Neurosurgery
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The fiber dissection technique involves peeling away the white matter tracts of the brain to display its three-dimensional anatomic organization. Early anatomists demonstrated many tracts and fasciculi of the brain using this technique. The complexities of the preparation of the brain and the execution of fiber dissection have led to the neglect of this method, particularly since the development of the microtome and histological techniques. Nevertheless, the fiber dissection technique is a very relevant and reliable method for neurosurgeons to study the details of brain anatomic features. ⋯ The complex structures of the brain can be more clearly defined and understood when the fiber dissection technique is used. This knowledge can be incorporated into the preoperative planning process and applied to surgical strategies. Fiber dissection is time-consuming and complex, but it greatly adds to our knowledge of brain anatomic features and thus helps improve the quality of microneurosurgery. Because other anatomic techniques fail to provide a true understanding of the complex internal structures of the brain, the reestablishment of fiber dissection of white matter as a standard study method is recommended.
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There are few data available on the cognitive deficits of patients with primary or secondary intracranial mass lesions before treatment. The aim of the present study was to document the incidence of cognitive impairments among patients with brain tumors of the frontal or temporal lobes, immediately after diagnosis but before the commencement of treatment. ⋯ The present findings suggest that most patients with brain tumors of the frontal or temporal lobes demonstrate impairments of cognitive functioning at the time of diagnosis. Therefore, for quality assessments of neurosurgical procedures, baseline evaluations of cognitive measures should be performed.
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Traumatic brain injury (TBI) has been shown to induce a significant change in polyamine metabolism. Polyamines and polyamine-dependent calcium influx play an important role in mediating the effects of excitotoxic amino acids at the N-methyl-D-aspartate (NMDA) receptor site. We studied the effects of ifenprodil, known as a noncompetitive inhibitor of polyamine sites at the NMDA receptor, on brain edema formation, blood-brain barrier breakdown, and volume of injury after TBI. ⋯ The polyamine-site NMDA receptor antagonist ifenprodil affords significant neuroprotection in a controlled cortical impact brain injury model and may hold promise for the discovery and treatment of the mechanism of delayed neurological deficits after TBI.