Evaluation of O-(2-[18F]-Fluoroethyl)-L-Tyrosine in the Diagnosis of Glioblastoma.

Objective: To assess the feasibility of synthesis of O-(2-[(18)F]-fluoroethyl)-l-tyrosine (FET), a new positron emission tomographic (PET) tracer described in several studies but not yet considered standard in management of glioma, in routine practice and to determine FET uptake in a homogeneous group of patients with suspected high-grade glioma.

Design: Prospective nonrandomized trial.

Patients: Twelve patients with suspicion of high-grade glioma.

The role of surgery when endovascular treatment is considered the first choice therapy for ruptured intracranial aneurysms.

Aim: Nowadays endovascular therapy is more and more considered as first choice treatment for ruptured intracranial aneurysms. The aim of this study was to understand the impact that endovascular treatment (EVT), chosen as first therapeutic strategy, has had in the selection of ruptured intracranial aneurysms submitted to surgery at our Institution and what role neurosurgeons still play in this setting.

Methods: From 1998 to 2002, 272 consecutive patients were treated at the Hospital of Toulouse for ruptured intracranial aneurysms: 222 by embolization and 50 by surgery.

Initial primary endovascular treatment in the management of ruptured intracranial aneurysms: a prospective consecutive series.

Introduction: From January 1998 to December 2002, endovascular treatment (EVT) was used as first intention in all patients with ruptured aneurysms. The objective of this study was to analyze the results of this therapeutic strategy.

Methods: Among 401 patients admitted with a subarachnoid hemorrhage (SAH), 73 (18%) had a nonaneurysmal perimesencephalic SAH, 28 were not explored by angiography due to very poor clinical status, and 28 with aneurysmal SAH were not treated due to poor clinical status.

Holistic care facilitates seamless transitions for a community-dwelling elder: a case study.

Community-dwelling seniors with declining self-sufficiency are at risk for premature institutionalization. Early intervention while the senior has capabilities is the solution for guiding the elder to appropriate care along the continuum. This article demonstrates how a gerontological nurse as facilitator of healing helped an elder achieve the desired maximum quality of life.

[Decompressive craniectomy and intracranial hypertension].

Decompressive craniectomy was purposed for the treatment of refractory intracranial hypertension after head injury. This review discusses results obtained by this surgery in severe head trauma. Several studies have confirmed a reduction in intracranial pressure secondary to decompressive craniectomy.

Immunodetection of SV40 large T antigen in human central nervous system tumours.

Background/aims: DNA sequences from Simian virus 40 (SV40) have been previously isolated from various human tumours of the central nervous system (CNS). This study aimed to investigate a series of tumours of the CNS for the expression of the SV40 large T antigen (Tag), which is an oncogenic protein of the virus.

Methods: A French series of 82 CNS tumours was investigated for Tag expression using a monoclonal antibody and immunohistochemistry.

Detection of human cytomegalovirus genome and gene products in central nervous system tumours.

Human cytomegalovirus (HCMV) genome and related proteins have been reported in a great proportion of malignant gliomas. However, these results are unexpected since HCMV is not known as an oncogenic virus. By immunohistochemistry (with an anti-IE1 monoclonal antibody) and in situ hybridisation (with biotinylated DNA probes) on tissue microarrays and frozen sections, we investigated a French series of central nervous system (CNS) tumours, including 97 glioblastomas.

Mutations within the programmed cell death 10 gene cause cerebral cavernous malformations.

Cerebral cavernous malformations (CCMs) are hamartomatous vascular malformations characterized by abnormally enlarged capillary cavities without intervening brain parenchyma. They cause seizures and cerebral hemorrhages, which can result in focal neurological deficits. Three CCM loci have been mapped, and loss-of-function mutations were identified in the KRIT1 (CCM1) and MGC4607 (CCM2) genes.

Intra-operative mapping of cortical areas involved in reading in mono- and bilingual patients.

