C raniopharyngiomas are rare, benign, and slow-growing intracranial neoplasms derived from the remnants of squamous epithelium along the craniopharyngeal duct. 1 They can occur in both adult and pediatric age groups. Pediatric craniopharyngiomas account for between 30% and 50% of all craniopharyngiomas and between 1.2% and 4.6% of all pediatric intracranial tumors. 2–4 Historically, transcranial microsurgery (TCM) with gross-total resection (GTR) was the mainstay treatment for craniopharyngiomas, but excess morbidities and mortality associated with
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Jie Wu, ChengBing Pan, ShenHao Xie, Bin Tang, Jun Fu, Xiao Wu, ZhiGao Tong, BoWen Wu, YouQing Yang, Han Ding, ShaoYang Li, and Tao Hong
Doo-Sik Kong, Chang-Ki Hong, Sang Duk Hong, Do-Hyun Nam, Jung-Il Lee, Ho Jun Seol, Jiwoong Oh, Dong Gyu Kim, and Yong Hwy Kim
surgical management of meningiomas arising from the TS. With recent advances in high-definition endoscopic techniques, the endoscopic endonasal approach (EEA) allows direct access to the TS and opens a new corridor to the subchiasmatic space compared with the transcranial approach (TCA). 3 , 6 , 15 , 17 , 29 , 31 No consensus has been reached on which surgical approach is more advantageous for TS meningiomas without radiographic evidence of vascular encasement in terms of optimal GTR, visual outcome, and morbidity. In addition, the optimal indication for EEA in the
Evan D. Bander, Harminder Singh, Colin B. Ogilvie, Ryan C. Cusic, David J. Pisapia, Apostolos John Tsiouris, Vijay K. Anand, and Theodore H. Schwartz
compression of the optic nerves and chiasm. 14 Resection of these tumors can decompress the optic nerves and prevent further deterioration, or, in some cases, reverse damage to those nerves. 33 The use of an endoscopic endonasal approach (EEA) for the resection of anterior skull base meningiomas has been developed as an alternative to the transcranial approach (TCA). 1 , 4–6 , 8 , 13 , 15–18 , 21 , 25 , 28 , 34 EEA arose as an extension of extended microscopic transsphenoidal surgery, which can also be used to remove meningiomas. 4 EEA offers several advantages over TCA
Jan Kubanek
with medication-refractory action or resting tremor in patients with essential tremor (ET) or Parkinson’s disease. 14 , 44 , 46 The main strength of DBS is that it provides stimulation throughout the lifetime of the implanted device, which generally results in lasting treatments. The main drawback of DBS is that the associated surgeries may lead to complications such as infection or hemorrhage. 3 , 4 Researchers and clinicians have been considering alternative, noninvasive approaches to neurostimulation. In particular, transcranial magnetic stimulation (TMS) and
Charles F. Kieck and Jacques C. de Villiers
may lead to death days to weeks later because of rupture of a traumatic intracranial aneurysm or infection. Fig. 1. A minor laceration in the left temporal region. Recent literature has dealt adequately with traumatic aneurysms following blunt trauma, but descriptions of those due to non-missile penetrating injuries are uncommon. 1, 4, 5, 7, 8 Recent reports have described the problems of transcranial and transorbital stab wounds, 2, 3, 6 but the present study highlights the vascular lesions that may be associated with such wounds. The pitfalls of
Werner Hassler, Helmuth Steinmetz, and Jürgen Pirschel
. 4, 14 The level of angiographic cessation of flow was assumed to descend caudad with time following clinical brain death. 4 Using transcranial Doppler ultrasound (TCD) monitoring, * Hassler, et al. , 9 recognized three different stages of intracranial circulatory arrest. The characteristic flow velocity patterns, which are recorded from the basal cerebral arteries, succeed one another in the following order: oscillating flow, systolic spike flow, and zero flow (see Fig. 1 ). The question studied in the present investigation was whether a correlation exists
Cole A. Giller, Kurt Hodges, and H. Hunt Batjer
rounded shape will have a lower pulsatility than a peaked waveform. Unfortunately, diminished pulsatility is induced both by stenosis 6, 7, 20, 34, 39, 40 and by a decrease in downstream resistance, 22, 25, 28, 30, 38 and so can not be used to distinguish these two causes of increased velocity. Fig. 1. Normal transcranial Doppler sonogram showing the waveform of middle cerebral artery velocity. It has been our clinical impression, however, that the magnitude of pulsatility decrease is greater at a given velocity for vasodilation than for stenosis, and
Martin Schöoning, Reiner Buchholz, and Jochen Walter
S ince the initial report by Aaslid, et al. , 2 describing transcranial Doppler sonography (TCD), the question arises whether the frequency shift recorded in basal cerebral arteries corresponds to “true” flow velocities. In the past few years, with advances in transcranial Doppler ultrasound technology, new diagnostic methods such as transcranial duplex sonography 23 and transcranial color Doppler sonography 8, 12 have been described. Initial studies of color-coded duplex measurements of flow velocities in the middle cerebral arteries (MCA's) 28, 30
Shouri Lahiri, Mani Nezhad, Konrad H. Schlick, Brenda Rinsky, Axel Rosengart, Stephan A. Mayer, and Patrick D. Lyden
velocities are proportional to vessel diameter, and pulsatility can be used as surrogate marker for distal vessel resistance. Existing studies using transcranial Doppler (TCD) have reported conflicting findings on nicardipine's effect on cerebral blood flow velocities, 1 , 4 and do not provide detailed descriptions of waveforms and pulsatility indices (PIs). We sought to test the hypothesis that nicardipine administration results in a decrease in PI as measured by TCD waveforms. In this study, we describe TCD waveform characteristics in a series of patients who received
Joanna M. Wardlaw, G. T. Vaughan, A. James W. Steers, and Robin J. Sellar
management problems still occur in some patients. 10 Patients with cerebral venous sinus thrombosis may present with headaches, nausea, vomiting, disturbed vision, and symptoms of raised intracranial pressure 3, 9 and may have focal neurological signs mimicking subarachnoid hemorrhage (SAH), acute ischemic stroke, or central nervous system infection. The patient may be unable to cooperate, even with a relatively short procedure such as CT; MR imaging and angiography may require sedation to be successful, making investigation of these patients difficult. Transcranial
