Supracerebellar transtentorial approach-resection of the tentorium instead of an opening-to provide broad exposure of the mediobasal temporal lobe: anatomical aspects and surgical applications Clinical article

Object. The aim of this study was to describe the surgical anatomy of the mediobasal aspect of the temporal lobe and the supracerebellar transtentorial (SCTT) approach performed not with an opening, but with the resection of the tentorium, as an alternative route for the neurosurgical management of vascular and tumoral lesions arising from this region. Methods. Cadaveric specimens were used to illustrate the surgical anatomy of the mediobasal region of the temporal lobe. Demographic aspects, characteristics of lesions, clinical presentation, surgical results, follow-up findings, and outcomes were retrospectively reviewed for patients referred to receive the SCTT approach with tentorial resection. Results. Ten patients (83%) were female and 2 (17%) were male. Their ages ranged from 6 to 59 years (mean 34.5 +/- 15.8 years). All lesions (3 posterior cerebral artery aneurysms, 3 arteriovenous malformations, 3 cavernous malformations, and 3 tumors) were completely excluded or resected. After a mean follow-up period of 143 months (range 10-240 months), the mean postoperative Glasgow Outcome Scale score was 4.9. Conclusions. Knowledge of the surgical anatomy provides improvement for microsurgical approaches. The evolution from a small opening to a resection of the tentorium absolutely changed the exposure of the mediobasal aspect of the temporal lobe. The SCTT approach with tentorial resection is an excellent alternative route to the posterior part of mediobasal aspect of the temporal lobe, and it was enough to achieve the best neurosurgical management of tumoral and vascular lesions located in this area. (http://thejns.org/doi/abs/10.3171/2011.12.JNS111256)

Ultrassonografia transcraniana em cães adultos hígidos: padronização da técnica, aspectos anatômicos e biométricos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Online Dictionary of Invertebrate Zoology: T

tabula tabular tachyauxesis tachyblastic tachygen tachygenesis tachytelic tactic tactile tactoreceptors taenia taeniate taenidium taenioglossate tagma tagmata tagmosis tail tailfan Takakura's talon talus tandem tangent tangoreceptor tanylobous tapetal tapetum tapinoma-odor Tardigrada tardigrades tarsal tarsation tarsite tarsomere tarsungulus tarsus taste tautonomy tautonym taxa taxes taxis taxis taxodont taxometrics taxon taxonomic taxonomist taxonomy tectiform tectostracum tectum teeth teges tegillum tegmen tegmentum tegula tegular tegulum tegumen tegument tegumentary tela telaform telamon telegonic teleiochrysalis telenchium teleoconch teleodont teleology teleotrocha telepod telescope telescopic teletrophic telioderma teliophan telmophage telocentric telodendria telofemur telogonic telolecithal telomitic telophase telophragma telopod telopodite telorhabdions telosonic telostome telosynapsis telosyndesis telotarsus telotaxis telotroch telson template temporal tenacipeds tenaculum tenent teneral tensor tentacle tentacular tentaculocyst tentaculozooid tentilla tentorial tentorium tenuous teratocyte teratogen teratogenesis teratogyne teratology terebella terebra terebrant terebrate teres terete terga tergal tergite tergolateral tergopleural tergopore tergum tergum termen terminal terminalia termitarium termitophile terranes terrestrial terricolous territory tertiary tertibrach tertibrachial tessellate test testaceology testaceous test-cross testes testis testisac testudinate tetanus tetany tetractinal tetractine tetrad tetradelphic tetramerous tetramorphic tetraploid tetrapod tetrapterous tetrasomic tetrathyridial tetrathyridium tetraxon tetraxonid thalassophilous thallus thamnophilous thanatocoenosis thanatosis theca thecae thecal thecate thelycum thelygenesis thelygenous thelyotokous thelyotoky theory thermocline thermophile thermophobe thermoreceptor thermotaxis thickness thigmotactic thigmotaxis thigmotropism third-form thoraces thoracic thoracomere thoracopod(ite) thorax thoraxes thread thylacium thylacogen thyridial thyridium thyroid thysanuriform tibia tibial tibiotarsal tibiotarsus Tiedemann's tiled timbal tinctorial tine tissue tissue titilla titillae titillator tocopherol tocospermal tocospermia tocostome tokostome tomentose tomentum Tomosvary tone tonic tonofibrillae tonus topochemical topogamodeme topomorph topomorphic toponym topotype tori torma tormogen tornote tornus torose torpid torqueate torsion tortuose torulose torus totipotent totomount toxa toxicognath toxicology toxin toxinosis toxoglossate toxoid trabecula trabeculate trabeculated trachea tracheae tracheal tracheate tracheoblast tracheolar tracheoles trachychromatic tract Tragardh's tragus transad transcoxa transcurrent transect transection transformation transient transitional translocation translucent transmission transposed transscutal transstadial transtilla transverse trapeziform trapezium trapezoid trema tremata Trematoda trenchant trepan triact triactinal triad triaene triage triangle triangular triangulate triaulic triaxial triaxon tribe tribocytic trichite trichobothrium trichobranchia trichobranchiate trichocerous trichodes trichodeum trichodragmata trichogen trichoid trichomes trichophore trichopore trichosors trichostichal trichotomous trichroism tricolumella tricomes tricostate tricrepid tricuspid tricuspidate tridactyl trident tridentate trifid trifurcate triglycerides trignathan trigonal trigoneutism trilabiate trilateral trilobate trilocular trimorphic trimorphism Trinominal triordinal tripartite tripectinate triplet triploblastic triploid triquetral triquetrous triradiate triradiates tritocerebral tritocerebrum tritocerebrum tritonymph tritosternum triturate triungulin triungulinid trivial trivium trivoltine trixenic troch trochal trochalopodous trochantellus trochanter trochanteral trochantin trochi trochiform trochlea trocholophous trochophore trochosphere trochus troglobiont troglodytic troglophile trogloxene tropeic trophal trophallactic trophallaxis trophamnion trophi trophic trophidium trophobiont trophobiont trophobiosis trophobiotic trophocytes trophodisc trophogeny trophoporic trophorhinium trophosome trophotaxis trophothylax trophozooid trophus tropis tropism tropotaxis trumpet truncate truncation trunk trypsin tryptic tryptophan tryptophane T-tubule tube tube-feet tubercle tubercula tuberculate tuberculose tuberiferous tubicolous tubifacient tubule tubulus tubus tuft Tullgren tumefaction tumescence tumid tumulus tunic tunica tunicary tunicate turbinate turgid turreted turriculate tychoparthenogenesis tylasters tylenchoid tyli tyloid tyloides tylosis tylostyle tylote tylus tymbal tympanal tympanal tympanic tympanum Tyndall type typhlosole typologist typolysis typostasis

