Semi-sitting position and retrosigmoid approach for a large petroclival meningioma resection: 3-dimensional operative video.

Background: Petroclival meningiomas are still a neurosurgical challenge due to their proximity to cranial nerves and cerebral vasculature along the surgical corridor. The usual extension of large petroclival meningiomas is along the posterior fossa, frequently compromising and displacing adjunct cranial nerves such as the sixth and seventh-eight cranial nerve complex with brainstem compression, causing progressive neurological deficit and severe headache. The goal of sizeable petroclival meningioma surgery treatment is a maximal resection with preservation of neurological function.

[Microvascular decompression in hemifacial spasm: functional outcome].

Introduction: Hemifacial spasm (HFS) is a rare condition, characterized by unilateral, paroxysmal and involuntary contraction of the muscles innervated by the facial nerve (FN). The most common cause is a vascular conflict in the exit zone of the FN. The objective of this work is to demonstrate the efficacy and safety of neurovascular decompression (NVD).

Transposition of Megadolichoectatic Basilar Artery in Trigeminal Neuralgia: 3-Dimensional Operative Video.

Trigeminal neuralgia is usually associated with vascular compression of the nerve entry zone. However, a dolichoectatic basilar artery represents the cause in only up to 3% of cases. This is characterized by dilation, elongation, or tortuosity of the vertebrobasilar arteries.

Endoscopic reconstruction to primary empty sella: "7 E" technique.

We present the seven "E" technique step by step for the reconstruction of the empty sella with an illustrative case.

Hemifacial spasm associated with trigeminal neuralgia secondary to trigeminal vascular compression.

The coincidence in a patient of Hemifacial Spasm and Trigeminal Neuralgia is not frequent. A case is presented with the objective of showing this association due to the abnormal activation of the Trigemino-Facial Reflex. A 55-year-old woman with an 8-year history of left-sided hemifacial spasm and typical trigeminal pain in the ipsilateral V1 and V2 territory.

[Neurovascular decompression in trigeminal neuralgia: Functional outcome].

Introduction: The most frequent pathology of the fifth cranial nerve is trigeminal neuralgia (TN), characterized by unilateral orofacial pain, of a paroxysmal nature, with distribution in one or more divisions of the trigeminal nerve. The main objective of this work is to demonstrate the efficacy and safety of neurovascular decompressive surgery (NVD).

Methods: Retrospective analytical study, patients operated on for NVD by TN (n: 155), from January 2006 - 2022, using a retrosigmoid approach and clinicalradiological follow-up, whose intraoperative recording was in 3D system (n: 42).

Novel Hybrid Technique for Preservation of Frontal Branch of Facial Nerve: Subgaleal Preinterfascial Dissection.

Objective: The pterional approach is the workhorse of skull-base neurosurgery, which allows virtual access to any intracranial lesion around the circle of Willis. Preserving the frontotemporal branch of the facial nerve and conserving the temporal muscle's symmetry are fundamental objectives besides the access that can be obtained through this versatile neurosurgical technique. This manuscript proposes a subgaleal preinterfascial dissection, a novel hybrid technique that provides advantages of previously described temporal muscle dissection techniques while preserving the integrity of facial nerve branches and the unobstructed broad pterional region.

Comparative Analysis of Surgical Working Corridors for Meckel Cave Trigeminal Schwannomas: A Quantitative Anatomic Study.

Background And Objectives: Volumetric analysis of the working corridors of the interdural approach to the Meckel cave may lead to a selection of routes which are anatomically more advantageous for trigeminal schwannoma resection. The herein-reported anatomic study quantitively compares the infratrochlear (IT) transcavernous, anteromedial (AM), and anterolateral (AL) corridors, highlighting their feasibility, indications, advantages, and limitations.

Methods: Anatomic boundaries and depth of Meckel cave, porus trigeminus, IT transcavernous, AM, and AL corridors were identified in 20 formalin-fixed latex-injected cadaveric heads and were subsequently measured.

technique for resection of selected pituitary adenomas.

Introduction: Since the introduction of the endoscopic endonasal approach (EEA) to skull base, the nasal phase has been a true challenge as it represents the moment of definition of the corridor, thus defining the instruments maneuverability at tumor removal phase. The longstanding cooperation between ENT and neurosurgeons have provided the possibility of creating adequate corridor with maximal respect toward nasal structures and mucosa. This sparked the idea of entering the sella as thieves, so we named "Guanti Bianchi" technique a lesser invasive variation of the approach for the removal of selected pituitary adenoma.

Observational study of the heterogeneous global meteotsunami generated after the Hunga Tonga-Hunga Ha'apai Volcano eruption.

The Hunga Tonga-Hunga Ha'apai volcano eruption of January 15th 2022 generated a global atmospheric and oceanic response that was recorded by an unprecedented amount of sensors. The eruption caused an atmospheric perturbation that travelled as a Lamb wave surrounding the Earth at least 3 times, and was recorded by hundreds of barographs worldwide. The atmospheric wave showed complex patterns of amplitude and spectral energy content, although most of the energy was concentrated in the band (2-120 min).

