Pterional (Frontosphenotemporal) Craniotomy
Indications • Surgical approach for clipping aneurysms of the anterior and posterior circulation (upper basilar and its proximal branches) • Surgical approach for tumors of the anterior and middle cranial…
Suboccipital Craniotomy
Indications • Most lesions in the posterior fossa • Developmental anomalies such as Chiari malformations • Brain tumors such as meningiomas, ependymomas, astrocytomas, and medulloblastomas • Vascular lesions such as…
Extended Retrosigmoid Craniotomy
Indications • Lesions in the cerebellopontine angle and petroclival region can be surgically challenging to resect because of surrounding vascular and eloquent neural structures (i.e., brainstem) that have zero tolerance…
Subtemporal (Intradural and Extradural) Craniotomy
Indications • This technique is preferred for lesions of the middle fossa (i.e., cavernous sinus, medial temporal lobe, tentorial region, petrous bone, incisura) and posterior fossa (i.e., extraaxial lesions in…
Temporal and Frontotemporal Craniotomy
Indications • Treatment option in temporal lobe epilepsy for patients in whom anticonvulsant medications do not control epileptic seizures • Techniques for removing temporal lobe tissue, such as in anterior…
Occipital Craniotomy
Indications • The occipital craniotomy is a versatile approach that provides access to the occipital lobes; tentorium; torcular Herophili; transverse sinus; sigmoid sinus; and tumors, vascular malformations, or other lesions…
Anatomical Approach to Giant Pituitary Tumors
Introduction Various classifications of pituitary tumors have been proposed on the basis of size, radiographic appearance, cytogenesis, staining properties, and endocrine function. There is no consensus regarding the terminology to…
Endoscopic Transsphenoidal Surgery: Anatomy, Instrumentation, Techniques
Anatomy If a thin endoscope (1 to 2 mm in diameter) is inserted into the nasal cavity and through the sphenoid ostium, it can reach the sellar floor without touching…
Transsphenoidal Resection of Craniopharyngiomas
“The most formidable of intracranial tumors” Harvey Cushing (1932) Introduction The introduction of the transsphenoidal approach to the pituitary fossa by Schloffer in 1907 revolutionized the management of pituitary pathology….
Closure Methods
Introduction Since the first attempts to remove pituitary tumors through the transsphenoidal approach almost a century ago, it became clear that one of the main challenges was to create an…
