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https://www.readbyqxmd.com/read/28427592/pathologic-active-mtor-mutation-in-brain-malformation-with-intractable-epilepsy-leads-to-cell-autonomous-migration-delay
#1
Sae Hanai, Sayuri Sukigara, Hongmei Dai, Tomoo Owa, Shin-Ichi Horike, Taisuke Otsuki, Takashi Saito, Eiji Nakagawa, Naoki Ikegaya, Takanobu Kaido, Noriko Sato, Akio Takahashi, Kenji Sugai, Yuko Saito, Masayuki Sasaki, Mikio Hoshino, Yu-Ichi Goto, Schuichi Koizumi, Masayuki Itoh
The activation of phosphatidylinositol 3-kinase-AKTs-mammalian target of rapamycin cell signaling pathway leads to cell overgrowth and abnormal migration and results in various types of cortical malformations, such as hemimegalencephaly (HME), focal cortical dysplasia, and tuberous sclerosis complex. However, the pathomechanism underlying abnormal cell migration remains unknown. With the use of fetal mouse brain, we performed causative gene analysis of the resected brain tissues from a patient with HME and investigated the pathogenesis...
May 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28419879/challenging-the-myth-of-right-non-dominant-hemisphere-lessons-from-cortico-subcortical-stimulation-mapping-in-awake-surgery-and-surgical-implications
#2
REVIEW
Tatiana Vilasboas, Guillaume Herbet, Hugues Duffau
For a long time, the right hemisphere (RH) was considered as "non-dominant", especially in right-handers. In neurosurgical practice, this dogma resulted in the selection of awake procedure with language mapping only for lesions of the left "dominant" hemisphere. Conversely, surgery under general anesthesia (possibly with motor mapping) was usually proposed for right lesions. However, when objective neuropsychological assessments were performed, they frequently revealed cognitive and behavioral deficits following brain surgery, even in the RH...
April 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28416459/the-error-of-broca-from-the-traditional-localizationist-concept-to-a-connectomal-anatomy-of-human-brain
#3
REVIEW
Hugues Duffau
Neurology, especially aphasiology, was mainly built on behavioral-structural correlations ("lesion method"). In this setting, Broca's area has been considered as the "speech area"; moreover, this observation led to localizationism. However, advances in brain mapping techniques, as functional neuroimaging and direct electrical stimulation in patients undergoing awake surgery for gliomas, has resulted in a paradigmatic shift regarding models of neural architecture. In fact, the brain is organized in distributed complex networks underpinning sensorimotor, visuospatial, language, cognitive and emotional functions...
April 14, 2017: Journal of Chemical Neuroanatomy
https://www.readbyqxmd.com/read/28414967/pharmacodynamics-of-remifentanil-induced-intracranial-spike-activity-in-mesial-temporal-lobe-epilepsy
#4
Troels Wesenberg Kjaer, Hans Hogenhaven, Andrea P Lee, Flemming Find Madsen, Bo Jespersen, Jannick Brennum, Lennart Derm, Finn Borgbjerg Moltke
Patients with medically refractory epilepsy may benefit from resective epilepsy surgery. However even the best centers experience surgical failures. It is therefore important to find techniques that may aid in neurosurgical planning of epileptic focus resection. Recordings of electrical brain activity with EEG during seizures reveal abnormal cortical hypersynchronization. Between seizures the EEG often shows interictal depolarizing phenomena such as spikes reflecting an irritable focus of the brain. In the present study we investigated the effect of intravenous remifentanil on the spike activity in the temporal neocortex and hippocampus...
March 31, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28412559/interictal-ripples-nested-in-epileptiform-discharge-help-to-identify-the-epileptogenic-zone-in-neocortical-epilepsy
#5
Shuang Wang, Norman K So, Bo Jin, Irene Z Wang, Juan C Bulacio, Rei Enatsu, Shenyi Dai, Zhong Chen, Jorge Gonzalez-Martinez, Imad M Najm
OBJECTIVE: This study aimed to identify the subtype of interictal ripples that help delineate the epileptogenic zone in neocortical epilepsy. METHODS: Totally 25 patients with focal neocortical epilepsy who had invasive electroencephalography (EEG) evaluation and subsequent surgery were included. They were followed up for at least 2years. Interictal ripples (80-250Hz) and fast ripples (250-500Hz) during slow-wave sleep were identified. Neocortical ripples were defined as type I ripples when they were superimposed on epileptiform discharges, and as type II ripples when they occurred independently...
