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https://www.readbyqxmd.com/read/28530250/the-hump-columellar-strut-a-reliable-technique-for-correction-of-nasal-tip-underprojection
#1
P G Giacomini, S Mocella, S Di Girolamo, R De Berardinis, A Boccieri
Nasal tip under projection is often found in rhinoplasty cases both for congenital or post-traumatic deformity. Nasal trauma may result in alteration of the external and internal nasal structures with following aesthetic impairment and difficulties in breathing. Post-traumatic surgery is frequent, but restoration of pre-traumatic form and function remains a challenge. The present paper describes a new method to increase tip projection by a columellar strut harvested from the autologous nasal bone and cartilage of the resected hump...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28520633/insular-cortex-surgery-for-the-treatment-of-refractory-epilepsy
#2
Marec von Lehe, Yaroslav Parpaley
Focal epilepsy originating from the insular cortex is rare. One reason is the small amount of cortical tissue compared with other lobes of the brain. However, the incidence of insular epilepsy might be underestimated because of diagnostic difficulties. The semiology and the surface EEG are often not meaningful or even misleading, and elaborated imaging might be necessary. The close connections of the insular cortex with other potentially epileptogenic areas, such as the temporal lobe or frontal/central cortex, is increasingly recognized as possible reason for failure of epilepsy surgery for temporal or extratemporal seizures...
May 16, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28510905/zoomed-mri-guided-by-combined-eeg-meg-source-analysis-a-multimodal-approach-for-optimizing-presurgical-epilepsy-work-up-and-its-application-in-a-multi-focal-epilepsy-patient-case-study
#3
Ü Aydin, S Rampp, A Wollbrink, H Kugel, J -H Cho, T R Knösche, C Grova, J Wellmer, C H Wolters
In recent years, the use of source analysis based on electroencephalography (EEG) and magnetoencephalography (MEG) has gained considerable attention in presurgical epilepsy diagnosis. However, in many cases the source analysis alone is not used to tailor surgery unless the findings are confirmed by lesions, such as, e.g., cortical malformations in MRI. For many patients, the histology of tissue resected from MRI negative epilepsy shows small lesions, which indicates the need for more sensitive MR sequences...
May 16, 2017: Brain Topography
https://www.readbyqxmd.com/read/28507956/an-unusual-case-of-giant-cell-tumor-of-first-metatarsal-a-rare-case-report-and-review-of-literature
#4
Kumar Prashant, Tulsi Das Bhattacharyya, Herman Frank, Prema Ram
INTRODUCTION: Giant cell tumor (GCT) or osteoclastoma is an osteolytic, mostly benign but locally aggressive tumor occurring in young adults at the epiphysis. Area of predilection is mainly long bones (85-90%). 4% of GCT are also found in iliac bone, spine and only 2% in hand (of which GCT phalanges are more common than metacarpal). GCT of metatarsal is a very rare occurrence with very few cases being reported so far. We report a case of GCT 1(st) metatarsal in a 40-year-old male which is a very rare entity...
November 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28506486/preoperative-and-intraoperative-neurophysiological-investigations-for-surgical-resections-in-functional-areas
#5
G Huberfeld, A Trébuchon, L Capelle, J-M Badier, S Chen, J-P Lefaucheur, M Gavaret
Brain regions are removed to treat lesions, but great care must be taken not to disturb or remove functional areas in the lesion and in surrounding tissue where healthy and diseased cells may be intermingled, especially for infiltrating tumors. Cortical functional areas and fiber tracts can be localized preoperatively by probabilistic anatomical tools, but mapping of functional integrity by neurophysiology is essential. Identification of the primary motor cortex seems to be more effectively performed with transcranial magnetic stimulation (TMS) than functional magnetic resonance imaging (fMRI)...
