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https://www.readbyqxmd.com/read/28812301/changing-treatment-paradigms-for-brain-metastases-from-melanoma-part-1-diagnosis-prognosis-symptom-control-and-local-treatment
#1
REVIEW
Vyshak Alva Venur, Pauline Funchain, Rupesh Kotecha, Samuel T Chao, Manmeet S Ahluwalia
Melanoma is the third most common cause of brain metastases, after lung and breast cancer. The management of melanoma brain metastases can be broadly divided into symptom control and therapeutic strategies. Supportive treatments include corticosteroids to reduce peritumoral edema, antiepileptics for seizure control, and medications to preserve cognitive function. Until recently, therapeutic strategies consisted primarily of local treatments, including surgery, whole-brain radiation therapy (WBRT), and stereotactic radiosurgery (SRS)...
August 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28808901/the-utility-of-routine-intensive-care-admission-for-patients-undergoing-intracranial-neurosurgical-procedures-a-systematic-review
#2
Cesar Cimonari de Almeida, M Dustin Boone, Yosef Laviv, Burkhard S Kasper, Clark C Chen, Ekkehard M Kasper
BACKGROUND: Patients who have undergone intracranial neurosurgical procedures have traditionally been admitted to an intensive care unit (ICU) for close postoperative neurological observation. The purpose of this study was to systematically review the evidence for routine ICU admission in patients undergoing intracranial neurosurgical procedures and to evaluate the safety of alternative postoperative pathways. METHODS: We were interested in identifying studies that examined selected patients who presented for elective, non-emergent intracranial surgery whose postoperative outcomes were compared as a function of ICU versus non-ICU admission...
August 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28804898/epilepsy-surgery-of-low-grade-epilepsy-associated-neuroepithelial-tumors-a-retrospective-nationwide-italian-study
#3
Marco Giulioni, Gianluca Marucci, Veronica Pelliccia, Francesca Gozzo, Carmen Barba, Giuseppe Didato, Flavio Villani, Giancarlo Di Gennaro, Pier Paolo Quarato, Vincenzo Esposito, Alessandro Consales, Matteo Martinoni, Gianfranco Vornetti, Corrado Zenesini, Carlo Efisio Marras, Nicola Specchio, Luca De Palma, Raffaele Rocchi, Flavio Giordano, Giovanni Tringali, Paolo Nozza, Gabriella Colicchio, Guido Rubboli, Giorgio Lo Russo, Renzo Guerrini, Paolo Tinuper, Francesco Cardinale, Massimo Cossu
OBJECTIVE: To analyze the attitude and results of Italian epilepsy surgery centers in the surgical management of "low grade epilepsy associated neuroepithelial tumors" (LEATs). METHODS: We conducted a retrospective study enrolling 339 consecutive patients with LEATs who underwent surgery between January 2009 and June 2015 at eight Italian epilepsy surgery centers. We compared demographic, clinical, pathologic, and surgical features of patients with favorable (Engel class I) and unfavorable (Engel class II, III, and IV) seizure outcome...
August 14, 2017: Epilepsia
https://www.readbyqxmd.com/read/28803773/low-dose-versus-high-dose-tranexamic-acid-reduces-the-risk-of-nonischemic-seizures-after-cardiac-surgery-with-cardiopulmonary-bypass
#4
Pierre Couture, Jean-Sébastien Lebon, Éric Laliberté, Georges Desjardins, Marie-Ève Chamberland, Christian Ayoub, Antoine Rochon, Jennifer Cogan, André Denault, Alain Deschamps
OBJECTIVE: The incidence of postoperative nonischemic seizures associated with the use of tranexamic acid (TXA) and the possibility of prevention with a low-dose regimen of TXA were evaluated. DESIGN: Retrospective study. SETTING: Tertiary care university hospital. PARTICIPANTS: A total of 12,195 patients who underwent cardiac surgical procedures under cardiopulmonary bypass (CPB) were evaluated. INTERVENTIONS: The files of every clinical seizure case diagnosed in the surgical intensive care unit between April 2006 and April 2014 were reviewed...
