62,567 research outputs found
Endoscopic anatomy for transnasal transsphenoidal pituitary surgery in the presence of a persistent trigeminal artery
No full textOBJECTIVE: Endoscopic procedures are becoming increasingly important for transnasal transsphenoidal approaches to the skull base and particularly for pituitary surgery. A persistent trigeminal artery (PTA) is rare. Its presence, if it goes unnoticed or if the surgeon is not aware of such a variant, may endanger the success of surgery.
METHOD: During an endoscopic inspection using a supraorbital approach in a fresh cadaveric specimen in which the arteries had been injected with latex glue, the presence of an anomalous intracranial artery, suggestive for PTA, was disclosed. The specimen was then fixed and a CT scan with 3D reconstruction of the circle of Willis was done to evaluate the imaging of such an anatomical variation. Thereafter an endoscopic transsphenoidal approach to the pituitary fossa was performed, to verify the endoscopic anatomy.
RESULTS: The performed CT scan allowed visualization of the entire course of the anomalous vessel, confirming a PTA. During the endoscopic transsphenoidal approach, the presence of the vascular anomaly, altering the bony bulging of the internal carotid artery on the lateral side of the sphenoidal roof, was disclosed. The parasellar course of the PTA could be exposed by drilling the overhanging bone. The presence of the anatomical variant did not interfere with surgical manoeuvres and the procedure, simulating a transsphenoidal approach to the pituitary, could be safely completed.
CONCLUSION: Variants such as PTA are rare and routine preoperative imaging for pituitary procedures does not always include studies to detect this vascular anomaly. The occasional intraoperative detection of a PTA during an endoscopic transsphenoidal procedure can be managed; almost any surgical manipulation is possible and pituitary surgery can be successfully completed, provided the surgeon is aware of the possible existence of this variant and its irregular anatomical course. However, the presence of a PTA may have dramatic consequences if surgery is directed to the lateral parasellar region, as for intracavernous lesions; in these cases a complete neuroradiological study including MRI-angiography and possibly CT-angiography is advised
Erratum: Engraftment, neuroglial transdifferentiation and behavioral recovery after complete spinal cord transection in rats (Surg Neurol Int 2018 9 :19 DOI: 10.4103/sni.sni_369_17)
No full textIn the article titled “Engraftment, neuroglial transdifferentiation and behavioral recovery after complete spinal cord transection in rats”, published on pages 19, Issue 1, Volume 9 of Surgical Neurology International,[1] the name of the authors is written incorrectly as The “How to cite this article” section should read correctly as “Luzzi S, Crovace AM, Lacitignola L, Valentini V, Francioso E, Rossi G, Invernici G, Galzio RJ, Crovace A”
Letter from J. R. Eakin to Arthur G. Ringland
No full textLetter (copy) from J. R. Eakin to Arthur C. Ringland about the alignment of 40 acres near the Buggeln ranch
Letter from Arno B. Cammerer to J. R. Eakin
No full textLetter from Arno B. Cammerer to J. R. Eakin describing the procedure for purchasing Bright Angel Trail
Letter from J. R. Eakin to Carl Hayden
No full textLetter from J. R. Eakin to Carl T. Hayden concerning access to Rowe Well and the canyon
Letter from J. R. Eakin to Stephen Mather
No full textLetter from J. R. Eakin to Stephen T. Mather about expenses and reconstruction of the Kaibab Trail
Letter from Carl Hayden to J. R. Eakin
No full textLetter from Carl T. Hayden to J. R. Eakin regarding changes to the Grand Canyon National Park boundaries and the purchase of lands from William Randolph Hearst
Letter from J. R. Eakin to Stephen Mather
No full textLetter from J. R. Eaking to the National Park Service director about changes to the Grand Canyon National Park boundaries, and access to water near the Buggeln property on Desert View road
[Letter from J. R. Roberts to Sister, November 24, 1878]
No full textLetter from J. R. Roberts to sister. J. R. thanked his sister for gifts that were sent and went on to update her on what was happening in their families' lives. The letter ended with a mention that people were searching for land claims in the area and the author wanted their mother to not worry about them
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