The Experts below are selected from a list of 939 Experts worldwide ranked by ideXlab platform
Ali R Rezai - One of the best experts on this subject based on the ideXlab platform.
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subthalamic nucleus targeting using Interpeduncular Cistern as an internal landmark
Neurosurgery, 2011Co-Authors: Milind Deogaonkar, Tiago Da Silva Freitas, Andre G. Machado, Ali R RezaiAbstract:BACKGROUND: Internal landmarks for the subthalamic nucleus (STN) have been used in past. This study uses a yet-unused internal landmark to refine STN targeting. OBJECTIVE: To determine the effect of the width of the Interpeduncular Cistern (IPC) on STN targeting during placement of deep brain stimulation (DBS) for Parkinson disease. METHODS: Fifty consecutive patients with Parkinson disease underwent 90 STN DBS implantations. X, Y, and Z coordinates for the tip of the DBS electrodes and the active contact were recorded. Internal landmarks such as width of the third ventricle, width of IPC at a predefined point, and anterior commissure-posterior commissure length were measured. Statistical analysis was done using linear regression analysis and Pearson correlation coefficient. RESULTS: The average IPC diameter at the predefined point was 7.59 mm (range, 5- to 14 mm). Average X, Y, and Z coordinates for the location of the tip of lead were 11.5, -3.5, ―5.4, and those of the location of active contact were 12.5, ―1.9, ―1.4 from the midcommissural point. The mediolateral location of the tip of the DBS as well as the location of the active contact for long-term stimulation were greatly dependent on IPC width (r = 0.83) (P = .0022). CONCLUSION: The width of the IPC is a strong predictor of laterality of STN DBS electrode placement in patients with Parkinson disease. It can be used as an additional internal landmark for refining STN targeting using the simple formula X coordinate for STN target = 0.6 X IPC width + 7 mm.
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Subthalamic nucleus targeting using Interpeduncular Cistern as an internal landmark.
Neurosurgery, 2011Co-Authors: Milind Deogaonkar, Tiago Freitas, Andre Machado, Ali R RezaiAbstract:Internal landmarks for the subthalamic nucleus (STN) have been used in past. This study uses a yet-unused internal landmark to refine STN targeting. To determine the effect of the width of the Interpeduncular Cistern (IPC) on STN targeting during placement of deep brain stimulation (DBS) for Parkinson disease. Fifty consecutive patients with Parkinson disease underwent 90 STN DBS implantations. X, Y, and Z coordinates for the tip of the DBS electrodes and the active contact were recorded. Internal landmarks such as width of the third ventricle, width of IPC at a predefined point, and anterior commissure-posterior commissure length were measured. Statistical analysis was done using linear regression analysis and Pearson correlation coefficient. The average IPC diameter at the predefined point was 7.59 mm (range, 5- to 14 mm). Average X, Y, and Z coordinates for the location of the tip of lead were 11.5, -3.5, -5.4, and those of the location of active contact were 12.5, -1.9, -1.4 from the midcommissural point. The mediolateral location of the tip of the DBS as well as the location of the active contact for long-term stimulation were greatly dependent on IPC width (r = 0.83) (P = .0022). The width of the IPC is a strong predictor of laterality of STN DBS electrode placement in patients with Parkinson disease. It can be used as an additional internal landmark for refining STN targeting using the simple formula X coordinate for STN target = 0.6 × IPC width + 7 mm.
Michiyasu Suzuki - One of the best experts on this subject based on the ideXlab platform.