May 12, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28506485/surgery-for-dysembryoplastic-neuroepithelial-tumors-and-gangliogliomas-in-eloquent-areas-functional-results-and-seizure-control
#6
B Devaux, F Chassoux, E Landré, B Turak, A Laurent, M Zanello, C Mellerio, P Varlet
INTRODUCTION: Dysembryoplastic neuroepithelial tumors and gangliogliomas are developmental glioneuronal tumors usually revealed by partial epilepsy. High epileptogenicity, childhood epilepsy onset, drug-resistance, temporal location, and seizure freedom after complete resection are common characteristics of both tumors. We report the specificity of surgical management, functional results and seizure outcome in cases of a tumor location in eloquent areas. METHODS: Among 150 patients (88 males, 3-55 years) operated on for refractory epilepsy due to a glioneuronal tumor (1990-2015), 30 (20%, dysembryoplastic neuroepithelial tumors=21; gangliogliomas=9) had a tumor located in an eloquent cortex (sensory-motor, insular or language areas)...
May 12, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28506484/a-surgical-approach-to-the-anatomo-functional-structure-of-language
#7
REVIEW
E Mandonnet
INTRODUCTION: Language is the most widely mapped cognitive function during brain surgery. Intraoperative language functional mapping using direct electrical stimulation under awake conditions is currently the gold standard technique for establishing the causal link between an area and a deficit that would be caused by its resection. It is also a powerful tool to investigate the anatomical correlates of current neuropsychological models of language. MATERIAL AND METHODS: The aim of this article is to reexamine the anatomo-functional structure of language that could be inferred from data obtained in direct electrical stimulation studies during awake surgery...
May 12, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28506482/technical-principles-of-direct-bipolar-electrostimulation-for-cortical-and-subcortical-mapping-in-awake-craniotomy
#8
J Pallud, E Mandonnet, R Corns, E Dezamis, E Parraga, M Zanello, G Spena
INTRODUCTION: Intraoperative application of electrical current to the brain is a standard technique during brain surgery for inferring the function of the underlying brain. The purpose of intraoperative functional mapping is to reliably identify cortical areas and subcortical pathways involved in eloquent functions, especially motor, sensory, language and cognitive functions. MATERIAL AND METHODS: The aim of this article is to review the rationale and the electrophysiological principles of the use of direct bipolar electrostimulation for cortical and subcortical mapping under awake conditions...
May 12, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28502568/resection-of-cavernous-angioma-located-in-eloquent-areas-using-functional-cortical-and-subcortical-mapping-under-awake-conditions-outcomes-in-a-50-case-multicentre-series
#9
M Zanello, M Wager, R Corns, L Capelle, E Mandonnet, D Fontaine, N Reyns, E Dezamis, R Matsuda, D Bresson, H Duffau, J Pallud
INTRODUCTION: Surgical resection of supratentorial cavernous angiomas located in eloquent areas poses a significant risk to the patient of postoperative neurological impairment and justifies intraoperative functional monitoring. METHODS: Multicentre retrospective series of adult patients with cavernous angiomas located within eloquent areas and treated with functional-based surgical resection according to functional boundaries under intraoperative functional cortico-subcortical monitoring under awake conditions...
May 11, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28498095/risk-factors-for-development-of-postoperative-cerebellar-mutism-syndrome-in-children-after-medulloblastoma-surgery
#10
San Y C V Pols, Marie Lise C van Veelen, Femke K Aarsen, Antonia Gonzalez Candel, Coriene E Catsman-Berrevoets
OBJECTIVE Postoperative cerebellar mutism syndrome (pCMS) occurs in 7%-50% of children after cerebellar tumor surgery. Typical features include a latent onset of 1-2 days after surgery, transient mutism, emotional lability, and a wide variety of motor and neurobehavioral abnormalities. Sequelae of this syndrome usually persist long term. The principal causal factor is bilateral surgical damage (regardless of tumor location) to any component of the proximal efferent cerebellar pathway, which leads to temporary dysfunction of cerebral cortical regions as a result of diaschisis...
