Microsurgical Treatment for a Ruptured PICA Aneurysm. A 3-Dimensional Surgical Video and Anatomical Landmarks Review.

2021 ◽  
Author(s):  
José Ernesto Chang M. ◽  
Guilherme Salemi Riechelmann ◽  
Sebastián Aníbal Alejandro ◽  
Samantha Lorena Paganelli ◽  
Evelyn Judith Vela Rojas ◽  
...  
Keyword(s):  
Anatomical Landmarks ◽  
3 Dimensional ◽  
Microsurgical Treatment ◽  
Surgical Video

Microsurgery for Upper Basilar Tip Aneurysm With Intraoperative Rupture: 3-Dimensional Operative Video

2018 ◽  
Vol 16 (2) ◽  
pp. E43-E43 ◽  
Author(s):  
Oliver Soto Granados ◽  
Marcos Devanir Silva da Costa ◽  
Bruno Lourenço Costa ◽  
Kléber González-Echeverría ◽  
Samantha Lorena Paganelli ◽  
...  
Keyword(s):  
Young Patients ◽  
3 Dimensional ◽  
Microsurgical Treatment ◽  
Fluid Analysis ◽  
Interpeduncular Cistern ◽  
Orbitozygomatic Approach ◽  
Aneurysm Occlusion ◽  
Aneurysm Dissection ◽  
Intraoperative Rupture ◽  
Spontaneous Subarachnoid Hemorrhage

Abstract In the last years, a shift from the microsurgical treatment to an endovascular therapy in patients with basilar apex aneurysm has been settled, part of this phenomenon is related to the significant tendency of vital perforators to be involved in the aneurysm dissection and clipping, which can implicate unfavorable outcomes. Nevertheless, microsurgical treatment remains the treatment that can provide the superior rates of stable and durable aneurysm occlusion, which is most important to young patients. In this video, we present the case of a 45-yr-old female patient who complained of a sudden and severe headache and presented with progressive lethargy during the following 3 d. At admission, computed tomography did not show abnormal findings. However, cerebrospinal fluid analysis showed erythrocytes and corroborated the clinical suspicion of spontaneous subarachnoid hemorrhage. The patient signed the Institutional Consent Form, which allows the use of his/her images and videos for any type of medical publications in conferences and/or scientific articles. Angiography and magnetic resonance imaging revealed a saccular basilar apex aneurysm. It showed a wide neck as well as a lobulated dome with upward and slightly left projection. The aneurysm did not involve angiographically visible thalamoperforator arteries, which allowed the microsurgical treatment by the fronto-orbitozygomatic approach. However, during the interpeduncular cistern dissection, an intraoperative rupture of the aneurysm occurred. This video exemplifies the steps required to manage an intraoperative rupture of a basilar apex aneurysm.

Supracerebellar-Infratrochlear Approach for Midbrain Cavernoma: 3-Dimensional Operative Video

2019 ◽  
Vol 19 (2) ◽  
pp. E151-E151
Author(s):  
Alvaro Campero ◽  
Guillermo Román ◽  
Matías Baldoncini ◽  
Juan F Villalonga
Keyword(s):  
Brain Edema ◽  
Cavernous Malformation ◽  
3 Dimensional ◽  
Surgical Video

Abstract Gravity retraction is an underutilized adjunct in neurosurgery. Gravity is gentler than retractor blades; it does not cause brain edema or injury, and it tends to open natural subarachnoidal plans to deep lesions.1-3 A good example of this is the supracerebellar infratrochlear approach4-7 in semisitting position for resection to a midbrain cavernous malformation. This approach was selected because the cavernous malformation was 1 mm under the lateral mesencephalic sulcus. The procedure was developed with the use of transesophageal ultrasound and physiological neuromonitoring. We present a 3-dimensional video of this surgery with all the tricks and details used in the procedure. The patient consented to the procedure and to publication of the photos and surgical video.

Accuracy of 3-dimensional freehand ultrasound to estimate anatomical landmarks in children and adolescents with obesity

2021 ◽  
Vol 90 ◽  
pp. 232-233
Author(s):  
C. Schwab ◽  
S. Durstberger ◽  
H. Kainz ◽  
A. Baca ◽  
A. Thajer ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Anatomical Landmarks ◽  
3 Dimensional ◽  
Freehand Ultrasound

scholarly journals Relationship of Intraoperative Anatomical Landmarks, the Scapular Plane and the Perpendicular Plane with Glenoid for Central Guide Insertion during Shoulder Arthroplasty

2018 ◽  
Vol 21 (3) ◽  
pp. 113-119
Author(s):  
Jung Han Kim ◽  
Young Kyoung Min
Keyword(s):  
Average Distance ◽  
Case Series ◽  
Coracoid Process ◽  
Glenoid Component ◽  
Anatomical Landmarks ◽  
Ct Reconstruction ◽  
Level Of Evidence ◽  
3 Dimensional ◽  
Perpendicular Plane ◽  
Scapular Plane

