Journal of neurosurgery
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Journal of neurosurgery · Jan 2013
Case ReportsInvolvement of the right inferior longitudinal fascicle in visual hemiagnosia: a brain stimulation mapping study.
Neural foundations underlying visual agnosia are poorly understood. The authors present the case of a patient who underwent awake surgery for a right basal temporooccipital low-grade glioma in which direct electrostimulation was used both at the cortical and subcortical level. ⋯ These original findings are in agreement with recent tractography data that have confirmed the existence of an occipitotemporal pathway connecting occipital visual input to higher-level processing in temporal lobe structures. This is the first report of a true transient visual hemiagnosia elicited through electrostimulation, supporting the crucial role of inferior longitudinal fascicle in visual recognition.
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Journal of neurosurgery · Jan 2013
Risk for symptomatic hemorrhage of cerebral cavernous malformations during pregnancy.
The threat of symptomatic hemorrhage from cerebral cavernous malformations (CCMs) during pregnancy remains poorly understood. The authors undertook this study to better define the risk of pregnancy-related hemorrhage in this population. ⋯ The authors' experience suggests that the risk of symptomatic hemorrhage from a CCM during pregnancy is not increased and that a history of CCM is not a contraindication to pregnancy or vaginal delivery.
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Journal of neurosurgery · Jan 2013
Randomized Controlled Trial Multicenter StudyEffects of cilostazol on cerebral vasospasm after aneurysmal subarachnoid hemorrhage: a multicenter prospective, randomized, open-label blinded end point trial.
Cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is a major cause of subsequent morbidity and mortality. Cilostazol, a selective inhibitor of phosphodiesterase 3, may attenuate cerebral vasospasm because of its antiplatelet and vasodilatory effects. A multicenter prospective randomized trial was conducted to investigate the effect of cilostazol on cerebral vasospasm. ⋯ Oral administration of cilostazol is effective in preventing cerebral vasospasm with a low risk of severe adverse events. Clinical trial registration no. UMIN000004347, University Hospital Medical Information Network Clinical Trials Registry.
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Journal of neurosurgery · Jan 2013
The value of serial plasma and cerebrospinal fluid nuclear and mitochondrial deoxyribonucleic acid levels in aneurysmal subarachnoid hemorrhage.
Increased plasma nuclear and mitochondrial DNA levels have been reported in critically ill patients, and extracellular DNA may originate from damaged tissues having undergone necrosis. This study tested the hypothesis that nuclear and mitochondrial DNA levels in CSF and plasma are substantially increased in patients with acute spontaneous aneurysmal subarachnoid hemorrhage (SAH) and decrease thereafter, such that nuclear and mitochondrial DNA levels may be predictive of treatment outcomes. ⋯ Higher CSF DNA levels on presentation, rather than plasma DNA levels, are associated with worse outcomes in patients with acute spontaneous aneurysmal SAH. More prospective multicenter investigations are needed to confirm the predictive value of CSF and plasma DNA levels on outcome.