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  • 1
    ISSN: 0942-0940
    Keywords: Keywords: Cavernous sinus; pituitary adenoma; lateral growth; transsphenoidal surgery.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ Background. The purpose of this study was to evaluate the usefulness of an oblique “cross court” transsphenoidal approach using a speculum with slightly modified projections for pituitary adenomas showing lateral extension.  Method. The projection of the speculum on the side of the cavernous lesion was shortened by 5 mm. The tip of the longer projection was placed in the sphenoid sinus, while the end of the shorter projection was placed on the concha sphenoidalis. An oblique transsphenoidal view was then easily obtained by opening the speculum. The contralateral nasal incisura had to be widened in some cases to achieve a more oblique view.  Findings. Twenty-eight patients diagnosed with pituitary adenoma showing lateral growth underwent adenomectomy under direct observation of the medial portion of the cavernous sinus using this approach. Postoperative normalization of hyperendocrinopathy or gross total removal of the tumour was achieved in the majority of patients.  Interpretation. An oblique transsphenoidal approach using this speculum and contralateral minor maxillary osteotomy afforded a direct view of the medial cavernous sinus, sufficient for the removal of adenomas showing minor to moderate lateral growth.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 0942-0940
    Keywords: Keywords: Dissecting aneurysm; posterior inferior cerebellar artery; subarachnoid haemorrhage; anastomosis.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ Dissecting aneurysms of intracranial posterior circulation have recently been shown to be less uncommon than previously thought. However, those involving the posterior inferior cerebellar artery (PICA) and not vertebral artery at all are extremely rare. We report here a case of a patient with a dissecting aneurysm of the lateral medullary segment of PICA which presented as subarachnoid haemorrhage. The aneurysm was treated by trapping surgery and the distant PICA was anastomosed to the occipital artery. The patient showed a slight ataxia immediately after surgery but recovered fully.  Recovery from immediately postoperative cerebellar symptoms due to intra-operative ischemia seemed to be due largely to recovery of flow in the region of cortical branches of PICA.
    Type of Medium: Electronic Resource
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