Simultaneous multiple craniotomies in the management of multifocal malignant brain lesions: case reports.

The appropriate strategy for treating multiple malignant brain tumors has not been well established. We discuss the indications and surgical considerations of multiple craniotomies in the same surgical session, and present three such cases. A 41-year-old woman (case 1) and a 65-year-old man (case 2), both presented with two metastatic brain lesions, one in each hemisphere.

Predictive Factors Associated with Pain Relief of Spinal Cord Stimulation for Central Post-stroke Pain.

The efficacy and predictive factors associated with successful spinal cord stimulation (SCS) for central post-stroke pain (CPSP) have yet to be definitively established. Thus, this study evaluated the rates of pain relief found after more than 12 months and the predictive factors associated with the success of SCS for CPSP. The degree of pain after SCS in 18 patients with CPSP was assessed using the Visual Analog Scale preoperatively, at 1, 6 and 12 months after surgery, and at the time of the last follow-up.

Long-term Effect and Predictive Factors of Motor Cortex and Spinal Cord Stimulation for Chronic Neuropathic Pain.

The long-term effects of motor cortex stimulation (MCS) and spinal cord stimulation (SCS) remain unknown. To identify the long-term effects after MCS or SCS and determine any associated predictive factors for the outcomes. Fifty patients underwent MCS (n = 15) or SCS (n = 35) for chronic neuropathic pain.

[Supratentorial-infraoccipital approach supported by navigation and intraoperative magnetic resonance imaging for glioma located at the medial posterior temporal lobe: two case reports].

Resection of posteromedial temporal lobe lesions is challenging because surgical access through standard approaches requires excessive retraction or resection of temporal cortex. The utility of the supratentorial-infraoccipital approach for posteromedial temporal lobe lesions was first reported in 1995. Here, we report two cases of glioma located at the medial posterior temporal lobe.

[Severe rhabdomyolysis and intracranial hemorrhage associated with synthetic cannabinoid: a case report].

A 28-year-old male presented with language and behavior disorders a few days prior to examination. Magnetic resonance images and cerebral angiography revealed an arteriovenous malformation (AVM) in the right frontal lobe. The size of the nidus was 2.

[Biopsy of brain parenchymal lesions: procedure selection and ingenuity of accurate and safety biopsy].

Introduction: Biopsy procedures of intra-parenchymal lesions are divided into needle biopsy (stereotactic or frameless) or navigation-guided endoscopic biopsy.

Methods: We retrospectively reviewed 36 consecutive patients with intra-parenchymal lesions who underwent biopsy at our institution. Fourteen patients underwent navigation-guided endoscopic biopsy (endoscopic group) and 22 patients underwent needle biopsy (needle group).

[Efficacy of tramadol/acetaminophen medication for central post-stroke pain].

Objective: Central post-stroke pain(CPSP)is the most difficult type of central neuropathic pain to control with medical treatment. Opioids are commonly used for chronic neuropathic pain, but their efficacy in treating central neuropathic pain, particularly CPSP, is not clear. Tramadol is an opioid analgesic that, in combination with acetaminophen, has been approved since 2011 for the treatment of non-cancer pain in Japan.

Use of high-field intraoperative magnetic resonance imaging during endoscopic transsphenoidal surgery for functioning pituitary microadenomas and small adenomas located in the intrasellar region.

The usefulness of 1.5-T high-field intraoperative magnetic resonance (iMR) imaging during transsphenoidal surgery for functioning pituitary adenomas was retrospectively evaluated based on long-term endocrine remission from the records of 14 patients who underwent transsphenoidal surgery with iMR imaging for functioning pituitary microadenomas and small adenomas located in the intrasellar region. The maximum tumor diameter was 9.

Endoscopic biopsy for lesions located in the parenchyma of the brain: preoperative planning based on stereotactic methods. Technical note.

Endoscope biopsy guided navigation for intra-parenchymal lesions is safe and effective, but determination of the entry point and trajectory of the endoscopic biopsy is less clear. We describe preoperative planning based on stereotactic methods, and achieving the plan using several techniques. The preoperative planning was based on stereotactic methods such as determining target, entry point, and trajectory.

Differentiation of newly diagnosed glioblastoma multiforme and intracranial diffuse large B-cell Lymphoma using (11)C-methionine and (18)F-FDG PET.

Purpose: The aim of our study was to examine the usefulness of PET with C-methionine (MET) and F-fluorodeoxyglucose (FDG) in the differentiation of glioblastoma multiforme (GBM) and intracranial diffuse large B-cell lymphoma (DLBCL).

Materials And Methods: We evaluated 22 patients retrospectively with an enhancing brain tumor on MRI, including 15 GBM and 7 DLBCL, which was confirmed by histopathology. Dynamic PET scans with MET and FDG were performed for preoperative differential diagnosis.

