World Neurosurg
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Previous studies of percutaneous endoscopic lumbar discectomy (PELD) to treat lumbar disc herniation (LDH) have shown good clinical results. However, limited information has been reported regarding postoperative improvement in back muscle function. We aimed to determine whether changes in neuromuscular patterns, assessed using the flexion-relaxation phenomenon (FRP), could be observed after PELD. ⋯ PELD for individuals with LDH appears to normalize paraspinal muscle activation during lumbar flexion-extension movement. The gross range of motion and disability-related limitations of physical activity also improved.
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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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Intraoperative assessment of functional connectivity (FC) provides a new possibility for mapping the eloquent brain region before, during, and after tumor resection. The aim of this study was to perform a systematic analysis of detectability of FC and its variation between subjects and sessions. ⋯ Significant FC could be detected under anesthesia but showed a significant decrease in the second session. To implement FC intraoperative brain mapping, further studies are required to optimize the depth sedation to obtain stable FC between sessions.
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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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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.