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Unilateral coronal synostosis: An indication of early frontobasal advancement
Thursday, / 0 July /997
1. This approach has the following advantages: -Minimal exposure of cerebral parenchyma -Less traction on the frontal lobes -Easy view on the dissection 01 controlateral segments A1 and A2. In Anterior Cerebral and Anterior Communicating artery aneurysms approach, we also had good view on the lateral wall of the other side internal carotid artery. Therefore. in this case of bilateral symmetric bifurcation middle cerebral artery aneurism at first, on the basis of the angiographic aspects indicating the possible source of bleeding. the left aneurysm was clipped, but its "innocence" was checkedand by the same way, the symmetrical aneurysm on the other side, which had really bled, was approached and clipped. We introduce the technique and stress the reliability of this approacheven for contralateral aneurysms.
IV-7-93I for A combined trans-sylvian and subtemporal approach basilar bifurcation aneurysms Hiromi Goto, Kazuo Watanabe. Southern Tonoku Research Institute for Neuroscience. 18 Maebayashi Fukuyama-machiKoriyama-city, Fukushima, Japan A combined trans-sylvian and subtemporal approach lor basilar bifurcation aneurysms has the advantage 01 preventing the periorating artery injury, because of the origin 01 both Pt segments and their associated perforating and chroidal arteries are web visualized. By this approach, we can clip the vasilar bifurcation aneurysms as well as perform artery, so we can clip the aneurysms without obstruction of the temporaryclip. We demonstrate this approachby video in details
IV-7-941 frontobasal Unilateral coronal synostosis: An indication of early advancement M. Rittierodt, R. Schmelzeisen I , M. Samii, J.-E. Hausamen 1 . Neurochirurgische KJinik, Medizinische Hochschule Hannover. 0-30623 Hannover. Germany, 1 Mund-, Kieffer-und Gesichtschirurgie, Medizinische Hochschule Hannover. 0-30623 Hannover. Germany Introduction: Unilateralcoronal synostosis (plagiocephalus) - often combined with sphenoethmoidal or lrontosphenoidal synostosis - has an incidence of 5-16 % of all synostosis. Frequent clinical findings are skull deformity with orbital hypoplasia, exophthalmus. midfacial hypoplasia, and nasopharyngeal obstruction; maxillar malformation can result in malocclusions. Video Case Report: The video demonstrates our neurosurgical and facialsurgical operative technique: a frontobasal advancement and a fronto-orbital remodelling in a 3.5 months old female baby. For imaging diagnostics we use 3-D-CT. Conclusion: Indication of early operative management - between the 3rd and 6th month of life - is decompression of the frontal lobe and frontobasal reconstruction.
IV-7-951
Acoustic neurinoma surgery with preservation of hearing and facial function
Ricardo Ramina, Ari A. Pedrozo, Murilo S. Meneses. Sonivai C. Hunhevlcz, Joao J. Maniglia. CuritibalScull BaseFoundation. CuritiOO. Brazil The case of a 32-year old womanwith 1.5 em acoustic neurinoma is presented. The lesion was totally removed through a retrosigmoidltransmeatal approach with preservation of cochlear, facial and superior vestibular nerves and their lunctions.
1V-7-961
Meningiomas of cavernous sinus. Transzygomatic approach
Ricardo Ramina, Ari A. Pedrozo, Murilo S. Meneses. SonivalC. Hunhevicz, Joao J. Maniglia. Curitiba! Scull BaseFoundation, Curifiba, Brazil Two cases of meningiomas of cavernous sinus are presented. The first patient presented also a carotid ophtalmic aneurysm. which was cliPPed in the same surgicalprocedure. The surgical approach used was transzygomatic.
