A New Window for the Treatment of Posterior Cerebral Artery, Superior Cerebellar Artery, and Basilar Apex Aneurysm: The Expanded Endoscopic Endonasal Approach

Lemos-Rodriguez, Ana M.; Sreenath, Satyan B.; Unnithan, Ajay S.; Doan, Vivian; Recinos, Pablo F.; Zanation, Adam M.; Sasaki‐Adams, Deanna

doi:10.1055/s-0035-1566252

Cited by 10 publications

(6 citation statements)

References 25 publications

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“…The boxplot, and the significant improvement of reconstructive techniques have significantly extended the endoscopic option beyond the limits of the extradural compartments. In fact, the use of the EEEAs has recently been proposed for intradural lesions, such as meningiomas involving the ventral FM and the petroclival region (4,19,23,53), and ventrally located ponto-medullary cavernomas (12,18,27,36,44,51), or even aneurysms of the vertebrobasilar system (14,26,45,48,49). Due to the lower rate of infection or functional complications with the use of EEEAs, such approaches are more preferred than purely microscopic or endoscope-assisted transoral approaches (7).…”

Section: Dimensional Variability Of the Condylar And Basilar Partmentioning

confidence: 99%

Morphometric and radiomorphometric study of the correlation between the foramen magnum region and the anterior and posterolateral approaches to ventral intradural lesions

Luzzi

Maestro

Elia

et al. 2019

Turkish Neurosurgery

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AIM: To identify the range of dimensional morphometric variability correlated to the basilar and condylar part of the occipital bone, which may affect the choice of approach to ventral intradural foramen magnum (FM) lesions. MATERIAL and METHODS: In total, 25 dry skulls and 50 head computed tomography (CT) scan results have been assessed in detail, focusing on the FM, occipital condyles, jugular tubercles (JT), and hypoglossal canals (HC). A morphometric analysis has been carried out using linear and angular measurements to estimate the range of the dimensional variability of these structures. Data were presented as mean ± standard deviation, ranges, and interquartile range on a boxplot. The sagittal intercondylar angle (SICA) and anterior condylar angle (ACA) have been found to be important in estimating the axial orientation of the condyles, whereas the JT-HC interline ratio has indicated the prominence of the tubercles. RESULTS: The SICA and ACA have exhibited high variability. The average JT-HC interline ratio was 0.8. Wider SICA-ACA and higher JT-HC interline ratio make the posterolateral approach advantageous. An anterior medial or far-medial endoscopic route is indicated in opposite conditions. In this study, two illustrative cases have been reported. CONCLUSION: A cautious preoperative morphometric evaluation of the FM region must be considered prior to using tailored and safe anterior endoscopic and posterolateral approaches to ventral intradural lesions to identify the advantages of a certain corridor as much as possible, thereby minimizing the risk of complications.

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Section: Dimensional Variability Of the Condylar And Basilar Partmentioning

confidence: 99%

Morphometric and radiomorphometric study of the correlation between the foramen magnum region and the anterior and posterolateral approaches to ventral intradural lesions

Luzzi

Maestro

Elia

et al. 2019

Turkish Neurosurgery

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“…There are also some literature reports on the cadaver study using the EEA for clipping intracranial aneurysms. [30][31][32][33][34][35][36][37][38][39][40][41] Many previous articles on cadaver studies have suggested that ACoA aneurysms can be clipped through the EEA, but Montaser et al 32 did not fully agree. To further analyze the clipping of ACoA aneurysms by this approach, we first simulated the approach with a cadaver head.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Endonasal Approach for Clipping Anterior Communicating Artery Aneurysms From Cadaver Studies and Three-Dimensional Printed Models to a Clinical Case

Qin

Guo

Zheng

et al. 2021

Journal of Craniofacial Surgery

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“…It is also worth mentioning a relatively new approach for the treatment of basilar apex, PCA, and superior cerebellar artery aneurysms which is the expanded endoscopic endonasal transclival approach [28]. Unfortunately, to our knowledge, there are no reports which compare the results of this approach with the classical microsurgical or endovascular techniques.…”

Section: Discussionmentioning

confidence: 99%

Acute Obstructive Hydrocephalus due to a Giant Posterior Cerebral Artery Aneurysm in a Pediatric Patient

et al. 2018

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Introduction: Intracranial aneurysms are very rare in children. Although subarachnoidal hemorrhage (SAH) is by far the most common presentation of aneurysms in the majority of the pediatric case series, it is not rare for an unruptured aneurysm to present with a mass effect. Acute hydrocephalus is a common finding following aneurysmal SAH. However, this malady may develop even in the absence of SAH but secondary to direct obstruction by a giant aneurysm. This situation is extremely rare in children, with only a few known case reports in the literature. Case Report: We report the case of a 10-year-old girl who presented with signs and symptoms of acute hydrocephalus; further radiological evaluation revealed obstructive hydrocephalus and a giant posterior cerebral artery aneurysm. Following endovascular treatment of the aneurysm, hydrocephalus was completely resolved, and the patient was symptom free. Conclusion: Although they are very rare, giant intracranial aneurysms must be kept in mind during the differential diagnosis of pediatric acute hydrocephalus cases. Hydrocephalus may resolve spontaneously after the successful treatment of these aneurysms.

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A New Window for the Treatment of Posterior Cerebral Artery, Superior Cerebellar Artery, and Basilar Apex Aneurysm: The Expanded Endoscopic Endonasal Approach

Abstract: The endoscopic endonasal transclival approach represents a potentially feasible surgical corridor to treat aneurysms arising from these vessels.

Cited by 10 publications

References 25 publications

Morphometric and radiomorphometric study of the correlation between the foramen magnum region and the anterior and posterolateral approaches to ventral intradural lesions

Morphometric and radiomorphometric study of the correlation between the foramen magnum region and the anterior and posterolateral approaches to ventral intradural lesions

Endoscopic Endonasal Approach for Clipping Anterior Communicating Artery Aneurysms From Cadaver Studies and Three-Dimensional Printed Models to a Clinical Case

Acute Obstructive Hydrocephalus due to a Giant Posterior Cerebral Artery Aneurysm in a Pediatric Patient

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