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Endoscopic ultrasound guided resection of a Cushing's adenoma invading the medial cavernous sinus wall using the "interdural peeling" technique. 超声内镜引导下应用硬膜间剥离技术切除侵犯海绵窦内侧壁的库欣腺瘤。
Neurosurgical focus: Video Pub Date : 2023-07-01 DOI: 10.3171/2023.4.FOCVID22150
Guilherme Finger, Kyle C Wu, Jaskaran S Gosal, Basit Jawad, Joshua Vignolles-Jeong, Ricardo L Carrau, Daniel M Prevedello
{"title":"Endoscopic ultrasound guided resection of a Cushing's adenoma invading the medial cavernous sinus wall using the \"interdural peeling\" technique.","authors":"Guilherme Finger,&nbsp;Kyle C Wu,&nbsp;Jaskaran S Gosal,&nbsp;Basit Jawad,&nbsp;Joshua Vignolles-Jeong,&nbsp;Ricardo L Carrau,&nbsp;Daniel M Prevedello","doi":"10.3171/2023.4.FOCVID22150","DOIUrl":"https://doi.org/10.3171/2023.4.FOCVID22150","url":null,"abstract":"<p><p>Cushing's adenoma invading the cavernous sinus requires aggressive resection to be cured. MRI is frequently inconclusive for identifying microadenomas, and visualizing the involvement of the medial cavernous sinus is even more challenging. In this video, the authors present a patient with an adrenocorticotropic hormone (ACTH)-producing microadenoma with doubtful left medial cavernous sinus involvement on MRI. She underwent an endoscopic endonasal exploration of the medial compartment of the cavernous sinus. The abnormally thickened wall, confirmed by intraoperative endoscopic endonasal ultrasound, was safely excised using the \"interdural peeling\" technique. Complete resection of the tumor resulted in normalization of her postoperative cortisol levels and disease remission with no complications. The video can be found here: https://stream.cadmore.media/r10.3171/2023.4.FOCVID22150.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"9 1","pages":"V4"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10321548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9806560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management protocol and surgical techniques for MRI-Negative Cushing's disease: a series of 6 cases. 6例mri阴性库欣病的治疗方案及手术技术
Neurosurgical focus: Video Pub Date : 2023-07-01 DOI: 10.3171/2023.4.FOCVID2318
Nidhisha Sadhwani, Ashish Suri, Amol Raheja, Santanu Kumar Bora, Rajesh Khadgawat, Mehar Chand Sharma, Ajay Garg, Rajni Sharma
{"title":"Management protocol and surgical techniques for MRI-Negative Cushing's disease: a series of 6 cases.","authors":"Nidhisha Sadhwani,&nbsp;Ashish Suri,&nbsp;Amol Raheja,&nbsp;Santanu Kumar Bora,&nbsp;Rajesh Khadgawat,&nbsp;Mehar Chand Sharma,&nbsp;Ajay Garg,&nbsp;Rajni Sharma","doi":"10.3171/2023.4.FOCVID2318","DOIUrl":"https://doi.org/10.3171/2023.4.FOCVID2318","url":null,"abstract":"<p><p>Up to 40% of Cushing's disease (CD) patients show no evidence of an adenoma on dynamic contrast-enhanced MRI. Inferior petrosal sinus sampling (IPSS) remains the gold standard for diagnosis in these patients. Remission rates in MRI-Negative CD are far less at 50%-71%, compared with patients in whom an adenoma is identified on MRI. Endoscopic endonasal transsphenoidal surgery is the surgical approach of choice in these cases. Various adjuncts can be used to localize an adenoma. In this video, the authors highlight their additional usage of pituitary perfusion MRI for identification of the adenoma. They present their stepwise management algorithm and surgical techniques for sellar and suprasellar exploration in 6 cases of MRI-Negative CD operated on by the senior author (A.S.). The video can be found here: https://stream.cadmore.media/r10.3171/2023.4.FOCVID2318.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"9 1","pages":"V7"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10321547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9806565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Techniques in MRI–Negative Cushing disease mri阴性库欣病的治疗技术
Neurosurgical focus: Video Pub Date : 2023-07-01 DOI: 10.3171/2023.4.FOCVID2340