IV-7-971 both Meningioma of tuberculum sella8 with Involvement of anterior cerebral arteries and anterior communicating artery Ricardo Ramina, Ari A. Pedrozo, Murilo S. Meneses, Sonival C. Hunhevicz. Joao J. Maniglia. CuritibalSCUll Base Foundation, CuritiOO, Brazil The case of a 44 year-old womanwith a large tubercullum sellae meningioma is presented. The lesion involved both anterior cerebral arteries, right optic nerve
Miscellaneous
S223
and anterior cerebral artery. total removal of the tumor and preservation of neurovascular structureswas possible.
Iv-7-9a l Left vertebral artery aneurysm: Surgical treatment RicardoRamina, Ari A. Pedrozo, Murilo S. Meneses, Sonivai C. Hunhevicz, Joao J. Maniglia. CuritiOOI Scull BaseFoundation, cumioe; Brazil In this video the approachto a left sided vertebral aneurysm (PICA) is demonstrated. Adequate surgical exposition of the lesion with proximal and distal control was possibleusing a far lateral approach.
1
V-7-99I Cavernous angioma of fornix and foramen of Monro
Ricardo Ramina, Ari A. Pedrozo, Murilo S. Meneses. Sonival C. Hunhevicz, Joao J. Maniglia. CuritibalScullBase Foundation. Curitiba, Brazil An unusual case of a cavernous angioma of fornix and foramen of Monro is presented. The lesion was totally removed througha transventricular approach.
IV-7-100 I Petroclival meningioma. Presigmoid approach Ricardo Ramina, Ari A. Pedrozo, Murilo S. Meneses, Sonival C. Hunhevicz, Joao J. Maniglia. CuritibalScull BaseFoundation. Curitiba, Brazil The use of presigmoid approach to removea petroclival meningioma is showed in this video. The tumor involved the clivus, III and V cranial nerves. Total removal with preservation 01the cranial nerves III to VIII is demonstrated.
IV-7-101 I artery Noninvasive detection of intracranial internal carotid lesions by recording blood flow sounds Yasushi Kurokawa, Seisho Abiko, KohsakuWatanabe, Norio Ikeda, Tomomi Okamura. Department of Neurosurgery, Ube IndustrJ'es Central Hospital, Ube, Japan Introduction: Transorbital blood flow sound recordings have the potential to be used for noninvasive detection of intracranial cerebrovascular disease. We present our system and experience in detecting intracranial internal carotid artery (ICA) disease. Methods: A small transducer was placed on the unilateral eyelid to record the intracranialblood flowsounds.which were amplifiedand convertedto digital data at a samplingfrequency of 2000 Hz to provide a spectral analysis. Results: No spectral peaks were recorded in 30 healthy adults. whereas 16 abnormal peaks were recorded in 29 patients with intracranial ICA lesions. Sharp peak were recorded in 9 of 14 patients with unclipped aneurysms, and broad peaks were recorded in two patients with vasospasm after aneurysmal clippingand in all patientswith severeintracranial lCA stenosis. Abnormalpeaks were recorded also in two patientswith CCF.No abnormalpeaks were detected in the patientswith small or fusiformtype aneurysm or mild stenosis. Conclusion: This completely noninvasive technique has the potential to be used for screening patients as well as for emergency of repeat evaluation of neurologically ill patients.
IV
o7
-1021 Bifrontal craniotomy for various lesions of the anterior cranial fossa under preservation of the olfactory tract
Abolghassem Sepehrnia, Ulrich Knopp. Neurosurgical Dept., Universityof Lubeck, Germany Introduction: The preservation 01the olfactorytract during bilrontal approachfor lesions located in the frontal skull base and the supra- and parasellar region has not previouslybeen investigated. Method: In our study 12 patients underwent surgery for various lesions via the subfrontalroute, All patients wereobserved prospectively, olfactometry was performed pre- and postoperatively by an independent otorhinolarhyngologist Result: We obtained completepreservation of the olfactorytracts and normal postoperative olfaction in all twelve cases. Discussion and Conclusion: The bifrontal approach allows a bilateral, wide operative field with better orientation and views ot important structures. The shortcoming of this method. damage of the olfactory tracts and postoperative anosmiacan be overcome.
