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Neurologia Medico-chirurgica

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https://www.readbyqxmd.com/read/28637947/neurosurgical-virtual-reality-simulation-for-brain-tumor-using-high-definition-computer-graphics-a-review-of-the-literature
#1
Taichi Kin, Hirofumi Nakatomi, Naoyuki Shono, Seiji Nomura, Toki Saito, Hiroshi Oyama, Nobuhito Saito
Simulation and planning of surgery using a virtual reality model is becoming common with advances in computer technology. In this study, we conducted a literature search to find trends in virtual simulation of surgery for brain tumors. A MEDLINE search for "neurosurgery AND (simulation OR virtual reality)" retrieved a total of 1,298 articles published in the past 10 years. After eliminating studies designed solely for education and training purposes, 28 articles about the clinical application remained. The finding that the vast majority of the articles were about education and training rather than clinical applications suggests that several issues need be addressed for clinical application of surgical simulation...
June 22, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28637943/stereoelectroencephalography-indication-and-efficacy
#2
Koji Iida, Hiroshi Otsubo
Stereoelectroencephalography (SEEG) is a method for invasive study of patients with refractory epilepsy. Localization of the epileptogenic zone in SEEG relied on the hypothesis of anatomo-electro-clinical analysis limited by X-ray, analog electroencephalography (EEG), and seizure semiology in the 1950s. Modern neuroimaging studies and digital video-EEG have developed the hypothesis aiming at more precise localization of the epileptic network. Certain clinical scenarios favor SEEG over subdural EEG (SDEEG). SEEG can cover extensive areas of bilateral hemispheres with highly accurate sampling from sulcal areas and deep brain structures...
June 20, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28592714/the-2016-who-classification-of-tumours-of-the-central-nervous-system-the-major-points-of-revision
#3
Takashi Komori
The updated 2016 edition of the World Health Organization (WHO) Classification of Tumours of the Central Nervous System (CNS) uses molecular parameters and the histology to define the main tumor categories for the first time. This represents a shift from the traditional principle of using neuropathological diagnoses, which are primarily based on the microscopic features, to using molecularly-oriented diagnoses. Major restructuring was made with regard to diffuse gliomas, medulloblastomas and other embryonal tumors...
June 8, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28592748/epigenetic-targeted-therapy-for-diffuse-intrinsic-pontine-glioma
#4
Rintaro Hashizume
Diffuse intrinsic pontine glioma (DIPG) is a rare but uniformly fatal cancer of the brain, with peak incidence in children of 5-7 years of age. In contrast to most types of human cancer, there has been no significant improvement in treatment outcomes for patients with DIPG. Since DIPG occurs in the brainstem, a vital region of the brain, there are no surgical options for providing relief to patients, and chemotherapy as well as radiation therapy provide palliative relief at best. To date, more than 250 clinical trials evaluating radiotherapy along with conventional cytotoxic chemotherapy, as well as newer biologic agents, have failed to improve the dismal outcome when compared with palliative radiation alone...
June 7, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28579577/evaluation-of-venous-drainage-patterns-for-skull-base-meningioma-surgery
#5
Kazuhide Adachi, Mitsuhiro Hasegawa, Yuichi Hirose
The evaluation of venous drainage patterns prior to surgery for skull base meningioma is important owing to their deep location and the vulnerability of surrounding vascular structures. In recent years, the microsurgical skull base approach has matured as a surgical technique, making it an important option for reducing complications related to skull base meningioma surgery. In addition, knowledge of the venous anatomy can prevent venous drainage route disturbance and potentially life-threatening complications...
June 5, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28539528/prospect-of-immunotherapy-for-glioblastoma-tumor-vaccine-immune-checkpoint-inhibitors-and-combination-therapy
#6
Eiichi Ishikawa, Tetsuya Yamamoto, Akira Matsumura
To date, clinical trials of various vaccine therapies using autologous tumor antigens or tumor-associated/specific antigen peptide with adjuvants have been performed to treat patients with high-grade gliomas (HGG). Furthermore, immune checkpoint pathway-targeted therapies including anti- programmed cell death 1 (PD-1) antibody have been remarkably effective in other neoplasms, and various clinical trials with anti-PD-1 antibody in patients with HGG have started to date. It is possible that up-regulation of immune checkpoint molecules in tumor tissues after vaccine therapy may be one of the mechanisms of vaccine failure...
