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Francesco Sala, Stanley A Skinner, Jeffrey E Arle, Shlomi Constantini, Vedran Deletis, Karl F Kothbauer, David B MacDonald, Jay Shils, Francisco Soto, Andrea Szelenyi
No abstract text is available yet for this article.
June 11, 2018: Neurosurgery
Vedran Deletis, Sedat Ulkatan
No abstract text is available yet for this article.
July 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Vedran Deletis, Kathleen Seidel, Francesco Sala, Andreas Raabe, Darko Chudy, Juergen Beck, Karl F Kothbauer
OBJECTIVES: Anatomical identification of the corticospinal tract (CT) and the dorsal column (DC) of the exposed spinal cord is difficult when anatomical landmarks are distorted by tumour growth. Neurophysiological identification is complicated by the fact that direct stimulation of the DC may result in muscle motor responses due to the centrally activated H-reflex. This study aims to provide a technique for intraoperative neurophysiological differentiation between CT and DC in the exposed spinal cord...
February 7, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
B Verriere, L Gastaud, E Chamorey, F Peyrade, E Deletie, K Bouredji, D Quinsat, R Schiappa, A Thyss, D Re
Bendamustine (B) associated with rituximab (R) is widely described in literature for the management of patients with chronic lymphoid leukaemia (CLL) and indolent non-Hodgkin lymphoma. Safety data regarding late hematotoxicity such as late onset neutropenia (LON) are scarce. The aim of our study was to assess the incidence and to identify risk factors for LON in patients with indolent non-Hodgkin lymphoma and CLL treated with B and R (B-R). One hundred forty five patients were treated with B-R as first or second line...
February 2018: Hematological Oncology
Darko Chudy, Vedran Deletis, Fadi Almahariq, Petar Marčinković, Jasenka Škrlin, Veronika Paradžik
OBJECTIVE An effective treatment of patients in a minimally conscious state (MCS) or vegetative state (VS) caused by hypoxic encephalopathy or traumatic brain injury (TBI) is not yet available. Deep brain stimulation (DBS) of the thalamic reticular nuclei has been attempted as a therapeutic procedure mainly in patients with TBI. The purpose of this study was to investigate the therapeutic use of DBS for patients in VS or MCS. METHODS Fourteen of 49 patients in VS or MCS qualified for inclusion in this study and underwent DBS...
April 2018: Journal of Neurosurgery
Catherine F Sinclair, Maria J Téllez, Oscar R Tapia, Sedat Ulkatan, Vedran Deletis
OBJECTIVE: To describe a novel methodology for intraoperative neuro-monitoring of laryngeal and vagus nerves by utilizing the laryngeal adductor reflex (LAR). METHODS: Case series of 15 patients undergoing thyroid and cervical spine surgeries under total intravenous general anesthesia. Vocal fold mucosa was electrically stimulated to elicit a LAR using endotracheal tube based electrodes. Contralateral R1 (cR1) and R2 (cR2) responses were recorded using the endotracheal tube electrode contralateral to the simulating electrode...
July 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Sedat Ulkatan, Ana Maria Jaramillo, Maria J Téllez, Robert R Goodman, Vedran Deletis
OBJECTIVE: To explore the feasibility of eliciting the brainstem H reflex in the masseter muscle in patients under general anesthesia. METHODS: We electrically stimulated the masseteric nerve, a branch of the trigeminal nerve, and recorded ipsilateral masseteric and temporalis muscle responses. We tested eight patients who presented with trigeminal neuralgia; one patient had a temporal bone tumor and one patient had a brainstem arteriovenous malformation. All responses were elicited when patients were under general anesthesia and before the initiation of surgery...
January 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Vedran Deletis, Karl F Kothbauer, Francesco Sala, Kathleen Seidel
No abstract text is available yet for this article.