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hounsfield unit value of Interpeduncular Cistern hematomas can predict symptomatic vasospasm
Stroke, 2020Co-Authors: Hideyuki Ishihara, Fumiaki Oka, Reo Kawano, Mizuya Shinoyama, Takuma Nishimoto, Shohei Kudomi, Michiyasu SuzukiAbstract:Background and Purpose- Symptomatic vasospasm is an important factor that affects the outcomes of aneurysmal subarachnoid hemorrhage. Subarachnoid blood volume can predict symptomatic vasospasm, and we postulated that the blood clot density would also be an important factor involved in such events. The present study aimed to determine the relationship between the incidence of symptomatic vasospasm and the Hounsfield unit (HU) value of the Interpeduncular Cistern that reflects the density of hematomas. Methods- Data from 323 patients admitted and treated at a single center between 2008 and 2017 within 24 hours of subarachnoid hemorrhage onset were retrospectively analyzed. Initial HU values of the Interpeduncular Cistern were measured using CT, then correlations with the incidence of symptomatic vasospasm and HU values as well as other variables were assessed. Results- Symptomatic vasospasm developed in 54 (16.7%) of the 323 patients. The incidence of symptomatic vasospasm was low (1.8%, 2/166) for HU 50 to ≤60, and 45.3%, 29/64 for HU >60). The odds ratio for symptomatic vasospasm was 2.0 (95% CI, 1.6-2.4) per 5 HU increase. Symptomatic vasospasm correlated significantly with intraventricular hemorrhage (P=0.05) and with intracerebral hematoma (P=0.046) but even more significantly with the HU value of the Interpeduncular Cistern (P<0.0001). Conclusions- The HU value of the Interpeduncular Cistern on initial CT is an accurate and reliable predictor of symptomatic vasospasm.
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Hounsfield Unit Value of Interpeduncular Cistern Hematomas Can Predict Symptomatic Vasospasm.
Stroke, 2019Co-Authors: Hideyuki Ishihara, Fumiaki Oka, Reo Kawano, Mizuya Shinoyama, Takuma Nishimoto, Shohei Kudomi, Michiyasu SuzukiAbstract:Background and Purpose— Symptomatic vasospasm is an important factor that affects the outcomes of aneurysmal subarachnoid hemorrhage. Subarachnoid blood volume can predict symptomatic vasospasm, an...
Ricardo L Carrau - One of the best experts on this subject based on the ideXlab platform.
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Anatomic comparison of the endonasal and transpetrosal approaches for Interpeduncular fossa access
Neurosurgical focus, 2014Co-Authors: Kenichi Oyama, Daniel M Prevedello, Leo F. S. Ditzel Filho, Jun Muto, Ramazan Gun, Edward E. Kerr, Bradley A. Otto, Ricardo L CarrauAbstract:Object The Interpeduncular Cistern, including the retrochiasmatic area, is one of the most challenging regions to approach surgically. Various conventional approaches to this region have been described; however, only the endoscopic endonasal approach via the dorsum sellae and the transpetrosal approach provide ideal exposure with a caudal-cranial view. The authors compared these 2 approaches to clarify their limitations and intrinsic advantages for access to the Interpeduncular Cistern Methods Four fresh cadaver heads were studied. An endoscopic endonasal approach via the dorsum sellae with pituitary transposition was performed to expose the Interpeduncular Cistern. A transpetrosal approach was performed bilaterally, combining a retrolabyrinthine presigmoid and a subtemporal transtentorium approach. Water balloons were used to simulate space-occupying lesions. “Water balloon tumors” (WBTs), inflated to 2 different volumes (0.5 and 1.0 ml), were placed in the Interpeduncular Cistern to compare visualizatio...
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endoscopic endonasal pituitary transposition for a transdorsum sellae approach to the Interpeduncular Cistern
Neurosurgery, 2008Co-Authors: Amin B Kassam, Daniel M Prevedello, Ajith J Thomas, Paul A Gardner, Arlan Mintz, Carl H Snyderman, Ricardo L CarrauAbstract:OBJECTIVE: The Interpeduncular Cistern, including the retroinfundibular area, is one of the most challenging regions to approach surgically. The pituitary gland and the infundibulum guard the region when an endonasal route is undertaken. Superior transposition of the pituitary gland and infundibulum is described as a functional means to access this complex region through a fully endoscopic, completely transnasal route. METHODS: Ten consecutive patients in whom a pituitary transposition was performed during an expanded endonasal approach at the University of Pittsburgh Medical Center for resection of retroinfundibular lesions were reviewed. The series consisted of seven men and three women with a mean age of 44.4 years. Pathology consisted of four craniopharyngiomas, four chordomas, and two petroclival meningiomas. RESULTS: Five patients (50%) underwent total resection of the tumor, three patients (30%) underwent near total resection ( > 95% removal), and two patients (20%) had partial resection of petroclival meningiomas with the goal of optic apparatus decompression. All four patients with visual deficits recovered their vision completely. There was no neurological deterioration. Eight patients had normal pituitary function preoperatively, seven of whom (87.5%) had confirmed function preservation postoperatively, with one of these patients experiencing transient diabetes insipidus. The remaining patient with a hypothalamic craniopharyngioma underwent complete resection with obligatory panhypopituitarism and diabetes insipidus. CONCLUSION: Endoscopic endonasal transposition of the pituitary gland and its stalk can provide a valuable corridor to the retroinfundibular space and Interpeduncular Cistern with pituitary function preservation in the majority of patients. This approach should only be pursued once significant experience with endoscopic endonasal approaches has been acquired.
