Neurosurgical Atlasさんのイラストまとめ

For microvascular decompression for trigeminal neuralgia, I specifically insert a piece of shredded Teflon along the shoulder & medial axilla of the nerve & gently push it distally to prevent contact between the vessel & the root entry zone or brainstem

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For microvascular decompression operations, I attempt, but do not persist, on performing a watertight dural closure because these operations are associated with a very low rate of CSF leak through the incision or the nose.

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During microvascular decompression for trigeminal neuralgia, careful arachnoid dissection and correct CN identification are paramount. Care must be taken to preserve all of the vessels around the brainstem.

https://t.co/Km71G4zbW8

During placement of a ventriculo-gallbladder shunt, two concentric purse-string sutures are placed in the dome of the gallbladder. A puncture is made and the purse-string sutures are tightened around the metallic straight connector.

https://t.co/rty8NAPFuR

Here we demonstrate four possible approaches to the pineal region, including interhemispheric, transcallosal, occipital transtentorial, and transventricular. The lateral supracerebellar is most effective and safe, sparing the midline cerebellar veins.

https://t.co/0fwGAlbwxk

The black line marks the ideal size for a #decompressive #craniectomy, while the red line is too restrictive and could lead to strangulation of the herniating brain at the edges of the craniectomy, causing further infarction.

#nsgy #trauma

https://t.co/JMRapuE2LY

Following epidural #hematoma evacuation, #dural tenting sutures can help prevent delayed reaccumulation of hemorrhage from dural vessels. The sutures should be placed around and in the center of the bone flap.

#nsgy #trauma

https://t.co/l2xTG8so43

The #bicoronal incision should extend from the bilateral zygoma to include the vertex, 2 fingerbreadths posterior to the coronal suture. Which vital midline structure must be maintained throughout the operation?

#nsgy #decompressive #craniectomy

https://t.co/JMRapumrUq

A large epidural #hematoma (#EDH) causing mass effect is demonstrated. Which types of #herniation could be caused by a large, expanding EDH?

#nsgy #trauma

https://t.co/l2xTG8so43

The answer to yesterday’s #imagechallenge was an epidermoid cyst! Congratulations to all those who answered correctly! In the image above, you can see that the pearly flakes of the cyst can be easily removed using handheld suction or pituitary rongeurs.

https://t.co/csdCtlyYMq