Intracranial multimodal monitoring in neurocritical care (Neurocore-iMMM): an open, decentralized consensus.

Background: Intracranial multimodal monitoring (iMMM) is increasingly used in neurocritical care, but a lack of standardization hinders its evidence-based development. Here, we devised core outcome sets (COS) and reporting guidelines to harmonize iMMM practices and research.

Methods: An open, decentralized, three-round Delphi consensus study involved experts between December 2023 and June 2024.

Erosion of the temporal bone by vestibular schwannoma: morphometrics and predictive modeling.

Purpose: To perform a comprehensive morphometric analysis of vestibular schwannomas (VS) using multimodal imaging, focusing on the relationship between tumor characteristics and internal acoustic canal (IAC) changes.

Methods: We analyzed a cohort of patients undergoing radiosurgery for VS, utilizing high-definition MRI and bone CT for detailed anatomical assessment. Image co-registration and fusion techniques were employed to examine VS and IAC dimensions.

Deviation of DBS Recording Microelectrodes during Insertion Assessed by Intraoperative CT.

Introduction: Intraoperative microelectrodes recording with the Ben Gun microdrive system are often used during DBS surgery. An accurate location of these microelectrodes will directly influence the interest of this recording. We have studied the imprecision of implantation of these microelectrodes.

MRI Changes in Failed Radiosurgery for Vestibular Schwannomas.

Introduction: Radiosurgery is now a recognized treatment of vestibular schwannoma (VS); however, radiosurgical irradiation sometimes fails to stop tumor growth in the long term. Some changes in MR imaging after radiosurgery that are supposed to be related to permanent tumor control may be observed in patients with failed treatment. The objective of the present study was to evaluate the MRI changes observed early after radiosurgery in a cohort of patients with failed radiosurgery for VS.

Application of morphological characteristics of radiofrequency lesions to individual parameters of thermal rhizolysis for trigeminal neuralgia.

Background: Thermic rhizolysis is a reliable therapy for pharmaco-resistant trigeminal neuralgia (TN). Temperature, duration of electrocautery and needle location can influence the efficacy and complications of the therapy.

Methods: We performed experimental thermocautery on egg white with increasing parameters of time (30-120 s) and temperature (60-95°C); we analysed the shape, size and volume of the thermic lesions produced.

Acute skin allergy to thermoplastic mask used for patient immobilization during radiation therapy: a case report.

Background: Radiosurgical treatments of brain tumors, vascular malformations, and functional disorders are more and more frequently used. Gamma Knife irradiation with the Icon system necessitates the use of a thermoplastic mask for head immobilization during treatment. Acute cutaneous allergy to thermoplastic masks has never been reported.

A marsupialized retrovermian arachnoid cyst and psychotic symptoms.

In this article, we report a male patient that developed psychotic symptoms after the excision of an arachnoid cyst from the posterior fossa detected by magnetic resonance and subsequent clinical improvement after anti-psychotic treatment.

Repeat Gamma Knife surgery for vestibular schwannomas.

Background: Gamma Knife (GK) surgery is a recognized treatment option for the management of small to medium-sized vestibular schwannoma (VS) associated with high-tumor control and low morbidity. When a radiosurgical treatment fails to stop tumor growth, repeat GK surgery can be proposed in selected cases.

Methods: A series of 27 GK retreatments was performed in 25 patients with VS; 2 patients underwent three procedures.

Five-fraction Gamma Knife radiosurgery using the Extend relocatable system for benign neoplasms close to optic pathways.

Purpose: To evaluate the precision of hypofractionated radiosurgery using the Gamma Knife Extend relocatable system in patients with benign neoplasms located close to the optic pathways.

Methods And Materials: A series of 59 irradiation procedures with the Extend system were performed on 12 patients. We treated 11 meningiomas and 1 craniopharyngioma.

Long-term outcome of surgical disconnection of the epileptic zone as an alternative to resection for nonlesional mesial temporal epilepsy.

Background: Pharmacoresistant epilepsy can be treated by either resection of the epileptic focus or functional isolation of the epileptic focus through complete disconnection of the pathways of propagation of the epileptic activity.

Objective: To evaluate long-term seizure outcome and complications of temporal lobe disconnection (TLD) without resection for mesial temporal lobe epilepsy (MTLE).

Methods: Data of 45 patients operated on for intractable MTLE using a functional disconnection procedure have been studied.

Clinical added value of magnetic source imaging in the presurgical evaluation of refractory focal epilepsy.

Objective: This prospective, bicentre, blinded, intention to treat study assessed the clinical added value of magnetic source imaging (MSI) in the presurgical evaluation of patients with refractory focal epilepsy (RFE).

Methods: 70 consecutive patients with RFE (42 men; mean age 31.5 years, range 3-63) from two Belgian centres were prospectively included.

Dosimetric and clinical analysis of spatial distribution of the radiation dose in gamma knife radiosurgery for vestibular schwannoma.

Objectives: We investigated variations in the distribution of radiation dose inside (dose inhomogeneity) and outside (dose falloff) the target volume during Gamma Knife (GK) irradiation of vestibular schwannoma (VS). We analyzed the relationship between some parameters of dose distribution and the clinical and radiological outcome of patients.

Methods And Materials: Data from dose plans of 203 patients treated for a vestibular schwannoma by GK C using same prescription dose (12 Gy at the 50% isodose) were collected.

