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1. List of Contributors

Author

Abbatemarco, J.A., primary, Adams, R.J., additional, Adkins, D.L., additional, Akamatsu, Y., additional, Akyol, O., additional, Alexandrov, A.V., additional, Alim, I., additional, Alkhachroum, A.M., additional, Amin-Hanjani, S., additional, Andjelkovic, A.V., additional, Anrather, J., additional, Applegate, R., additional, Arai, K., additional, Ayata, C., additional, Aziz-Sultan, M.A., additional, Ballesteros, I., additional, Bar, B., additional, Barone, F.C., additional, Barrow, D.L., additional, Başkaya, M.K., additional, Bateman, K., additional, Bazan, N.G., additional, Beecher, J.S., additional, Beer-Furlan, A., additional, Belayev, L., additional, Bhattacharya, P., additional, Bhole, R., additional, Biller, J., additional, Biousse, V., additional, Borlongan, C.V., additional, Bouts, M.J.R.J., additional, Brey, R.L., additional, Bronstein, R., additional, Bryer, A., additional, Bulsara, K.R., additional, Can, A., additional, Canhão, P., additional, Caplan, L.R., additional, Carmichael, S.T., additional, Carrau, R., additional, Castaldo, J., additional, Catanese, L., additional, Chabriat, H., additional, Chaturvedi, S., additional, Chaudhary, N., additional, Chen, Jieli, additional, Chen, S., additional, Chen, Jun, additional, Choi, D.W., additional, Choi, B., additional, Chopp, M., additional, Chung, D.Y., additional, Chung, C.-P., additional, Cipolla, M.J., additional, Colbourne, F., additional, Colburn, Q., additional, Cord, B.J., additional, Coull, B.M., additional, Cuartero, M.I., additional, Cummings, J.L., additional, Dafer, R.M., additional, Dalkara, T., additional, Daou, B., additional, Dave, K.R., additional, Davis, T.P., additional, De Georgia, M., additional, De Silva, T.M., additional, Dharap, A., additional, Di Tullio, M.R., additional, Dietrich, W.D., additional, Dijkhuizen, R.M., additional, Dobkin, B.H., additional, Du, R., additional, Ducruet, A.F., additional, Duncan, K.R., additional, Edvinsson, L., additional, Edwards, M.J., additional, Egemen, E., additional, El-Hunjul, M., additional, Emanuele, M., additional, Emanuele, N., additional, Erdman, M.K., additional, Ergul, A., additional, Fagan, S.C., additional, Faraci, F.M., additional, Federau, C., additional, Ferro, J.M., additional, Fisher, M., additional, Flemming, K.D., additional, Foerch, C., additional, Freitas, R.S., additional, Friedlander, R.M., additional, Gaberel, T., additional, Gakuba, C., additional, Giffard, R.G., additional, Goldberg, M.P., additional, González, R.G., additional, Gopinath, S., additional, Gorelick, P.B., additional, Goshgarian, C., additional, Greenberg, D.A., additional, Griessenauer, C.J., additional, Groshans, K.A., additional, Gupta, R., additional, Hachem, R.A., additional, Hage, Z.A., additional, Hall, E.D., additional, Hamel, E., additional, Hao, Q., additional, Haqqani, A.S., additional, Hariman, R., additional, Hasan, D., additional, Haussen, D.C., additional, He, L., additional, Heiferman, D.M., additional, Herndon, J.M., additional, Ho, W.M., additional, Hoffmann, S., additional, Howard, B.M., additional, Hu, B.R., additional, Huber, J.D., additional, Huisa, B., additional, Hurn, P.D., additional, Iliff, J.J., additional, Jabbour, P., additional, Jamshidi, A.O., additional, Jankowitz, B., additional, Jickling, G.C., additional, Johansen, M., additional, Jovin, T.G., additional, Karuppagounder, S.S., additional, Kasper, E.M., additional, Keep, R.F., additional, Kim, H.