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Endoscopic endonasal pituitary transposition for a transdorsum sellae approach to the Interpeduncular Cistern.
Neurosurgery, 2008Co-Authors: Amin B Kassam, Daniel M Prevedello, Arlan Mintz, Carl H Snyderman, Ajith Thomas, Paul Gardner, Ricardo L CarrauAbstract:The Interpeduncular Cistern, including the retroinfundibular area, is one of the most challenging regions to approach surgically. The pituitary gland and the infundibulum guard the region when an endonasal route is undertaken. Superior transposition of the pituitary gland and infundibulum is described as a functional means to access this complex region through a fully endoscopic, completely transnasal route. Ten consecutive patients in whom a pituitary transposition was performed during an expanded endonasal approach at the University of Pittsburgh Medical Center for resection of retroinfundibular lesions were reviewed. The series consisted of seven men and three women with a mean age of 44.4 years. Pathology consisted of four craniopharyngiomas, four chordomas, and two petroclival meningiomas. Five patients (50%) underwent total resection of the tumor, three patients (30%) underwent near total resection ( > 95% removal), and two patients (20%) had partial resection of petroclival meningiomas with the goal of optic apparatus decompression. All four patients with visual deficits recovered their vision completely. There was no neurological deterioration. Eight patients had normal pituitary function preoperatively, seven of whom (87.5%) had confirmed function preservation postoperatively, with one of these patients experiencing transient diabetes insipidus. The remaining patient with a hypothalamic craniopharyngioma underwent complete resection with obligatory panhypopituitarism and diabetes insipidus. Endoscopic endonasal transposition of the pituitary gland and its stalk can provide a valuable corridor to the retroinfundibular space and Interpeduncular Cistern with pituitary function preservation in the majority of patients. This approach should only be pursued once significant experience with endoscopic endonasal approaches has been acquired.
Milind Deogaonkar - One of the best experts on this subject based on the ideXlab platform.
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subthalamic nucleus targeting using Interpeduncular Cistern as an internal landmark
Neurosurgery, 2011Co-Authors: Milind Deogaonkar, Tiago Da Silva Freitas, Andre G. Machado, Ali R RezaiAbstract:BACKGROUND: Internal landmarks for the subthalamic nucleus (STN) have been used in past. This study uses a yet-unused internal landmark to refine STN targeting. OBJECTIVE: To determine the effect of the width of the Interpeduncular Cistern (IPC) on STN targeting during placement of deep brain stimulation (DBS) for Parkinson disease. METHODS: Fifty consecutive patients with Parkinson disease underwent 90 STN DBS implantations. X, Y, and Z coordinates for the tip of the DBS electrodes and the active contact were recorded. Internal landmarks such as width of the third ventricle, width of IPC at a predefined point, and anterior commissure-posterior commissure length were measured. Statistical analysis was done using linear regression analysis and Pearson correlation coefficient. RESULTS: The average IPC diameter at the predefined point was 7.59 mm (range, 5- to 14 mm). Average X, Y, and Z coordinates for the location of the tip of lead were 11.5, -3.5, ―5.4, and those of the location of active contact were 12.5, ―1.9, ―1.4 from the midcommissural point. The mediolateral location of the tip of the DBS as well as the location of the active contact for long-term stimulation were greatly dependent on IPC width (r = 0.83) (P = .0022). CONCLUSION: The width of the IPC is a strong predictor of laterality of STN DBS electrode placement in patients with Parkinson disease. It can be used as an additional internal landmark for refining STN targeting using the simple formula X coordinate for STN target = 0.6 X IPC width + 7 mm.
