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Emmanuel Mandonnet, Juan Martino, Silvio Sarubbo, Francesco Corrivetti, Schahraed Bouazza, Damien Bresson, Hugues Duffau, Sebastien Froelich
BACKGROUND: Advances in the oncological and functional results of insular surgery have been reported recently. Such successes have been made possible by the advent of the transopercular approach under awake monitoring and by the improved anatomical and functional knowledge of the white matter pathways surrounding the insula. Nonetheless, given the rarity of insular tumors, it is difficult to get familiar with the complex 3D anatomy of the different neuronal and vascular structures encountered during a transopercular insular resection...
October 17, 2016: World Neurosurgery
Fang Zhang, WenMing Hong, Yan Guo, QianYing Guo, XiaoPeng Hu
BACKGROUND: Microsurgery is a common treatment of brainstem tumors. However, misdirection, vascular damage, nerves injuries, paralysis, even death are all well-known complications, and the risk of adverse events is more likely in less experienced operators. This study was aimed to validate the accuracy of multimodal neuronavigation during microsurgery resection of brainstem tumors. METHODS: Ten patients with brainstem tumors underwent preoperative MRI, diffusion tensor imaging, computed tomography, three-dimensional print, and images loaded into the neuronavigation platform were used for its segmentation and preoperative planning...
October 14, 2016: Journal of Craniofacial Surgery
Weihua Ding, Shuping Chen, Rong Wang, Jun Cai, Yuan Cheng, Liang Yu, Qinghua Li, Fang Deng, Shengmei Zhu, Wenhua Yu
Percutaneous radiofrequency thermocoagulation (RFT) of the Gasserian ganglion is an effective treatment for primary trigeminal neuralgia (pTN). Currently Hartel anterior approach is the most commonly used method to access the Gasserian ganglion. However, this approach is associated with high recurrence rate and technical difficulties in certain patients with foramen ovale (FO) anatomical variations. In the present study, we assessed the feasibility of accessing the Gasserian ganglion through the FO from a mandibular angle under computed tomography (CT) and neuronavigation guidance...
October 2016: Medicine (Baltimore)
Jane Halliday, Ian Kamaly
BACKGROUND: Neuronavigation, the ability to perform real-time intra-operative guidance during cranial and/or spinal surgery, has increased both accuracy and safety in neurosurgery [2]. Cranial navigation of existing surgical instruments using Brainlab requires the use of an instrument adapter and clamp, which in our experience renders an endoscope 'top-heavy', difficult to manipulate, and the process of registration of the adapter quite time-consuming. METHODS: A Brainlab Disposable Stylet was used to navigate fenestration of an entrapped temporal horn in a pediatric case...
October 14, 2016: Acta Neurochirurgica
Tao Xie, Wei Sun, Xiaobiao Zhang, Tengfei Liu, Hailing Ding, Fan Hu, Yong Yu, Ye Gu
BACKGROUND: In this study, we investigated the value of three-dimensional (3D) fast-imaging employing steady-state acquisition (FIESTA) magnetic resonance imaging (MRI) in detecting non-iatrogenic cerebrospinal fluid (CSF) rhinorrhoea and compared it with regular MRI and 3D magnetisation prepared rapid acquisition gradient echo (MPRAGE) MRI sequences, as well as high-resolution computed tomography (HRCT) imaging. We also present the endoscopic experiences of such cases. METHOD: From June 2011 to Feb 2016, 17 patients with non-iatrogenic cerebrospinal fluid rhinorrhoea were included...
October 13, 2016: Acta Neurochirurgica
N De Geeter, P Lioumis, A Laakso, G Crevecoeur, L Dupré
When delivered over a specific cortical site, TMS can temporarily disrupt the ongoing process in that area. This allows mapping of speech-related areas for preoperative evaluation purposes. We numerically explore the observed variability of TMS responses during a speech mapping experiment performed with a neuronavigation system. We selected four cases with very small perturbations in coil position and orientation. In one case (E) a naming error occurred, while in the other cases (NEA, B, C) the subject appointed the images as smoothly as without TMS...