Risk Factors Related to Transient Diabetes Insipidus Development Following Transsphenoidal Pituitary Adenoma Resection: A Multicentric Study.

Objective: To analyze and find risk factors associated with developing transient diabetes insipidus (DI) using a multicenter case series after trans-sphenoidal surgery.

Methods: Medical records of patients who underwent trans-sphenoidal surgery for pituitary adenoma resection between 2010 and 2021 at 3 different neurosurgical centers by 4 experienced neurosurgeons were retrospectively analyzed. The patients were divided into 2 groups (DI group or control group).

A simple technique for generating 3D endoscopic images.

Background: Most neurosurgical photographs are limited to two-dimensional (2D), in this sense, most teaching and learning of neuroanatomical structures occur without an appreciation of depth. The objective of this article is to describe a simple technique for obtaining right and left 2D endoscopic images with manual angulation of the optic.

Methods: The implementation of a three-dimensional (3D) endoscopic image technique is reported.

Micromirrors in Neurosurgery: Technical Overview and Benefits Assessment.

Aim: To weight the benefits and limitations of intraoperative use of micromirrors in neurosurgery.

Material And Methods: Surgical cases where micromirrors were employed were retrospectively selected from the surgical database of five different surgeons in different hospitals. Complications directly attributable to the micromirrors were assessed intraoperatively and confirmed with postoperative neuroimaging studies.

Clinical Applicability of the Sellar Barrier Concept in Patients with Pituitary Apoplexy: Is It Possible?

There is evidence of association between sellar barrier thickness and intraoperative cerebrospinal fluid (CSF) leakage, impacting the postoperative prognosis of the patients. The aim of this study is to analyze the clinical applicability of the sellar barrier concept in a series of operated patients with pituitary apoplexy (PA). A retrospective study was conducted including 47 patients diagnosed with PA who underwent surgical treatment through a transsphenoidal approach.

Single-Stage Complete Removal of Dumbbell-Shaped Trigeminal Schwannoma: 3-Dimensional Operative Video.

Intracranial trigeminal schwannomas are rare tumors that may extend into multiple cranial compartments and may emerge from the root, ganglion, or intracranial portion of any of its branches. The aim of this 3-dimensional operative video is to present a single-stage complete removal of a dumbbell-shaped trigeminal schwannoma through a pretemporal approach (Video 1). Informed consent was given by the patient for use of images and the surgical video.

Clinical application of the "sellar barrier's concept" for predicting intraoperative CSF leak in endoscopic endonasal surgery for pituitary adenomas with a machine learning analysis.

Background: Recently, it was defined that the entity could be identified as a predictor of cerebrospinal fluid (CSF) intraoperative leakage. The aim of this study is to validate the application of the sellar barrier concept for predicting intraoperative CSF leak in endoscopic endonasal surgery for pituitary adenomas with a machine learning approach.

Methods: We conducted a prospective cohort study, from June 2019 to September 2020: data from 155 patients with pituitary subdiaphragmatic adenoma operated through endoscopic approach at the Division of Neurosurgery, Università degli Studi di Napoli "Federico II," were included.

Microneurosurgical management of aneurysms of the A1 segment of the anterior cerebral artery: Anatomy and surgical technique.

Background: Aneurysms of the A1 segment of the anterior cerebral artery (ACA) are rare and have characteristics differentiating them from other intracranial aneurysms. Their microsurgical management is challenging and requires different strategies. In this article, we review the surgical anatomy of the A1 segment of the ACA with cadaveric dissections and describe the microsurgical management of complex A1 aneurysms with illustrative cases.

Anatomic variations of the floor of the third ventricle: Surgical implications for endoscopic third ventriculostomy.

Background: Endoscopic third ventriculostomy (ETV) is currently used as a treatment for different types of hydrocephalus. However, the anatomical endoscopic variants of the third ventricle floor (3VF), as well as their surgical implications, have been underrated. The anatomic variations of the 3VF can influence the technique and the success rate of the ETV.

Piggyback Stacking and Booster Clipping Technique: A Technical Note.

In certain cases, the closing force of a single vascular clip is not sufficient for complete aneurysmal occlusion, and the use of multiple clips, or clip stacking, is required. Many stacking techniques have been described in the literature, such as in tandem stacking and overstacking. However, these may not be feasible during procedures with limited exposure or narrow corridors.

Contralateral Interhemispheric Transfalcine Approach for Supratentorial Extraventricular Ependymoma Resection.

Background/aim: Extraventricular supratentorial ependymomas are rare entities. Most ependymomas are located at the infratentorial and intraventricular level, and only in a small group of cases they do not present continuity with the ventricular system. This is a case report of a patient with an atypical location of a cerebral ependymoma, which required the implementation of a complex and infrequent approach for its complete microsurgical removal.