A New Paradigm: How to Study the Exact Location of a Paraclinoid Aneurysm and the Cavernous Sinus in the Preoperative Stage through Imaging

Intracranial aneurysms (IAs) found in the subarachnoid compartment of the internal carotid artery are at risk of rupturing and producing hemorrhage into this space, producing all the known serious pathological manifestations of subarachnoid hemorrhage. On the other hand, those who are exclusively in the intracavernous segment have this negligible risk. It is in this context that a peculiar class of IAs fits, the paraclinoid aneurysms, which are characterized by their complex anatomical relationships with the optic apparatus, anterior clinoid process, the first supraclinoidal arterial branches of the carotid artery, the oculomotor nerve and the segment mainly said clinoid, which is delimited by the proximal and distal dural rings. It is of crucial importance, and challenging, to determine the location of paraclinoid aneurysms and their exact relationship with the cavernous sinus, given the need to establish an adequate line of treatment for each case. Through preoperative studies of 3 t Magnetic Resonance, comparison with 3D bio models and microsurgical exploration, it was possible to accurately demarcate these anatomical relationships. Therefore, today it is possible to establish the accurate location of the paraclinoid aneurysm in relation to the cavernous sinus by means of MR images and to carry out an adequate, effective, and safe operative planning

The Pterional Craniotomy: Tips And Tricks.

This review intended to describe in a didactic and practical manner the frontotemporosphenoidal craniotomy, which is usually known as pterional craniotomy and constitute the cranial approach mostly utilized in the modern neurosurgery. This is, then, basically a descriptive text, divided according to the main stages involved in this procedure, and describes with details how the authors currently perform this craniotomy.70727-3

A craniotomia pterional: dicas e truques

This review intended to describe in a didactic and practical manner the frontotemporosphenoidal craniotomy, which is usually known as pterional craniotomy and constitute the cranial approach mostly utilized in the modern neurosurgery. This is, then, basically a descriptive text, divided according to the main stages involved in this procedure, and describes with details how the authors currently perform this craniotomy

A craniotomia pterional: dicas e truques

This review intended to describe in a didactic and practical manner the frontotemporosphenoidal craniotomy, which is usually known as pterional craniotomy and constitute the cranial approach mostly utilized in the modern neurosurgery. This is, then, basically a descriptive text, divided according to the main stages involved in this procedure, and describes with details how the authors currently perform this craniotomy.A presente revisão visou descrever de forma didática e prática a realização da craniotomia frontotemporoesfenoidal, usualmente denominada pterional, que constitui a craniotomia mais utilizada na prática neurocirúrgica atual. Trata-se, portanto, de um texto fundamentalmente descritivo, dividido conforme as principais etapas envolvidas na realização desse procedimento, que mostra com detalhes a técnica utilizada atualmente pelo presente grupo de autores.72773

Craniotomia pré temporal

This paper aims to describe the performance of the pretemporal craniotomy performed didactically from 2002 to 2012 in eighty patients. It is therefore a fundamentally descriptive text, organized in the sequence of the main stages in which such a craniotomy is performed, and describing in detail the technique with which this group of evolutionarily authors came to accomplish the task.O presente artigo visa descrever de forma didática e prática a realização da craniotomia pré-temporal aplicada em oitenta pacientes de 2002 a 2012. Trata-se, portanto, de um texto fundamentalmente descritivo, dividido conforme as principais etapas da realização desta craniotomia, e que descreve com detalhes a técnica com que o presente grupo de autores evolutivamente veio a realizá-la.14515

Cerebellar anatomy as applied to cerebellar microsurgical resections

OBJECTIVE: To define the anatomy of dentate nucleus and cerebellar peduncles, demonstrating the surgical application of anatomic landmarks in cerebellar resections. METHODS: Twenty cerebellar hemispheres were studied. RESULTS: The majority of dentate nucleus and cerebellar peduncles had demonstrated constant relationship to other cerebellar structures, which provided landmarks for surgical approaching. The lateral border is separated from the midline by 19.5 mm in both hemispheres. The posterior border of the cortex is separated 23.3 mm from the posterior segment of the dentate nucleus; the lateral one is separated 26 mm from the lateral border of the nucleus; and the posterior segment of the dentate nucleus is separated 25.4 mm from the posterolateral angle formed by the junction of lateral and posterior borders of cerebellar hemisphere. CONCLUSIONS: Microsurgical anatomy has provided important landmarks that could be applied to cerebellar surgical resections