April 15, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28799517/imaging-biomarkers-of-anti-epileptic-drug-action-insights-from-magnetic-resonance-imaging
#5
Lorenzo Caciagli, Fenglai Xiao, Britta Wandschneider, Matthias J Koepp
BACKGROUND: Approximately one third of patients with epilepsy are refractory to medical treatment. Adverse effects associated with anti-epileptic drugs (AEDs) are considered to affect quality of life often more than seizures themselves. Neuroimaging techniques, particularly magnetic resonance imaging (MRI), have proven instrumental in clinical decision making in relation to epilepsy surgery, but may also provide further insights into the mechanisms underlying treatment response and side effects associated with AEDs...
August 9, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28799142/what-to-do-in-failed-hemispherotomy-our-clinical-series-and-review-of-the-literature
#6
REVIEW
Andrea Bartoli, Y El Hassani, B Jenny, S Momjian, C M Korff, M Seeck, S Vulliemoz, K Schaller
Hemispherotomy is an established surgical technique to cure or palliate selected, mostly young patients suffering from refractory epilepsy. However, a few patients continue to have seizures despite the surgical hemispherical disconnection. We present a case series of patients who underwent redo hemispherotomy after a first unsuccessful hemispherical disconnection and provide a roadmap for subsequent workup and treatment. The institutional database of epilepsy surgery was reviewed. Twenty-four patients who underwent hemispherotomies for refractory epilepsy were identified between 2007 and 2016...
August 10, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28782435/rufinamide-pretreatment-attenuates-ischemia-reperfusion-injury-in-the-gerbil-hippocampus
#7
Chan Woo Park, Tae-Kyeong Lee, Jeong Hwi Cho, In Hye Kim, Jae-Chul Lee, Bich-Na Shin, Ji Hyeon Ahn, Sung Koo Kim, Myoung Cheol Shin, Taek Geun Ohk, Jun Hwi Cho, Moo-Ho Won, Young Joo Lee, Jeong Yeol Seo, Joon Ha Park
OBJECTIVES: Rufinamide, a voltage-gated sodium channel (VGSC) blocker, is widely used for the clinical treatment of seizures associated with Lennox-Gastaut syndrome. Previous studies have demonstrated that VGSC blockers have neuroprotective properties against ischemic damage following experimental cerebral ischemia. However, protective effects of rufinamide against cerebral ischemic insults have not been addressed. Therefore, in the present study, we firstly examined neuroprotective effects of rufinamide using a gerbil model of transient global cerebral ischemia...
August 7, 2017: Neurological Research
https://www.readbyqxmd.com/read/28782373/correlating-resting-state-functional-mri-connectivity-by-independent-component-analysis-based-epileptogenic-zones-with-intracranial-eeg-localized-seizure-onset-zones-and-surgical-outcomes-in-prospective-pediatric-intractable-epilepsy-study
#8
Varina Boerwinkle, Deepankar Mohanty, Stephen Foldes, Danielle Guffey, Charles G Minard, Lucia Mirea, Aditya Vedantam, Jeffery S Raskin, Sandi Lam, Margaret Bond, P David Adelson, Angus A Wilfong, Daniel J Curry
OBJECTIVE: Prospective investigation determining agreement between the epileptogenic zone(s) (EZ) localization by resting state functional MRI (rs-fMRI) and the seizure onset zone(s) (SOZ) identified by intracranial EEG (ic-EEG) using novel differentiating and ranking criteria of rs-fMRI abnormal independent components in a consecutive heterogeneous pediatric intractable epilepsy population prospectively was conducted. METHODS: The EZ criteria were developed from an initial cohort of 350 patients evaluated for epilepsy surgery over a 3-year period...
August 7, 2017: Brain Connectivity
https://www.readbyqxmd.com/read/28781917/long-term-recurrence-of-dysembryoplastic-neuroepithelial-tumor-clinical-case-report
#9
Daniel A Tonetti, William J Ares, R Mark Richardson, Ronald L Hamilton, Frank S Lieberman
BACKGROUND: Dysembryoplastic neuroepithelial tumors (DNETs) are rare, benign brain neoplasms that typically arise in children and adolescents and classically present with intractable, partial complex seizures. DNETs are classically associated with a favorable prognosis after complete surgical resection. CASE DESCRIPTION: We describe a case of long-term recurrence of a DNET, which initially resected and diagnosed as an oligodendroglioma prior to the recognition of DNETs...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28776646/postoperative-seizure-freedom-does-not-normalize-altered-connectivity-in-temporal-lobe-epilepsy
#10
Luigi Maccotta, Mayra A Lopez, Babatunde Adeyemo, Beau M Ances, Brian K Day, Lawrence N Eisenman, Joshua L Dowling, Eric C Leuthardt, Bradley L Schlaggar, Robert Edward Hogan
OBJECTIVES: Specific changes in the functional connectivity of brain networks occur in patients with epilepsy. Yet whether such changes reflect a stable disease effect or one that is a function of active seizure burden remains unclear. Here, we longitudinally assessed the connectivity of canonical cognitive functional networks in patients with intractable temporal lobe epilepsy (TLE), both before and after patients underwent epilepsy surgery and achieved seizure freedom. METHODS: Seventeen patients with intractable TLE who underwent epilepsy surgery with Engel class I outcome and 17 matched healthy controls took part in the study...