BACKGROUND: This study was undertaken to evaluate the positional relationship between planes of the glenoid component (the scapular plane and the perpendicular plane to the glenoid) and its surrounding structures.METHODS: Computed tomography (CT) images of both shoulders of 100 patients were evaluated using the 3-dimensional CT reconstruction program (Aquarius®; TeraRecon). We determined the most lateral scapular bony structure of the scapular plane and measured the shortest distance between the anterolateral corner of the acromion and the scapular plane. The distance between the scapular plane and the midpoint of the line connecting the posterolateral corner of acromion and the anterior tip of the coracoid process (fulcrum axis) was also evaluated. The perpendicular plane was then adjusted to the glenoid and the same values were re-assessed.RESULTS: The acromion was the most lateral scapular structure of scapular plane and perpendicular plane to the glenoid. The average distance from the anterolateral corner of the acromion to the scapular plane was 10.44 ± 5.11 mm, and to the plane perpendicular to the glenoid was 9.55 ± 5.13 mm. The midpoint of fulcrum axis was positioned towards the acromion and was measured at 3.90 ± 3.21 mm from the scapular plane and at 3.84 ± 3.17 mm from the perpendicular plane to the glenoid.CONCLUSIONS: Our data indicates that the relationship between the perpendicular plane to the glenoid plane and its surrounding structures is reliable and can be used as guidelines during glenoid component insertion (level of evidence: Level IV, case series, treatment study).

scholarly journals Operative Anatomy of the Human Skull: A Virtual Reality Expedition

2018 ◽  
Vol 15 (4) ◽  
pp. 368-377 ◽  
Author(s):  
Benjamin K Hendricks ◽  
Akash J Patel ◽  
Jerome Hartman ◽  
Mark F Seifert ◽  
Aaron Cohen-Gadol
Keyword(s):  
Education Research ◽  
Computer Modelling ◽  
Careful Analysis ◽  
Anatomical Landmarks ◽  
Virtual Model ◽  
Valuable Resource ◽  
Human Skull ◽  
Anatomical Features ◽  
3 Dimensional ◽  
Intellectual Challenge

Abstract INTRODUCTION The human cranial vault possesses an incredible, complex anatomical intricacy. Bridging the divide between 2-dimensional (2D) learning resources and the 3-dimensional (3D) world in which the anatomy becomes clinically relevant poses an intellectual challenge. Advances in computer graphics and modelling technologies have allowed increasingly accurate and representative resources to supplement cadaveric dissection specimens. OBJECTIVE To create accurate virtual models of all cranial bones to augment education, research, and clinical endeavours. METHODS Through a careful analysis of osteological specimens and high-resolution radiographic studies, a highly accurate virtual model of the human skull was created and annotated with relevant anatomical landmarks. RESULTS The skull was divided into 6 major segments including frontal, ethmoid, sphenoid, temporal, parietal, and occipital bones. These bones were thoroughly annotated to demonstrate the intricate anatomical features. CONCLUSION This virtual model has the potential to serve as a valuable resource for educational, research, and clinical endeavours, and demonstrates the significance of advances in computer modelling that can contribute to our understanding of neurosurgical anatomical substrates.

Occlusal Angles of Equine Incisors

2017 ◽  
Vol 34 (4) ◽  
pp. 259-267 ◽  
Author(s):  
Laura Listmann ◽  
Patricia Schrock ◽  
Klaus Failing ◽  
Carsten Staszyk
Keyword(s):  
Transverse Plane ◽  
Data Sets ◽  
Anatomical Landmarks ◽  
3D Reconstructions ◽  
Mean Values ◽  
3 Dimensional ◽  
Lower Jaw ◽  
Ct Data ◽  
The Right ◽  
Lower Incisors

The angulation of equine incisors is frequently used as a parameter for dental corrections. However, the term incisor angle is only vaguely defined, and no studies exist presenting a series of reliable measurements in individual incisors of multiple horses. The aim of this study was to establish an exact method to determine incisor angles and to test whether clinically accessible landmarks (facial crest and bars) are suitable to estimate incisor angles. Eighteen horses were used to create 3-dimensional (3D) reconstructions of the skulls from computed tomography (CT) data sets. Reference planes (median and transverse plane) were calculated using defined anatomical landmarks. Subsequently, occlusal planes for incisors and for incisor quadrants were calculated. Occlusal table angles were measured in relation to the reference planes. For each incisor, sagittal and transverse angles were measured. Mean values of individual incisor angles ranged from 3.5° to 6.8° (transverse angle) and from 32.6° to 44.9° (sagittal angle). No significant differences were detected in mean between the left and the right side when teeth in same Triadan positions were compared. However, in individual horses, marked differences between the left and the right side of the jaws occurred. Mandibular incisors showed significantly steeper sagittal angles than maxillary incisors. Furthermore, angles of opposing incisors were correlated with each other. The facial crest and the upper jaw bars featured a curved shape and were therefore of limited use to estimate the angulation of the upper incisors. In contrast, the lower jaw bars were suitable to determine the angulations of lower incisors.

