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Intracranial OR Aneurysm Neuro*

April A Carlson, Ueli Rutishauser, Adam N Mamelak
BACKGROUND: Invasive electrode monitoring provides more precise localization of epileptogenic foci in patients with medically refractory epilepsy. The use of hybrid depth electrodes that include microwires for simultaneous single-neuron monitoring is becoming more widespread. OBJECTIVE: To determine the safety and utility of hybrid depth electrodes for intracranial monitoring of medically refractory epilepsy. METHODS: We reviewed the medical charts of 53 cases of medically refractory epilepsy operated on from 2006 to 2017, where both non-hybrid and hybrid microwire depth electrodes were used for intracranial monitoring...
October 16, 2018: Stereotactic and Functional Neurosurgery
Maika Kreßner, Felix Arlt, Wolf Riepl, Jürgen Meixensberger
OBJECTIVE: Peri- and postoperative time course of meningioma patients who had undergone surgical treatment was evaluated to determine prognostic factors of neurological outcome by focusing on preoperative parameters. MATERIAL AND METHODS: A retrospective monocenter analysis was performed including patients who were operated in the Department of Neurosurgery, University Hospital Leipzig, from 2009 to 2015. Data from all patients with histologically confirmed diagnosis of intracranial meningioma treated microsurgically were included in the study...
2018: PloS One
Joseph A Bovi
The incidence of brain metastases is projected to rise because survival rates of lung cancer, breast cancer, and melanoma continue to improve (1). The brain is being identified as a sanctuary site for harboring metastases despite excellent control of extracranial disease. This is thought to occur because the drug therapies that control extracranial disease have limited central nervous system (CNS) penetration. The development of brain metastases is a devastating diagnosis affecting both quality of life (QOL) and survival...
2018: Frontiers in Neurology
Farkhad Manapov, Lukas Käsmann, Olarn Roengvoraphoj, Maurice Dantes, Nina-Sophie Schmidt-Hegemann, Claus Belka, Chukwuka Eze
Over 10% of small-cell lung cancer (SCLC) patients have brain metastases (BM) at initial diagnosis; more than 50% will develop BM within 2 years. BM are detected in up to 80% of all patients at autopsy. After primary treatment, prophylactic cranial irradiation (PCI) has been established as standard of care in SCLC patients responding to initial therapy. Based on level I evidence, PCI significantly decreases the risk of intracranial relapse and shows a modest survival benefit after 3 years. However, the role of PCI in defined patient subgroups such as resected SCLC, elderly and extensive stage patients with access to magnetic resonance imaging surveillance and stereotactic radiotherapy is yet to be fully clarified...
2018: Lung Cancer: Targets and Therapy
Daniela Laino, Elisabetta Mencaroni, Susanna Esposito
Febrile seizures (FS), events associated with a fever in the absence of an intracranial infection, hypoglycaemia, or an acute electrolyte imbalance, occur in children between six months and six years of age. FS are the most common type of convulsions in children. FS can be extremely frightening for parents, even if they are generally harmless for children, making it important to address parental anxiety in the most sensitive manner. The aim of this review was to focus on the management of FS in the pediatric age...
October 12, 2018: International Journal of Environmental Research and Public Health
Natalie C Wheeler, Sadhana Murali, Justin A Sattin
There are ethical aspects to each of the three phases of cerebrovascular disease: hyperacute management, acute prognostication and management of early complications, and long-term recovery and reintegration with the community. This article addresses ethical concerns pertinent to each phase. First, we discuss ethical issues regarding consent for thrombolysis and endovascular treatment for acute ischemic stroke, including a review of considerations regarding the provision of acute stroke treatment advice over the telephone...
October 2018: Seminars in Neurology
V V Shlomin, I G Drozhzhin, Iu P Didenko, N Iu Grebenkina, P D Puzdriak, P B Bondarenko, D G Pavlov, G A Vereshchako
Described herein is a clinical case report concerning treatment of a 32-year-old female patient with rupture of an aneurysm of the arch and descending portion of the thoracic aorta, with the bleeding having penetrated the upper lobe of the left lung. The woman was admitted to the Department of Vascular Surgery of Municipal Multimodality Hospital No 2 of Saint Petersburg, presenting with a clinical pattern of aneurysmal rupture previously diagnosed by computed tomography performed at one of the local hospitals...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Iván Pérez-Neri, Carlos Eduardo Diéguez-Campa
Despite its beneficial effects for the cardiovascular system, taurine remains a controversial substance. Taurine increases cardiac muscle strength and prevents arrhythmias, but its benefits go beyond this. Determining taurine levels may become an issue of life or death. In aneurysmal subarachnoid hemorrhage, taurine may be a warning signal informing of the risk of death in a patient. High plasma taurine levels may identify those patients at a high risk for death or a vegetative state at discharge from the hospital; thus, taurine may be a vital marker for the prognosis of this disorder...