Endovascular Treatment of Tentorial Dural Arteriovenous Fistulae

Tentorial dural arteriovenous fistula (DAVF) is a rare vascular disease, which accounts for less than 4% of all cases of intracranial DAVF Because of the high risk of intracranial hemorrhage, patients with tentorial DAVF need aggressive treatment. Management approaches are still controversial, and endovascular treatment has emerged as an effective alternative. In the current work, we describe our experience with the endovascular approach in the treatment of these deep and complex DAVF of the tentorium. Eight patients were treated between January 2006 and July 2009. Six patients (75%) presented with intracranial hemorrhage related to the DAVF rupture. Four patients (50%) had subarachnoid bleeding and two had intraparenchymal hematoma. Endovascular treatment was performed via the transarterial route alone in five cases (62.5%), by the transvenous approach in two cases (25.0%) and in a combined procedure using both arterial and venous routes in one patient (12.5%). Complete obliteration of the fistula was achieved in all cases. The outcome at 15 months was favorable (modified Rankin scale 0-3) in seven (87.5%) patients. Complete cure of the lesion was confirmed in these cases. This paper reports on the effectiveness of endovascular treatment in tentorial DAVF management The choice of the venous versus the arterial approach is determined by regarding different anatomical dispositions.

Combined pre- and subtemporal transtentorial approach for epidermoid cysts of the cerebellopontine angle

Objective Epidermoid cysts of the cerebellopontine angle (CPA) can be a surgical challenge for the pediatric neurosurgeon. Ideally, total removal must be achieved; however, occasional adhesions of these tumors to vital neurovascular structures and extension far beyond the midline may preclude their total removal. The aims of this article are to present an alternative surgical approach to these lesions and to provide the rationale for this technique. Material and methods A 16-year-old boy was admitted to our pediatric neurosurgery department with a 1-year history of nonspecific headaches. His neurological examination showed right-sided dysmetria and gait ataxia. Magnetic resonance scans showed a space-occupying lesion on the right CPA with low intensity on T-1-weighted images and high intensity on T-2-weighted images. Results Craniotomy for tumor excision via pre- and subtemporal transtentorial approach was performed disclosing a 3.5 x 3 x 2.8-cm(3) well-encapsulated tumor, which was confirmed to be an epidermoid cyst. The postoperative course was uneventful. Conclusions A combined pre- and subtemporal approach utilizes a wide opening of the tentorium and the option of supratentorial retraction of the cerebellum to provide an excellent angle of approach to CPA lesions involving the anterolateral aspect of the brain stem in children.

