Asian Journal of Neurosurgery最新文献

{"title":"Development of a Model for Plaque Induction in Rat Carotid Arteries.","authors":"Akira Wakako, Akiyo Sadato, Motoki Oeda, Saeko Higashiguchi, Motoharu Hayakawa, Marie Oshima, Yuichi Hirose","doi":"10.1055/s-0043-1763522","DOIUrl":"10.1055/s-0043-1763522","url":null,"abstract":"<p><p><b>Objective</b>  Plaque induction through intimal injury using a balloon catheter in small animals and by artificial ligation of the carotid artery in large animals have been reported. However, these reports have not yet succeeded in inducing stable plaques nor creating a high degree of intimal thickening to be used as animal models. We have previously developed a plaque induction model in rats but have failed to obtain a plaque incidence frequency that can be used as a model. Thus, in the current study, we aimed to create a versatile disease model to examine the pharmacokinetics of drug administration, determine the efficacy of treatment, and examine the process of intimal thickening. We also attempted to create an improved model with shorter, more frequent, and more severe intimal thickening. <b>Materials and Methods</b>  The common carotid artery of male Wistar rats was surgically exposed and completely ligated with a wire and 6-0 nylon thread. Then, the wire was removed to create a partial ligation. To create a high frequency and high degree of intimal thickening, 72 rats were divided into two groups: a single lesion group with a 0.25-mm wire and a single ligature point, and a tandem lesion group with a 0.3-mm wire and two ligature points. Each group was further divided into normal diet and high cholesterol diet groups. The presence and frequency of intimal thickening were examined for each group after 4, 8, and 16 weeks of growth. <b>Results</b>  In the single lesion group, intimal thickening was observed in 42% of the 4-week group and 75% of the 8-week group. In the tandem lesion group, intimal thickening was observed in 75% of the 4-week group and 50% of the 8-week group. In addition, 50% of the individuals reared for 16 weeks developed intimal thickening. <b>Conclusion</b>  We successfully induced intimal thickening in the carotid arteries of rats with high frequency in the single lesion and tandem lesion groups. The results also showed that the tandem lesion group tended to induce intimal thickening earlier than the single lesion group.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10749859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82968588","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}

{"title":"Refractory Delayed Pneumocephalus after Transsphenoidal Cyst Drainage for Rathke's Cleft Cyst in a Patient with a Cerebrospinal Fluid Shunt.","authors":"Tetsuo Hashiba,&nbsp;Masahiro Nonaka,&nbsp;Haruka Iwamura,&nbsp;Takamasa Kamei,&nbsp;Junichi Takeda,&nbsp;Akio Asai","doi":"10.1055/s-0043-1768573","DOIUrl":"https://doi.org/10.1055/s-0043-1768573","url":null,"abstract":"<p><p>A 75-year-old man presented with bilateral lower limb weakness to our hospital from another clinic. Radiological examinations implied the possibilities of idiopathic normal pressure hydrocephalus (iNPH) and a suprasellar cyst, but both were observed conservatively at that time. Due to the progressive gait disturbance, a lumboperitoneal shunt was implanted 1 year later. The clinical symptoms improved, but the cyst had grown after another year, causing visual impairment. Transsphenoidal drainage of the cyst was performed, but delayed pneumocephalus occurred. Repair surgery was performed with temporary suspension of shunt function, but pneumocephalus relapsed two and a half months after the resumption of shunt flow. In the second repair surgery, the shunt was removed because it was assumed that it would prevent closure of the fistula by lowering intracranial pressure. Two and a half months later, after confirming involution of the cyst and no pneumocephalus, a ventriculoperitoneal shunt was implanted, and cerebrospinal fluid (CSF) leakage has not relapsed since then. The coexistence of idiopathic normal pressure hydrocephalus (iNPH) and Rathke's cleft cyst (RCC) is rare, but it can occur. RCC can be cured by simple drainage, but delayed pneumocephalus can occur in cases whose intracranial pressure decreases due to CSF shunting. When simple drainage without sellar reconstruction for RCC is attempted after CSF shunting for coexistent iNPH, attention should be paid to changes in intracranial pressure, and it is desirable to stop the flow of the shunt for a certain period.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/46/75/10-1055-s-0043-1768573.PMC10310442.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9744832","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}

