The So-Called Cranial Dural Channels and Their Relationship with the Bridging Veins

Author(s):  
Gerasimos Baltsavias ◽  
Vincenzo Paterno ◽  
Heinrich Lanfermann
Keyword(s):  

Neurosurgery ◽  
1989 ◽  
Vol 25 (6) ◽  
pp. 942-947 ◽  
Author(s):  
W. Hassler ◽  
J. Zentner

Abstract We present our experience with the surgical treatment of olfactory groove meningiomas using a pterional approach. This approach provides the advantages of previous techniques, such as preserving the frontal brain and superior sagittal sinus, early devascularization of the tumor, and late dissection of tumor borders. Moreover, it also compensates for the shortcomings of other techniques, e.g., compression of frontal bridging veins, late dissection of dorsal tumor aspects involving vessels and optic nerves as well as facultative infection and cerebrospinal fluid fistula-related complications caused by opening of frontal sinuses. To date, 11 patients were treated in this way. As we encountered no surgical complications in our series we are encouraged to present our procedure.





Author(s):  
José M.C. Costa ◽  
Fábio A.O. Fernandes ◽  
Ricardo J. Alves de Sousa


2005 ◽  
Vol 102 (6) ◽  
pp. 1130-1132 ◽  
Author(s):  
Alessio Albanese ◽  
Antonio Tuttolomondo ◽  
Carmelo Anile ◽  
Giovanni Sabatino ◽  
Angelo Pompucci ◽  
...  

✓ Chronic subdural hematomas (SDHs) generally occur in elderly patients. Its pathogenesis is usually related to head trauma with tearing and rupture of the bridging veins, although in some cases a history of trauma is not recognizable. There are many reports regarding the association between spontaneous chronic SDHs and an alteration in coagulative parameters. A coagulative disorder should be suspected when an unexplained hemorrhage occurs, especially in a young patient. The authors report on three young men with a deficiency in coagulation factor XIII (FXIII) who underwent surgery for chronic SDHs. The role of FXIII in the pathogenesis of chronic SDH is emphasized. In patients with unexplained chronic SDH all coagulation parameters and factors should be screened to identify an eventual coagulative disorder.



2011 ◽  
Vol 113 (10) ◽  
pp. 889-894 ◽  
Author(s):  
Shi-Xin Gu ◽  
De-Lin Yang ◽  
Da-Ming Cui ◽  
Qi-Wu Xu ◽  
Xiao-ming Che ◽  
...  


Author(s):  
Helmut Maxeiner ◽  
Claudia Spies ◽  
B. Irnich ◽  
Mario Brock


2011 ◽  
Vol 7 (3) ◽  
pp. 224-228 ◽  
Author(s):  
Sean A. McNatt ◽  
Ivan J. Sosa ◽  
Mark D. Krieger ◽  
J. Gordon McComb

Object The interhemispheric transcallosal approach offers an excellent surgical corridor for the treatment of deep-seated midline lesions. The approach typically requires the sacrifice of one or more middle-third superior sagittal sinus (SSS) cortical bridging veins, which introduces the risk of venous infarction and associated neurological injury. The authors studied the incidence of venous infarcts following this operative approach in a pediatric population. Methods The authors performed a retrospective review of surgical cases involving pediatric patients treated at the Children's Hospital Los Angeles between 1990 and 2007, in which an interhemispheric transcallosal operative procedure was performed and one or more middle-third SSS cortical bridging veins were occluded. Postoperative MR imaging studies done 1–3 days following the procedure were analyzed and compared with preoperative studies. Results Sixty-three patients met the inclusion criteria. No patient developed MR imaging evidence of venous infarction. Conclusions The occlusion of one or more middle-third SSS cortical bridging veins related to the interhemispheric transcallosal approach resulted in no incidence of cerebral venous infarction in this pediatric population.



2012 ◽  
Vol 116 (3) ◽  
pp. 566-573 ◽  
Author(s):  
Mari Kusumi ◽  
Takanori Fukushima ◽  
Ankit I. Mehta ◽  
Hamidreza Aliabadi ◽  
Yoichi Nonaka ◽  
...  

Object The combined petrosal approach is a suitable technique for the resection of medium-to-large petroclival meningiomas (PCMs). Multiple technical modifications have been reported to increase the surgical corridor, including the method of dural and tentorial opening. The authors describe their method of dural opening and tentorial resection, and detail the microanatomy related to their technique to clarify pitfalls and effects. Methods The relationship of temporal bridging veins and cranial nerves (CNs) around the tentorial resection area was examined during the combined petrosal approach in 20 cadaveric specimens. The authors also reviewed their 23 consecutive clinical cases treated using this technique between 2002 and 2010, focusing on the effects and risks of the procedure. Results In the authors' method, the tentorial resection extends from 5 to 10 mm anterior to the junction of the sigmoid sinus and the superior petrosal sinus (“sinodural point”) to the trigeminal fibrous ring and the dural sleeve of CN IV. Temporal bridging veins enter the transverse sinus no more than 5 mm anterior to the sinodural point. The CN IV should be freed from its tentorial dural sleeve while avoiding disruption of the posterior cavernous sinus. The clinical data demonstrate a total resection rate of 78.3%, intraoperative estimated blood loss < 400 ml at a rate of 80.9%, and a venous congestion rate of 0%. Conclusions Understanding the anatomical relationship between the tentorium and temporal bridging veins and CNs IV–VI allows neurosurgeons the ability to develop a combined petrosal approach to PCMs that will effectively supply a wide operative corridor after resecting the tentorium, while significantly devascularizing tumors.



1971 ◽  
Vol 34 (1) ◽  
pp. 70-76 ◽  
Author(s):  
Joseph Ransohoff ◽  
M. Vallo Benjamin ◽  
E. Lyle Gage ◽  
Fred Epstein

✓ Acute subdural hematomas requiring surgical drainage as a life-saving procedure shortly after injury have been associated with mortality rates as high as 90%. Important factors include early diagnosis, complete clot removal, control of active bleeding, and provision for control of subsequent cerebral edema. In a series of 35 patients who had large, unilateral acute subdural hematomas and were unconscious and decerebrate, the mortality rate was reduced to 60%, and 28% returned to normal activity, through the use of a radical procedure. Following establishment of airway and intravenous Mannitol, emergency angiography was carried out to demonstrate the exact intracranial pathology. A hemicranial bone flap was utilized to aid in clot removal and control of hemorrhage from bridging veins and/or cerebral lacerations. The bone flaps were discarded and the dura not closed to afford postoperative decompression. Plating of the skull defects was carried out at a later date when indicated.





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