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Neurosurgical Approach

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https://www.readbyqxmd.com/read/28429707/the-human-amygdala-parametrically-encodes-the-intensity-of-specific-facial-emotions-and-their-categorical-ambiguity
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28387633/smart-bioimpedance-controlled-craniotomy-concept-and-first-experiments
#6
Annegret Niesche, Meiko Müller, Fritz Ehreiser, Daniel Teichmann, Steffen Leonhardt, Klaus Radermacher
Craniotomy is part of many neurosurgical interventions to create surgical access to intracranial structures. The procedure conventionally bears a high risk of unintended dural tears or damage of the soft tissue underneath the bone. A new synergistically controlled instrument has recently been introduced to address this problem by combining a soft tissue preserving saw with an automatic cutting depth control. Many approaches are known to obtain the information required on the local bone thickness. However, they suffer from unsatisfactory robustness against disturbances occurring during surgery and many approaches require additional intra- or preoperative steps in the workflow...
March 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28384832/obsessive-compulsive-disorder-advances-in-diagnosis-and-treatment
#7
Matthew E Hirschtritt, Michael H Bloch, Carol A Mathews
Importance: Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder associated with significant impairment and a lifetime prevalence of 1% to 3%; however, it is often missed in primary care settings and frequently undertreated. Objective: To review the most current data regarding screening, diagnosis, and treatment options for OCD. Evidence Review: We searched PubMed, EMBASE, and PsycINFO to identify randomized controlled trials (RCTs), meta-analyses, and systematic reviews that addressed screening and diagnostic and treatment approaches for OCD among adults (≥18 years), published between January 1, 2011, and September 30, 2016...
April 4, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28384126/an-automated-method-for-accurate-vessel-segmentation
#8
Xin Yang, Chaoyue Liu, Hung Le Minh, Zhiwei Wang, Aichi Chien, Kwang-Ting Tim Cheng
Vessel segmentation is a critical task for various medical applications, such as diagnosis assistance of diabetic retinopathy, quantification of cerebral aneurysm's growth, and guiding surgery in neurosurgical procedures. Despite technology advances in image segmentation, existing methods still suffer from low accuracy for vessel segmentation in the two challenging while common scenarios in clinical usage: (1) regions with a low signal-to-noise-ratio (SNR), and (2) at vessel boundaries disturbed by adjacent non-vessel pixels...
April 6, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28382256/prognostication-of-traumatic-brain-injury-outcomes-in-older-trauma-patients-a-novel-risk-assessment-tool-based-on-initial-cranial-ct-findings
#9
Stanislaw P Stawicki, Thomas R Wojda, John D Nuschke, Ronnie N Mubang, James Cipolla, William S Hoff, Brian A Hoey, Peter G Thomas, Joan Sweeney, Daniel Ackerman, Jonathan Hosey, Steven Falowski
INTRODUCTION: Advanced age has been traditionally associated with worse traumatic brain injury (TBI) outcomes. Although prompt neurosurgical intervention (NSI, craniotomy or craniectomy) may be life-saving in the older trauma patient, it does not guarantee survival and/or return to preinjury functional status. The aim of this study was to determine whether a simple score, based entirely on the initial cranial computed tomography (CCT) is predictive of the need for NSI and key outcome measures (e...
