'Moderate global aphasia': A generalized decline of language processing caused by glioma surgery but not stroke.

Unlike stroke, neurosurgical removal of left-hemisphere gliomas acts upon a reorganized language network and involves brain areas rarely damaged by stroke. We addressed whether this causes the profiles of neurosurgery- and stroke-induced language impairments to be distinct. K-means clustering of language assessment data (neurosurgery cohort: N = 88, stroke cohort: N = 95) identified similar profiles in both cohorts.

Functional linguistic specificity of the left frontal aslant tract for spontaneous speech fluency: Evidence from intraoperative language mapping.

The left frontal aslant tract (FAT) has been proposed to be relevant for language, and specifically for spontaneous speech fluency. However, there is missing causal evidence that stimulation of the FAT affects spontaneous speech, and not language production in general. We present a series of 12 neurosurgical cases with awake language mapping of the cortex near the left FAT.

Comprehension and production of nouns and verbs in temporal lobe epilepsy.

Previous research on linguistic performance at the single-word level in patients with temporal lobe epilepsy (TLE) has mostly been limited to the comprehension and production of nouns, and findings have been inconsistent. Results are likewise limited and controversial regarding the lateralization of the epileptogenic focus. The present study investigates comprehension and production of nouns and verbs in patients with left and right TLE (12 in each group).

A novel device for hands-free positioning and adjustment of the surgical microscope.

The authors have developed a novel device, which they have named Mari, that allows hands-free utilization of the surgical microscope. The device is attached to the eyepieces of a multifunction counterweight-balanced surgical microscope and consists of a metallic holder with supportive plates that facilitate interaction between the device and surgeon's head. On the holder are installed 1) an electric switch, which allows the surgeon to release the microscope's magnetic clutches, allowing movement of the microscope along the x, y, and z axes as well as the rotational and diagonal ones, and 2) a joystick at the level of the surgeon's mouth for adjustment of focus and zoom.

Microsurgical third ventriculostomy with stenting in intrinsic brain tumors involving anterior third ventricle.

Objective: Microsurgical fenestration of the third ventricular floor performed in one session with resection of deep seated tumors has been recently demonstrated as an approach to specifically address the concomitant obstructive hydrocephalus. As with endoscopic third ventriculostomy, occlusion of the stoma may result in progression of the obstructive hydrocephalus. In order to provide reliable communication between the basal cisterns and ventricles, we propose stenting of the stoma in cases of direct surgical approach to deep seated tumors.

Intraoperative direct third ventriculostomy and aqueductal stenting in deep-seated midline brain tumor surgery.

Objective: Surgical resection of deep-seated midline brain tumors does not always resolve obstruction of cerebrospinal fluid pathways, and an additional operation--ventricular shunting--is required. To prevent postoperative obstructive hydrocephalus, we combine tumor removal and internal ventricular shunting in 1 stage.

Methods: Between 2000 and 2006, 82 patients with deep-seated midline brain tumors (tumors of the third ventricle, pineal region, thalamus, upper brainstem, and superior half of the fourth ventricle) underwent 84 tumor resections with intraoperative internal ventricular shunting.