Objective Evaluation of Sylvian Fissure Development by Multiplanar 3-Dimensional Ultrasonography

Abstract Cavernous malformations (CM) of the anterior midbrain are best reached through an orbitozygomatic (OZ) approach with removal of the orbital rim and wide Sylvian fissure dissection. Our surgical video demonstrates this approach to resect a ruptured CM in a 36-yr-old woman who presented with headaches, left face and left arm paresthesias/weakness, and right-sided partial oculomotor nerve (CN III) palsy. Initial magnetic resonance imaging (MRI) showed a midbrain CM, and the patient was managed conservatively. However, 1 wk later, she presented again with worsened left arm and leg weakness and complete CN III palsy. Seven Tesla MRI demonstrated a larger hematoma, and the CM with new mass effect and upper pons extension. The patient underwent a right modified OZ craniotomy and Sylvian fissure split under guidance of intraoperative neuronavigation and with neuromonitoring. The carotid-oculomotor triangle and the Liliequist membrane were dissected to access the midbrain, and CN III was identified and followed posteriorly to the midbrain. Confirmed with neuronavigation, a longitudinal incision of the midbrain was performed, and the CM was encountered. The hematoma and CM were debulked and removed in a piece-meal fashion, leaving hemosiderin-stained brain intact to prevent unnecessary additional damage to the midbrain. Postoperative MRI confirmed gross-total resection, and the patient's weakness recovered substantially. In this video, we demonstrate that the brainstem is no longer forbidden surgical territory, and show how the use of neuronavigation for surgical planning, positioning, and approach, in addition to the understanding of safe entry zones and meticulous microsurgical technique have made safe and effective surgery on the brainstem possible.

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An Objective Evaluation of Breast Symmetry and Shape Differences Using 3-Dimensional Images

Annals of Plastic Surgery ◽

10.1097/01.sap.0000185459.49434.5f ◽

2005 ◽

Vol 55 (6) ◽

pp. 571-575 ◽

Cited By ~ 75

Author(s):

Albert Losken ◽

Inessa Fishman ◽

Donald D. Denson ◽

Hunter R. Moyer ◽

Grant W. Carlson

Keyword(s):

Objective Evaluation ◽

3 Dimensional ◽

Breast Symmetry

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Measuring the perimeter and area of the Sylvian fissure in fetal brain during normal pregnancies using 3-dimensional ultrasound

Prenatal Diagnosis ◽

10.1002/pd.4653 ◽

2015 ◽

Vol 35 (11) ◽

pp. 1097-1105 ◽

Cited By ~ 4

Author(s):

Liat Gindes ◽

Shir Malach ◽

Boaz Weisz ◽

Reuven Achiron ◽

Zvi Leibovitz ◽

...

Keyword(s):

Fetal Brain ◽

Sylvian Fissure ◽

3 Dimensional

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Surgical Resection of a Complex Spetzler-Martin Grade IV Medial Sylvian Arteriovenous Malformation: 3-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opz312 ◽

2019 ◽

Vol 19 (1) ◽

pp. E60-E60

Author(s):

Amrit K Chiluwal ◽

Georgios Klironomos ◽

Amir R Dehdashti

Keyword(s):

Surgical Resection ◽

Video Clip ◽

Sylvian Fissure ◽

Complete Excision ◽

3 Dimensional ◽

Bifurcation Aneurysm ◽

Close Proximity ◽

Complete Obliteration ◽

Martin Grade

Abstract Sylvian arteriovenous malformations (AVMs) are challenging lesions for surgical management. They are classified according to the Sugita classification based on the location of the nidus in the sylvian fissure: pure, lateral, medial, and deep. Resection of these lesions are fraught with risks, as it requires extensive arachnoid dissection in the sylvian fissure in close proximity to surrounding eloquent tissue, and the presence of en passage arteries can resemble feeding arteries. In this video illustration, the authors describe a complex, Spetzler-Martin Grade IV right sylvian AVM and its surgical resection. By Sugita classification, this was a medial sylvian AVM, with an associated flow related middle cerebral artery (MCA) bifurcation aneurysm. Informed consent was obtained from the patient prior to the procedures. The AVM was embolized preoperatively, and surgical resection was carried out via a pterional approach. The detail of the AVM resection is described in the video clip. Postoperative digital subtraction angiography showed complete excision of the lesion, and the patient was discharged to home on postoperative day 6 without any neurological deficit. In 1-yr follow-up angiogram, beside complete obliteration of the AVM, the flow-related MCA bifurcation aneurysm as well as the M1 and M2 vessels have decreased in size and are much less prominent in comparison to the pretreatment angiography.

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Three-Dimensional Reconstruction Using Stereo Pairs from Serial Thick Sections

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100080249 ◽

1977 ◽

Vol 35 ◽

pp. 562-563

Author(s):

Robert Glaeser ◽

Thomas Bauer ◽

David Grano

Keyword(s):

Three Dimensional ◽

Dimensional Structure ◽

Serial Sections ◽

Thin Sections ◽

3 Dimensional ◽

Transmission Electron ◽

Freeze Dried ◽

Dimensional Reconstruction ◽

Stereo Imagery ◽

Whole Mounts

In transmission electron microscopy, the 3-dimensional structure of an object is usually obtained in one of two ways. For objects which can be included in one specimen, as for example with elements included in freeze- dried whole mounts and examined with a high voltage microscope, stereo pairs can be obtained which exhibit the 3-D structure of the element. For objects which can not be included in one specimen, the 3-D shape is obtained by reconstruction from serial sections. However, without stereo imagery, only detail which remains constant within the thickness of the section can be used in the reconstruction; consequently, the choice is between a low resolution reconstruction using a few thick sections and a better resolution reconstruction using many thin sections, generally a tedious chore. This paper describes an approach to 3-D reconstruction which uses stereo images of serial thick sections to reconstruct an object including detail which changes within the depth of an individual thick section.

