the microbiota in the mouth and gut could potentially play a role in the pathogenesis of various diseases, and conversely, these diseases may have an influence on the composition of the gut microbiota. Acromegaly disease can potentially affect physiological processes in the mouth and gut. The present study was designed to investigate the relationship between acromegaly and the oral and gut microbiota, as data on this topic are scarce.

Sublabial transmaxillary approach to the inferior aspect of the orbit.

Objective: The objective was to demonstrate the surgical steps and outcomes of the sublabial transmaxillary microsurgical approach with endoscopic assistance to treat lesions in the inferior aspect of the orbit, as well as to describe the use of patient-specific 3D models to facilitate surgical preparation and improve experience with the technique.

Methods: The authors' study evaluated data from patients who underwent an endoscope-assisted sublabial transmaxillary approach for inferior orbital lesions. For 2 patients, 3D models were created for preoperative planning and assessment of the approach.

Selective amygdalohippocampectomy via the paramedian supracerebellar-transtentorial approach for mediobasal temporal epilepsy.

Selective amygdalohippocampectomy via the pterional transsylvian approach is a feasible option for many patients with mediobasal temporal epilepsy. However, it may be insufficient for patients when the posterior hippocampal region is involved. The paramedian supracerebellar transtentorial approach offers precise anatomical orientation when exposing the entire length of the mediobasal temporal region, including the fusiform gyrus.

Revisiting the microsurgical anatomy of the sagittal stratum and surgical implications: fiber microdissection and tractography study.

Objective: The term "sagittal stratum" was coined by Heinrich Sachs in 1892 to define a parasagittally oriented white matter layer at the temporo-occipital cortex. Although this term has been widely used for more than 100 years, the description, classification, borders, and involved fibers of the structure vary among authors and remain imprecise. Through fiber microdissection and tractography, the authors aimed to define the sagittal stratum and resolve the uncertainty by revealing the relationship of this structure to other cerebral white matter pathways and the orientation of fibers in it.

Human Adapted Prosomeric Model: A Future for Brainstem Tumor Classification.

This study reevaluates the conventional understanding of midbrain anatomy and neuroanatomical nomenclature in the context of recent genetic and anatomical discoveries. The authors assert that the midbrain should be viewed as an integral part of the forebrain due to shared genetic determinants and evolutionary lineage. The isthmo-mesencephalic boundary is recognized as a significant organizer for both the caudal midbrain and the isthmo-cerebellar area.

Creating a neuroanatomy education model with augmented reality and virtual reality simulations of white matter tracts.

Objective: The utilization of digital technologies has experienced a notable surge, particularly in cases where access to cadavers is constrained, within the context of practical neuroanatomy training. This study evaluates augmented reality (AR)- and virtual reality (VR)-based educational models for neuroanatomy education.

Methods: Three-dimensional models were created using advanced photogrammetry.

Neglected tracts of the brainstem: transverse peduncular tract of Gudden and taenia pontis.

Objective: The anatomy and function of the brainstem have fascinated scientists for centuries; however, the brainstem remains one of the least studied regions of the human brain. As the authors delved into studying this structure, they observed a growing tendency to forget or neglect previously identified structures. The aim of this study was to describe two such structures: the transverse peduncular tract, also known as the Gudden tract, and the taenia pontis.

Thrombosed Posterior Inferior Cerebellar Artery Aneurysm Mimicking a Medulla Oblongata Cavernous Malformation: 2-Dimensional Operative Video.

The incidence of posterior inferior cerebellar artery (PICA) aneurysms is estimated to be between 0.5% and 3% of total aneurysm cases.1 Most patients with these aneurysms typically present with subarachnoid hemorrhage, although there are instances in which patients may present with symptoms resulting from mass effect exerted on the brain stem or lower cranial nerves.

Identification of Reference Genes in Chordoma Cells Allows Cross-Comparison of Expression Studies Across Subtypes.

Aim: To present the best housekeeping genes including clival/sacral based chordoma, and the nucleus pulposus cells.

Material And Methods: We investigated 13 candidate reference genes in public chordoma array transcriptome datasets, validated these genes by using RT-PCR, and evaluated their stability with NormFinder, geNorm, and Bestkeeper.

Results: YWHAZ, TBP and PGK1 genes were identified as the most stable reference genes as confirmed with three different approaches.

Microsurgical Resection of a Parachiasmatic Craniopharyngioma via a Left-Sided Pterional Transsylvian Approach.

Craniopharyngiomas are histologically benign tumors that originate from squamous rests along the pituitary stalk. They make up approximately 1.2% to 4.

Creation of a microsurgical neuroanatomy laboratory and virtual operating room: a preliminary study.

Objective: A comprehensive understanding of microsurgical neuroanatomy, familiarity with the operating room environment, patient positioning in relation to the surgery, and knowledge of surgical approaches is crucial in neurosurgical education. However, challenges such as limited patient exposure, heightened patient safety concerns, a decreased availability of surgical cases during training, and difficulties in accessing cadavers and laboratories have adversely impacted this education. Three-dimensional (3D) models and augmented reality (AR) applications can be utilized to depict the cortical and white matter anatomy of the brain, create virtual models of patient surgical positions, and simulate the operating room and neuroanatomy laboratory environment.

Revealing the confusion of the evolution of the term sagittal stratum. Historical overview and systematic literature review.

The fiber dissection technique is one of the earliest methods used to demonstrate the internal structures of the brain, but until the development of fiber tractography, most neuroanatomy studies were related to the cerebral cortex and less attention was given to the white matter. During the historical evolution of white matter dissection, debates have arisen about tissue preservation methods, dissection methodology, nomenclature, and efforts to adopt findings from primates to the human brain. Since its first description, the sagittal stratum has been one of the white matter structures subject to controversy and has not been sufficiently considered in the literature.

Anterolateral upper cervical approach for ventral C1-C2 meningioma.

The surgical management of ventral upper cervical meningiomas poses significant challenges due to their deep location and limited accessibility. These tumors have the potential to compress or involve nearby neurovascular structures, leading to various neurological complications including inferior cranial nerve palsy, motor deficits, and sensory disturbances such as hypoesthesia, paresthesia, and impaired coordination. To address this issue, surgical intervention through an anterolateral or far lateral approach has been recognized as the optimal treatment strategy.

Posterior Interhemispheric Transtentorial Subsplenial Approach for Posterior Thalamic Tumors: 2-Dimensional Operative Video.

Indications Corridor And Limits Of Exposure: The posterior interhemispheric transtentorial subsplenial approach provides a direct corridor to posterior thalamic lesions without a cortical or callosal incision. 1.

Anatomic Essentials Need For Preoperative Planning And Assessment: This corridor is through the posterior interhemispheric fissure along the medial surface of the cuneus and allows the subsplenial region to be explored.