Journal of neurosurgery
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Journal of neurosurgery · Aug 2024
Functional mapping of movement and speech using task-based electrophysiological changes in stereoelectroencephalography.
Stereoelectroencephalography (SEEG) has become the predominant method for intracranial seizure localization. When imaging, semiology, and scalp EEG findings are not in full agreement or definitively localizing, implanted SEEG recordings are used to test candidate seizure onset zones (SOZs). Discovered SOZs may then be targeted for resection, laser ablation, or neurostimulation. If an SOZ is eloquent, resection and ablation are both contraindicated, so identifying functional representation is crucial for therapeutic decision-making. The authors present a novel functional brain mapping technique that utilizes task-based electrophysiological changes in SEEG during behavioral tasks and test this in pediatric and adult patients. ⋯ Task-based electrophysiological mapping using broadband changes in the SEEG signal reliably identifies movement and speech representation in pediatric and adult epilepsy patients.
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Journal of neurosurgery · Aug 2024
Presentation, surgical outcome, and supplementary motor area syndrome risk of posterior superior frontal gyrus tumors.
Following resection of posterior superior frontal gyrus (PSFG) tumors, patients can experience supplementary motor area (SMA) syndrome consisting of contralateral hemiapraxia and/or speech apraxia. Given the heterogeneity of PSFG tumors, the authors sought to determine the risk of postoperative deficits and assess predictors of outcomes for all intraparenchymal PSFG tumors undergoing surgery (biopsy or resection), regardless of histology. ⋯ Nearly half of all patients undergoing resection of PSFG-region tumors experience a postoperative SMA syndrome. Individuals with corpus callosum and/or motor cortex involvement may be at an increased risk of experiencing SMA syndrome. However, these deficits are usually transient, and the risk of permanent new deficits is very low (3%). Preoperative characteristics including corpus callosum involvement and tumor enhancement-in addition to pathology-might serve as predictors of overall survival within this patient population.
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Journal of neurosurgery · Aug 2024
Efficacy of high-resolution vessel wall MRI in the postoperative assessment of intracranial aneurysms following flow diversion treatment.
Certain patients must undergo frequent postoperative digital subtraction angiography (DSA) after flow diversion (FD) therapy. No imaging modality with an efficacy comparable to that of DSA has been established. This study was conducted to determine the efficacy of contrast-enhanced delay alternating with nutation for tailored excitation (DANTE) T1-sampling perfection with application-optimized contrasts by using different flip angle evolution (SPACE), a high-resolution vessel wall magnetic resonance imaging technique for evaluating the occlusion status of intracranial aneurysms after FD treatment, with DSA serving as the reference standard. ⋯ Contrast-enhanced DANTE T1-SPACE is a very useful option in the follow-up of aneurysms after FD treatment.
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Journal of neurosurgery · Aug 2024
Long-term survivors in 976 supratentorial glioblastoma, IDH-wildtype patients.
Glioblastoma, isocitrate dehydrogenase (IDH)-wildtype is the most aggressive glioma with poor outcomes. The authors explored survival rates and factors associated with long-term survival in patients harboring a glioblastoma, IDH-wildtype. ⋯ Five-year overall survival in patients with glioblastoma, IDH-wildtype is extremely low. Predictors of a longer survival are mostly treatment factors, emphasizing the importance of a complete oncological treatment plan, when achievable. Glioblastoma, IDH-wildtype 5-year survivors could be screened for actionable targets in case of recurrence.
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Journal of neurosurgery · Aug 2024
Role of aneurysmal hemodynamic changes in pathogenesis of headaches associated with unruptured cerebral aneurysms.
One symptom commonly associated with the presence of unruptured intracranial aneurysms is headache. In this study, the authors aimed to analyze factors associated with headaches among patients with intracranial aneurysms, with special consideration of hemodynamic parameters. ⋯ Hemodynamic parameters of intracranial aneurysms might be associated with headaches and their relief after aneurysm treatment.