Craniotomy for anterior cranial fossa meningiomas: historical overview

2014 ◽  
Vol 36 (4) ◽  
pp. E14 ◽  
Author(s):  
Saul F. Morales-Valero ◽  
Jamie J. Van Gompel ◽  
Ioannis Loumiotis ◽  
Giuseppe Lanzino
Keyword(s):  
Cranial Base ◽  
Anterior Cranial Fossa ◽  
Past Century ◽  
Historical Overview ◽  
Surgical Strategies ◽  
The Past ◽  
Harvey Cushing ◽  
Anterior Cranial Base ◽  
Technical Advances ◽  
Cranial Fossa

The surgical treatment of meningiomas located at the base of the anterior cranial fossa is often challenging, and the evolution of the surgical strategy to resect these tumors parallels the development of craniotomy, and neurosurgery in general, over the past century. Early successful operations to treat these tumors were pioneered by prominent figures such as Sir William Macewen and Francesco Durante. Following these early reports, Harvey Cushing made significant contributions, allowing a better understanding and treatment of meningiomas in general, but particularly those involving the anterior cranial base. Initially, large-sized unilateral or bilateral craniotomies were necessary to approach these deep-seated lesions. Technical advances such as the introduction of electrosurgery, the operating microscope, and refined microsurgical instruments allowed neurosurgeons to perform less invasive surgical procedures with better results. Today, a wide variety of surgical strategies, including endoscopic surgery and radiosurgery, are used to treat these tumors. In this review, the authors trace the evolution of craniotomy for anterior cranial fossa meningiomas.

The versatile frontal sinus approach to the floor of the anterior cranial fossa

1990 ◽  
Vol 72 (3) ◽  
pp. 513-516 ◽  
Author(s):  
John A. Persing ◽  
John A. Jane ◽  
Paul A. Levine ◽  
Robert W. Cantrell
Keyword(s):  
Frontal Sinus ◽  
Cranial Base ◽  
Anterior Cranial Fossa ◽  
Operative Field ◽  
Content Type ◽  
Cosmetic Results ◽  
Anterior Cranial Base ◽  
Cranial Fossa ◽  
Burr Holes ◽  
Fine Print

✓ A technique to expose the anterior cranial base is described with entry through the anterior and posterior walls of the frontal sinus. Burr holes are avoided in the visible portion of the forehead. Expansion of the operative field may be accomplished, if necessary, by supplemental superior frontal or supraorbital rim osteotomy. The technique is rapid, safe, and provides excellent operative exposure and superior cosmetic results.

Eyelid approach to the anterior cranial base

2008 ◽  
Vol 109 (2) ◽  
pp. 341-346 ◽  
Author(s):  
Norberto Andaluz ◽  
Alberto Romano ◽  
Likith V. Reddy ◽  
Mario Zuccarello
Keyword(s):  
Minimally Invasive ◽  
Skull Base ◽  
Artery Aneurysm ◽  
Anterior Cranial Fossa ◽  
Anterior Communicating Artery ◽  
Surgical Morbidity ◽  
Anterior Circulation ◽  
Unruptured Aneurysms ◽  
Anterior Cranial Base ◽  
Cranial Fossa

Skull base approaches play a fundamental role in modern neurosurgery by reducing surgical morbidity. Increasing experience has allowed surgeons to perform minimally invasive approaches without straying from the premises of skull base surgery. The eyelid approach has evolved from the orbitopterional osteotomy into a more effective and targeted approach to disease of the anterior cranial fossa. In this technique, after an incision is made on the supratarsal fold, the orbicularis oculi muscle is incised, and a myocutaneous flap composed of the elements of the anterior lamella is elevated. Subperiosteal dissection is used to expose the superior and lateral walls of the orbit, the superior and lateral orbital rim, and the frontosphenoidal suture. A MacCarty bur hole is drilled, and a frontal osteotomy is fashioned medial to the supraorbital notch and extending through the orbital roof back toward the orbital half of the MacCarty bur hole, exposing the frontobasal brain. A conventional microsurgical technique is used to treat tumors and aneurysms of the anterior cranial fossa under the operative microscope. Five patients were treated for unruptured aneurysms of the anterior circulation (3 anterior communicating artery aneurysms, 1 ophthalmic artery aneurysm, and 1 posterior communicating artery aneurysm) using the eyelid approach. The mean aneurysm size was 5 mm, and all aneurysms were approached from the right side. Three tumors in the anterior fossa (2 suprasellar pituitary adenomas and 1 craniopharyngioma) were also excised using this approach. There was no surgical morbidity. Three months after surgery all patients presented excellent cosmetic results. The eyelid approach may be considered as an effective, cosmetically beneficial, and minimally invasive skull base approach to selected aneurysms and tumors of the anterior circulation.

