Irakliy Abramov, Mohamed A Labib, Lena Mary Houlihan, Thanapong Loymak, Visish M Srinivasan, Mark C Preul, Michael T Lawton
{"title":"Quantitative Anatomic Comparison of the Extreme Lateral Transodontoid vs Extreme Medial Endoscopic Endonasal Approaches to the Jugular Foramen and Craniovertebral Junction.","authors":"Irakliy Abramov, Mohamed A Labib, Lena Mary Houlihan, Thanapong Loymak, Visish M Srinivasan, Mark C Preul, Michael T Lawton","doi":"10.1227/ons.0000000000000350","DOIUrl":"https://doi.org/10.1227/ons.0000000000000350","url":null,"abstract":"<p><strong>Background: </strong>Large, destructive intracranial and extracranial lesions at the jugular foramen (JF) and anterior craniovertebral junction (CVJ) are among the most challenging lesions to resect.</p><p><strong>Objective: </strong>To compare the extreme lateral transodontoid approach (ELTOA) with the extreme medial endoscopic endonasal approach (EMEEA) to determine the most effective surgical approach to the JF and CVJ.</p><p><strong>Methods: </strong>Seven formalin-fixed cadaveric heads were dissected. Using neuronavigation, we quantitatively measured and compared the exposure of the intracranial and extracranial neurovascular structures, the drilled area of the clivus and the C1 vertebra, and the area of exposure of the brainstem.</p><p><strong>Results: </strong>The mean total drilled area of the clivus was greater with the EMEEA than with the ELTOA (1043.5 vs 909.4 mm 2 , P = .02). The EMEEA provided a longer exposure of the extracranial cranial nerves (CNs) IX, X, and XI compared with the ELTOA (cranial nerve [CN] IX: 18.8 vs 12.0 mm, P = .01; CN X: 19.2 vs 10.4 mm, P = .003; and CN XI, 18.1 vs 11.9 mm, P = .04). The EMEEA, compared with the ELTOA, provided a significantly greater area of exposure of the contralateral ventromedial medulla (289.5 vs 80.9 mm 2 , P < .001) and pons (237.5 vs 86.2 mm 2 , P = .005) but less area of exposure of the ipsilateral dorsolateral medulla (51.5 vs 205.8 mm 2 , P = .008).</p><p><strong>Conclusion: </strong>The EMEEA and ELTOA provide optimal exposures to different aspects of the CVJ and JF. A combination of these approaches can compensate for their disadvantages and achieve significant exposure.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"396-405"},"PeriodicalIF":2.3,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40358271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reaching the Far Corners of Neurosurgery.","authors":"","doi":"10.1227/ons.0000000000000417","DOIUrl":"https://doi.org/10.1227/ons.0000000000000417","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"277-278"},"PeriodicalIF":2.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40356992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erik M Wolfswinkel, Kristine Ravina, Robert C Rennert, Mark Landau, Ben A Strickland, Alice Chun, Jordan R Wlodarczyk, Aidin Abedi, Joseph N Carey, Jonathan J Russin
{"title":"Cerebral Bypass Using the Descending Branch of the Lateral Circumflex Femoral Artery: A Case Series.","authors":"Erik M Wolfswinkel, Kristine Ravina, Robert C Rennert, Mark Landau, Ben A Strickland, Alice Chun, Jordan R Wlodarczyk, Aidin Abedi, Joseph N Carey, Jonathan J Russin","doi":"10.1227/ons.0000000000000144","DOIUrl":"https://doi.org/10.1227/ons.0000000000000144","url":null,"abstract":"<p><strong>Background: </strong>When performing extracranial to intracranial (EC-IC) and intracranial to intracranial (IC-IC) bypass, the choice of donor vessel and interposition graft depends on several factors: vessel size and accessibility, desired blood flow augmentation, revascularization site anatomy, and pathology. The descending branch of the lateral circumflex femoral artery (DLCFA) is an attractive conduit for cerebrovascular bypass.</p><p><strong>Objective: </strong>To present our institutional experience using DLCFA grafts for cerebral revascularization.