May 24, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28529246/surgical-outcome-of-laminoplasty-for-cervical-spondylotic-myelopathy-in-an-elderly-population-potentiality-for-effective-early-surgical-intervention-a-meta-analysis
#7
Yasuhiro Takeshima, Ryuta Matsuoka, Ichiro Nakagawa, Fumihiko Nishimura, Hiroyuki Nakase
A systematic review and meta-analysis was conducted to determine differences in surgical outcomes of laminoplasty for cervical spondylotic myelopathy (CSM) between elderly and non-elderly patients. PubMed and Google Scholar searches were performed using several key words and phrases related to cervical laminoplasty in elderly populations. Included studies were written in English, addressed laminoplasty for cervical spondylotic myelopathy, and evaluated outcomes of the treatment. Statistical analysis was performed using a random-effect model...
May 19, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28515372/spinal-arteriovenous-shunts-angioarchitecture-and-historical-changes-in-classification
#8
Keisuke Takai
The purposes of this study were to review historical changes in the classification of spinal arteriovenous (AV) shunts and to propose a practical classification system. The associated literature regarding the classification of spinal AV shunts was reviewed in the angiography era between 1967 and 2015. The classification systems of spinal AV shunts and a proposed classification system were presented with neuroradiological imaging and medical illustrations. There have been seven major classification systems based on the evolution of diagnostic methods as well as treatments for spinal AV shunts: the first description of spinal AV shunts diagnosed and classified using spinal angiography in 1971; the second classification based on a case report of intradural direct perimedullary arteriovenous fistulas (AVFs) treated by microsurgery in 1987; the third classification based on a case series of intradural perimedullary AVFs treated by endovascular interventions in 1993; the fourth and fifth classification systems based on a case series of spinal AVFs and arteriovenous malformations (AVMs) treated by microsurgery or endovascular interventions in 2002; the sixth classification based on a case series of cranio-spinal dural AV shunts in 2009; and the seventh classification based on a case series of extradural AVFs treated by microsurgery and endovascular interventions in 2011...
May 18, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28484132/unilateral-trans-cerebellomedullary-fissure-approach-for-occipital-artery-to-posterior-inferior-cerebellar-artery-bypass-during-aneurysmal-surgery
#9
Hiroshi Abe, Koichi Miki, Hiromasa Kobayashi, Toshiyasu Ogata, Mitsutoshi Iwaasa, Toshio Matsushima, Tooru Inoue
Occipital artery (OA) to the posterior inferior cerebellar artery (PICA) bypass is indispensable for the management of complex aneurysms of the PICA that cannot be reconstructed with surgical clipping or coil embolization. Although OA-PICA bypass is a comparatively standard procedure, the bypass is difficult to perform in some cases because of the location and situation of the PICA. We describe the usefulness of the unilateral trans-cerebellomedullary fissure (CMF) approach for OA-PICA bypass. Thirty patients with aneurysms in the vertebral artery (VA) or PICA were treated using OA-PICA bypasses between 2010 and 2015...
May 9, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28458386/carotid-vertebrobasilar-anastomoses-with-reference-to-their-segmental-property
#10
Katsunari Namba
The primitive carotid-vertebrobasilar anastomoses are primitive embryonic cerebral vessels that temporarily provide arterial supply from the internal carotid artery to the longitudinal neural artery, the future vertebrobasilar artery in the hindbrain. Four types known are the trigeminal, otic, hypoglossal, and proatlantal intersegmental arteries. The arteries are accompanied by their corresponding nerves and resemble an intersegmental pattern. These vessels exist in the very early period of cerebral arterial development and rapidly involute within a week...
