Deep brain stimulation and development of a high-grade glioma: incidental or causal association?

We report the case of a patient in whom 8.8 years following the implantation of a bilateral deep brain stimulation (DBS) into the Vim, a high-grade glioma was diagnosed in close proximity to the two electrode leads. A possible relationship between the permanent DBS and the development of the brain tumour is discussed.

[The neurosurgical therapy of trigeminal neuralgia].

The Trigeminal Neuralgie (TN) is he most common cause of facial pain with an incidence of 27 per 100'000 patients per year. The symptoms are paroxysmal stabbing, tearing, and burning pain usually in the area of the second and third trigeminal nerve, that can be provoked by drinking, shaving, chewing or talking. If the classical drug therapy with anticonvulsants is not sufficient or must be discontinued due to side effects, then the retrosigmoidal craniotomy and micro-vascular decompression in vascular-nerve-contact ot partial rhizotomy are good pain-free procedures.

Acute treatment with red wine polyphenols protects from ischemia-induced excitotoxicity, energy failure and oxidative stress in rats.

Red wine polyphenolic compounds (RWPC) possess numerous neuroprotective activities that may be beneficial for treating cerebral ischemia. To investigate the in vivo effects of an acute treatment with RWPC during stroke, male Wistar rats were subjected to transient ischemia for 90 min and immediately treated with RWPC. The extracellular concentrations of excitatory amino acids, free radical scavengers and energy metabolites during occlusion and reperfusion were monitored using microdialysis.

Hypothermia reduces early hypoperfusion and metabolic alterations during the acute phase of massive subarachnoid hemorrhage: a laser-Doppler-flowmetry and microdialysis study in rats.

Morbidity and mortality of subarachnoid hemorrhage (SAH) are correlated with the severity of the patient's acute neurological deficit. This initial presentation has been attributed to cerebral hypoperfusion in the acute phase, and we investigated the impact of moderate hypothermia on the early changes in perfusion and metabolism following massive experimental SAH. SAH was induced in 61 anesthetized rats by rapid injection of 0.

Chronic treatment with red wine polyphenol compounds mediates neuroprotection in a rat model of ischemic cerebral stroke.

In this study, we investigated the in vivo effects of red wine polyphenol compounds (RWPC) in rats that were submitted to middle cerebral occlusion as an experimental model of stroke. Male Wistar rats were given RWPC [30 mg/(kg x d) dissolved in drinking water] or water for 1 wk before being subjected to transient middle cerebral artery occlusion followed by reperfusion. Sham-operated rats were subjected to transient occlusion in which the filament was not completely introduced.

Effects of isoflurane on glutamate and taurine releases, brain swelling and injury during transient ischemia and reperfusion.

The volatile anesthetic agent isoflurane was thought to provide neuroprotection against ischemic damage; however, this effect remains controversial. Using the middle cerebral artery occlusion model and intracerebral microdialysis, the authors monitored the variations of glutamate and taurine concentrations in the extra-cellular space in male rats anesthetized with pentobarbital or isoflurane. Brain injury and edema were evaluated 24 h after ischemia.

Acute effects of 17beta-estradiol on the extracellular concentration of excitatory amino acids and energy metabolites during transient cerebral ischemia in male rats.

Elevation of extracellular levels of amino acids has been implicated in the pathogenesis of stroke. The failure of brain energy metabolism due to the lack of oxygen and glucose contributes also to cell loss. Estrogen has been shown to protect brain cells against ischemia by a still unclear mechanism.

Clinical outcome of standard extracranial-intracranial bypass surgery in patients with symptomatic atherosclerotic occlusion of the internal carotid artery.

Objective: In this retrospective study we wanted to determine the role of cerebral revascularization in patients with symptomatic occlusive cerebrovascular disease. Special emphasis was put on subsequent cerebrovascular events, benefit in neurological functioning and bypass patency, as evaluated during the follow-up period.

Methods: A total of 73 superficial temporal artery to the middle cerebral artery bypasses were performed on 67 patients from 1986-2000.

17beta-estradiol effect on the extracellular concentration of amino acids in the glutamate excitotoxicity model in the rat.

Estrogen has demonstrated a neuroprotective role in a rat model of glutamate excitotoxicity and other neurodegenerative disorders. We studied the effect of 17beta-estradiol on glutamate-induced increases in amino acids levels (aspartate, histidine, taurine and GABA) in the rat cortex. Local perfusion of glutamate produced a transient increase of aspartate, histidine, taurine and GABA in the extracellular fluid.

Effect of 17 beta-estradiol on the brain damage and metabolic changes in rats.

An in vivo model of glutamate excitotoxicity in which glutamate is applied to the cortex of rats through a microdialysis probe has been used to investigate the neuroprotective processes initiated by 17 beta-estradiol. Rats were pre-treated with 17 beta-estradiol i.v.

Extracellular levels of glucose and lactate measured by quantitative microdialysis in the human brain.

The aim of this study was to use quantitative microdialysis to estimate the true extracellular concentrations of glucose and lactate in minimally disturbed human brain. These values are important as criteria for microdialytical monitoring in critical care patients and for determining therapy. Microdialysis procedures were carried out during tumor operations, the probe being inserted distant from the site of manipulation in minimally disturbed tissue.

Microdialytical monitoring of uric and ascorbic acids in the brains of patients after severe brain injury and during neurovascular surgery.

