Rocio Zamora - Academia.edu (original) (raw)

Papers by Rocio Zamora

Research paper thumbnail of C1 Hemilaminectomy for Resection of Foramen Magnum Meningioma: 2-Dimensional Operative Video

Journal of Neurological Surgery Part B: Skull Base, 2020

We present a case of a sizeable foramen magnum meningioma that was resected through a C1 hemilami... more We present a case of a sizeable foramen magnum meningioma that was resected through a C1 hemilaminectomy in prone (concorde) position. The patient is a 51-year-old woman with a 3-month history of progressive paresthesia of the upper and lower extremities, followed by gait disturbance, and hand apraxia. There was no complaint of nuchal pain.On magnetic resonance imaging (MRI) a briskly enhancing extra-axial, intradural craniospinal lesion, extending from the basion of the lower clivus, over the tectorial membrane to the middle of the axis' body was discovered. There was significant transposition and compression of the medulla and corresponding focal hyperintensity on T2-weighted imaging.On physical examination, the patient was ambulatory independently, notwithstanding a pronounced spinal ataxia. There were deficits in sensation and proprioception, as well as urinary retention, but preserved function of the lower cranial nerves.In view of the profound transposition of the medulla,...

Research paper thumbnail of Surgical management of primary and secondary pilocytic astrocytoma of the cerebellopontine angle (in adults and children) and review of the literature

Neurosurgical Review, 2020

Glial tumors in the cerebellopontine angle (CPA) are uncommon and comprise less than 1% of CPA tu... more Glial tumors in the cerebellopontine angle (CPA) are uncommon and comprise less than 1% of CPA tumors. We present four cases of pilocytic astrocytoma of the CPA (PA-CPA) that were treated in our department. Patients who received surgical treatment for PA-CPA from January 2004 to December 2019 were identified by a computer search of their files from the Department of Neurosurgery, Tübingen. Patients were evaluated for initial symptoms, pre- and postoperative facial nerve function and cochlear function, complications, and recurrence rate by reviewing surgical reports, patient documents, neuroradiological data, and follow-up data. We identified four patients with PA-CPA out of about 1500 CPA lesions (~ 0.2%), which were surgically treated in our department in the last 16 years. Of the four patients, three were male, and one was a female patient. Two were adults, and two were children (mean age 35 years). A gross total resection was achieved in three cases, and a subtotal resection was ...

Research paper thumbnail of Extraordinary Tumor Growth Rates in Bilateral Meningioma-Vestibular Schwannoma Collision Tumors in a Patient with Neurofibromatosis Type 2: Case Report and Literature Review

SN Comprehensive Clinical Medicine, 2020

Collision tumors seem to be an extraordinary pathology with unusual features. We sought to report... more Collision tumors seem to be an extraordinary pathology with unusual features. We sought to report the management of very fast-growing bilateral meningioma-vestibular schwannoma collision tumors in a patient with neurofibromatosis type 2. Both meningiomas and both vestibular schwannoma, when analyzed by volumetry, showed a very rapid growth rate (0.476–0.833 cm3 per month) in comparison with two meningiomas of other locations (0.132–0.233 cm3 per month). To the best of our knowledge, the growth rates of both vestibular schwannomas in the present case are the fastest that have been described in literature for a vestibular schwannoma so far.

Research paper thumbnail of Midline Suboccipital Subtonsillar Approach with C1 Laminectomy for Resection of Foramen Magnum Meningioma: 2-Dimensional Operative Video

Journal of Neurological Surgery Part B: Skull Base, 2019

We present a case of a medium-sized foramen magnum meningioma that was resected through a midline... more We present a case of a medium-sized foramen magnum meningioma that was resected through a midline suboccipital subtonsillar approach with C1 laminectomy in prone (Concorde) position. The patient is a 77-year-old woman with a 6-month history of intermittent vertigo, moderate gait instability, and slight decline of memory.On magnetic resonance imaging (MRI) an extra-axial intradural lesion was discovered that originated from the right epicondylar region just inferior to the jugular tubercle and occupied the anterolateral aspect of the foramen magnum. There was moderate transposition and compression of the medulla at the level of the cerebellar tonsils.On physical examination the patient was ambulatory independently without motor weakness but exhibited some gait instability. The function of the lower cranial nerves was preserved.A gross-total resection was achieved, histopathology confirmed a WHO grade-I meningothelial meningioma with a low-proliferation index. The patient was discharg...

