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Thomas P. Naidich and Christopher J. Moran

sphenoethmoidal CSF leaks in whom surgical approach to the exact site indicated by MCTC terminated CSF leakage; there was no recurrence. Technique Preliminary Evaluation The approximate site of CSF leakage is determined as accurately as possible by clinical findings and review of plain skull radiographs obtained in a brow-up position and in the position of maximum leakage. Pluridirectional tomography is employed to evaluate fractures and destructive lesions of the skull base. Routine computerized tomography (CT) is used to rule out hydrocephalus, obstructive neoplasms

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The transoral approach to the superior cervical spine

A review of 53 cases of extradural cervicomedullary compression

Mark N. Hadley, Robert F. Spetzler and Volker K. H. Sonntag

approach is complex. The precise location of the craniocervical pathology and the mechanism(s) of brain-stem or spinal cord compression are the influencing factors that determine which specific surgical approach should be utilized in a given patient. 1, 2, 11, 15, 21, 22, 25 In general, ventral craniovertebral junction pathology should be approached anteriorly; dorsal pathology is best treated from a posterior approach. A number of patients, particularly those with basilar invagination due to congenital skull base C1–2 anomalies, will require a combination of surgical

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Wenya Linda Bi, Patrick A. Brown, Mohammad Abolfotoh, Ossama Al-Mefty, Srinivasan Mukundan Jr., and Ian F. Dunn

tumor and cranial anatomy in a safe and rapid manner, while also allowing this information to be incorporated into image guidance platforms. We investigated 320–detector row dynamic volume CTA/CTV as an effective alternative in elucidating critical vascular, especially venous, anatomy, and we evaluated its impact on surgical approach in complex intracranial tumors. Methods Patient Identification All patients with complex intracranial tumors who had undergone dynamic CTA/CTV as well as MRI prior to surgery in the period from July 2010 to June 2012 were

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Harry R. van Loveren, Jeffrey T. Keller, Magdy El-Kalliny, Daniel J. Scodary and John M. Tew Jr.

and trochlear nerves superiorly and the trigeminal and abducens nerves inferiorly. The inherent risks of circulatory arrest and the method used to achieve vascular control in these procedures dissuaded others from adopting this technique. More recently, drawing upon existing knowledge as well as extensive personal research, Dolenc 2 reported a method of cavernous sinus exploration without the need for circulatory arrest. Utilizing the work of Parkinson, 10–13 Dolenc, 2, 3 and other pioneering investigators, we have developed a comprehensive surgical approach

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Mohammed F. Shamji, Chad Cook, Sean Tackett, Christopher Brown and Robert E. Isaacs

either the spinal cord or exiting nerve roots, and to allow fusion to be performed for treatment of either pathological or iatrogenic spinal instability. Key factors affecting the choice of surgical approach include relative location of the stenosis, cervical spine sagittal alignment, and the number of diseased levels. 19 , 22 Central, anterior pathological entities such as spondylotic bars or herniated disc material are imaging features that favor an anterior approach. Similarly, the presence of cervical kyphosis also supports that choice of technique. Multiple

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Juan Luis Gómez-Amador, Luis Alberto Ortega-Porcayo, Isaac Jair Palacios-Ortíz, Alexander Perdomo-Pantoja, Felipe Eduardo Nares-López and Alfredo Vega-Alarcón

patient-year. 1 , 14 BSCMs are challenging because of the critical anatomy and potential surgical risks. Minimizing pial incision and brainstem transection is the main consideration when deciding the optimal surgical approach for each patient. We present a case of a midline ventral pontine CM that was resected through an endoscopic endonasal transclival approach that allowed for minimal brainstem transection, negligible cranial nerve (CN) manipulation, and a straightforward trajectory. Case Report Presentation and Examination A 29-year-old man presented with acute

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Ian Johnston

: Carotid cavernous fistula: direct repair with preservation of the carotid artery. Technical note. J Neurosurg 38: 99–106, 1973 12. Parkinson D : A surgical approach to the cavernous portion of the carotid artery. Anatomical studies and case report. J Neurosurg 23 : 474 – 483 , 1965 Parkinson D: A surgical approach to the cavernous portion of the carotid artery. Anatomical studies and case report. J Neurosurg 23: 474–483, 1965 13. Seltzer J , Hurteau EF : Bilateral symmetrical aneurysms of internal carotid

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Charles A. Sansur, Davis L. Reames, Justin S. Smith, D. Kojo Hamilton, Sigurd H. Berven, Paul A. Broadstone, Theodore J. Choma, Michael James Goytan, Hilali H. Noordeen, Dennis Raymond Knapp Jr., Robert A. Hart, Reinhard D. Zeller, William F. Donaldson III, David W. Polly Jr., Joseph H. Perra, Oheneba Boachie-Adjei and Christopher I. Shaffrey

a comprehensive review of the M&M data for the various surgical options available to treat IS and DS. The purpose of this paper was to review the SRS M&M database to assess overall complication rates in IS and DS, and to determine what clinical factors influence the rate of complications. In particular, age, surgical approach, history of previous surgery, and type and grade of spondylolisthesis were assessed for potential association with the occurrence of complications. The SRS has been collecting data on short-term surgical complications from its members for

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Tamara D. Simon, Matthew Hall, J. Michael Dean, John R. W. Kestle and Jay Riva-Cambrin

C erebrospinal fluid shunt placement is the mainstay of hydrocephalus treatment. 17 While allowing children with hydrocephalus to avoid further brain injury, CSF shunts can be associated with new and chronic surgical and medical problems. 33 Infections are frequent complications 12 , 23 and have been seen in 11.7% of patients undergoing CSF shunt placement. 32 There is significant variation in surgical and medical decision-making in the treatment of CSF shunt infection. 18 , 19 , 21 , 39 Surgical approaches to the treatment of CSF shunt infection

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Marino Zorzon, Miran Skrap, Silvana Diodato, Davide Nasuelli and Bruno Lucci

desirable to avoid the consequences of a long-lasting compression of the spinal cord. Surgical outcome is generally favorable and short-term recurrences have not been reported; 2 however, long-term follow-up studies are lacking. Mainly for ventral cysts, transoral decompression, which allows complete excision, has been performed; 2, 3, 6 however, the posterolateral surgical approach, which is better tolerated by the patient, has been considered adequate by most authors. 1, 2, 4, 5, 7–9 We report two additional cases of synovial cysts situated posteriorly to the dens