Journal of Neurosurgery Academy

Surgical video of transsylvian resection of prechiasmatic craniopharyngioma

2026-04-01T11:31:49+00:00

The Sylvian fissure (SF), also referred to as the lateral sulcus, is one of the most prominent anatomical landmarks on the lateral surface of the cerebral hemisphere. This fissure separates the frontal and parietal lobes superiorly from the temporal lobe inferiorly and forms an important corridor in neurosurgical procedures. Within the depth of the fissure lies the Sylvian cistern, which contains critical neurovascular structures such as the middle cerebral artery (MCA) and its branches, superficial Sylvian veins, and arachnoid trabeculae. We present an operative video of a 16-year-old boy who presented with a bifrontal headache and visual impairment for 1 month. He was subjected to transsylvian resection of the suprasellar lesion, after which there was significant improvement in his symptoms. This manuscript highlights the surgical technique of SF dissection with emphasis on the principles of microneurosurgery.

Hybrid operating theatre in neurosurgery: the future of neurosurgery

2026-04-04T07:39:47+00:00

Cisternostomy: surgical technique and technical nuances in the management of intracranial hypertension

2026-04-10T07:42:43+00:00

Cisternostomy is a microsurgical strategy aimed at lowering intracranial pressure (ICP) by re-establishing cerebrospinal fluid (CSF) communication across basal cisterns. In contrast to decompressive craniectomy, it achieves effective relaxation of the brain while preserving the calvarium. Over the past decade, growing clinical data have supported its use in traumatic brain injury (TBI) and aneurysmal subarachnoid hemorrhage (SAH). This article provides a detailed, stepwise description of the operative technique, emphasises key anatomical landmarks, and highlights practical nuances that improve safety and completeness of decompression.

Endoscopic endonasal approach to sellar-suprasellar lesions

2025-03-12T07:32:00+00:00

The endoscopic endonasal approach through the transphenoidal and transtubercular access provides an excellent and panoramic view of the sellar-suprasellar lesions. The indications include pituitary adenomas, craniopharyngiomas, meningiomas, etc. The surgery is done using a zero-degree endoscope and, if required, angled endoscopes for resecting tumors around the corners. Tumors going lateral to the optic nerves are contraindications. Cerebrospinal fluid leak is a common complication of this skull base approach; however, it has been decreased significantly with the use of the nasoseptal mucosal flap. This educational video article describes a step-by-step approach to a case of pituitary macroadenoma, along with the indications, contraindications, advantages, limitations, complications, and their avoidance of this approach.