OBJECTIVE The medial wall of the cavernous sinus (CS) is often invaded by pituitary adenomas. Surgical mobilization and/or removal remains a challenge. METHODS Endoscopic endonasal dissection was performed in 20 human cadaver heads. configuration wall, its relationship to internal carotid artery (ICA), and ligamentous connections between them were investigated 40 CSs. RESULTS CS confirmed be an intact single layer dura that distinct from capsule gland periosteal forms anterior CS. In 32.5%...

OBJECTIVE Brain arteriovenous malformations (AVMs) present significant challenges in neurosurgery, requiring detailed planning and execution. In this study, the authors aimed to evaluate efficacy of mixed reality (MxR), a synergistic application virtual (VR) augmented (AR), surgical management AVMs. METHODS A retrospective review was conducted on 10 patients who underwent AVM resection between 2021 2023. Preoperative used patient-specific 360° VR models, while intraoperative guidance AR...

The endoscopic endonasal approach has become a routine corridor to the suprasellar region. superior hypophyseal arteries (SHAs) are intimately related lesions in space, such as craniopharyngiomas and meningiomas. Here authors investigate surgical anatomy variations of SHA from perspective.

The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes disease 2019 (COVID-19), is responsible for an array of extrapulmonary manifestations, including direct and indirect neurological complications. Currently, all published cases noting pituitary apoplexy in patients with COVID-19 have discovered underlying macroadenomas. Herein, we describe the first documented case, to our knowledge, attributed solely absence other identifiable causes. While much...

OBJECTIVE The endoscopic endonasal transcavernous approach with interdural pituitary transposition provides surgical access to the posterior clinoids and interpeduncular cistern. Prior clinoidectomy, selective coagulation transection of inferior hypophyseal artery (IHA) is recommended prevent uncontrolled tearing its avulsion from wall cavernous carotid artery. authors’ preliminary experience has shown that unilateral sacrifice IHA caused no permanent endocrine dysfunction. In this study,...

The past two decades have witnessed the rise of keyhole microscopic minimally invasive surgeries, including transciliary supraorbital approach (TCA) and transpalpebral (TPA), commonly known as transorbital approach. This study aims to elucidate nuances, specific indications, advantages each

Intracranial stent placement for the treatment of cerebral aneurysms is increasingly utilized in both ruptured and unruptured scenarios. Intravenous (IV) cangrelor a relatively new antiplatelet agent that was initially approved coronary interventions. In addition to our institution, five other centers have published their results using IV neurointerventional procedures. This article combines aneurysm data from all prior studies provide insight into safety efficacy intracranial treatment.A...

Knowledge of neurovascular anatomy is vital for neurosurgeons, neurologists, neuro-radiologists and students, amongst others, to fully comprehend the brain's with utmost depth. This paper aims enhance foundational knowledge novice physicians in this area.

Despite improvements in surgical techniques, cranial nerve (CN) deficits remain the most frequent cause of disability following cavernous sinus (CS) surgery. The common tumor affecting CS is meningioma. They originate from lateral wall and have their blood supply meningohypophyseal trunk (MHT) inferolateral (ILT). Pituitary adenomas commonly invade through its medial receive form branches internal carotid artery (ICA) (superior inferior hypophyseal arteries). Some tumors may grow within...

The endoscopic endonasal approach is a surgical alternative for midline anterior skull base tumors. A detailed understanding of the proximal cerebral artery (ACA) branches' anatomy from an perspective essential avoiding vascular complications.To evaluate, perspective, anatomic variations ACA and its branches, specifically recurrent Heubner (RAH), fronto-orbital (FOA) frontopolar (FPA) arteries.We study origin, course, branching pattern, diameter, relationship between branches optic apparatus...

The lateral transorbital approach is a minimally invasive that was first described for accessing the cavernous sinus. 1 Although other approaches have been broadly applied to aneurysm surgery, 2 use of keyholes this still quite rare. 3,4 We present 72-year-old man with an incidentally discovered 5-mm middle cerebral artery aneurysm. Despite low rupture risk, 5 patient himself opted treatment, and because complex shape aneurysm, he chose surgical clipping as treatment choice. Two unique...

ABSTRACT BACKGROUND Suprachiasmatic subcallosal lesions may have an intimate relationship with the anterior communicating artery (AcomA); injury to AcomA branches can result in basal forebrain infarction and cognitive dysfunction. OBJECTIVE To evaluate anatomic variations of perforating branches, especially (ScA), for clinical implications when approaching suprachiasmatic region from endonasal transcranial routes. METHODS The origin, course, diameter, branching pattern AcomA’s were studied...

Superior cerebellar artery (SCA) aneurysms are rare. The management options not well defined. There is increasing role of endovascular treatment for all aneurysms, especially the posterior circulation. However in some situations (wide base, dysmorphic features) coiling feasible. surgical these has its own distinct complexity and requires careful planning. classic pterional or subtemporal approaches had limitation proper visualization neurovascular anatomy. In this video, we describe...

Keyhole approaches, performed with the endoscope, microscope, or exoscope, aim to minimize tissue traumatization while maximizing surgical view. The exoscope can provide better ergonomics than microscope without restricting space inside of keyhole, as when using endoscope. However, a frequently quoted reason for intraoperative exoscope-to-microscope conversion is absence sufficient light. In this video, authors present 4 patients who underwent posterior fossa keyhole surgery conversion....

Background: Dural arteriovenous fistulas (dAVFs) with cortical venous drainage (CVD. are high-risk vascular malformations requiring prompt intervention. While endovascular approaches often effective, surgical management is crucial in cases refractory to or unsuitable for treatment. This study evaluates the efficacy of Mixed Reality (MxR) enhancing outcomes where options were not viable.

Chondrosarcoma of the skull base is treated with upfront surgery in most healthy patients and carries a prognosis better than chordoma occurring similar locations. This surgical video about woman who presented headache hearing loss, whose MRI showed petrous bone tumor consistent chondrosarcoma. A combined anterior transpetrosal retrosigmoid approach was used. Additional drilling posterior fossa above below jugular bulb provided access for total resection.

Background: Brain Arteriovenous malformations (AVMs) pose significant challenges in neurosurgery and require detailed planning execution. The aim of this study is to assess the utility Mixed Reality (MxR), an integration Virtual (VR) Augmented (AR), surgical treatment AVMs.