-H., additional, Kim, D.E., additional, Kim, J.S., additional, Kim, J.Y., additional, Klahr, A.C., additional, Koch, M.J., additional, Kole, M., additional, Koleilat, S.M., additional, Kozan, A., additional, Kuroda, S., additional, Lamy, C., additional, Lanzino, G., additional, Larsen, A.G., additional, Laviv, Y., additional, Lawton, M.T., additional, Leary, M.C., additional, Leira, E.C., additional, Li, L., additional, Li, Q., additional, Liebeskind, D.S., additional, Lin, L., additional, Lioutas, V.A., additional, Lippert, T., additional, Liu, R., additional, Liu, J., additional, Liu, C.L., additional, Lizasoain, I., additional, Lo, E.H., additional, Loftus, C.M., additional, Logsdon, A.F., additional, Lucke-Wold, B.P., additional, Madhavan, S., additional, Madhugiri, V., additional, Malhotra, K., additional, Manning, W.J., additional, Marcell, S.J., additional, Mas, J.-L., additional, Masamoto, K., additional, Matute, C., additional, McCullough, L.D., additional, McDowell, M.M., additional, Mehdiratta, M., additional, Mehta, D., additional, Meisel, A., additional, Messegee, J., additional, Miller, B., additional, Mirza, S., additional, Modak, J.M., additional, Moro, M.A., additional, Nagel, M.A., additional, Namura, S., additional, Nedergaard, M., additional, Newell, D.W., additional, Newman, N.J., additional, Ng, K.L., additional, Nguyen, D., additional, Nguyen, H., additional, Nielsen, G., additional, Nishijima, Y., additional, Nishimura, N., additional, Nogueira, R.G., additional, Ogilvy, C.S., additional, Orbach, D.B., additional, Ostendorf, A.P., additional, Otto, B., additional, Ozpinar, A., additional, Panczykowski, D.M., additional, Patel, A.B., additional, Perez, Y., additional, Perez-Pinzon, M.A., additional, Potey, C., additional, Pradillo, J.M., additional, Prevedello, D.M., additional, Rajamani, K., additional, Rangel-Castilla, L., additional, Rao, N.M., additional, Ratan, R.R., additional, Raval, A.P., additional, Reddy, G.D., additional, Reis, C., additional, Roach, E.S., additional, Ronaldson, P.T., additional, Rosen, C.L., additional, Rosenberg, G.A., additional, Rutledge, W.C., additional, Sabzwari, R., additional, Salzano, G., additional, Santucci, P.A., additional, Saver, J.L., additional, Schallert, T., additional, Schermerhorn, M.L., additional, Schneck, M.J., additional, See, A.P., additional, Shakir, H.J., additional, Sharp, F.R., additional, Shuja, F., additional, Siddiqui, A.H., additional, Silva, M.A., additional, Singhal, A.B., additional, Sivakumar, K., additional, Slade, D.H., additional, Smith, E.R., additional, Sohrabji, F., additional, Solaroglu, I., additional, Sriraman, S.K., additional, Stamova, B., additional, Stanimirovic, D.B., additional, Stapleton, C.J., additional, Stary, C.M., additional, Steinberg, G.K., additional, Stephen, C., additional, Stetler, R.A., additional, Stone, J., additional, Sumbria, R., additional, Sweis, R., additional, Tahir, R., additional, Tarawneh, R., additional, Tarsia, J., additional, Tehrani, R., additional, Teo, M.K., additional, Testai, F.D., additional, Thrane, A.S., additional, Tobin, M.K., additional, Tome, M.E., additional, Topcuoglu, M.A., additional, Topel, C.H., additional, Torchilin, V., additional, Traystman, R.J., additional, Tsirka, S.E., additional, Turan, Y., additional, Tymianski, M., additional, van Leyen, K., additional, Varade, P., additional, Veluz, J.S., additional, Vemuganti, R., additional, Venkat, P., additional, Vexler, Z.S., additional, Vial, C.M., additional, Vinters, H.V., additional, Vosko, M.R., additional, Waeber, C., additional, Walcott, B.P., additional, Wang, J., additional, Wang, X., additional, Wang, Y.T., additional, Wei, Z.Z., additional, Wei, L., additional, Welch, B.G., additional, Winn, H.R., additional, Wintermark, M., additional, Wityk, R.J., additional, Wu, O., additional, Wu, K.C., additional, Xi, G., additional, Yacoub, H.A., additional, Yakhkind, A., additional, Yamamoto, Y., additional, Yang, S.-H., additional, Yenari, M., additional, Yigitkanli, K., additional, Yonas, H., additional, Yu, Z., additional, Zettervall, S.L., additional, Zhang, J., additional, Zhang, W., additional, and Zhao, H., additional

