Patterns of Failure After Linear Accelerator Radiosurgery for Cerebral Arteriovenous Malformations.

Background: Numerous studies have assessed the predictive factors for the arteriovenous malformation (AVM) response to stereotactic radiosurgery (SRS). However, only a few have discussed the causes of failure. The aim of the present study was to evaluate the patterns of failure in patients with AVM who had undergone linear accelerator SRS.

CT-scan contouring technique allows for direct and reliable measurements of the cochlear duct length: implication in cochlear implantation with straight electrode-arrays.

Objectives: The advent of hybrid electro-acoustic implants requires precise positioning of the electrode-array (EA) within the cochlea. The cochlea size, that is, the length of the cochlear scala tympani, is often indirectly estimated from distance A by Escudé's method. This technique has been confirmed by anatomical studies, in a bunch of cadaveric specimens, but it is not yet widely established in the field of computed tomography (CT).

Deep brain stimulation in five patients with severe disorders of consciousness.

Objective: The efficacy of deep brain stimulation in disorders of consciousness remains inconclusive. We investigated bilateral 30-Hz low-frequency stimulation designed to overdrive neuronal activity by dual pallido-thalamic targeting, using the Coma Recovery Scale Revised (CRS-R) to assess conscious behavior.

Methods: We conducted a prospective, single center, observational 11-month pilot study comprising four phases: baseline (2 months); surgery and titration (1 month); blind, random, crossover, 1.

Subthalamus stimulation in Parkinson disease: Accounting for the bilaterality of contacts.

Background: Deep brain stimulation (DBS) in Parkinson's disease uses bi-hemispheric high-frequency stimulation within the subthalamus, however, the specific impacts of bilaterality of DBS are still not clear. Thus, we aimed to study the individual-level clinical impact of locations of right-left contact pair-up accounting for each subthalamic nucleus (STN) anatomy.

Methods: Contact locations and effects at 1 year were studied retrospectively in an unselected series of 53 patients operated between 2004 and 2010.

Anatomy of the Spinal Meninges.

Background: The spinal meninges have received less attention than the cranial meninges in the literature, although several points remain debatable and poorly understood, like their phylogenesis, their development, and their interactions with the spinal cord. Their constancy among the chordates shows their crucial importance in central nervous system homeostasis and suggests a role far beyond mechanical protection of the neuraxis.

Objective: This work provides an extensive study of the spinal meninges, from an overview of their phylogenesis and embryology to a descriptive and topographic anatomy with clinical implications.

The value of a rapid contrast-enhanced angio-MRI protocol in the detection of head and neck paragangliomas in SDHx mutations carriers: a retrospective study on behalf of the PGL.EVA investigators.

Objectives: To assess the performance of a simplified MRI protocol consisting of a contrast-enhanced three-dimensional MR angiography (CE-MRA) in association with a post-contrast T1-weighted sequence (T1WIV) for the detection of HNPGLs in SDHx mutation carriers.

Methods: This retrospective sub-study is based on the multicenter PGL.EVA cohort, which prospectively enrolled SDHx mutation carriers from 2005 to 2009; 157 index cases or relatives were included.

Validation of a noninvasive test routinely used in otology for the diagnosis of cerebrospinal fluid shunt malfunction in patients with normal pressure hydrocephalus.

Objective: Ventriculoperitoneal shunting is the first-line treatment for normal pressure hydrocephalus. Noninvasive auditory tests based on recorded otoacoustic emissions were assessed, as currently used for universal neonatal hearing screenings, for the diagnosis of cerebrospinal fluid shunt malfunction. The test was designed based on previous works, which demonstrated that an intracranial pressure change induces a proportional, characteristic, otoacoustic-emission phase shift.

Use of a prototype radioprotection cabin in vascular neuroradiology: Dosimetry and ergonomics.

Objectives: The aim of this work was to compare the performance of a prototype radioprotection cabin in interventional neuroradiology, and to assess its suitability for routine use.

Materials And Methods: The radioprotection cabin was a prototype derived from the CATHPAX AF(®) model. Three operators carried out 21 procedures (19 brain arteriographies and 2 embolizations) using the radioprotection cabin and not wearing the usual lead individual protection equipment (IPE), and 17 procedures (16 brain arteriographies and 1 embolization) wearing the standard lead IPE (vest, skirt, thyroid shield and goggles), and not using the radioprotection cabin.

Cochlear implantation through the round window with a straight slotted electrode array: optimizing the surgical procedure.

The question addressed here is how optimizing the quality of insertion through the round window with the lower morbidity, when using a straight and slotted electrode array of regular length. This retrospective analysis includes all cases implanted with a cochlear implant Digisonic SP (Neurelec-Oticon Medical) since 2004. We checked the operative charts, the depth of insertion, and the follow-up.

