Cerebrovascular and Skull Base Surgery: Current Status and Future Perspective

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 30 September 2024 | Viewed by 1420

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Guest Editor
Neurosurgery Unit, Ospedale Moriggia Pelascini, Gravedona, Italy
Interests: general neurosurgery; endoscopy; neuro-oncology surgery; hydrocephalus
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Special Issue Information

Dear Colleagues,

The field of cerebrovascular and skull base surgery has witnessed remarkable advancements in recent years, transforming the diagnosis and treatment of complex brain pathologies. To capture the latest developments and shed light on future perspectives, this Special Issue aims to provide a comprehensive overview of the current status and emerging trends in these specialized areas.

The primary aim of this Special Issue is to reflect current research and address the core problems faced in cerebrovascular and skull base surgery. With advancements in surgical techniques, imaging modalities, and perioperative management, there is a need to evaluate the effectiveness and safety of these approaches, as well as identify areas for further improvement.

Contributions may include original research articles, review articles, case studies, and perspectives on surgical techniques, innovative approaches, imaging modalities, complication management, and emerging technologies. Furthermore, this Special Issue encourages interdisciplinary collaborations, inviting contributions from neurosurgeons, neuroradiologists, neurologists, and other allied healthcare professionals.

By gathering diverse perspectives and experiences, this Special Issue will contribute to advancing the field of cerebrovascular and skull base surgery and improving patient outcomes.

Dr. Cesare Zoia
Guest Editor

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Keywords

  • neurosurgery
  • cerebrovascular diseases
  • skull base tumors
  • surgical techniques
  • minimally invasive approaches
  • advanced imaging modalities
  • future perspectives

Published Papers (2 papers)

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Research

14 pages, 6717 KiB  
Article
Navigating Complexity: A Comprehensive Approach to Middle Cerebral Artery Aneurysms
by Anna Maria Auricchio, Rina Di Bonaventura, Enrico Marchese, Giuseppe Maria Della Pepa, Carmelo Lucio Sturiale, Grazia Menna, Benjamin Skrap, Alessandro Olivi and Alessio Albanese
J. Clin. Med. 2024, 13(5), 1286; https://doi.org/10.3390/jcm13051286 - 24 Feb 2024
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Abstract
Background: The concept of aneurysm “complexity” has undergone significant changes in recent years, with advancements in endovascular treatments. However, surgical clipping remains a relevant option for middle cerebral artery (MCA) aneurysms. Hence, the classical criteria used to define surgically complex MCA aneurysms require [...] Read more.
Background: The concept of aneurysm “complexity” has undergone significant changes in recent years, with advancements in endovascular treatments. However, surgical clipping remains a relevant option for middle cerebral artery (MCA) aneurysms. Hence, the classical criteria used to define surgically complex MCA aneurysms require updating. Our objective is to review our institutional series, considering the impacts of various complexity features, and provide a treatment strategy algorithm. Methods: We conducted a retrospective review of our institutional experience with “complex MCA” aneurysms and analyzed single aneurysmal-related factors influencing treatment decisions. Results: We identified 14 complex cases, each exhibiting at least two complexity criteria, including fusiform shape (57%), large size (35%), giant size (21%), vessel branching from the sac (50%), intrasaccular thrombi (35%), and previous clipping/coiling (14%). In 92% of cases, the aneurysm had a wide neck, and 28% exhibited tortuosity or stenosis of proximal vessels. Conclusions: The optimal management of complex MCA aneurysms depends on a decision-making algorithm that considers various complexity criteria. In a modern medical setting, this process helps clarify the choice of treatment strategy, which should be tailored to factors such as aneurysm morphology and patient characteristics, including a combination of endovascular and surgical techniques. Full article
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12 pages, 12047 KiB  
Article
Ultra-Early Treatment of Neurosurgical Emergencies with Endoscopic Endonasal Approach: Experience from Three Italian Referral Centers
by Pier Paolo Mattogno, Matteo Zoli, Quintino Giorgio D’Alessandris, Daniele Bongetta, Valerio Maria Caccavella, Mario Rigante, Giuseppe Maria Della Pepa, Diego Mazzatenta, Liverana Lauretti, Alessandro Olivi, Giannantonio Spena and Cesare Zoia
J. Clin. Med. 2023, 12(17), 5471; https://doi.org/10.3390/jcm12175471 - 23 Aug 2023
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Abstract
Purpose: the aim of this multicenter study is to preliminarily assess the role of the Endoscopic Endonasal Approach (EEA) in ultra-early (i.e., within 12 h) management of selected neurosurgical emergencies in terms of clinical and radiological outcomes. Methods: 26 patients affected by sellar/parasellar [...] Read more.
Purpose: the aim of this multicenter study is to preliminarily assess the role of the Endoscopic Endonasal Approach (EEA) in ultra-early (i.e., within 12 h) management of selected neurosurgical emergencies in terms of clinical and radiological outcomes. Methods: 26 patients affected by sellar/parasellar pathologies with rapid progression of symptoms were managed with EEA within 12 h from diagnosis in three Italian tertiary referral Centers from January 2016 to December 2019. Both clinical and radiological data have been collected preoperatively as well as post-operatively in order to perform retrospective analysis. Results: The average time from admission to the operating room was 5.5 h (±2.3). The extent of resection was gross-total in 20 (76.9%), subtotal in 6 (23.1%) patients. One patient experienced re-bleeding after a subtotal removal of a hemorrhagic lesion. Patients with a longer time from admission (>4 h) to the operatory room (OR) experienced stable impairment of the visual acuity (p = 0.033) and visual field (p = 0.029) in the post-operative setting. Conclusions: The Endoscopic Endonasal Approach represents a safe, effective technique that can be efficiently used with good results in the management of selected neurosurgical emergencies in centers with adequate experience. Full article
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