1. This approach has the following advantages: -Minimal exposure of cerebral parenchyma -Less traction on the frontal lobes -Easy view on the dissection 01 controlateral segments A1 and A2. In Anterior Cerebral and Anterior Communicating artery aneurysms approach, we also had good view on the lateral wall of the other side internal carotid artery. Therefore. in this case of bilateral symmetric bifurcation middle cerebral artery aneurism at first, on the basis of the angiographic aspects indicating the possible source of bleeding. the left aneurysm was clipped, but its "innocence" was checkedand by the same way, the symmetrical aneurysm on the other side, which had really bled, was approached and clipped. We introduce the technique and stress the reliability of this approacheven for contralateral aneurysms.
IV-7-93I for A combined trans-sylvian and subtemporal approach basilar bifurcation aneurysms Hiromi Goto, Kazuo Watanabe. Southern Tonoku Research Institute for Neuroscience. 18 Maebayashi Fukuyama-machiKoriyama-city, Fukushima, Japan A combined trans-sylvian and subtemporal approach lor basilar bifurcation aneurysms has the advantage 01 preventing the periorating artery injury, because of the origin 01 both Pt segments and their associated perforating and chroidal arteries are web visualized. By this approach, we can clip the vasilar bifurcation aneurysms as well as perform artery, so we can clip the aneurysms without obstruction of the temporaryclip. We demonstrate this approachby video in details
IV-7-941 frontobasal Unilateral coronal synostosis: An indication of early advancement M. Rittierodt, R. Schmelzeisen I , M. Samii, J.-E. Hausamen 1 . Neurochirurgische KJinik, Medizinische Hochschule Hannover. 0-30623 Hannover. Germany, 1 Mund-, Kieffer-und Gesichtschirurgie, Medizinische Hochschule Hannover. 0-30623 Hannover. Germany Introduction: Unilateralcoronal synostosis (plagiocephalus) - often combined with sphenoethmoidal or lrontosphenoidal synostosis - has an incidence of 5-16 % of all synostosis. Frequent clinical findings are skull deformity with orbital hypoplasia, exophthalmus. midfacial hypoplasia, and nasopharyngeal obstruction; maxillar malformation can result in malocclusions. Video Case Report: The video demonstrates our neurosurgical and facialsurgical operative technique: a frontobasal advancement and a fronto-orbital remodelling in a 3.5 months old female baby. For imaging diagnostics we use 3-D-CT. Conclusion: Indication of early operative management - between the 3rd and 6th month of life - is decompression of the frontal lobe and frontobasal reconstruction.
IV-7-951
Acoustic neurinoma surgery with preservation of hearing and facial function
Ricardo Ramina, Ari A. Pedrozo, Murilo S. Meneses. Sonivai C. Hunhevlcz, Joao J. Maniglia. CuritibalScull BaseFoundation. CuritiOO. Brazil The case of a 32-year old womanwith 1.5 em acoustic neurinoma is presented. The lesion was totally removed through a retrosigmoidltransmeatal approach with preservation of cochlear, facial and superior vestibular nerves and their lunctions.
1V-7-961
Meningiomas of cavernous sinus. Transzygomatic approach
Ricardo Ramina, Ari A. Pedrozo, Murilo S. Meneses. SonivalC. Hunhevicz, Joao J. Maniglia. Curitiba! Scull BaseFoundation, Curifiba, Brazil Two cases of meningiomas of cavernous sinus are presented. The first patient presented also a carotid ophtalmic aneurysm. which was cliPPed in the same surgicalprocedure. The surgical approach used was transzygomatic.