August 3, 2017: Epilepsia
https://www.readbyqxmd.com/read/28774708/epileptologist-s-view-laser-interstitial-thermal-ablation-for-treatment-of-temporal-lobe-epilepsy
#11
Joon Y Kang, Michael R Sperling
A procedure called laser interstitial thermal ablation has been utilized to treat drug resistant epilepsy. With this technique, a probe is stereotactically inserted into a target structure responsible for seizures, such as mesial temporal lobe, hypothalamic hamartoma, or a small malformation of cortical development, and the tip is then heated by application of laser energy to ablate structures adjacent to the probe tip. This procedure has the advantage of selectively targeting small lesions responsible for seizures, and is far less invasive than open surgery with shorter hospitalization, less pain, and rapid return to normal activities...
July 25, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28765064/treatment-of-epilepsy-in-patients-with-myasthenia-gravis-is-really-harder-than-it-looks
#12
Paulo José Lorenzoni, Renata Dal-Prá Ducci, Tallulah Spina Tensini, Giuliano Dalledone, Claudia Suemi Kamoi Kay, Luciano de Paola, Lineu Cesar Werneck, Rosana Herminia Scola, Carlos Silvado
The relationship between myasthenia gravis (MG) and epilepsy has been rarely reported. As consequence, there are no specific guidelines for the management of these conditions when they mutually occur. We reported on three patients in whom epilepsy and MG are coexisting, but in different clinical settings. Two patients were treated with antiepileptic drugs which improved their symptoms. One patient has controlled the seizures after a successful anterior temporal lobectomy with no appreciable consequences to her MG...
July 29, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28762039/hypothalamic-hamartoma-presenting-with-infantile-spasms
#13
Uğur Işık, Sema Saltık, Bahattin Tanrıkulu, M Memet Özek
BACKGROUND: Hypothalamic hamartomas (HH) generally present with gelastic seizures. It is very unusual for a pediatric patient with HH to present with infantile spasms (IS). CASE PRESENTATION: Here we present a 6-month-old boy diagnosed with IS whose brain magnetic resonance imaging (MRI) showed an 18 × 18 × 16 mm mass in the hypothalamus. His seizures did not respond to antiepileptic treatment with vigabatrin and valproic acid. He had disconnective surgery for HH...
July 31, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28758184/motor-evoked-potentials-and-bis-guided-anaesthesia-in-image-guided-mini-invasive-neurosurgery-of-supratentorial-tumors-nearby-the-cortico-spinal-tract
#14
Roberto Cordella, Eleonora Orena, Francesco Acerbi, Elena Beretta, Dario Caldiroli, Francesco Dimeco, Carla Carozzi
AIM: to describe and evaluate the anaesthesiological regimen used in neurophysiologically monitored image-guided mini-invasive neurosurgery. MATERIAL AND METHODS: 24 patients underwent elective surgery under general anaesthesia that was administered through Target Controlled Infusion (TCI) for effect-site concentration (Ce) of Propofol and Remifentanil, targeting Bispectral Index (BIS) in the 40-60 intervals. Stimulating intensity of transcranial motor evoked potentials (tMEP), BIS index, Propofol and Remifentanil Ce were collected at MEPs threshold (T) definition (respectively BIS@T, CeProp@T and CeRemi@T)...