May 1, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28458385/recent-trends-in-neuro-endovascular-treatment-for-acute-ischemic-stroke-cerebral-aneurysms-carotid-stenosis-and-brain-arteriovenous-malformations
#11
Yuji Matsumaru, Eiichi Ishikawa, Tetsuya Yamamoto, Akira Matsumura
The efficacy of mechanical thrombectomy with stent retrievers for emergent large vessel occlusion has been proved by randomized trials. Mechanical thrombectomy is increasingly being adopted in Japan since stent retrievers were first approved in 2014. An urgent clinical task is to offer structured systems of care to provide this treatment in a timely fashion to all patients with emergent large vessel occlusion. Treatment with flow-diverting stents is currently a preferred treatment option worldwide for large and giant unruptured aneurysms...
May 1, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28458384/clinical-utility-of-positron-emission-tomography-in-patients-with-malignant-glioma
#12
Hirohito Yano, Jun Shinoda, Toru Iwama
Positron emission tomography (PET) is being increasingly utilized for the management of brain tumors. Herein, we primarily review our previous studies on the use of PET in glioma that utilize three types of tracers: (11)C-methionine (MET), (11)C-choline, and (18)F-fluorodeoxyglucose. These studies included aspects such as tumor behavior, diagnosis, grade of malignancy, spread and invasion, viability, and genetic deletions; moreover, they also evaluated PET as a tool for planning radiation therapy (RT) and determining its outcome...
May 1, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28458383/efficacy-of-fiber-tractography-in-the-stereotactic-surgery-of-the-thalamus-for-patients-with-essential-tremor
#13
Susumu Sasada, Takashi Agari, Tatsuya Sasaki, Akihiko Kondo, Aiko Shinko, Takaaki Wakamori, Mihoko Okazaki, Ittetsu Kin, Ken Kuwahara, Masahiro Kameda, Takao Yasuhara, Isao Date
Several targets and targeting methods are utilized in stereotactic surgery to achieve tremor suppression for patients with intractable tremor. Recent developments in magnetic resonance imaging, including diffusion tensor imaging, have enabled the setting of appropriate targets in stereotactic surgery. In this retrospective study, the optimal target to suppress tremors in stereotactic surgery was explored using diffusion tensor image-based fiber tractography. Four tracts were focused on in this study, namely: the cerebello-thalamo-premotor cortical fiber tract, cerebello-thalamo-primary motor cortical fiber tract, spino-thalamo-somatosensory cortical fiber tract, and pyramidal tract...
May 1, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28450666/anomalies-of-the-middle-cerebral-artery
#14
Naoyuki Uchiyama
There are several anomalies of the middle cerebral artery (MCA) in humans, such as accessory MCA, duplicated MCA, fenestration of MCA, and duplicated origin of MCA. Recently, unfused or twig-like MCA, which indicates MCA trunk occlusion with collateral plexiform arterial network, have been reported. During the embryonic stage, MCA is thought to generate from plexiform arterial twigs arising from the anterior cerebral artery, and these twigs form the definitive MCA by fusion and regression at the end of the development stage...
April 27, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28450677/intra-arterial-contrasted-cone-beam-computed-tomography-assessment-of-vessels-distal-from-occluded-site-in-acute-ischemic-stroke-with-major-vessel-occlusion
#15
Tatsuo Amano, Masayuki Sato, Yuji Matsumaru, Hideyuki Sakuma, Syogo Yoda, Yusuke Hamada
Characterization of vessels distal from occluded site is important when considering endovascular revascularization therapy (EVT) for acute ischemic stroke. The goal of this study was to assess the clinical value of intra-arterial contrasted high-resolution cone-beam computed tomography from the ascending aorta (Ao-CBCT) for visualization of the vessels distal from occluded site. Acute ischemic stroke patients with large vessel occlusion who were to undergo EVT were evaluated. In EVT, digital subtraction angiography (DSA) and Ao-CBCT were performed with local anesthesia...
