Indications Majority of the posterior fossa lesions Chiari malformations and other developmental abnormalities Brain tumors including meningiomas, ependymomas, astrocytomas, and medulloblastomas Vascular lesions such as aneurysms, cavernous malformations, arteriovenous malformations, and hemangioblastomas ( Fig. 5.1 ) Posterior fossa infections Contraindications…
Indications This technique is effective for lesions of the middle fossa (i.e., cavernous sinus, medial temporal lobe, tentorial region, petrous bone, incisura) and posterior fossa (i.e., extraaxial lesions in the petroclival region, intraaxial lesions in the anteromedial region of the…
Indications The frontotemporal “pterional” craniotomy is considered the workhorse of skull base approaches. Temporal lobectomy in patients with medically refractory epilepsy (anterior temporal lobectomy versus selective amygdalohippocampectomy) Removal of sphenoid wing meningiomas and intrinsic frontal/temporal lobe tumors Access to the…
Indications The occipital craniotomy is an adaptable approach that allows us to access lesions, vascular malformations, and congenital abnormalities located at the occipital lobes, tentorium, torcular herophili, transverse sinus, and sigmoid sinus. Contraindications Any pathology located in the cervical spine…
Indications Exposure of the sphenoid wing, suprasellar and sellar regions, cavernous sinus, and upper clivus. Aneurysms clipping the anterior and posterior circulation (upper basilar and its proximal branches). Resection of extraaxial tumors of the anterior and middle cranial fossa and…
Introduction Arachnoiditis is an inflammatory condition of the arachnoid mater, leading to thickened leptomeninges and neurological symptoms in many cases. Ninety percent of patients with arachnoiditis experience a burning type pain. The most common location of spinal arachnoiditis is the…
Introduction Tethered cord syndrome (TCS) refers to the clinical condition produced by excessive tension of the spinal cord, with its caudal part anchored by inelastic structures that restrict its vertical movement. Inelastic structures include adipose filum terminale, tumor, myelomeningoceles, lipomyelomeningoceles,…
Introduction As described in Chapter 67 , Chiari I malformation is a condition derived from the abnormal caudal displacement of the cerebellar tonsils through the foramen magnum into the upper cervical canal, often with intramedullary cyst formation. Surgical treatment is…
Introduction Chiari malformations represent a class of posterior fossa disorders that stem from congenital abnormalities. The Chiari I malformation is the most common type, characterized by tonsillar descent that may or may not be associated with syringomyelia. The overall prevalence…
Introduction Hemangioblastoma of the spine is an infrequent, benign (World Health Organization [WHO] I), and highly vascularized tumor accounting for about 3% of all intramedullary spinal tumors and 2% to 15% of all the spinal cord neoplasms. Among the intramedullary…