Neurosurgery
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Review
The enigmatic psalterium: a review and anatomic study with relevance to callosotomy procedures.
Recalcitrant seizures after callosotomy procedures are challenging to treat. One commissure, the psalterium, has received little attention. ⋯ Better understanding of the commissures of the human brain, including the psalterium, might help the neurosurgeon during procedures near this structure.
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The recent interest in concussion in sport has resulted in significant media focus about chronic traumatic encephalopathy (CTE), although a direct causative link(s) between concussion and CTE is not established. Typically, sport-related CTE occurs in a retired athlete with or without a history of concussion(s) who presents with a constellation of cognitive, mood, and/or behavioral symptoms and who has postmortem findings of tau deposition within the brain. There are many confounding variables, however, that can account for brain tau deposition, including genetic mutations, drugs, normal aging, environmental factors, postmortem brain processing, and toxins. ⋯ While many of these athletes have a history of exposure to head impacts as a part of contact sport, there is insufficient evidence to establish causation between sports concussion and CTE. It is likely that many of the cases with neuropathological findings represent the normal aging process, the effects of opiate abuse, or a variant of frontotemporal lobar degeneration. Whether particular genetic causes may place athletes at greater risk of neurodegenerative disease is yet to be determined.
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Intraoperative quantitative flow measurement by a microvascular ultrasonic flow probe is an established methodology in aneurysm surgery. ⋯ Multistage intraoperative quantitative flow measurement proved to be a feasible, safe, repeatable, and reliable methodology to assist surgery in different phases of AVM resection. Further studies are needed to assess the impact of this approach on AVM patient outcomes.VA, indocyanine green videoangiographymRS, modified Rankin ScaleSM, Spetzler Martin.
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Tractography based on diffusion tensor imaging has become a popular tool for delineating white matter tracts for neurosurgical procedures. ⋯ The implementation of tractography based on nTMS increases the accuracy of fiber tracking. Moreover, this combination of methods has the potential to become a supplemental tool for guiding electrode implantation.