February 2017: Journal of Neurosurgery. Spine
Vedran Deletis, Isabel Fernández-Conejero
The risk of iatrogenic damage is very high in surgical interventions in or around the brainstem. However, surgical techniques and intraoperative neuromonitoring (ION) have evolved sufficiently to increase the likelihood of successful functional outcomes in many patients. We present a critical review of the methodologies available for intraoperative monitoring and mapping of the brainstem. There are three main groups of techniques that can be used to assess the functional integrity of the brainstem: 1) mapping, which provides rapid anatomical identification of neural structures using electrical stimulation with a hand-held probe, 2) monitoring, which provides real-time information about the functional integrity of the nervous tissue, and 3) techniques involving the examination of brainstem reflexes in the operating room, which allows for the evaluation of the reflex responses that are known to be crucial for most brainstem functions...
July 2016: Journal of Clinical Neurology
Sedat Ulkatan, Ana Maria Jaramillo, Maria J Téllez, Jinu Kim, Vedran Deletis, Kathleen Seidel
OBJECTIVE The purpose of this study was to investigate the incidence of seizures during the intraoperative monitoring of motor evoked potentials (MEPs) elicited by electrical brain stimulation in a wide spectrum of surgeries such as those of the orthopedic spine, spinal cord, and peripheral nerves, interventional radiology procedures, and craniotomies for supra- and infratentorial tumors and vascular lesions. METHODS The authors retrospectively analyzed data from 4179 consecutive patients who underwent surgery or an interventional radiology procedure with MEP monitoring...
April 2017: Journal of Neurosurgery
Paolo Costa, Vedran Deletis
OBJECTIVE: Intraoperative electrical stimulation of the spinal cord evokes not only high amplitude cortical somatosensory evoked potentials (ScEPs: spinal cord-evoked potentials) recorded from the scalp but also early potentials. It has been postulated that the early potential recorded from the scalp could be generated by antidromic stimulation of the cortico-spinal tract (ACSP: Antidromic Corticospinal tract Potential or "anti D-wave"). In this study, we aimed to investigate the anti D-wave evoked by epidural stimulation in a population of neurologically uncompromised/compromised patients during spine and spinal cord surgery...
February 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
J Urriza, B Arranz-Arranz, S Ulkatan, M J Téllez, V Deletis
OBJECTIVE: The objective of this study was to provide evidence on the integrative action of axonal membrane in humans and its ability to integrate multipulse subthreshold stimuli and generate action potential. METHODS: The median nerve was stimulated at the wrist in six healthy subjects and 17 patients who underwent low spine surgery by means of percutaneous electrodes, with trains of one to nine near-threshold constant-current stimuli of 500-μs duration. The interstimulus interval between stimuli was 2 or 4 ms...
February 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Benjamin Verriere, Vanessa Ferreira, Eric Denis, Khaled Zahreddine, Emmanuelle Deletie, Denis Quinsat, Daniel Re
Azacitidine is a demethylating and cytotoxic drug for the treatment of adult patients with (1) myelodysplastic syndromes, (2) chronic myelomonocytic leukemia, and (3) acute myeloid leukemia who are not eligible for induction treatment or hematopoietic stem cell transplantation. Widely described in the literature, the main adverse events are hematotoxicity, digestive toxicity, asthenia, cutaneous toxicity, and infections such as neutropenic sepsis and pneumonia. The pivotal phase III comparative and supporting studies did not point out interstitial pneumonitis as a significant adverse event...
September 2016: American Journal of Therapeutics
P Costa, G Faccani, F Sala, E Montalenti, M L Giobbe, V Deletis
STUDY DESIGN: Prospective, observational study. OBJECTIVES: To assess the spinal cord function intraoperatively in subjects during spine stabilization for spinal cord trauma, by recording muscular (m-MEPs) and epidural motor evoked potentials (e-MEPs, D wave) along with cortical and epidural somatosensory evoked potentials (e-SEPs) and predicting the outcome of spinal cord injury (SCI). SETTING: Regional Trauma Center, Torino, Italy. METHODS: Fifty-five patients were intraoperatively studied during posterior spine stabilization surgery for traumatic SCI...
