scholarly journals Posterior vault “free-floating” bone flap: indications, technique, advantages, and drawbacks

2021 ◽  
Author(s):  
Gianpiero Tamburrini ◽  
Martina Offi ◽  
Luca Massimi ◽  
Paolo Frassanito ◽  
Federico Bianchi
Keyword(s):  
Posterior Fossa ◽  
Surgical Management ◽  
Distraction Osteogenesis ◽  
Honeycomb Structure ◽  
Posterior Cranial Fossa ◽  
Bone Flap ◽  
Intracranial Volume ◽  
Review Of The Literature ◽  
Management Options ◽  
Cranial Fossa

Abstract Background The enlargement of the posterior cranial fossa volume is considered one of the main steps of the surgical management of children with multiple sutures craniosynostosis. Different management options have been proposed including fixed expansive craniotomy, free bone flap craniotomy, and distraction osteogenesis. Objectives To review indications to “free bone flap” craniotomy for the posterior fossa expansion, detailing advantages, disadvantages, and complications related to the technique. Results and conclusions A review of the literature shows that “free bone flap” posterior expansion cranioplasty still has a role, particularly in infants with thin and “honeycomb” structure of the bone, allowing to gain adequate intracranial volume increases and to postpone to a more adequate time surgery aimed at anterior cranial fossa expansion.

Complete posterior cranial vault distraction osteogenesis to correct Chiari malformation type I associated with craniosynostosis

2021 ◽  
pp. 1-7
Keyword(s):  
Foramen Magnum ◽  
Posterior Cranial Fossa ◽  
Type I ◽  
Intracranial Volume ◽  
Tonsillar Herniation ◽  
Chiari Malformation Type I ◽  
Cerebellar Tonsillar Herniation ◽  
Cranial Fossa ◽  
The Mean ◽  
Tonsillar Descent

OBJECTIVE Posterior vault distraction osteogenesis (PVDO) is an effective tool to increase intracranial volume and expand the posterior cranial fossa. During PVDO, the authors extended osteotomy posterior to the foramen magnum to fully expand the posterior cranial fossa. The aim of this study was to investigate the efficacy of complete PVDO in posterior fossa expansion and treatment of Chiari malformation type I (CM-I) in patients with craniosynostosis. METHODS Patients with craniosynostosis who had undergone complete PVDO between January 2012 and May 2020 were reviewed retrospectively. A coronal osteotomy extending to the foramen magnum was performed and the foramen magnum was decompressed by removing its posterior rim with a 1-mm Kerrison rongeur. Four distractor devices were placed and the vector of distraction was controlled from the posterior to the inferior-posterior direction, depending on the deformity. Changes in the intracranial volume, posterior cranial fossa area, and cerebellar tonsillar descent were measured after complete PVDO by using CT and MRI. RESULTS A total of 11 patients with craniosynostosis and concurrent CM-I were included in the study. The mean age was 34.6 ± 24.0 months (continuous variables are expressed as the mean ± SD throughout). One patient had sleep apnea, which was consistent with CM-I, and another patient had a headache, which was nonspecific. The intracranial volume increased from 1179.6 ± 180.2 cm3 to 1440.6 ± 251.5 cm3 (p = 0.003; 24.5% increase compared to the preoperative volume). The posterior skull base area increased from 44.9 ± 19.3 cm2 to 72.7 ± 18.1 cm2 (p = 0.004). Cerebellar tonsillar descent decreased in all 11 patients after complete PVDO (preoperative: 10.8 ± 3.7 mm, postoperative: 2.7 ± 3.0 mm; p = 0.003). Among the 11 patients, 5 showed complete resolution of cerebellar tonsillar herniation. CONCLUSIONS Complete PVDO can more efficiently expand the posterior cranial fossa, unlike conventional methods. Moreover, it helps to relieve cerebellar tonsillar herniation. Complete PVDO is a powerful tool to increase the intracranial and posterior fossa volumes in patients with craniosynostosis and concurrent CM-I.