June 14, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28755546/temporal-spatial-characteristics-of-phase-amplitude-coupling-in-electrocorticogram-for-human-temporal-lobe-epilepsy
#15
Ruihua Zhang, Ye Ren, Chunyan Liu, Na Xu, Xiaoli Li, Fengyu Cong, Tapani Ristaniemi, YuPing Wang
OBJECTIVE: Neural activity of the epileptic human brain contains low- and high-frequency oscillations in different frequency bands, some of which have been used as reliable biomarkers of the epileptogenic brain areas. However, the relationship between the low- and high-frequency oscillations in different cortical areas during the period from pre-seizure to post-seizure has not been completely clarified. METHODS: We recorded electrocorticogram data from the temporal lobe and hippocampus of seven patients with temporal lobe epilepsy...
June 28, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28753117/new-onset-seizure-during-and-after-brain-tumor-excision-a-risk-assessment-analysis
#16
Soliman Oushy, Stefan H Sillau, Douglas E Ney, Denise M Damek, A Samy Youssef, Kevin O Lillehei, D Ryan Ormond
OBJECTIVE Prophylactic use of antiepileptic drugs (AEDs) in seizure-naïve brain tumor patients remains a topic of debate. This study aimed to characterize a subset of patients at highest risk for new-onset perioperative seizures (i.e., intraoperative and postoperative seizures occurring within 30 days of surgery) who may benefit from prophylactic AEDs. METHODS The authors conducted a retrospective case-control study of all adults who had undergone tumor resection or biopsy at the authors' institution between January 1, 2004, and June 31, 2015...
July 28, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28753091/neuroendoscopic-surgery-in-children-does-age-at-intervention-influence-safety-and-efficacy-a-single-center-experience
#17
Amy L Bowes, Josh King-Robson, William J Dawes, Greg James, Kristian Aquilina
OBJECTIVE The aim of this study was to review the safety of pediatric intraventricular endoscopy across separate age groups and to determine whether intraventricular endoscopy is associated with an increased risk of complications or reduced efficacy in infants younger than 1 year. METHODS In this retrospective cohort study, 286 pediatric patients younger than 17 years underwent intraventricular endoscopy at Great Ormond Street Hospital between December 2005 and December 2014. The primary diagnosis, procedure, and complications were recorded...
July 28, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28751428/cerebral-haemorrhage-as-a-clinical-manifestation-of-human-ehrlichiosis
#18
Catalina Garc Ía-Baena, MarÍa Fernanda Cárdenas, Juan Fernando Ramón
A 16-year-old young man presented to the emergency room with new-onset generalised tonic-clonic seizures. Examination showed a Glasgow score of 13 and predominantly crural left hemiparesis. Imaging demonstrated a right frontoparietal haemorrhage of non-vascular origin with perilesional oedema. Surgical drainage was carried out, but rebleeding occurred within 24 hours following surgery, and again 1 week after discharge. On reinterrogation and examination, Ehrlichia canis infection was suspected and empirical management with doxycycline was begun...
July 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28749544/combined-electroencephalography-functional-magnetic-resonance-imaging-and-electrical-source-imaging-improves-localization-of-pediatric-focal-epilepsy
#19
Maria Centeno, Tim M Tierney, Suejen Perani, Elhum A Shamshiri, Kelly St Pier, Charlotte Wilkinson, Daniel Konn, Serge Vulliemoz, Frédéric Grouiller, Louis Lemieux, Ronit M Pressler, Christopher A Clark, J Helen Cross, David W Carmichael
OBJECTIVE: Surgical treatment in epilepsy is effective if the epileptogenic zone (EZ) can be correctly localized and characterized. Here we use simultaneous electroencephalography-functional magnetic resonance imaging (EEG-fMRI) data to derive EEG-fMRI and electrical source imaging (ESI) maps. Their yield and their individual and combined ability to (1) localize the EZ and (2) predict seizure outcome were then evaluated. METHODS: Fifty-three children with drug-resistant epilepsy underwent EEG-fMRI...
July 27, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28744852/phenomenological-network-models-lessons-for-epilepsy-surgery
#20
Jurgen Hebbink, Hil Meijer, Geertjan Huiskamp, Stephan van Gils, Frans Leijten
The current opinion in epilepsy surgery is that successful surgery is about removing pathological cortex in the anatomic sense. This contrasts with recent developments in epilepsy research, where epilepsy is seen as a network disease. Computational models offer a framework to investigate the influence of networks, as well as local tissue properties, and to explore alternative resection strategies. Here we study, using such a model, the influence of connections on seizures and how this might change our traditional views of epilepsy surgery...
July 26, 2017: Epilepsia
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