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Article: Do Not Give Up on Ossified Tuberculum Sellae Meningioma - Vision Restored.

Candanedo, Carlos / Attia, Moshe

2020 Volume 12, Issue 10, Page(s) e11258

Abstract: This case report accompanies a video of the treatment of a Tuberculum sellae meningioma (TSM) in a woman that presented with left eye near-blindness. The senior author conducted the operation via a pterional retractorless approach, and the patient had a ... ...

Abstract	This case report accompanies a video of the treatment of a Tuberculum sellae meningioma (TSM) in a woman that presented with left eye near-blindness. The senior author conducted the operation via a pterional retractorless approach, and the patient had a full recovery. This case report discusses the unique anatomy of conchal sphenoid sinus, ossified TSM with very calcified consistency, and retractorless brain microsurgery. The resection of ossified TSM is still safe and viable with adequate microsurgical techniques and skull base instruments without compromising the neurovascular structure and with good neurological and visual outcomes for the patient.
Language	English
Publishing date	2020-10-30
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.11258
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: ICG Flow 800 technology targeted STA-MCA microvascular bypass for exclusion of deep-seated fusiform MCA aneurysm: 2-dimensional operative video.

Candanedo, Carlos / Goldstein, Kobi / Cohen, José E / Spektor, Sergey

Neurosurgical focus: Video

2022 Volume 6, Issue 1, Page(s) V14

Abstract: The authors present the case of an 18-year-old male with a deep-seated left fusiform dissecting M3 aneurysm for which endovascular treatment was not applicable. At the open surgery, they used the less commonly reported FLOW 800 fluorescent indocyanine ... ...

Abstract	The authors present the case of an 18-year-old male with a deep-seated left fusiform dissecting M3 aneurysm for which endovascular treatment was not applicable. At the open surgery, they used the less commonly reported FLOW 800 fluorescent indocyanine green (ICG) videoangiography, before and after parental aneurysmal artery temporary clipping, to locate the distal outflow branch of the aneurysm and use it as the recipient artery for a superficial temporal artery-M4 bypass, excluding the aneurysm by clipping the parental artery. Repeated ICG FLOW 800 angiography confirmed bypass patency and adequate blood flow. The aneurysm's exclusion from circulation was confirmed by digital subtraction angiography postoperatively. The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID21183.
Language	English
Publishing date	2022-01-01
Publishing country	United States
Document type	Journal Article
ISSN	2643-5217
ISSN (online)	2643-5217
DOI	10.3171/2021.10.FOCVID21183
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Article: Cavernous Sinus Epidermoid Cyst Removal through a No-Keyhole Pterional Craniotomy: Operative Video and Technical Nuances.

Candanedo, Carlos / Moscovici, Samuel / Spektor, Sergey

Journal of neurological surgery. Part B, Skull base

2021 Volume 83, Issue Suppl 3, Page(s) e623–e624

Abstract: Intracranial epidermoid cysts are considered benign tumors with good general prognosis. However, their radical removal may be associated with certain morbidity, especially when the capsule is attached to neurovascular structures. Epidermoid cysts located ...

Abstract	Intracranial epidermoid cysts are considered benign tumors with good general prognosis. However, their radical removal may be associated with certain morbidity, especially when the capsule is attached to neurovascular structures. Epidermoid cysts located in the cavernous sinus are very rare. We present an operative video of a 22-year-old female patient, who suffered a right-sided headache for 5 years. The video demonstrates main steps and surgical nuances of resection of a right interdural cavernous sinus epidermoid cyst, measuring 22 × 19 × 21 mm (4.3 cc) ( Fig. 1A ). On initial physical examination, the patient had a right partial third nerve palsy (mild ptosis with minimal diplopia), without any other cranial nerve deficit. A right no-keyhole pterional craniotomy was performed, followed by extradural anterior clinoidectomy and peeling of the outer dural layer of the lateral wall of the cavernous sinus. The dura matter was also detached from the distal carotid dural ring, which was exposed by the clinoidectomy ( Fig. 2A ). This maneuver provided excellent exposure of the interdural epidermoid cyst, which severely compressed the oculomotor nerve against the posterior petroclinoid dural fold ( Fig. 2B ). Gross total resection of the epidermoid cyst was achieved ( Fig. 1B and C ). The patient developed a transient worsening of the third nerve palsy, which recovered completely 3 months after the surgery. Postoperative magnetic resonance imaging revealed no signs of residual tumor. The link to the video can be found at: https://youtu.be/pobhYb5ZNig .
Language	English
Publishing date	2021-05-03
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2654269-9
ISSN	2193-634X ; 2193-6331
ISSN (online)	2193-634X
ISSN	2193-6331
DOI	10.1055/s-0041-1727118
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Article: CPA Epidermoid Cyst with Rare Anatomic Variant: Anterior Inferior Cerebellar Artery Embedded in the Subarcuate Fossa: Operative Video and Technical Nuances.

