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Neurosurgical Approach

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https://www.readbyqxmd.com/read/28544168/presurgical-language-fmri-mapping-of-six-critical-regions
#1
Christopher F Benjamin, Patricia D Walshaw, Kayleigh Hale, William D Gaillard, Leslie C Baxter, Madison M Berl, Monika Polczynska, Stephanie Noble, Rafeed Alkawadri, Lawrence J Hirsch, Todd C Constable, Susan Y Bookheimer
Language mapping is a key goal in neurosurgical planning. fMRI mapping typically proceeds with a focus on Broca's and Wernicke's areas, although multiple other language-critical areas are now well-known. We evaluated whether clinicians could use a novel approach, including clinician-driven individualized thresholding, to reliably identify six language regions, including Broca's Area, Wernicke's Area (inferior, superior), Exner's Area, Supplementary Speech Area, Angular Gyrus, and Basal Temporal Language Area...
May 23, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28533868/-rare-medico-surgical-emergency-spinal-epidural-abscess-about-3-cases
#2
Abderrazzak El Saqui, Mohamed Aggouri, Mohamed Benzagmout, Khalid Chakour, Mohamed El Faiz Chaoui
The awareness about infections in the epidural space is increasing thanks to the development of neurosurgery, including MRI. Spinal epidural abscess is a rare pathology but extremely serious from a functional point of view and potentially life threatening. We report three cases of male patients (the first one aged 52 years, the second 57 years and the third 63 years) with diagnosed spinal epidural abscess. Two patients were admitted to the Neurosurgical Emergencies with slow progressive spinal cord compression evolving in the context of infection...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28524125/-surgical-management-of-venous-compression-causing-trigeminal-neuralgia
#3
V K Poshataev, A N Konovalov, V N Shimanskiy
Venous compression is a rare cause of trigeminal neuralgia (TN). Vascular decompression of the trigeminal nerve root, as the only etiopathogenetic treatment of trigeminal neuralgia, is a well-known procedure that is extensively used at various neurosurgical clinics. As the number of interventions for TN increases, the absolute number of surgeries for eliminating venous compression of the trigeminal nerve also grows. Five hundred TN patients underwent surgery at the Neurosurgical Institute in the period from 2000 to 2015...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28516966/expanded-transcanal-transpromontorial-approach-to-the-internal-auditory-canal-and-cerebellopontine-angle-a-cadaveric-study
#4
L Presutti, M Bonali, D Marchioni, G Pavesi, A Feletti, L Anschuetz, M Alicandri-Ciufelli
The aim of this paper is to describe and evaluate the feasibility of an expanded endoscopic transcanal transpromotorial approach (ExpTTA) to the internal auditory canal and the cerebellopontine angle. To this end, we performed a cadaveric dissection study in September 2015. In total, 2 heads (4 sides) were dissected focusing on anatomical landmarks and surgical feasibility. Data from dissections were reviewed and analysed for further consideration. In all 4 sides of the cadavers the procedure was feasible. In all cadavers, it was necessary to extensively drill the temporo-mandibular joint and to calibrate the external ear canal to allow adequate room to manoeuver the instruments and optics and to comfortably access the cerebellopontine angle...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28509682/new-neurosurgical-approaches-for-tremor-and-parkinson-s-disease
#5
Alfonso Fasano, Andres M Lozano, Esther Cubo
PURPOSE OF REVIEW: The objective of this review is to gather the newest advances in the surgical treatment of tremor and Parkinson's disease. We will briefly discuss the potential applications of the new technologies of deep brain stimulation (DBS), and we will focus on MRI-guided focused ultrasound (MRgFUS). RECENT FINDINGS: Novel DBS devices are being progressively adopted, particularly electrodes allowing a longer stimulating surface (suitable for multiple targets stimulation) and current radial steering (to minimize side effects of stimulation)...
May 13, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28502682/intra-rectal-anesthesia-in-neurosurgery
#6
REVIEW
Ladina Greuter, Alexander G Weil, Gerhard Hildebrandt, Werner Surbeck
In the early days of modern neurological surgery, the inconveniences and potential dangers of general anesthesia by chloroform and ether using the so-called "open-drop technique" led to the quest for alternative methods of anesthesia. This became all the more necessary, since patient positioning and the surgical arrangements often hindered the use of a drop bottle. One approach to solve this problem was intra-rectal ether application. The present article aims to shed light on this original, less well-known anesthesia technique in the neurosurgical field...
May 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28499903/utilization-of-paine-s-technique-projecting-puncture-point-to-the-skull-and-skin
#7
Hiroaki Matsuzaki, Tadahiro Otsuka, Ken Uekawa, Takashi Nakagawa, Nobuyuki Tsubota
OBJECTIVE: Ventriculostomy from Paine's point is an effective technique to obtain a slack brain for aneurysm surgery. This study aimed to use Paine's point for other neurosurgical procedures (except for those that require pterional approach) by delineation of surface landmarks for identification of Paine's point on the cranium and scalp. METHODS: Based on the anatomical knowledge and examination of 3D CT images of skull, we determined novel surface landmarks to identify Paine's point on cranium and scalp...