January 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28377253/implementing-functional-preoperative-mapping-in-the-clinical-routine-of-a-neurosurgical-department-technical-note
#10
Nico Sollmann, Bernhard Meyer, Sandro M Krieg
BACKGROUND: Navigated transcranial magnetic stimulation (nTMS) is increasingly being used for mapping of various brain functions and nTMS-based tractography in neurosurgical departments worldwide. When a department starts integrating nTMS data into the clinical workflow, smooth implementation in the existing hospital's infrastructure is mandatory. However, standardized approaches beyond the mapping or tractography procedures themselves have not yet been described. METHODS: To create an effective workflow for neurosurgical nTMS mapping, we present the results of our 7 years of experience and progressive integration into clinical routine...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28377210/similar-patterns-of-neural-activity-predict-memory-function-during-encoding-and-retrieval
#11
James E Kragel, Youssef Ezzyat, Michael R Sperling, Richard Gorniak, Gregory A Worrell, Brent M Berry, Cory Inman, Jui-Jui Lin, Kathryn A Davis, Sandhitsu R Das, Joel M Stein, Barbara C Jobst, Kareem A Zaghloul, Sameer A Sheth, Daniel S Rizzuto, Michael J Kahana
Neural networks that span the medial temporal lobe (MTL), prefrontal cortex, and posterior cortical regions are essential to episodic memory function in humans. Encoding and retrieval are supported by the engagement of both distinct neural pathways across the cortex and common structures within the medial temporal lobes. However, the degree to which memory performance can be determined by neural processing that is common to encoding and retrieval remains to be determined. To identify neural signatures of successful memory function, we administered a delayed free-recall task to 187 neurosurgical patients implanted with subdural or intraparenchymal depth electrodes...
April 1, 2017: NeuroImage
https://www.readbyqxmd.com/read/28371170/state-of-the-art-novel-applications-for-cortical-stimulation
#12
REVIEW
Dirk De Ridder, Sanjaya Perera, Sven Vanneste
OBJECTIVE: Electrical stimulation via implanted electrodes that overlie the cortex of the brain is an upcoming neurosurgical technique that was hindered for a long time by insufficient knowledge of how the brain functions in a dynamic, physiological, and pathological way, as well as by technological limitations of the implantable stimulation devices. METHODS: This paper provides an overview of cortex stimulation via implantable devices and introduces future possibilities to improve cortex stimulation...
April 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28363833/postoperative-neurosurgical-infection-rates-after-shared-resource-intraoperative-magnetic-resonance-imaging-a-single-center-experience-with-195-cases
#13
Nikolaj Dinevski, Johannes Sarnthein, Flavio Vasella, Jorn Fierstra, Athina Pangalu, David Holzmann, Luca Regli, Oliver Bozinov
OBJECTIVE: To determine the rate of surgical site infections (SSI) in neurosurgical procedures involving a shared-resource intraoperative magnetic resonance imaging (ioMRI) scanner at a single institution derived from a prospective clinical quality management database METHODS: All consecutive neurosurgical procedures that were performed with a high-field, two-room ioMRI between April 2013 and June 2016 were included (N=195; 109 craniotomies and 86 endoscopic transsphenoidal procedures)...
March 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28357627/anser-emt-the-first-open-source-electromagnetic-tracking-platform-for-image-guided-interventions
#14
Herman Alexander Jaeger, Alfred Michael Franz, Kilian O'Donoghue, Alexander Seitel, Fabian Trauzettel, Lena Maier-Hein, Pádraig Cantillon-Murphy
PURPOSE: Electromagnetic tracking is the gold standard for instrument tracking and navigation in the clinical setting without line of sight. Whilst clinical platforms exist for interventional bronchoscopy and neurosurgical navigation, the limited flexibility and high costs of electromagnetic tracking (EMT) systems for research investigations mitigate against a better understanding of the technology's characterisation and limitations. The Anser project provides an open-source implementation for EMT with particular application to image-guided interventions...
March 29, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28331887/android-application-for-determining-surgical-variables-in-brain-tumor-resection-procedures
#15
Rohan C Vijayan, Reid C Thompson, Lola B Chambless, Peter J Morone, Le He, Logan W Clements, Rebekah H Griesenauer, Hakmook Kang, Michael I Miga
The fidelity of image-guided neurosurgical procedures is often compromised due to the mechanical deformations that occur during surgery. In recent work, a framework was developed to predict the extent of this brain shift in brain-tumor resection procedures. The approach uses preoperatively determined surgical variables to predict brain shift and then subsequently corrects the patient's preoperative image volume to more closely match the intraoperative state of the patient's brain. However, a clinical workflow difficulty with the execution of this framework is the preoperative acquisition of surgical variables...
