By E. De Divitiis, R. Spaziante, L. Stella (auth.), H. Krayenbühl, J. Brihaye, F. Loew, V. Logue, S. Mingrino, B. Pertuiset, L. Symon, H. Troupp, M. G. Yaşargil (eds.)
As an addition to the eu postgraduate education approach for younger neurosurgeons we started to submit in 1974 this sequence dedicated to Advances and Technical criteria in Neurosurgery which used to be later backed via the Euro pean organization of Neurosurgical Societies. the truth that the English language is easily that allows you to changing into the foreign medium at eu medical meetings is a smart asset by way of mutual realizing. consequently now we have made up our minds to post all contributions in English, whatever the local language of the authors. All contributions are submitted to the complete editorial board prior to book of any quantity. Our sequence isn't really meant to compete with the courses of unique medical papers in different neurosurgical journals. Our purpose is, relatively, to offer fields of neurosurgery and similar parts during which vital fresh advances were made. The contributions are written by means of experts within the given fields and represent the 1st a part of each one quantity. within the moment a part of each one quantity, we post unique descriptions of ordinary operative systems, supplied via skilled clinicians; in those articles the authors describe the concepts they hire and clarify the benefits, problems and hazards excited about a number of the approaches. This half is meant basically to aid younger neurosurgeons of their postgraduate education. although, we're confident that it'll even be invaluable to skilled, absolutely knowledgeable neurosurgeons.
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T l'W"O ... -, ... 4111 of A~ l"Pro~nt Tr . ovllll of"~ 1"'ProOlO"l81\t -- 40 E. : In benign intra sellar cysts, either route of entry can be used 8,85 although in principle and because of the surgical anatomy, we feel that the trans-sphenoidal one is preferable. The results are good, with recovery of vision and improvement of visual field defects 67,94. Great care must be taken in filling the sellar cavity and closing its floor, to avoid the formation of a secondary empty sella, or a fistula with cerebrospinal rhinorrhoea.
25 a-c). These findings suggested an empty sella secondary to a partially liquefied GH-secreting adenoma, necessitating exploration of the sella. Operation: The sella, reached via the trans-sphenoidal route, was found to be principally filled by soft, almost liquefied adenomatous tissue, which was removed by aspiration and curettage (Fig. 26). The arachnoid diverticulum was not damaged. Post-operative 'course uneventful and biological regression of acromegaly. Comments: GH-secreting adenoma with spontaneous liquefaction, transient arrest of the acromegaly and secondary formation of an empty sella.
24 a Fig. 24. Case 24. a = lateral tomography, b = PEG: lateral view, c = CAT: axial plane, d = CAT: coronal plane b Fig. 24 b Empty Sella and Benign Intrasellar Cysts 51 Fig. 24d 4* 52 E. 25a Fig. 25. Case 24. a = venography of the cavernous and intercavernous sinuses: base view, b = the same, after photographic subtraction, c = the same: magnification of the sellar region dings normal. Endocrine studies: increased basal levels of GR and altered response to stimulation and inhibition tests. Radiological findings: Skull X -rays: balloon-shaped sella of increased volume (Fig.