Bedside Sonographic Duplex Technique as a Monitoring Tool in Patients after Decompressive Craniectomy: A Single Centre Experience.

Background And Objectives: Bedside sonographic duplex technique (SDT) may be used as an adjunct to cranial computed tomography (CCT) to monitor brain-injured patients after decompressive craniectomy (DC). The present study aimed to assess the value of SDT in repeated measurements of ventricle dimensions in patients after DC by comparing both techniques.

Materials And Methods: Retrospective assessment of 20 consecutive patients after DC for refractory intracranial pressure (ICP) increase following subarachnoid hemorrhage (SAH), bleeding and trauma which were examined by SDT and CCT in the context of routine clinical practice.

Systematic evaluation of stroke thrombectomy in clinical practice: The German Stroke Registry Endovascular Treatment.

Background: Endovascular treatment has become standard of care for the treatment of acute ischemic stroke with large vessel occlusion. However, patients treated in clinical practice differ from the selected populations randomized in clinical trials.

Aims: The German Stroke Registry Endovascular Treatment (GSR-ET) aims at a systematic evaluation of outcome, safety, and process parameters of endovascular stroke treatment in standard of care in Germany.

Cerebral Ventricular Dimensions After Decompressive Craniectomy: A Comparison Between Bedside Sonographic Duplex Technique and Cranial Computed Tomography.

Background: The objective of this study was to assess and compare ventricle diameters in patients after decompressive craniectomy by using cranial computed tomography (CCT) versus sonographic duplex technique (SDT).

Methods: A total of 102 consecutive patients after decompressive craniectomy following brain infarct, bleeding and trauma were examined by CCT and SDT. SDT was performed within 24 h after repeated postinterventional control CCT and the correlation between both methods was assessed via measurement of dimensions of all four ventricles.

Remote effects of hippocampal damage on default network connectivity in the human brain.

In the healthy human brain the hippocampus is known to work in concert with a variety of cortical brain regions. It has recently been linked to the default network of the brain, with the precuneus being its core hub. Here we studied the remote effects of damage to the hippocampus on functional connectivity patterns of the precuneus.

Reduced interhemispheric hippocampal BOLD signal coupling related to early epilepsy onset.

In order to investigate the factors influencing interhemispheric hippocampal connectivity we used fMRI to assess the time course of hippocampal activity during a spatial memory task. Data were obtained from 14 patients with unilateral hippocampal sclerosis and focal unilateral medial temporal lobe epilepsy. Correlation coefficients between left and right hippocampal BOLD signal fluctuations were determined in each patient as a measure for interhemispheric hippocampal coupling.

Thinking around the corner: the development of planning abilities.

The ability to plan and search ahead is essential for problem solving in most situations in everyday life. To investigate the development of planning and related processes, a sample of four- and five-year-old children was examined in a variant of the Tower of London, a frequently used neuropsychological assessment tool of planning abilities. The applied problems either required searching ahead for optimal solution or were solvable by pure step-by-step forward processing.

Testing the diagnostic value of electrical ear canal stimulation in cochlear implant candidates by functional magnetic resonance imaging.

Prior to cochlear implant (CI) surgery in children, the integrity of the auditory pathway is sometimes assessed by electrical ear canal stimulation (ECS). However, the evaluation of reactions as auditory is subjective. To test the prognostic value of ECS, functional magnetic resonance imaging (fMRI) was performed during ECS vicariously in 18 adult CI candidates.

Occurrence of a germinoma 22 years after resection of a mature cerebral teratoma.

We present the rare case of a 31-year-old man who developed a germinoma 22 years after resection of a mature teratoma of the pineal region. The initial stereotactic biopsy showed a granulomatous inflammation, but no malignant cells. The correct diagnosis could only be confirmed in a second cerebral biopsy, allowing for proper treatment with radiation therapy.

Differential effect of side of temporal lobe epilepsy on lateralization of hippocampal, temporolateral, and inferior frontal activation patterns during a verbal episodic memory task.

The encoding of verbal stimuli elicits left-lateralized activation patterns within the medial temporal lobes in healthy adults. In our study, patients with left- and right-sided temporal lobe epilepsy (LTLE, RTLE) were investigated during the encoding and retrieval of word-pair associates using functional magnetic resonance imaging. Functional asymmetry of activation patterns in hippocampal, inferior frontal, and temporolateral neocortical areas associated with language functions was analyzed.

Hippocampal functional connectivity reflects verbal episodic memory network integrity.

Using functional magnetic resonance imaging during a verbal memory task, we investigated correlations of signal fluctuations within the hippocampus and ipsilateral frontal as well as temporal areas in temporal lobe epilepsy patients. Declarative memory abilities were additionally examined before and after temporal lobe epilepsy surgery. A significant difference exists in functional connectivity between patients whose mnemonic functions deteriorated and those who remained stable or improved.

Functional neuroimaging of emotional learning and autonomic reactions.

This article provides a selective overview of the functional neuroimaging literature with an emphasis on emotional activation processes. Emotions are fast and flexible response systems that provide basic tendencies for adaptive action. From the range of involved component functions, we first discuss selected automatic mechanisms that control basic adaptational changes.