May 12, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28497233/standardization-and-optimization-of-intraoperative-molecular-imaging-for-identifying-primary-pulmonary-adenocarcinomas
#11
Jarrod D Predina, Olugbenga Okusanya, Andrew D Newton, Philip Low, Sunil Singhal
PURPOSE: Intraoperative molecular imaging (IMI) is an emerging technology used to locate pulmonary adenocarcinomas and identify positive margins during surgery. Background noise and tissue autofluorescence have been major obstacles. The goal of this study is to optimize the image quality of folate receptor alpha (FRα) targeted IMI for pulmonary adenocarcinomas by modifying emission data. PROCEDURES: A total of 15 lung cancer patients were enrolled in a pilot study...
May 11, 2017: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/28490224/prevalence-of-abnormal-magnetic-resonance-imaging-findings-in-children-with-persistent-symptoms-after-pediatric-sports-related-concussion
#12
Robert H Bonow, Seth D Friedman, Francisco A Perez, Richard G Ellenbogen, Samuel R Browd, Christine L MacDonald, Monica S Vavilala, Frederick P Rivara
A subset of patients experience persistent symptoms after pediatric concussion, and magnetic resonance imaging (MRI) is commonly used to evaluate for pathology. The utility of this practice is unclear. We conducted a retrospective cohort study to describe the MRI findings in children with concussion. A registry of all patients seen at our institution from January 2010 through March 2016 with pediatric sports-related concussion was cross-referenced with a database of radiographic studies. Radiology reports were reviewed for abnormal findings...
May 10, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28483395/seizure-outcomes-in-children-following-electrocorticography-guided-single-stage-surgical-resection
#13
Seema Bansal, Andrew J Kim, Anne T Berg, Sookyong Koh, Linda C Laux, Srishti Nangia, John J Millichap, Alexandra Shaw, Breanne Fisher, Catherine Dezort, Arthur J DiPatri, Tord D Alden, Douglas R Nordli
BACKGROUND: In children with abnormal imaging, single-stage epilepsy surgery is an attractive alternative to the two-stage approach that relies on invasive recording of seizures. Implanted electrodes carry risks of their own and extend hospitalization, but the efficacy of one-stage resections in a variety of pathologies and cerebral locations is not well established. We report our center's experience with single-stage epilepsy surgery guided by intraoperative electrocorticography (ECoG)...
February 7, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28482124/collagen-scaffold-combined-with-human-umbilical-cord-derived-mesenchymal-stem-cells-promote-functional-recovery-after-scar-resection-in-rats-with-chronic-spinal-cord-injury
#14
Nuo Wang, Zhifeng Xiao, Yannan Zhao, Bin Wang, Xing Li, Jing Li, Jianwu Dai
Effective therapeutic strategies for treating chronic spinal cord injury (SCI) are currently unavailable. Scar tissue in the lesion area is a main inhibitory factor for axonal regeneration and repair of chronic SCI. In this study, scar tissue was surgically resected from adult rats with 12-week chronic SCI, and then collagen scaffold (named NeuroRegen Scaffold [NRS]) and human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) were implanted into the resected cavity to repair chronic SCI. The results demonstrated that the locomotor function of rats was not affected by surgical scar resection, indicating its safety in treating chronic SCI...
May 8, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/28474309/preoperative-prediction-of-language-function-by-diffusion-tensor-imaging
#15
C F Freyschlag, J Kerschbaumer, D Pinggera, T Bodner, A E Grams, C Thomé
For surgery of eloquent tumors in language areas, the accepted gold standard is functional mapping through direct cortical stimulation (DCS) in awake patients. Ever since, neuroscientists are searching for reliable noninvasive detection of function in the human brain, with variable success. The potential of diffusion tensor imaging (DTI) in combination with computational cortical parcellation to predict functional areas in language eloquent tumors has not been assessed so far. We present a proof-of-concept report involving awake surgery for a temporodorsal tumor...