J. V. Van Gompel, M. Celda, M. Zoli, J. Fernandez-Miranda
{"title":"Techniques in MRI–Negative Cushing disease","authors":"J. V. Van Gompel, M. Celda, M. Zoli, J. Fernandez-Miranda","doi":"10.3171/2023.4.FOCVID2340","DOIUrl":"https://doi.org/10.3171/2023.4.FOCVID2340","url":null,"abstract":"agnetic resonance imaging (MRI)–negative Cushing disease is one of the most difficult and challenging surgical cases in both pituitary and skull base surgery. Experience is gained by a sequence of success and, unfortunately, failure, which results in a hard-fought experience with these cases. There are a variety of established and novel techniques that would benefit from high-quality video documentation, which could help established surgeons and novices alike improve patient care for this difficult population. In this Neurosurgical Focus: Video edition, we present high-quality videos addressing pituitary exploration, cavernous sinus exploration with medial wall removal, and methods of subtotal gland re-section. In addition, a video correlating the novel imaging technique of intraoperative ultrasound with a prior MRI-negative case is presented. Finally, a very interesting series of cases demonstrating suprasellar/infundibular disease is presented. We believe this collection of videos will be a valuable resource for the neurosurgery and endocrine community in these most difficult cases, MRI-negative Cushing disease.","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45893578","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}
引用次数: 0
Endoscopic ultrasonic resection of calcified tumor of the third ventricle. 超声内镜下第三脑室钙化瘤切除术。
Neurosurgical focus: Video Pub Date : 2023-04-01 DOI: 10.3171/2023.1.FOCVID22143
Pietro Spennato, Nicola Onorini, Francesca Vitulli, Alessia Imperato, Lucia De Martino, Claudio Ruggiero, Giuseppe Cinalli
{"title":"Endoscopic ultrasonic resection of calcified tumor of the third ventricle.","authors":"Pietro Spennato,&nbsp;Nicola Onorini,&nbsp;Francesca Vitulli,&nbsp;Alessia Imperato,&nbsp;Lucia De Martino,&nbsp;Claudio Ruggiero,&nbsp;Giuseppe Cinalli","doi":"10.3171/2023.1.FOCVID22143","DOIUrl":"https://doi.org/10.3171/2023.1.FOCVID22143","url":null,"abstract":"<p><p>In this video, the authors present ultrasonic resection of calcified tumor of the third ventricle in a 12-year-old boy. He presented to the emergency department with a 1-week history of headache, drowsiness, and bilateral papilledema. Despite extensive calcification visible on a CT scan, a minimally invasive pure endoscopic approach was chosen. The use of an ultrasonic aspirator allows fast and safe removal of the tumor. The histological diagnosis was a low-grade glioneuronal tumor. In conclusion, the endoscopic ultrasonic aspirator is a useful tool to resect tumors in the ventricular system. The presence of calcifications within the tumor does not contraindicate an endoscopic approach. The video can be found here: https://stream.cadmore.media/r10.3171/2023.1.FOCVID22143.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"8 2","pages":"V6"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10114909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9392474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Introduction. Intraventricular endoscopic surgery 介绍。脑室内窥镜手术
Neurosurgical focus: Video Pub Date : 2023-04-01 DOI: 10.3171/2023.1.focvid2311
M. Hamilton, A. Toma, C. Teo, C. Hayhurst, M. Souweidane
{"title":"Introduction. Intraventricular endoscopic surgery","authors":"M. Hamilton, A. Toma, C. Teo, C. Hayhurst, M. Souweidane","doi":"10.3171/2023.1.focvid2311","DOIUrl":"https://doi.org/10.3171/2023.1.focvid2311","url":null,"abstract":"","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69677993","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}
引用次数: 0
Endoscopic transventricular resection of a colloid cyst. 内镜下经脑室胶体囊肿切除术。