Precuneus is involved in allocentric spatial location encoding and recognition.

Using a declarative memory paradigm, the anatomical correlates of spatial location encoding and retrieval in the healthy human brain as reflected by BOLD fMRI were investigated. During encoding, subjects were instructed to view and keep in mind different locations of an object on a platform seen from different viewpoints in virtual 3D. In retrieval trials, subjects had to recognize previously learned object locations.

Gender-related differences in lateralization of hippocampal activation and cognitive strategy.

Gender-related differences in brain activation patterns and their lateralization associated with cognitive functions have been reported in the field of language, emotion, and working memory. Differences have been hypothesized to be due to different cognitive strategies. The aim of the present study was to test whether lateralization of brain activation in the hippocampi during memory processing differs between the sexes.

Enhanced visualization of blurred gray-white matter junctions in focal cortical dysplasia by voxel-based 3D MRI analysis.

Purpose: Focal cortical dysplasia (FCD), a frequent cause of partial epilepsy, is often associated with blurring of the gray-white matter junction in magnetic resonance images (MRI). To improve the recognition and delineation of FCD we developed a novel voxel-based image post-processing method for enhanced visualization of blurred gray-white matter junctions.

Methods: Using standard algorithms of statistical parametric mapping software (SPM99) a T1-weighted MRI volume data set is normalized and segmented.

The reliability of fMRI activations in the medial temporal lobes in a verbal episodic memory task.

The test-retest reliability of activation patterns elicited by encoding and recognition of word-pair associates within the whole brain and a predefined medial temporal region of interest (ROI) was investigated. Twenty healthy right-handed subjects were studied within two sessions, either on the same day or 210-308 days later. Three quantitative measures of reliability were calculated for the contrasts encoding and recognition versus a control condition within the ROI and also for the whole brain: A group correlational analysis between the lateralization indices of the first and second session, correlations of the individual SPM(t) maps of the first and the second run, and overlap ratios between both sessions.

Rapid and fully automated visualization of subdural electrodes in the presurgical evaluation of epilepsy patients.

For rapid visualization of subdural electrodes with respect to cortical and subcortical structures, we describe a novel and fully automated method based on coregistration, normalization, optional cerebellum masking, and volume rendering of 3D MR imaging data taken before and after implantation. The key step employs the skull-stripped preimplantation image as a mask to also remove the skull in the postimplantation image. The extracted brain is presented in 3D with the electrodes directly visible by their susceptibility artifacts.

The brain tumor board: lessons to be learned from an interdisciplinary conference.

Background: The aim of this study is to analyze the work of the interdisciplinary Brain Tumor Board (BTB) which was established at Freiburg University Hospital in 1998.

Patients And Methods: From January 1998 to December 2003, a total of 1,516 patients were discussed in 259 meetings of the BTB. The protocols of the BTB were analyzed retrospectively.

Activation of cortical areas in music execution and imagining: a high-resolution EEG study.

Neuroimaging studies have shown that execution of a musical sequence on an instrument activates bilateral frontal opercular regions, in addition to bilateral sensorimotor and supplementary motor areas. During imagining activation of the same areas without primary sensorimotor areas was shown. We recorded EEG from 58 scalp positions to investigate the temporal sequence and the time course of activation of these areas while violin players prepared to execute, executed, prepared to imagine, or imagined a musical sequence on a violin.

Dynamic contrast enhancement of paragangliomas of the head and neck: evaluation with time-resolved 2D MR projection angiography.

Our objective was to evaluate tumor hemodynamics of paragangliomas of the head and neck. A 2D magnetic resonance projection angiography (MRPA) protocol was developed. Six patients with histologically proven paragangliomas were included in the study.

Activation of a residual cortical network during painful stimulation in long-term postanoxic vegetative state: a 15O-H2O PET study.

Survivors of prolonged cerebral anoxia often remain in the persistent vegetative state (PVS). In this study, long-term PVS patients were investigated by 15O-H(2)O PET to analyze their central processing of pain. The study was approved by the local Ethics Committee, the experiments were performed in accordance with the Helsinki Declaration of 2000.

Reasoning and working memory: common and distinct neuronal processes.

The neuronal processes underlying reasoning and the related working memory subsystems were examined with functional magnetic resonance imaging (fMRI). Twelve volunteers solved relational reasoning problems which either supported a single (determinate) or several alternative solutions (indeterminate). In a second condition, participants maintained the identical premises of these problems in working memory without making inferences.

Wegener granuloma in the fourth ventricle.

We report the case of a 57-year-old man with a known history of antineutrophil cytoplasmic antibody-positive Wegener granulomatosis with initial involvement of the upper and lower respiratory tract. MR imaging of the brain was performed because of new onset CNS symptoms (nausea, altered mental status). The images revealed a mass in the fourth ventricle.

Primary stenting as emergency therapy in acute basilar artery occlusion.

In three patients with acute occlusion of the basilar artery intra-arterial fibrinolysis resulted in only partial recanalization and revealed severe stenosis as the underlying cause. Application of micro-stents without previous dilatation resulted in vessel re-opening. Two patients had an excellent clinical outcome.