Planning and surgical strategies for early management of vertebral artery and vertebrobasilar junction aneurysms.

Abstract:

:Selection of the approach and technique for surgical repair of aneurysm of the vertebrobasilar artery system is mainly based on angiographic features. This report emphasizes that planning the surgical procedure should also include preoperative evaluation of the individual skull base configuration, as well as the relationship between aneurysm site and surrounding bony structures. These features are evaluated on thin slice CT scans using bone tissue algorithms and are particularly important for adequate exposure of distal vertebral artery (VA) or midline aneurysms, because these cases require drilling of the jugular tubercle. For the use of lateral approaches, the surgeon must be familiar with the extradural and intradural anatomy of the foramen magnum region and may rely on at least five anatomical landmarks for orientation during surgery: 1) the dural entrance of the vertebral artery; 2) the posterior condylar emissary vein; 3) the medial rim of the distal sigmoid sinus; 4) the hypoglossal canal; 5) the jugular tubercle. To increase the safety of the procedure, the authors recommend an individualized tailoring of the surgical approach according to the variable morphological situation of each patient.

journal_name

Acta Neurochir (Wien)

journal_title

Acta neurochirurgica

authors

Bertalanffy H,Gilsbach JM,Mayfrank L,Kawase T,Shiobara R,Toya S

doi

10.1007/BF01428505

subject

Has Abstract

pub_date

1995-01-01 00:00:00

pages

60-5

issue

1-2

eissn

0001-6268

issn

0942-0940

journal_volume

134

pub_type

杂志文章
  • Children with unilateral occlusion or stenosis of the ICA associated with surrounding moyamoya vessels--"unilateral" moyamoya disease.

    abstract::The clinical features of 6 children who are probable sufferers of "unilateral" Moyamoya disease are here reported. They showed angiographic findings which were compatible with those of Moyamoya disease, albeit only on one side. They did not, however, show any basic aetiologic factors. The age of onset, the clinical sy...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/BF01808612

    authors: Matsushima T,Inoue T,Natori Y,Fujii K,Fukui M,Hasuo K,Kuwabara Y

    更新日期:1994-01-01 00:00:00

  • A surgical technique to expand the operative corridor for supracerebellar infratentorial approaches: technical note.

    abstract:BACKGROUND:The supracerebellar infratentorial approach is a commonly used route in neurosurgery. It provides a narrow and deep corridor to the dorsal midbrain and pineal region. The authors describe a surgical technique to expand the operative corridor and the surgeon's working angles during this approach. METHODS:Thi...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s00701-013-1844-4

    authors: Rey-Dios R,Cohen-Gadol AA

    更新日期:2013-10-01 00:00:00

  • Respiration and acid-base balance of blood after diffuse experimental brain injury.

    abstract::Diffuse brain injury in rabbits was caused by injecting olive oil and saline into one internal carotid artery. In this report, the fourth of a series, the effects of this experimental brain injury on respiration and acid-base balance of blood are analyzed. The animals that withstood the injury best were those that had...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/BF01405898

    authors: Valtonen S

    更新日期:1975-01-01 00:00:00

  • The in-vivo-nerve response to direct low-energy-laser irradiation.

    abstract::To study the in-vivo effects of direct Low-Energy Laser Irradiation (LELI) on the Peripheral Nervous System, the sciatic nerve in rats was surgically exposed, crushed and then subjected to the direct irradiation of either of two continuous-wave HeNe lasers--0.3 mW or 17 mW. We found that the 0.3 mW laser significantly...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/BF01406620

    authors: Rochkind S,Nissan M,Lubart R,Avram J,Bartal A

    更新日期:1988-01-01 00:00:00

  • Characteristics and management of ruptured distal middle cerebral artery aneurysms.

    abstract:OBJECTIVE:Distal middle cerebral artery (dMCA) aneurysms are very rare with a reported frequency of 2-6%. Typically, patients with ruptured distal MCA aneurysms have poor clinical outcomes because often there is both a subarachnoid haemorrhage (SAH) and an intracerebral haematoma (ICH). The goals of this study were to ...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s00701-007-1061-5

    authors: Joo SP,Kim TS,Choi JW,Lee JK,Kim YS,Moon KS,Kim JH,Kim SH

    更新日期:2007-01-01 00:00:00

  • Intraoperative computed tomography as reliable navigation registration device in 200 cranial procedures.