Simultaneous surgical resections of two distant metastatic malignant melanoma lesions--case report.

A 41-year-old woman presented with disturbance of consciousness, right hemiparesis, and symptoms of Gerstmann syndrome. She had a history of malignant melanoma resections of an ear mole and her right neck lymph nodes and parotid gland, with subsequent chemotherapy and radiotherapy. Computed tomography showed two large lesions in the right frontal and left parietal lobes surrounded by severe brain edema.

[Dual lead spinal cord stimulation using octad lead for central post-stroke pain].

Spinal cord stimulation (SCS) has become the preferred option for neurosurgical management of several intractable pains. To evaluate effects of dual lead SCS using two quad leads for central post-stroke pain (CPSP), we retrospectively reviewed eight consecutive patients with CPSP who underwent SCS. Six (75%) of eight patients obtained more than 50% pain relief during test stimulation, and the efficacies continued for about 12 months in five (83%) of six patients.

Isolated adrenocorticotropic hormone deficiency associated with Hashimoto's disease and thyroid crisis triggered by head trauma. Case report.

A 47-year-old man presented to our hospital after suffering transient loss of consciousness and falling to the floor. On admission, his Glasgow Coma Scale score was 11 (E3V3M5), and he exhibited restlessness. Blood examination revealed hyperthyroidism.

Selective propofol injection into the M1 segment of the middle cerebral artery (MCA Wada test) reduces adverse effects and enhances the reliability of the Wada test for determining speech dominance.

Object: The Wada test is had been the most reliable for determining speech dominance. Drugs injected into the internal carotid artery, however, may be heterogeneously distributed as the result of asymmetry of the anterior cerebral arteries and the presence of a fetal-type posterior cerebral artery. Variations in drug distribution could occasionally alter consciousness and complicate the evaluation of the test results.

Primary angiitis of the central nervous system mimicking tumor-like lesion--case report.

A 60-year-old man presented with a rare case of primary angiitis of the central nervous system mimicking a tumor-like lesion and manifesting as slight disorientation, left hemiparesis, and motor aphasia. Computed tomography showed multiple low density lesions in the left frontal lobe, brain stem, and right parietal lobe. Magnetic resonance images revealed a slightly enhanced mass lesion in the right parietal lobe with surrounding brain edema.

Efficacy of motor cortex stimulation for intractable central neuropathic pain: comparison of stimulation parameters between post-stroke pain and other central pain.

Motor cortex stimulation (MCS) has now become the preferred option for neurosurgical management of intractable central neuropathic pain such as post-stroke pain and trigeminal neuropathic pain. However, the efficacy of MCS for other central neuropathic pain such as pain resulting from spinal cord or brainstem lesions is unclear. We retrospectively reviewed 11 consecutive patients with intractable central neuropathic pain who underwent MCS in our institution.

[Removal of an arteriovenous malformation near the pyramidal tract using the neuronavigation system: a case report].

A 20-year-old female presented with sudden severe headaches. Computed tomography showed an intraventricular hemorrhage and slightly dilated lateral ventricles. Her neurological examinations revealed no abnormalities.

Changes in regional blood flow induced by unilateral subthalamic nucleus stimulation in patients with Parkinson's disease.

Changes in regional cerebral blood flow (rCBF) induced by unilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) were investigated in 7 consecutive patients with Parkinson's disease, 4 men and 3 women (mean age 62.3 +/- 8.1 years), who underwent rCBF measurement by N-isopropyl-p-(iodine-123)-iodoamphetamine single photon emission computed tomography at rest before and after unilateral STN DBS preoperatively in the on-drug condition, and postoperatively in the on-drug and on-stimulation condition.

Staged bilateral deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson's disease.

Background: Several investigators have described the efficacy and safety of unilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) for the treatment of Parkinson's disease (PD). Some patients who underwent unilateral STN DBS required additional surgery on the contralateral side because the unilateral treatment was insufficient. The goal of this study was to assess the efficacy and safety of staged bilateral STN DBS compared to the simultaneous bilateral procedure.

Suppression of secondary generalization of limbic seizures by stimulation of subthalamic nucleus in rats.

Object: Deep brain stimulation (DBS) of subcortical nuclei such as the subthalamic nucleus (STN) or the substantia nigra pars reticulata (SNR) may provide an alternative therapy for intractable epilepsy. The authors attempted to evaluate the antiepileptic effects of DBS to these structures in an experimental seizure model.

Methods: Three groups of rats were prepared.

Pilomotor seizures in mesial temporal lobe epilepsy: a case confirmed by intracranial EEG.

We report the first case in which intracranial EEG was used to confirm pilomotor seizures of mesial temporal origin. A 41-year-old man who had pilomotor seizures in the left arm in addition to complex partial seizures was admitted for presurgical evaluation. Intracranial EEG revealed ictal discharges in the left mesial temporal area during left pilomotor seizures.