AIM Endonasal transsphenoidal approaches are getting rapidly popular in removing many midline skullbase lesions from crista galli to foramen magnum. For safe removal of these lesions, familiarity with endoscopic endonasal anatomy of circle of Willis is very important. Furthermore, for safe development of this approach in vascular neurosurgery in the near future, endoscopic endonasal exposure of...

BACKGROUND Postoperative cerebrospinal fluid (CSF) fistula is the most serious complication after transsphenoidal surgery. OBJECTIVE To analyze the incidence of CSF fistula after endoscopic transsphenoidal surgery for tumor removal in sellar region; to discuss associated factors and methods used for sellar closure. METHOD Retrospective study of 67 patients (73 surgeries) operated via transs...

Endoscopic endonasal approaches are increasingly becoming the state of art in transsphenoidal pituitary surgery. The goal of this study is first to briefly introduce nasal and sphenoidal phases of the approach along with reconstruction phase. Then, the key points of radiologic studies of various parts of the surgery with images and movies are discussed. Difficult cases from 350 surgeries will b...

Uncontrolled cerebrospinal fluid (CSF) leakage after transsphenoidal surgery (TSS) for pituitary adenoma can lead to meningitis. Intracranial mycotic pseudoaneurysm is a rare complication in central nervous system infection. Large single pseudoaneurysm is more uncommon. Most mycotic aneurysms occur due to endocarditis. The present patient had no heart problem and was infected by CSF leakage aft...

Internal carotid artery (ICA) injury following transsphenoidal surgery is a rare but potentially fatal complication. Usually, endovascular occlusion of the ICA or stent graft placement is the treatment of these vascular complications described in literature. We present a case of ICA perforation during transsphenoidal surgery in a patient with limited collateral cerebral blood flow and with ecta...