Candanedo, Carlos / Spektor, Sergey

Journal of neurological surgery. Part B, Skull base

2018 Volume 80, Issue Suppl 3, Page(s) S323–S324

Abstract: Intracranial epidermoid cysts are considered benign tumors with a good general prognosis; however, their radical removal, including tumor capsule, is associated with significant morbidity, especially when the capsule is attached to neurovascular ... ...

Abstract	Intracranial epidermoid cysts are considered benign tumors with a good general prognosis; however, their radical removal, including tumor capsule, is associated with significant morbidity, especially when the capsule is attached to neurovascular structures. We show an operative video describing main steps and surgical nuances in the resection of a large right cerebellopontine angle (CPA) epidermoid cyst in a 42-year-old male patient who presented with intractable trigeminal neuralgia. Craniectomy was performed to exposure the transverse-sigmoid sinus junction. A mold for a polymethylmethacrylate (PMMA) bone flap was built before opening the dura to avoid potentially neurotoxic effects on the cerebellum. The video illustrates the management of the rare anatomical variant of the anterior inferior cerebellar artery (AICA). Its loop was embedded in the dura, covering the subarcuate fossa where it gives off the subarcuate artery. Near total removal of the epidermoid cyst was achieved, leaving only a tiny capsule remnant adhering to the abducens nerve. Postoperatively the patient's trigeminal neuralgia was fully relieved and medications were discontinued. The patient's hearing was preserved per audiometry at the preoperative level (Gardner-Robertson II). Postoperative magnetic resonance imaging (MRI) revealed no signs of residual tumor. In this case, it was not possible to obtain optimal surgical exposure of the CPA without handling a rare anatomical anomaly of the AICA in the dura of the subarcuate fossa, which demanded coagulation and transection of the subarcuate artery and transposition of AICA with the dural cuff. This manipulation enabled optimal surgical removal of the epidermoid and didn't cause any neurological deficit. The link to the video can be found at: https://youtu.be/lLZqBHlu-uA .
Language	English
Publishing date	2018-10-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2654269-9
ISSN	2193-634X ; 2193-6331
ISSN (online)	2193-634X
ISSN	2193-6331
DOI	10.1055/s-0038-1675165
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Article ; Online: Medulla oblongata cavernoma removal through a lazy far lateral approach: operative video and technical nuances.

Candanedo, Carlos / Moscovici, Samuel / Spektor, Sergey

Neurosurgical focus: Video

2019 Volume 1, Issue 2, Page(s) V21

Abstract: Removal of brainstem cavernous malformation remains a surgical challenge. We present a case of a 63-year-old female who was diagnosed with a large cavernoma located in the medulla oblongata. The patient suffered three episodes of brainstem bleeding ... ...

Abstract	Removal of brainstem cavernous malformation remains a surgical challenge. We present a case of a 63-year-old female who was diagnosed with a large cavernoma located in the medulla oblongata. The patient suffered three episodes of brainstem bleeding resulting in significant neurological deficits (hemiparesis, dysphagia, and dysarthria). It was decided to remove the cavernoma through a left-sided modified far lateral approach.
Language	English
Publishing date	2019-10-01
Publishing country	United States
Document type	Journal Article
ISSN	2643-5217
ISSN (online)	2643-5217
DOI	10.3171/2019.10.FocusVid.19430
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Article ; Online: The infratranstentorial subtemporal approach (ITSTA): a valuable skull base approach to deep-seated non-skull base pathology.

