Journal of neurosurgery
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A naming task has been used to spare cortical areas involved in language. In the present study, a calculation task was combined with electrostimulation mapping (awake surgery) to spare cortical areas involved in calculation in patients undergoing surgery for brain lesions. The organization of language and calculation areas was analyzed in relation to these surgical data. ⋯ To limit the risk of personal and professional disturbances caused by acquired anarithmetia in patients undergoing surgery for brain tumors or epilepsy, the authors think it is necessary to use a calculation task during brain mapping, especially when operating in the dominant parietal lobe.
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Journal of neurosurgery · Jun 2009
Computer-controlled electrical stimulation for quantitative mapping of human cortical function.
Cortical mapping with electrical stimulation (ES) in neurosurgical patients typically involves the manually controlled delivery of suprathreshold electrical current to a discrete area of the brain. Limited numbers of trials and imprecise current delivery methods increase the variability of the behavioral response and make it difficult to collect quantitative mapping data, which is especially important in research studies of human cortical function. ⋯ Computer-controlled ES is well suited for the systematic and quantitative study of the function of virtually any region of cerebral cortex. It may be especially useful for studying human cortical regions that are not well characterized and for verifying the presence of stimulation-evoked percepts that are difficult to objectively confirm.
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Journal of neurosurgery · Jun 2009
Safe entry point for twist-drill craniostomy of a chronic subdural hematoma.
Twist-drill craniostomy (TDC) with closed-system drainage is an effective treatment option for chronic subdural hematoma (CSDH). Because the entry point for TDC has not been described in a definitive area, the aim of this study was to define the optimal twist-drill entry point for CSDH. ⋯ One centimeter anterior to the coronal suture at the level of the STL is suitable as the normal entry point of the TDC for symptomatic CSDH. The thickness of the CSDH can be measured at this point on a preoperative brain CT scan. Furthermore, the entry point on the scalp can be accurately estimated using surface landmarks.
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Journal of neurosurgery · Jun 2009
Morbidity in epilepsy surgery: an experience based on 2449 epilepsy surgery procedures from a single institution.
In this paper the authors aimed to provide information related to major and minor surgical and neurological complications encountered following stereoelectroencephalography and epilepsy surgery.Methods The authors performed a retrospective review of 491 and 1905 patients who underwent intracranial electrode implantation and epilepsy surgery, respectively, between 1976 and 2006 at the Montreal Neurological Institute. All intracranial electrode implantations and surgical procedures were performed by 1 surgeon (A.O.). ⋯ Based on the authors' experience, intracranial electrode implantation is an effective method with an extremely low morbidity rate. Moreover, epilepsy surgery is safe, especially in experienced hands.
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Journal of neurosurgery · Jun 2009
Stability of symptom control after replacement of impulse generators for deep brain stimulation.
Impulse generators (IPGs) for deep brain stimulation (DBS) need to be replaced when their internal batteries fail or when technical problems occur. New IPGs are routinely programmed with the previous stimulation parameters. In this study, the authors evaluate the stability of symptom control after such IPG replacements. ⋯ Replacement of the IPG requires careful follow-up of patients with DBS to ensure stable symptom control.