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https://www.readbyqxmd.com/read/28621631/comparative-analysis-of-monotherapy-versus-duotherapy-antiseizure-drug-management-for-postoperative-seizure-control-in-patients-undergoing-an-awake-craniotomy
#1
Chikezie I Eseonu, Francisco Eguia, Oscar Garcia, Peter W Kaplan, Alfredo Quiñones-Hinojosa
OBJECTIVE Postoperative seizures are a common complication in patients undergoing an awake craniotomy, given the cortical manipulation during tumor resection and the electrical cortical stimulation for brain mapping. However, little evidence exists about the efficacy of postoperative seizure prophylaxis. This study aims to determine the most appropriate antiseizure drug (ASD) management regimen following an awake craniotomy. METHODS The authors performed a retrospective analysis of data pertaining to patients who underwent an awake craniotomy for brain tumor from 2007 to 2015 performed by a single surgeon...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28621626/a-multimodal-concept-for-invasive-diagnostics-and-surgery-based-on-neuronavigated-voxel-based-morphometric-mri-postprocessing-data-in-previously-nonlesional-epilepsy
#2
Daniel Delev, Carlos M Quesada, Alexander Grote, Jan P Boström, Christian Elger, Hartmut Vatter, Rainer Surges
OBJECTIVE Diagnosis and surgical treatment of refractory and apparent nonlesional focal epilepsy is challenging. Morphometric MRI voxel-based and other postprocessing methods can help to localize the epileptogenic zone and thereby support the planning of further invasive electroencephalography (EEG) diagnostics, and maybe resective epilepsy surgery. METHODS The authors developed an algorithm to implement regions of interest (ROI), based on postprocessed MRI data, into a neuronavigation tool. This was followed by stereotactic ROI-guided implantation of depth electrodes and ROI-navigated resective surgery...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28620830/anatomy-driven-multiple-trajectory-planning-admtp-of-intracranial-electrodes-for-epilepsy-surgery
#3
Rachel Sparks, Vejay Vakharia, Roman Rodionov, Sjoerd B Vos, Beate Diehl, Tim Wehner, Anna Miserocchi, Andrew W McEvoy, John S Duncan, Sebastien Ourselin
PURPOSE: Epilepsy is potentially curable with resective surgery if the epileptogenic zone (EZ) can be identified. If non-invasive imaging is unable to elucidate the EZ, intracranial electrodes may be implanted to identify the EZ as well as map cortical function. In current clinical practice, each electrode trajectory is determined by time-consuming manual inspection of preoperative imaging to find a path that avoids blood vessels while traversing appropriate deep and superficial regions of interest (ROIs)...
June 15, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28601603/enhanced-classical-complement-pathway-activation-and-altered-phagocytosis-signaling-molecules-in-human-epilepsy
#4
Season K Wyatt, Thomas Witt, Nicholas M Barbaro, Aaron A Cohen-Gadol, Amy L Brewster
Microglia-mediated neuroinflammation is widely associated with seizures and epilepsy. Although microglial cells are professional phagocytes, less is known about the status of this phenotype in epilepsy. Recent evidence supports that phagocytosis-associated molecules from the classical complement (C1q-C3) play novel roles in microglia-mediated synaptic pruning. Interestingly, in human and experimental epilepsy, altered mRNA levels of complement molecules were reported. Therefore, to identify a potential role for complement and microglia in the synaptodendritic pathology of epilepsy, we determined the protein levels of classical complement proteins (C1q-C3) along with other phagocytosis signaling molecules in human epilepsy...
June 7, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28598277/surgical-strategy-to-avoid-ischemic-complications-of-the-pyramidal-tract-in-resective-epilepsy-surgery-of-the-insula-technical-case-report
#5
Naoki Ikegaya, Akio Takahashi, Takanobu Kaido, Yuu Kaneko, Masaki Iwasaki, Nobutaka Kawahara, Taisuke Otsuki
Surgical treatment of the insula is notorious for its high probability of motor complications, particularly when resecting the superoposterior part. Ischemic damage to the pyramidal tract in the corona radiata has been regarded as the cause of these complications, resulting from occlusion of the perforating arteries to the pyramidal tract through the insular cortex. The authors describe a strategy in which a small piece of gray matter is spared at the bottom of the periinsular sulcus, where the perforating arteries pass en route to the pyramidal tract, in order to avoid these complications...