Gamma knife radiosurgery for intralabyrinthine schwannomas.

Object: To analyze indications and technical specificities of treatment of intralabyrinthine schwannoma (ILS) by Gamma Knife radiosurgery.

Methods: Six patients were treated by Gamma Knife irradiation for a schwannoma arising from the cochleo-vestibular structures. Patients presented hearing worsening at different stages, tinnitus, imbalance and/or vertigo.

Clinical interest of integrating positron emission tomography imaging in the workup of 55 children with incidentally diagnosed brain lesions.

Object: In this paper, the authors' goal was to evaluate the impact of PET data on the clinical management of incidental brain lesions in children.

Methods: Between 1995 and 2007, 442 children with a newly diagnosed brain lesion were referred to the authors' department. Of these, 55 presented with an incidental brain lesion and were selected for study because MR imaging sequences revealed limitations in assessing the tumor, its evolving nature, and/or the malignant potential of the lesion diagnosed.

Ectopic choroid plexus associated with trigeminal neuralgia: case report.

Introduction: A 55-year-old man underwent a microvascular decompression procedure for a pharmacoresistant trigeminal neuralgia. Preoperative MRI showed a neurovascular conflict between the Vth nerve root and the superior cerebellar artery.

Methods: Dissection of the intracisternal trigeminal root was undertaken, and a piece of Teflon was positioned between the artery and the nerve.

Tumors involving the base of the skull: diagnostic and therapeutic approaches.

Unlabelled: PROPOSE OF REVIEW: Surgical approaches of skull base tumors are complicated and invasive. We review all new therapeutic approaches that reduce the invasiveness of the surgery.

Recent Findings: The development of minimal invasive surgery has completely changed the management of this kind of tumor and also the importance of the quality of life of the patient after surgery.

Experimental analysis of radiation dose distribution in radiosurgery. II. Dose fall-off outside the target volume.

Introduction: The role of radiation dose delivered to surrounding tissues outside target is often minimized in radiosurgery. We study histopathological effects of dose fall-offs outside the target using an experimental model of trigeminal nerve irradiation in the rat.

Material And Methods: Sixteen rats were irradiated with a Gamma Knife at the right trigeminal nerve using a 90-Gy dose and 4 different gradients of dose fall-off; the brainstem at the trigeminal nerve root entry was histologically analyzed 3 months after irradiation.

Positron emission tomography-guided volumetric resection of supratentorial high-grade gliomas: a survival analysis in 66 consecutive patients.

Objective: Integrating positron emission tomographic (PET) images into the image-guided resection of high-grade gliomas (HGG) has shown that metabolic information on tumor heterogeneity and distribution are useful for planning surgery, improve tumor delineation, and provide a final target contour different from that obtained with magnetic resonance imaging (MRI) alone in about 80% of the procedures. Moreover, PET guidance helps to increase the amount of tumor removed and to target image-guided resection to anaplastic tissue areas. The present study aims to evaluate whether PET-guided volumetric resection (VR) in supratentorial HGG might add benefit to the patient's outcome.

Experimental analysis of radiation dose distribution in radiosurgery: I. Dose hot spot inside target volume.

Introduction: Radiosurgery is currently performed with different systems of focused radiation providing different dose heterogeneities within the target volume. Here, we aimed to study histological consequences of different dose distributions inside the target area in an experimental model of Gamma Knife irradiation in the rat striatum.

Material And Methods: Twelve rats were irradiated by Gamma Knife at the same volume in the right striatum; the same margin dose of 45 Gy was prescribed for all rats.

Three-dimensional Gaussian model to define brain metastasis limits on 11C-methionine PET.

Purpose: Since 11C-methionine (MET) heavily accumulates in brain tumors, PET with MET (MET-PET) is proposed for the image-guided planning of their targeted therapy. Determination of bulk tumor limits is therefore a crucial component of MET-PET image analysis. We aimed at validating a Gaussian model of tumor delineation on MET-PET.

Combination of functional magnetic resonance imaging-guided neuronavigation and intraoperative cortical brain mapping improves targeting of motor cortex stimulation in neuropathic pain.

Objective: To evaluate, regardless of the clinical results, the contribution of combining functional magnetic resonance imaging (fMRI) with intraoperative cortical brain mapping (iCM) as functional targeting methods for epidural chronic motor cortex stimulation (MCS) in refractory neuropathic pain.

Methods: Eighteen neuropathic pain patients (central stroke in six; trigeminal neuropathy in six; syrinx or amputation in six) who underwent operations for epidural MCS were studied with preoperative fMRI and iCM. fMRI investigated motor tasks of hands (as well as foot and tongue, when painful).

Results of positron emission tomography guidance and reassessment of the utility of and indications for stereotactic biopsy in children with infiltrative brainstem tumors.

Object: Most intrinsic infiltrative brainstem lesions diagnosed in children are gliomas, and these carry a very bad prognosis. Although the utility and risk of stereotactically guided biopsy procedures in intrinsic infiltrative brainstem lesions have been widely questioned, the neuroimaging diagnosis may be inaccurate in approximately 25% of cases, and the consequences of empirical therapy should not be underestimated. Stereotactic biopsy sampling is still performed in many centers, but the reported diagnostic yield ranges from 83 to 96%.