Diagnostic challenges of diffuse leptomeningeal glioneuronal tumor in an adult female: illustrative case.

Background: Diffuse leptomeningeal glioneuronal tumor (DLGNT) is a rare central nervous system tumor, especially in adult females. Typically, it presents with leptomeningeal enhancements in the basal cisterns and spinal cord. However, varied radiological and pathological features can complicate the diagnosis, as the present case illustrates.

Association Between the Serum α-Klotho Level and Insulin Resistance in Adults: NHANES 2007-2016.

Objective: This study aimed to investigate the relationship between serum α-Klotho levels and insulin resistance (IR), a precursor to type 2 diabetes.

Methods: The study analyzed data from 4,758 adult participants in the National Health and Nutrition Examination Survey (NHANES) spanning from 2007 to 2016. The relationship between α-Klotho concentration and IR was assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and odds ratios (OR) derived from logistic regression models.

Quantitative Validation of the Correlation Between Optimized Pyramidal Tract Delineation After Brain Shift Compensation and Direct Electrical Subcortical Stimulation During Brain Tumor Surgery.

It remains unclear whether tractography of pyramidal tracts is correlated with the intraoperative direct electrical subcortical stimulation (DESS), and brain shift further complicates the issue. The objective of this research is to quantitatively verify the correlation between optimized tractography (OT) of pyramidal tracts after brain shift compensation and DESS during brain tumor surgery. OT was performed for 20 patients with lesions in proximity to the pyramidal tracts based on preoperative diffusion-weighted magnetic resonance imaging.

Full-course resection control strategy in glioma surgery using both intraoperative ultrasound and intraoperative MRI.

Background: Intraoperative ultrasound(iUS) and intraoperative MRI (iMRI) are effective ways to perform resection control during glioma surgery. However, most published studies employed only one modality. Few studies have used both during surgery.

Optimized Tractography Mapping and Quantitative Evaluation of Pyramidal Tracts for Surgical Resection of Insular Gliomas: a Correlative Study with Diffusion Tensor Imaging-Derived Metrics and Patient Motor Strength.

We investigate the correlation between diffusion tensor imaging (DTI)-derived metric statistics and motor strength grade of insular glioma patients after optimizing the pyramidal tract (PT) delineation. Motor strength grades of 45 insular glioma patients were assessed. All the patients underwent structural and diffusion MRI examination before and after surgery.

Multimodal Image-Based Virtual Reality Presurgical Simulation and Evaluation for Trigeminal Neuralgia and Hemifacial Spasm.

Objective: To address the feasibility and predictive value of multimodal image-based virtual reality in detecting and assessing features of neurovascular confliction (NVC), particularly regarding the detection of offending vessels, degree of compression exerted on the nerve root, in patients who underwent microvascular decompression for nonlesional trigeminal neuralgia and hemifacial spasm (HFS).

Methods: This prospective study includes 42 consecutive patients who underwent microvascular decompression for classic primary trigeminal neuralgia or HFS. All patients underwent preoperative 1.

Intraoperative visualisation of functional structures facilitates safe frameless stereotactic biopsy in the motor eloquent regions of the brain.

Background: For stereotactic brain biopsy involving motor eloquent regions, the surgical objective is to enhance diagnostic yield and preserve neurological function. To achieve this aim, we implemented functional neuro-navigation and intraoperative magnetic resonance imaging (iMRI) into the biopsy procedure. The impact of this integrated technique on the surgical outcome and postoperative neurological function was investigated and evaluated.

Endoscopic Evacuation of Basal Ganglia Hematoma: Surgical Technique, Outcome, and Learning Curve.

Background: Minimally invasive endoscopic hematoma evacuation is a promising treatment option for intracerebral hemorrhage. However, the technique still needs improvement. We report our clinical experience of using this technique to evacuate deep-seated basal ganglia hematomas.

Image-guided endoscopic surgery for spontaneous supratentorial intracerebral hematoma.

OBJECTIVE Endoscopic removal of intracerebral hematomas is becoming increasingly common, but there is no standard technique. The authors explored the use of a simple image-guided endoscopic method for removal of spontaneous supratentorial hematomas. METHODS Virtual reality technology based on a hospital picture archiving and communications systems (PACS) was used in 3D hematoma visualization and surgical planning.

A Low-Cost iPhone-Assisted Augmented Reality Solution for the Localization of Intracranial Lesions.

