World Neurosurg
-
Recent advances in neuroimaging demonstrated many markedly improved images hitherto unavailable, specifically the areas that lie deep in the brain. The anatomic images of the deep brain structure taken in vivo using 7.0 T magnetic resonance imaging (MRI) and the molecular images using high resolution research tomography positron emission tomography, as well as the fusion images using state-of-art neuroimaging techniques can contribute to the noninvasive treatment of neurologic and psychiatric diseases. We present a pictorial review with selected brain images obtained from 7.0 T MRI, and the images of brain metabolic function accompanied with high resolution anatomic information obtained using the positron emission tomography-MRI fusion technique. In addition, we present some recent results of the cerebral microvasculature and diffusion tractography imaging for the deep brain areas acquired with 7.0 T MRI.
-
Advancements in diffusion-weighted imaging during the past decade have led to the use of diffusion tensor imaging to further characterize the structural integrity of neural tissue and to noninvasively trace neuronal tracts in the brain and spine. This has led to many clinical applications that have aided in surgical planning for brain and spinal cord tumors and has increased the diagnostic potential of magnetic resonance imaging in disorders such as multiple sclerosis, Alzheimer disease, and traumatic brain injury.
-
The supraorbital eyebrow craniotomy is being increasingly used for the removal of frontal fossa, parasellar, as well as some middle and posterior fossa tumors. ⋯ The supraorbital eyebrow craniotomy with endoscopic assistance provides minimally invasive access to a wide range of frontal fossa, parasellar, and some middle and posterior fossa tumors.
-
The efficacy of extensive resection on prolonging survival for patients with glioblastoma (GBM) is controversial because prior studies have included tumors with dissimilar resection capabilities. The true isolated effect of increasing resection on survival for GBM therefore remains unclear. ⋯ This is the first study to evaluate RV and EOR in a more uniform population of patients with tumors of similar surgical capabilities. This study shows that achieving a decreased RV and/or an increased EOR is independently associated with survival and recurrence in those patients with tumors with similar resection capacities.
-
The cerebellum is an uncommon location for arteriovenous malformations (AVM) with unique angioarchitecture compared to the cerebrum. We evaluate the outcomes of radiosurgery in a cohort of cerebellar AVMs and assess the effect of infratentorial location by comparing them to a matched cohort of supratentorial AVMs. ⋯ Radiosurgery is an effective treatment modality for cerebellar AVMs with relatively limited adverse events. Infratentorial location did not affect radiosurgery outcomes.