World Neurosurg
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To retrospectively review the clinicopathologic features and computed tomography (CT) and magnetic resonance imaging (MRI) findings of lumbosacral intraspinal paragangliomas (PGLs). ⋯ Lumbosacral intraspinal PGLs should be considered when a mass appears as well defined or oval, and when a striated solitary homogeneous or heterogeneous mass is characterized by a tadpolelike appearance with a marked enhancement pattern. The fluctuation of blood pressure before and after surgery is an interesting clinical feature of lumbosacral intraspinal PGLs.
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To investigate characteristics of the posterior cerebral artery anterior temporal branch aneurysm and the safety and efficacy of endovascular management. ⋯ The anterior temporal artery aneurysm is a special subtype of aneurysm and can be readily misdiagnosed as on the posterior cerebral artery trunk or the superior cerebellar artery. Endovascular management has a greater success rate, good effect, and fewer complications but with greater difficulties.
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To establish a workflow integrating preoperative 3-dimensional (3D) angiography data and intraoperative real-time vascular information in microscope-based navigation for aneurysm and arteriovenous malformation (AVM) surgery. ⋯ Registration CT imaging facilitates integrating preoperative and intraoperative vascular image data with a low registration error and low radiation exposure for the patient, improving the understanding of 3D vascular anatomy during surgery with easier identification of feeding vessels in AVMs, and of the projection and configuration of aneurysms.
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Type II focal cortical dysplasia is the most common malformation of cortical development associated with drug resistant epilepsy and susceptible to surgical resection. Although, at present, advanced imaging modalities are capable of detecting most cortical disorders, it is still a challenge for the surgeon to visualize them intraoperatively. The lack of direct identification between normal brain and subtle dysplastic tissue may explain the poor results in terms of being seizure-free versus other forms of epilepsy. The aim of this study is to compare magnetic resonance imaging (MRI) and intraoperative ultrasound-guided neuronavigation, along with cortical stimulation and acute electrocorticography, as a multimodal surgical approach to cortical dysplasia's tailored resection. ⋯ These results strongly suggest feasibility of ultrasound-guided resection of focal cortical dysplasia. Providing high resolution and accuracy, it allows an easy, real-time discrimination between normal and dysplastic brain.
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Deep brain stimulation (DBS) is a well-established neuromodulation therapy for advanced Parkinson disease, essential tremor and dystonia. In as much as this therapy is being developed in the Middle East, a better understanding of the incidence and prevalence of movement disorders, health care, and social framework is required for the region. ⋯ The Middle East is projected to be a growing market for neuromodulation. The available data on incidence and prevalence of movement disorders is from studies that were small, partial, and old, with inconsistent results, highlighting the need for newer, better-designed, and larger studies. DBS in the Middle East will need assessment of incidence and prevalence of movement disorders, existing challenges to its application, and focused efforts on key opportunities to foster development of DBS for this underserved region. This article is an attempt to identify and explore these challenges and propose solutions in anticipation.