Supracerebellar Infratentorial Variant Approaches to the Intercollicular Safe Entry Zone

Cavalcanti, Daniel D; Morais, Bárbara Albuquerque; Figueiredo, Eberval Gadelha; Spetzler, Robert F.; Preul, Mark C.

doi:10.1016/j.wneu.2018.11.033

Cited by 10 publications

(9 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Brainstem lesions have always generated debates from operability to adequate management. In a quest to minimize morbidity safe passageways have been methodically described from the microsurgical point of view, encompassing multiple supra and infratentorial approaches [20,[24][25][26]. Two stereotactic safe routes to the brainstem have proven their versatility to reach intrinsic brainstem lesions and deserve special consideration: the transcerebellar and the transfrontal routes.…”

Section: Routes To the Brainstemmentioning

confidence: 99%

Frameless robot-assisted stereotactic biopsies for lesions of the brainstem—a series of 103 consecutive biopsies

et al. 2022

View full text Add to dashboard Cite

PurposeTargeted treatment for brainstem lesions requires above all a precise histopathological and molecular diagnosis. In the current technological era, robot-assisted stereotactic biopsies represent an accurate and safe procedure for tissue diagnosis.We present our center's experience in frameless robot-assisted biopsies for brainstem lesions. MethodsWe performed a retrospective analysis of all patients bene tting from a frameless robot-guided stereotactic biopsy at our University Hospital, from 2001 to 2017. Patients consented to the use of data and/or images. The NeuroMate ® robot (Renishaw™, UK) was used. We report on lesion location, trajectory strategy, histopathological diagnosis and procedure safety. ResultsOur series encompasses 96 patients (103 biopsies) treated during a 17 years period. Mean age at biopsy: 34.0 years (range 1-78). Most common location: pons (62.1%). Transcerebellar approach: 61 procedures (59.2%). Most common diagnoses: diffuse glioma (67.0%), metastases (7.8%) and lymphoma (6.8%).Non conclusive diagnosis: 10 cases (9.7%). After second biopsy this decreased to 4 cases (4.1%). Overall biopsy diagnostic yield: 95.8%. Permanent disability was recorded in 3 patients (2.9%, all adults), while transient complications in 17 patients (17.7%). Four cases of intra-tumoral hematoma were recorded (one case with rapid decline and fatal issue). Adjuvant targeted treatment was performed in 72.9% of patients.Mean follow-up (in the Neurosurgery Department): 2.2 years. ConclusionFrameless robot-assisted stereotactic biopsies can provide the initial platform towards a safe and accurate management for brainstem lesions, offering a high diagnostic yield with low permanent morbidity.

show abstract

Section: Routes To the Brainstemmentioning

confidence: 99%

Frameless robot-assisted stereotactic biopsies for lesions of the brainstem—a series of 103 consecutive biopsies

et al. 2022

View full text Add to dashboard Cite

show abstract

“…44 Variants of the SCIT include the midline, paramedian, and extreme-lateral approaches, which have few differences regarding operative maneuverability. 6,14,45 We prefer the paramedian approach because of its less-invasive nature and the protection of the midline supracerebellar veins that it provides.…”

Section: Topographymentioning

confidence: 99%

“…The pons is a common site for intrinsic brainstem lesions. [45][46][47] During resection of these lesions, the primary goal is to avoid the corticospinal, corticonuclear, and MLF tracts, as well as the nuclei and intrapontine segments of cranial nerves (CNs) V to VIII.…”

Section: Ponsmentioning

confidence: 99%

Virtual Exploration of Safe Entry Zones in the Brainstem: Comprehensive Definition and Analysis of the Operative Approach

Meybodi

Hendricks²,

Witten

et al. 2020

World Neurosurgery

View full text Add to dashboard Cite

Background: Detailed and accurate understanding of intrinsic brainstem anatomy and the interrelationship between its internal tracts and nuclei and external landmarks is of paramount importance for safe and effective brainstem surgery. Using anatomical models can be an important step in sharpening such understanding.Objective: To show the applicability of our developed virtual 3D model in depicting the safe entry zones (SEZs) to the brainstem.Methods: Accurate 3D virtual models of brainstem elements were created using high-resolution magnetic resonance imaging and computed tomography to depict brainstem SEZs.Results: All the described SEZs to different aspects of the brainstem were successfully depicted using our 3D virtual models. Conclusions:The virtual models provide an immersive experience of brainstem anatomy, allowing users to understand the intricacies of the microdissection that is necessary to appropriately traverse the brainstem nuclei and tracts toward a particular target. The models provide an unparalleled learning environment for illustrating SEZs into the brainstem that can be used for training and research.

show abstract

“…É formado por fi bras frontopontinas e corticonucleares que se originam da porção inferior do giro precentral. Estima-se ser um território menos eloquente que o restante do pedúnculo cerebral (Figuras 4) [17][18][19][20] .…”

Section: Zona Perioculomotoraunclassified

“…A zona de entrada de segurança correspondente ao sulco mesencefálico lateral é descrita como um sulco que percorre a superfície do mesencéfalo entre o pedúnculo cerebral e o lemnisco lateral 18 .…”

Section: Sulco Mesencefálico Lateralunclassified

Relação anatômica entre a arquitetura interna e as zonas de segurança externas do tronco encefálico

Moraes¹,

Holanda²,

Cavalheiro³

2020

jbnc

View full text Add to dashboard Cite

Introdução: Compreender a complexa anatomia interna do tronco encefálico permite um melhor planejamento cirúrgico ao acessar as zonas de entrada de segurança localizadas na superfície externa. Objetivo: Analisar a anatomia intrínseca do tronco encefálico através do uso de técnicas de dissecção de peças de encéfalo humano em laboratório. O objetivo é buscar a preservação de estruturas eloquentes nas abordagens cirúrgicas. Metodologia: Seis espécimes de tronco encefálico foram fixados no formol e congelados, sendo analisados por técnicas de dissecção de fibras e vistos ao microscópio para definir a anatomia (D.F. Vasconcellos M 900A). As estruturas estão apresentadas em diversos ângulos, destacando-se uma série de secções transversais axiais paralelas. Resultados: Quando as lesões não afloram à superfície pial, as zonas de entrada de segurança representam estreitos referenciais em que há paucidade de estruturas eloquentes e ausência de vasos perfurantes. Conclusão: O conhecimento anatômico é fundamental para tornar o acesso cirúrgico ao tronco encefálico mais seguro.

show abstract

Supracerebellar Infratentorial Variant Approaches to the Intercollicular Safe Entry Zone

Cited by 10 publications

References 13 publications

Frameless robot-assisted stereotactic biopsies for lesions of the brainstem—a series of 103 consecutive biopsies

Frameless robot-assisted stereotactic biopsies for lesions of the brainstem—a series of 103 consecutive biopsies

Virtual Exploration of Safe Entry Zones in the Brainstem: Comprehensive Definition and Analysis of the Operative Approach

Relação anatômica entre a arquitetura interna e as zonas de segurança externas do tronco encefálico

Contact Info

Product

Resources

About