In order to identify the cortical areas involved in the reading process and to spare them during surgery, we systematically studied cortical areas by direct cortical stimulation in patients operated on for brain tumours. Seventy-six cortical stimulation mapping studies for language were performed in 35 monolingual and 19 bi- or multilingual patients over a 5-year period. We systematically searched for reading interference areas in addition to standard naming areas using an 'awake surgery' technique for brain mapping.

Mutations within the MGC4607 gene cause cerebral cavernous malformations.

Cerebral cavernous malformations (CCM) are hamartomatous vascular malformations characterized by abnormally enlarged capillary cavities without intervening brain parenchyma. They cause seizures and focal neurological deficits due to cerebral hemorrhages. CCM loci have already been assigned to chromosomes 7q (CCM1), 7p (CCM2), and 3q (CCM3) and have been identified in 40%, 20%, and 40%, respectively, of families with CCM.

Writing, calculating, and finger recognition in the region of the angular gyrus: a cortical stimulation study of Gerstmann syndrome.

Object: In an attempt to gain a better understanding of the cerebral functions represented in the angular gyrus and to spare them during surgery, the authors studied patients with brain tumors located close to the angular gyrus and mapped cortical sites by using electrostimulation.

Methods: Before undergoing tumor removal, six right-handed patients (five with left and one with right hemisphere tumors) were studied using cortical mapping with the aid of calculating, writing, finger-recognition, and color-naming tasks in addition to standard reading and object-naming tasks (for a total of 36 brain mapping studies). Strict conditions of functional site validation were applied to include only those cortical sites that produced repetitive interferences in the function tested.

Neurotological complications after radiosurgery versus conservative management in acoustic neuromas: a systematic review-based study.

Objective: Treatment modalities for acoustic neuroma (AN) include surgery, observation and gamma-knife surgery. The aim of this study was to compare neurotological complications resulting from two treatment alternatives to microsurgery: radiosurgery and observation.

Material And Methods: We conducted a systematic review of the literature dealing with radiosurgery for AN and compared the rate of neurotological complications in this population with that in a cohort of patients managed conservatively.

Organization of language areas in bilingual patients: a cortical stimulation study.

Object: In an attempt to gain a better understanding of how multiple languages are represented in the human brain, the authors studied bilingual patients who underwent surgery for brain tumors, during which the authors mapped cortical language sites by using electrostimulation.

Methods: Reading, counting, and word retrieval tasks were studied in 12 right-handed bilingual patients with no language deficit. All bilingual patients were native to France.

Third ventriculocisternostomy in cerebellar haematomas.

Background: We prospectively evaluated the role of endoscopic third ventriculocisternostomy in the management of acute obstructive hydrocephalus created by cerebellar hematomas.

Method: Following a therapeutic diagram based on clinical and radiological signs, endoscopic third ventriculocisternostomy was used to treat hydrocephalus associated with cerebellar hematomas in 8 patients (male: 5, female: 3, mean age: 67 years-old). Causes of cerebellar hemorrhage were spontaneous in 6 cases, traumatic in 1 case, and acute bleeding of a posterior fossa tumor (lung metastasis) in the remaining case.

Methodological and technical issues for integrating functional magnetic resonance imaging data in a neuronavigational system.

Objective: The aim of this article was to analyze the technical and methodological issues resulting from the use of functional magnetic resonance image (fMRI) data in a frameless stereotactic device for brain tumor or pain surgery (chronic motor cortex stimulation).

Methods: A total of 32 candidates, 26 for brain tumor surgery and six chronic motor cortex stimulation, were studied by fMRI scanning (61 procedures) and intraoperative cortical brain mapping under general anesthesia. The fMRI data obtained were analyzed with the Statistical Parametric Mapping 99 software, with an initial analysis threshold corresponding to P < 0.

Effectiveness of conservative management of acoustic neuromas.

Objective: The goal of this study was to assess the effectiveness of the conservative management in patients with acoustic neuroma (vestibular schwannoma).

Study Design: This retrospective study was performed in a university hospital.

Patients: Patients were selected for this wait-and-see policy on the basis of age, general condition, audiometric results, tumor size, and patient preference.