scholarly journals Transarterial embolization of an anterior fossa cranial base dural arteriovenous fistula

2014 ◽  
Vol 37 (v1supplement) ◽  
pp. 1 ◽  
Author(s):  
Brian Lee ◽  
Vivek A. Mehta ◽  
Arun P. Amar ◽  
Matthew S. Tenser ◽  
William J. Mack
Keyword(s):  
Ophthalmic Artery ◽  
Transarterial Embolization ◽  
Cranial Base ◽  
Anterior Cranial Fossa ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Endovascular Approach ◽  
Anterior Fossa ◽  
Cranial Fossa ◽  
Embolic Materials

Open surgical disconnection has long been the treatment of choice for dural arteriovenous fistulas (dAVFs) of the anterior cranial fossa. However, advanced patient age and the presence of medical comorbidities can substantially increase the risk of craniotomy and favor a less invasive endovascular approach. Optimal positioning within the distal ophthalmic artery, beyond the origin of the central retinal branch, is achievable using current microcatheter technology and embolic materials. Here we present the case of an 88-year-old female with an incidentally discovered dAVF of the anterior cranial fossa. Angiographic cure was achieved with one-stage Onyx embolization.The video can be found here: http://youtu.be/KVE0fUIECQM.

Cranial base kyphosis and the surface morphology of the anterior cranial fossa

2002 ◽  
Vol 184 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Josip Paladino ◽  
Vicko Glunčić ◽  
Ranka Štern-Padovan ◽  
Ivan Vinter ◽  
Ivan Krešimir Lukić ◽  
...  
Keyword(s):  
Surface Morphology ◽  
Cranial Base ◽  
Anterior Cranial Fossa ◽  
Cranial Fossa

scholarly journals Knut Hamsun at the movies in transnational contexts

Nordlit ◽  
2009 ◽  
Vol 13 (2) ◽  
pp. 41
Author(s):  
Arne Lunde
Keyword(s):  
United States ◽  
The Netherlands ◽  
Digital Age ◽  
Third Reich ◽  
The United States ◽  
Past Century ◽  
Historical Overview ◽  
Silent Cinema ◽  
The Past ◽  
Knut Hamsun

 This historical overview examines how the literary works of Knut Hamsun have been adapted into films over the past century, from early silent cinema to the digital age. It traces how different national and transnational cinemas have appropriated the author's texts at different historical moments. Nazi propaganda minister Joseph Goebbels, for example, took a keen interest in two Third Reich adaptations of Hamsun novels (Victoria and Pan) in the 1930s. Pan remains the Hamsun novel most frequently adapted, while Henning Carlsen's 1966 pan-Scandinavian version of Hunger is arguably the artistic highpoint to date. Nations producing or co-producing Hamsun films include Norway, Sweden, Denmark, Germany, France, the Netherlands, Russia, the United States, and Canada (Guy Maddin's 1997 Twilight of the Ice Nymphs). Hamsun at the movies has shown remarkable elasticity, crossing multiple borders, and being appropriated by disparate national cinemas for surprisingly diverse ends.

scholarly journals Anterior Cranial Fossa Calcifying Pseudoneoplasm of the Neuroaxis—Diagnosis Using a Transblepharoplasty Approach