October 15, 2018: Postgraduate Medicine
Ji Wang, Rui Yu, Chuncheng Qu, Jun Jiang, Chengwei Wang, Qinghu Meng, Shengcheng Wei
OBJECTIVE: To evaluate and compare the long-term efficacy and safety of microvascular decompression (MVD) and glossopharyngeal nerve roots rhizotomy (GNR) in the treatment of glossopharyngeal neuralgia (GN). PATIENTS AND METHODS: The data of 37 patients with glossopharyngeal neuralgia undergoing MVD alone and MVD + GNR from July 2004 to March 2017 were analyzed retrospectively. Among them, 22 were MVD alone and 15 were MVD + GNR. All patients underwent preoperative cocaine experiments to verify diagnoses, preoperative magnetic resonance imaging examinations to detect compressing vessels near the root entry zone of the glossopharyngeal nerve...
October 12, 2018: Journal of Craniofacial Surgery
Arda Kucukguven, Mert Calis, Haluk Topaloglu, Figen Ozgur
Accompanying neurologic disorders directly affect psychosocial development of cleft lip and/or cleft palate (CLP) patients and make it difficult for their family to look after them properly. The aim of this study was to investigate the diversity and the incidence of additional neurologic malformations in children with CLP and to evaluate their effects on cleft care. All patients who applied to our Cleft and Craniofacial Center between July 2014 and July 2017 were included in the study. Demographic and perioperative data such as gender, cleft type, syndromic status of the patient, associated neurologic anomalies, timing and duration of operation, hospitalization period, and follow-up period in the intensive care unit are all recorded...
October 12, 2018: Journal of Craniofacial Surgery
Suneel D Kamath, Priya U Kumthekar
While the CNS has long been viewed as an immune-privileged environment, a paradigm shift in neuro-immunology has elevated the role of systemic immunotherapy for the treatment of metastatic disease. Increasing knowledge regarding the presence of a CNS lymphatic system and the physical and biochemical alteration of the blood brain barrier (BBB) by the tumor microenvironment suggests immune cell trafficking in and out of the CNS is possible. Emerging clinical data suggest immune checkpoint inhibitors (ICIs) can stimulate T cells peripherally to in turn have anti-tumor effects in the CNS...
2018: Frontiers in Oncology
Charlotte Cordonnier, Andrew Demchuk, Wendy Ziai, Craig S Anderson
Acute spontaneous intracerebral haemorrhage is a life-threatening illness of global importance, with a poor prognosis and few proven treatments. As a heterogeneous disease, certain clinical and imaging features help identify the cause, prognosis, and how to manage the disease. Survival and recovery from intracerebral haemorrhage are related to the site, mass effect, and intracranial pressure from the underlying haematoma, and by subsequent cerebral oedema from perihaematomal neurotoxicity or inflammation and complications from prolonged neurological dysfunction...
October 6, 2018: Lancet
Manjul Tripathi, Chirag Kamal Ahuja, Abhishek Gupta, Kanchan Kumar Mukherjee, Aman Batish, Manish Buddhiraja
PURPOSE: Dural arteriovenous fistula (DAVF) of the anterior cranial fossa with cortical venous reflux is an aggressive neurovascular entity with a high rate of intracranial bleeding. Only two cases of anterior cranial fossa DAVF presenting with epistaxis alone have been reported. Endovascular approaches have emerged as the primary and safer treatment modality for most DAVFs. Certain fistulas are better treated with open surgical approaches and disconnection. CASE DESCRIPTION: A 55 years old male presented with the history of multiple episodes of severe epistaxis...
October 13, 2018: British Journal of Neurosurgery
Nicola Toschi, Luca Passamonti
OBJECTIVE: Differences in myelination across the cortical mantle are important neurobiological mediators of variability in cognitive, emotional, and behavioural functioning. Past studies have found that personality traits reflecting such variability are linked to neuroanatomical and functional changes in prefrontal and temporo-parietal cortices. Whether these effects are partially mediated by differences in intra-cortical myelin remains to be established. METHOD: To test this hypothesis, we employed vertex-wise intra-cortical myelin maps in n=1,003 people from the Human Connectome Project...
