Indications The major advantages of this approach include broad exposure to the anterior cranial base with minimal brain retraction. The approach can facilitate the access to the anterior skull base, especially at the midline, including orbits, planum sphenoidale, sphenoid sinus,…
Preoperative Considerations The standard retrosigmoid approach allows for expeditious access to the posterior fossa, specifically to the cerebellopontine angle (CPA). The extended retrosigmoid approach includes the skeletonization of the transverse–sigmoid sinus and an optional partial mastoidectomy to the standard retrosigmoid…
Indications In general, most focal cervicomedullary tumors are considered benign in pathology. Common tumors of the cervicomedullary region include low-grade astrocytomas, gangliogliomas and ependymomas. They are typically well-delineated and benign tumors, typically amenable to gross total resection. Contraindications Anaplastic astrocytomas…
Indications Intra-axial lesions are located in close proximity to the motor cortex (rolandic and perirolandic regions including the supplementary motor area). The infiltrative rather displacing nature of gliomas makes this approach suitable for low-grade gliomas (astrocytoma, oligoastrocytoma or oligodendrogliomas) and…
Acknowledgment The authors and editors wish to thank Dr. Edward H. Oldfield and Dr. John Heiss for their contributions to this chapter in the previous edition. Definition and History In 1891, Hans Chiari described three types of cerebellar malformations that…
The first clinical report of spinal cord stimulation (SCS) was published in 1967. These devices were the logical progression of the concept of gate control theory proposed by Wall and Melzack in 1965. This theory proposed that “control of pain…
Acknowledgments We would like to thank Dr. Hitoshi Ganaha and Dr. Tabiko Ganaha for critically reviewing this manuscript. Introduction Idiopathic intracranial hypertension (IIH) is a complex disease whose incidence has been increasing since 1990. , It is highly correlated with…
Historical Aspects The “workhorse of skull base neurosurgery,” the orbitozygomatic approach (OZA) is a highly versatile surgical technique that provides access to lesions involving the orbital apex, cavernous sinus, anterior and middle fossa floor, and posterior fossa cisterns, and minimizes…
Acknowledgment In memory of Axel Perneczky. The authors and the editors thank Dr. Shaan Raza and Dr. Rodrigo Ramos-Zuniga for their contribution in the previous edition. The fundamental basis of “keyhole” neurosurgery lies in the fact that, if designed and…
Meningiomas are intracranial, extra-axial lesions that represent about one-third of all primary brain tumors, and over a half of noncancerous central nervous system (CNS) neoplasms. Falcine meningiomas are relatively rare. They arise from the falx cerebri and make up approximately…