Abstract:
:OBJECTIVE Despite the advances in skull base techniques, large petroclival meningiomas (PCMs) still pose a challenge to neurosurgeons. The authors' objective of this study was to describe a pretemporal trans-Meckel's cave transtentorial approach for large PCMs and to report the surgical outcomes. METHODS From 2014 to 2017, patients harboring large PCMs (> 3 cm) and undergoing their first resection via this procedure at the authors' institute were included. In combination with pretemporal transcavernous and anterior transpetrosal approaches, the trans-Meckel's cave transtentorial route was created. Surgical details are described and a video demonstrating the procedure is included. Retrospective review of the medical records and imaging studies was performed. RESULTS A total of 18 patients (6 men and 12 women) were included in this study, with mean age of 53 years. The mean sizes of the preoperative and postoperative PCMs were 4.36 cm × 4.09 cm × 4.13 cm (length × width × height) and 0.83 cm × 1.08 cm × 0.75 cm, respectively. Gross-total removal was performed in 7 patients, near-total removal (> 95%) in 7 patients, and subtotal removal in 4 patients (> 90% in 3 patients and > 85% in 1 patient). There were no surgical deaths or patients with postoperative hemiplegia. Surgical complications included transient cranial nerve (CN) III palsy (all patients, resolved in 3 months), transient CN VI palsy (2 patients), CN IV palsy (3 patients, partial recovery), hydrocephalus (3 patients), and CSF otorrhea (1 patient). Temporal lobe retraction-related neurological deficits were not observed. CONCLUSIONS A pretemporal trans-Meckel's cave transtentorial approach offers large surgical exposure and multiple trajectories to the suprasellar, interpeduncular, prepontine, and upper-half clival regions without overt traction, which is mandatory to remove large PCMs. To unlock Meckel's cave where a large PCM lies abutting the cave, pretemporal transcavernous and anterior transpetrosal approaches are prerequisites to create adequate exposure for the final trans-Meckel's cave step.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Liao CH,Wang JT,Lin CF,Chen SC,Lin CJ,Hsu SPC,Chen MHdoi
10.3171/2018.1.FOCUS17733subject
Has Abstractpub_date
2018-04-01 00:00:00pages
E10issue
4issn
1092-0684pii
2018.1.FOCUS17733journal_volume
44pub_type
杂志文章abstract:OBJECT:Clinical and radiographic results were assessed to determine the clinical outcomes and fusion rate in eight consecutive patients selected for minimally invasive transforaminal lumbar interbody fusion (TLIF) in which a percutaneous pedicle screw system was used unilaterally. METHODS:Eight patients underwent one-...
journal_title:Neurosurgical focus
pub_type: 临床试验,杂志文章
doi:
更新日期:2006-03-15 00:00:00
abstract::Cerebral edema is frequently encountered in clinical practice in critically ill patients with acute brain injury from diverse origins and is a major cause of increased morbidity and death in this subset of patients. The consequences of cerebral edema can be lethal and include cerebral ischemia from compromised regiona...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2007.22.5.13
更新日期:2007-05-15 00:00:00
abstract::For decades, lumbar disc herniation and lumbar stenosis have been treated surgically via traditional open techniques. With recent emphasis on minimally invasive approaches in spine surgery, a number of new techniques has been introduced that are aimed at treating these 2 common pathological conditions. Currently the m...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC/2008/25/8/E11
更新日期:2008-01-01 00:00:00
abstract::Cerebral cavernous malformations (CCMs) are common vascular lesions of the CNS that may lead to seizures, focal neurological deficits, and fatal hemorrhagic stroke. Human genetic studies have identified 3 genes associated with CCM, and biochemical and molecular studies in mice have elucidated signaling pathways with i...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2010.6.FOCUS10135
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:Convection-enhanced delivery (CED) and osmotic pump delivery both have been promoted as promising techniques to deliver drugs to pediatric diffuse intrinsic pontine gliomas (DIPGs). Correspondingly, the aim of this study was to understand how infusate molecular weight (MW), duration of delivery, and mechanism...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.10.FOCUS19703
更新日期:2020-01-01 00:00:00
