scholarly journals Endoscopic posterior interhemispheric complete corpus callosotomy

2016 ◽  
Vol 18 (6) ◽  
pp. 689-692 ◽  
Author(s):  
Sandeep Sood ◽  
Eishi Asano ◽  
Deniz Altinok ◽  
Aimee Luat
Keyword(s):  
Corpus Callosum ◽  
Coronal Suture ◽  
Corpus Callosotomy ◽  
Interhemispheric Approach ◽  
Interhemispheric Fissure

Traditionally corpus callosotomy is done through a craniotomy centered at the coronal suture, with the aid of a microscope. This involves dissecting through the interhemispheric fissure below the falx to reach the corpus callosum. The authors describe a posterior interhemispheric approach to complete corpus callosotomy with an endoscope, which bypasses the need to perform interhemispheric dissection because the falx is generally close to the corpus callosum in this region.

scholarly journals Posterior callosotomy using a parietooccipital interhemispheric approach in the semi-prone park-bench position

2015 ◽  
Vol 123 (5) ◽  
pp. 1322-1325 ◽  
Author(s):  
Hirotaka Ito ◽  
Michiharu Morino ◽  
Manabu Niimura ◽  
Sachiko Takamizawa ◽  
Yoshie Shimizu
Keyword(s):  
Surgical Technique ◽  
Corpus Callosum ◽  
Lower Risk ◽  
Skin Incision ◽  
Corpus Callosotomy ◽  
Disconnection Syndrome ◽  
Palliative Procedure ◽  
Interhemispheric Approach ◽  
Second Surgery ◽  
Generalized Epilepsy

A 2-stage corpus callosotomy is accepted as a palliative procedure for patients older than 16 years with, in particular, medically intractable generalized epilepsy and drop attack seizures and is preferable for a lower risk of disconnection syndrome. Although the methods by which a previously performed craniotomy can be reopened for posterior callosotomy have already been reported, posterior corpus callosotomy using a parietooccipital interhemispheric approach with the patient in a semi-prone park-bench position has not been described in the literature. Here, the authors present a surgical technique for posterior callosotomy using a parietooccipital interhemispheric approach with a semi-prone park-bench position as a second surgery. Although this procedure requires an additional skin incision in the parietooccipital region, it makes the 2-stage callosotomy safer and easier to perform because of reduced intracranial adhesion, less bleeding, and an easier approach to the splenium of the corpus callosum.

Interhemispheric approach with callosal resection for distal anterior cerebral artery aneurysms

1992 ◽  
Vol 77 (3) ◽  
pp. 481-483 ◽  
Author(s):  
Vincent C. Traynelis ◽  
Ralph O. Dunker
Keyword(s):  
Corpus Callosum ◽  
Cerebral Artery ◽  
Early Identification ◽  
Anterior Cerebral Artery ◽  
Feeding Artery ◽  
Content Type ◽  
Interhemispheric Approach ◽  
Interhemispheric Fissure ◽  
Distal Anterior Cerebral Artery ◽  
Fine Print

✓ Distal anterior cerebral artery aneurysms are commonly found near the genu of the corpus callosum. While these aneurysms may be surgically obliterated through a variety of approaches, exposure via the interhemispheric fissure is used by many surgeons. Early identification of the afferent artery may be difficult with this approach, however, particularly if the aneurysm lies just beneath the genu of the corpus callosum. The authors have modified the interhemispheric approach to distal anterior cerebral artery aneurysms by electively exposing the feeding artery through a small anterior callosotomy. While this maneuver is not necessary for all distal anterior cerebral artery aneurysms, it can greatly enhance exposure in the region just below the genu of the corpus callosum. Experience with this technique in five patients is reported. In all cases, the limited anterior callosotomy enhanced surgical exposure. No morbidity could be attributed to the callosotomy in any patient. It is concluded that, when the interhemispheric approach is used, anterior callosotomy improves exposure of the region just below the genu of the corpus callosum and may be a useful maneuver when treating distal anterior cerebral artery aneurysms.