April 26, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28428448/unruptured-cerebral-aneurysms-in-elderly-patients
#16
Tomohito Hishikawa, Isao Date
The prevalence of unruptured cerebral aneurysms (UCAs) in elderly patients is increasing in our aging population. UCA management in elderly patients has some difficulties, such as reduced life expectancy, increased comorbidities and treatment risks, and poor prognosis in case of rupture. In this review article, we summarize the most recent findings on the natural history, therapeutic options and treatment results for UCAs exclusively in elderly patients, and describe possible medical treatments for patients with UCAs...
April 19, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28381652/treatment-outcome-of-carotid-artery-stenting-underwent-within-14-days-of-stroke-onset-consideration-of-safety-and-efficacy-of-urgent-carotid-artery-stenting-for-neurologically-progressing-patients
#17
Yasuhisa Kanematsu, Junichiro Satomi, Kazuyuki Kuwayama, Izumi Yamaguchi, Shotaro Yoshioka, Tomoya Kinouchi, Yoshiteru Tada, Nobuaki Yamamoto, Shunji Matsubara, Koichi Satoh, Shinji Nagahiro
As the safety and effectiveness of urgent carotid artery stenting (CAS) for neurologically progressing patients remain controversial, we retrospectively analyzed the outcome of urgent CAS based on the patients' pathophysiological condition and neuroimaging findings. We divided 71 patients who underwent CAS within 14 days of stroke onset into two groups. Group 1 (n = 35) was comprised of patients with progressing neurologic signs and a reversible ischemic penumbra on magnetic resonance images (MRI). They were treated by urgent CAS...
April 6, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28413181/review-of-past-reports-and-current-concepts-of-surgical-management-for-craniosynostosis
#18
Shigeo Kyutoku, Takayuki Inagaki
The purposes of surgery for craniosynostosis are to release increased intracranial pressure and to normalize cranial shape. The procedure was developed from a simple strip craniectomy in practice which ranged from the removal of the fused suture before the 1960s to total calvarial remodeling after 1970s and later methods of the 1990s, such as distraction and its modifications. According to its history, craniofacial surgeons might be changing their procedures with more effective, than less invasive ways. Since the late 1990s, when the distraction was applied to the craniofacial surgery, the gradual expansion, in particular of the anterior cranium, common in Japan, has long been controversial until the Caucasians accepted its use for the posterior cranium...
May 15, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28381654/disorder-of-executive-function-of-the-brain-after-head-injury-and-mild-traumatic-brain-injury-neuroimaging-and-diagnostic-criteria-for-implementation-of-administrative-support-in-japan
#19
Jun Shinoda, Yoshitaka Asano
The diagnotic criteria for disorder of the executive function of the brain (DEFB) as a syndrome of sequela were administratively established (ad-DEFB) in Japan in 2006 to support disabled patients whose impairment, limited to cognition (memory, attention, execution, and behavior), emerges after organic brain injuries regardless of physical deficits. However, some patients suffering from traumatic brain injury (TBI) have been excluded from receiving medico-social services. In particular, this tendency is more prominent in patients with mild TBI because no lesions are apparent on conventional computed tomography (CT) or magnetic resonance imaging (MRI) in the chronic phase...
May 15, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28381653/hands-on-simulation-versus-traditional-video-learning-in-teaching-microsurgery-technique
#20
Yusuke Sakamoto, Sho Okamoto, Kenzo Shimizu, Yoshio Araki, Akihiro Hirakawa, Toshihiko Wakabayashi
Bench model hands-on learning may be more effective than traditional didactic practice in some surgical fields. However, this has not been reported for microsurgery. Our study objective was to demonstrate the efficacy of bench model hands-on learning in acquiring microsuturing skills. The secondary objective was to evaluate the aptitude for microsurgery based on personality assessment. Eighty-six medical students comprising 62 men and 24 women were randomly assigned to either 20 min of hands-on learning with a bench model simulator or 20 min of video-learning using an instructional video...
May 15, 2017: Neurologia Medico-chirurgica
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