abstract::OBJECT Cushing's disease (CD) is a potentially lethal neuroendocrinopathy that often requires specialized multidisciplinary treatment to achieve optimized outcomes. The authors analyzed data pertaining to patient, hospital, and admission characteristics as they relate to outcomes following transsphenoidal surgery (TSS...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.11.FOCUS14694
更新日期:2015-02-01 00:00:00
abstract::OBJECTIVE Anterior skull base meningiomas are benign lesions that cause neurological symptoms through mass effect on adjacent neurovascular structures. While traditional transcranial approaches have proven to be effective at removing these tumors, minimally invasive approaches that involve using an endoscope offer the...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.1.FOCUS17734
更新日期:2018-04-01 00:00:00
abstract::The author addresses the issue of neurofibroma classification and implications for treatment. He emphasizes the importance of understanding that not all neurofibromas are the same and that the key differences between the types of neurofibromas involve which portions of the nerve sheath contribute to the distinctive be...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2007.22.6.4
更新日期:2007-06-15 00:00:00
abstract:OBJECT:The goal of this study was to evaluate the definition of treatment-resistant depression (TRD), review the literature regarding deep brain stimulation (DBS) for TRD, and identify potential anatomical and functional targets for future widespread clinical application. METHODS:A comprehensive literature review was ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC/2008/25/7/E3
更新日期:2008-01-01 00:00:00
abstract::Frontal sinus fractures are heterogeneous, and management of these fractures is often modified based on injury pattern and institutional experience. The optimal initial treatment of frontal sinus fractures is controversial. Treatment strategies are aimed at correcting cosmetic deformity, as well as at preventing delay...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2012.3.focus1266
更新日期:2012-06-01 00:00:00
abstract::Tentorial dural arteriovenous fistulae (TDAVFs) are complex lesions with the arteriovenous fistula located between the leaves of the tentorium cerebelli. While a large portion of dural arteriovenous fistulae are treated endovascularly, TDAVF may require additional microsurgical treatment given their high risk of hemor...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.1.FocusVid.15420
更新日期:2016-01-01 00:00:00
abstract::Healthcare spending has become a grave concern to national budgets worldwide, and to a greater extent in low-income countries. Brain tumors are a serious disease that affects a significant percentage of the population, and thus proper allocation of healthcare provisions for these patients to achieve acceptable outcome...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.7.FOCUS18258
更新日期:2018-10-01 00:00:00
abstract::There will be major scientific advances and socioeconomic changes in the 21st century that will influence the development of medicine and neurosurgery. These changes will affect those in academic medical centers and the private practitioners of medicine and neurosurgery. Neurosurgeons' philosophy and practice methods ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2002.12.4.10
更新日期:2002-04-15 00:00:00
abstract::Spinal epidural lipomatosis is most commonly observed in patients receiving long-term exogenous steroid therapy, but can also be seen in patients with endogenous steroid overproduction, obesity, or idiopathic disease. With this condition, there is hypertrophy of the epidural adipose tissue, causing a narrowing of the ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:
更新日期:2004-04-15 00:00:00
abstract:OBJECT:Postoperative infection after cranial surgery is a serious complication that requires immediate recognition and treatment. In certain cases such as postoperative meningitis, the patient can be treated with antibiotics only. In cases that involve a bone flap infection, subdural empyema, or cerebral abscess, howev...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC/2008/24/6/E10
更新日期:2008-01-01 00:00:00
abstract::The authors detail the life and career of Dr. J. Lawrence Pool, as well as his significant contributions to the field of cerebrovascular neurosurgery. The discipline of cerebrovascular neurosurgery is a young and dynamic field, which underwent rapid and substantial growth during the middle of the twentieth century. As...
