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Anatomical variations in pneumatization of the anterior clinoid process

Takeshi Mikami, Yoshihiro Minamida, Izumi Koyanagi, Takeo Baba, and Kiyohiro Houkin

-Spellman J , Heros RC : A pneumatized anterior clinoid mimicking an aneurysm on MR imaging. Report of two cases . J Neurosurg 71 : 128 – 132 , 1989 10.3171/jns.1989.71.1.0128 13 Hoh BL , Carter BS , Budzik RF , Putman CM , Ogilvy CS : Results after surgical and endovascular treatment of paraclinoid aneurysms by a combined neurovascular team . Neurosurgery 48 : 78 – 90 , 2001 14 Huynh-Le P , Natori Y , Sasaki T : Surgical anatomy of the anterior clinoid process . J Clin Neurosci 11 : 283 – 287 , 2004 10.1016/j.jocn.2003

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Removal of the anterior clinoid process for exposure of the proximal intracranial carotid artery

Stephen Lawrence Nutik

R emoval of the anterior clinoid process is of well-recognized value in the treatment of proximal internal carotid artery aneurysms. Many authors have described techniques of removal but seldom refer to the relevant anatomy of the region or state how much exposure can be expected. 4, 5, 8, 10, 16, 25, 29 This paper describes the pertinent anatomy, the maximum carotid exposure expected, and some complications that can result from removal of the anterior clinoid process. Clinical Material and Methods Anatomical Observations Tissue blocks containing

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Primary isolated skull base eosinophilic granuloma confined to the anterior clinoid process: illustrative case

Ahmad Pour-Rashidi, Payam Asem, Kazem Abbasioun, and Abbas Amirjamshidi

LHC tumors mostly involve the flat bones, and more than 50% occur in the skull, mandible, spine, ribs, and pelvis. Skin, pituitary gland, brain, lung, liver, spleen, and gastrointestinal tract are less common tumor locations. 1 EG can be differentiated from other infections and tumors by histology. 1–4 To the best of our knowledge, no similar case of surgically treated, symptomatic EG confined to the anterior clinoid process (ACP) has been reported previously. We reviewed the relevant literature regarding clinical, imaging, and best treatment options for such a

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Endoscope-assisted clipping of a superior hypophyseal artery aneurysm without removal of the anterior clinoid process

Case report

Hiroyuki Kinouchi, Katsuya Futawatari, Kazuo Mizoi, Naoki Higashiyama, Hisashi Kojima, and Tetsuya Sakamoto

, 23, 27 In addition to the ipsilateral and midline approaches to aneurysms, 17, 24 the contralateral approach has also been undertaken because lesions arising from the medial wall of the ICA can be visualized directly without retracting the optic nerve and/or without removing the anterior clinoid process. 1, 4–6, 9, 14, 19, 20, 26, 27 Nevertheless, the contralateral approach has the disadvantage that proximal control of the ICA is relatively difficult compared with that during the ipsilateral approach. 4 Preliminary experience with the use of endoscopic

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Anterior clinoidal mucocele causing optic neuropathy: resolution with nonsurgical therapy

Case report

Sameer Deshmukh and Franco Demonte

I nflammatory mucoceles, which are cystic masses of mucoid secretions lined by respiratory epithelium, can develop in the paranasal sinuses secondary to both osteum obstruction and sinus inflammation. 1–3 In certain individuals, the anterior clinoid processes may become pneumatized during the development of the skull base, making these structures susceptible to mucocele formation. Mucoceles and the resulting inflammation in the anterior clinoid process can cause visual dysfunction due to compression or inflammation of the optic nerve. A reduction in the

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Selective extradural anterior clinoidectomy for supra- and parasellar processes

Technical note

Yasuhiro Yonekawa, Nobuyoshi Ogata, Hans-Georg Imhof, Magnus Olivecrona, Kevin Strommer, Tae Eon Kwak, Peter Roth, and Peter Groscurth

T he need for removal of the anterior clinoid process (ACP) has been emphasized in previous descriptions of the surgical treatment of internal carotid artery (ICA)—ophthalmic artery (OA) and giant ICA aneurysms. 5, 6, 8, 12, 13, 19, 20, 24 It provides exposure of the ICA and optic nerve with less need for brain retraction. The intradural technique of ACP removal has been described in detail. 16, 22 The extradural technique has been described as a component of a more extensive approach; 2, 3 however, the indications for its use and its optimal extent

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Subclinoid aneurysms

Stephen L. Nutik

: Carotid cave aneurysms of the internal carotid artery. J Neurosurg 70 : 216 – 221 , 1989 Kobayashi S, Kyoshima K, Gibo H, et al: Carotid cave aneurysms of the internal carotid artery. J Neurosurg 70: 216–221, 1989 10.3171/jns.1989.70.2.0216 10. Korosue K , Heros RC : “Subclinoid” carotid aneurysm with erosion of the anterior clinoid process and fatal intraoperative rupture. Neurosurgery 31 : 356 – 360 , 1992 Korosue K, Heros RC: “Subclinoid” carotid aneurysm with erosion of the anterior clinoid process and

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Extradural anterior clinoidectomy

Technical note

Akio Noguchi, Vijayabalan Balasingam, Yoshiaki Shiokawa, Sean O. McMenomey, and Johnny B. Delashaw Jr.

aneurysms: surgical techniques, complications, and results. Neurosurgery 12 : 153 – 163 , 1983 Heros RC, Nelson PB, Ojemann RG, Crowell RM, DeBrun G: Large and giant paraclinoid aneurysms: surgical techniques, complications, and results. Neurosurgery 12: 153–163, 1983 10.1227/00006123-198302000-00004 12. Huynh-Le P , Natori Y , Sasaki T : Surgical anatomy of the anterior clinoid process. J Clin Neurosci 11 : 283 – 287 , 2004 Huynh-Le P, Natori Y, Sasaki T: Surgical anatomy of the anterior clinoid process

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Giant anterior clinoidal meningiomas: surgical technique and outcomes

Clinical article

Moshe Attia, Felix Umansky, Iddo Paldor, Shlomo Dotan, Yigal Shoshan, and Sergey Spektor

system for predicting extent of resection . Acta Neurochir (Wien) 150 : 865 – 877 , 2008 5 Coscarella E , Başkaya MK , Morcos JJ : An alternative extradural exposure to the anterior clinoid process: the superior orbital fissure as a surgical corridor . Neurosurgery 53 : 162 – 167 , 2003 6 Cushing H , Eisenhardt L : Meningiomas: Their Classification, Regional Behavior, Life History, and Surgical End Results Springfield, IL , Charles C. Thomas , 1938 7 Day JD : Cranial base surgical techniques for large sphenocavernous meningiomas

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Endoscopic endonasal anterior clinoidectomy: surgical anatomy, technique nuance, and case series

Limin Xiao, Shenhao Xie, Bin Tang, Jialing Hu, and Tao Hong

of these procedures to increase surgical safety. Several advantages and limitations of transcranial anterior clinoidectomy have been described, but there is still a lack of studies describing anterior clinoidectomy via an endoscopic endonasal approach. Recently, Bardeesi et al. 2 reported the surgical removal of an anterior clinoid meningioma via an endoscopic endonasal approach without anterior clinoid process (ACP) resection. However, the authors did not consider experience with pure endoscopic anterior clinoidectomy to be “mature” enough at the time the article