The Experts below are selected from a list of 255 Experts worldwide ranked by ideXlab platform

Robert F. Spetzler - One of the best experts on this subject based on the ideXlab platform.

  • Lateral transpeduncular approach to intrinsic lesions of the rostral pons.
    Neurosurgery, 2010
    Co-Authors: Matthew O. Hebb, Robert F. Spetzler
    Abstract:

    OBJECTIVE We describe the lateral transpeduncular approach to access lesions in the rostral pons. The surgical indications and technique are discussed in the context of an illustrative case and pertinent anatomic considerations. METHODS A 38-year-old man with acute right hemiparesis and bulbar symptoms had a left pontine hemorrhage with an associated cavernous malformation and venous anomaly. There was no pial or ependymal representation of the lesion. To avoid disruption of eloquent structures, the pia was entered in the posterolateral aspect of the middle cerebellar peduncle. Subsequent dissection was guided by stereotactic neuronavigation in a ventromedial trajectory along the course of the Pontocerebellar Fibers. RESULTS The cavernous malformation was resected completely without procedure-related morbidity. The patient's preoperative deficits slowly improved to a functionally independent state. CONCLUSION The lateral transpeduncular approach may be used to access intrinsic lesions of the rostral pons with relatively low morbidity. Stereotactic neuronavigation and intraoperative electrophysiological monitoring are important surgical adjuncts to guide dissection and lesion extirpation. Candidate selection, microsurgical technique, and pragmatic treatment goals remain fundamental to optimal patient outcomes.

  • Lateral Transpeduncular Approach to Intrinsic Lesions of the Rostral Pons. Commentary
    Neurosurgery, 2010
    Co-Authors: Matthew O. Hebb, Robert F. Spetzler, Jorge Mura, Evandro De Oliveira
    Abstract:

    OBJECTIVE: We describe the lateral transpeduncular approach to access lesions in the rostral pons.The surgical indications and technique are discussed in the context of an illustrative case and pertinent anatomic considerations. METHODS: A 38-year-old man with acute right hemiparesis and bulbar symptoms had a left pontine hemorrhage with an associated cavernous malformation and venous anomaly. There was no pial or ependymal representation of the lesion. To avoid disruption of eloquent structures, the pia was entered in the posterolateral aspect of the middle cerebellar peduncle. Subsequent dissection was guided by stereo t actic neuronavigation in a ventromedial trajectory along the course of the Pontocerebellar Fibers. RESULTS: The cavernous malformation was resected completely without procedure-related morbidity. The patient's preoperative deficits slowly improved to a functionally independent state. CONCLUSION: The lateral transpeduncular approach may be used to access intrinsic lesions of the rostral pons with relatively low morbidity. Stereotactic neuronavigation and intraoperative electrophysiological monitoring are important surgical adjuncts to guide dissection and lesion extirpation. Candidate selection, microsurgical technique, and pragmatic treatment goals remain fundamental to optimal patient outcomes.

Matthew O. Hebb - One of the best experts on this subject based on the ideXlab platform.

  • Lateral transpeduncular approach to intrinsic lesions of the rostral pons.
    Neurosurgery, 2010
    Co-Authors: Matthew O. Hebb, Robert F. Spetzler
    Abstract:

    OBJECTIVE We describe the lateral transpeduncular approach to access lesions in the rostral pons. The surgical indications and technique are discussed in the context of an illustrative case and pertinent anatomic considerations. METHODS A 38-year-old man with acute right hemiparesis and bulbar symptoms had a left pontine hemorrhage with an associated cavernous malformation and venous anomaly. There was no pial or ependymal representation of the lesion. To avoid disruption of eloquent structures, the pia was entered in the posterolateral aspect of the middle cerebellar peduncle. Subsequent dissection was guided by stereotactic neuronavigation in a ventromedial trajectory along the course of the Pontocerebellar Fibers. RESULTS The cavernous malformation was resected completely without procedure-related morbidity. The patient's preoperative deficits slowly improved to a functionally independent state. CONCLUSION The lateral transpeduncular approach may be used to access intrinsic lesions of the rostral pons with relatively low morbidity. Stereotactic neuronavigation and intraoperative electrophysiological monitoring are important surgical adjuncts to guide dissection and lesion extirpation. Candidate selection, microsurgical technique, and pragmatic treatment goals remain fundamental to optimal patient outcomes.

