Al-Mefty’s Meningiomas: Medicine & Health Science Books @ Al-Mefty’s Meningiomas Second Edition. Franco DeMonte, MD, FRCSC, FACS Professor of Neurosurgery and Head and Neck Surgery Mary. Al-Mefty O(1). Author information: (1)Department of Neurosurgery, University of Mississippi Medical Center, Jackson. Anterior clinoidal meningiomas are.
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Positioning and Scalp Incision The patient is placed supine and a spinal drainage needle is inserted. They described clinoidal or sphenocavernous meningiomas en masse as: Tumor Debulking Under the operating microscope, a plane of dissection is established between the tumor and the frontal and temporal lobes.
Only partial but extensive removal was possible in all three Group I patients. Hence, our meningiomaw has a deep impact on surgical decision-making and outcome. Without meningiomaw removal, however, recurrence is expected.
This observation correlates with reports in the literature concerning the feasibility of tumor dissection despite total vascular encasement. When this membrane was absent Group I in our classificationdissection was impossible; none of the tumors was removed totally and the outcome was a disappointment. This results in the meningioas temporal artery coursing posterior to the incision while the branches of the facial nerve are located anteriorly.
Retouched operative photograph showing the carotid cistern intact. Thieme emails meftyy you the latest medical and scientific resources.
Bone was not involved, except for the anterior clinoid process, nor were the craniofacial cavities. The tumor T is small and extends into the optic canal. A Group II meningioma.
The tumor encases the carotid artery and its branches, with direct attachment to the adventitia. Recognizing these differences, Bonnal, et al.
Junge Jupiter Jutta Hochschild K? Summary of Meninguomas Case Material Twenty-four cases qualifying as clinoidal meningiomas were operated on over mefgy 7-year period, from November,through October, Since the tumor may be supplied by arterial twigs from the cerebral artery, the surgeon first confirms that they are tumor feeders and not hypothalamic perforators or the optic nerve blood supply.
Ragel and Randy Meinngiomas. To subclassify anterior clinoidal meningiomas into three groups may be surprising since many authors find it difficult to distinguish clinoidal meningiomas from those with more lateral attachment on the sphenoid ridge, and prefer the notion of wide or small attachment.
Meningiomas[Title] – NLM Catalog Result
Recent advances in cranial-base exposure and cavernous sinus surgery have facilitated radical total removal. Dissection of the Pituitary Stalk The pituitary stalk is easily recognized by its distinctive color and vascular network.
Artist’s drawing of a Group I meningioma. Artist’s drawing showing the tumor encasing the carotid artery and its branches. Sincewe have exclusively used the orbitocranial approach described elsewhere 2, 3 for removal of these tumors. All patients underwent cerebral angiography to delineate the anatomy of the cerebral circulation, arterial displacement, encasement of major vessels, and blood supply.
In seven of our cases, the optic nerve was totally engulfed, but memingiomas all cases the optic nerve maintained its arachnoid barrier formed by the wall of the chiasmatic cistern. Delayed thrombosis of the internal carotid and middle cerebral arteries leading to stroke has been reported after surgery of these tumors. The Role of Radiation Therapy The role of radiation therapy cannot be left meningomas in a discussion of clinoidal meningiomas in which subtotal removal or recurrence are prominent features.
The text begins with important Opening the dura under the microscope provides a transitional adjustment of the surgeon’s dexterity from bone work to fine microsurgical dissection.
Tumor removal around this area is continued using only microsurgical dissection with bipolar coagulation and careful piecemeal removal by microdissection. Twenty-four cases qualifying as clinoidal meningiomas were operated on over a 7-year period, from November,through October, As the carotid artery emerges from the cavernous sinus inferomedial to the anterior clinoid, it enters the subdural space to be vested in the carotid cistern.
Recent advances in skull-base exposure, anesthesia, cerebral protection, microsurgical techniques, imaging, and surgery of the cavernous sinus have assisted in overcoming many of the formidable tasks in dissecting and preserving the vital neural and vascular structures involved with these tumors. The optic nerve maintains an arachnoid plane from meningiomzs chiasmatic cistern.
Recent reports, however, have advocated the effectiveness of radiotherapy in conjunction with subtotal surgical excision. Al; mefty meningioma is an excellent book on meningioma which i have ever seen in my life. Thus, each arterial branch is dissected and followed to ascertain its course.
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These meningiomxs are usually small.
Meningiomas – Ossama Al-Mefty – Google Books
These subgroups relate to the presence of interfacing arachnoid membranes between the tumor and cerebral vessels. However, unless total removal is achieved, detrimental regrowth is expected in the majority of patients. Artist’s drawing showing the tumor originating in the optic foramen.
Mfningiomas second operation carries a significantly higher mortality and failure rate. I can opt out at any time by clicking the “unsubscribe” link at the end of each newsletter.
Dissection is carried to the bifurcation of the carotid artery, removing the tumor from the anterior cerebral artery. One patient had permanent third cranial nerve palsy.
The carotid artery was totally encased in 11 patients, the branches of the middle cerebral artery were encased in seven, the anterior cerebral artery was encased in three, and the optic nerve was encased in seven. It is a must-have in all neurosurgery, neurology, and radiology mefgy.