Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Sep 2009
Endoscopic biopsy of foramen of Monro and third ventricle lesions guided by frameless neuronavigation: usefulness and limitations.
To describe our institution experience regarding the usefulness and limitations of frameless neuronavigation in the endoscopic biopsy of foramen of Monro and third ventricle lesions. ⋯ In our experience, image-guided neuroendoscopy can improve the accuracy of the endoscopic approach, minimising brain trauma. It can be particularly helpful when performing a brain biopsy in the absence of clear intraventricular landmarks or in the event of adverse visual conditions such as intraventricular bleeding.
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Clin Neurol Neurosurg · Sep 2009
Evidence for an occipito-temporal tract underlying visual recognition in picture naming.
A 24-year-old male underwent awake surgery for a lesion in the left dominant basal temporo-occipital junction. During the intraoperative functional mapping using picture naming, cortical stimulation near the visual word form area led to visual paraphasia. These visual paraphasias were also elicited axonally by subcortical stimulation at the anterior wall of the cavity. ⋯ We suggest that its afference, whose stimulation also induced visual paraphasias, may be one part of the U-shaped fibers distributed along the posterior part of the occipito-temporal connection system (inferior longitudinal fasciculus). Preservation of this white matter tract is essential for visual recognition. Thus, it should be mapped intraoperatively more systematically.
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Clin Neurol Neurosurg · Jul 2009
Case ReportsMedulloblastoma mimicking Lhermitte-Duclos disease on MRI and CT.
Although previous reports purport that the unique magnetic resonance imaging (MRI) features of Lhermitte-Duclos disease (LDD) obviates the need for biopsy, medulloblastoma can have an indistinguishable imaging appearance. ⋯ In those patients where imaging is highly suggestive of LDD but lack other manifestations of Cowden syndrome, biopsy is required and advanced imaging with magnetic resonance spectroscopy (MRS) should be strongly considered.
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Clin Neurol Neurosurg · Jul 2009
Comparative StudySpectroscopy-supported frame-based image-guided stereotactic biopsy of parenchymal brain lesions: comparative evaluation of diagnostic yield and diagnostic accuracy.
Comparative evaluation of diagnostic efficacy of stereotactic brain biopsy performed with and without additional use of spectroscopic imaging ((1)H-MRS) for target selection was done. ⋯ While in the present study the diagnostic yield of (1)H-MRS-supported frame-based stereotactic brain biopsy was 100%, its statistically significant diagnostic advantages over MRI-guided technique were not proved. Optimal selection of the spectroscopic target for tissue sampling remains unclear.