Candanedo, Carlos / Moscovici, Samuel / Spektor, Sergey

Acta neurochirurgica

2019 Volume 161, Issue 11, Page(s) 2335–2342

Abstract: Background: Surgical access to space-occupying lesions such as tumors and vascular malformations located in the area of the tentorial notch, mediobasal temporal lobe, and para-midbrain is difficult. Lesions in this area are typically resected with ... ...

Abstract	Background: Surgical access to space-occupying lesions such as tumors and vascular malformations located in the area of the tentorial notch, mediobasal temporal lobe, and para-midbrain is difficult. Lesions in this area are typically resected with supratentorial approaches demanding significant elevation of the temporal lobe or even partial lobectomy, or via a supracerebellar transtentorial approach. We introduce an alternative, the skull base infratranstentorial subtemporal approach (ITSTA), which provides excellent exposure of the incisural area while minimizing risk to the temporal lobe. Methods: We included consecutive patients with pathology involving the area of the tentorial incisura, para-midbrain, and mediobasal temporal area who underwent surgery via ITSTA from 2012 to 2018. The approach includes partial mastoidectomy, temporal craniotomy, and tentorial section. Space obtained by mastoidectomy provides a sharp high-rising angle-of-attack, significantly diminishing the need for temporal lobe retraction. Surgeries were performed using microsurgical techniques, neuronavigation, and electrophysiological monitoring. Clinical presentation, tumor characteristics, extent of resection, complications, and outcome were retrospectively reviewed under a waiver of informed consent. Results: Nine patients met inclusion criteria (five female, four male; mean age 44 years, range 7-72). They underwent surgery for removal of para-midbrain arteriovenous malformation (AVM, 3/9), medial tentorial meningioma (2/9), mediobasal epidermoid cyst (2/9), oculomotor schwannoma (1/9), or pleomorphic xanthoastrocytoma (PXA) of the fusiform gyrus (1/9). Three AVMs were removed completely; among six patients with tumors, gross total resection was achieved in three and subtotal resection in three. All surgeries were uneventful without complications. There were no new permanent neurological deficits. At late follow-up (mean 42.5 months), eight patients had a Glasgow Outcome Score (GOS) of 5. One 66-year-old female died 18 months after surgery for reasons not related to her disease or surgery. Conclusions: The ITSTA is a valuable skull base approach for removal of non-skull base pathologies located in the difficult tentorial-incisural parabrainstem area.
MeSH term(s)	Adult ; Aged ; Arteriovenous Malformations/surgery ; Brain Neoplasms/surgery ; Child ; Dura Mater/surgery ; Female ; Humans ; Male ; Middle Aged ; Neuronavigation/adverse effects ; Neuronavigation/methods ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Skull Base/surgery ; Temporal Lobe/surgery
Language	English
Publishing date	2019-09-05
Publishing country	Austria
Document type	Journal Article
ZDB-ID	80010-7
ISSN	0942-0940 ; 0001-6268
ISSN (online)	0942-0940
ISSN	0001-6268
DOI	10.1007/s00701-019-04050-9
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Article ; Online: Dural based tumor causing cognitive decline: Question.

Candanedo, Carlos / Kaye, Andrew H / Moscovici, Samuel

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

2019 Volume 72, Page(s) 420

Language	English
Publishing date	2019-11-09
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	1193674-5
ISSN	1532-2653 ; 0967-5868
ISSN (online)	1532-2653
ISSN	0967-5868
DOI	10.1016/j.jocn.2019.10.016
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Article ; Online: Dural based tumor causing cognitive decline: Answer.

