Ludwig Benes

Klinikum Arnsberg

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Helmut Bertalanffy

International Neuroscience Institute

Ulrich Sure

University of Duisburg-Essen

Wuttipong Tirakotai

Neurological Institute of Thailand

Oliver Bozinov

University of St. Gallen

Dorothea Miller

Ruhr University Bochum

Thomas Riegel

Centre Hospitalier Universitaire Amiens-Picardie

Dirk Michael Schulte

Kernkraftwerk Gundremmingen

Olaf Alberti

Asklepios Kliniken Schildautal

Boris Krischek

University Hospital Cologne

Christoph Kappus

Philipps University of Marburg

Cooperative Institutions

Neurological Surgery

241

Johns Hopkins University

Harvard University

Johns Hopkins Medicine

Philipps University of Marburg

Johns Hopkins Hospital

Brigham and Women's Hospital

University of California, San Francisco

Oxford University Press (United Kingdom)

Massachusetts General Hospital

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Arteriovenous Malformation Surrounding the Trigeminal Nerve-Case Report-

Neurologia medico-chirurgica (2004)

Boris Krischek Sachiko Yamaguchi Ulrich Sure Ludwig Benes Siegfried Bien

A 57-year-old man presented with subarachnoid hemorrhage due to the rupture of an arteriovenous malformation (AVM) located at the base of the root of the right trigeminal nerve. In contrast to previous similar cases, his history included no evidence of trigeminal neuralgia or sensory loss. Right vertebral artery angiography revealed a doubled superior cerebellar artery feeding the angioma nidus. The patient refused radiotherapy and preferred surgical treatment. Intraoperatively, a close relationship between arterial feeders and rootlets of the trigeminal nerve was observed. Complete removal of the malformation was achieved and confirmed angiographically. The postoperative course was complicated by subdural hygroma that required repeated drainage and eventually a shunting procedure. This case demonstrates that microsurgical treatment of a trigeminal AVM is feasible. However, stereotactic radiosurgery may be the preferred treatment option considering the potential for postoperative complications.

Superior cerebellar artery

Trigeminal Nerve

Arteriovenous malformation

Shunting

Trigeminal artery

10.2176/nmc.44.68

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Citations (8)

Dorsolateral Approach to the Craniocervical Junction

Springer eBooks (2010)

Helmut Bertalanffy Oliver Bozinov Oǧuzkan Sürücü Ulrich Sure Ludwig Benes

Vascularity

10.1007/978-88-470-1167-0_14

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Citations (10)

Surgical management of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb

Neurosurgical Review (2006)

Wuttipong Tirakotai Ludwig Benes Christoph Kappus Ulrich Sure Ahmed Farhoud

Dural arteriovenous fistulas located in the vicinity of the jugular foramen are complex vascular malformations and belong to the most challenging skull base lesions to treat. The authors comprehensively analyze multiple features in a series of dural arteriovenous fistulas with transosseous arterial feeders involving the jugular bulb. Four patients who underwent surgery via the transcondylar approach to treat dural arteriovenous fistulas around the jugular foramen were retrospectively reviewed. Previously, endovascular treatment was attempted in all patients. The success of the surgical treatment was examined with postoperative angiography. Complete obliteration of the dural arteriovenous fistulas (DAVFs) was achieved in three patients, and significant flow reduction in one individual. All patients had a good postoperative outcome, and only one experienced mild hypoglossal nerve palsy. Despite extensive bone drilling, an occipitocervical fusion was necessary in only one patient with bilateral lesions. The use of an individually tailored transcondylar approach to treat dural arteriovenous fistulas at the region of the jugular foramen is most effective. This approach allows for complete obliteration of the connecting arterial feeders, and removal of bony structures containing pathological vessels.

Jugular foramen

Arteriovenous malformation

10.1007/s10143-006-0056-2

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Citations (25)

Seizure intractability in patients with mesial temporal lobe epilepsy caused by hippocampal sclerosis as compared to mesiotemporal cavernomas

Aktuelle Neurologie (2009)

K Hattemer Patricia Thiel Anja Haag X Chen Ludwig Benes

Introduction: The success of drug treatment is associated to the epilepsy syndrome and the underlying pathology, hippocampal sclerosis being an important risk factor for seizure recurrence. However, other mesiotemporal lesions like mesiotemporal cavernomas are also associated with a higher risk of intractability as compared to patients with extra-mesiotemporal lesions. The aim of the present study was to evaluate differences in seizure control as well as seizure semiology in patients with mesial temporal lobe epilepsy (MTLE) caused by either hippocampal sclerosis or cavernomas.

Hippocampal sclerosis

Semiology

10.1055/s-0029-1238600

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Citations (0)

Endoscopic Stereotaxy - An Eight Year's Experience

Stereotactic and Functional Neurosurgery (1997)

D. Hellwig Ludwig Benes Helmut Bertalanffy B. L. Bauer

During the 10th meeting of the WSSFN in Maebashi in 1989, we discussed 'endoscopic stereotaxy', and presented our preliminary results. This technique was first designed to optimize stereotactic biopsy, but it proved to be effective for other neurosurgical indications as well, including endoscopic stereotactic evacuation of intraparenchymal and intraventricular space-occupying cysts, endoscopic stereotactic cystoventriculostomy, third ventriculostomy, evacuation of brain abscess and intracerebral hematoma, and retrieval of adherent or free-floating ventricular catheters. Our results with endoscopic stereotaxy in different indications are encouraging, compared to conventional microsurgical techniques and pure stereotactic techniques. From 1989 to 1997 we have performed more than 400 stereotactic endoscopic procedures. The mortality rate is below 1%, the operative morbidity is below 3%.

