Case report: Endoscopic endonasal transposterior clinoid approach for resection of posterior clinoid process meningioma: technical notes and literature review.

Background: Posterior clinoid process (PCP) meningioma is an exceedingly rare entity. It remains the most challenging skull base lesion for neurosurgeons due to its treacherous location that insinuates amongst critical neurovascular structures. This article will describe the technical notes using the endoscopic endonasal approach that provide the earliest devascularization and detachment of the tumor PCP meningioma. Methods: We are introducing the surgical implementation of an endoscopic endonasal approach to removing PCP meningioma. Furthermore, we perform a literature review of posterior clinoid process meningioma that undergoes surgical intervention, then summarize the benefits and limitations of each approach. Results: We present a case of right PCP meningioma that was removed using an endoscopic endonasal approach through the transposterior clinoid corridor in a 52-year-old-woman. We describe the technical notes in performing this approach to have the earliest devascularization and detachment of the tumor by performing posterior clinoidectomy. Safe tumor removal is performed with a wide and clear view of the surrounding neurovascular structure. Based on our database search, we found nine articles reported on the surgical management of PCP meningiomas, with a total number of 15 cases. All of the reported cases performed the tumor removal using the transcranial approach. Conclusion: The endoscopic endonasal transposterior clinoid approach circumvents all disadvantages faced by the traditional transcranial approach, providing the earliest approach to devascularized and detaching the tumor from its attachment at PCP. This approach demonstrates safety and efficacy, making it an acceptable alternative for PCP meningioma resections.

Severe traumatic atlantoaxial dislocation and type III odontoid fracture treated with occipitocervical fixation: a case report.

The combination of atlantoaxial joint dislocation accompanied by an odontoid process fracture is exceptionally rare, with only a few cases reported. The estimated frequency of these cases is < 2% of all upper cervical spine injuries. In this report, the authors describe an unusual case of traumatic atlantoaxial dislocation with a type III odontoid fracture in a 44-year-old male patient. Before the diagnosis, the patient had a history of seeking a masseur for a neck massage. Subsequently, the patient underwent occipitocervical stabilization to address the underlying condition. This procedure aims to treat the instability between the skull and cervical spine and should be considered in the treatment planning if the patient's anatomy suits it.

Complete resection versus functional preservation in resection of cystic vestibular schwannoma in a 56-year-old female: case report and literature review.

Surgery for vestibular schwannoma presents unique challenges to the surgeon, given that the primary objectives are achieving complete resection while preserving both facial nerve and hearing function. Consequently, a comprehensive preoperative and perioperative assessment of the tumor is essential to determine its extent, particularly in cases involving dumbbell-shaped lesions. This case report describes our experience in managing a patient with a dumbbell-shaped vestibular schwannoma, where we achieved near-total resection while successfully preserving the patient's facial nerve and hearing function. The early postoperative evaluation revealed no morbidity, and the patient experienced a significant improvement in their symptoms.

Particular Surgical Technique for Transorbital-Penetrating Craniocerebral Injury Inflicted by a Screwdriver: Technical Case Report.

Surgical techniques for non-missile penetrating brain injuries (PBI) are challenging because they require good preoperative planning. Generally, extraction is performed ipsilaterally at the entry site. In certain cases, the extraction can be performed contralaterally through the inner end of the foreign body; however, this requires special consideration. We present a case report of a patient who had a stab wound on the head via a screwdriver and underwent surgery, during which extraction was performed contralaterally through the inner end of the screwdriver without inducing any neurological deficit. Careful preoperative planning and surgical technique modification are required to minimize morbidity and mortality in patients with PBIs.

Intraparenchymal cerebellar capillary hemangioma in a 32-year-old man: a case report.

The authors present an unusual case of a 32-year-old adult male with a capillary hemangioma, which developed within the left cerebellar parenchyma. The histopathological examination reveals a mass mostly formed by the proliferation of capillaries, lined by a layer of flat-plump endothelial cells, some branching and dilating large capillaries, forming a lobulated structure separated by fibrocollagenous connective tissue. Immunohistochemistry examination with CD31 and S100 was positive on the endothelial and stromal cells, respectively, and negative S100 on the endothelial cells. Although rare, capillary hemangioma should be one of the differential diagnoses for diagnosing intra-axial lesions in the cerebellar region. Confirmation of the histopathological characteristic is necessary to determine the diagnosis of capillary hemangioma and exclude other differential diagnoses.

Transcranial approach as surgical treatment for giant pituitary adenoma during COVID 19 pandemic - What can we learn?: A case report.

INTRODUCTION: In the COVID 19 pandemic, pituitary surgery is one of challenging surgical treatment, especially the involving transsphenoid approach. It was reported that the aerosolisation and mucosal involvement increase the risk of viral transmission during operation. Therefore, transcranial is a safer surgical approach during COVID-19 pandemic. This study aimed to reported transcranial approach to treat giant pituitary adenoma with aggressive visual disturbance which require urgent surgical management. CASE PRESENTATION: We reported a 21-year old male, who required urgent surgery because of progressive visual disturbance due to giant pituitary adenoma. On brain MRI with contrast, it was revealed an extraaxial tumor extending anteriorly over plannum sphenoidal with the greatest diameter was 5.34 cm. Transcranial approach was chosen to resect the tumor. Near total removal of the tumor was achieved without damaging vital neurovascular structure. The visual acuity was improved and no significant postoperative complication. Pathology examination revealed pituitary adenoma. CONCLUSION: Transcranial surgery for pituitary adenoma is still an armamentarium in neurosurgical practice, especially in the COVID 19 pandemic to provide safer surgical approach.