    abstract:BACKGROUND:Registration accuracy is a main factor influencing overall navigation accuracy. Standard fiducial- or landmark-based patient registration is user dependent and error-prone. Intraoperative imaging offers the possibility for user-independent patient registration. The aim of this paper is to evaluate our initia...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s00701-018-3641-6

    authors: Carl B,Bopp M,Saß B,Nimsky C

    更新日期:2018-09-01 00:00:00

  • Chronic anterior pallidal stimulation for Parkinson's disease.

    abstract::We present the case of a 51-year-old female who had a four-year history of Parkinson's disease with severe "on-off' and disabling progression of symptoms on chronic levodopa therapy. After obtaining FDA approval, we implanted a Medtronic deep brain stimulation lead stereotactically into the right anterior pallidum con...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/BF02188792

    authors: Iacono RP,Lonser RR,Maeda G,Kuniyoshi S,Warner D,Mandybur G,Yamada S

    更新日期:1995-01-01 00:00:00

  • Pain and brachial plexus lesions: evaluation of initial outcomes after reconstructive microsurgery and validation of a new pain severity scale.

    abstract:BACKGROUND:Peripheral nerve lesions usually are associated with neuropathic pain. In the present paper, we describe a simple scale to quantify pain after brachial plexus injuries and apply this scale to a series of patients to determine initial outcomes after reconstructive surgery. METHODS:Fifty-one patients with tra...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s00701-010-0709-3

    authors: Bonilla G,Di Masi G,Battaglia D,Otero JM,Socolovsky M

    更新日期:2011-01-01 00:00:00

  • Near-anatomical reduction and stabilization of burst fractures of the lower thoracic or lumbar spine.

    abstract::Thirty-one consecutive symptomatic patients with burst fractures of the lower thoracic or lumbar spine (T 11-L4) were treated by early surgery in a 36-month period, with near-anatomical reduction being achieved via the postero-lateral route. Fusion and reconstruction of the vertebral body was done by using autologous ...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/BF01541254

    authors: Silvestro C,Francaviglia N,Bragazzi R,Viale GL

    更新日期:1992-01-01 00:00:00

  • Small acoustic neuromas: monitoring the growth rate by MRI.

    abstract::In a proportion of small acoustic neuroma patients, monitoring with magnetic resonance imaging shows no volumetric increase of tumour size over the years. The object of the study was to identify some indications for the clinical choice between immediate surgery (with the related risks) and watchful waiting. We perform...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s007010050483

    authors: Modugno GC,Pirodda A,Ferri GG,Fioravanti A,Calbucci F,Pezzi A,Ceroni AR,Pirodda E

    更新日期:1999-01-01 00:00:00

  • About a very rare variation of the course and width of the vertebral arteries and the hypoglossal nerve.

    abstract::Described are: 1. A very thin intracisternal part of the vertebral artery (0.9 mm). 2. A very rare course of the vertebral artery (dorsal to the hypoglossal nerve). 3. Rare anastomoses between the vertebral artery and the PICA. 4. A rare upwards coiling of the PICA and 5. The origin and prevertebral course of the vert...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/BF01809336

    authors: Lang J

    更新日期:1990-01-01 00:00:00

  • Systemic and cerebral haemodynamics during craniotomy under mild hypothermia in patients with acute subarachnoid haemorrhage.

    abstract:BACKGROUND:Mild hypothermia provides cerebral protection against ischaemic insults in various animal models. We compared systemic and cerebral oxygenation between mild hypothermic and normothermic management in 60 patients with acute subarachnoid haemorrhage who underwent clipping of cerebral aneurysms. METHOD:The tem...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s007010070056

    authors: Sato K,Sato K,Yoshimoto T

    更新日期:2000-01-01 00:00:00

  • Postural intermittent headaches as the initial symptom of a cavernoma in the third ventricle.

    abstract::Cavernous malformations (CM) occur very rarely in the ventricular system. We report a patient with a rare location in the third ventricle who had intermittent headaches as the initial symptom. ...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s00701-004-0393-2

    authors: Milenkovic Z

    更新日期:2005-01-01 00:00:00

  • ICP management in patients suffering from traumatic brain injury: a systematic review of randomized controlled trials.

    abstract:BACKGROUND:Severe traumatic brain injury (sTBI) is a major cause of morbidity and mortality. Intracranial pressure (ICP) monitoring and management form the cornerstone of treatment paradigms for sTBI in developed countries. We examine the available randomized controlled trial (RCT) data on the impact of ICP management ...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章,评审

    doi:10.1007/s00701-017-3363-1

    authors: Abraham P,Rennert RC,Gabel BC,Sack JA,Karanjia N,Warnke P,Chen CC

    更新日期:2017-12-01 00:00:00

  • Quality of life in nonfunctioning pituitary macroadenoma patients before and after surgical treatment.

