0000000000201818

AUTHOR

Arthur J Ulm

The Transcallosal Anterior Interfoniceal Approach: A Microsurgical Anatomy Study

Objectives: A plethora of surgical strategies have been described to reach deeply lesions situated within the third ventricle, including the Rosenfeld or anterior transcallosal interfoniceal approach (TAIF). Firstly, introduced in 2001, it consists of a small callosotomy followed by the midline transseptal dissection of fornices to enter the roof of the third ventricle. The aim of this microsurgical anatomy study is to describe and show each stage of the surgical procedure, focusing on the possible trajectories to anatomic landmarks. Participants: A total of twenty adult cadaveric specimens were used in this study. Using x3 to x40 magnifications the surgical dissection was carried out in a …

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Insights on a Giant Aneurysm Treated Endovascularly

Background  Endovascular treatment with stent-assisted Guglielmi detachable coils is an accepted method for treating intracranial giant aneurysms that otherwise would require more invasive or destructive treatment or could not be treated at all. Nevertheless, there is a paucity of information concerning inner postcoiling aneurysmal changes in human subjects over the long term. We report a postmortem analysis of a patient with a giant aneurysm at the vertebrobasilar junction (VBJ) who was treated endovascularly and studied pathologically 24 months after treatment. Materials and Method  The head was removed at autopsy and prefixed in a 10% neutral buffered formalin solution. The brain was gen…

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Emergency Endovascular Treatment of Petrous Carotid Artery False Aneurysm

Abstract Introduction The management of ruptured intracranial false aneurysms (IFAs) might be tricky as any kind of treatment modality, surgical or endovascular, is burdened with significant challenges. A case report of the endovascular treatment of IFA in emergency setting is presented to provide more understanding of its pathophysiology as well as of the best operative work-up for petrous carotid artery reconstruction. Methods Technical notes from a left sided skull base abscess, involving and eroding the carotid canal and petrous carotid artery (PCA) resulting in an IFA are shown and analyzed. Results Balloon-assisted low viscosity Onyx embolization seems an effective method for the emer…

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Vertebrobasilar junction giant aneurysm: Lessons learned from a neurosurgical audit and anatomical investigation.

The treatment of vascular lesions of the vertebrobasilar junction (VBJ) remains a challenging task in the neurosurgical practice and the gold standard therapy is still under debate. In this article, the authors report a detailed postmortem study of a VBJ giant aneurysm (GA) previously endovascularly treated. Although the decision-making process for the vast majority of neurosurgical treatment can nowadays be accurately carried out during the preoperative planning (i.e., with the aid of neuroimaging fusion protocols, neuronavigation platforms, etc.) meant to maximize the anatomical understanding of the lesions and minimize possible intraprocedural challenges, this postmortem study represents…

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