Stereotaxy

Stereotactic surgery

Stereotaxis

Neuronavigation

10.1159/000099908

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Citations (29)

The Doppler-Guided Transfalcine Venous Approach in Selected Cases of Vein of Galen Malformations

Central European Neurosurgery - Zentralblatt für Neurochirurgie (2003)

Ludwig Benes J.-P. Wakat J. Jüttner Thomas Riegel Boris Krischek

Objective: This investigation was performed to evaluate the specific procedural issues and indications of a surgically assisted Doppler-guided endovascular transfalcine venous approach for the treatment of vein of Galen aneurysmal malformations (VGAM) in critically ill neonates. Patients and Methods: Two neonates out of a clinical series of 15 children (8 males and 7 females) with vein of Galen malformations were treated by our neurovascular team, using a combined surgically assisted endovascular transfalcine approach. In the biplanar angiography room a radiographically guided craniotomy (1.5 cm) was placed over the cranial projection of the falciforme sinus. After craniotomy the orthograd flow of the falciforme sinus was identified by Doppler ultrasonography. The sinus was punctured by an i. v. cannula with injection port and was sutured to the skin. A microcatheter was maneuvered over a guide into the malformation under fluoroscopic control. For embolization Guglielmi electrolytically detachable platinum coils were placed into the malformation as an embolic agent. Neurological examination records, available MR images, computed tomographic scans, pre- and postembolization angiograms and follow-up data were analyzed. Results: In both individuals the malformation was classified as VGAM. The follow-up was 6 and 7 months, respectively. No technique associated morbidity or mortality occurred in the present series. At discharge both selected neonates were in stable condition and the flow in the VGAMs could be significantly reduced by a combination of approaches including the venous transfalcine approach. Meanwhile, 6 months after birth one neonate died due to a deterioration of the pulomanry hypertension. Conclusions: Endovascular treatment is presently the most efficient strategy to allow neonates and infants survive the early manifestation of vein of Galen malformations and probably render a normal neurological development. Consequently, a combination of approaches in selected cases including the Doppler guided venous transfalcine route should be regarded as a preferential treatment modality, especially in patients with arterial vasospasms and venous stenosis.

Neurovascular bundle

Computed tomographic angiography

Venous malformation

10.1055/s-2003-40371

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Citations (2)

The Use of Venovenous Extracorporeal Membrane Oxygenation (VV-ECMO) in Acute Respiratory Distress Syndrome (ARDS) Patients with and Without Meeting the EOLIA Trial Disease Severity Criteria

Ludwig Benes Vladyslav Dieiev Carla Rosenzvit Kevin Yang D. Fleitas Sosa

Extracorporeal

10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a1615

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Citations (0)

Management of Supratentorial Intracerebral Hemorrhage—Still a Controversy?

World Neurosurgery (2011)

Ludwig Benes Christopher Nimsky

Invasive surgery

Glasgow Outcome Scale

Spontaneous intracerebral hemorrhage

10.1016/j.wneu.2011.08.008

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Citations (4)

A 54‐YEAR‐OLD WOMAN WITH A MENINGEAL LESION COMPRESSING THE MEDULLA OBLONGATA

Brain Pathology (2010)

Małgorzata Kołodziej Ludwig Benes Christopher Nimsky Hans‐Eckart Schaefer Axel Pagenstecher

A 54-year-old woman had nausea, vomiting and personality changes since a few weeks. Paresis of the abducens and hypoglossal nerves on the left side, a right sided reduction of the visual field, discrete dysarthri×a and ataxia were diagnosed. Cranial magnetic resonance imaging demonstrated a contrast enhancing circular meningeal lesion of the foramen magnum. Histological examination revealed a granulomatous lesion of the meninges with focal necrosis, vasculitis and neutrophils indicating immune complex reactions. A diagnosis of primary meningeal Wegener's disease was made. Medication with low dose prednisolone led to complete remission of the lesion 1.5 years later.

Paresis

Meninges

Prednisolone

Foramen magnum

10.1111/j.1750-3639.2010.00434.x

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Citations (0)

Image-guided Transsylvian, Transinsular Approach for Insular Cavernous Angiomas

Neurosurgery (2003)

Wuttipong Tirakotai Ulrich Sure Ludwig Benes Boris Krischek Siegfried Bien

Abstract OBJECTIVE Surgical treatment of cavernomas arising in the insula is especially challenging because of the proximity to the internal capsule and lenticulostriate arteries. We present our technique of image guidance for operations on insular cavernomas and assess its clinical usefulness. METHODS Between 1997 and 2003, with the guidance of a frameless stereotactic system (BrainLab AG, Munich, Germany), we operated on eight patients who harbored an insular cavernoma. Neuronavigation was used for 1) accurate planning of the craniotomy, 2) identification of the distal sylvian fissure, and, finally, 3) finding the exact site for insular corticotomy. Postoperative clinical and neuroradiological evaluations were performed in each patient. RESULTS The navigation system worked properly in all eight neurosurgical patients. Exact planning of the approach and determination of the ideal trajectory of dissection toward the cavernoma was possible in every patient. All cavernomas were readily identified and completely removed by use of microsurgical techniques. No surgical complications occurred, and the postoperative course was uneventful in all patients. CONCLUSION Image guidance during surgery for insular cavernomas provides high accuracy for lesion targeting and permits excellent anatomic orientation. Accordingly, safe exposure can be obtained because of a tailored dissection of the sylvian fissure and minimal insular corticotomy.

Neuronavigation

Surgical Planning

Corticotomy

10.1227/01.neu.0000093496.61236.66

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Citations (52)