March 25, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28411414/laser-interstitial-thermotherapy-litt-in-epilepsy-surgery
#6
REVIEW
Christian Hoppe, Juri-Alexander Witt, Christoph Helmstaedter, Thomas Gasser, Hartmut Vatter, Christian E Elger
Besides other innovative stereotactic procedures (radiofrequency thermocoagulation, focused ultrasound, gamma knife) laser interstitial thermotherapy (LiTT) provides minimally invasive destruction of pathological soft tissues which could be especially relevant for epilepsy surgeries involving adult and pediatric patients. Unlike standard resections, no craniotomy is required; just a tiny borehole trepanation is sufficient. Damage to cortical areas when accessing deep lesions can be minimized or completely avoided, and treating epileptogenic foci near eloquent or even vital brain areas becomes possible...
April 6, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28391383/percutaneous-radiofrequency-ablation-for-spinal-osteoid-osteoma-and-osteoblastoma
#7
Ben Wang, Song Bo Han, Liang Jiang, Hui Shu Yuan, Chen Liu, Bin Zhu, Zhong Jun Liu, Xiao Guang Liu
PURPOSES: We sought to verify the efficacy and safety of RFA in spinal OO and osteoblastomas (OB) (Enneking Stage 2, S2). METHODS: We retrospectively reviewed patients treated in our hospital. Surgical resection was indicated for Enneking Stage 3 OB. RFA indications for spinal OO and OB (S2) were no neurological deficits, complete bone cortex around the lesion on computed tomography (CT), and cerebrospinal fluid between a lesion and the spinal cord/nerve root on magnetic resonance imaging...
April 8, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28388012/methylation-profiling-of-paediatric-pilocytic-astrocytoma-reveals-variants-specifically-associated-with-tumour-location-and-predictive-of-recurrence
#8
Alexandra Sexton-Oates, Andrew Dodgshun, Volker Hovestadt, David T W Jones, David M Ashley, Michael Sullivan, Duncan MacGregor, Richard Saffery
Childhood pilocytic astrocytomas (PA) are low grade tumours with an excellent prognosis. However, a minority, particularly those in surgically inaccessible locations, have poorer long term outcome. At present it is unclear whether anatomical location in isolation, or in combination with underlying biological variation, determines clinical behaviour. Here we have tested the utility of DNA methylation profiling to inform tumour biology and to predict behaviour in paediatric PA. Genome-wide DNA methylation profiles were generated for 117 paediatric PAs...
April 7, 2017: Molecular Oncology
https://www.readbyqxmd.com/read/28386926/extratemporal-resections-in-pediatric-epilepsy-surgery-an-overview
#9
Jeffrey P Blount
Despite optimized medical treatment, approximately one third of all patients with epilepsy continue to have seizures and by definition have medically resistant epilepsy (MRE). For these patients, surgical disruption of the epileptogenic network may enable freedom or great improvement in control of their seizures. The success of surgery is dependent on accurate localization of the epileptogenic zone and network. Epilepsy arising from regions of cortical dysplasia within the neocortex of the frontal, parietal, and occipital lobes show a propensity for reorganization and progressive decline in seizure freedom and consequent poorer surgical outcome...
April 2017: Epilepsia
https://www.readbyqxmd.com/read/28382122/use-of-an-osteoplastic-flap-for-the-prevention-of-mastoidectomy-retroauricular-defects
#10
Ricardo Ferreira Bento, Robinson Koji Tsuji, Anna Carolina de Oliveira Fonseca, Ricardo Dourado Alves
Introduction After mastoidectomy, patients usually complain of bone depressions in the retroauricular region in the surgical site, especially in procedures that require extensive cortical resections. This causes inconveniences such as difficulty wearing glasses, cleaning, and aesthetics complaints. Objective This study aims to describe a vascularized flap surgical technique that uses the mastoid cortical bone adhered to the periosteum, which is pedicled on the anterior portion and repositioned at the end of the surgery...