    abstract:BACKGROUND:Nonfunctioning pituitary macroadenoma (NFMA) is a benign neoplasm that causes visual function disturbances and headaches and can be treated by transsphenoidal surgery (TSS). It is unclear how quality of life (QOL) changes with surgery and which QOL factors are affected by treatment. METHODS:The aim is to as...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s00701-012-1473-3

    authors: Tanemura E,Nagatani T,Aimi Y,Kishida Y,Takeuchi K,Wakabayashi T

    更新日期:2012-10-01 00:00:00

  • Oculomotor nerve neurinoma: report of two cases.

    abstract::Being motor nerves neurinomas originating from ocular nerves are very rare, unless associated with neurofibromatosis. Authors describe two cases of oculomotor nerve i.e. third nerve, Schwann cell tumours. One of them presented as a cavernous sinus mass in a middle aged lady while the other was a middle aged man with a...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s007010050229

    authors: Kachhara R,Nair S,Radhakrishnan VV

    更新日期:1998-01-01 00:00:00

  • Early post-operative ACTH and cortisol as predictors of remission in Cushing's disease.

    abstract:AIM:To study the value of early (24 h) post-operative ACTH and serum cortisol as predictors of remission after transsphenoidal surgery in Cushing's disease. METHODS:We prospectively studied 44 patients who underwent transsphenoidal surgery for Cushing's disease between 1997 and 2005. The mean follow-up period of patie...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s00701-007-1133-1

    authors: Acebes JJ,Martino J,Masuet C,Montanya E,Soler J

    更新日期:2007-01-01 00:00:00

  • rCBF in impending brain death.

    abstract::Regional cerebral blood flow (rCBF) was measured in three patients after relief of elevated intracranial pressure and restoration of normal cerebral perfusion pressure. Two patients, studied within 4 hours after closed head injury were found to have marked impairment of cortical blood flow and elevation of cerebrovasc...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/BF01406289

    authors: Overgaard J,Tweed WA

    更新日期:1975-01-01 00:00:00

  • Dexamethasone inhibits ICAM-1 and MMP-9 expression and reduces brain edema in intracerebral hemorrhagic rats.

    abstract:BACKGROUND:The molecular mechanism of hemorrhagic stroke is unclear, and the identification of therapeutic agents for attenuating post-stroke brain damage remains an unresolved challenge. Dexamethasone (DEX) is used clinically to treat spinal cord injury and brain tumor patients by reducing edema formation, but has pro...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s00701-011-1122-2

    authors: Yang JT,Lee TH,Lee IN,Chung CY,Kuo CH,Weng HH

    更新日期:2011-11-01 00:00:00

  • Initial misdiagnosis of aneurysmal subarachnoid hemorrhage: associating factors and its prognosis.

    abstract:BACKGROUND:Predicting the fate of patients who are given a misdiagnosis of aneurysmal subarachnoid hemorrhage (aSAH) remains unclear. The purpose was to examine factors associated with initial misdiagnosis of aSAH and to investigate the impact of initial misdiagnosis of aSAH on clinical outcomes. METHODS:Between Janua...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s00701-018-3552-6

    authors: Oh SY,Lim YC,Shim YS,Song J,Park SK,Sim SY,Kim MJ,Shin YS,Chung J

    更新日期:2018-06-01 00:00:00

  • Effect of dexamethasone on various stages of experimental brain abscess.

    abstract::Rats were inoculated with staphylococcus aureus to produce cerebral abscesses and treated with either antibiotic or dexamethasone and with antibiotic plus dexamethasone at sequential stages of abscess formation. Antibiotic alone shortened the cerebritis stage, accelerated the encapsulation and affected the bacterial c...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/BF01456174

    authors: Yildizhan A,Paşaoğlu A,Kandemir B

    更新日期:1989-01-01 00:00:00

  • Capsule plication as a protective measure against post-operative intracapsular haematoma formation following trans-sphenoidal removal of pituitary macroadenoma.

    abstract:BACKGROUND:Post-operative haematoma and visual deterioration are rare but serious complications after trans-sphenoidal surgery. For more reliable decompression of the optic nerve, we introduce a new technique for volume reduction of the cavity remaining after trans-sphenoidal resection of macroadenomas. TECHNIQUE:Afte...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s00701-008-1583-0

    authors: Kitano M,Taneda M

    更新日期:2008-08-01 00:00:00

  • Concomitant renal cell carcinoma with pituitary adenoma.