2018 ◽  
Vol 79 (03) ◽  
pp. e75-e78 ◽  
Author(s):  
Timothy Blood ◽  
Fausto Rodriguez ◽  
Norris Nolan ◽  
Murugappan Ramanathan ◽  
Shaun Desai
Keyword(s):  
Frontal Sinus ◽  
Spinal Column ◽  
Pathological Diagnosis ◽  
Anterior Cranial Fossa ◽  
Benign Tumors ◽  
Orbital Roof ◽  
Anterior Cranial Base ◽  
Cranial Fossa ◽  
The Right ◽  
Orbital Rim

AbstractCalcifying pseudoneoplasms of the neuroaxis (CAPNON) are rare, benign tumors of unknown histogenesis. CAPNON generally are found intracranially or within the spinal column in symptomatic patients. We present the case of an asymptomatic patient with an incidentally discovered right anterior cranial fossa mass with extension through the posterior and anterior table of the right frontal sinus and right superior orbital roof. Open biopsy was performed via a transblepharoplasty incision with pathological diagnosis of CAPNON. The biopsy approach was well hidden and resulted in minimal to no postoperative scarring and little postoperative pain. We present the first documented case of CAPNON involving the frontal sinus via the anterior cranial base. Given our experience, in a patient with a mass involving the frontal sinus and superior orbital rim, the transblepharoplasty approach provides excellent exposure and access for pathological diagnosis. Further, we recommend that CAPNON remain on the differential for aggressive appearing calcified masses of the anterior cranial fossa.

Minimally Invasive Transpalpebral “Eyelid” Approach to the Anterior Cranial Base

2011 ◽  
Vol 69 (suppl_2) ◽  
pp. ons195-ons207 ◽  
Author(s):  
Khaled M. Abdel Aziz ◽  
Sanjay Bhatia ◽  
Mohammed Hammad Tantawy ◽  
Raymond Sekula ◽  
Jeffrey T. Keller ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Cosmetic Outcome ◽  
Hospital Length Of Stay ◽  
Anterior Cranial Fossa ◽  
Low Grade ◽  
Closing Time ◽  
Anterior Circulation ◽  
Simpson Grade ◽  
Anterior Cranial Base ◽  
Cranial Fossa

Abstract BACKGROUND Supra orbital frontal minicraniotomy is one of the most commonly used minimally invasive approaches for anterior cranial fossa lesions. OBJECTIVE To describe our experience with the transpalpebral “eyelid” incision to obtain access to the anterior cranial fossa. METHODS We describe the approach and technique of the transpalpebral eyelid incision in a step-by-step fashion and discuss the results of 40 cases for which the eyelid incision was used. We retrospectively reviewed the charts of these patients to analyze outcomes with regard to opening and closing time, length of hospital stay, residual aneurysm or Simpson grade for resection, complications, and cosmetic result. RESULTS We treated 31 anterior circulation aneurysms (28 unruptured and 3 ruptured), 7 anterior skull base meningiomas, 1 frontal low-grade glioma, and 1 frontal cavernoma using the transpalpebral incision. Opening time was about 45 to 60 minutes, and closure time from dura to skin was about 45 to 60 minutes. The hospital length of stay was similar to that in our open craniotomy cases. No residual aneurysm was demonstrated in the follow-up studies of all 31 aneurysms. Simpson grade I resection was achieved in 6 meningiomas. Complications included 1 postoperative eyelid hematoma, 2 postoperative infections, and a subclinical stroke discovered on postoperative imaging. Excellent cosmetic outcome was accomplished in 39 of 40 patients. CONCLUSION The transpalpebral approach provides dissection in natural anatomical planes, affords preservation of the frontalis muscle, avoids injury to nerve VII branches, and results in an excellent cosmetic outcome.