October 7, 2016: Physics in Medicine and Biology
Justin A Neira, Timothy H Ung, Jennifer S Sims, Hani R Malone, Daniel S Chow, Jorge L Samanamud, George J Zanazzi, Xiaotao Guo, Stephen G Bowden, Binsheng Zhao, Sameer A Sheth, Guy M McKhann, Michael B Sisti, Peter Canoll, Randy S D'Amico, Jeffrey N Bruce
OBJECTIVE Extent of resection is an important prognostic factor in patients undergoing surgery for glioblastoma (GBM). Recent evidence suggests that intravenously administered fluorescein sodium associates with tumor tissue, facilitating safe maximal resection of GBM. In this study, the authors evaluate the safety and utility of intraoperative fluorescein guidance for the prediction of histopathological alteration both in the contrast-enhancing (CE) regions, where this relationship has been established, and into the non-CE (NCE), diffusely infiltrated margins...
October 7, 2016: Journal of Neurosurgery
Renato Torres, Guillaume Kazmitcheff, Daniele De Seta, Evelyne Ferrary, Olivier Sterkers, Yann Nguyen
It has previously reported that alignment of the insertion axis along the basal turn of the cochlea was depending on surgeon' experience. In this experimental study, we assessed technological assistances, such as navigation or a robot-based system, to improve the insertion axis during cochlear implantation. A preoperative cone beam CT and a mastoidectomy with a posterior tympanotomy were performed on four temporal bones. The optimal insertion axis was defined as the closest axis to the scala tympani centerline avoiding the facial nerve...
October 4, 2016: European Archives of Oto-rhino-laryngology
Yad R Yadav, Vijay S Parihar, Mina Todorov, Yatin Kher, Ishwar D Chaurasia, Sonjjay Pande, Hemant Namdev
Hydrocephalus is one of the commonest complications of tuberculous meningitis (TBM). It can be purely obstructive, purely communicating, or due to combinations of obstruction in addition to defective absorption of cerebrospinal fluid (CSF). Endoscopic third ventriculostomy (ETV) as an alternative to shunt procedures is an established treatment for obstructive hydrocephalus in TBM. ETV in TBM hydrocephalus can be technically very difficult, especially in acute stage of disease due to inflamed, thick, and opaque third ventricle floor...
October 2016: Asian Journal of Neurosurgery
Stefan Linsler, Sebastian Antes, Sebastian Senger, Joachim Oertel
OBJECTIVE: The safety of endoscopic skull base surgery can be enhanced by accurate navigation in preoperative computed tomography (CT) and magnetic resonance imaging (MRI). Here, we report our initial experience of real-time intraoperative CT-guided navigation surgery for pituitary tumors in childhood. MATERIALS AND METHODS: We report the case of a 15-year-old girl with a huge growth hormone-secreting pituitary adenoma with supra- and perisellar extension. Furthermore, the skull base was infiltrated...
October 2016: Journal of Neurosciences in Rural Practice
Tuo Lin, Lisheng Jiang, Zulin Dou, Cheng Wu, Feng Liu, Guangqing Xu, Yue Lan
BACKGROUND: Continuous theta burst stimulation (cTBS) and intermittent TBS (iTBS) are powerful patterns of repetitive transcranial magnetic stimulation (rTMS), with substantial potential for motor function rehabilitation post-stroke. However, TBS of suprahyoid motor cortex excitability has not been investigated. This study investigated TBS effects on suprahyoid motor cortex excitability and its potential mechanisms in healthy subjects. METHODS: Thirty-five healthy subjects (23 females; mean age = 21...
August 24, 2016: Brain Stimulation
Sebastian Ille, Nico Sollmann, Vicki M Butenschoen, Bernhard Meyer, Florian Ringel, Sandro M Krieg
BACKGROUND: The resection of left-sided perisylvian brain lesions harbours the risk of postoperative language impairment. Therefore the individual patient's language distribution is investigated by intraoperative direct cortical stimulation (DCS) during awake surgery. Yet, not all patients qualify for awake surgery. Non-invasive language mapping by repetitive navigated transcranial magnetic stimulation (rTMS) has frequently shown a high correlation in comparison with the results of DCS language mapping in terms of language-negative brain regions...
September 29, 2016: Acta Neurochirurgica
J E Palmgren, E Kallioniemi, P Julkunen
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
G Chen, W W Zhai, Z Q Yu
Objective: To explore experience and methods in the microsurgical treatment of midline deep brain lesions. Methods: The clinical data of patients with midline deep brain lesions were retrospectively analyzed. The clinical manifestation, imaging findings, lesion locations, surgical procedures, pathological diagnosis and follow-up results were summarized and analyzed. All the lesions were located deeply in the brain midline: corpus callosum (n=1), thalamus and basal ganglia (n=6), lateral ventricle (n=4), the third ventricle (n=2), pineal region (n=8), brainstem and fourth ventricle region (n=4)...