Neurosurgical focus: Video Pub Date : 2023-04-01 DOI: 10.3171/2023.1.FOCVID22140
Sebastian Lehmann, Henry W S Schroeder
{"title":"Endoscopic transventricular resection of a colloid cyst.","authors":"Sebastian Lehmann,&nbsp;Henry W S Schroeder","doi":"10.3171/2023.1.FOCVID22140","DOIUrl":"https://doi.org/10.3171/2023.1.FOCVID22140","url":null,"abstract":"<p><p>This video demonstrates the purely endoscopic gross-total resection of a third ventricle colloid cyst that is partially covered by a large thalamostriate vein. To gain an ideal approach, the initial trajectory pointed to the interventricular septum above the cyst. After the head of the caudate nucleus is passed, it is retracted laterally by the endoscopic sheath for the ideal far lateral approach to the cyst. Using a pneumatic endoscope holder enables the surgeon to perform the procedure bimanually. After complete removal of the cyst, postoperative inspection confirms the intact fornix, veins, and caudate nucleus without signs of pressure-related damage. The video can be found here: https://stream.cadmore.media/r10.3171/2023.1.FOCVID22140.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"8 2","pages":"V3"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10114912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9387867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Purely endoscopic biportal and monoportal removal of the choroid plexus papilloma of the third ventricle with bilateral spread to the lateral ventricles. 纯内窥镜双门静脉和单门静脉切除第三脑室脉络膜丛乳头状瘤伴双侧脑室扩散。
Neurosurgical focus: Video Pub Date : 2023-04-01 DOI: 10.3171/2023.1.FOCVID22170
Albert A Sufianov, Ilshat A Gaysin, Iurii A Iakimov, Rinat A Sufianov
{"title":"Purely endoscopic biportal and monoportal removal of the choroid plexus papilloma of the third ventricle with bilateral spread to the lateral ventricles.","authors":"Albert A Sufianov,&nbsp;Ilshat A Gaysin,&nbsp;Iurii A Iakimov,&nbsp;Rinat A Sufianov","doi":"10.3171/2023.1.FOCVID22170","DOIUrl":"https://doi.org/10.3171/2023.1.FOCVID22170","url":null,"abstract":"<p><p>Modern neuroendoscopy makes it possible to treat tumors of various localizations with a reduced risk of intra- and postoperative complications. In this video, the authors present biportal and monoportal techniques for the removal of the choroid plexus papilloma of the third ventricle with bilateral spread to the lateral ventricles in a 1-year-old boy. For this operation, they successfully used a new instrument for neuroendoscopy, LigaSure, specially designed for intra-abdominal surgery. The video can be found here: https://stream.cadmore.media/r10.3171/2023.1.FOCVID22170.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"8 2","pages":"V7"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10114914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9387861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Navigation guidance in neuroendoscopic management of complex hydrocephalus. 神经内窥镜治疗复杂脑积水的导航指导。
Neurosurgical focus: Video Pub Date : 2023-04-01 DOI: 10.3171/2023.1.FOCVID22152
Nishanth Sadashiva, Subhas Konar, Chirag Jain, Dhaval Shukla
{"title":"Navigation guidance in neuroendoscopic management of complex hydrocephalus.","authors":"Nishanth Sadashiva,&nbsp;Subhas Konar,&nbsp;Chirag Jain,&nbsp;Dhaval Shukla","doi":"10.3171/2023.1.FOCVID22152","DOIUrl":"https://doi.org/10.3171/2023.1.FOCVID22152","url":null,"abstract":"<p><p>Patients with multiloculated hydrocephalus have multiple, separate abnormal CSF collections with no communication between them. Causes include complications of neonatal meningitis, germinal matrix hemorrhage in neonates, head trauma, and intracranial surgery. Endoscopic fenestration with shunt insertion is a safe and less invasive technique as the initial treatment. In this video, the authors demonstrate a few cases in which electromagnetic navigation was used with a stylet inserted through the operating endoscope to guide the surgeon. Modalities such as insertion of intraventricular contrast and fluorescein may be used as adjuvants, as demonstrated. The use of navigation helps to identify distorted anatomical landmarks and guides surgery. The video can be found here: https://stream.cadmore.media/r10.3171/2023.1.FOCVID22152.