Interest of local intra-arterial fibrinolysis in acute central retinal artery occlusion: Clinical experience in 16 patients.

Objective: Central retinal artery occlusion (CRAO) is a rare disease with poor visual prognosis. We evaluated clinical effectiveness of in situ fibrinolysis with original angiographic scores describing the aspect of carotid siphon, proximal ophthalmic artery, and choroid blush.

Methods: Retrospective study of 16 consecutive cases of CRAO between 2007 and 2013.

Vasospasm of labyrinthine artery in cerebellopontine angle surgery: evidence brought by distortion-product otoacoustic emissions.

In cerebellopontine angle (CPA) surgery, postoperative deafness can be due to alteration of cochlear blood flow that is supplied by the labyrinthine artery (LA). In particular, vasospasm is likely to occur and, if so, can be reversed. This work attempted to track down vascular events occurring during CPA surgery.

Maps of the adult human hypothalamus.

The human hypothalamus is a small deeply located region placed at the crossroad of neurovegetative, neuroendocrine, limbic, and optic systems. Although deep brain stimulation techniques have proven that it could be feasible to modulate these systems, targeting the hypothalamus and in particular specific nuclei and white bundles, is still challenging. Our goal was to make a synthesis of relevant topographical data of the human hypothalamus, under the form of magnetic resonance imaging maps useful for mastering its elaborated structure as well as its neighborhood.

Direct stereotactic targeting of the ventrointermediate nucleus of the thalamus based on anatomic 1.5-T MRI mapping with a white matter attenuated inversion recovery (WAIR) sequence.

Background: The ventrointermediate nucleus (Vim) of the thalamus is still considered "invisible" on current magnetic resonance imaging (MRI), requiring indirect methods based on stereotactic atlases for estimation of its location. Direct visualization of Vim is desirable to improve targeting.

Objective: To evaluate the ability of Inversion-Recovery 1.

Anatomy of the human thalamus based on spontaneous contrast and microscopic voxels in high-field magnetic resonance imaging.

Background: Since the pioneering studies of human thalamic anatomy based on histology and binding techniques, little new work has been done to bring this knowledge into clinical practice.

Objective: With the advent of magnetic resonance imaging (MRI) we hypothesized that it was possible, in vitro, to make use of high spontaneous MRI contrasts between white and grey matter to directly identify the subcompartmentalisation of the thalamus.

Methods: An anatomic specimen was imaged at high field (4.

Subthalamic nucleus location: relationships between stereotactic AC-PC-based diagrams and MRI anatomy-based contours.

Subthalamic nucleus (STN) targeting is classically performed based on AC-PC probabilistic position. Nevertheless, MRI allows direct visualization and targeting. We aimed to compare the position localized on MR images with standard stereotactic diagrams.

Contact position analysis of deep brain stimulation electrodes on post-operative CT images.

Purpose: Groups performing deep brain stimulation advocate post-operative imaging [magnetic resonance imaging (MRI) or computer tomography (CT)] to analyse the position of each electrode contact. The artefact of the Activa 3389 electrode had been described for MRI but not for CT. We undertook an electrode artefact analysis for CT imaging to obtain information on the artefact dimensions and related electrode contact positions.

Acute abscess of the base of the tongue: a rare but important emergency.

Background: Acute posterior lingual abscess is rare, but may potentially compromise the airway acutely.

Objective: Lingual abscesses call for prompt and aggressive management because they are potentially life-threatening infections. Anterior lingual abscess (the most common) and posterior third lingual abscess must be differentiated.

Brain mapping in stereotactic surgery: a brief overview from the probabilistic targeting to the patient-based anatomic mapping.

In this article, we briefly review the concept of brain mapping in stereotactic surgery taking into account recent advances in stereotactic imaging. The gold standard continues to rely on probabilistic and indirect targeting, relative to a stereotactic reference, i.e.

Rapidly developing leptomeningeal carcinomatosis following anterior skull base surgery: a case report.

Leptomeningeal carcinomatosis is rare in evolution of head and neck cancers. Prognosis is poor and treatment is through supportive care. We report an atypical rapid post-operative leptomeningeal carcinomatosis after skull base resection for an ethmoidal adenocarcinoma.

A multicenter study of 705 ruptured intracranial aneurysms treated with Guglielmi detachable coils.

Background And Purpose: The long-term durability of Guglielmi detachable coil (GDC) embolization of cerebral aneurysms is still unknown. The purpose of this study was to evaluate the stability of anatomic occlusion of aneurysms treated with GDCs and assess the rate of recanalization and re-treatment.

Methods: A multicenter study involving 650 patients with 705 ruptured aneurysms treated with GDCs between January 1998 to May 2003 was conducted.