journal_title:Neurosurgical focus
pub_type: 传,历史文章,杂志文章
doi:
更新日期:2006-06-15 00:00:00
abstract:OBJECT:Previous methods to determine stroke prevalence, such as nationwide surveys, are labor-intensive endeavors. Recent advances in search engine query analytics have led to a new metric for disease surveillance to evaluate symptomatic phenomenon, such as influenza. The authors hypothesized that the use of search eng...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2011.2.FOCUS1124
更新日期:2011-06-01 00:00:00
abstract::Microsurgical aspects of clipping of a giant partially thrombosed VA aneurysm in a 57-year-old female are presented and explained in the form of a short video. The presentation includes preparation of the VA, PICA and perforating arteries, the clipping of the aneurysm itself as well as the reduction of the aneurysm ma...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.V1.FOCUS14598
更新日期:2015-01-01 00:00:00
abstract::Flow diversion has become a well-accepted option for the treatment of cerebral aneurysms. Given the significant treatment effect of flow diverters, numerous options have emerged since the initial Pipeline embolization device studies. In this review, the authors describe the available flow diverters, both endoluminal a...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2017.3.FOCUS16427
更新日期:2017-06-01 00:00:00
abstract::The authors describe the case of a boy with Muenke syndrome, an autosomal dominant disorder associated with craniosynostosis. The family history was significant for syndromic craniosynostosis in the patient's maternal grandmother, who died in adulthood after a craniofacial reconstruction. The patient, her grandson, un...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.2.FOCUS151
更新日期:2015-05-01 00:00:00
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journal_title:Neurosurgical focus
pub_type: 杂志文章,多中心研究
doi:10.3171/foc.2007.22.1.6
更新日期:2007-01-15 00:00:00
abstract::OBJECTIVE The aim of this study was to identify and discuss operative nuances utilizing image guidance in the surgical management of aggressive sacral tumors. METHODS The authors report on their single-institution, multi-surgeon, retrospective case series involving patients with pathology-proven aggressive sacral tumo...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2016.6.FOCUS16125
更新日期:2017-01-01 00:00:00
abstract::The ability of diffusion tensor MRI to detect the preferential diffusion of water in cerebral white matter tracts enables neurosurgeons to noninvasively visualize the relationship of lesions to functional neural pathways. Although viewed as a research tool in its infancy, diffusion tractography has evolved into a neur...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2019.11.FOCUS19785
更新日期:2020-02-01 00:00:00
abstract::Drug addiction represents a significant public health concern that has high rates of relapse despite optimal medical therapy and rehabilitation support. New therapies are needed, and deep brain stimulation (DBS) may be an effective treatment. The past 15 years have seen numerous animal DBS studies for addiction to var...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2018.5.FOCUS18163
更新日期:2018-08-01 00:00:00
abstract:OBJECT:Positional plagiocephaly (PP) has been on the rise in recent years. In this review, the authors' aim was to assess the effectiveness of current recommendations to parents on this exceedingly common problem through a comprehensive literature search. Additionally, the current treatment options and the most recent ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,meta分析,评审
doi:10.3171/2013.8.FOCUS13261
更新日期:2013-10-01 00:00:00
abstract::Spine surgery is a key target for cost reduction within the United States health care system. One possible strategy involves the transition of inpatient surgeries to the ambulatory setting. Lumbar laminectomy with or without discectomy, lumbar fusion, anterior cervical discectomy and fusion, and cervical disc arthropl...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2018.2.FOCUS17790
更新日期:2018-05-01 00:00:00
abstract:OBJECT:The authors present a series of 4 patients with rare facial nerve tumors. The relevant literature is reviewed and is discussed regarding diagnostic features, the role of operative management, and surgical approach. METHODS:A retrospective chart review was conducted for patients with tumors of the facial nerve t...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2013.1.FOCUS12380
更新日期:2013-03-01 00:00:00
abstract:OBJECT:The management of pediatric intraventricular tumors is highly dependent on identification of the tumor type. Choroid plexus papillomas, a common intraventricular tumor in children, can be difficult to distinguish radiographically from choroid plexus carcinomas and other common pediatric central nervous system (C...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:2005-06-15 00:00:00
abstract:OBJECTIVE:Nonfunctioning pituitary adenomas present without biochemical or clinical signs of hormone excess and are the second most common type of pituitary adenomas. The 2017 WHO classification scheme of pituitary adenomas differentiates null-cell adenomas (NCAs) and silent gonadotroph adenomas (SGAs). The present stu...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.3.FOCUS20114
更新日期:2020-06-01 00:00:00
abstract::OBJECTIVEAdult spinal deformity surgery is an effective way of treating pain and disability, but little research has been done to evaluate the costs associated with changes in health outcome measures. This study determined the change in quality-adjusted life years (QALYs) and the cost per QALY in patients undergoing s...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.9.FOCUS18381
更新日期:2018-12-01 00:00:00