Approaches to the Lateral and Third Ventricles, Decompressive Craniectomies, and Cranioplasty Flashcards
Which of following approaches to trigone of lateral ventricles is not used if neurology of the patient is intact?
● A. Lateral temporal parietal
● B. Superior parietal occipital
● C. Tanscallosal
● D. Transtemporal horn
● E. Occipital lobe incision or occipital lobectomy
E. Occipital lobe incision or occipital lobectomy
Which approach is preferred for tumors in the 3rd ventricle extending into lateral ventricle with gross hydrocephalus?
● A. Transcallosal approach
● B. Transsphenoidal approach
● C. Transcortical approach
● D. Subfrontal approach
● E. Subtemporal approach
C. Transcortical approach
What are the parameters for craniotomy while using transcallosal approach to the 3rd ventricle so as to preserve important structures?
● A. 3 cm anterior and 3 cm posterior to coronal suture
● B. 4 cm anterior and 3 cm posterior to coronal suture
● C. 2 cm anterior and 4 cm posterior to coronal suture
● D. 4 cm anterior and 2 cm posterior to coronal suture
● E. 4 cm anterior and 4 cm posterior to coronal suture
D. 4 cm anterior and 2 cm posterior to coronal suture
To prevent complication of disconnection syndrome, callosotomy performed must not exceed how much?
● A. 0.5 cm
● B. 2.5 cm
● C. 3.5 cm
● D. 4.5 cm
● E. 1.5 cm
B. 2.5 cm
Bilateral forniceal lesions can result in loss of short-term memory and ability for new learning, which can be avoided while approaching the 3rd ventricle via all methods except?
● A. Stay as close to midline as possible
● B. If needed open foramen of Monro laterally
● C. Making incision posteriorly sacrificing thalamostriate vein
● D. Incising the anterosuperior margin of the foramen through the column of both fornices
● E. Interforniceal approach
D. Incising the anterosuperior margin of the foramen through the column of both fornices
After decompressive craniectomy, bone flap can be stored externally for future reimplantation by saturating with sterile preservative solution (e.g., RPMI medium). It must be stored at what temperature?
● A.−80C
● B.−70C
● C.−60C
● D.−50C
● E.−40C
A.−80C
In noncontaminated situations, cranioplasty can be done after how long?
● A. 1 to 2 weeks
● B. 3 to 4 weeks
● C. 5 to 10 weeks
● D. 6 to 12 weeks
● E. 6 months
D. 6 to 12 weeks
For transcallosal approach to the lateral or third ventricle, thorax should be elevated up to what degrees?
● A. 10 degrees
● B. 20 degrees
● C. 30 degrees
● D. 40 degrees
● E. 50 degrees
B. 20 degrees
Which of the following statements are correct regarding approaches to the lateral ventricle?
● A. Approaches to the atrium (trigone) include middle temporal gyrus, lateral temporal parietal approach, superior parietal occipital approach, transcallosal, transtemporal horn, and
through occipital lobe incision or occipital lobectomy
● B. Approach to frontal horn is through middle frontal gyrus
● C. Midventricular body approach includes through transcallosal and middle frontal gyrus approach
● D. Temporal horn is approached by dissection through middle temporal gyrus and transtemporal horn
● E. All of the above
E. All of the above
Approaches to the third ventricle include which of the following?
● A. Transcortical approach
● B. Transcallosal approach
● C. Subfrontal approach
● D. Transsphenoidal approach
● E. Subtemporal approach
● F. All of the above
F. All of the above
Transcallosal approach to the lateral or third ventricle is performed through an interhemispheric approach to the corpus callosum via a parietal craniotomy, usually right sided in a left hemisphere dominant patient. Following statements are correct regarding indications of this approach except?
● A. Colloid cysts is excised through this approach
● B. Craniopharyngiomas in the third ventricle can also be approached through this approach
● C. Cysticercosis cyst cannot be removed through this approach
● D. Thalamic gliomas can also be removed using this approach
● E. AVM can also be excised using this approach
C. Cysticercosis cyst cannot be removed through this approach
During approach to corpus callosum through interhemispheric approach, the two cingulate gyri can be easily mistaken for the corpus callosum. This error may be compounded by mistaking the callosomarginal arteries for the pericallosal arteries. What are the differentiating points between corpus callosum and cingulate gyrus?
● A. Corpus callosum is a pure white structure
● B. Corpus callosum is usually deeper than one anticipates
● C. Corpus callosum is appreciated beneath the paired pericallosal arteries
● D. Image-guided surgery or measuring the depth of the corpus callosum on the preoperative MRI may help
● E. All of the above are correct
E. All of the above are correct
The callosotomy is usually performed between the two pericallosal arteries. Disconnection syndrome can occur with it which is more common with posterior callosotomy where more information crosses. The risk is reduced by creating the callosotomy of what distance?
● A. < 5.5 cm
● B. < 4.5 cm
● C. < 3.5 cm
● D. < 2.5 cm
● E. < 1.5 cm
D. < 2.5 cm
Venous infarction during interhemispheric approach can occur because of which of the following?
● A. Damage to the critical cortical draining veins
● B. Damage or thrombosis of superior sagittal sinus
● C. Damage to thalamostriate veins
● D. Damage to vein of Trolard
● E. Both A and B
E. Both A and B
Transcortical approach to the lateral or third ventricle is used for tumors of atrium of lateral ventricle, tumor of the roof of the third ventricle, or third ventricular tumors with significant extension onto lateral ventricle. Which of the following are the
approaches included in transcortical approach?
● A. Posterior parietal approach
● B. Middle temporal gyrus
● C. Middle frontal gyrus
● D. All of the above
D. All of the above