January 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28325456/minimally-invasive-surgical-approaches-for-chronic-subdural-hematomas
#16
REVIEW
Ian A Buchanan, William J Mack
Chronic subdural hematomas are one of the most common clinical entities encountered in today's neurosurgical practices owing to an aging population and continued increases in life expectancy. Although there is a role for conservative management, surgical drainage remains the mainstay of current therapy. Regardless of the technique used for hematoma drainage, there is level I evidence to suggest that use of closed-system drainage during the perioperative period significantly decreases the likelihood for hematoma recurrence, length of hospital stay, and mortality...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28314403/management-of-cavernous-sinus-involvement-in-sinonasal-and-ventral-skull-base-malignancies
#17
REVIEW
Amol Raheja, William T Couldwell
Cavernous sinus (CS) involvement by sinonasal and ventral skull base malignancies is infrequently encountered in neurosurgical practice. Despite advancements in skull base microneurosurgery and endoscopic techniques, detailed knowledge and experience of the surgical management of these lesions are limited. This article elaborates on surgical strategies and approaches for CS involvement of malignant ventral skull base tumors. The article discusses the indications, techniques, nuances, advantages, limitations, and complications of minimally invasive CS biopsy, transcranial microscopic, and transfacial endoscopic approaches to the CS using illustrative diagrams and operative videos...
April 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28306420/ventriculo-ureteral-shunt-insertion-using-percutaneous-nephrostomy-a-novel-minimally-invasive-option-in-a-patient-with-chronic-hydrocephalus-complicated-by-multiple-distal-ventriculoperitoneal-shunt-failures
#18
Ashok Pillai, Georgie Mathew, Sivasankaran Nachimuthu, Sanjeevan Vasudevan Kalavampara
The management of ventriculoperitoneal (VP) shunt failure is a common problem in neurosurgical practice. On occasion, extraperitoneal sites for CSF diversion are required when shunting to the peritoneal cavity has failed after multiple attempts. The authors report a novel minimally invasive procedure allowing cannulation of the ureter for the purpose of ventriculo-ureteral (VU) shunting. Sixteen years prior to presentation, this 46-year-old woman had contracted tuberculous meningitis and had chronic hydrocephalus, with multiple distal shunt failures in recent months...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28303207/management-strategies-for-neoplastic-and-vascular-brain-lesions-presenting-during-pregnancy-a-series-of-29-patients
#19
Celestino Esteves Pereira, Jose Carlos Lynch
BACKGROUND: The occurrence of a brain tumor or intracranial vascular lesion during pregnancy is a rare event, but when it happens, it jeopardizes the lives of both the mother and infant. It also creates challenges of a neurosurgical, obstetric, and ethical nature. A multidisciplinary approach should be used for their care. METHODS: Between 1986 and 2015, 12 pregnant women diagnosed with brain tumors and 17 women with intracranial vascular lesion underwent treatment at the Neurosurgery Department of the Servidores do Estado Hospital and Rede D'Or/São Luis...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28299248/a-previously-unreported-arterial-variant-of-the-suboccipital-region-based-on-cadaveric-dissection
#20
Christian Fisahn, Brittni Burgess, Joe Iwanaga, Fernando Alonso, Jens R Chapman, Rod J Oskouian, R Shane Tubbs
Introduction Several arterial variants have been reported to occur around the posterior arch of the atlas. Understanding the various anomalies and diagnosing them preoperatively can dramatically reduce the risk of surgical insult during neurosurgical procedures. Herein we report a case of an arterial variant found just below the posterior arch of C1. Case Report During the routine dissection of the suboccipital region via a posterior approach, an unusual bulge was identified just inferior to the inferior capitis oblique muscle...
January 2017: Journal of Neurological Surgery Reports
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