Alba Scerrati

By Mario Ammirati and Alba Scerrati

Extra-axial tumors are lesions, neoplastic and not, which are external to the brain parenchyma and can originate in the skull, meninges, cranial nerves, and brain appendages such as the pituitary gland. Surgery provides a diagnosis and can be the first step in the treatment. When chosen as a treatment, we should consider the access and the approach to the lesion, the adequate operative technique, and related skills, minor or major complications. Because of the benign nature of these tumors, the evaluation of the risk/benefit in submitting a patient to a surgical treatment has to be considered. We would like to give an overview about benign extra-axial tumors and surgical operative techniques and tools that can be applied to improve patient’s outcome.

Part of the book: Trauma, Tumors, Spine, Functional Neurosurgery

By Oriela Rustemi, Alessandro Della Puppa and Alba Scerrati

Surgery of cerebral aneurysms has evolved over the years. Advances regard enhanced intraoperative visualization and monitoring of both function and perfusion. Technological assistance used in oncological or skull base surgery, such as intraoperative neurophysiological monitoring (IONM) or endoscopy, now adopt to vascular surgery. Intraoperative indocyanine green video angiography (ICG-VA) and techniques for its interpretation (squeezing maneuver; entrapment sign), endoscopes, and exoscopes increase visualization. Flow evaluation by microflow probe permits perfusion monitoring; IONM allows functional monitoring. Bypasses replace flow in complex aneurysm cases. Pre-, intra-, and postoperative imaging and flow measurement techniques help in donor selection and follow-up. Despite some progression in the aneurysm clips, the principle has not changed. Innovation and even change of principle in aneurysm exclusion might be desirable. Basic research in aneurysm wall and flow dynamics might in the future change the paradigms of cerebral aneurysm treatment.

Part of the book: Neurosurgical Procedures

By Giorgio Mantovani and Alba Scerrati

Cerebral physiology and pathology are still frequently missing a comprehensive explanation and a complete description, but new data and hypothesis are emerging on a daily basis. Particularly, comprehension of the cerebral venous system’s functions and functioning has undergone through the last decades a deep and extended change. Depiction of the perivascular spaces and the mechanisms of glymphatic system has given light about venous system pivotal role in the genesis of different pathologies such as multiple sclerosis, hydrocephalus, cerebral hemorrhages, and strokes. After a key point discussion about embryology, physiology, and anatomy of the cerebral venous system, an overview is provided on the main pathologies, both well-known and newly described ones, in which cerebral veins act a major pathogenic role.

Part of the book: Cerebral Circulation

By Alba Scerrati

Part of the book: Cerebral Circulation