Intraoperative Determination of the Extent of Corpus Callosotomy for Epilepsy: Two Simple Techniques

Neurosurgery ◽  
1990 ◽  
Vol 26 (1) ◽  
pp. 102-106 ◽  
Author(s):  
Issam A. Awad ◽  
Elaine Wyllie ◽  
Hans Luders ◽  
Jennifer Ahl
Keyword(s):  
Corpus Callosum ◽  
Precise Determination ◽  
Planar Geometry ◽  
Corpus Callosotomy ◽  
Midsagittal Plane ◽  
Anatomic Landmarks ◽  
Mri Scan ◽  
Simple Modification ◽  
X Ray

Abstract There is increasing interest in staged corpus callosotomy for intractable generalized epilepsy. At the first procedure, a portion (usually the anterior two-thirds) of the corpus callosum is sectioned. If seizures persist, completion of callosotomy or alternative treatment approaches can be considered. It is obviously important to ascertain that the desired extent of callosotomy was in fact accomplished at the time of initial operation. Our experience and the published literature indicate that the surgeon's impression at operation can be erroneous. We describe a technique of determining extent of corpus callosotomy during the procedure. The magnetic resonance imaging (MRI) scan in the midsagittal plane is used to select the desired extent of callosotomy. That point on the corpus callosum is characterized using simple planar geometry in relation to three anatomic landmarks in that same plane: the glabella, the inion, and the bregma (midline intersection of the coronal suture). The same point along the corpus callosum can then be located on a lateral skull xray using these same three anatomic landmarks. At surgery, an intraoperative lateral skull x-ray is obtained with a marking clip, thereby verifying the actual extent of callosotomy. We have verified the reliability of this scheme in 5 callosotomy procedures and have used this technique for intraoperative localization of midline and parasagittal targets in another 7 cases (3 tumors, 2 aneurysms, and 2 placements of interhemispheric subdural grids). In addition, we reviewed corpus callosum topography on 25 randomly selected MRI scans. A perpendicular line bisecting the glabellainion line intersects the corpus callosum at a point near its two-thirds extent in every case. This allows a quick determination of the approximate two-thirds point along the corpus callosum by skull x-ray alone, without the need of an MRI scan. The use of the new technique and its simple modification for the two-thirds callosotomy allows a precise determination of the extent of corpus callosum section at surgery and should avoid unintended deviations from the desired procedure. (Neurosurgery 26:102-106, 1990)

Interhemispheric approach for the surgical removal of thalamocaudate arteriovenous malformations

1987 ◽  
Vol 66 (3) ◽  
pp. 345-351 ◽  
Author(s):  
Robert A. Solomon ◽  
Bennett M. Stein
Keyword(s):  
Corpus Callosum ◽  
Arteriovenous Malformations ◽  
Surgical Removal ◽  
Cerebral Arteriovenous Malformations ◽  
Total Removal ◽  
Recurrent Hemorrhage ◽  
Content Type ◽  
Interhemispheric Approach ◽  
Parinaud’S Syndrome ◽  
Fine Print

✓ A series of 250 surgically treated cerebral arteriovenous malformations (AVM's) is presented, in which 22 lesions were located primarily in the thalamus and caudate nucleus. A standardized interhemispheric approach through the posterior corpus callosum and into the atrium of the lateral ventricle was utilized for the surgical removal of these AVM's. Total removal was confirmed by angiography in 18 patients; removal was subtotal in four cases. There were no deaths in this group of patients. Disturbances of recent memory pre- and postoperatively were seen in half of the patients, but most of these deficits were temporary. Other complications included: postoperative homonymous hemianopsia (six cases), transient hemiparesis (three cases), hemisensory loss (two cases), Parinaud's syndrome (one case), and recurrent hemorrhage 2 years after surgery (one case). All 22 patients returned to their previous occupations and are leading independent lives. The results of this experience indicate that thalamocaudate AVM's can be effectively treated by resection.

scholarly journals Preservation of electrophysiological functional connectivity after partial corpus callosotomy: case report

2018 ◽  
Vol 22 (2) ◽  
pp. 214-219 ◽  
Author(s):  
Kaitlyn Casimo ◽  
Fabio Grassia ◽  
Sandra L. Poliachik ◽  
Edward Novotny ◽  
Andrew Poliakov ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Corpus Callosum ◽  
Seizure Activity ◽  
Diffusion Tensor ◽  
Phase Locking ◽  
Corpus Callosotomy ◽  
Left And Right ◽  
Phase Locking Value ◽  
Anatomical Mri ◽  
Electrophysiological Methods