Published
2017
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6. The Flower Petal Training System in Microsurgery: Validation of a Training Model Using a Randomized Controlled Trial

Author

Volovici, V. (Victor), Dammers, R. (Ruben), Lawton, M.T. (Michael T.), Dirven, C.M.F. (Clemens), Ketelaar, T. (Tijs), Lanzino, G. (Giuseppe), Zamfirescu, D.G. (Dragos G.), Volovici, V. (Victor), Dammers, R. (Ruben), Lawton, M.T. (Michael T.), Dirven, C.M.F. (Clemens), Ketelaar, T. (Tijs), Lanzino, G. (Giuseppe), and Zamfirescu, D.G. (Dragos G.)

Abstract

INTRODUCTION: Despite hundreds of training models for microsurgery being available in the literature, very few of them are scientifically validated. We chose to validate our low-fidelity training model on flower petals by comparing it head-to-head with a moderate fidelity training model, the anastomosis on chicken leg femoral artery. MATERIALS AND METHODS: A total of 16 participants of different levels of expertise were randomized into 2 groups, 1 training on flower petals and 1 on chicken leg femoral arteries. The groups were evaluated on performing a rat femoral artery anastomosis using the validated Stanford Microsurgical Assessment (SMaRT) Scale. The Mann-Whitney U test was used to check for statistically significant differences between the groups. The flower petal sutures were also evaluated and Pearson correlation was used to check for associations between better petal anastomosis scores and better final SMaRT results. RESULTS: After 6 weeks of flower petal training, microsurgical trainees had significantly better overall SMaRT scores than trainees using chicken leg training, better fine tissue feeling, and better scores in knot tying. The anastomosis times for the rat

Published
2019
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9. Genome-wide association study of sporadic brain arteriovenous malformations

Author

Weinsheimer, S., Bendjilali, N., Nelson, J., Guo, D.E., Zaroff, J.G., Sidney, S., McCulloch, C.E., Salman, R. Al-Shahi, Berg, J.N., Koeleman, B.P.C., Simon, M., Bostroem, A., Fontanella, M., Sturiale, C.L., Pola, R., Puca, A., Lawton, M.T., Young, W.L., Pawlikowska, L., Klijn, C.J.M., Kim, H., Weinsheimer, S., Bendjilali, N., Nelson, J., Guo, D.E., Zaroff, J.G., Sidney, S., McCulloch, C.E., Salman, R. Al-Shahi, Berg, J.N., Koeleman, B.P.C., Simon, M., Bostroem, A., Fontanella, M., Sturiale, C.L., Pola, R., Puca, A., Lawton, M.T., Young, W.L., Pawlikowska, L., Klijn, C.J.M., and Kim, H.

Abstract

Item does not contain fulltext, BACKGROUND: The pathogenesis of sporadic brain arteriovenous malformations (BAVMs) remains unknown, but studies suggest a genetic component. We estimated the heritability of sporadic BAVM and performed a genome-wide association study (GWAS) to investigate association of common single nucleotide polymorphisms (SNPs) with risk of sporadic BAVM in the international, multicentre Genetics of Arteriovenous Malformation (GEN-AVM) consortium. METHODS: The Caucasian discovery cohort included 515 BAVM cases and 1191 controls genotyped using Affymetrix genome-wide SNP arrays. Genotype data were imputed to 1000 Genomes Project data, and well-imputed SNPs (>0.01 minor allele frequency) were analysed for association with BAVM. 57 top BAVM-associated SNPs (51 SNPs with p<10(-05) or p<10(-04) in candidate pathway genes, and 6 candidate BAVM SNPs) were tested in a replication cohort including 608 BAVM cases and 744 controls. RESULTS: The estimated heritability of BAVM was 17.6% (SE 8.9%, age and sex-adjusted p=0.015). None of the SNPs were significantly associated with BAVM in the replication cohort after correction for multiple testing. 6 SNPs had a nominal p<0.1 in the replication cohort and map to introns in EGFEM1P, SP4 and CDKAL1 or near JAG1 and BNC2. Of the 6 candidate SNPs, 2 in ACVRL1 and MMP3 had a nominal p<0.05 in the replication cohort. CONCLUSIONS: We performed the first GWAS of sporadic BAVM in the largest BAVM cohort assembled to date. No GWAS SNPs were replicated, suggesting that common SNPs do not contribute strongly to BAVM susceptibility. However, heritability estimates suggest a modest but significant genetic contribution.