The zoonotic potential of bat-borne coronaviruses

2020 ◽  
Vol 4 (4) ◽  
pp. 365-381
Author(s):  
Ny Anjara Fifi Ravelomanantsoa ◽  
Sarah Guth ◽  
Angelo Andrianiaina ◽  
Santino Andry ◽  
Anecia Gentles ◽  
...  
Keyword(s):  
Genetic Material ◽  
Field Research ◽  
Sympatric Species ◽  
Animal Origin ◽  
Mammalian Host ◽  
Past Century ◽  
The Past ◽  
Novel Host ◽  
Horseshoe Bat ◽  
Human Infections

Seven zoonoses — human infections of animal origin — have emerged from the Coronaviridae family in the past century, including three viruses responsible for significant human mortality (SARS-CoV, MERS-CoV, and SARS-CoV-2) in the past twenty years alone. These three viruses, in addition to two older CoV zoonoses (HCoV-229E and HCoV-NL63) are believed to be originally derived from wild bat reservoir species. We review the molecular biology of the bat-derived Alpha- and Betacoronavirus genera, highlighting features that contribute to their potential for cross-species emergence, including the use of well-conserved mammalian host cell machinery for cell entry and a unique capacity for adaptation to novel host environments after host switching. The adaptive capacity of coronaviruses largely results from their large genomes, which reduce the risk of deleterious mutational errors and facilitate range-expanding recombination events by offering heightened redundancy in essential genetic material. Large CoV genomes are made possible by the unique proofreading capacity encoded for their RNA-dependent polymerase. We find that bat-borne SARS-related coronaviruses in the subgenus Sarbecovirus, the source clade for SARS-CoV and SARS-CoV-2, present a particularly poignant pandemic threat, due to the extraordinary viral genetic diversity represented among several sympatric species of their horseshoe bat hosts. To date, Sarbecovirus surveillance has been almost entirely restricted to China. More vigorous field research efforts tracking the circulation of Sarbecoviruses specifically and Betacoronaviruses more generally is needed across a broader global range if we are to avoid future repeats of the COVID-19 pandemic.

PCSK9 inhibition for LDL lowering and beyond – implications for patients with peripheral artery disease

VASA ◽  
2018 ◽  
Vol 47 (3) ◽  
pp. 165-176 ◽  
Author(s):  
Katrin Gebauer ◽  
Holger Reinecke
Keyword(s):  
Cardiovascular Risk ◽  
Risk Reduction ◽  
Ldl Receptor ◽  
Density Lipoprotein ◽  
Past Century ◽  
Pcsk9 Inhibitors ◽  
Cardiovascular Risk Reduction ◽  
Simultaneous Application ◽  
The Past ◽  
Pcsk9 Inhibition

Abstract. Low-density lipoprotein cholesterol (LDL-C) has been proven to be a causal factor of atherosclerosis and, along with other triggers like inflammation, the most frequent reason for peripheral arterial disease. Moreover, a linear correlation between LDL-C concentration and cardiovascular outcome in high-risk patients could be established during the past century. After the development of statins, numerous randomized trials have shown the superiority for LDL-C reduction and hence the decrease in cardiovascular outcomes including mortality. Over the past decades it became evident that more intense LDL-C lowering, by either the use of highly potent statin supplements or by additional cholesterol absorption inhibitor application, accounted for an even more profound cardiovascular risk reduction. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a serin protease with effect on the LDL receptor cycle leading to its degradation and therefore preventing continuing LDL-C clearance from the blood, is the target of a newly developed monoclonal antibody facilitating astounding LDL-C reduction far below to what has been set as target level by recent ESC/EAS guidelines in management of dyslipidaemias. Large randomized outcome trials including subjects with PAD so far have been able to prove significant and even more intense cardiovascular risk reduction via further LDL-C debasement on top of high-intensity statin medication. Another approach for LDL-C reduction is a silencing interfering RNA muting the translation of PCSK9 intracellularly. Moreover, PCSK9 concentrations are elevated in cells involved in plaque composition, so the potency of intracellular PCSK9 inhibition and therefore prevention or reversal of plaques may provide this mechanism of action on PCSK9 with additional beneficial effects on cells involved in plaque formation. Thus, simultaneous application of statins and PCSK9 inhibitors promise to reduce cardiovascular event burden by both LDL-C reduction and pleiotropic effects of both agents.

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