June 9, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28591823/the-survival-advantage-of-supratotal-resection-of-glioblastoma-using-selective-cortical-mapping-and-the-subpial-technique
#6
(no author information available yet)
No abstract text is available yet for this article.
June 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28588826/novel-case-of-resolution-of-hypsarrhythmia-following-tuber-resection-in-a-patient-with-infantile-spasms-and-tuberous-sclerosis
#7
Robert Marsh, Courtney Nichols, Mary Payne
This article describes a case involving the resolution of hypsarrhythmia, a generalized abnormal EEG pattern, following focal resection of a cortical tuber in a patient with tuberous sclerosis.
June 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28583883/preferential-susceptibility-of-limbic-cortices-to-microstructural-damage-in-temporal-lobe-epilepsy-a-quantitative-t1-mapping-study
#8
REVIEW
Boris C Bernhardt, Fatemeh Fadaie, Reinder Vos De Wael, Seok-Jun Hong, Min Liu, Marie C Guiot, David A Rudko, Andrea Bernasconi, Neda Bernasconi
The majority of MRI studies in temporal lobe epilepsy (TLE) have utilized morphometry to map widespread cortical alterations. Morphological markers, such as cortical thickness or grey matter density, reflect combinations of biological events largely driven by overall cortical geometry rather than intracortical tissue properties. Because of its sensitivity to intracortical myelin, quantitative measurement of longitudinal relaxation time (qT1) provides and an in vivo proxy for cortical microstructure. Here, we mapped the regional distribution of qT1 in a consecutive cohort of 24 TLE patients and 20 healthy controls...
June 3, 2017: NeuroImage
https://www.readbyqxmd.com/read/28580818/xanthomatous-posttraumatic-fibro-osseous-lesion-of-the-rib-a-rare-and-underrecognized-entity-case-report-and-literature-review
#9
Hussein Nassereddine, Frédérique Larousserie, Raphaël Campagna, Yves Castier, Anne Couvelard, Laurence Choudat, Aurélie Sannier
Posttraumatic fibro-osseous lesion (PTFOL) is a rare lesion that typically affects the ribs and is probably a posttraumatic reactive process. Because PTFOL is often misdiagnosed as fibrous dysplasia, osteoid osteoma, benign fibrous histiocytoma or rib metastases, chest wall resection, leading to a significant morbidity, is the main treatment modality. We report the case of a 30-year-old male patient with no history of previous trauma presenting with chest pain. Computed tomography scan showed an eighth left rib well-defined ovoid and hypodense lesion with circumferential sclerotic margin and no cortical breakthrough...
June 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28574317/reoperation-after-failed-resective-epilepsy-surgery-in-children
#10
Osama Muthaffar, Klajdi Puka, Luc Rubinger, Cristina Go, O Carter Snead, James T Rutka, Elysa Widjaja
OBJECTIVE Although epilepsy surgery is an effective treatment option, at least 20%-40% of patients can continue to experience uncontrolled seizures resulting from incomplete resection of the lesion, epileptogenic zone, or secondary epileptogenesis. Reoperation could eliminate or improve seizures. Authors of this study evaluated outcomes following reoperation in a pediatric population. METHODS A retrospective single-center analysis of all patients who had undergone resective epilepsy surgery in the period from 2001 to 2013 was performed...
June 2, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28574123/orthogonal-plating-of-vancouver-b1-and-c-type-periprosthetic-femur-fracture-nonunions
#11
Christopher E Birch, Michael Blankstein, Jesse D Chlebeck, Craig S Bartlett Rd
BACKGROUND: Periprosthetic femoral shaft fractures are a significant complication after total hip arthroplasty (THA). Plate osteosynthesis has been the mainstay of treatment around well-fixed stems. Nonunions are a rare and challenging complication of this fixation method. We report the outcomes of a novel orthogonal plating surgical technique for Vancouver B1 and C-type periprosthetic fractures that previously failed open reduction internal fixation (ORIF). METHODS: A retrospective review identified all patients with Vancouver B1/C THA periprosthetic femoral nonunions from 2010 to 2015...
