Neurosurgery
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The knowledge about the management of patients with brain arteriovenous malformations (AVM) during pregnancy is limited, owing partly to insufficient evidence about the outcomes of newborns. This study aims to explore symptomatic AVMs and their outcomes during pregnancy, delivery, and the postpartum period. ⋯ Most mothers in the study had prior pregnancies, suggesting a potentially weaker association between AVM rupture and pregnancy compared to previous reports. Notably, 2 AVM ruptures occurred during spontaneous vaginal deliveries. Outcomes were generally favorable in both mothers and infants. More research is needed to refine our understanding of the optimal timing for invasive treatment during pregnancy.
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Case Reports
A Speech Neuroprosthesis in the Frontal Lobe and Hippocampus: Decoding High-Frequency Activity into Phonemes.
Loss of speech due to injury or disease is devastating. Here, we report a novel speech neuroprosthesis that artificially articulates building blocks of speech based on high-frequency activity in brain areas never harnessed for a neuroprosthesis before: anterior cingulate and orbitofrontal cortices, and hippocampus. ⋯ This may open the way for a novel strategy of neuroprosthesis implantation at earlier disease stages (eg, amyotrophic lateral sclerosis), while speech is intact, for improved training that still allows silent control at later stages. The results demonstrate clinical feasibility of direct decoding of high-frequency activity that includes spiking activity in the aforementioned areas for silent production of phonemes that may serve as a part of a neuroprosthesis for replacing lost speech control pathways.
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Magnetic resonance-guided focused ultrasound (MRgFUS) has been increasingly performed in recent years as a minimally invasive treatment of essential tremor and tremor-dominant Parkinson disease. One of the side effects after treatment is dysgeusia. Some centers use tractography to facilitate the treatment planning. However, there have been no reports of identifying gustatory tracts so far. Our aim was to investigate the technical feasibility of isolating and visualizing the gustatory tracts, as well as to explore the relationship between the gustatory tract and the MRgFUS lesion using actual patient data. ⋯ The thalamic gustatory tracts can be reliably visualized using tractography.
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Historical Article
Vesalius and His Manikin: An Enduring Influence on Modern Anatomic Teaching.
Anatomic teaching has long informed surgical knowledge, experience, and skills. One tool for teaching that emerged during the Renaissance was the fugitive anatomic sheet, which used flap layers to reveal different levels of anatomy. In 1538, Vogtherr introduced the first fugitive sheets, which included illustrations of male and female figures with a torso paper flap that, when lifted, revealed the internal organs in a cartoonish style. ⋯ Vesalius's groundbreaking discoveries, his use of the most advanced printing techniques, and his innovative teaching style are fundamental aspects of the legacy of medical education. This article shows these remarkable fugitive anatomic sheets from the original publications of Fabrica and Epitome together for the first time. It explores the innovative concepts and applications of Vesalius's unique printings.
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Inflammation is a key pathomechanism for growth and rupture of intracranial aneurysms. Anti-inflammatory mechanisms may reduce rupture of intracranial aneurysms and the incidence of aneurysmal subarachnoid hemorrhage (SAH). Ultraviolet (UV) radiation from sunlight exposure induces systemic anti-inflammatory responses through immunosuppressive mechanisms. We studied whether SAH incidence is associated with UV radiation. ⋯ The incidence of SAH is inversely associated with UV radiation. Further studies should assess the actual UV exposure in relation to SAH incidence and potential biological explanations for the relation we found.