April 2017: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/28368547/the-survival-advantage-of-supratotal-resection-of-glioblastoma-using-selective-cortical-mapping-and-the-subpial-technique
#11
Yoshua Esquenazi, Elliott Friedman, Zheyu Liu, Jay-Jiguang Zhu, Sigmund Hsu, Nitin Tandon
BACKGROUND: A substantial body of evidence suggests that cytoreductive surgery is a prerequisite to prolonging survival in patients with glioblastoma (GBM). OBJECTIVE: To evaluate the safety and impact of "supratotal" resections beyond the zone of enhancement seen on magnetic resonance imaging scans, using a subpial technique. METHODS: We retrospectively evaluated 86 consecutive patients with primary GBM, managed by the senior author, using a subpial resection technique with or without carmustine (BCNU) wafer implantation...
March 23, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28365908/spinal-adrenal-cortical-adenoma-associated-with-beckwith-wiedemann-syndrome-case-report-and-review-of-the-literature
#12
Javier Giner, Isabel Esteban, Fernando Carceller, Javier Saceda, R M Regojo
PURPOSE: Ectopic adrenal cortical adenoma in the spinal region is extremely rare. The majority of cases of ectopic adrenocortical tissue are found along the path of embryonic migration within the urogenital tract. Beckwith-Wiedemann syndrome (BWS) is a pediatric overgrowth disorder involving a predisposition to tumor development, including adrenal lesions. To date, only eight spinal cases have been reported. This is the third reported case in pediatric population, the first one associated with genetic syndrome and the first benign to recur...
April 1, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28365529/giant-cell-tumour-of-bone-in-the-denosumab-era
#13
REVIEW
Lizz van der Heijden, P D Sander Dijkstra, Jean-Yves Blay, Hans Gelderblom
Giant cell tumour of bone (GCTB) is an intermediate locally aggressive primary bone tumour, occurring mostly at the meta-epiphysis of long bones. Overexpression of receptor activator of nuclear factor kappa-B ligand (RANKL) by mononuclear neoplastic stromal cells promotes recruitment of numerous reactive multinucleated osteoclast-like giant cells, causing lacunar bone resorption. Preferential treatment is curettage with local adjuvants such as phenol, alcohol or liquid nitrogen. The remaining cavity may be filled with bone graft or polymethylmethacrylate (PMMA) bone cement; benefits of the latter are a lower risk of recurrence, possibility of direct weight bearing and early radiographic detection of recurrences...
March 30, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28363248/the-resting-state-fmri-regional-homogeneity-reho-metrics-kcc-reho-cohe-reho-are-valid-indicators-of-tumor-related-neurovascular-uncoupling
#14
Shruti Agarwal, Haris I Sair, Jay J Pillai
AIM: To determine whether regional homogeneity (ReHo) of resting state BOLD fMRI (rsfMRI) data based on Kendall's coefficient of concordance (KCC-ReHo) & Coherence (Cohe-ReHo) metrics may allow detection of brain tumor-induced NVU in the sensorimotor network similar to findings in standard motor task-based BOLD fMRI (tbfMRI) activation. METHODS: Twelve de novo brain tumor patients undergoing clinical fMRI exams (tbfMRI and rsfMRI) were included in this IRB-approved study...
March 31, 2017: Brain Connectivity
https://www.readbyqxmd.com/read/28358603/metastatic-thymoma-in-a-scarlet-macaw-ara-macao
#15
Barbara Lang, Susanne Vorbrüggen, Ruth Kothe, Gerd Britsch, Volker Schmidt
A 49-year-old female scarlet macaw ( Ara macao ) was presented with a mass in the cervical region. The bird showed no evidence of pain or discomfort, it swallowed food normally, and its breathing pattern was unremarkable. Results of contrast radiographic imaging revealed a well-demarcated mass in the right cervical region not related to the crop. After surgical resection and histopathologic evaluation, a malignant nodular stage of an epithelioid cortical-type thymoma was diagnosed. One year later, metastasis of the thymoma to the lung was diagnosed and confirmed at postmortem examination...