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Subthalamic nucleus targeting using Interpeduncular Cistern as an internal landmark.
Neurosurgery, 2011Co-Authors: Milind Deogaonkar, Tiago Freitas, Andre Machado, Ali R RezaiAbstract:Internal landmarks for the subthalamic nucleus (STN) have been used in past. This study uses a yet-unused internal landmark to refine STN targeting. To determine the effect of the width of the Interpeduncular Cistern (IPC) on STN targeting during placement of deep brain stimulation (DBS) for Parkinson disease. Fifty consecutive patients with Parkinson disease underwent 90 STN DBS implantations. X, Y, and Z coordinates for the tip of the DBS electrodes and the active contact were recorded. Internal landmarks such as width of the third ventricle, width of IPC at a predefined point, and anterior commissure-posterior commissure length were measured. Statistical analysis was done using linear regression analysis and Pearson correlation coefficient. The average IPC diameter at the predefined point was 7.59 mm (range, 5- to 14 mm). Average X, Y, and Z coordinates for the location of the tip of lead were 11.5, -3.5, -5.4, and those of the location of active contact were 12.5, -1.9, -1.4 from the midcommissural point. The mediolateral location of the tip of the DBS as well as the location of the active contact for long-term stimulation were greatly dependent on IPC width (r = 0.83) (P = .0022). The width of the IPC is a strong predictor of laterality of STN DBS electrode placement in patients with Parkinson disease. It can be used as an additional internal landmark for refining STN targeting using the simple formula X coordinate for STN target = 0.6 × IPC width + 7 mm.
Hideyuki Ishihara - One of the best experts on this subject based on the ideXlab platform.
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hounsfield unit value of Interpeduncular Cistern hematomas can predict symptomatic vasospasm
Stroke, 2020Co-Authors: Hideyuki Ishihara, Fumiaki Oka, Reo Kawano, Mizuya Shinoyama, Takuma Nishimoto, Shohei Kudomi, Michiyasu SuzukiAbstract:Background and Purpose- Symptomatic vasospasm is an important factor that affects the outcomes of aneurysmal subarachnoid hemorrhage. Subarachnoid blood volume can predict symptomatic vasospasm, and we postulated that the blood clot density would also be an important factor involved in such events. The present study aimed to determine the relationship between the incidence of symptomatic vasospasm and the Hounsfield unit (HU) value of the Interpeduncular Cistern that reflects the density of hematomas. Methods- Data from 323 patients admitted and treated at a single center between 2008 and 2017 within 24 hours of subarachnoid hemorrhage onset were retrospectively analyzed. Initial HU values of the Interpeduncular Cistern were measured using CT, then correlations with the incidence of symptomatic vasospasm and HU values as well as other variables were assessed. Results- Symptomatic vasospasm developed in 54 (16.7%) of the 323 patients. The incidence of symptomatic vasospasm was low (1.8%, 2/166) for HU 50 to ≤60, and 45.3%, 29/64 for HU >60). The odds ratio for symptomatic vasospasm was 2.0 (95% CI, 1.6-2.4) per 5 HU increase. Symptomatic vasospasm correlated significantly with intraventricular hemorrhage (P=0.05) and with intracerebral hematoma (P=0.046) but even more significantly with the HU value of the Interpeduncular Cistern (P<0.0001). Conclusions- The HU value of the Interpeduncular Cistern on initial CT is an accurate and reliable predictor of symptomatic vasospasm.
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Hounsfield Unit Value of Interpeduncular Cistern Hematomas Can Predict Symptomatic Vasospasm.
Stroke, 2019Co-Authors: Hideyuki Ishihara, Fumiaki Oka, Reo Kawano, Mizuya Shinoyama, Takuma Nishimoto, Shohei Kudomi, Michiyasu SuzukiAbstract:Background and Purpose— Symptomatic vasospasm is an important factor that affects the outcomes of aneurysmal subarachnoid hemorrhage. Subarachnoid blood volume can predict symptomatic vasospasm, an...