May 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28498054/first-clinical-use-of-stereotaxy-in-humans-the-key-role-of-x-ray-localization-discovered-by-gaston-contremoulins
#8
Pierre Bourdillon, Caroline Apra, Marc Lévêque
Although attempts to develop stereotactic approaches to intracranial surgery started in the late 19th century with Dittmar, Zernov, and more famously, Horsley and Clarke, widespread use of the technique for human brain surgery started in the second part of the 20th century. Remarkably, a significant similar surgical procedure had already been performed in the late 19th century by Gaston Contremoulins in France and has remained unknown. Contremoulins used the principles of modern stereotaxy in association with radiography for the first time, allowing the successful removal of intracranial bullets in 2 patients...
May 12, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28493023/the-paramedian-supracerebellar-infratentorial-approach
#9
Biagia La Pira, Thomas Sorenson, Vicent Quillis-Quesada, Giuseppe Lanzino
BACKGROUND: Lesions of the superior cerebellar surface, pineal region, lateral and dorsal midbrain and mesial temporal lobe are challenging to treat and often require neurosurgical intervention. METHODS: The paramedian variation of the supracerebellar infratentorial approach utilizes the downward slope of the cerebellum to facilitate exposure and the lower density of cerebellar bridging veins away from the midline decreases the need to sacrifice larger venous channels...
May 10, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28484528/extradural-anterior-clinoidectomy-technical-nuances-from-a-learner-s-perspective
#10
Shashwat Mishra, Baltazar Leão, Diego Mendez Rosito
BACKGROUND: Extradural removal of the anterior clinoid process (ACP) is a crucial step in the proper surgical exposure of various pathologies in and around the central skull base. Since the pioneering description by Dolenc, the technique of extradural clinoidectomy has undergone several refinements in the light of improved understanding of microsurgical anatomy and maturation of neurosurgical techniques. Mastery of the surgical nuances involved in performing this surgical exercise will allow the young neurosurgeon to execute this step without undue reluctance and trepidation...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28481397/endoscopic-endonasal-cerebrospinal-fluid-leak-repair-on-the-ventral-midline-skull-base-a-single-neurosurgical-center-experience
#11
Cihan Isler, Merdin Lyutviev Ahmedov, Mehmet Yigit Akgun, Baris Kucukyuruk, Nurperi Gazioglu, Galip Sanus, Necmettin Tanriover
AIM: The aim of this study was to present the results of endoscopic endonasal repair of ventral midline skull base cerebrospinal fluid (CSF) leak (VMSBL) at our institution and to discuss the technique and results from a neurosurgical perspective. MATERIAL AND METHODS: A retrospective analysis of all VMSBL cases that underwent endoscopic endonasal skull base approach (EESBA) for CSF leak repair at a single tertiary neurosurgical center was performed. Twenty six patients with an average age of 44...
March 25, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28477043/multimodal-use-of-indocyanine-green-endoscopy-in-neurosurgery-a-single-center-experience-and-review-of-the-literature
#12
REVIEW
Giuseppe Catapano, Francesco Sgulò, Lili Laleva, Laura Columbano, Iacopo Dallan, Matteo de Notaris
During the last 10 years, microscope-integrated indocyanine green fluorescence (m-ICG) has been widely used for assessing real-time blood flow during aneurysm surgery. More recently, an endoscope-integrated indocyanine green fluorescence (e-ICG) has been adopted as a versatile tool during different endoscopic neurosurgical procedures. The purpose of the present report is to evaluate multimodal applications of e-ICG during different endonasal, intraventricular, aneurysm and brain tumor surgeries and provide technical nuances...
May 6, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28468268/an-instrumented-glove-to-assess-manual-dexterity-in-simulation-based-neurosurgical-education
#13
Juan Diego Lemos, Alher Mauricio Hernandez, Georges Soto-Romero
The traditional neurosurgical apprenticeship scheme includes the assessment of trainee's manual skills carried out by experienced surgeons. However, the introduction of surgical simulation technology presents a new paradigm where residents can refine surgical techniques on a simulator before putting them into practice in real patients. Unfortunately, in this new scheme, an experienced surgeon will not always be available to evaluate trainee's performance. For this reason, it is necessary to develop automatic mechanisms to estimate metrics for assessing manual dexterity in a quantitative way...
April 29, 2017: Sensors
https://www.readbyqxmd.com/read/28463621/computer-aided-design-computer-aided-manufacturing-skull-base-drill
#14
William T Couldwell, Joel D MacDonald, Charles L Thomas, Bradley C Hansen, Aniruddha Lapalikar, Bharat Thakkar, Alagar K Balaji
The authors have developed a simple device for computer-aided design/computer-aided manufacturing (CAD-CAM) that uses an image-guided system to define a cutting tool path that is shared with a surgical machining system for drilling bone. Information from 2D images (obtained via CT and MRI) is transmitted to a processor that produces a 3D image. The processor generates code defining an optimized cutting tool path, which is sent to a surgical machining system that can drill the desired portion of bone. This tool has applications for bone removal in both cranial and spine neurosurgical approaches...