October 2014: Spinal Cord
Michael J Malcharek, Andrea Kulpok, Vedran Deletis, Sedat Ulkatan, Armin Sablotzki, Gerd Hennig, Jochen Gille, Stefanie Pilge, Gerhard Schneider
BACKGROUND: Methods for detecting intraoperative cerebral ischemia arising from internal carotid artery (ICA) cross-clamping during carotid endarterectomy (CEA) should be sensitive, specific, and rapid to prevent intraoperative stroke. We had 3 objectives pertaining to this: (1) investigation of the rates of success of multimodal evoked potential (mEP) monitoring using a combination of median nerve (m) somatosensory (SS) EPs, tibial nerve SSEPs (tSSEPs), and transcranial electrical stimulated motor EPs (tcMEPs); (2) evaluation of the rates of false-negative mEP results; and (3) analysis of the relationship between different time periods associated with ICA cross-clamping and the postoperative outcome of motor function in patients with significant changes in mEP monitoring...
June 2015: Anesthesia and Analgesia
Vedran Deletis, Maja Rogić, Isabel Fernández-Conejero, Andreu Gabarrós, Ana Jerončić
OBJECTIVE: The aim of this study was to identify neurophysiologic markers generated by primary motor and premotor cortex for laryngeal muscles, recorded from laryngeal muscle. METHODS: Ten right-handed healthy subjects underwent navigated transcranial magnetic stimulation (nTMS) and 18 patients underwent direct cortical stimulation (DCS) over the left hemisphere, while recording neurophysiologic markers, short latency response (SLR) and long latency response (LLR) from cricothyroid muscle...
September 2014: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Maja Rogić, Vedran Deletis, Isabel Fernández-Conejero
OBJECT: Until now there has been no reliable stimulation protocol for inducing transient language disruptions while mapping Broca's area. Despite the promising data of only a few studies in which speech arrest and language disturbances have been induced, certain concerns have been raised. The purpose of this study was to map Broca's area by using event-related navigated transcranial magnetic stimulation (nTMS) to generate a modified patterned nTMS protocol. METHODS: Eleven right-handed subjects underwent nTMS to Broca's area while engaged in a visual object-naming task...
May 2014: Journal of Neurosurgery
Sedat Ulkatan, Milton Waner, Beatriz Arranz-Arranz, Inanna Weiss, Theresa M J O, Mehra Saral, Vedran Deletis, Alejandro Berenstein
OBJECTIVE: To develop a more reliable methodology for monitoring the facial nerve in surgeries of vascular malformations where the extracranial segment of the nerve is at risk. METHODS: Our methodology comprises: (1) preoperative mapping to identify the anatomical location of the nerve branches, (2) continuous intraoperative monitoring of the compound muscle action potential (CMAP) by stimulating the facial nerve extracranially, in close proximity to where the trunk of the facial nerve exits the skull at the stylomastoid foramen, (3) intraoperative mapping to identify the nerve branches during surgical dissection and quantify the innervating contribution of each branch to the target muscle...
April 2014: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Thomas Picht, Sandro M Krieg, Nico Sollmann, Judith Rösler, Birat Niraula, Tuomas Neuvonen, Petri Savolainen, Pantelis Lioumis, Jyrki P Mäkelä, Vedran Deletis, Bernhard Meyer, Peter Vajkoczy, Florian Ringel
BACKGROUND: Navigated transcranial magnetic stimulation (nTMS) is increasingly used in presurgical brain mapping. Preoperative nTMS results correlate well with direct cortical stimulation (DCS) data in the identification of the primary motor cortex. Repetitive nTMS can also be used for mapping of speech-sensitive cortical areas. OBJECTIVE: The current cohort study compares the safety and effectiveness of preoperative nTMS with DCS mapping during awake surgery for the identification of language areas in patients with left-sided cerebral lesions...
May 2013: Neurosurgery
Maja Rogić, Ana Jerončić, Marija Bošnjak, Ana Sedlar, Darko Hren, Vedran Deletis
The aim of the present study was to provide normative data for the Croatian language using 346 visually presented objects (Cycowicz, Friedman, Rothstein, & Snodgrass Journal of Experimental Child Psychology 65:171-237, 1997; Roach, Schwartz, Martin, Grewal, & Brecher Clinical Aphasiology 24:121-133, 1996; Snodgrass & Vanderwart Journal of Experimental Psychology: Human Learning and Memory 6:174-215, 1980). Picture naming was standardized according to seven variables: naming latency, name agreement, familiarity, visual complexity, word length, number of syllables, and word frequency...
December 2013: Behavior Research Methods
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