Research paper thumbnail of Resection of a Petroclival Meningioma via the Endoscope-Assisted Retrosigmoid Approach: 2-D Operative Video

Journal of Neurological Surgery Part B: Skull Base, 2018

We present a case of a petroclival meningioma that was resected through an endoscope-assisted ret... more We present a case of a petroclival meningioma that was resected through an endoscope-assisted retrosigmoid approach via corridors above and below the facial-vestibulocochlear nerve complex. The patient is a 61-year-old female with complaints of left-sided hypesthesia and neuralgia of the infraorbital and zygomatic region, intermittent periorbital myokymia, and a slight facial palsy (HB II). This 2D video demonstrates the operative technique, anatomical and surgical nuances of the skull base approach and microdissection of the tumor from the critical neurovascular structures. A gross total resection was achieved. The patient’s facial and trigeminal symptoms resolved completely within a few weeks. At 2 year follow up there was no indication of residual or recurrence.In summary, the retrosigmoid approach with endoscopic assistance is an important and powerful tool in the armamentarium for the microsurgical management of meningiomas of the lateroventral skullbase of the posterior fossa....

Research paper thumbnail of Endoscopic assistance in retrosigmoid transmeatal approach to intracanalicular vestibular schwannomas – An alternative for middle fossa approach. Technical note

Neurologia i Neurochirurgia Polska, 2017

Vestibular schwannomas (VSs) are a common pathology, representing ca. 6-8% of all intracranial tu... more Vestibular schwannomas (VSs) are a common pathology, representing ca. 6-8% of all intracranial tumors [1]. Despite recent progress in neuroimaging and resultant increase in the detection rate of pure intracanalicular tumors (T1 according to Hannover classification), their incidence is still no greater than 8% [2,3]. According to Samii and other authors, the decision whether patients with pure intracanalicular VSs should be n e u r o l o g i a i n e u r o c h i r u r g i a p o l s k a 5 1

Research paper thumbnail of C1 Hemilaminectomy for Resection of Foramen Magnum Meningioma: 2-Dimensional Operative Video

Journal of Neurological Surgery Part B: Skull Base, 2020

We present a case of a sizeable foramen magnum meningioma that was resected through a C1 hemilami... more We present a case of a sizeable foramen magnum meningioma that was resected through a C1 hemilaminectomy in prone (concorde) position. The patient is a 51-year-old woman with a 3-month history of progressive paresthesia of the upper and lower extremities, followed by gait disturbance, and hand apraxia. There was no complaint of nuchal pain.On magnetic resonance imaging (MRI) a briskly enhancing extra-axial, intradural craniospinal lesion, extending from the basion of the lower clivus, over the tectorial membrane to the middle of the axis' body was discovered. There was significant transposition and compression of the medulla and corresponding focal hyperintensity on T2-weighted imaging.On physical examination, the patient was ambulatory independently, notwithstanding a pronounced spinal ataxia. There were deficits in sensation and proprioception, as well as urinary retention, but preserved function of the lower cranial nerves.In view of the profound transposition of the medulla,...

Research paper thumbnail of Surgical management of primary and secondary pilocytic astrocytoma of the cerebellopontine angle (in adults and children) and review of the literature

Neurosurgical Review, 2020

Glial tumors in the cerebellopontine angle (CPA) are uncommon and comprise less than 1% of CPA tu... more Glial tumors in the cerebellopontine angle (CPA) are uncommon and comprise less than 1% of CPA tumors. We present four cases of pilocytic astrocytoma of the CPA (PA-CPA) that were treated in our department. Patients who received surgical treatment for PA-CPA from January 2004 to December 2019 were identified by a computer search of their files from the Department of Neurosurgery, Tübingen. Patients were evaluated for initial symptoms, pre- and postoperative facial nerve function and cochlear function, complications, and recurrence rate by reviewing surgical reports, patient documents, neuroradiological data, and follow-up data. We identified four patients with PA-CPA out of about 1500 CPA lesions (~ 0.2%), which were surgically treated in our department in the last 16 years. Of the four patients, three were male, and one was a female patient. Two were adults, and two were children (mean age 35 years). A gross total resection was achieved in three cases, and a subtotal resection was ...

