The pretemporal approach: Surgical anatomy, operative technique, and rationale

Wen, Hung Tzu; Oliveira, Evandro de; Tedeschi, Hélder; Andrade, Francisco Carlos de; Rhoton, Albert L.

doi:10.1053/otns.2001.25569

Cited by 12 publications

(5 citation statements)

References 7 publications

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“…This last one is helpful for high basilar bifurcation aneurysms that require a more superiorly angled surgical field. 25 The basic principles of surgical suitability are related to the relationship of the basilar apex to the posterior clinoid, and the orientation of the dome and the PCAs. It is mandatory to preserve the perforating arteries, especially when the artery of Percheron is responsible for the thalamus vascularization.…”

Section: Surgical Strategymentioning

confidence: 99%

Surgical Treatment of Posterior Circulation Aneurysms – Anatomical Study and Surgical Technique

et al. 2018

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Posterior circulation aneurysms represent 10–15% of intracranial aneurysms. The diagnosis is usually secondary to subarachnoid hemorrhage due to its initial asymptomatic presentation and higher risk of rupture compared with aneurysms in the anterior circulation. The surgical treatment of posterior circulation aneurysms is complex and challenging for neurosurgeons because of the particular anatomy of the posterior circulation with its close relation to the brainstem and cranial nerves and also because of the depth and narrowness of the surgical approach. Aneurysms from different locations have specific anatomical relationships and surgical approaches for better visualization and dissection. Therefore, a detailed anatomy knowledge of the posterior circulation is mandatory for an individualized preoperative planning and good neurological and angiographic outcomes. We selected the main aneurysm sites on the posterior circulation, such as: posterior inferior cerebellar artery, basilar trunk, basilar bifurcation, posterior cerebral artery (PCA) and superior cerebellar artery for a detailed description of the relevant anatomy related to aneurysm, and the main surgical approaches for its surgical treatment. Furthermore, we performed a literature review with the most recent outcomes regarding to the surgical treatment of posterior circulation aneurysms.

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Section: Surgical Strategymentioning

confidence: 99%

Surgical Treatment of Posterior Circulation Aneurysms – Anatomical Study and Surgical Technique

et al. 2018

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“…O desenvolvimento de estudos anatômicos e o entendimento da complexa anatomia do SC que iniciaram com Parkinson [79][80][81] , Dolenc [23][24][25][26][27][28] , Taptas 103 , Umansky 107,108 e Harris e Rhoton 33 enfatizavam a necessidade de aprofundar o conhecimento da microanatomia cirúrgica deste compartimento da base do crânio, antes de abordar patologias neste local. Desta forma, uma região considerada até metade da década de 80 como sendo "inoperável", graças ao aprofundamento de seu conhecimento microanatômico 10,12,17,19,22,[38][39][40][41]47,50,51,58,[65][66][67]69,71,[84][85][86][87]90,91,93,95,97,98,106,[110][111][112][113]116,…”

Section: Introductionunclassified

Anatomia Microcirúrgica e abordagens ao seio cavernoso

Isolan¹,

Vedolin²,

Bertholdo³

et al. 2018

jbnc

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O seio cavernoso é uma das regiões mais complexas do corpo humano e pode ser acometido por diversas patologias. Atualmente, diversos tipos de tratamento podem ser usados para tratar doenças nesta região, porém o conhecimento anatômico ainda é fundamental para estabelecer o melhor manejo. Nosso objetivo é apresentar a anatomia microcirúrgica do seio cavernoso, as abordagens cirúrgicas (incluindo a abordagem endonasal endoscópica), a correlação radiológica desta anatomia, bem como uma série inicial de casos. As fotos são apresentadas pelo método convencional e anaglífico estereoscópico. São descritas as estruturas neurovasculares do seio cavernoso bem como suas relações ósseas e durais, as paredes e os triângulosda base do crânio relacionados ao seio cavernoso. As abordagens crânio-órbito zigomática, transpetrosa, zigomática e endonasal endoscópica são apresentadas, sendo as estruturas anatômicas identificadas também nos exames de imagem. Casos ilustrativos ilustram esta anatomia.

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“…He also advocated for the use of the pretemporal approach for basilar tip aneurysms. 3 He always looked for solutions to overcome the surgical challenges he faced. He realized that the key to the mysteries of paraclinoid and low basilar tip aneurysms, upper petroclival, and anterolateral pontine lesions resided in our understanding the anatomy of the cavernous sinus.…”

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confidence: 99%