    abstract::Renal cell carcinoma has a complex and variable natural history. We report a case underlining this who presented concomitant renal cell carcinoma metastasis with pituitary and adrenocortical adenomas. A 62-year-old woman presented with visual loss. Imaging revealed a large sellar mass with suprasellar extension. Four ...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s00701-002-1060-0

    authors: Weber J,Gassel AM,Hoch A,Spring A

    更新日期:2003-03-01 00:00:00

  • Alteration of ischemic reperfusion injury in the rat neocortex by a potent antioxidant mexiletine.

    abstract::The mechanisms by which mexiletine exerts its effects in increasing myocardial circulation, and smooth muscle perfusion and alleviating diabetic neuropathic pain have been widely discussed. The purpose of this study was to examine the protective effect of this compound in ischemia/reperfusion-induced cerebral injury f...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s007010200023

    authors: Chang CZ,Winardi D,Loh JK,Kung SS,Howng SL,Jeng AY,Kwan AL

    更新日期:2002-02-01 00:00:00

  • Surgical results of intracranial ruptured aneurysms in the acute stage.

    abstract::To evaluate the operative mortality and morbidity of definitive intracranial microsurgical aneurysm obliteration as a function of timing of early operative intervention and as a function of clinical condition at the acute state, we retrospectively review 164 consecutive patients who underwent surgery within 72 hours f...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/BF01728872

    authors: Hotta T,Tokuda S,Nishiya M,Tanaka Y,Nakamura J

    更新日期:1982-01-01 00:00:00

  • Cavernous angiomas of the lateral ventricles.

    abstract:BACKGROUND:Cavernous angiomas are vascular malformations which rarely involve the cavities of the lateral ventricles. Knowledge of the specific clinical and neuroradiological features displayed by these lesions is limited by the scarcity of patients included in the reported series. OBJECTIVE AND METHODS:The aim of thi...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章,评审

    doi:10.1007/s00701-009-0186-8

    authors: Carrasco R,Pedrosa M,Pascual JM,Navas M,Liberal R,Sola RG

    更新日期:2009-02-01 00:00:00

  • "Black bone": the new backbone in CAD/CAM-assisted craniosynostosis surgery?

    abstract:BACKGROUND:Computer-assisted design and manufacturing (CAD/CAM) techniques have been implemented in craniosynostosis surgery to facilitate cranial remodeling. However, until now, computed tomography (CT) scans with ionizing radiation were necessary to plan the procedure and create guiding templates. The purpose of this...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s00701-020-04445-z

    authors: Lethaus B,Gruichev D,Gräfe D,Bartella AK,Hahnel S,Yovev T,Pausch NC,Krause M

    更新日期:2020-06-09 00:00:00

  • Dural arteriovenous malformation: an unusual cause of trigeminal neuralgia.

    abstract::Trigeminal neuralgia has been rarely reported in association with dural arteriovenous malformations (DAVMs). We describe a case of trigeminal neuralgia resulting from compression of the trigeminal nerve at its root entry zone by a large tentorial DAVM. Surgical interruption of the draining vein at its exit from the te...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章,评审

    doi:10.1007/s00701-007-1251-9

    authors: Rahme R,Ali Y,Slaba S,Samaha E

    更新日期:2007-01-01 00:00:00

  • Patients in poor neurological condition after subarachnoid hemorrhage: early management and long-term outcome.

    abstract::We report management and outcome data on 118 patients that presented to our emergency room over a 4 year interval (1990-1994) in poor neurological condition after subarachnoid hemorrhage. All patients were treated following a strict protocol. After initial evaluation, patients underwent a head computerized tomography ...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/BF01410974

    authors: Rordorf G,Ogilvy CS,Gress DR,Crowell RM,Choi IS

    更新日期:1997-01-01 00:00:00

  • Bilateral chylothorax following anterior cervical spine surgery.

    abstract::Bilateral chylothorax following anterior cervical spine surgery is very rare. This report documents the first case of chylothorax after anterior cervical spine surgery through a right-side surgical approach. Unidentified chyle leakage can easily remain unrecognized and, thus, is difficult to treat. For early diagnosis...

    journal_title:Acta neurochirurgica

    pub_type: 杂志文章

    doi:10.1007/s00701-017-3294-x

    authors: Bae JS,Park JH,Jang IT

    更新日期:2017-10-01 00:00:00