scholarly journals A Giant Solitary Solid Hemangioblastoma: A Case Report and Review of The Literature

2017 ◽  
Vol 14 (2) ◽  
pp. 47-50
Author(s):  
Rajeev Bhandari ◽  
Gopal R Sharma ◽  
Prakash Bista ◽  
Rajiv Jha ◽  
Rajendra Shrestha ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Case Report ◽  
Vascular Tumor ◽  
Posterior Cranial Fossa ◽  
Magnetic Resonance Imaging Scan ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Cranial Fossa ◽  
Resonance Imaging Scan

We present a case of solitary vascular tumor on posterior cranial fossa in a 15-year-old female who had a complaint of headache on/off for six months with associated dizziness, nausea, vomiting and vertigo. Well circumscribed solid vascular mass was localized on posterior fossa by computed tomography along with magnetic resonance imaging scan. Furthermore, the diagnosis was confirmed by surgical findings and histological examinations.Nepal Journal of Neuroscience, Vol. 14, No. 2,  2017 Page: 47-50 

scholarly journals PHACE Syndrome: Persistent Fetal Vascular Anomalies

2005 ◽  
Vol 11 (4) ◽  
pp. 355-361 ◽  
Author(s):  
V. Prochazka ◽  
T. Hrbac ◽  
J. Chmelova ◽  
D. Skoloudik ◽  
M. Prochazka
Keyword(s):  
Posterior Fossa ◽  
Posterior Cranial Fossa ◽  
Vascular Anomalies ◽  
Cardiac Defects ◽  
Phace Syndrome ◽  
Cranial Fossa ◽  
Arterial Anomalies

PHACE(S) syndrome is an acronym for neurocutaneous disease encompassing the expression of (P) posterior cranial fossa malformations, (H) facial haemangiomas, (A) arterial anomalies, (C) aortic coarctaion and other cardiac defects, (E) eye abnormalities and (S) for sternal malformation or stenotic arterial diseases. We report on a case of PHACE syndrome complete expression with persistent fetal vascular anomalies unusually in a 55-year-old women with large bilateral facial and neck haemangioma and posterior fossa circulation insufficiency.

scholarly journals Inion Not a Reliable Landmark of the Torcula in Posterior Fossa Craniotomies

2020 ◽  
Vol 17 (3) ◽  
pp. 103-105
Author(s):  
Elisha Harry Otieno ◽  
Philip Mwachaka ◽  
Paul Odula ◽  
Isaac Cheruiyot ◽  
Jeremiah Munguti
Keyword(s):  
Posterior Fossa ◽  
Posterior Cranial Fossa ◽  
Burr Hole ◽  
Surgical Approaches ◽  
Iatrogenic Injuries ◽  
Cranial Fossa

Background: Sub-occipital craniotomies are used in surgical approaches into the posterior cranial fossa. The inion is used as an extracranial landmark of the torcula in burr hole placement. However, inadvertent damage to the torcula and the related sinuses due to variant intracranial location of the torcula has been reported. This study aimed at determining the position of the torcula in relation to the inion. Method: 40 adult open skulls were obtained and the positional relationship between the inion and the torcula assessed. Results: The torcula was at the same level with the inion in half of the cases (50%), below it in 12 cases (30%), and above in 8 cases (20%). The position above the inion ranged from 0.38 to 2.40 cm and below it from 0.75 to 2.45 cm. Conclusion: The torcula lies either at the level of the inion in only half of the cases. The surgeon should augment this physical landmark with radiographs to avoid iatrogenic injuries. Keywords: Inion, Posterior fossa, Craniotomies

Patterns for Differentiation of Posterior Fossa Neoplasms as Detected by Brain Scans

1970 ◽  
Vol 09 (04) ◽  
pp. 303-316
Author(s):  
Frank DeLand ◽  
A. EveretteJames ◽  
Henry Wagner
Keyword(s):  
Skull Base ◽  
Posterior Fossa ◽  
Cerebellopontine Angle ◽  
Lateral View ◽  
Posterior Cranial Fossa ◽  
Anatomical Location ◽  
Posterior View ◽  
Brain Scans ◽  
Histological Characteristics ◽  
Cranial Fossa

