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Gabriel Zada

increasing popularity of extended endoscopic endonasal approaches and more routine use of the Hadad-Bassagasteguy nasoseptal flap. 2 , 4 One of the inherent and major drawbacks associated with endonasal surgery for intracranial pathology is the risk for developing postoperative CSF rhinorrhea and its associated counterparts, meningitis and pneumocephalus. The advent and widespread dissemination of pedicled nasoseptal flap repair has provided endoscopic skull base surgeons with the peace of mind required to perform extended endonasal approaches and address complex skull

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Gabriel Zada

-up for at least a decade after the operation. Conclusions Rathke cleft cysts are benign, epithelial-lined cysts that cause symptoms in a minority of patients in whom they are found. Headache, visual loss, and endocrine dysfunction are the most common presenting features. Transsphenoidal surgery remains the preferred option for patients with symptomatic RCCs or those with subclinical visual loss or hypopituitarism and offers excellent outcomes with regard to symptomatic improvement, preservation of normal pituitary function, and minimization of complications

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Eisha Christian, Brianna Harris, Bozena Wrobel and Gabriel Zada

S everal studies and worldwide initiatives have previously established that intraoperative and perioperative surgical checklists can minimize the incidence of and prevent adverse events. 5 , 9 , 15 , 16 Checklists for surgical procedures have been used on an international basis, and major reductions in morbidity and complication rates have been achieved. 6 , 12 Endoscopic endonasal surgery is highly dependent on the technology and instrumentation that are integral to successful completion of the operation; the unavailability or dysfunction of any of

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Andres A. Gonzalez, Dhiraj Jeyanandarajan, Chris Hansen, Gabriel Zada and Patrick C. Hsieh

I ntraoperative neurophysiological monitoring is a continually evolving field that aims to localize and monitor neural structures according to their functional basis and ultimately preserve their structural integrity. During spinal surgery, several structures are placed at risk for potential injury, including the spinal cord, nerve roots, lumbar plexus, and all relevant vascular supply to these elements. Several electrophysiological modalities are currently available for monitoring various aspects of the central and peripheral nervous system, each offering a

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Paolo Cappabianca, Theodore H. Schwartz, John A. Jane Jr., M.D. and Gabriel Zada

This issue of Neurosurgical Focus attempts to address recent advances in endoscopic endonasal skull base surgery. Although the concept of minimal invasiveness is not new to our discipline, improvements in endoscopic technology and instrumentation, as well as the gradual refinement of a variety of endonasal endoscopic approaches, have greatly facilitated our ability to safely treat a wide variety of skull base pathology that was not possible two decades ago. This speciality of neurosurgery requires precise anatomical knowledge, technical skills, and

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Gabriel Zada, J. Diaz Day and Steven L. Giannotta

of 66 patients who underwent surgery via the temporopolar approach performed by the senior authors (JDD and SLG) between 1992 and 2008 were retrospectively reviewed. Pertinent information from clinic notes, operative reports, and radiographic studies was reviewed and entered into a patient database for subsequent analysis. The present study was preapproved by the institutional review board at each author's institution. Operative Technique The patient is positioned in the supine position with the head fixed at an angle of ~ 45° away from the operative side

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Grace Lam, Vivek Mehta and Gabriel Zada

, most frequently with thin-slice CT images in the coronal plane. The average initial prolactin level in patients with spontaneous CSF leakage was 9169 ng/ml, compared with 4917 ng/ml in those with medically induced leakage. Due to a small number of values from the spontaneous leakage group, however, this difference was not statistically significant. Interestingly, no cases of spontaneous CSF leakage following radiation therapy or radiosurgery for pituitary adenomas were identified. One case of a spontaneous CSF leak developing 4 months following Gamma Knife surgery

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Parham Yashar, Gabriel Zada, Brianna Harris and Steven L. Giannotta

CVSs include clinical observation, radiosurgery, open resection, or a combination of surgery and radiosurgery. When the goal of surgery has been GTR, reported outcomes for facial nerve function have unfortunately been less successful than those for solid VSs, which can be attributed to the adherent nature of these cystic tumors to surrounding structures. 3 , 6 , 8 , 17 , 20 , 23 In this paper we review our experience in the surgical treatment of CVSs, including surgical approached used, extent of resection, and early postoperative facial nerve outcomes. We also

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Gabriel Zada, Ning Lin and Edward R. Laws Jr.

sphenoid sinus and clivus. 6 , 13 In this study, we aimed to analyze patterns of tumor extension on MR imaging studies of these 2 most commonly treated macroadenomas at our institution (GH-secreting and nonfunctional macroadenomas) to better understand the proclivity of these tumors to preferentially invade various parasellar regions. Methods We conducted a retrospective review of the Brigham and Women's Hospital Pituitary Center database to identify all patients who underwent transsphenoidal surgery performed by the senior author (E.R.L.) between April 2008 and

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Gabriel Zada, Thomas C. Solomon and Steven L. Giannotta

postural headache, n/v, diplopia abducens lt epidural blood patch yes Mikawa & Ebina, 2001 41, M postural headache, memory loss oculomotor lt epidural blood patch, evacuation of SDH yes Garcia-Morales et al., 2001 70, M headache, diplopia abducens NR surgical repair yes Brady-McCreery et al., 2002 42, M diplopia oculomotor, trochlear bilat † eye muscle surgery no Warner, 2002 26, M headache, n/v, unilateral hearing loss, blurred vision oculomotor rt none yes Beck et al., 2003 40, F headache