Research paper thumbnail of Extraordinary Tumor Growth Rates in Bilateral Meningioma-Vestibular Schwannoma Collision Tumors in a Patient with Neurofibromatosis Type 2: Case Report and Literature Review

SN Comprehensive Clinical Medicine, 2020

Collision tumors seem to be an extraordinary pathology with unusual features. We sought to report... more Collision tumors seem to be an extraordinary pathology with unusual features. We sought to report the management of very fast-growing bilateral meningioma-vestibular schwannoma collision tumors in a patient with neurofibromatosis type 2. Both meningiomas and both vestibular schwannoma, when analyzed by volumetry, showed a very rapid growth rate (0.476–0.833 cm3 per month) in comparison with two meningiomas of other locations (0.132–0.233 cm3 per month). To the best of our knowledge, the growth rates of both vestibular schwannomas in the present case are the fastest that have been described in literature for a vestibular schwannoma so far.

Research paper thumbnail of Midline Suboccipital Subtonsillar Approach with C1 Laminectomy for Resection of Foramen Magnum Meningioma: 2-Dimensional Operative Video

Journal of Neurological Surgery Part B: Skull Base, 2019

We present a case of a medium-sized foramen magnum meningioma that was resected through a midline... more We present a case of a medium-sized foramen magnum meningioma that was resected through a midline suboccipital subtonsillar approach with C1 laminectomy in prone (Concorde) position. The patient is a 77-year-old woman with a 6-month history of intermittent vertigo, moderate gait instability, and slight decline of memory.On magnetic resonance imaging (MRI) an extra-axial intradural lesion was discovered that originated from the right epicondylar region just inferior to the jugular tubercle and occupied the anterolateral aspect of the foramen magnum. There was moderate transposition and compression of the medulla at the level of the cerebellar tonsils.On physical examination the patient was ambulatory independently without motor weakness but exhibited some gait instability. The function of the lower cranial nerves was preserved.A gross-total resection was achieved, histopathology confirmed a WHO grade-I meningothelial meningioma with a low-proliferation index. The patient was discharg...

Research paper thumbnail of Resection of a Petroclival Meningioma via the Endoscope-Assisted Retrosigmoid Approach: 2-D Operative Video

Journal of Neurological Surgery Part B: Skull Base, 2018

We present a case of a petroclival meningioma that was resected through an endoscope-assisted ret... more We present a case of a petroclival meningioma that was resected through an endoscope-assisted retrosigmoid approach via corridors above and below the facial-vestibulocochlear nerve complex. The patient is a 61-year-old female with complaints of left-sided hypesthesia and neuralgia of the infraorbital and zygomatic region, intermittent periorbital myokymia, and a slight facial palsy (HB II). This 2D video demonstrates the operative technique, anatomical and surgical nuances of the skull base approach and microdissection of the tumor from the critical neurovascular structures. A gross total resection was achieved. The patient’s facial and trigeminal symptoms resolved completely within a few weeks. At 2 year follow up there was no indication of residual or recurrence.In summary, the retrosigmoid approach with endoscopic assistance is an important and powerful tool in the armamentarium for the microsurgical management of meningiomas of the lateroventral skullbase of the posterior fossa....

Research paper thumbnail of Endoscopic assistance in retrosigmoid transmeatal approach to intracanalicular vestibular schwannomas – An alternative for middle fossa approach. Technical note

Neurologia i Neurochirurgia Polska, 2017

Vestibular schwannomas (VSs) are a common pathology, representing ca. 6-8% of all intracranial tu... more Vestibular schwannomas (VSs) are a common pathology, representing ca. 6-8% of all intracranial tumors [1]. Despite recent progress in neuroimaging and resultant increase in the detection rate of pure intracanalicular tumors (T1 according to Hannover classification), their incidence is still no greater than 8% [2,3]. According to Samii and other authors, the decision whether patients with pure intracanalicular VSs should be n e u r o l o g i a i n e u r o c h i r u r g i a p o l s k a 5 1