Safety and Accuracy of Ultrasound-guided Burr Hole Brain Abscess Aspiration.

Background:  Ultrasound-guided burr hole biopsies or catheter placements are quick and safe procedures. The use of these procedures for treatment of brain abscesses has been reported, but larger series are missing. The aim of our study was to evaluate the accuracy and safety of the methods.

Polyether Ether Ketone Cranioplasties Are Permeable to Diagnostic Ultrasound.

It is a common assumption that the human skull and solid skull implants are impermeable to diagnostic ultrasound. We demonstrated in 2 patients that frontoparietal polyetheretherketone cranioplasties allowed useful imaging of intracranial parenchymal and vascular structures with higher ultrasound frequencies than the 2 MHz used for the temporal bone window. This knowledge about additional imaging properties may be helpful in emergency situations and for vascular monitoring.

Differential somatostatin, CXCR4 chemokine and endothelin A receptor expression in WHO grade I-IV astrocytic brain tumors.

Purpose: Glioblastomas represent the most common primary malignant tumor of the nervous system and the most frequent type of astrocytic tumors. Despite improved therapeutic options, prognosis has remained exceptionally poor over the last two decades. Therefore, new treatment approaches are urgently needed.

The value of intraoperative ultrasonography during the resection of relapsed irradiated malignant gliomas in the brain.

Purpose: The aim of this study was to investigate whether intraoperative ultrasonography (IOUS) helped the surgeon navigate towards the tumor as seen in preoperative magnetic resonance imaging and whether IOUS was able to distinguish between tumor margins and the surrounding tissue.

Methods: Twenty-five patients suffering from high-grade gliomas who were previously treated by surgery and radiotherapy were included. Intraoperatively, two histopathologic samples were obtained a sample of unequivocal tumor tissue (according to anatomical landmarks and the surgeon's visual and tactile impressions) and a small tissue sample obtained using a navigated needle when the surgeon decided to stop the resection.

Real-time ultrasound monitoring during intracranial needle biopsies: operative results and detection of complications in 100 cases.

Objective: Intraoperative ultrasound displays dynamic processes intraoperatively. Performing burr-hole biopsies under a real-time visual control is an interesting option for the neurosurgeon. However, the percentage of conclusive diagnoses obtained by this technique and the rate of complications must be evaluated in a larger series.

Irrigation can cause prolonged intracranial pressure elevations during endoscopic treatment of intraventricular haematomas.

Background: Irrigation may elevate the intracranial pressure (ICP) during neuroendoscopic procedures. It is unlikely that rinsing the ventricles during routine endoscopic ventriculostomy causes persistent neurological impairment or damage, but procedures such as the endoscopic evacuation of intraventricular haematomas (IVH) are performed in patients who may be prone to elevated ICP. We report a series of such patients in which we measured the ICP intraoperatively.

An ultrasound study of brain tissue biomechanics in patients following craniectomy.

So far, little attention has been paid to the biomechanical aspects of decompressive craniectomy. The brain tissue deformation occurring in these patients is difficult to quantify. Twenty-six patients suffering from a large bone defect after craniectomy were examined in supine position.

A remote control for intraoperative ultrasound--is it really necessary?

Background: A remote control, which can be used to manipulate the scanner functions remotely from within the sterile field, is designed to save time during IOUS. This study was designed to evaluate whether the time saved by using a remote control should be a decisive factor in buying a special system.

Methods: During 50 intracranial operations, the temporary arrest of the operative procedure caused by the use of ultrasound was measured.

Lumbar subdural haematoma after temporomesial resection in epilepsy patients--report of two cases and review of the literature.

We present two cases of lumbar subdural haematoma, both occurring after an uneventful temporomesial focus resection in patients suffering from medically intractable epilepsy. Initial symptom was back pain and sciatica 4 days and 13 days postoperatively, but no neurological deficits were observed. The diagnosis was confirmed by MRI.

Epidermal growth factor receptor inhibition for the treatment of glioblastoma multiforme and other malignant brain tumours.

Gliomas are the most common primary central nervous system tumours and about 55% are glioblastoma multiforme (GBM). Between 40% and 50% of GBM have dysregulated epidermal growth factor receptor (HER1/EGFR), and almost half of these co-express the mutant receptor subtype EGFRvIII, which may contribute to the aggressive and refractory course of GBM. Limited therapeutic options exist for GBM, and recurrence is common.

Successful treatment of multiple Pseudallescheria boydii brain abscesses and ventriculitis/ependymitis in a 2-year-old child after a near-drowning episode.

Rationale: We report on a cerebral infection by Pseudallescheria boydii in a 21-month-old boy after a near-drowning episode. MRI revealed multiple (> 60) intracerebral abscesses.

Methods: The surgical therapy included CSF drainage and microsurgical resection of one abscess for microbiological diagnosis.

Malignant ectomesenchymoma of the cerebrum. Case report and discussion of therapeutic options.

Unlabelled: Malignant ectomesenchymoma is a rare tumour that contains both ectodermal and mesenchymal elements. Only three patients with a manifestation in the cerebrum and clinicopathological data have been reported until now. We present a patient with an intracerebral ectomesenchymoma, review the literature and discuss currently available therapeutic options.

Trigeminal evoked potentials and sensory deficits in atypical facial pain--a comparison with results in trigeminal neuralgia.

Trigeminal evoked potentials (TEPs) and sensory deficits in eighty-three patients admitted for first surgical treatment of facial pain were retrospectively analysed. Thirty-seven patients suffered from trigeminal neuralgia (TN), 10 from symptomatic TN (sTN), and 36 from atypical facial pain (AFP). Eighteen percent of the TN patients reported sensory deficits on the pain side, but 35% had delayed ipsilateral N13 waves.

Blood flow velocities in the basal cerebral vein after head trauma: a prospective study in 82 patients.

Background And Purpose: The authors' aim was to evaluate the time course of the basal vein's (BVR) mean flow velocity (VBVR) in patients after traumatic brain injury and its relation to intracranial pressure (ICP), cerebral perfusion pressure (CPP), and the clinical outcome.

Methods: In 82 head-injured patients (13 women and 69 men, median age = 31 years, Glasgow Coma Score = 15 to 3), daily measurement of the basal cerebral vein's and the middle cerebral artery's (MCA) flow velocities and pulsatilities was performed during each patient's entire stay in the intensive care unit. No angle correction was performed.

[Trigeminal neuralgia as symptom of an infratentorial space-occupying process].

Unlabelled: Despite excellent technical means of imaging the posterior fossa by magnetic resonance imaging (MRI), some infratentorial space-occupying processes still remain undiscovered, especially if they present only slight symptoms or imitate typical different diseases.

Methods: We analysed the data of 334 patients who were admitted because of infratentorial space-occupying processes in the years 1986 to 1995.

Results: There were six patients with trigeminal neuralgia caused by infratentorial tumors.