The purpose of this article is to advocate standard skull base technique for removing the clinoidal meningioma and to delineate the technique's advantages that aid in achieving an improved extent of tumor resection and enhancing the patients' overall outcome, specially their visual outcome. Methods: A retrospective analysis was performed on 10 consecutive patients with clinoidal meningiomas who underwent surgical resection at the Bangabandhu Sheikh Mujib Medical University and other private clinics between May 2013 and July 2016. A standard pterional craniotomy technique consisting of extradural anterior clinoidectomy, coupled with optic canal unroofing and optic nerve sheath opening was used in all patients. All patients had thorough preoperative and postoperative ophthalmological evaluations. The follow-up period ranged from 6 to 42 months. Results: Total resection was achieved in 5 (50.0%) of the 10 patients in this series. The majority of the patients with preoperative visual impairment experienced significant visual improvement 7 of 10 patients; 70.0%). Conclusion: In the majority of patients with clinoidal meningiomas, total resection may be achieved with minimal complications. For large tumors encasing the optic nerve and internal carotid artery, or for those tumors causing preoperative visual impairment, use of the cranial base technique delineated in this study may lead to significant improvement in the patients' visual and overall outcomes.

Atlantoaxial dislocation (AAD), is a challenging disorder of the craniocervical junction. Because of its deep location and intricate anatomic structure, the craniocervical junction is always a difficult region for spine surgery. (1) Risk of vertebral artery injury makes the surgery difficult. Patient having an abnormal vertebral artery, like our patient, makes the situation more complicated. Bang. J Neurosurgery 2022; 11(2): 118-121

Background: Craniosynostosis is a congenital problem of brain development that causes disfigurement of the head and face. Multiple synostoses is an abnormal development of head where fusion ofmany or all cranial sutures ’! oxycephaly (tower skull with undeveloped sinuses and shallow orbits). The most accepted surgical correction involves frontoorbital advancement and forehead remodeling. Aim of the Study: In this study, we described our experience and technique in surgical correction of multiple synostoses (Oxycephaly) in BSMMU,department of neurosurgery. Bang. J Neurosurgery 2022; 11(2): 134-137

Background: The surgical management of symptomatic adult Chiari malformation type 1 (CM1) with or without syringomyelia (SM) continues to be a dilemma considering the outcomes. Objectives: The study aimed to compare the clinical outcomes between stealth cranioplasty (SC) and one of the most commonly practiced standard procedures, posterior fossa decompression with duraplasty (PFDD). Clinical outcomes between SC and another procedure posterior fossa decompression (PFD) were also compared. Methods: This comparative cross-sectional study was carried out on 37 males and 16 females symptomatic adult CM1 patients, ranging from 18 to 47 years of age from June 2019 to May 2021. Clinical outcomes were assessed, compared, and analyzed in terms of changes in clinical symptoms and signs, chicago chiari outcome scale (CCOS) score, and occurrence of complications.  Results: Of the 53 patients, 23, 19 and 11 underwent SC, PFDD, and PFD, respectively. There were no significant post-operative changes in symptoms and signs among groups except changes in limb weakness between SC and PFDD (P=0.004). Considering average CCOS score, SC performed better only than PFDD (P=0.003), while category-wise SC was better than both PFDD (P=0.004) and PFD (P=0.010). Considering complications, the PFDD group had a significantly higher rate of complications than the SC group (P=0.001), while there was no significant difference in the rate of complications between the PFD and SC groups. Conclusion: SC was found to have better clinical outcomes than the PFDD and PFD groups as a technique. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(1): 08-16

To review the surgical approaches, techniques, outcomes, and recurrence rates in a series of 6 olfactory groove meningioma (OGM) patients operated from January 2010 to April 2011.Methods: Six patients underwent craniotomy and micro-neurosurgical removal of olfactory groove meningioma maximum. Tumor diameter varied from 5 to 8.5 cm among six cases, 2 cases underwent glabellar mini craniotomy another 2 by bifrontal approach and rest of them were by frontolateral approach. Result: Total removal was possible in all cases. Histopathology revealed typical meningioma (WHO grade 1). there was no operative mortality and no permanent focal neurological deficit except anosmia. One patient developed leak and two cases meningitis which was resolved by lumber drain and antibiotic therapy. No tumor recurrence within six months of followup. For the removal of large olfactory groove meningiomas we used three different surgical approaches: frontolateral approaches, bifrontal approach and glabellar mini craniotomy. We consider the frontolateral approach is an alternative, if not superior, to standard bifrontal approaches. DOI: http://dx.doi.org/10.3329/medtoday.v24i1.13942 Medicine TODAY Vol.24(1) 2012 pp.5-7