Background: Precise location of intracranial lesions before surgery is important, but occasionally difficult. Modern navigation systems are very helpful, but expensive. A low-cost solution that could locate brain lesions and their surface projections in augmented reality would be beneficial.

iPhone-Assisted Augmented Reality Localization of Basal Ganglia Hypertensive Hematoma.

Objective: A low-cost, time-efficient technique that could localize hypertensive hematomas in the basal ganglia would be beneficial for minimally invasive hematoma evacuation surgery. We used an iPhone to achieve this goal and evaluated its accuracy and feasibility.

Methods: We located basal ganglia hematomas in 26 patients and depicted the boundaries of the hematomas on the skin.

In vivo visualization of the facial nerve in patients with acoustic neuroma using diffusion tensor imaging-based fiber tracking.

OBJECTIVE Preoperative determination of the facial nerve (FN) course is essential to preserving its function. Neither regular preoperative imaging examination nor intraoperative electrophysiological monitoring is able to determine the exact position of the FN. The diffusion tensor imaging-based fiber tracking (DTI-FT) technique has been widely used for the preoperative noninvasive visualization of the neural fasciculus in the white matter of brain.

Facial and Cochlear Nerve Complications following Microsurgical Resection of Vestibular Schwannomas in a Series of 221 Cases.

Background: Despite improvements in microsurgical technique and the use of intraoperative electrophysiological monitoring, the potential for facial and cochlear nerve injury remains a possibility in the resection of vestibular schwannomas (VS). We reviewed a series of 221 cases of VS resected via a retrosigmoid approach at our institution from October 2008 to April 2014 and determined the incidence of postoperative facial and cochlear deficits.

Material And Methods: A total of 221 patients - 105 (47.

Functional outcome of surgery for glioma directly adjacent to pyramidal tract depicted by diffusion-tensor based fiber tracking.

Aim: To investigate the outcome of glioma resection surgery and changes of pyramidal tract (PT) for patients where PT is immediately adjacent to the tumors, which were revealed by diffusion tensor imaging (DTI) based fiber tracking (FT) technique.

Material And Methods: 40 patients enrolled. Preoperative and intraoperative tractography of the PT was performed before and after glioma resection.

Endoscopic endonasal transsphenoidal surgery of 1,166 pituitary adenomas.

Aim: To report the results of a series of patients undergoing pure endoscopic endonasal pituitary surgery and to evaluate the efficacy and safety of this procedure.

Materials And Methods: The data of 1,166 patients that underwent endoscopic endonasal transsphenoidal adenoma removal between December 2006 and June 2013 were retrospectively reviewed. Pre- and postoperative hormonal status (3 months after surgery) were analyzed and compared with the clinical parameters originally presented by the patients.

Prediction of the location of the pyramidal tract in patients with thalamic or basal ganglia tumors.

Background: Locating the pyramidal tract (PT) is difficult in patients with thalamic or basal ganglia tumors, especially when the surrounding anatomical structures cannot be identified using computed tomography or magnetic resonance images. Hence, we objected to find a way to predict the location of the PT in patients with thalamic and basal ganglia tumors

Methodology/principal Findings: In 59 patents with thalamic or basal ganglia tumors, the PTs were constructed by with diffusion tensor imaging (DTI)-based fiber tracking (FT). In axial slices crossing the foramen of Monro, the tumor position was classified according to three lines.

[High-field intraoperative magnetic resonance imaging suite with neuronavigation system: implementation and preliminary experience in the pituitary adenoma operation with transsphenoidal approach].

Objectives: To review the preliminary clinical experience with high-field-strength intraoperative magnetic resonance imaging (iMRI) suite with neuronavigation system in the pituitary adenoma operation with transsphenoidal approach.

Methods: From March 2009 to December 2010, 31 patients [range, 29 - 76 years, mean age (47 ± 11) years]of pituitary adenoma were operated with transsphenoidal approach and intraoperatively with a movable 1.5 T high-field-strength iMRI suite in combination with neuronavigation system.

[Implementation and preliminary experience of high-field intraoperative magnetic resonance imaging in the endoscopic chordoma operation with transsphenoidal or transoral approach].

Objective: To review the preliminary clinical experience with high-field-strength intra-operative magnetic resonance imaging (iMRI) in the endoscopic chordoma operation with transsphenoidal or transoral approach.

Methods: From January 2009 to December 2010, 23 patients [range, 29 - 64 years, mean age (42 ± 3) years] of chordoma were operated with endoscopic transsphenoidal or transoral approach and examined intraoperatively with a movable 1.5 T iMRI magnet.