Functional MRI and intraoperative brain mapping to evaluate brain plasticity in patients with brain tumours and hemiparesis.

Objective: To support the hypothesis about the potential compensatory role of ipsilateral corticofugal pathways when the contralateral pathways are impaired by brain tumours.

Methods: Retrospective analysis was carried out on the results of functional MRI (fMRI) of a selected group of five paretic patients with Rolandic brain tumours who exhibited an abnormally high ipsilateral/contralateral ratio of activation-that is, movements of the paretic hand activated predominately the ipsilateral cortex. Brain activation was achieved with a flexion extension of the fingers.

[Importance and limitations of the validation of functional MRI of motor function and language using preoperative cortical stimulation].

Unlabelled: This chapter describes and discusses the value of the localization of functional areas obtained from functional MRI in brain tumor cases. Correlation method is cortical brain mapping by intraoperative stimulation. The experience reported here is focused on the study of motricity and language.

Characterization of choline compounds with in vitro 1H magnetic resonance spectroscopy for the discrimination of primary brain tumors.

Rationale And Objectives: The authors sought to compare 1H magnetic resonance spectroscopy (MRS) spectra from extracts of low-grade and high-grade gliomas, especially with respect to the signals of choline-containing compounds.

Methods: Perchloric acid extracts of six high-grade and six low-grade gliomas were analyzed by 1H MRS at 9.4 Tesla.

Cortical intraoperative stimulation in brain tumors as a tool to evaluate spatial data from motor functional MRI.

Rationale And Objective: The purpose of this prospective, double-blind study was to correlate motor functional MRI (fMRI) with cortical brain mapping by intraoperative stimulation using 3D reconstructed images of the surface of the brain, and to validate the spatial data of fMRI in patients with brain tumors.

Methods: Fourteen patients with tumors of the rolandic region underwent functional MR mapping of the hand region and subsequently cortical mapping before tumor resection. Data obtained with fMRI and brain mapping were not known previously by the neurosurgeon and by the neuroradiologist, respectively (double-blind study).

Usefulness of motor functional MRI correlated to cortical mapping in Rolandic low-grade astrocytomas.

The indications for surgery of slow growing tumours like low grade astrocytomas in eloquent areas are difficult. The timing and the benefit/risk ratio of the surgery must be evaluated, taking into account the potential post operative deficit. The purpose of this study was: a) to validate the data obtained with functional MRI (FMRI) by direct cortical stimulation in patients who are candidate for surgery; b) to demonstrate the usefulness of FMRI coupled with cortical brain mapping and 3D reconstructions of the surfaces of the brain in low grade astrocytoma.

Prognostic factors in pediatric spinal cord astrocytoma.

Background: Factors that could optimize the management of pediatric spinal cord astrocytoma remain unclear and controversial.

Methods: To determine the factors that influence the prognosis of pediatric patients with spinal cord astrocytomas, a series of 73 consecutive patients at 13 French treatment centers with histologically proven spinal cord astrocytomas was retrospectively reviewed. Hospital records, operative records, and results of radiologic investigations were available in all cases.

[Presurgical evaluation of cerebral tumors with functional MRI].

Purpose: To evaluate the capabilities and the limitations of motor functional magnetic resonance imaging (FMRI) in the presurgical planning of the cerebral tumors located in or near the motor homunculus and to correlate each type of activation with the histologic characteristics of each tumor.

Materials And Methods: FMRI was performed in 17 patients (14 adults and 3 children), without motor deficit, presenting with various intra cerebral tumors. Three FMRI activation paradigms were used, controlateral to the lesion: ballistic opposition of the fingers, flexion-extension of the foot and click of the tongue.

Pre-operative and per-operative factors conditioning long-term facial nerve function in vestibular schwannoma surgery through translabyrinthine approach.

Facial nerve function was evaluated in 103 patients, after vestibular schwannoma removal through the translabyrinthine approach. The mean follow-up was 43 months (minimum six months). Grade I facial function was achieved in 100 per cent of stage I schwannomata compared with 36 per cent of stage IV schwannomata.