World Neurosurg
-
Autonomic nervous system dysfunction is a known entity in strokes involving insula. It causes significant morbidity and mortality. No study to date has demonstrated autonomic nervous system dysfunction in patients with insular glioma. This is an exploratory study to identify the subclinical autonomic dysfunctions in insular glioma. ⋯ Patients with insular gliomas have significant impairment of autonomic functions, with left insular glioma showing sympathetic dominance. Suppression of autonomic function is greater in those presenting with seizures.
-
Intracranial aneurysm rupture is associated with a high mortality and disability despite modern medical care. Multiple aneurysms occur in nearly 16% of patients, and imaging studies of naturally occurring multiple aneurysms are valuable for computational fluid dynamics studies. In this study, we describe and analyze the hemodynamic changes produced in a distal aneurysm after the treatment of a proximal aneurysm. ⋯ The hemodynamic changes in a distal aneurysm after treatment of a proximal aneurysm showed an unfavorable profile associated with an increased theoretical risk of bleeding.
-
There is a need to further anatomically describe the nucleus accumbens (NA), as there is a growing neurosurgical interest in this locus but a limited understanding of its structure. In this study, we evaluated quantitative NA parameters and spatial relationships with adjacent structures found in the telencephalon. ⋯ We obtained the stereotactic coordinates of (x, y, z) = (8, 17, -8) for the NA. From this and other delineations of the described position of the NA, it is possible to contribute to stereotactic surgical atlases, improving neurosurgical interventions in this structure.
-
The fusiform gyrus and the collateral sulcus are the anatomical structures located in the temporobasal region. In this study, the topographic anatomy of the fusiform gyrus and the collateral sulcus is detailed to make a contribution for a successful course of temporal lobe surgery. ⋯ The topographic anatomy of the collateral sulcus with its surrounding structures is detailed in this study. This study clarifies and supplements the knowledge presently available to help develop a more feasible surgical concept.
-
Awake craniotomy (AC) is generally a safe and effective procedure; however, a small but not insignificant portion of cases are aborted due to patient intolerance of the awake portion of surgery. There is not yet a firm understanding of what characteristics indicate patient tolerance or failure of AC. ⋯ AC remains an effective treatment option; the majority of patients tolerate the procedure without issue. Male patients have lower rates of surgical failure, whereas remifentanil administration may increase failure rate.