Published
2016

12. List of Contributors

Author

Abramowicz, A.E., Artru, A.A., Asgarzadie, F., Bendo, A.A., Bruder, N.J., Chui, J., Cole, D.J., Cottrell, J.E., Crosby, G., Culley, D.J., Czosnyka, M., Daly, S.C., Deer, T.R., DeKosky, S.T., Domino, K.B., Dowd, C.F., Drummond, J.C., Ehrenfeld, J.M., Ellis, J.A., Emory, L., Friese, M.B., Gambling, D.R., Gelb, A.W., Griffiths, T.L., Hensley, J., Herrick, I.A., Higashida, R.T., Hou, J.Y., St. Jacques, P.J., Jameson, L.C., Janik, D.J., Joshi, S., Kass, I.S., Kirkman, M.A., Kofke, W.A., Koht, A., Kutteruf, R., Lam, A.M., Lawton, M.T., Lee, C.Z., Lei, B., Manninen, P.H., Matsumoto, M., Matta, B., McManus, M.L., Minokadeh, A., Moreno, J.D., Ornstein, E., Patel, P., Phan, R.D., Pong, R.P., Pope, J.E., Ravussin, P., Rizvi, T., Rozet, I., Rusa, R., Sakabe, T., Schlichter, R.A., Schoettker, P., Schubert, A., Sloan, T.B., Smith, M., Smith, D.S., Soriano, S.G., III, Stier, G.R., Talke, P.O., U, H.S., Vagnerova, K., Venkatraghavan, L., Wintermark, M., Wlody, D.J., Worah, S.H., and Yocum, G.T.

Published
2017
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15. A genome-wide investigation of copy number variation in patients with sporadic brain arteriovenous malformation

Author

Bendjilali, N., Kim, H., Weinsheimer, S., Guo, D.E., Kwok, P.Y., Zaroff, J.G., Sidney, S., Lawton, M.T., McCulloch, C.E., Koeleman, B.P.C., Klijn, C.J., Young, W.L., Pawlikowska, L., Bendjilali, N., Kim, H., Weinsheimer, S., Guo, D.E., Kwok, P.Y., Zaroff, J.G., Sidney, S., Lawton, M.T., McCulloch, C.E., Koeleman, B.P.C., Klijn, C.J., Young, W.L., and Pawlikowska, L.

Abstract

Contains fulltext : 169573.PDF (publisher's version ) (Open Access), BACKGROUND: Brain arteriovenous malformations (BAVM) are clusters of abnormal blood vessels, with shunting of blood from the arterial to venous circulation and a high risk of rupture and intracranial hemorrhage. Most BAVMs are sporadic, but also occur in patients with Hereditary Hemorrhagic Telangiectasia, a Mendelian disorder caused by mutations in genes in the transforming growth factor beta (TGFbeta) signaling pathway. METHODS: To investigate whether copy number variations (CNVs) contribute to risk of sporadic BAVM, we performed a genome-wide association study in 371 sporadic BAVM cases and 563 healthy controls, all Caucasian. Cases and controls were genotyped using the Affymetrix 6.0 array. CNVs were called using the PennCNV and Birdsuite algorithms and analyzed via segment-based and gene-based approaches. Common and rare CNVs were evaluated for association with BAVM. RESULTS: A CNV region on 1p36.13, containing the neuroblastoma breakpoint family, member 1 gene (NBPF1), was significantly enriched with duplications in BAVM cases compared to controls (P = 2.2x10(-9)); NBPF1 was also significantly associated with BAVM in gene-based analysis using both PennCNV and Birdsuite. We experimentally validated the 1p36.13 duplication; however, the association did not replicate in an independent cohort of 184 sporadic BAVM cases and 182 controls (OR = 0.81, P = 0.8). Rare CNV analysis did not identify genes significantly associated with BAVM. CONCLUSION: We did not identify common CNVs associated with sporadic BAVM that replicated in an independent cohort. Replication in larger cohorts is required to elucidate the possible role of common or rare CNVs in BAVM pathogenesis.