May 27, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28565831/clinical-characteristics-and-epilepsy-outcomes-following-surgery-caused-by-focal-cortical-dysplasia-type-iia-in-110-adult-epileptic-patients
#12
Yuqiang Sun, Xiaofeng Wang, Ningwei Che, Huamin Qin, Shuping Liu, Xinling Wu, Minghai Wei, Huakun Cheng, Jian Yin
The aim of the present study was to investigate the effects of surgical intervention of focal cortical dysplasia (FCD) IIa on the outcome of epilepsy, and to evaluate the prognostic factors of seizure freedom. Patient data from epilepsy surgeries were retrospectively reviewed at the Second Affiliated Hospital of Dalian Medical University between 2007 and 2015. A total of 110 patients with a definite pathological diagnosis of FCD IIa were included. Moreover, the clinical characteristics, seizure outcome and quality of life in adults with FCD IIa were evaluated...
May 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28557904/characteristics-of-eeg-seizure-onset-patterns-recorded-from-subdural-electrodes-over-mri-visible-frontal-focal-cortical-dysplasia-type-iib-lesions
#13
Daisuke Hirozawa, Kiyohito Terada, Kazumi Matsuda, Keiko Usui, Naotaka Usui, Takayasu Tottori, Akihiko Kondo, Yasukiyo Araki, Yoshio Omote, Yumi Kashida, Hideki Mochizuki, Yushi Inoue
PURPOSE: Focal cortical dysplasia (FCD) is intrinsically epileptogenic, and an MRI-visible lesion typically constitutes the core part of the epileptogenic zone. We aimed to identify ictal EEG patterns that represent the epileptogenic zone by using subdural electrodes placed over the MRI-visible FCD lesion. METHODS: We selected seven patients with frontal lobe epilepsy caused by pathologically proven FCD type IIb who underwent preoperative intracranial EEG evaluation with subdural electrodes followed by resection surgery with seizure-free outcome...
May 25, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28557010/rapid-amyloid-%C3%AE-oligomer-and-protofibril-accumulation-in-traumatic-brain-injury
#14
Sami Abu Hamdeh, Erik Rollman Waara, Christer Möller, Linda Söderberg, Hans Basun, Irina Alafuzoff, Lars Hillered, Lars Lannfelt, Martin Ingelsson, Niklas Marklund
OBJECTIVE: Deposition of amyloid-β (Aβ) is central to Alzheimer's disease (AD) pathogenesis and associated with progressive neurodegeneration in traumatic brain injury (TBI). We analysed predisposing factors for Aβ deposition including monomeric Aβ40, Aβ42 and Aβ oligomers/protofibrils, Aβ species with pronounced neurotoxic properties, following human TBI. METHODS: Highly selective ELISAs were used to analyse N-terminally intact and truncated Aβ40 and Aβ42, as well as Aβ oligomers/protofibrils, in human brain tissue, surgically resected from severe TBI patients (n=12; mean age 49...
May 29, 2017: Brain Pathology
https://www.readbyqxmd.com/read/28532252/chronic-subthreshold-cortical-stimulation-a-therapeutic-and-potentially-restorative-therapy-for-focal-epilepsy
#15
Brian Nils Lundstrom, Gregory A Worrell, Matt Stead, Jamie J Van Gompel
Approximately one third of patients with focal epilepsy continue to have ongoing seizures despite adequate trials of anti-seizure medications. Surgery to remove the epileptogenic zone remains the most efficacious treatment option for focal drug-resistant epilepsy. However, when cortical areas are eloquent or there are multiple epileptogenic zones, surgical resection is not an ideal approach. Cortical stimulation provides an attractive alternative. Area covered: Here, the authors describe Chronic Subthreshold Cortical Stimulation (CSCS), which uses continuous intracranial electrical stimulation applied near the epileptogenic zone to lower seizure probability...
May 25, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28530250/the-hump-columellar-strut-a-reliable-technique-for-correction-of-nasal-tip-underprojection
#16
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
#17
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
#18
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
#19
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
#20
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
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