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"8 2","pages":"V4"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10114916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9387864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endoscopic fenestration of an enlarging giant occipital arachnoid cyst. 巨大枕网膜囊肿扩大的内窥镜开窗术。
Neurosurgical focus: Video Pub Date : 2023-04-01 DOI: 10.3171/2023.1.FOCVID22129
Rachel Blue, Jaskeerat Gujral, Hasan S Ahmad, Omar Choudhri
{"title":"Endoscopic fenestration of an enlarging giant occipital arachnoid cyst.","authors":"Rachel Blue,&nbsp;Jaskeerat Gujral,&nbsp;Hasan S Ahmad,&nbsp;Omar Choudhri","doi":"10.3171/2023.1.FOCVID22129","DOIUrl":"https://doi.org/10.3171/2023.1.FOCVID22129","url":null,"abstract":"<p><p>This case demonstrates an endoscopic fenestration of an enlarging giant occipital arachnoid cyst. The patient is a 42-year-old woman presenting with headache, progressive vision loss, and nausea and vomiting. MRI demonstrates a large, nonenhancing cystic lesion in the right occipital lobe measuring up to 8.3 cm, consistent with an arachnoid cyst. This surgical video illustrates the technique for an endoscopic fenestration into the native ventricular system utilizing stereotactic MRI-guided stealth navigation. Postoperatively, the patient had full recovery with improvement of headaches and vision and was discharged on postoperative day 1 without complications. The video can be found here: https://stream.cadmore.media/r10.3171/2023.1.FOCVID22129.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"8 2","pages":"V2"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10114910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9443813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feasibility of extended transforaminal approach (medial subchoroid) for resection of a benign aqueductal tumor in a patient with type 1 neurofibromatosis. 扩展经椎间孔入路(内侧脉络膜下)切除1型神经纤维瘤患者良性输尿管肿瘤的可行性。
Neurosurgical focus: Video Pub Date : 2023-04-01 DOI: 10.3171/2023.1.FOCVID22155
Jose M Narro-Donate, Jose J Guil-Ibañez, Maria José Castelló-Ruiz, Fernando García-Pérez, Gaizka Urreta-Juarez, José Masegosa-González
{"title":"Feasibility of extended transforaminal approach (medial subchoroid) for resection of a benign aqueductal tumor in a patient with type 1 neurofibromatosis.","authors":"Jose M Narro-Donate,&nbsp;Jose J Guil-Ibañez,&nbsp;Maria José Castelló-Ruiz,&nbsp;Fernando García-Pérez,&nbsp;Gaizka Urreta-Juarez,&nbsp;José Masegosa-González","doi":"10.3171/2023.1.FOCVID22155","DOIUrl":"https://doi.org/10.3171/2023.1.FOCVID22155","url":null,"abstract":"<p><p>The extended transforaminal endoscopic approach allows visualization and manipulation of the third ventricle posterior structures in a safe and comfortable manner. The medial subchoroidal approach has been described as a feasible alternative to the classical transchoroidal approach. In this video, the authors present the case of a 14-year-old male with a history of neurofibromatosis type 1 who was referred to our department after presenting with headaches and diplopia for 2 weeks. Suspecting an aqueduct tumor, the authors performed an endoscopic surgical procedure through a single approach with third cisternostomy and resection of the tumor that produced the stenosis. The video can be found here: https://stream.cadmore.media/r10.3171/2023.1.FOCVID22155.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"8 2","pages":"V5"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10114915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9387863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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