October 14, 2018: Journal of Personality
Farhan A Mirza, Muhammad Shahzad Shamim
Hydrocephalus, unless treated, is one of the terminal manifestations of intracranial metastatic disease. Single lesions causing obstructive hydrocephalus are amenable to surgical resection, but in the setting of multiple lesions and communicating hydrocephalus from leptomeningeal disease, the approach to treatment is much less defined. The use of endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunting (VPS) has been described, but data is limited. In this review, we summarize the sparse data available in literature describing the use of CSF diversion for patients with metastatic disease presenting with hydrocephalus and neurological decline...
September 2018: JPMA. the Journal of the Pakistan Medical Association
Shang-Ying Tsai, Ariel G Gildengers, Jung-Lung Hsu, Kuo-Hsuan Chung, Pao-Huan Chen, Yu-Jui Huang
BACKGROUND: Bipolar disorder (BD) and aging appear to be associated with inflammatory activation. Inflammatory processes might affect hippocampal function, neurogenesis, and gray matter loss. This study investigated the relationship between BD-specific brain regions and the total gray matter volume, peripheral inflammatory markers, and clinical features in older patients with BD. METHODS: We recruited euthymic patients with bipolar I disorder aged ≥50 years to undergo whole-brain magnetic resonance imaging...
October 6, 2018: Journal of Affective Disorders
Mara Cavallin, Manuele Mine, Marion Philbert, Nathalie Boddaert, Jean Marie Lepage, Thibault Coste, Vanessa Lopez-Gonzalez, Maria Jose Sanchez-Soler, Maria Juliana Ballesta-Martínez, Ganaëlle Remerand, Laurent Pasquier, Agnès Guët, Jamel Chelly, Karine Lascelles, Carol Prieto-Morin, Manoelle Kossorotoff, Elisabeth Tournier Lasserve, Nadia Bahi-Buisson
Mutations in COL4A1 have been reported in schizencephaly and porencephaly combined with microbleeds or calcifications, often associated with ocular and renal abnormalities, myopathy, elevated creatine kinase levels and haemolytic anaemia. In this study, we aimed to clarify the phenotypic spectrum of COL4A1/A2 mutations in the context of cortical malformations that include schizencephaly, polymicrogyria and/or heterotopia. METHODS: We screened for COL4A1/A2 mutations in 9 patients with schizencephaly and/or polymicrogyria suspected to be caused by vascular disruption and leading to a cerebral haemorrhagic ischaemic event...
October 10, 2018: European Journal of Medical Genetics
Keiichiro Kasama, Keiji Uchida, Norihisa Karube, Shigeo Takebayashi, Kiyotaka Imoto, Munetaka Masuda
BACKGROUND: In aortic surgery, a severely atherosclerotic aorta is a known risk factor for perioperative stroke. We adopted a novel procedure of selective cerebral perfusion, named isolated cerebral perfusion (ICP), for the prevention of stroke during aortic arch surgery. METHODS: Between January 2010 and June 2016, 48 patients (mean age, 80 ± 3 years) underwent total aortic arch replacement at our institute, which included nine emergency cases with rupture. ICP was routinely performed for extracorporeal circulation during total arch replacement...
October 10, 2018: Annals of Thoracic Surgery
H Gurbuz Aytuluk, O Aktas
Cranial nerve palsy is a rare neurological complication of epidural and subarachnoid blocks. Most of these complications are attributed to secondary intracranial hypotension due to cerebrospinal fluid leakage following dural puncture. Vocal fold paralysis (VFP) seems more likely to be overlooked and underreported due to delayed onset of symptoms and lack of attribution of dysphonia to spinal anesthesia. Therefore, VFP can often be missed and described as idiopathic. This article describes a case of VFP due to vagus nerve injury following subarachnoid block...
October 12, 2018: Der Anaesthesist
Omri Raccah, Amy L Daitch, Aaron Kucyi, Josef Parvizi
The past decade has seen a large number of neuroimaging studies focused on the anti-correlated functional relationship between the default mode network (DMN) and the dorsal attention network (DAN). Due principally to the low-temporal resolution of functional neuroimaging modalities, the fast-neuronal dynamics across these networks remains poorly understood. Here we report novel human intracranial electrophysiology data from six neurosurgical patients (four males) with simultaneous coverage of well-characterized nodes of the DMN and DAN...
October 12, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
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