IV-7-971 both Meningioma of tuberculum sella8 with Involvement of anterior cerebral arteries and anterior communicating artery Ricardo Ramina, Ari A. Pedrozo, Murilo S. Meneses, Sonival C. Hunhevicz. Joao J. Maniglia. CuritibalSCUll Base Foundation, CuritiOO, Brazil The case of a 44 year-old womanwith a large tubercullum sellae meningioma is presented. The lesion involved both anterior cerebral arteries, right optic nerve
Miscellaneous
S223
and anterior cerebral artery. total removal of the tumor and preservation of neurovascular structureswas possible.
Iv-7-9a l Left vertebral artery aneurysm: Surgical treatment RicardoRamina, Ari A. Pedrozo, Murilo S. Meneses, Sonivai C. Hunhevicz, Joao J. Maniglia. CuritiOOI Scull BaseFoundation, cumioe; Brazil In this video the approachto a left sided vertebral aneurysm (PICA) is demonstrated. Adequate surgical exposition of the lesion with proximal and distal control was possibleusing a far lateral approach.
1
V-7-99I Cavernous angioma of fornix and foramen of Monro
Ricardo Ramina, Ari A. Pedrozo, Murilo S. Meneses. Sonival C. Hunhevicz, Joao J. Maniglia. CuritibalScullBase Foundation. Curitiba, Brazil An unusual case of a cavernous angioma of fornix and foramen of Monro is presented. The lesion was totally removed througha transventricular approach.
IV-7-100 I Petroclival meningioma. Presigmoid approach Ricardo Ramina, Ari A. Pedrozo, Murilo S. Meneses, Sonival C. Hunhevicz, Joao J. Maniglia. CuritibalScull BaseFoundation. Curitiba, Brazil The use of presigmoid approach to removea petroclival meningioma is showed in this video. The tumor involved the clivus, III and V cranial nerves. Total removal with preservation 01the cranial nerves III to VIII is demonstrated.
IV-7-101 I artery Noninvasive detection of intracranial internal carotid lesions by recording blood flow sounds Yasushi Kurokawa, Seisho Abiko, KohsakuWatanabe, Norio Ikeda, Tomomi Okamura. Department of Neurosurgery, Ube IndustrJ'es Central Hospital, Ube, Japan Introduction: Transorbital blood flow sound recordings have the potential to be used for noninvasive detection of intracranial cerebrovascular disease. We present our system and experience in detecting intracranial internal carotid artery (ICA) disease. Methods: A small transducer was placed on the unilateral eyelid to record the intracranialblood flowsounds.which were amplifiedand convertedto digital data at a samplingfrequency of 2000 Hz to provide a spectral analysis. Results: No spectral peaks were recorded in 30 healthy adults. whereas 16 abnormal peaks were recorded in 29 patients with intracranial ICA lesions. Sharp peak were recorded in 9 of 14 patients with unclipped aneurysms, and broad peaks were recorded in two patients with vasospasm after aneurysmal clippingand in all patientswith severeintracranial lCA stenosis. Abnormalpeaks were recorded also in two patientswith CCF.No abnormalpeaks were detected in the patientswith small or fusiformtype aneurysm or mild stenosis. Conclusion: This completely noninvasive technique has the potential to be used for screening patients as well as for emergency of repeat evaluation of neurologically ill patients.
IV
o7
-1021 Bifrontal craniotomy for various lesions of the anterior cranial fossa under preservation of the olfactory tract
Abolghassem Sepehrnia, Ulrich Knopp. Neurosurgical Dept., Universityof Lubeck, Germany Introduction: The preservation 01the olfactorytract during bilrontal approachfor lesions located in the frontal skull base and the supra- and parasellar region has not previouslybeen investigated. Method: In our study 12 patients underwent surgery for various lesions via the subfrontalroute, All patients wereobserved prospectively, olfactometry was performed pre- and postoperatively by an independent otorhinolarhyngologist Result: We obtained completepreservation of the olfactorytracts and normal postoperative olfaction in all twelve cases. Discussion and Conclusion: The bifrontal approach allows a bilateral, wide operative field with better orientation and views ot important structures. The shortcoming of this method. damage of the olfactory tracts and postoperative anosmiacan be overcome.