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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Meningiomas[Title] – NLM Catalog Result
Careful dissection under high magnification is continued to free the ventriculostriate arteries, the perforator of the anterior cerebral artery, and the internal carotid artery branches to the optic memingiomas.
Dissection becomes easier along the posterior communicating artery and the anterior choroidal artery, since these two arteries have their own vesting arachnoid membranes. Dade Lunsford 7 pages.
Al-Mefty’s Meningiomas, Second Edition is the definitive guide to meningioma diagnosis, treatment, and surgery, and reflects over a decade of major advances in the diagnosis and management of both intracranial and spinal meningiomas since the first edition was published. Embedded carotid and middle cerebral artery branches can be dissected free under magnification by means of microsurgical techniques.
Delayed thrombosis of the internal carotid and middle cerebral arteries leading to stroke has been reported after surgery of these tumors. Preservation of the olfactory nerve deters excessive frontal lobe retraction, otherwise resulting in avulsion of the olfactory nerve. The anterior clinoid is already removed, facilitating exposure of the superior aspect of the cavernous sinus. Under the operating microscope, a plane of dissection is established between the tumor and the frontal and temporal lobes.
The book is extensively illustrated with high quality figures—over —including anatomic drawings, operative photographs, and contemporary radiologic images with MR and CT. This approach provides the following advantages: These chapters include specific details of the operative approach and complications for a wide variety of specific meningioma locations.
Most neurosurgeons have had the experience of carefully observing slow-growing tumors, and there have been reports of patients who remain in satisfactory condition for years after partial removal of their tumors.
Particular attention is paid to spare the artery of Heubner and the vital branches of the striatum.
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. In conclusion, this is a solid, up to date, and thorough review of the most common primary tumor of the central nervous system.
Any further bone hyperostosis is drilled with the diamond bit of a high-speed drill. The Liliequist membrane was intact in all of our cases of Group II tumors; consequently, removal of the tumor from the interpeduncular fossa and the posteriorly displaced basilar artery meniniomas usually easy.
This results in the superficial temporal artery coursing posterior to the incision while the branches of the facial nerve are located anteriorly. Section IV of the book covers Diagnostic Radiology with one chapter mmefty cross-sectional imaging and one on angiography: Tumors in Group III originate at the optic foramen, extending into the optic canal and the tip of the anterior clinoid process.
Twenty-four cases qualifying as clinoidal meningiomas were operated on over a 7-year period, from November,through October, Memingiomas groups relate to the presence of interfacing arachnoid membranes between the tumor and the cerebral vessels. Removal of the orbitocranial menjngiomas then proceeds as described elsewhere. Lateral carotid arteriogram demonstrating narrowing of the carotid and middle cerebral arteries by the encasing tumor.
Meningiomas – Ossama Al-Mefty – Google Books
Dissection of the Pituitary Stalk The pituitary stalk is easily recognized by its distinctive color and vascular network. Once the tumor is debulked, the distal branches of the middle cerebral artery are identified under high magnification and, using microdissection, the tumor capsule is removed from the arterial wall.
Recent reports, however, have advocated the effectiveness of radiotherapy in conjunction with subtotal surgical excision. Notice the resection of menimgiomas anterior clinoid. Acknowledging that the best chance for cure menongiomas through radical total removal, most authors, both pioneer and modern, have been content with subtotal removal to avoid the devastating sequelae of injury to the encased cerebral vessels; 6, 9, 17, 22, 31, 43, 51, 56 hence, repeated surgery and radiation therapy are frequently required.
Hence, our classification has a deep impact on surgical decision-making and outcome. Overall, the references for every chapter are up-to-date and include recent articles from the modern imaging era, up to To avoid injury to encased cerebral vessels, most surgeons are content with subtotal removal. We excluded from the study meningiomas with origins as described intraoperatively on the tuberculum sellae, diaphragma sellae, planum sphenoidale, and middle and lateral sphenoid ridge, as well as hyperostosing en plaque meningiomas.
Operative Technique Early in this series, the pterional approach was used in seven patients and subfrontal approach msfty three.
Ragel and Randy L.