  • Lateral Transpeduncular Approach to Intrinsic Lesions of the Rostral Pons. Commentary
    Neurosurgery, 2010
    Co-Authors: Matthew O. Hebb, Robert F. Spetzler, Jorge Mura, Evandro De Oliveira
    Abstract:

    OBJECTIVE: We describe the lateral transpeduncular approach to access lesions in the rostral pons.The surgical indications and technique are discussed in the context of an illustrative case and pertinent anatomic considerations. METHODS: A 38-year-old man with acute right hemiparesis and bulbar symptoms had a left pontine hemorrhage with an associated cavernous malformation and venous anomaly. There was no pial or ependymal representation of the lesion. To avoid disruption of eloquent structures, the pia was entered in the posterolateral aspect of the middle cerebellar peduncle. Subsequent dissection was guided by stereo t actic neuronavigation in a ventromedial trajectory along the course of the Pontocerebellar Fibers. RESULTS: The cavernous malformation was resected completely without procedure-related morbidity. The patient's preoperative deficits slowly improved to a functionally independent state. CONCLUSION: The lateral transpeduncular approach may be used to access intrinsic lesions of the rostral pons with relatively low morbidity. Stereotactic neuronavigation and intraoperative electrophysiological monitoring are important surgical adjuncts to guide dissection and lesion extirpation. Candidate selection, microsurgical technique, and pragmatic treatment goals remain fundamental to optimal patient outcomes.

Evandro De Oliveira - One of the best experts on this subject based on the ideXlab platform.

  • Lateral Transpeduncular Approach to Intrinsic Lesions of the Rostral Pons. Commentary
    Neurosurgery, 2010
    Co-Authors: Matthew O. Hebb, Robert F. Spetzler, Jorge Mura, Evandro De Oliveira
    Abstract:

    OBJECTIVE: We describe the lateral transpeduncular approach to access lesions in the rostral pons.The surgical indications and technique are discussed in the context of an illustrative case and pertinent anatomic considerations. METHODS: A 38-year-old man with acute right hemiparesis and bulbar symptoms had a left pontine hemorrhage with an associated cavernous malformation and venous anomaly. There was no pial or ependymal representation of the lesion. To avoid disruption of eloquent structures, the pia was entered in the posterolateral aspect of the middle cerebellar peduncle. Subsequent dissection was guided by stereo t actic neuronavigation in a ventromedial trajectory along the course of the Pontocerebellar Fibers. RESULTS: The cavernous malformation was resected completely without procedure-related morbidity. The patient's preoperative deficits slowly improved to a functionally independent state. CONCLUSION: The lateral transpeduncular approach may be used to access intrinsic lesions of the rostral pons with relatively low morbidity. Stereotactic neuronavigation and intraoperative electrophysiological monitoring are important surgical adjuncts to guide dissection and lesion extirpation. Candidate selection, microsurgical technique, and pragmatic treatment goals remain fundamental to optimal patient outcomes.

Mario Savoiardo - One of the best experts on this subject based on the ideXlab platform.

  • Wallerian Degeneration of the Pontocerebellar Fibers
    2015
    Co-Authors: Tiziana De Simone, M Carriero, Laura Farina, Caroline Regna-gladin, Mario Savoiardo
    Abstract:

    Summary: Two cases of pontine infarct with Wallerian degeneration (WD) of the Pontocerebellar Fibers are de-scribed. WD of Pontocerebellar Fibers, seen bilaterally along the transverse pontine Fibers, is more visible in the middle cerebellar peduncles and extends into the white matter of the cerebellar hemispheres. Understanding the anatomy of the white matter and the temporal evolution of this degeneration is essential in identifying WD. Wallerian degeneration (WD) is the process of progressive demyelination and disintegration of the distal axonal segment following the transection of the axon or damage to the neuron. Although this term originally referred to lesions of peripheral nerves, today it can also refer to the CNS when the degener-ation affects a fiber bundle or tract through the sam

  • wallerian degeneration of the Pontocerebellar Fibers
    American Journal of Neuroradiology, 2005
    Co-Authors: Tiziana De Simone, Caroline Regnagladin, M Carriero, Laura Farina, Mario Savoiardo
    Abstract:

    Two cases of pontine infarct with Wallerian degeneration (WD) of the Pontocerebellar Fibers are described. WD of Pontocerebellar Fibers, seen bilaterally along the transverse pontine Fibers, is more visible in the middle cerebellar peduncles and extends into the white matter of the cerebellar hemispheres. Understanding the anatomy of the white matter and the temporal evolution of this degeneration is essential in identifying WD.

Cristina Granziera - One of the best experts on this subject based on the ideXlab platform.

  • Crossed Ataxia: A Case Report and a Diffusion Tensor Imaging Tractography Study
    Stroke, 2011
    Co-Authors: Julien F. Bally, Pierre Mégevand, Duy Nguyen, Theodor Landis, Cristina Granziera
    Abstract:

    Background and Purpose— Ever since the seminal description of ataxic hemiparesis contralateral to a pontine lesion by Miller-Fisher, the question of why contralesional crossing Pontocerebellar Fibers do not more frequently produce ipsilesional hemiataxia was raised. The few cases of “quadrataxic hemiparesis” or bilateral leg ataxia remain exceptions. Summary of Case— We report an even more unusual variant, namely “crossed ataxia” of the contralesional arm and the ipsilesional leg subsequent to an anteromedial pontine ischemic stroke. Conclusions— MRI diffusion tensor imaging tractography shows that caudal contralesional crossing Pontocerebellar Fibers (those for the leg) travel trough the lesion, whereas more rostral Fibers (those for the arm) are spared.