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Meningiomas of the lateral ventricles

Neuroradiological and surgical considerations in 18 cases

Maurizio Fornari, Mario Savoiardo, Giulio Morello and Carlo L. Solero

M eningiomas of the lateral ventricles are uncommon tumors. They represent about 2% of intracranial meningiomas, which, in their turn, account for 13% to 18% of all intracranial tumors. 27 Most of the reports dealing with this subject are not recent. We reviewed 18 cases of meningiomas of the lateral ventricles operated on at the Neurological Institute of Milan from 1956 through 1978 (1.5% of the 1175 intracranial meningiomas operated on in that period) with special regard to the neuroradiological diagnosis and the surgical approach. Summary of Cases

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Madjid Samii, Gustavo A. Carvalho, Marcos Tatagiba, Cordula Matthies and Peter Vorkapic

T entorial meningiomas are estimated to represent only 2% to 3% of all intracranial meningiomas. 5, 9, 18 Because of the intricate anatomical relationship of the tentorial notch to the surrounding neurovascular structures, 17, 18 meningiomas in this region need to be exactly delineated in their location and extension before surgery. These tumors represent complex surgical entities. The surgical approach, surgical technique, and the postoperative results are the outgrowth of careful analysis and understanding. The tentorial notch or tentorial incisura is

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Lee Onn Chieng, Karthik Madhavan and Steven Vanni

the other hand, subaxial canal diameter, which is the space available for the spinal cord below the axis, was shown to have similar finding (< 14 mm) as a useful prognostic factor in subaxial subluxation. Furthermore, vertical subluxation, as in basilar invagination, has a worse prognosis and poor motor recovery compared with horizontal subluxation. Despite the high rate of morbidity resulting from surgery, the fear of potentially life-threatening events eventually prompts most spinal surgeons to perform surgery. Discussion The optimal surgical approach in the

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The far lateral/combined supra- and infratentorial approach

A human cadaveric prosection model for routes of access to the petroclival region and ventral brain stem

Hillel Z. Baldwin, Christopher G. Miller, Harry R. van Loveren, Jeffrey T. Keller, C. Phillip Daspit and Robert F. Spetzler

lateral approach in order to obtain an unobstructed view of the entire clivus and ventral brain stem. The exposures can be used individually or combined, depending upon the location of the lesion and the view needed, to minimize brain retraction. TABLE 1 Selection of surgical approach in patients with lesions in the petroclival region * Location of Lesion Surgical Approach upper third of clivus subtemporal craniotomy with optional anterior petrosectomy 15, 16 upper & middle third of clivus subtemporal craniotomy, or

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Akio Morita and Laligam N. Sekhar

, even relaxing the vein by removing the small portion of the cortex adherent to it. To avoid injury to the temporal vein during a petrosal approach, the technique of cutting the tentorium anterior to the confluence of vein to the tentorial venous lake has been reported. 5, 12 However, no techniques have been reported to reconstruct the cortical vein once injury occurs. Direct anastomosis or suturing were not successful in the majority of cases. Also, in cases in which a high-risk venous configuration has been encountered, an alternate surgical approach has been used

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Surgical management of giant presacral schwannoma: systematic review of published cases and meta-analysis

Presented at the 2019 AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves

Zach Pennington, Erick M. Westbroek, A. Karim Ahmed, Ethan Cottrill, Daniel Lubelski, Matthew L. Goodwin and Daniel M. Sciubba

presacral schwannoma, and 2) perform a meta-analysis to look for significant differences in local recurrence, estimated blood loss (EBL), and complication rates as a function of both surgical approach and extent of resection (EOR). The main questions we sought to address were: 1) what are the most common presenting symptoms of giant presacral schwannoma; 2) does en bloc resection provide superior recurrence-free survival relative to piecemeal gross-total (GTR) or subtotal resection (STR); 3) do complication rates differ among the available surgical approaches; and 4) does

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Charles B. Stillerman, Thomas C. Chen, William T. Couldwell, Wei Zhang and Martin H. Weiss

/or progressive myelopathy is generally regarded as an absolute indication for surgery. The role of surgery as a means to control pain is controversial; it has been reported that radicular pain responds better to surgery than does nonradiating thoracic pain. 36, 48, 67 Selection of the optimum surgical approach for disc removal is also controversial. In early series patients were treated with laminectomy, which resulted in suboptimal outcomes. 38, 39, 66, 68, 70 This presumably relates to the fact that the ventral force placed on the spinal cord by the herniated disc is

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Stephanie Chen, Brandon Gaynor and Allan D. Levi

P elvic schwannomas are rare tumors, with only two previously reported cases of pudendal nerve schwannomas in the English-language literature. 4 , 8 However, entrapment of the pudendal nerve in Alcock's canal is a well-described phenomenon. This syndrome is characterized by perineal and vulvar or scrotal pain that worsens with sitting. 2 Similar surgical approaches for release of pudendal nerve entrapment and pelvic schwannomas have been described. Those used in the two case reports of pudendal nerve schwannomas were the transgluteal approach and

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Taner Tanriverdi, Roy William Roland Dudley, Alya Hasan, Ahmed Al Jishi, Qasim Al Hinai, Nicole Poulin, M.Ed., Sophie Colnat-Coulbois and André Olivier

1982, Wieser and Yaşargil 62 reported on a rather small number of patients and found that SelAH produces less cognitive impairment than CAH. However, their findings were disputed when other studies produced different results a decade later. The more recent studies revealed that side and type of surgery affected cognitive functions, and different results were reported. Some found that SelAH, like CAH, can cause cognitive decline but to a lesser extent, 12 , 16 , 55 but others did not find differences between the surgical approaches. 17 , 26 Furthermore, in a

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Joseph M. Zabramski, Talat Kiriş, Suresh K. Sankhla, Josep Cabiol and Robert F. Spetzler

cavernous sinus. J Neurosurg 71 : 699 – 704 , 1989 Hakuba A, Tanaka K, Suzuki T, et al: A combined orbitozygomatic infratemporal epidural and subdural approach for lesions involving the entire cavernous sinus. J Neurosurg 71: 699–704, 1989 7. Ikeda K , Yamashita J , Hashimoto M , et al : Orbitozygomatic temporopolar approach for a high basilar tip aneurysm associated with a short intracranial internal carotid artery: a new surgical approach. Neurosurgery 28 : 105 – 110 , 1991 Ikeda K, Yamashita J