Purpose: In resective epilepsy surgery for drug-resistant focal epilepsy (DRE), good seizure outcome is strongly associated with visualization of an epileptogenic lesion on MRI. Standard clinical MRI (≤ 3 Tesla (T)) may fail to detect subtle lesions. 7T MRI enhances detection and delineation, the potential benefits of increasing field strength to 9.
View Article and Find Full Text PDFIntroduction: Headholders or skull clamps serve as indispensable tools in neurosurgery, facilitating the precise positioning and stabilization of the head for surgery. The realm of neurosurgical training in cadaver labs presents a clear challenge due to the lack of suitable non-clinical headholders.
Research Question: We describe a 3D printed stainless-steel headholder for use in neurosurgical cadaver lab training.
Background And Purpose: Higher magnetic field strength introduces stronger magnetic field inhomogeneities in the brain, especially within temporal lobes, leading to image artifacts. Particularly, T2-weighted fluid-attenuated inversion recovery (FLAIR) images can be affected by these artifacts. Here, we aimed to improve the FLAIR image quality in temporal lobe regions through image processing of multiple contrast images via machine learning using a neural network.
View Article and Find Full Text PDFIntroduction: Intracranial multiple myeloma (MM) is a rare manifestation of MM, a malignant plasma cell disorder that primarily affects bone marrow. Dural involvement in MM is even rarer and can manifest as a dural mass. We present a case of MM presenting as an intracranial dural tumor with primary hemi-dural involvement.
View Article and Find Full Text PDFTemporal lobe epilepsy (TLE) is increasingly associated with blood-brain barrier dysfunction and microvascular alterations, yet the pathophysiological link is missing. An important barrier function is exerted by the glycocalyx, a gel-like layer coating the endothelium. To explore such associations, we used intraoperative videomicroscopy to quantify glycocalyx and microcirculation properties of the neocortex and hippocampus of 15 patients undergoing resective brain surgery as treatment for drug-resistant TLE, and 15 non-epileptic controls.
View Article and Find Full Text PDFFocal epilepsy is a common and severe neurologic disorder. Neuroimaging aims to identify the epileptogenic zone (EZ), preferably as a macroscopic structural lesion. For approximately a third of patients with chronic drug-resistant focal epilepsy, the EZ cannot be precisely identified using standard 3.
View Article and Find Full Text PDFPurpose: Resective epilepsy surgery is a well-established, evidence-based treatment option in patients with drug-resistant focal epilepsy. A major predictive factor of good surgical outcome is visualization and delineation of a potential epileptogenic lesion by MRI. However, frequently, these lesions are subtle and may escape detection by conventional MRI (≤ 3 T).
View Article and Find Full Text PDFJ Cereb Blood Flow Metab
October 2021
The blood-brain barrier (BBB) is dysfunctional in temporal lobe epilepsy (TLE). In this regard, microvascular changes are likely present. The aim of this review is to provide an overview of the current knowledge on microvascular changes in epilepsy, and includes clinical and preclinical evidence of seizure induced angiogenesis, barriergenesis and microcirculatory alterations.
View Article and Find Full Text PDFRationale: Resective epilepsy surgery is an evidence-based curative treatment option for patients with drug-resistant focal epilepsy. The major preoperative predictor of a good surgical outcome is detection of an epileptogenic lesion by magnetic resonance imaging (MRI). Application of ultra-high field (UHF) MRI, i.
View Article and Find Full Text PDFBackground: Since the International Subarachnoid Aneurysm Trial, coiling has been favored over clipping for intracranial aneurysms, resulting in selection of increasingly complex aneurysm configurations for clipping. We present the outcomes of clipping of aneurysms not suitable for coiling, with transit time flowmetry technology to aid monitoring of intraoperative flow.
Methods: All consecutive patients surgically treated for intracranial aneurysms were included.
Holocene drift-sand activity in the northwest European sand belt is commonly directly linked to population pressure (agricultural activity) or to climate change (e.g. storminess).
View Article and Find Full Text PDFBackground: Anterior temporal lobectomy (ATL) as a treatment for drug-resistant temporal lobe epilepsy (TLE) frequently causes visual field deficits (VFDs). Reported VFD encompasses homonymous contralateral upper quadrantanopia. Its reported incidence ranges from 15 to 90%.
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