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Structural preservation and absolute contrast of catalase crystal sections prepared with tannic acid

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010007597x ◽

1983 ◽

Vol 41 ◽

pp. 448-449

Author(s):

C.W. Akey ◽

M. Szalay ◽

S.J. Edelstein

Keyword(s):

Tannic Acid ◽

Beef Heart ◽

X Rays ◽

Screw Axis ◽

General Applicability ◽

Thin Sections ◽

Beef Liver ◽

3 Dimensional ◽

Dimensional Reconstruction ◽

Structural Preservation

Three methods of obtaining 20 Å resolution in sectioned protein crystals have recently been described. They include tannic acid fixation, low temperature embedding and grid sectioning. To be useful for 3-dimensional reconstruction thin sections must possess suitable resolution, structural fidelity and a known contrast. Tannic acid fixation appears to satisfy the above criteria based on studies of crystals of Pseudomonas cytochrome oxidase, orthorhombic beef liver catalase and beef heart F1-ATPase. In order to develop methods with general applicability, we have concentrated our efforts on a trigonal modification of catalase which routinely demonstrated a resolution of 40 Å. The catalase system is particularly useful since a comparison with the structure recently solved with x-rays will permit evaluation of the accuracy of 3-D reconstructions of sectioned crystals.Initially, we re-evaluated the packing of trigonal catalase crystals studied by Longley. Images of the (001) plane are of particular interest since they give a projection down the 31-screw axis in space group P3121. Images obtained by the method of Longley or by tannic acid fixation are negatively contrasted since control experiments with orthorhombic catalase plates yield negatively stained specimens with conditions used for the larger trigonal crystals.

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Deviations from Ideal Decagonal Symmetry in Electron Diffraction Patterns of the “Decagonal” Phase in the Al-Co-Cu Alloy System

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100088889 ◽

1991 ◽

Vol 49 ◽

pp. 914-915

Author(s):

Atul S. Ramani ◽

Earle R. Ryba ◽

Paul R. Howell

Keyword(s):

Electron Microscope ◽

Alloy System ◽

Nominal Composition ◽

Dimensional Lattice ◽

3 Dimensional ◽

Decagonal Phase ◽

Cu Alloy ◽

Transmission Electron ◽

Lattice Periodicity ◽

Diffraction Patterns

The “decagonal” phase in the Al-Co-Cu system of nominal composition Al65CO15Cu20 first discovered by He et al. is especially suitable as a topic of investigation since it has been claimed that it is thermodynamically stable and is reported to be periodic in the dimension perpendicular to the plane of quasiperiodic 10-fold symmetry. It can thus be expected that it is an important link between fully periodic and fully quasiperiodic phases. In the present paper, we report important findings of our transmission electron microscope (TEM) study that concern deviations from ideal decagonal symmetry of selected area diffraction patterns (SADPs) obtained from several “decagonal” phase crystals and also observation of a lattice of main reflections on the 10-fold and 2-fold SADPs that implies complete 3-dimensional lattice periodicity and the fundamentally incommensurate nature of the “decagonal” phase. We also present diffraction evidence for a new transition phase that can be classified as being one-dimensionally quasiperiodic if the lattice of main reflections is ignored.

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A Novel Reconstitution Method for Inducing the Formation of Regular 2-Dimensional Arrays of Membrane Proteins and Lipids

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100102845 ◽

1988 ◽

Vol 46 ◽

pp. 152-153 ◽

Cited By ~ 1

Author(s):

A. Engel ◽

A. Holzenburg ◽

K. Stauffer ◽

J. Rosenbusch ◽

U. Aebi

Keyword(s):

Membrane Proteins ◽

Flow Rate ◽

Lipid Membranes ◽

Functional Characterization ◽

Dimensional Structure ◽

Electron Crystallography ◽

Peltier Element ◽

Protein Ratio ◽

Precise Control ◽

3 Dimensional

Reconstitution of solubilized and purified membrane proteins in the presence of phospholipids into vesicles allows their functions to be studied by simple bulk measurements (e.g. diffusion of differently sized solutes) or by conductance measurements after transformation into planar membranes. On the other hand, reconstitution into regular protein-lipid arrays, usually forming at a specific lipid-to-protein ratio, provides the basis for determining the 3-dimensional structure of membrane proteins employing the tools of electron crystallography.To refine reconstitution conditions for reproducibly inducing formation of large and highly ordered protein-lipid membranes that are suitable for both electron crystallography and patch clamping experiments aimed at their functional characterization, we built a flow-dialysis device that allows precise control of temperature and flow-rate (Fig. 1). The flow rate is generated by a peristaltic pump and can be adjusted from 1 to 500 ml/h. The dialysis buffer is brought to a preselected temperature during its travel through a meandering path before it enters the dialysis reservoir. A Z-80 based computer controls a Peltier element allowing the temperature profile to be programmed as function of time.

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