World Neurosurg
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Diffusion tensor imaging (DTI) tractography provides useful information that can be used to optimize surgical planning and help avoid injury during subcortical dissection of eloquent tracts. The objective is to provide a safe, timely, and affordable algorithm for preoperative DTI language reconstruction for intrinsic frontotemporal diseases. ⋯ We present a safe and efficacious preoperative DTI language reconstruction algorithm that could be used as a feasible treatment strategy in a challenging subset of tumors in low- to middle-income countries.
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Perforation of a solid visceral organ and subsequent development of a cerebrospinal fluid pseudocyst is a rare complication of ventriculoperitoneal shunts. ⋯ A series of 22 cases of previously reported intrahepatic pseudocysts and abscesses is presented, and the putative mechanisms that have been put forward to explain the development of these collections are discussed. Review of the literature demonstrates that several techniques have been successfully employed in the management of this complication.
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Three-dimensional (3D), high-definition (HD) endoscopy has been recently introduced in neurosurgery, and its value has been discussed extensively in endonasal skull base surgery. Because there has been no reported clinical series on the use of a recent 3D-HD ventriculoscope, the aim of this study was to describe our initial experience with this novel device. ⋯ 3D-HD technology seems to provide potential advantages in ventricular surgery. This initial experience is promising but must be confirmed by larger series.
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The overall survival rates for breast cancer are increasing due to controlled brain disease and improved systemic treatments. This study examined neurologic outcomes, tumor control, and survival data in breast cancer patients with multiple brain metastases and who required salvage stereotactic radiosurgery (SRS) for recurrent breast cancer brain metastases. ⋯ This report indicated that both initial and salvage SRS procedures in breast cancer patients with multiple brain metastases are effective for local control of intracranial disease while minimizing adverse radiation effects.
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Case Reports
Real-Time Ex-Vivo MR Image-Guided Dissection of Human Brain White-Matter: A Proof-of-Principle Study.
Modern neuroanatomic education should be based on interdisciplinary methods that allow an understanding of the cerebral circuitry, which is at the base of the structural connectivity. Ex-vivo MRI-guided dissection is an essential method for developing and refining the knowledge of complex 3-dimensional brain anatomy and the mutual relationships between structures and architecture of the white matter bundles. The aim of this technical note is to present a new and innovative method of studying human brain white matter. ⋯ Image-guided neuronavigated dissection can significantly improve the quality of white matter dissection and represents a valid tool for learning the 3-dimensional anatomy of the human brain tracts.