Objectives: Microdialysis has been extensively used to monitor brain metabolism in the extracellular fluid of patients with severe head injury, to detect the onset of secondary ischaemic damage. The aim was to investigate whether concentrations of uric and ascorbic acids were altered in such patients. Both these compounds play a part in free radical metabolism, which is accelerated after ischaemia and brain injury.

17beta-Estradiol reduces cortical lesion size in the glutamate excitotoxicity model by enhancing extracellular lactate: a new neuroprotective pathway.

Estrogens play an important role in neuronal function and in protecting neurones in the cerebral cortex against pathological conditions. An in vivo model of glutamate excitotoxicity in which glutamate is applied to the cortex of rats through a microdialysis probe has been used to investigate the neuroprotective processes initiated by 17beta-estradiol. Rats were pre-treated with 17beta-estradiol (i.

Microdialysis: intraoperative and posttraumatic applications in neurosurgery.

Microdialysis offers a unique opportunity to study the extracellular human brain environment. Our aim was to improve the ability to detect neuronal injury in patients undergoing complicated neurovascular procedures and to detect secondary brain lesions after severe head injury with the use of in vivo microdialytic monitoring. We employed intraoperative microdialysis monitoring in patients with a variety of neurovascular procedures including high-flow and low-flow bypass surgery and aneurysm clipping.

A four lumen screwing device for multiparametric brain monitoring.

We describe multiparametric monitoring in severe head trauma using a new screwing device. Our aim was to create a screw which would make the implantation of the probes and thus multiparametric monitoring easier. The new screw allows us to implant 3 probes (microdialysis, Paratrend and an intracranial pressure device) through one burr hole.

An increase in extracellular glutamate is a sensitive method of detecting ischaemic neuronal damage during cranial base and cerebrovascular surgery. An in vivo microdialysis study.

All patients undergoing neurological surgery are at risk for serious complications. Ischaemic damage presenting with hemiparesis or speech difficulties occurs in up to 6% of patients undergoing cerebral bypass procedures and other complicated neurosurgical procedures. Currently available methods for detection of such damage include the use of somatosensory evoked potentials (SSEPs) and electro-encephalography (EEG).

Cortical brain microdialysis and temperature monitoring during hypothermic circulatory arrest in humans.

Objectives: Critical vascular surgery of the brain or the heart occasionally requires total cessation of the circulatory system. Profound hypothermia is used to protect the brain from ischaemic injury. This study explores the use of microdialysis to measure metabolic indices of ischaemia: glutamate, lactate, and pH, and cerebral temperature during profound hypothermia and circulatory arrest.

Intraoperative on-line monitoring of cerebral pH by microdialysis in neurosurgical procedures.

The objective of this study was to improve the ability to detect cerebrovascular complications in patients undergoing complicated neurosurgical procedures using on-line monitoring of cerebral pH with in vivo microdialysis. We employed on-line pH monitoring in patients with a variety of neurosurgical procedures including high-flow bypass surgery, aneurysm clipping, and temporal resection in epilepsy treatment. The pH was monitored with a microdialysis probe, usually inserted into the frontal cortex and pH of the dialysate was measured on-line with a pH electrode.

EC-IC bypass improves chronic ischemia in a patient with moyamoya disease secondary to sickle cell disease: an in vivo microdialysis study.

Patients with sickle cell disease may develop intracranial vascular disease, with the occlusion or obstruction of the large or small arteries, which may lead to the secondary development of moyamoya disease. In this report, we describe the neurochemical changes in the brain before, during, and after an extracranial-intracranial bypass procedure on a patient with sickle cell disease and a moyamoya disease like pattern on angiography. We used the in vivo microdialysis technique to measure the on-line pH, lactate and amino acid concentrations in the extracellular fluid.

Microdialytic monitoring during cerebrovascular surgery.

Using microdialysis, levels of metabolites in the extracellular fluid of the cerebral cortex were monitored during neurovascular surgery (9 aneurysm and 5 extra-intracranial bypass operations). Our aim was to use microdialysis to detect any local ischemia which might be caused by brain retraction or temporary clipping. Parameters were therefore quantified whose levels in the dialysate are known to be influenced by ischemia (on-line pH, ascorbic acid, uric acid, glutathione, cysteine, glucose, lactate, glucose:lactate ratio).

Molecular neuroanatomy of human monoamine oxidases A and B revealed by quantitative enzyme radioautography and in situ hybridization histochemistry.

Monoamine oxidases are key enzymes in the metabolism of amine neurotransmitters and neuromodulators and are targets for drug therapy in depression, Parkinson's and Alzheimer's diseases. Knowledge of their distribution in the brain is essential to understand their physiological role. To study the regional distribution and abundance of monoamine oxidases A and B in human brain, pituitary and superior cervical ganglion, we used quantitative enzyme radioautography with radioligands [3H]Ro41-1049 and [3H]lazabemide, respectively.

Microdialytic monitoring during a cardiovascular operation.

In an aorta-coronary bypass operation, the heart is excluded from the circulation for many minutes, leading to ischemia. During this time the heart is cooled in order to mitigate damage. Microdialysis has been shown to be very suitable for detecting ischaemic changes e.

A new screwing device for fixing a microdialysis probe in critical care patients.

We describe a new, easy method which extends the use of clinical microdialysis to neurotrauma patients who primarily do not need a decompressing surgical intervention. In all head trauma patients in whom a Camino ICP-monitor is indicated a second hole (2 mm in diameter) is made, and the MD probe is fixed using the new screwing device. Before clinical use the system was tested during postmortem, confirming correct cortical placement of the probe in almost all cases.