{"title":"Outcome of Transforaminal Endoscopic Discectomy in Rural India in a Single-Level Lumbar Disc Prolapse Under Local Anesthesia.","authors":"Vishnu Vikraman Nair,&nbsp;Sarabjeet Kohli,&nbsp;Nilesh Vishwakarma,&nbsp;Juilee Mhatre","doi":"10.1055/s-0043-1769756","DOIUrl":"https://doi.org/10.1055/s-0043-1769756","url":null,"abstract":"<p><p><b>Aim</b>  The aim of this study was to undertake a clinical study to evaluate the outcomes of transforaminal endoscopic discectomy under local anesthesia and to study the complication rate. <b>Study Design</b>  It is a prospective study. <b>Methods</b>  We prospectively analyzed outcomes of 60 patients with a single-level lumbar disc prolapse in rural India from December 2018 to April 2020 who underwent endoscopic discectomy under local anesthesia. Follow-up was done using the visual analogue score (VAS) and Oswestry Disability Index (ODI) scoring systems with a minimum follow-up up to 1 year postoperatively. <b>Results</b>  In our study of 60 patients, there was 38 cases of L4-L5 disc pathology, 13 L5-S1 discs, and 9 L3-L4 discs. Our study showed a significant clinical reduction in mean VAS score that was 7.07/10 preoperatively and reduced to 3.88/10 at the third month and 3.64/10 at 1 year of follow-up ( <i>p</i> -value < 0.05) showing clinical significance. The ODI scoring done preoperatively was an average mean of 57.37% pointing to how crippled the patients were with lumbar disc prolapse and showed a significant reduction to 29.32% postoperatively at 1 year ( <i>p</i> -value < 0.05) showing clinical significance. This reduction in ODI directly corelates to how almost all patients returned to normal life coping to all activities and were completely pain free at 1 year of follow-up. <b>Conclusion</b>  Endoscopic spine surgery in lumbar disc prolapse is highly effective and can deliver a good functional outcome if done with correct preoperative planning and approach.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4e/fa/10-1055-s-0043-1769756.PMC10310452.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9736491","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}

{"title":"A Rare Case of COVID-19-Associated Solitary <i>Aspergillus</i> Brain Abscess.","authors":"Rajeev Mandaka Parambil,&nbsp;Binoy Damodar Thavara,&nbsp;Saji Francis,&nbsp;Poornima Mankara Valsan,&nbsp;Byjo Valiyaveetil Jose,&nbsp;Vishal Mangla,&nbsp;Harikrishnan Sreenivasan,&nbsp;Shanavas Cholakkal","doi":"10.1055/s-0043-1768570","DOIUrl":"https://doi.org/10.1055/s-0043-1768570","url":null,"abstract":"Abstract Surgically operated case of solitary Aspergillus brain abscess caused by Aspergillus fumigatus in coronavirus disease 2019 (COVID-19) patient is not reported. The authors report a case of 33-year-old diabetic female patient presented with generalized seizure followed by left hemiparesis. Patient was treated with steroids for COVID-19 pneumonia. Initial imaging revealed a right frontal lobe infarct that later confirmed as a case of frontal lobe abscess. Patient underwent craniotomy and thick yellow pus was drained. Abscess wall was excised. Postoperatively patient improved with Glasgow coma scale 15/15 and Medical Research Committee grade 5 power of all limbs. Microbiological examination of pus was done. The gram stain showed numerous pus cells with acute angle branching hyphae. Gomori methenamine silver (GMS) preparation showed filamentous black colored hyphae. Mycelial colonies appeared on chocolate agar after 48 hours of incubation. Cellophane tape mount from the plate showed conical shaped vesicle with conidia arising from the upper third of vesicle. Light green velvety colonies appeared on Sabouraud Dextrose Agar that later turned into smoky green. The isolate was identified as Aspergillus fumigatus . The hematoxylin and eosin stain of abscess wall section showed extensive areas of necrosis with few fungal hyphae. GMS stain of abscess wall showed fungal hyphae that are septate and showing acute angled branching which are consistent with Aspergillus species. Patient was treated with voriconazole. Imaging done after 8 months of surgery revealed no residue. Surgical excision of life-threatening solitary Aspergillus brain abscess along with antifungal medication voriconazole carries good result. The authors believe that decreased immunity in patient has contributed to the development of this rare disease. This is a rarest case of surgically operated solitary brain abscess caused by Aspergillus fumigatus in COVID-19 patient.","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/60/10-1055-s-0043-1768570.PMC10310437.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9736493","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}