Published
2013

25. Transcutaneous transfacial approaches to the anterior skull base

Author

Kaplan, M.J., McDermott, M.W., Gutin, P.H., Lawton, M.T., Fischbein, N.J., and Berger, M.S.

Abstract

The six-level anatomic classification scheme of transfacial approaches used by the multidisciplinary skull base surgery team at the Barrow Neurological Institute and discussed extensively in these articles is an excellent way to systematically discuss approaches to the anterior and central skull base. Choosing among these options usually involves selecting the best angle of approach in order to minimized brain retraction, as well as optimizing accessibility to structures requiring resection while limiting aesthetic and functional side effects. Have we advanced to the point that we can usually avoid visible transcutaneous facial incisions while not sacrificing the primary goals of tumor resection and minimization of side effects? In this article we will briefly overview the role of transcutaneous approaches to the anterior skull base.

Published
2000
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26. Clinical application of the classification scheme of transfacial approaches

Author

Han, P.P., Beals, S.P., Spetzler, R.F., Lawton, M.T., Feiz-Erfan, I., Joganic, E.F., Detwiler, P.W., Porter, R.W., and Reiff, J.

Abstract

Between 1990 and 1998, 63 patients (39 men and 24 women) underwent a transfacial approach. Based on the level I through level VI classification scheme developed by the Barrow Neurological Institute Skull Base Team, 83 transfacial procedures were performed: 49 procedures involved a single level, 8 involved a level III approach combined with a level V approach, and 3 involved a level I through III aoproach combined with either a pterional craniotomy or orbitozygomatic craniotomy. Eleven procedures were performed in a staged fashion. Thirty-five different pathologies were addressed: Chordomas (7), angiofibromas (7), and pituitary macroadenomas (5) were most common. One patient (1.6%) died postoperatively. Overall, 29 (46%) patients experienced complications after transfacial surgery. Six (9.5%) patients experienced major complications, and 23 (36.5%) patients experienced minor complications. The transfacial surgeries were without complications in 34 (54%) patients. This large series demonstrates the versatility of transfacial skull base approaches for treating benign and malignant lesions. The procedures are associated with good patient outcomes and an acceptable rate of complications.

Published
1999
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27. The transfacial approaches to midline skull base lesions: A classification scheme

Author

Lawton, M.T., Beals, S.P., Joganic, E.F., Han, P.P., and Spetzler, R.F.

Abstract

A variety of transfacial surgical approaches to midline skull base lesions can be organized in a simple classification scheme of six techniques or levels. Three intracranial approaches use a subfrontal trajectory and variable amounts of transfacial exposure through the nasal and orbital bones. Surgical exposure increases with the amount of bone removed with the facial fragment: supraorbial bar (level 1), supraorbitonasal bar (level II), and orbitonasal bar (level III). Three extracranial approaches use a more inferior trajectory and variable amounts of transfacial exposure through the maxilla. The transnasomaxillary approach (level IV) requires a Le Fort II osteotomy with splitting of the maxillary fragment. The transmaxillary approach (level V) requires a Le Fort l osteotomy with splitting of the palate. The transpalatal approach (level VI) requires circumferential osteotomy and removal of the hard palate. These versatile transfacial approaches, used alone or in combination, have a distinct role in the armamentarium of the skull base surgeon who develops individualized treatment strategies for curative resection of midline skull base lesions.