May 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28463617/robot-assisted-procedures-in-pediatric-neurosurgery
#15
Alessandro De Benedictis, Andrea Trezza, Andrea Carai, Elisabetta Genovese, Emidio Procaccini, Raffaella Messina, Franco Randi, Silvia Cossu, Giacomo Esposito, Paolo Palma, Paolina Amante, Michele Rizzi, Carlo Efisio Marras
OBJECTIVE During the last 3 decades, robotic technology has rapidly spread across several surgical fields due to the continuous evolution of its versatility, stability, dexterity, and haptic properties. Neurosurgery pioneered the development of robotics, with the aim of improving the quality of several procedures requiring a high degree of accuracy and safety. Moreover, robot-guided approaches are of special interest in pediatric patients, who often have altered anatomy and challenging relationships between the diseased and eloquent structures...
May 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28429707/the-human-amygdala-parametrically-encodes-the-intensity-of-specific-facial-emotions-and-their-categorical-ambiguity
#16
Shuo Wang, Rongjun Yu, J Michael Tyszka, Shanshan Zhen, Christopher Kovach, Sai Sun, Yi Huang, Rene Hurlemann, Ian B Ross, Jeffrey M Chung, Adam N Mamelak, Ralph Adolphs, Ueli Rutishauser
The human amygdala is a key structure for processing emotional facial expressions, but it remains unclear what aspects of emotion are processed. We investigated this question with three different approaches: behavioural analysis of 3 amygdala lesion patients, neuroimaging of 19 healthy adults, and single-neuron recordings in 9 neurosurgical patients. The lesion patients showed a shift in behavioural sensitivity to fear, and amygdala BOLD responses were modulated by both fear and emotion ambiguity (the uncertainty that a facial expression is categorized as fearful or happy)...
April 21, 2017: Nature Communications
https://www.readbyqxmd.com/read/28419308/brain-invasion-in-meningiomas-clinical-considerations-and-impact-of-neuropathological-evaluation-a-systematic-review
#17
Benjamin Brokinkel, Katharina Hess, Christian Mawrin
With the release of the 2016 edition of the WHO Classification of Central Nervous System tumors, brain invasion in meningiomas has been added as a stand-alone criterion for atypia and can therefore impact grading and indirectly adjuvant therapy. Regarding this rising clinical importance, we have reviewed the current knowledge about brain invasion with emphasis on its implications on current and future clinical practice. We found various definitions of brain invasion and approaches for evaluation in surgically obtained specimen described over the past decades...
April 17, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/28408264/single-session-hematoma-removal-and-transcranial-coil-embolization-for-a-cavernous-sinus-dural-arteriovenous-fistula-a-technical-case-report
#18
Yosuke Akamatsu, Kenichi Sato, Hidenori Endo, Yasushi Matsumoto, Teiji Tominaga
BACKGROUND: Patients with cavernous sinus dural arteriovenous fistulas (CS dAVFs) with cortical venous varix are indicated for aggressive treatment because of the associated risk for intracranial hemorrhage. CASE DESCRIPTION: We present a case of surgical transvenous embolization in an 84-year-old woman with CS dAVF who presented with massive intracerebral hematoma. Cerebral angiograms revealed the dural AVF drained only into the superficial middle cerebral vein...
April 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28403097/predictive-factors-for-surgical-outcome-in-anterior-clinoidal-meningiomas-analysis-of-59-consecutive-surgically-treated-cases
#19
Ju-Hwi Kim, Woo-Youl Jang, Tae-Young Jung, In-Young Kim, Kyung-Hwa Lee, Woo Dae Kang, Seul-Kee Kim, Kyung-Sub Moon, Shin Jung
Despite the advances in the microsurgical technique and anatomical understanding of the anterior and middle skull base, anterior clinoidal meningiomas are still challenging lesions to resect completely and safely due to their intimate relationship with vital neurovascular structures. We report predictive factors for tumor recurrence and postoperative complications based on surgical outcome of patients with anterior clinoidal meningiomas treated at our institution.Fifty-nine consecutive patients with anterior clinoidal meningioma who were surgically treated between March, 1993, and July, 2015, were reviewed retrospectively...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28401404/controversy-about-management-of-hydrocephalus-shunt-vs-endoscopic-third-ventriculostomy
#20
REVIEW
Vikas Kumar, Shaam Bodeliwala, Daljit Singh
The best management of hydrocephalus is still controversial in the twenty-first century. Shunt treatment for hydrocephalus is the most common procedure performed in neurosurgical practice and is associated with the highest complications rate. But during the last 2 decades, the treatment of hydrocephalus has improved with better shunt devices available today, increased facilities for investigations and newer approaches like endoscopic third ventriculostomy. The recent advances in development of better endoscopes have provided the patient and treating doctor with an option for an alternative surgery for treatment of hydrocephalus...
April 12, 2017: Indian Journal of Pediatrics
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