</p><p><strong>Methods: </strong>Retrospective review of perioperative data and outcomes for patients undergoing cerebrovascular bypass surgery using a DLCFA graft from 2016 to 2019.</p><p><strong>Results: </strong>Twenty consecutive patients underwent EC-IC bypass using a DLCFA interposition graft. Bypass indications included 13 (65%) intracranial aneurysms, 4 (20%) medically refractory atherosclerotic large artery occlusions (internal carotid artery or middle cerebral artery), 2 (10%) internal carotid artery dissections, and 1 (5%) patient with moyamoya disease. Most commonly, a donor superior temporal artery was bypassed to a recipient middle cerebral artery (14 of 20; 70%). Two cases demonstrated graft spasm. Graft occlusion occurred in one patient and was asymptomatic. Perioperative bypass surgery-related ischemia occurred in 3 patients: 1 patient with insufficient bypass flow, 1 patient with graft stenosis because of an adventitial band, and 1 patient with focal status epilepticus in the bypassed territory resulting in cortical ischemia. One donor site hematoma occurred. The median (range) modified Rankin scale (mRS) score on follow-up was 1.5 (1-4) at 7.8 (1-27) months, with most patients achieving good functional outcomes (mRS ≤2).</p><p><strong>Conclusion: </strong>The DLCFA is a versatile graft for cerebral revascularization surgery, demonstrating good outcomes with minimal graft harvest site morbidity and an acceptable graft patency rate.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"364-372"},"PeriodicalIF":2.3,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40614955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Commentary: Intrathecal Fentanyl With a Myofascial Plane Block in Open Lumbar Surgeries: A Case Series.","authors":"Hani Chanbour, Scott L Zuckerman","doi":"10.1227/ons.0000000000000195","DOIUrl":"https://doi.org/10.1227/ons.0000000000000195","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e241-e242"},"PeriodicalIF":2.3,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicole M De La Peña, Richard S Zimmerman, Bernard R Bendok
{"title":"Commentary: Associating Surgeon Feedback With Material Physical Properties in the Development Process of a Resective Epilepsy Surgery Simulator.","authors":"Nicole M De La Peña, Richard S Zimmerman, Bernard R Bendok","doi":"10.1227/ons.0000000000000230","DOIUrl":"https://doi.org/10.1227/ons.0000000000000230","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e293-e294"},"PeriodicalIF":2.3,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guilherme H W Ceccato, Júlia S de Oliveira, Pedro H Dos Santos Neto, Nick D Carvalho, Vinícius N Coelho, Hugo A Hasegawa, Daniel A B Valli, Adelmo Ferreira, Albert A Sufianov, Luis A B Borba
{"title":"Microsurgical Resection of Giant Posterior Fossa Epidermoid Cyst Using Combined Presigmoid and Retrosigmoid Approaches: 3-Dimensional Operative Video.","authors":"Guilherme H W Ceccato, Júlia S de Oliveira, Pedro H Dos Santos Neto, Nick D Carvalho, Vinícius N Coelho, Hugo A Hasegawa, Daniel A B Valli, Adelmo Ferreira, Albert A Sufianov, Luis A B Borba","doi":"10.1227/ons.0000000000000159","DOIUrl":"https://doi.org/10.1227/ons.0000000000000159","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e274"},"PeriodicalIF":2.3,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shriya Gupta, Erica C Becker, Aziz Khan, Gracia Mui, Ketan R Bulsara, Qian Wu
{"title":"Commentary: Central Nervous System Vasculitis Post-COVID-19 Infection: A New Challenge With Histopathological Confirmation.","authors":"Shriya Gupta, Erica C Becker, Aziz Khan, Gracia Mui, Ketan R Bulsara, Qian Wu","doi":"10.1227/ons.0000000000000225","DOIUrl":"https://doi.org/10.1227/ons.0000000000000225","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"e295-e298"},"PeriodicalIF":2.3,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}