Microsurgical Treatment of Ruptured Spetzler-Martin Grade 3 Right Hippocampal Arteriovenous Malformation: 3-Dimensional Operative Video

2019 ◽  
Vol 18 (1) ◽  
pp. E17-E17
Author(s):  
Kléber González Echeverría ◽  
Marcos Devanir Silva da Costa ◽  
Bruno Lourenço Costa ◽  
Robert Zanabria Ortiz ◽  
Samantha Lorena Paganelli ◽  
...  
Keyword(s):  
Brain Mri ◽  
Venous Drainage ◽  
The Body ◽  
Temporal Region ◽  
3 Dimensional ◽  
Microsurgical Treatment ◽  
Generalized Seizures ◽  
History Of ◽  
Grade 3 ◽  
The Right

Abstract We present a 14-yr-old male with a history of traumatic brain injury in March 2016, secondary to clonic tonic generalized seizures. CT scan showed hemorrhage at mesial temporal region in the body of right hippocampus, intraventricular hemorrhage at the level of lateral ventricles (right and left side) and fourth ventricle. After this the patient presented with pulsating right temporal headache of high intensity (VAS 10/10) that improved with common analgesics, dizziness, and clonic tonic generalized seizures despite taking Phenobarbital 100 mg/24 h. Neuropsychological assessment reveal major deficits regarding executive functions: working memory, verbal fluency, and planning abilities. Brain MRI and angiography showed AVM at the right level of hippocampus body. An intranidal aneurysm was also observed. Venous drainage was through the basal vein of Rosenthal. We planned for surgery and resection of the hippocampal AVM through the trans-T2 approach. Postoperatively, the patient was without medical complications. We present a 3-dimensional video of the microsurgical treatment for right hippocampal AVM performed through a trans-T2 approach. The patient signed the Institutional Consent Form, which allows the use of his/her images and videos for any type of medical publications in conferences and/or scientific articles.

Determination of Stent Frame Displacement After Endovascular Aneurysm Sealing

2017 ◽  
Vol 25 (1) ◽  
pp. 52-61 ◽  
Author(s):  
Ruben van Veen ◽  
Kim van Noort ◽  
Richte C. L. Schuurmann ◽  
Jan Wille ◽  
Cornelis H. Slump ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Lateral Displacement ◽  
Intraclass Correlation ◽  
Ct Scans ◽  
Anatomical Landmarks ◽  
3 Dimensional ◽  
Type Ia ◽  
Conventional Ct

Purpose: To describe and validate a new methodology for visualizing and quantifying 3-dimensional (3D) displacement of the stent frames of the Nellix endosystem after endovascular aneurysm sealing (EVAS). Methods: The 3D positions of the stent frames were registered to 5 fixed anatomical landmarks on the post-EVAS computed tomography (CT) scans, facilitating comparison of the position and shape of the stent frames between consecutive follow-up scans. Displacement of the proximal and distal ends of the stent frames, the entire stent frame trajectories, as well as changes in distance between the stent frames were determined for 6 patients with >5-mm displacement and 6 patients with <5-mm displacement at 1-year follow-up. The measurements were performed by 2 independent observers; the intraclass correlation coefficient (ICC) was used to determine interobserver variability. Results: Three types of displacement were identified: displacement of the proximal and/or distal end of the stent frames, lateral displacement of one or both stent frames, and stent frame buckling. The ICC ranged from good (0.750) to excellent (0.958). No endoleak or migration was detected in the 12 patients on conventional CT angiography at 1 year. However, of the 6 patients with >5-mm displacement on the 1-year CT as determined by the new methodology, 2 went on to develop a type Ia endoleak in longer follow-up, and displacement progressed to >15 mm for 2 other patients. No endoleak or progressive displacement was appreciated for the patients with <5-mm displacement. Conclusion: The sac anchoring principle of the Nellix endosystem may result in several types of displacement that have not been observed during surveillance of regular endovascular aneurysm repairs. The presented methodology allows precise 3D determination of the Nellix endosystems and can detect subtle displacement better than standard CT angiography. Displacement >5 mm on the 1-year CT scans reconstructed with the new methodology may forecast impaired sealing and anchoring of the Nellix endosystem.

Microsurgical Treatment of Bowhunter's Syndrome: 3-Dimensional Operative Video

2018 ◽  
Vol 15 (6) ◽  
pp. E83-E83
Author(s):  
Vijay Agarwal ◽  
Daniel L Barrow
Keyword(s):  
3 Dimensional ◽  
Microsurgical Treatment
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