SummaryThe histological characteristics of neoplasms that occur in the posterior cranial fossa can often be predicted by a knowledge of the patient’s age and the specific anatomical location of the tumor. Dividing the posterior fossa into midline, cerebellar fossa and cerebellopontine angle provides a scheme to characterize abnormal accumulations of radioactivity according to their anatomical locations. Midline lesions arise from bases activity on the lateral view and are in the midline on the posterior view. Lesions of the cerebellar fossa may be adjacent to but do not appear to arise from the basal structures and are not in the midline. Cerebellopontine angle tumors are adjacent to and appear to arise from the normal radioactivity at the skull base but lie lateral to the midline. The expected distribution of histological types of neoplasms in each area according to age are discussed.

Dermoid cysts of the posterior cranial fossa in children. Report of nine cases and review of the literature

1990 ◽  
Vol 34 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Pierpaolo Lunardi ◽  
Paolo Missori ◽  
Franco Maria Gagliardi ◽  
Aldo Fortuna
Keyword(s):  
Posterior Cranial Fossa ◽  
Review Of The Literature ◽  
Cranial Fossa

scholarly journals Bilateral Severely Stenotic Jugular Foramen: Diagnosis and Management from the Otologist/Neurotologist Point of View

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Raquel Acinho Bento ◽  
David Rodrigues ◽  
João Levy ◽  
Tiago Eça ◽  
Vitor Oliveira ◽  
...  
Keyword(s):  
Jugular Foramen ◽  
Jugular Bulb ◽  
Posterior Cranial Fossa ◽  
Point Of View ◽  
Review Of The Literature ◽  
Venous Anastomosis ◽  
Diagnosis And Management ◽  
Anatomical Abnormality ◽  
Cranial Fossa

Bilateral jugular foramen stenosis with jugular bulb and vein aplasia is rare in nonsyndromic craniosynostosis and usually diagnosed during childhood. We present a case of bilateral jugular foramen stenosis with jugular bulb and vein aplasia, with subsequent persistence and enlargement of the fetal venous anastomosis in the middle and posterior cranial fossa, along with a review of the literature about this anatomical abnormality, highlighting the surgical challenges and management from the otologist/neurotologist point of view.

Volumetric analysis of the posterior cranial fossa in a family with four generations of the Chiari malformation Type I

2008 ◽  
Vol 1 (1) ◽  
pp. 21-24 ◽  
Author(s):  
R. Shane Tubbs ◽  
Mark Hill ◽  
Marios Loukas ◽  
Mohammadali M. Shoja ◽  
W. Jerry Oakes
Keyword(s):  
Posterior Fossa ◽  
Chiari Malformation ◽  
Familial Aggregation ◽  
Volumetric Analysis ◽  
Posterior Cranial Fossa ◽  
Preoperative Imaging ◽  
Type I ◽  
Chiari Malformation Type I ◽  
Hindbrain Herniation ◽  
Cranial Fossa

Object Many authors have concluded that the Chiari malformation Type I (CM-I) is due to a smaller than normal posterior cranial fossa. In order to establish this smaller geometry as the cause of hindbrain herniation in a family, the authors of this paper performed volumetric analysis in a family found to have this malformation documented in 4 generations. Methods Members from this family found to have a CM-I by imaging underwent volumetric analysis of their posterior cranial fossa using the Cavalieri method. Results No member of this family found to have CM-I on preoperative imaging had a posterior fossa that was significantly smaller than that of age-matched controls. Conclusions The results of this study demonstrate that not all patients with a CM-I will have a reduced posterior cranial fossa volume. Although the mechanism for the development of hindbrain herniation in this cohort is unknown, this manifestation can be seen in multiple generations of a familial aggregation with normal posterior fossa capacity.

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