Abstract：
BACKGROUND:Anatomic variations of the anterior clinoid process (ACP) should be recognized before clinoidectomy to ensure a safe approach. This study describes the incidence of caroticoclinoid foramen (CCF), interclinoid osseous bridge, and pneumatization of the ACP during extradural anterior clinoidectomy. The problems and technical issues encountered in such cases are described. METHODS:Using multidetector-row computed tomography, 144 sides in 72 cases of paraclinoid aneurysm treated by extradural anterior clinoidectomy were analyzed preoperatively. RESULTS:CCF, interclinoid osseous bridge, and pneumatization of the ACP were observed in 16.6%, 2.77%, and 27.7% of cases. Pneumatized patterns were divided into 3 groups according to route: pneumatization via the optic strut (in 74.1%), pneumatization via the anterior root (in 14.8%), and pneumatization via optic strut and anterior root (in 11.1%). CCF and interclinoid osseous bridge represent obstacles to complete extradural removal of the ACP. The ACP should not be moved even after drilling the lateral wall of the ACP, orbital roof, and optic strut, so an intradural approach is sometimes needed. A CCF warrants careful removal to open the distal dural ring. Awareness of the routes of pneumatization for the ACP should reduce the risk of tears in the paranasal mucosa. If tears arise in the mucosa, suturing and closure are needed to prevent liquorrhea. CONCLUSIONS:Preoperative computed tomography is useful to detect variations in the anatomy around the ACP. When performing extradural anterior clinoidectomy in such anomalous cases, appropriate modifications are needed to ensure a safe approach.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Ota N,Tanikawa R,Miyazaki T,Miyata S,Oda J,Noda K,Tsuboi T,Takeda R,Kamiyama H,Tokuda Sdoi
10.1016/j.wneu.2014.12.014subject
Has Abstractpub_date
2015-04-01 00:00:00pages
635-43issue
4eissn
1878-8750issn
1878-8769pii
S1878-8750(14)01385-0journal_volume
83pub_type
杂志文章abstract：BACKGROUND:Anterior cervical diskectomy and fusion (ACDF) is the main surgical treatment of cervical radiculopathy. Controversy exists about the need to resect the posterior longitudinal ligament (PLL) to directly decompress the nerve roots, or if it is sufficient to indirectly decompress with diskectomy and graft plac...
journal_title：World neurosurgery
pub_type： 杂志文章
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abstract：OBJECTIVE:Spine trauma management in children varies from one team to another, and to date, no clear consensus has been reached. The goal of this study was to describe the epidemiology of spine trauma in children and evaluate the timing and techniques of surgery when it was required. METHODS:A retrospective review of ...
journal_title：World neurosurgery
pub_type： 杂志文章
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journal_title：World neurosurgery
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journal_title：World neurosurgery
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journal_title：World neurosurgery
pub_type： 杂志文章,评审
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abstract：BACKGROUND:Unruptured brain arteriovenous malformations (AVMs) represent a complex disease in young healthy adults. Most often AVMs are clinically silent but also can display a neurologic syndrome due to hypoperfusion/hypometabolism in perilesional brain tissue called steal phenomenon. CASE DESCRIPTION:A 34-year-old w...
journal_title：World neurosurgery
pub_type： 杂志文章
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journal_title：World neurosurgery
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pub_type： 杂志文章,随机对照试验
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更新日期：2019-12-01 00:00:00
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journal_title：World neurosurgery
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journal_title：World neurosurgery
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journal_title：World neurosurgery
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更新日期：2018-07-01 00:00:00
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journal_title：World neurosurgery
pub_type： 传,历史文章,杂志文章,评审
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更新日期：2018-01-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
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更新日期：2020-05-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章,评审
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更新日期：2013-11-01 00:00:00
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journal_title：World neurosurgery
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journal_title：World neurosurgery
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pub_type： 杂志文章
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更新日期：2018-11-01 00:00:00
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更新日期：2019-05-01 00:00:00
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journal_title：World neurosurgery
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更新日期：2018-02-01 00:00:00
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journal_title：World neurosurgery
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journal_title：World neurosurgery
pub_type： 杂志文章
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更新日期：2020-01-01 00:00:00
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journal_title：World neurosurgery
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更新日期：2019-01-03 00:00:00