Published
1999
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28. Transpetrosal and combination approaches to skull base lesions

Author

Lawton, M.T., Daspit, C.P., and Spetzler, R.F.

Abstract

Petrosectomy is the essential component of many of the important skull base approaches. The transpetrosal approaches enable safe surgical treatment of many petroclival lesions. The combination approaches further increase surgical exposure for more complex lesions. Selecting the best surgical approach requires careful evaluation of lesion location, size, pathology, and the patient's preoperative neurological function. Successful management of these difficult lesions requires a multidisciplinary team that is critically dependent on the neuro-otologist.

Published
1996
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29. The state of the art of neuronavigation with frameless stereotaxy in intracranial neurosurgery

Author

Lawton, M.T., Golfinos, J.G., Geldmacher, T.R., and Spetzler, R.F.

Abstract

Various localizing mechanisms for intraoperative navigation with frameless stereotaxy have been developed, including proprioceptive arms, freehand probes with infrared optical tracking systems, and integrated microscope/stereotactic systems that map the microscope's focal point. During a 5-year period, 1,212 procedures were performed on 1,155 patients using five navigational devices, and the accuracy and clinical performance of the systems were compared. Operative pathology included 193 gliomas, 128 convexity meningiomas, 117 skull-base tumors, 113 epilepsy operations, 106 cavernous malformations, 65 arteriovenous malformations, 6 aneurysms, 25 acoustic neuromas, 25 ventriculoperitoneal shunt procedures, 45 metastases, 338 other or unspecified primary brain tumors, and 51 miscellaneous lesions. The proprioceptive arm was used in 1,112 procedures (mean error, 1.86 mm); the freehand probe (1-dimensional cameras) was used in 29 procedures (mean error, 1.72 mm); the freehand probe (2-dimensional cameras) was used in 40 procedures (mean error, 2.64 mm); the MKM microscope system (Carl Zeiss, Thornwood, NY) was used in 16 procedures (mean error, 3.08 mm); and the SMN microscope system (Carl Zeiss) was used in 15 procedures (mean error, 2.30 mm). According to a survey of performance characteristics and surgeons' preferences, the proprioceptive arm system had the best apparatus, computer software, tracking mechanism, and display. It was accurate, reliable, and the easiest of the five systems to use. Freehand systems are hampered by tracking interference, and integrated microscope systems are still in the early stages of development.

Published
1998
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32. Intracranial Venous Alteration in Patients With Aneurysmal Subarachnoid Hemorrhage: Protocol for the Prospective and Observational SAH Multicenter Study (SMS)

Author

Giuseppe E. Umana, S. Ottavio Tomasi, Paolo Palmisciano, Gianluca Scalia, Valerio Da Ros, Rahman Al-Schameri, Stefano M. Priola, Lara Brunasso, Giuseppe Roberto Giammalva, Federica Paolini, Roberta Costanzo, Lapo Bonosi, Rosa Maria Gerardi, Rosario Maugeri, Lidia Strigari, Philip E. Stieg, Giuseppe Esposito, Michael T. Lawton, Christoph J. Griessenauer, Peter A. Winkler, University of Zurich, Umana G.E., Tomasi S.O., Palmisciano P., Scalia G., Da Ros V., Al-Schameri R., Priola S.M., Brunasso L., Giammalva G.R., Paolini F., Costanzo R., Bonosi L., Gerardi RM, Maugeri R., Strigari L., Stieg P.E., Esposito G., Lawton M.T., Griessenauer C.J., and Winkler P.A.

Subjects
surgical clipping, 10180 Clinic for Neurosurgery, brain circulation, Settore MED/36, endovascular coiling, subarachnoid hemorrhage, 610 Medicine & health, Surgery, brain aneurysm, venous alteration, vasospasm
Abstract