Prior studies of functional connectivity following callosotomy have disagreed in the observed effects on interhemispheric functional connectivity. These connectivity studies, in multiple electrophysiological methods and functional MRI, have found conflicting reductions in connectivity or patterns resembling typical individuals. The authors examined a case of partial anterior corpus callosum connection, where pairs of bilateral electrocorticographic electrodes had been placed over homologous regions in the left and right hemispheres. They sorted electrode pairs by whether their direct corpus callosum connection had been disconnected or preserved using diffusion tensor imaging and native anatomical MRI, and they estimated functional connectivity between pairs of electrodes over homologous regions using phase-locking value. They found no significant differences in any frequency band between pairs of electrodes that had their corpus callosum connection disconnected and those that had an intact connection. The authors’ results may imply that the corpus callosum is not an obligatory mediator of connectivity between homologous sites in opposite hemispheres. This interhemispheric synchronization may also be linked to disruption of seizure activity.

Bifrontal interhemispheric approach to aneurysms of the anterior communicating artery

1986 ◽  
Vol 64 (2) ◽  
pp. 183-190 ◽  
Author(s):  
Jiro Suzuki ◽  
Kazuo Mizoi ◽  
Takashi Yoshimoto
Keyword(s):  
Cerebral Arteries ◽  
Distal Portion ◽  
Anterior Communicating Artery ◽  
Content Type ◽  
Interhemispheric Approach ◽  
Interhemispheric Fissure ◽  
Early Operations ◽  
Temporary Clip ◽  
Fine Print

✓ The authors review their experience with the bifrontal interhemispheric approach in 603 cases of single anterior communicating artery (ACoA) aneurysms and describe the operative technique. With this approach, the olfactory tracts are dissected, and both A1 segments of the anterior cerebral arteries are identified subfrontally. The interhemispheric fissure is then dissected and A2segments are followed from the distal portion toward the ACoA complex. Following the administration of a combination of mannitol, vitamin E, and dexamethasone, a temporary clip is placed on at least the dominant A1 segment prior to dissection of the aneurysm itself. Once the aneurysm has been completely freed from the surrounding structures, the neck is ligated and clipped. If the aneurysm ruptures during surgery, temporary clips are placed on both A1 and A2 segments bilaterally and the operation proceeds in a completely dry field. With this method, it is possible to occlude any of the intracranial vessels for up to 40 minutes within 100 minutes of drug administration. To prevent the possibility of rerupture and the development of vasospasm in the period before aneurysm surgery, the authors have adopted a policy of performing ultra-early operations within 48 hours of the onset of symptoms. Among the 257 cases operated on during the 9 years since 1975, one-fifth have been operated on within 48 hours of rupture, and the in-hospital mortality rate has been only 4.3% (11 cases). Follow-up studies have shown that 87% of the 246 surviving patients have returned to useful lives.

scholarly journals DRAXIN regulates interhemispheric fissure remodelling to influence the extent of corpus callosum formation

eLife ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Laura Morcom ◽  
Timothy J Edwards ◽  
Eric Rider ◽  
Dorothy Jones-Davis ◽  
Jonathan WC Lim ◽  
...  
Keyword(s):  
Corpus Callosum ◽  
Base Pair ◽  
Congenital Disorder ◽  
Mouse Strains ◽  
Btbr Mouse ◽  
Structural Correlate ◽  
Base Pair Deletion ◽  
Cellular Factors ◽  
Interhemispheric Fissure ◽  
Genetic Events

Corpus callosum dysgenesis (CCD) is a congenital disorder that incorporates either partial or complete absence of the largest cerebral commissure. Remodelling of the interhemispheric fissure (IHF) provides a substrate for callosal axons to cross between hemispheres, and its failure is the main cause of complete CCD. However, it is unclear whether defects in this process could give rise to the heterogeneity of expressivity and phenotypes seen in human cases of CCD. We identify incomplete IHF remodelling as the key structural correlate for the range of callosal abnormalities in inbred and outcrossed BTBR mouse strains, as well as in humans with partial CCD. We identify an eight base-pair deletion in Draxin and misregulated astroglial and leptomeningeal proliferation as genetic and cellular factors for variable IHF remodelling and CCD in BTBR strains. These findings support a model where genetic events determine corpus callosum structure by influencing leptomeningeal-astroglial interactions at the IHF.