May 4, 2017: Brain Informatics
https://www.readbyqxmd.com/read/28474166/undisturbed-local-bone-formation-capacity-in-patients-with-atypical-femoral-fractures-a-case-series
#16
H P Bögl, P Aspenberg, J Schilcher
We excised the fracture site in 8 patients with incomplete atypical femoral fractures by drilling an 11-mm-diameter hole. New bone formation could be seen in the hole within a normal time frame. Delayed healing of these fractures might be unrelated to an impaired capacity to form bone. INTRODUCTION: Incomplete atypical femoral fractures (undisplaced cracks) heal slowly or not at all, and often progress to a complete fracture with minimal trauma. The impaired healing has been attributed to an impaired biologic healing capacity related to bisphosphonate use, or, alternatively, to the mechanical environment within the fracture crack...
May 4, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28465273/assessment-and-treatment-of-peritumoral-cortical-veins-in-parasagittal-meningiomas-with-application-of-3d-imaging-fusion-model
#17
Tengkun Yin, Jianjun Gu, Yinxing Huang, Liangfeng Wei, Jinxi Gao, Shousen Wang
BACKGROUND: Operation of cortical veins is the keystone of parasagittal meningiomas (PSM) resection. Little is known about pathological changes of the veins and proper treatment. We built three-dimensional (3D) image fusion models by neuronavigation to analyze the features of peritumoral cortical veins for PSM and explore intraoperative treatment options. METHODS: We performed a prospective study of 42 consecutive surgically treated PSM patients who underwent preoperative evaluation of peritumoral cortical veins using a 3D venous-tumor fusion model established by a neuronavigation system...
April 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28452617/intradiploic-encephalocele-of-the-primary-motor-cortex-in-an-adult-patient-electrophysiological-implications-during-surgery
#18
Luca Valci, Martina Dalolio, Dominique Kuhlen, Emanuele Pravatà, Claudio Gobbi, Michael Reinert
Encephaloceles are herniations of brain parenchyma through congenital or acquired osseous-dural defects of the skull base or cranial vault. Different types of symptoms, due to CSF fistulas, meningitis, or seizures, are often associated with this condition. The authors present a rare case of spontaneous right frontal parasagittal encephalocele in a 70-year-old man who was experiencing a spastic progressive paresis of his left lower limb. Results of routine electrophysiological workup (motor evoked potentials, somatosensory evoked potentials, and electroneuromyography), as well as those of MRI of the spinal cord, were normal...
April 28, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28441637/subtle-pathological-changes-in-neocortical-temporal-lobe-epilepsy
#19
Juan G Ochoa, Diana Hentgarden, Audrey Paulzak, Melissa Ogden, Richard Pryson, Markus Lamle, Walter G Rusyniak
This was a prospective observational study to correlate the clinical symptoms, electrophysiology, imaging, and surgical pathology of patients with temporal lobe epilepsy (TLE) without hippocampal sclerosis. We selected consecutive patients with TLE and normal MRI undergoing temporal lobe resection between April and September 2015. Clinical features, imaging, and functional data were reviewed. Intracranial monitoring and language mapping were performed when it was required according to our team recommendation...
April 22, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28434952/motor-outcomes-after-surgical-resection-of-lesions-involving-the-motor-pathway-a-prognostic-evaluation-scale
#20
Antonino Raco, Alessandro Pesce, Flavia Fraschetti, Alessandro Frati, Giancarlo D'Andrea, Marco Cimatti, Michele Acqui
BACKGROUND: Preservation of functions is essential in surgical resection of lesions involving the motor pathways. The aim of this work is to evaluate the effect of anatomical features of lesions located in the motor pathway on neurological and functional outcome. The authors propose an evaluation score in order to assess the risk of postoperative worsening. METHODS: 92 patients suffering from lesions involving the motor pathways have been studied for what concerns motor functions (MRC) after surgical treatment...
April 18, 2017: World Neurosurgery
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