Multiple meningiomas: clinical, radiological, surgical, and pathological findings with outcome in four cats

The present report describes the clinical signs, magnetic resonance imaging (MRI) findings, surgical procedure, pathological findings and follow-up in four cats with multiple meningiomas; three castrated male and one spayed female domestic shorthair indoor cats, ranging in age from 11 to 14 years. In three of four cats, clinical signs at presentation were suggestive of a focal lesion. Three cats had two meningiomas and one had four meningiomas. Most of the tumours were supratentorial, one arose from the tentorium and one was infratentorial. The duration of presenting signs before surgery ranged from 10 days to 11 months. Postoperative MRI revealed complete gross tumour removal in three cases. In one cat with two cranial fossa meningiomas, subtotal excision with a small basal remnant (2 x 2 mm) of the ventral part of one meningioma lying on the floor of the skull, was observed. Based on histopathological architecture, six tumours revealed features of a transitional subtype meningioma, and four of a meningotheliomatous meningioma. In each cat, the multiple meningiomas were all assigned to the same histopathological group. The preoperative presenting signs had resolved by the follow-up examinations 4 weeks after surgery in two cats. Long-term follow-up evaluation revealed that surgically-induced or exacerbated neurological deficits in two cats had completely or almost completely resolved within 8 weeks of surgery. All patients are still alive 12 to 21 months after surgery and no clinical signs of recurrence could be detected at that time.

Cerebral High-grade Oligodendroglioma with Sarcomatous Transdifferentiation ("Oligosarcoma") in a Boxer Dog.

A 9-year-old Boxer dog was referred to the Veterinary Teaching Hospital of the University of Bern for a history of chronic neck pain and gait problems, which rapidly progressed to a non-ambulatory status. Magnetic resonance imaging (MRI) examination of the head revealed a large intra-axial space-occupying lesion that was divided in two portions interconnected by a thin isthmus at the level of the cerebellar tentorium. Histopathology revealed a biphasic malignant neoplasm composed of neuroepithelial and mesenchymal elements. The former displayed characteristics of conventional anaplastic oligodendroglioma involving brisk mitotic activity and glomeruloid microvascular proliferation on a background of a fibrillary round cells with "honeycomb-like" perinuclear vacuolation. Conversely, the sarcomatous moiety exhibited haphazard fascicles of spindle cells amidst an intricate mesh of pericellular basal lamina and broad bands of collagen. Both tumor cell populations immunoreacted for Olig-2 and – to a lesser extent – GFAP. In addition, the sarcomatous areas focally expressed vimentin, muscular actin, and smooth muscle actin. "Oligosarcoma" - an exquisitely uncommon pattern of oligodendroglial malignancy in humans - has not previously been reported to affect dogs, although oligodendroglioma is a common CNS tumor in this species. Whether canine oligosarcoma shares with its human counterpart not only morphological aspects, but also molecular signatures, clinical behavior and responsiveness to therapy merits further investigation. In humans, oligodendroglial differentiation tends to confer significant clinical advantage with respect to prognosis and adjuvant treatment options. The awareness of such hallmarks and the investigation of their impact on prognosis are crucial for improved therapeutical strategies in dogs.

Megabenthic communities in the waters around Svalbard during POLARSTERN cruise ARK-VIII/2 (EPOS II)

Composition and distribution of megabenthic communities around Svalbard were investigated in June/July 1991 with 20 Agassiz trawl and 5 bottom trawl hauls in depths between 100 and 2100 m. About 370 species, ranging from sponges to fish, were identified in the catches. Species numbers per station ranged from 21 to 86. Brittle stars, such as Ophiacantha bidentata, Ophiura sarsi and Ophiocten sericeum, were most important in terms of constancy and relative abundance in the catches. Other prominent faunal elements were eunephthyid alcyonarians, bivalves, shrimps, sea stars and fish (Gadidae, Zoarcidae, Cottidae). Multivariate analyses of the species and environmental data sets showed that the spatial distribution of the megabenthos was characterized by a pronounced depth zonation: abyssal, bathyal, off-shore shelf and fjordic communities were discriminated. However, a gradient in sediment properties, especially the organic carbon content, seemed to superimpose on the bathymetric pattern. Both main factors are interpreted as proxies of the average food availability, which is, hence, suggested to have the strongest influence in structuring megabenthic communities off Svalbard.