{"title":"Oral Midodrine as an Adjunct in Rapid Weaning of Intravenous Vasopressor Support in Spinal Cord Injury.","authors":"Arunkumar Sekar,&nbsp;Debajyoti Datta,&nbsp;Avinash Lakha,&nbsp;Sritam Swaroop Jena,&nbsp;Sumit Bansal,&nbsp;Rabi Narayan Sahu","doi":"10.1055/s-0043-1769755","DOIUrl":"https://doi.org/10.1055/s-0043-1769755","url":null,"abstract":"<p><p><b>Background</b>  Majority of acute cervical spinal cord injury end up requiring long-term stay in intensive care unit (ICU). During the initial few days after spinal cord injury, most patients are hemodynamically unstable requiring intravenous vasopressors. However, many studies have noted that long-term intravenous vasopressors remain the main reason for prolongation of ICU stay. In this series, we report the effect of using oral midodrine in reducing the amount and duration of intravenous vasopressors in patients with acute cervical spinal cord injury. <b>Materials and Methods</b>  Five adult patients with cervical spinal cord injury after initial evaluation and surgical stabilization are assessed for the need for intravenous vasopressors. If patients continue to need intravenous vasopressors for more than 24 hours, they were started on oral midodrine. Its effect on weaning of intravenous vasopressors was assessed. <b>Results</b>  Patients with systemic and intracranial injury were excluded from the study. Midodrine helped in weaning of intravenous vasopressors in the first 24 to 48 hours and helped in complete weaning of intravenous vasopressors. The rate of reduction was between 0.5 and 2.0 µg/min. <b>Conclusion</b>  Oral midodrine does have an effect in reduction of intravenous vasopressors for patients needing prolonged support after cervical spine injury. The real extent of this effect needs to be studied with collaboration of multiple centers dealing with spinal injuries. The approach seems to be a viable alternative to rapidly wean intravenous vasopressors and reduce duration of ICU stay.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/2f/10-1055-s-0043-1769755.PMC10310436.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9744828","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}

{"title":"Controlled-Release Levodopa for the Treatment of Rapid Motor Fluctuations in Parkinson's Disease Subjects with Subthalamic Nucleus Deep Brain Stimulation.","authors":"Halil Onder,&nbsp;Selcuk Comoglu","doi":"10.1055/s-0043-1769757","DOIUrl":"https://doi.org/10.1055/s-0043-1769757","url":null,"abstract":"<p><p><b>Objectives</b>  We aimed to investigate the efficiency of controlled-release levodopa/benserazide (Madopar HBS) use during daytime in our pilot study on advanced-stage Parkinson's disease (PD) subjects with deep brain stimulation of the subthalamic nucleus (STN-DBS) therapy. <b>Methods</b>  We have evaluated all PD subjects with STN-DBS who had admitted to our outpatient polyclinic between February 2022 and March 2022. Among these patients, those who were taking levodopa therapy at least five times throughout the day and the efficiency of levodopa lasted less than 3 hours were detected. The standard levodopa therapy was switched to Madopar HBS in all patients who accepted the therapy chance and the clinical evaluation of the patients on Madopar HBS therapy was performed in the second month of the therapy. <b>Results</b>  Ultimately, the follow-up of all four patients in whom the levodopa therapy was changed to Madopar HBS yielded a significant reduction in the \"off\" periods and improvement in the PSQ-39 scores. <b>Conclusion</b>  We suggest the use of Madopar HBS in PD patients with STN-DBS surgery suffering from motor fluctuations, particularly in the subgroup with milder dyskinesias. Future study results of a large number of PD subjects with STN-DBS therapy are warranted to confirm our observations. The results of these studies may provide critical applications in clinical practice.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/13/11/10-1055-s-0043-1769757.PMC10310439.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9742956","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}

