World Neurosurg
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Case Reports
Subcortical calculation mapping during parietal glioma surgery in the dominant hemisphere: A case report.
To avoid permanent neurologic deficits and preserve brain function in and near the eloquent area, intraoperative electrical stimulation mapping (IESM) is necessary. However, little is known about how these subcortical regions are involved in calculation processing function in patients with glioma. ⋯ In this report, IESM performed during awake surgery in a subcortical site demonstrated a crucial role played by the dominant parietal lobe in calculation.
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Obesity has become a worldwide epidemic, with very few long-term successful treatment options for refractory disease. Deep brain stimulation (DBS) of the bilateral lateral hypothalamus (LH) in refractory obesity has been performed safely. However, questions remain regarding the optimal settings and its effects on metabolic rate. The goals of our experiment were to determine the optimal DBS settings and the actual effect of optimal stimulation on energy expenditure. ⋯ These findings have demonstrated the efficacy of optimized DBS of the LH on increasing the RMR acutely and maintaining this increase during overnight sleep. These promising preliminary findings have laid the groundwork for the possible treatment of refractory obesity with DBS.
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The disease-specific Graded Prognostic Assessment (ds-GPA) for patients with gastrointestinal (GI) tract cancer brain metastases (BM) suggests Karnofsky Performance Status (KPS) as the only pertinent prognostic factor. We evaluated the prognostic importance of cumulative intracranial tumor volume (CITV). ⋯ CITV is an important prognostic variable in patients with stereotactic radiosurgery-treated GI BM and augments the prognostic accuracy of the GI-ds-GPA index.
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To evaluate the stability of multiple rod-connector construct designs using a mechanical 4-point bending testing frame. ⋯ Our data indicate that the design, number, and placement of rod connectors have a significant impact on the bending stiffness of a surgical construct. Such mechanical data may influence construct design in primary and revision surgeries of the cervical spine and cervicothoracic junction.
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Glioblastoma multiforme (GBM) is the most common adult primary brain tumor. Human cytomegalovirus (HCMV) has been studied for the past decade, and conflicting results have been reported with no conclusive role established yet. Human papillomavirus (HPV) is involved in the pathogenesis of many cancers and has a high prevalence in patients with cervical and oral cancer in Pakistan. The objective of our study was to identify the prevalence of HCMV and HPV in Pakistani patients with primary GBM. ⋯ The presence of a single HCMV positive is intriguing. In addition, we discovered a substantially high 28% prevalence of HPV in GBM patients. The role of viruses in gliomagenesis warrants further investigation.