Search results for "Cistern"
showing 10 items of 35 documents
Introducing the concept of “CSF-shift edema” in traumatic brain injury
2018
Brain edema after severe traumatic brain injury (TBI) plays an important role in the outcome and survival of injured patients. It is also one of the main targets in the therapeutic approach in the current clinical practice. To date, the pathophysiology of traumatic brain swelling is complex and, being that it is thought to be mainly cytotoxic and vasogenic in origin, not yet entirely understood. However, based on new understandings of the hydrodynamic aspects of cerebrospinal fluid (CSF), an additional mechanism of brain swelling can be considered. An increase in pressure into the subarachnoid space, secondary to traumatic subarachnoid hemorrhage, would result in a rapid shift of CSF from t…
Anatomy and physiology of cisternostomy
2016
Cisternostomy is defined as opening the basal cisterns to atmospheric pressure. This technique helps to reduce the intracranial pressure in severe head trauma as well as other conditions when the so-called sudden “brain swelling” troubles the surgeon. We elaborated the surgical anatomy of this procedure as well as the proposed physiology of how cisternostomy works. This novel technique may change the current trends in neurosurgery.
Virtual endoscopy of the inner ear and the auditory canal.
2000
To assess the role of virtual endoscopy (VE) in the examination of intracisternal structures and of the inner ear, we studied the anatomy of the labyrinth and internal auditory canal using the original CT slices and VE on the unaffected side in three female and three male patients, age range 3–46 years, with contralateral retrocochlear hearing loss. We also examined seven patients with different pathological findings. VE was performed using an advanced postprocessing program with high- resolution 3D data sets of CT (1–1.5 mm thickness, pitch 1.25) and MRI-CISS-3D (constructive interference in steady state) images of the basal cisterns (1.5 T, slice thickness 0.7–1 mm). VE provides an endosc…
Cisternostomy for Traumatic Brain Injury: Pathophysiologic Mechanisms and Surgical Technical Notes
2016
Objective Traumatic brain injury (TBI) is one of the major challenges in health care, representing the third most frequent cause of death. Current optimal management is based on a progressive, target-driven approach combining both medical and surgical treatment strategies. Here we describe cisternostomy, an emerging surgical treatment for the treatment of TBI. Methods Cisternostomy is a novel technique that incorporates knowledge of skull base and microvascular surgery. By opening the brain cisterns to atmospheric pressure, the technique could decrease the intracranial pressure due to a backshift of the cerebrospinal fluid (CSF) from the swollen brain to the cisterns through the Virchow-Rob…
Endoscopic Treatment of Arachnoid Cysts
2010
Background Surgical treatment of arachnoid cysts remains under debate. Although many authors favor endoscopic techniques, others attribute a higher recurrence rate to the endoscope. Objective The authors report their experience with endoscopic procedures for arachnoid cyst. Methods All pure endoscopic procedures for arachnoid cysts performed by the authors were analyzed. Particular reference was given to surgical complications and patient outcome in relation to cyst location and endoscopic technique. Results Sixty-six endoscopic procedures were performed in 61 patients (mean age, 28 years; range, 23 days to 74 years; 35 males, 26 females). The main presenting symptoms were cephalgia (61%), …
Prospective sonographic detection of spina bifida at 11–14 weeks and systematic literature review
2015
Objective: To conduct a literature review to assess the effectiveness of first trimester ultrasonographic markers of spina bifida (SB) integrating data with our prospective experience. Methods: The analysis of the SB cases that we prospectively detected in the first trimester, between January 2012 and February 2014, and a systematic review of all the papers evaluating the effectiveness of SB ultrasonographic markers at 11–14 weeks, namely brain stem diameter (BS), fourth ventricle/intracranial translucency (IT), cisterna magna (CM), brain stem/occipital bone distance (BSOB), the ratio between BS and BSOB. Some studies assess only the effectiveness of IT, others include more parameters, and …
Biportal neuroendoscopic microsurgical approaches to the subarachnoid cisterns. A cadaver study.
1996
A preclinical cadaver study was performed to develop the technique of biportal neuroendoscopic dissection in the subarachnoid space of the basal cisterns and to test the feasibility, utility, and safety of this new technique. In 23 fresh post-mortem adult human cadavers and 2 formalin-fixed adult human head specimen a total of 33 biportal endomicrosurgical dissections into and within the basal cisterns were carried out. Following suction of cerebrospinal fluid from the subarachnoid space 0 degree-, 30 degrees-, and 70 degrees-lens-scopes (Aesculap AG, Tuttlingen, Germany) with outer diameters of 4.2 mm and trochars with outer diameters of 5 to 6.5 mm were introduced into the surgical field.…
Endo-neuro-sonography: Anatomical aspects of the basal cisterns
1997
SummaryTo evaluate the usefulness of transendoscopic sonography, two sono catheters of 6F diameter were studied in 15 fresh specimens. A precise imaging was seen of well known anatomical structures. An additional dimension in endoscopy was also obtained as the sono added to the endo view a transversal scan like a mini CT at the tip of the probe. The guiding characteristic of this imaging technique, which is in real time and on line, was also experienced. These observations offer such interesting prospects for use in minimally invasive neurosurgery that further development and clinical experience seem to be justified.
Ceramiche e altri rinvenimenti dalle cisterne del Castello di Butera: spunti e riflessioni
2011
The archaeological investigations (1998-1999) conducted in the area in front of the medieval castle of Butera (CL) have returned part of the internal courtyard of the building, equipped with a system of wells and siloi for water supply and granary. The stratigraphic relationships between the structures and the analysis of the material found inside the cisterns, as well as highlighting the different building phases during which the extensive collection system for water and grain was built (12th/13th-15th century ), allow us to have interesting indicators relating to the duration of circulation of the various pottery classes identified
Measurement of brain tissue pressure in cold induced cerebral oedema.
1973
Experiments were performed in order to evaluate the concept that brain oedema is associated with an increase in local interstitial fluid pressure. Assuming that the pressure measured by the cotton wick technique represents the hydrostatic interstitial fluid pressure, the tissue pressure was recorded with pressure transducers in the white matter adjacent and remote to a local cold injury, in the opposite hemisphere, and in the cisterna magna. In 9 cats during steady-state conditions mean tissue pressures between 1.20±0.30 mm Hg and 2.33±0.80 mm Hg were found, as compared to a mean CSF pressure of 5.17±0.82 mm Hg. The tissue pressure was found to increase significantly adjacent to the lesion …