{"title":"Life-Threatening Intracerebral Hemorrhage in Adult with ITP: Challenging Entity.","authors":"Batuk Diyora,&nbsp;Anup Purandare,&nbsp;Kavin Devani,&nbsp;Pramod Kale,&nbsp;Vikrant Shah,&nbsp;Roy Patankar","doi":"10.1055/s-0043-1769891","DOIUrl":"https://doi.org/10.1055/s-0043-1769891","url":null,"abstract":"<p><p>Intracerebral hemorrhage (ICH) is a rare and fatal complication of immune thrombocytopenia. ICH is more common in children than in the adult population. A 30-year-old male patient, a known case of immune thrombocytopenia, presented with sudden onset severe headache and vomiting. Computed tomography scan showed a large right frontal intracerebral hematoma. His platelet counts were low, and he received multiple transfusions. Though he was initially conscious, his neurological condition progressively deteriorated, so the decision was taken for an emergency craniotomy. Despite multiple transfusions, his platelet counts were 10,000/µL, so craniotomy was very risky. He underwent an emergency splenectomy and received one unit of single donor platelets. Subsequently, his platelets count increased a few hours after, and he underwent successful evacuation of intracerebral hematoma. He eventually had an excellent neurological outcome. Though intracranial hemorrhage carries significant morbidity and mortality, a timely decision of emergency splenectomy followed by craniotomy can result in an excellent clinical outcome.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/82/10-1055-s-0043-1769891.PMC10313438.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9748017","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}

{"title":"Isolated Cerebral Cyst Hydatid Removal with Dowling's Technique in a 6-Year-Old Pediatric Patient: Case Report.","authors":"Yigit Can Senol,&nbsp;Naime Dilara Ozkan,&nbsp;Servet Guresci,&nbsp;Ergun Daglioglu,&nbsp;Ahmet Deniz Belen","doi":"10.1055/s-0043-1768600","DOIUrl":"https://doi.org/10.1055/s-0043-1768600","url":null,"abstract":"<p><p>Hydatid disease, caused by the <i>Echinococcus</i> parasite, is a worldwide zoonosis produced by the larval stage of the tapeworm. In urban living patients with cerebral abscesses, hydatid cysts should not be excluded from the differential diagnosis. We report an exceptional primary cerebral hydatid cyst in which imaging showed a large, round, contrast-enhancing lesion with a mass effect. The patient presented with a dull headache for over a year and progressively worsened left hemiparesis. The magnetic resonance imaging showed a huge intracranial mass, and the pathology was corrected with cyst hydatid. Surgery was performed via Dowling's technique, and the patient recovered without neurologic deficits. Echinococcosis should be considered a differential diagnosis for single or multiple cerebral abscesses, even in the absence of liver infections. The history of living in rural areas does not exclude cerebral hydatid cysts and <i>Echinococcus</i> .</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/21/10-1055-s-0043-1768600.PMC10313441.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9748019","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}