Candanedo, Carlos / Kaye, Andrew H / Moscovici, Samuel

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

2019 Volume 72, Page(s) 493–494

Language	English
Publishing date	2019-11-20
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	1193674-5
ISSN	1532-2653 ; 0967-5868
ISSN (online)	1532-2653
ISSN	0967-5868
DOI	10.1016/j.jocn.2019.10.019
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Article: Cavernous Sinus Epidermoid Cyst Removal through a No-Keyhole Pterional Craniotomy: Operative Video and Technical Nuances

Candanedo, Carlos / Moscovici, Samuel / Spektor, Sergey

Journal of Neurological Surgery Part B: Skull Base

2021 Volume 83, Issue S 03, Page(s) e623–e624

Abstract	Intracranial epidermoid cysts are considered benign tumors with good general prognosis. However, their radical removal may be associated with certain morbidity, especially when the capsule is attached to neurovascular structures. Epidermoid cysts located in the cavernous sinus are very rare. We present an operative video of a 22-year-old female patient, who suffered a right-sided headache for 5 years. The video demonstrates main steps and surgical nuances of resection of a right interdural cavernous sinus epidermoid cyst, measuring 22 × 19 × 21 mm (4.3 cc) (Fig. 1A). On initial physical examination, the patient had a right partial third nerve palsy (mild ptosis with minimal diplopia), without any other cranial nerve deficit. A right no-keyhole pterional craniotomy was performed, followed by extradural anterior clinoidectomy and peeling of the outer dural layer of the lateral wall of the cavernous sinus. The dura matter was also detached from the distal carotid dural ring, which was exposed by the clinoidectomy (Fig. 2A). This maneuver provided excellent exposure of the interdural epidermoid cyst, which severely compressed the oculomotor nerve against the posterior petroclinoid dural fold (Fig. 2B). Gross total resection of the epidermoid cyst was achieved (Fig. 1B and C). The patient developed a transient worsening of the third nerve palsy, which recovered completely 3 months after the surgery. Postoperative magnetic resonance imaging revealed no signs of residual tumor. The link to the video can be found at: https://youtu.be/pobhYb5ZNig.
Keywords	anterior clinoidectomy ; cavernous sinus ; epidermoid cyst ; oculomotor nerve ; operative video ; posterior petroclinoid ligament ; pterional craniotomy
Language	English
Publishing date	2021-05-03
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2654269-9
ISSN	2193-634X ; 2193-6331
ISSN (online)	2193-634X
ISSN	2193-6331
DOI	10.1055/s-0041-1727118
Database	Thieme publisher's database

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Article ; Online: The oblique occipital sinus - implications in posterior fossa approaches.

Candanedo, Carlos / Moscovici, Samuel / Kaye, Andrew H / Spektor, Sergey

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

2020 Volume 76, Page(s) 202–204

Abstract: The retrosigmoid craniotomy is the standard approach to resect pathologies in the cerebellopontine angle (CPA). Following the craniotomy, the dura mater is opened in the inferolateral direction and the basal cistern arachnoid is dissected in order to ... ...

Abstract	The retrosigmoid craniotomy is the standard approach to resect pathologies in the cerebellopontine angle (CPA). Following the craniotomy, the dura mater is opened in the inferolateral direction and the basal cistern arachnoid is dissected in order to release pressure by the outflow of cerebrospinal fluid (CSF) from the foramen magnum, so that the CPA compartment can be approached with minimal retraction of the cerebellum. We report two patients, both with vestibular schwannoma, in whom preoperative magnetic resonance imaging (MRI) revealed unusual large oblique occipital sinus (OOS) draining laterally into the sigmoid sinus - jugular bulb junction. The sinuses were preserved intact while dura mater was opened for CSF release. Careful preoperative imaging is essential prior to posterior fossa lesions approaches in order to evaluate the persistency of an OOS, especially in a retrosigmoid approach. Inadvertent OOS damage might result in, not only significant bleeding during dural opening, but also air embolism or venous hypertension, if the contralateral sigmoid sinus is small or absent.
MeSH term(s)	Adult ; Cerebellopontine Angle/surgery ; Cranial Fossa, Posterior/surgery ; Cranial Sinuses/pathology ; Craniotomy ; Dura Mater/surgery ; Female ; Foramen Magnum/surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neuroma, Acoustic/surgery ; Preoperative Care
Language	English
Publishing date	2020-04-18
Publishing country	Scotland
Document type	Case Reports ; Journal Article
ZDB-ID	1193674-5
ISSN	1532-2653 ; 0967-5868
ISSN (online)	1532-2653
ISSN	0967-5868
DOI	10.1016/j.jocn.2020.04.055
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