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John A. Persing

assessments of excellent, good, and poor postoperative results, it would be best to have the photographs independently reviewed and graded by individuals not directly involved in the surgery. Overall, I think the authors are to be commended for introducing and adopting a surgical approach that has improved the care of many patients with unilateral coronal synostosis. However, I think additional information and innovation are necessary before one describes this procedure as the best method to treat the problem, as the authors have recommended. References 1

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Nicholas C. Bambakidis, Sunil Manjila, Shervin Dashti, Robert Tarr and Cliff A. Megerian

) Type I (aneurysms on the loop, not in the IAM) Type II (partially in the IAM) Type III (fully in the IAM) LPS-premeatal LPS-meatal LPS-meatal distal (aneurysms arising from the end of the meatal loop to the distal AICA) postmeatal flocculopeduncular & cortical segments * LPS = lateral pontine segment. Management Options for AICA Aneurysms Surgical Approaches Depending on the anatomical features of the aneurysm, various skull base approaches, including the retrosigmoid, far-lateral, middle fossa, transcochlear, translabyrinthine

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Jian Ren, Tao Hong, Chuan He, Xiaoyu Li, Yongjie Ma, Jiaxing Yu, Feng Ling and Hongqi Zhang

subsequent lifelong hemorrhagic risk. 12 , 26 The clinical presentations, surgical management, and long-term outcomes of ISCCMs have been discussed in recent decades, especially in several large series. 1–3 , 5–7 , 11 , 12 , 15 , 16 , 18 , 19 , 24 , 26 However, the indications for surgical management and the selection of surgical approaches available in ISCCMs remain unoptimized and problematic, especially in asymptomatic, transient, or minimally symptomatic patients with ventral or deeply located ISCCMs. 12 , 13 , 15 We previously reported our initial experiences in 96

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Surgical approach to giant intracranial aneurysms

Operative experience with 80 cases

Thoralf M. Sundt Jr. and David G. Piepgras

aneurysm following common carotid ligation. J Neurosurg 19 : 41 – 50 , 1962 Odom GL, Woodhall B, Tindall GT, et al: Changes in distal intravascular pressure and size of intracranial aneurysm following common carotid ligation. J Neurosurg 19: 41–50, 1962 13. 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

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Richard K. Gurgel, Salim Dogru, Richard L. Amdur and Ashkan Monfared

have advocated partial resections, 2-stage resections, and combined partial resection with radiation therapy. 3 , 17 , 40 , 42 Moreover, questions remain regarding the surgical approach that provides the optimal facial nerve outcome. In this study, we systematically reviewed studies reporting postoperative outcomes of large VSs (≥ 2.5 cm of maximal or extrameatal diameter), with special attention to the facial nerve outcomes as a function of surgical approach and degree of tumor resection. Methods Search Criteria Following an Institutional Review Board

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Santiago Gil Robles, Peggy Gatignol, Stéphane Lehéricy and Hugues Duffau

. In the present study we show that a multistage surgical approach can be undertaken in eloquent areas without inducing permanent deficits because of the functional reshaping that occurs between operations. To demonstrate this plasticity, we used a combination of repeated preoperative fMR imaging and intraoperative electrical stimulation mapping before and during 2 surgeries spaced by several years in 2 patients with Grade II gliomas of the left dominant premotor area. To our knowledge, this is the first such study. Case Reports Case 1 Examination This

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Douglas E. Anderson, John Leonetti, Joshua J. Wind, Denise Cribari and Karen Fahey

hydrocephalus and in one patient cerebellar swelling. Four patients presented with bilateral tumors along with a previous diagnosis of neurofibromatosis Type 2, and five of those eight tumors met the criterion for inclusion in the study (their diameters were 3, 3.5, 3.5, 3.8, and 4 cm), averaging 3.6 cm in the largest diameter. One patient underwent resection for the original tumor and a recurrence measuring 4 cm 1 year later. Selection Criteria for the Surgical Approach We used three different surgical approaches, two of which are well documented in the literature

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Dorothee Koch-Wiewrodt, Wolfgang Wagner and Axel Perneczky

. Taking into account the functional importance of these structures, it is possible that surgical approaches to the vertebral column that remove bone structures at multiple levels carry the risk of early or late spinal instability. 10 , 32 Traditionally, most intraspinal space-occupying tumors have been removed via laminectomy. This technique has been described even in recent clinical reports on the evacuation of spinal hematomas, 8 , 12 , 13 , 18 , 23 , 24 the decompression of lumbar stenosis (at least in elderly patients), 9 , 28 tumor resection, 4 , 7 , 16 , 19

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Jeffrey W. Brennan, David W. Rowed, Julian M. Nedzelski and Joseph M. Chen

series have similar leakage rates, 5, 6, 8, 22 direct comparisons between these and the larger series are not valid for the reasons mentioned earlier. There was no significant change in the mean tumor size between each period of study ( Table 4 ). However, the overall standard deviation was greater in the current period than in the earlier. Analyzing the data according to surgical approach revealed that the TL approach was being used in the current study period to remove significantly larger tumors, and conversely, the RS approach was being used to remove

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Johnny Delashaw and Marc Mayberg

It is with great pleasure and pride we submit this Neurosurgical Focus video supplement on surgical approaches to the CPA angle. We had the privilege of viewing a multitude of videos describing surgical pathology and technique for lesions within the cerebellar pontine angle. The quality of work was outstanding! Hours of review were required to narrow down the videos for this supplement. This issue consists of 23 videos that we feel offer unique surgical pearls to the viewer in clinical evaluation, surgical planning and surgery, and outcomes. The videos are of different clinical problems and offer education for both the novice and expert skull base surgeon. We enjoyed being a part of this project, and feel very proud of its content and authors. We are confident that you will enjoy this supplement.