{"title":"Effect of Normal Saline versus PlasmaLyte on Coagulation and Metabolic Status in Patients Undergoing Neurosurgical Procedures.","authors":"Vandna Arora,&nbsp;Akanksha Khatri,&nbsp;Renu Bala,&nbsp;Vibhuti Kumar,&nbsp;Rashmi Arora,&nbsp;Shweta Jindal","doi":"10.1055/s-0043-1768598","DOIUrl":"https://doi.org/10.1055/s-0043-1768598","url":null,"abstract":"<p><p><b>Background</b>  The choice of intraoperative fluid in neurosurgical patients is important as we need to maintain adequate cerebral perfusion and oxygenation and also avoid cerebral edema. Normal saline (NS) is commonly used in neurosurgeries, but it leads to hyperchloremic metabolic acidosis, which may result in coagulopathy. Balanced crystalloid with physiochemical composition akin to that of plasma has favorable effects on metabolic profile and may avoid the problems associated with NS. Against this background, the present study aimed to compare the effects of NS versus PlasmaLyte (PL) on coagulation profile in patients undergoing neurosurgical procedures. <b>Methods</b>  This prospective, randomized, double-blinded study was conducted in 100 adult patients scheduled to undergo various neurosurgical procedures. Patients were randomly allocated in two groups of 50 each to receive either NS or PL intraoperatively and postoperatively till 4 hours after the surgery. Hemoglobin, hematocrit, coagulation profile (PT, PTT, and INR), serum chloride, pH, blood urea, and serum creatinine were measured prior to induction (baseline) and 4 hours after completion of surgery. <b>Results</b>  Demographic characteristics were statistically similar between the two groups. Coagulation profile parameters were comparable between the two groups at baseline as well as 4 hours after surgery. pH was significantly lower in the NS group as compared to the PL group at 4 hours after surgery. Postoperatively blood urea, serum creatinine, and serum chloride levels were significantly raised in the NS group as compared to the PL group. Hemoglobin and hematocrit values were similar between the two groups. <b>Conclusion</b>  Coagulation profile parameters were normal and statistically similar with intraoperative infusion of NS versus PL in patients undergoing neurosurgical procedures. However, use of PL was associated with a better acid-base and renal profile in these patients.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/db/c6/10-1055-s-0043-1768598.PMC10310450.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9736492","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}

{"title":"Pterional Approach for Anterior Skull Base Midline Meningiomas against \"The More The Merrier\" Approach: An Institutional Experience.","authors":"Matham Gowtham,&nbsp;Akhilesh G B Gowda,&nbsp;Sreenath Prabha Rajeev,&nbsp;Mathew Abraham,&nbsp;H V Easwer","doi":"10.1055/s-0043-1768575","DOIUrl":"https://doi.org/10.1055/s-0043-1768575","url":null,"abstract":"<p><p><b>Objective</b>  Anterior midline skull base meningiomas involving olfactory groove, planum sphenoidale, and tuberculum sellae were usually managed with bifrontal craniotomy until the dawn of advanced microsurgical techniques. With the emergence of microsurgical techniques, midline meningiomas could be tackled solely from a unilateral pterional approach. We present our experience with pterional approach in managing anterior skull base midline meningiomas, including the technical nuances and outcomes. <b>Methods</b>  Fifty-nine patients who underwent excision of anterior skull base midline meningiomas through a unilateral pterional craniotomy between 2015 and 2021 were retrospectively analyzed. The surgical technique and patient outcomes in the context of visual, behavioral, olfaction, and quality of life were evaluated during the follow-up. <b>Results</b>  A total of 59 consecutive patients were assessed over an average follow-up period of 26.6 months. Twenty-one (35.5%) patients had planum sphenoidale meningioma. Olfactory groove and tuberculum sellae meningioma groups consist of 19 (32%) patients each. Visual disturbance was the predominant symptom with almost 68% of patients presented with it. A total of 55 (93%) patients had complete excision of the tumor with 40 patients (68%) achieving Simpson grade II excision, and 11 (19%) patients had Simpson grade I excision. Among operated cases, 24 patients (40%) had postoperative edema among which 3 (5%) patients had irritability and 1 patient had diffuse edema requiring postoperative ventilation. Only 15 (24.6%) patients had contusion of the frontal lobe and were managed conservatively. Five patients (50%) with seizures had an association with contusion. Sixty-seven percent of patients had improvements in vision and 15% of patients had a stable vision. Only eight (13%) patients had postoperative focal deficits. Ten percent of patients had new-onset anosmia. The average Karnofsky score was improved. Only two patients had recurrence during follow-up. <b>Conclusion</b>  A unilateral pterional craniotomy is a versatile approach for the excision of anterior midline skull base meningioma, even for the larger lesions. The ability of this approach in the visualization of posterior neurovascular structures at the earlier stages of surgery while avoiding the opposite frontal lobe retraction and frontal sinus opening makes this approach more preferable over the other approaches.</p>","PeriodicalId":8521,"journal":{"name":"Asian Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/80/72/10-1055-s-0043-1768575.PMC10310447.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9736495","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}