Acta neurochirurgica
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Acta neurochirurgica · Mar 2013
Intraoperative visualisation of language fascicles by diffusion tensor imaging-based tractography in glioma surgery.
For gliomas, the goal of surgery is to maximise the extent of resection (EOR) while minimising the postoperative morbidity. The purpose of this study was to evaluate the benefits of a protocol developed for the surgical management of gliomas located in language areas, where tractography-integrated navigation was used in conjunction with direct electrical stimulations (DES). ⋯ The intraoperative combination of tractography and DES contributed to maximum safe resection of gliomas located in language areas.
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Acta neurochirurgica · Mar 2013
Live surgery in neurosurgical training courses: essential infrastructure and technical set-up.
Training courses in neurosurgery are essential educational elements of residency. Teaching methods vary due to cultural differences, monetary restrictions and infrastructure conditions. Anatomical dissection courses combined with annotated live surgeries performed by senior surgeons have proved to be best accepted by students. ⋯ A professionally prepared step-by-step educational program including surgical anatomy, cadaver dissection and live surgeries with online discussion offers a high level of training and enriches both the participants and instructors.
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Acta neurochirurgica · Mar 2013
ReviewHypertrophic olivary degeneration following surgical resection or gamma knife radiosurgery of brainstem cavernous malformations: an 11-case series and a review of literature.
We describe 11 patients with hypertrophic olivary degeneration (HOD) after surgical resection or gamma knife radiosurgery for brainstem cavernous malformations. In addition, we statistically analyzed the predicting factors associated with the development of HOD. ⋯ HOD should be recognized as a non-infrequent complication of surgical resection or gamma knife radiosurgery within the brainstem, especially for midbrain cavernous malformations. In addition, to the best of our knowledge, this is the first report on HOD development after radiosurgery.
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Acta neurochirurgica · Mar 2013
Comparative StudyApplicability of nTMS in locating the motor cortical representation areas in patients with epilepsy.
Transcranial magnetic stimulation (TMS) is increasingly used for non-invasive functional mapping in preoperative evaluation for brain surgery, and the reliability of navigated TMS (nTMS) motor representation maps has been studied in the healthy population and in brain tumor patients. The lesions behind intractable epilepsy differ from typical brain tumors, ranging from developmental cortical malformations to injuries early in development, and may influence the functional organization of the cortical areas. Moreover, the interictal cortical epileptic activity and antiepileptic medication may affect the nTMS motor threshold. The reliability of the nTMS motor representation localization in epilepsy patients has not been addressed. ⋯ nTMS can reliably locate the hand motor cortical representation area with the accuracy needed for pre-surgical evaluation in patients with epilepsy.
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Acta neurochirurgica · Mar 2013
Comparative StudyHow I do it--pineal surgery: supracerebellar infratentorial versus occipital transtentorial.
Resection of a pineal tumour requires fastidious pre-operative planning to select the optimal surgical approach and maximise resection while minimising morbidity. ⋯ Specific considerations include patient-specific anatomy, extent and relationships of the tumour, and the techniques likely to be employed during resection. The supracerebellar infratentorial approach provides a direct corridor to pineal tumours caudal to the deep veins; for tumours invaginating the tectal plate in a caudal direction the occipital transtentorial provides a better view.