September 13, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Luca Mattei, Francesco Prada, Federico Giuseppe Legnani, Alessandro Perin, Alessandro Olivi, Francesco DiMeco
PURPOSE: Pediatric low-grade gliomas (LGGs) are the most frequent solid tumor in childhood. Based on an increasing number of literature reports, maximal safe resection is recommended as the first line of treatment whenever possible. However, distinguishing tumor tissue from the surrounding normal brain is often challenging with infiltrating neoplasms, even with the assistance of intraoperative, microscopic and conventional neuronavigation systems. Therefore, any technique that enhances the detection and visualization of LGGs intraoperatively is certainly desirable...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Chen Li-Feng, Yang Yang, Ma Xiao-Dong, Yu Xin-Guang, Gui Qiu-Ping, Xu Bai-Nan, Zhou Ding-Biao
AIM: The author evaluated the impact of high-field intraoperative MRI (iMRI) and functional neuronavigation on insular high-grade glioma(HGG) surgery. MATERIAL AND METHODS: Between 2010 and 2014, 51 insular HGG patients underwent operations guided by combined high-field iMRI and functional neuronavigation.22 insular HGG patients underwent conventional neuronavigation operations were assessed as the control group. Tumor volumetric scan analysis, Karnofsky performance score (KPS) and follow-up results were reviewed retrospectively...
August 23, 2016: Turkish Neurosurgery
John S Kuo, Garni Barkhoudarian, Christopher J Farrell, Mary E Bodach, Luis M Tumialan, Nelson M Oyesiku, Zachary Litvack, Gabriel Zada, Chirag G Patil, Manish K Aghi
BACKGROUND: Numerous technological adjuncts are used during transsphenoidal surgery for nonfunctioning pituitary adenomas (NFPAs), including endoscopy, neuronavigation, intraoperative magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) diversion, and dural closure techniques. OBJECTIVE: To generate evidence-based guidelines for the use of NFPA surgical techniques and technologies. METHODS: An extensive literature search spanning January 1, 1966, to October 1, 2014, was performed, and only articles pertaining to technological adjuncts for NFPA resection were included...
October 2016: Neurosurgery
Manish K Aghi, Clark C Chen, Maria Fleseriu, Steven A Newman, Joshua William Lucas, John S Kuo, Garni Barkhoudarian, Christopher J Farrell, Jason Sheehan, Mateo Ziu, Ian F Dunn
BACKGROUND: Nonfunctioning pituitary adenomas (NFPAs) are the most frequent pituitary tumors. OBJECTIVE: To create evidence-based guidelines for the initial management of NFPAs. METHODS: A multidisciplinary task force composed of physician volunteers and evidence-based medicine-trained methodologists conducted a systematic review of the literature relevant to the management of NFPAs. To ascertain the class of evidence for the posttreatment follow-ups, the task force used the Clinical Assessment evidence-based classification...
October 2016: Neurosurgery
Elisa Kallioniemi, Minna Pitkänen, Mervi Könönen, Ritva Vanninen, Petro Julkunen
BACKGROUND: Although the relationship between neuronavigated transcranial magnetic stimulation (nTMS) and functional magnetic resonance imaging (fMRI) has been widely studied in motor mapping, it is unknown how the motor response type or the choice of motor task affect this relationship. NEW METHOD: Centers of gravity (CoGs) and response maxima were measured with blood-oxygen-level dependent (BOLD) and arterial spin labeling (ASL) fMRI during motor tasks against nTMS CoGs and response maxima, which were mapped with motor evoked potentials (MEPs) and silent periods (SPs)...
September 8, 2016: Journal of Neuroscience Methods
Dieter Henrik Heiland, Theo Demerath, Elias Kellner, Valerij G Kiselev, Dietmar Pfeifer, Oliver Schnell, Ori Staszewski, Horst Urbach, Astrid Weyerbrock, Irina Mader
The purpose of this study was to investigate the molecular background of cerebral blood volume (CBV) and vessel size (VS) of capillaries in glioblastoma multiforme (GBM). Both parameters are derived from extended perfusion MR imaging.A prospective case study including 21 patients (median age 66 years, 10 females) was performed. Before operation, CBV and VS of contrast enhancing tumor were assessed. Tissue was sampled from the assessed areas under neuronavigation control. After RNA extraction, transcriptional data was analyzed by Weighted Gene Co-Expression Network Analysis (WGCNA) and split into modules based on its network affiliations...
August 23, 2016: Oncotarget
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