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Amir Zolal, Stephan B. Sobottka, Dino Podlesek, Jennifer Linn, Bernhard Rieger, Tareq A. Juratli, Gabriele Schackert and Hagen H. Kitzler

. Discussion Our study shows that probabilistic fiber tracking can be used to depict the course of the cranial nerves more successfully than the previously described deterministic tracking. With the use of the gradual threshold increase technique, however, even the deterministic tracking delivered acceptable results corresponding to the known nerve anatomy. Therefore, the gradual threshold technique originally proposed by Yoshino et al. represents a promising method of noise removal in DTI of the cranial nerves. 22 , 24 The mean and median false-positive error values as

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Timothee Jacquesson, Fang-Chang Yeh, Sandip Panesar, Jessica Barrios, Arnaud Attyé, Carole Frindel, Francois Cotton, Paul Gardner, Emmanuel Jouanneau and Juan C. Fernandez-Miranda

T he introduction of diffusion imaging tractography has caught the interest of the scientific community by describing for the first time in vivo brain white matter anatomy. 22 The ability to reconstruct white matter fibers from the preferential orientation of water molecules on diffusion MR images has improved the understanding of both anatomy 8 and neurological disorders. 3 , 12 , 30 Visualizing the exact displacement of cranial nerves in skull base tumor cases would make surgery safer and, potentially, the clinical outcome better. 13 Though tractography

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Xavier Matias-Guiu, Maria Alejo, Teresa Sole, Isidre Ferrer, Roberto Noboa and Federico Bartumeus

V ascular malformations, although frequently found in the central nervous system, 5, 6 rarely arise from cranial nerves. 2, 4, 9, 11 In this report, we describe the clinical and neuropathological findings in two patients with cavernous angiomas of the third and eighth cranial nerves, respectively, and discuss the differential diagnosis of these malformations when presenting as space-occupying lesions. Case Reports Case 1 This 24-year-old woman complained of progressive hearing loss in the right ear and occasional tinnitus. Neurological examination

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Santosh Kumar Mohanty, Mario Barrios, Harold Fishbone and Reza Khatib

sweet, sour, salt or bitter substance could be perceived. The patient was discharged after 5 weeks in the hospital, and was lost to follow-up. The clinical findings of paralysis of the last four cranial nerves remained unchanged at discharge; the electromyographic findings remained as when first examined. Discussion Since Jackson 3, 4 in 1883 described symptoms due to ipsilateral paralysis of the larynx, tongue, and muscles of the neck, there have been a number of descriptions of lesions involving the last four cranial nerves. In 1915, Collet 2 was the

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Michael Scott

W e are reporting the following case of a calcified mass of the right base of the skull that involved nine cranial nerves. The long period during which it showed no symptoms or growth is of interest. Case Report When this patient was 12 years old he was first admitted to Temple University Hospital (December, 1935) complaining of visual difficulty, facial numbness, and loss of hearing in the right ear for 6 years. Examination The patient was alert and had no headache or papilledema. There was involvement of the 2nd, 5th, 6th, 7th, 8th, 9th, 10th, 11

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Susumu Oikawa, Kyutaro Kawagishi, Kumiko Yokouchi, Nanae Fukushima and Tetsuji Moriizumi

I n general, the postganglionic sympathetic fibers traverse along blood vessels and reach target organs. In the cranium, the superior cervical ganglion is the exact source of the postganglionic sympathetic fibers, and its branches form the nerve plexus (internal carotid nerve) around the ICA. 1 It has been reported that the internal carotid nerve communicates with the cranial nerves projecting to the orbit 1, 2, 4, 6–8, 11, 12, 15 and that the intraorbital cranial nerves seem to provide some routes for the postganglionic sympathetic fibers. Some of these

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Ulf Havelius, Bengt Hindfelt, Jan Brismar and Sten Cronqvist

U nilateral lesions of the lower cranial nerves (ninth, 10th, 11th, and 12th: the Collet-Sicard syndrome) are rare. This variant of the jugular foramen syndrome was described in the victims of World War I by Collet 3 and Sicard, 15 and penetrating injury has remained a rather frequent cause. 10 However, the syndrome may also be due to various neoplasms, and inflammatory and vascular lesions. 12 Among vascular disorders, an aneurysm of the internal carotid artery (ICA) at the base of the skull has rarely been reported as the presumptive cause. 2, 16 In

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Masato Shibuya, Kenichiro Sugita and Shigeaki Kobayashi

A lthough many kinds of cotton patties are commonly used in the neurosurgical operating field, rubber sheets are also useful in certain situations. A small piece of rubber sheeting was initially described by Yaşargil 1 for use during the microvascular anastomosis of fine cerebral arteries. We discuss the utility of silicone rubber sheets for the protection of critical structures such as cranial nerves and blood vessels during microneurosurgery. Description and Use of Material Sterilized silicone rubber (Silastic) sheets 0.125 mm thick were used. A

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Jeffrey J. Larson, Harry R. van Loveren, M. Gregory Balko and John M. Tew Jr.

M eningiomas of the cavernous sinus are frequently treated at skull base surgery centers. Interest in the operative management of these lesions has grown in the past 6 years. During this time, much has been learned about the complex anatomy of the skull base especially as it relates to the microsurgical techniques of operative exposure, tumor excision, and management of the internal carotid artery (ICA) and cranial nerves. Excellent results have been reported for completeness of tumor resection when defined at surgery or by postoperative imaging studies. In

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Laligam N. Sekhar, Giuseppe Lanzino, Chandra N. Sen and Spiros Pomonis

T he success of microsurgical peripheral nerve repair has led neurosurgeons to apply this technique in the reconstruction of cranial nerves. The grafting of the seventh nerve has been extensively studied because it represents a frequent problem in neurosurgical procedures. Due to the increasing frequency of complex operations involving the cranial base, neurosurgeons have encountered problems originating from involvement of the third, fourth, fifth, and sixth nerves since they are frequently encased and/or displaced by tumors in that area. 19, 20, 22, 23 When