An endoscopic assisted retrosigmoid approach to the cerebello-pontine angle for resection of an epidermoid cyst.

Epidermoid cysts are rare lesions accounting for 1% of intracranial tumors with approximately 50% located within the cerebello-pontine angle (CPA). Resection is complicated by their close anatomical relation to critical neurovascular structures and their tendency to be densely adherent making complete removal a significant neurosurgical challenge. We present a 35-year-old woman with left sided tongue numbness and lower lip paresthesias with a CPA epidermoid.

Colocalization of thin-walled dome regions with low hemodynamic wall shear stress in unruptured cerebral aneurysms.

Object: Wall shear stress (WSS) plays a role in regulating endothelial function and has been suspected in cerebral aneurysm rupture. The aim of this study was to evaluate the spatial relationship between localized thinning of the aneurysm dome and estimated hemodynamic factors, hypothesizing that a low WSS would correlate with aneurysm wall degeneration.

Methods: Steady-state computational fluid dynamics analysis was performed on 16 aneurysms in 14 patients based on rotational angiographic volumes to derive maps of WSS, its spatial gradient (WSSG), and pressure.

Cerebral aneurysm wall thickness analysis using intraoperative microscopy: effect of size and gender on thin translucent regions.

Objective: Wall thickness is a poorly documented characteristic of cerebral aneurysms which may provide insight into adaptive aneurysmal growth, aneurysm rupture risk and response to endovascular treatment. The distribution of aneurysm wall thickness, as observed by intraoperative video microscopy, is described.

Methods: 54 unruptured saccular cerebral aneurysms were selected based on the availability of intraoperative video obtained from patients undergoing microsurgical clipping.