Video Atlas of Neurosurgery

Orbitozygomatic Craniotomy

Indications and Contraindications The addition of the orbitozygomatic (OZ) osteotomies to the fronto-temporosphenoidal craniotomy increases the surgeon's workspace and minimizes the brain retraction required to reach deep-seated pathology. The orbital osteotomy allows increased visualization above the anterior clinoids while the…

Pterional Craniotomy

Indications The pterional craniotomy and the transsylvian approach are the most used techniques in contemporary neurosurgery. The pterional craniotomy allows exposure of the frontoparietal and temporal opercula together with the basal subarachnoid cisterns ( Figure 17.1 ). This approach allows…

Endoscopic Approach to the Ventricles

Preoperative Considerations Microscopic transcortical or transcallosal approaches may be associated with brain injury and/or retraction that can result in seizures, focal neurologic deficits and cognitive impairment. Endoscopic approaches for the management of intraventricular lesions are intended to be minimally invasive…

Telovelar Approach

Indications Indicated for lesions located within the fourth ventricle or brainstem that extend higher than the pontomedullary junction. The alternative approach has traditionally been the transvermian approach, where the vermis is split. This approach takes advantage of natural corridors without…

Transcallosal Approach for Intraventricular Tumors

Preoperative Considerations The transcallosal approach allows midline exposure of the anterior two-thirds of the third ventricle. Preoperatively, in addition to standard MR imaging, venography is often helpful to assess the pattern of cortical venous drainage in order to help determine…

Transcortical Approach to the Lateral Ventricles

Introduction Tumors of the lateral ventricle represent less than 1% of all intracranial tumors. The majority of these lesions are benign or low grade. The lateral ventricles are amongst the most challenging areas to operate in the brain and require…

Posterior Fossa Meningiomas

Indications and Preoperative Considerations Posterior fossa meningiomas are uncommon lesions that can be found virtually anywhere in the infratentorial space. The management of these lesions will depend on their size, location, growth rate and clinical presentation. These tumors can be…

Falcine and Falcotentorial Meningiomas

Indications and Preoperative Considerations Falcine meningiomas are extradural lesions that arise from the falx cerebri. They might be classified based on their relationship with the superior sagittal sinus (SSS) into anterior, middle or posterior lesions, each requiring different techniques for…

Convexity and Parasagittal Meningiomas

Indications and Preoperative Considerations Meningiomas are one of the most common primary intracranial brain tumors. They represent 34% of all primary brain tumors and originate from the arachnoid cells in the brain and spine. The brain convexity is the most…

Intraoperative Assessment of Extent of Resection

Introduction Neuro-oncological surgery has rapidly emerged and developed as a new field in neurosurgery focused on the treatment of tumors affecting the brain, cord and the peripheral nerves. It has undoubtedly relied on a parallel advance with technology. With the…