scholarly journals Mapping and anatomo-surgical techniques for SMA-cingulum-corpus callosum gliomas; how I do it

2021 ◽  
Author(s):  
Dimitris Klitsinikos ◽  
Justyna O. Ekert ◽  
Annefloor Carels ◽  
George Samandouras
Keyword(s):  
Corpus Callosum ◽  
Vascular Injury ◽  
Brain Mapping ◽  
Cognitive Functions ◽  
Early Identification ◽  
Surgical Techniques ◽  
Interhemispheric Approach ◽  
Full Protection

Abstract Background Awake brain mapping paradigms are variable, particularly in SMA, and not personalised to each patient. In addition, subpial resections do not offer full protection to vascular injury, as the pia can be easily violated. Methods Mapping paradigms developed by a multidisciplinary brain mapping team. During resection, a combined subpial/interhemispheric approach allowed early identification and arterial skeletonization. Precise anatomo-surgical dissection of the affected cingulum and corpus callosum was achieved. Conclusions In SMA-cingulum-CC tumours, a combined subpial/interhemispheric approach reduces risk of vascular injury allowing precise anatomo-surgical dissections. Knowledge of cognitive functions of affected parcels is likely to offer best outcomes.

scholarly journals Training for Interhemispheric Fissure Dissection in Basal Interhemispheric Approach: Patterns of Pial Injury by Resident Procedure and Methods of Avoiding Pial Injury

2008 ◽  
Vol 36 (5) ◽  
pp. 367-372 ◽  
Author(s):  
Junta MOROI ◽  
Hiromu HADEISHI ◽  
Tatsuya ISHIKAWA ◽  
Motoshi SAWADA ◽  
Akifumi SUZUKI ◽  
...  
Keyword(s):  
Interhemispheric Approach ◽  
Interhemispheric Fissure

scholarly journals Altered integrity of corpus callosum in generalized epilepsy in relation to seizure lateralization after corpus callosotomy

2020 ◽  
Vol 48 (4) ◽  
pp. E15 ◽  
Author(s):  
Po Ching Chen ◽  
Steven A. Messina ◽  
Eduardo Castillo ◽  
James Baumgartner ◽  
Joo Hee Seo ◽  
...  
Keyword(s):  
Corpus Callosum ◽  
Structural Damage ◽  
Structural Integrity ◽  
Diffusion Tensor ◽  
Case Series ◽  
Structural Difference ◽  
The Body ◽  
Corpus Callosotomy ◽  
Major Pathway ◽  
Generalized Epilepsy

OBJECTIVEGeneralized-onset seizures are usually conceptualized as engaging bilaterally distributed networks with no clear focus. However, the authors previously reported a case series demonstrating that in some patients with generalized-onset seizures, focal seizure onset could be discovered after corpus callosotomy. The corpus callosum is considered to be a major pathway for seizure generalization in this group of patients. The authors hypothesized that, in patients with generalized-onset seizures, the structure of the corpus callosum could be different between patients who have lateralized seizures and those who have nonlateralized seizures after corpus callosotomy. The authors aimed to evaluate the structural difference through statistical analysis of diffusion tensor imaging (DTI) scalars between these two groups of patients.METHODSThirty-two patients diagnosed with generalized-onset motor seizures and without an MRI lesion were included in this study. Among them, 16 patients developed lateralized epileptic activities after corpus callosotomy, and the remaining 16 patients continued to have nonlateralized seizures after corpus callosotomy. Presurgical DTI studies were acquired to quantify the structural integrity of the corpus callosum.RESULTSThe DTI analysis showed significant reduction of fractional anisotropy (FA) and increase in radial diffusivity (RD) in the body of the corpus callosum in the lateralized group compared with the nonlateralized group.CONCLUSIONSThe authors’ findings indicate the existence of different configurations of bilateral epileptic networks in generalized epilepsy. Generalized seizures with focal onset relying on rapid spread through the corpus callosum might cause more structural damage related to demyelination in the corpus callosum, showing reduced FA and increased RD. This study suggests that presurgical DTI analysis of the corpus callosum might predict the seizure lateralization after corpus callosotomy.

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