March 2017: Journal of Avian Medicine and Surgery
https://www.readbyqxmd.com/read/28351681/regional-mechanical-properties-of-human-brain-tissue-for-computational-models-of-traumatic-brain-injury
#16
John D Finan, Sowmya N Sundaresh, Benjamin S Elkin, Guy M McKhann, Barclay Morrison
To determine viscoelastic shear moduli, stress relaxation indentation tests were performed on samples of human brain tissue resected in the course of epilepsy surgery. Through the use of a 500µm diameter indenter, regional mechanical properties were measured in cortical grey and white matter and subregions of the hippocampus. All regions were highly viscoelastic. Cortical grey matter was significantly more compliant than the white matter or hippocampus which were similar in modulus. Although shear modulus was not correlated with the age of the donor, cortex from male donors was significantly stiffer than from female donors...
March 25, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28346953/lennox-gastaut-syndrome-a-state-of-the-art-review
#17
Mario Mastrangelo
Lennox-Gastaut syndrome (LGS) is a severe age-dependent epileptic encephalopathy usually with onset between 1 and 8 years of age. Functional neuroimaging studies recently introduced the concept of Lennox-Gastaut as "secondary network epilepsy" resulting from dysfunctions of a complex system involving both cortical and subcortical structures (default-mode network, corticoreticular connections, and thalamus). These dysfunctions are produced by different disorders including hypoxic-ischemic encephalopathies, meningoencephalitis, cortical malformations, neurocutaneous disorders, or tumors...
March 27, 2017: Neuropediatrics
https://www.readbyqxmd.com/read/28342138/does-removal-of-subchondral-cortical-bone-provide-sufficient-resection-depth-for-treatment-of-cam-femoroacetabular-impingement
#18
Penny R Atkins, Stephen K Aoki, Ross T Whitaker, Jeffrey A Weiss, Christopher L Peters, Andrew E Anderson
BACKGROUND: Residual impingement resulting from insufficient resection of bone during the index femoroplasty is the most-common reason for revision surgery in patients with cam-type femoroacetabular impingement (FAI). Development of surgical resection guidelines therefore could reduce the number of patients with persistent pain and reduced ROM after femoroplasty. QUESTIONS/PURPOSES: We asked whether removal of subchondral cortical bone in the region of the lesion in patients with cam FAI could restore femoral anatomy to that of screened control subjects...
March 24, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28327949/resection-of-navigated-transcranial-magnetic-stimulation-positive-prerolandic-motor-areas-causes-permanent-impairment-of-motor-function
#19
Tobias Moser, Lucia Bulubas, Jamil Sabih, Neal Conway, Noémie Wildschutz, Nico Sollmann, Bernhard Meyer, Florian Ringel, Sandro M Krieg
BACKGROUND: Navigated transcranial magnetic stimulation (nTMS) helps to determine the distribution of motor eloquent areas prior to brain surgery. Yet, the eloquence of primary motor areas frontal to the precentral gyrus identified via nTMS is unclear. OBJECTIVE: To investigate the resection of nTMS-positive prerolandic motor areas and its correlation with postsurgical impairment of motor function. METHODS: Forty-three patients with rolandic or prerolandic gliomas (WHO grade I-IV) underwent nTMS prior to surgery...
February 24, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327904/the-cost-of-brain-surgery-awake-vs-asleep-craniotomy-for-perirolandic-region-tumors
#20
Chikezie I Eseonu, Jordina Rincon-Torroella, Karim ReFaey, Alfredo Quiñones-Hinojosa
BACKGROUND: Cost effectiveness has become an important factor in the health care system, requiring surgeons to improve efficacy of procedures while reducing costs. An awake craniotomy (AC) with direct cortical stimulation (DCS) presents one method to resect eloquent region tumors; however, some authors assert that this procedure is an expensive alternative to surgery under general anesthesia (GA) with neuromonitoring. OBJECTIVE: To evaluate the cost effectiveness and clinical outcomes between AC and GA patients...
March 15, 2017: Neurosurgery
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