BackgroundArterial vasospasm has been ascribed as the responsible etiology of delayed cerebral infarction in patients with aneurysmal subarachnoid hemorrhage (aSAH), but other neurovascular structures may be involved. We present the protocol for a multicenter, prospective, observational study focused on analyzing morphological changes in cerebral veins of patients with aSAH.Methods and AnalysisIn a retrospective arm, we will collect head arterial and venous CT angiograms (CTA) of 50 patients with aSAH and 50 matching healthy controls at days 0–2 and 7–10, comparing morphological venous changes. A multicenter prospective observational study will follow. Patients aged ≥18 years of any gender with aSAH will be enrolled at 9 participating centers based on the predetermined eligibility criteria. A sample size of 52 aSAH patients is expected, and 52 healthy controls matched per age, gender, and comorbidities will be identified. For each patient, sequential CTA will be conducted upon admission (day 0–2), at 7–10 days, and at 14–21 days after aSAH, evaluating volumes and morphology of the cerebral deep veins and main cortical veins. One specialized image collecting center will analyze all anonymized CTA scans, performing volumetric calculation of targeted veins. Morphological venous changes over time will be evaluated using the Dice coefficient and the Jaccard index and scored using the Boeckh–Behrens system. Morphological venous changes will be correlated to clinical outcomes and compared between patients with aSAH and healthy-controls, and among groups based on surgical/endovascular treatments for aSAH.Ethics and DisseminationThis protocol has been approved by the ethics committee and institutional review board of Ethikkommission, SALK, Salzburg, Austria, and will be approved at all participating sites. The study will comply with the Declaration of Helsinki. Written informed consent will be obtained from all enrolled patients or their legal tutors. We will present our findings at academic conferences and peer-reviewed journals.Approved Protocol Version and RegistrationVersion 2, 09 June 2021.

Published
2022
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33. The Superficial Anastomosing Veins of the Human Brain Cortex: A Microneurosurgical Anatomical Study

Author

S. Ottavio Tomasi, Giuseppe Emmanuele Umana, Gianluca Scalia, Giuseppe Raudino, Francesca Graziano, Paolo Palmisciano, Stefano M. Priola, Pier Francesco Cappai, Crescenzo Capone, Peter M. Lawrence, Christian A. Erös, Klaus D. Martin, Bipin Chaurasia, Rosario Maugeri, Gerardo Iacopino, Valerio Da Ros, Michael T. Lawton, Christoph J. Griessenauer, Peter A. Winkler, Tomasi S.O., Umana G.E., Scalia G., Raudino G., Graziano F., Palmisciano P., Priola S.M., Cappai P.F., Capone C., Lawrence P.M., Eros C.A., Martin K.D., Chaurasia B., Maugeri R., Iacopino D., Da Ros V., Lawton M.T., Griessenauer C.J., and Winkler P.A.

Subjects
anastomosing vein, Settore MED/36, topography, vein of Trolard, RD1-811, Settore MED/27 - Neurochirurgia, vein of Labbé, cardiovascular system, Surgery, microneurosurgery, Original Research, brain cortex
Abstract

Introduction: In this microneurosurgical and anatomical study, we characterized the superficial anastomosing veins of the human brain cortex in human specimens.Material and Methods: We used 21 brain preparations fixed in formalin (5%) that showed no pathological changes and came from the autopsy sections. The superficial veins were dissected out of the arachnoid with the aid of a surgical microscope.Results: We dissected nine female and 12 male brain specimens, with an average age of 71 ± 11 years (range 51–88 years). We classified the superficial veins in five types: (I) the vein of Trolard as the dominat vein; (II) the vein of Labbé as the dominant vein; (III) a dominant sylvian vein group, and the veins of Trolard and Labbé nonexistent or only rudimentary present without contact to the Sylvian vein group; (IV) very weak sylvian veins with the veins of Trolard and Labbé codominant; and V) direct connection of Trolard and Labbé bypassing the Sylvian vein group. The vein of Trolard was dominant (Type I) in 21.4% and the vein of Labbé (Type II) in 16.7%. A dominant sylvian vein group (Type III) was found in 42.9%. Type IV and Type V were found in 14.3 and 4.7% respectively.Conclusion: No systematic description or numerical distribution of the superior anastomotic vein (V. Trolard) and inferior anastomotic vein (V. Labbé) has been found in the existing literature. This study aimed to fill this gap in current literature and provide data to neurosurgeons for the practical planning of surgical approaches.

Published
2022
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