Functional rearrangement of the primary and secondary motor cortex in patients with primary tumors of the central nervous system located in the region of the central sulcus depending on the histopathological type and the size of tumor: Examination by means of functional magnetic resonance imaging.

Background: The aim of this study was to analyze the reorganization of the centers of the motor cortex in patients with primary neuroepithelial tumors of the central nervous system (CNS) located in the region of the central sulcus in relation to the histopathological type and the size of tumor, as determined by means of functional magnetic resonance imaging (fMRI).

Material/methods: The fMRI was performed prior to the surgical treatment of patients with tumors located in the region of the central sulcus (WHO stage I and II, n=15; WHO stage III and IV, n=25). The analysis included a record of the activity in the areas of the primary motor cortex (M1) and the secondary motor cortex: the premotor cortex (PMA) and the accessory motor area (SMA).

Polypropylene-polyester cranial prostheses prepared with CAD/CAM technology. Report of first 15 cases.

Objectives: The authors described a new cranioplastic method where polypropylene-polyester knitwear was shaped according to individual patient's skull 3D model. The material was formed in a customized manner and preoperatively adjusted to the patient needs with modern CAD/CAM techniques.

Patients And Methods: The procedure consisted of a CT scan with a simple but unorthodox protocol, 3D modeling of the bone defect and planned prosthesis, finally the preparation of the plate itself.

Magnetic resonance imaging of rare intracranial neoplasms--role of the in vivo 1 h spectroscopy in the radiological differential diagnostics.

Background: The object of this study was to evaluate the usefulness of magnetic resonance (MR) spectroscopy in differentiating rare intracranial tumours in adult patients. Review of the literature on results of MR spectroscopy in these lesions is also included.

Material And Method: 89 patients with brain tumours were evaluated preoperatively with in vivo 1.

Glioblastoma multiforme and meningioma in the same patient - a case report.

We describe a case of a 64-year-old female who presented with concurrent left parietal glioblastoma multiforme and left occipital parasagittal meningioma. Both lesions were excised during the operation. There was no clinical evidence of phacomatosis.

[The usefulness of fused MRI and SPECT images for the voxel positioning in proton magnetic resonance spectroscopy and planning the biopsy of brain tumors: presentation of the method].

Background And Purpose: Progress in neurooncology suggests a need to combine information from anatomical-morphological and functional imaging in diagnosis and management. It is not always possible to establish a correct diagnosis using MRI imaging techniques alone, especially in the case of recurrent brain tumors. It is suggested that the results of different imaging techniques should be combined especially in these circumstances.

[Suprascapular nerve entrapment. A case report].

We present a case of a 35 year-old man, an office employee, who got ill when working hard building his own house. At the same time shoulder pain and fever occurred, the latter due to the tooth apical abscess. Several months later atrophy of the left supraspinatus and infraspinatus muscles was found.

[Role of proteoglycans and glycosaminoglycans in the intervertebral disc degeneration].

Proteoglycans and glycosaminoglycans are the main components of the extracellular matrix of the nucleus pulposus. Intervertebral disc degeneration due to aging and excessive mechanical loads results in adverse quantitative and structural changes to the macromolecules. Metalloproteinases induced by inflammatory mediators play a key role in degrading proteoglycans.

Clinical evaluation of the polypropylene-polyester knit used as a cranioplasty material.

Unlabelled: The paper presents clinical evaluation of the polypropylene-polyester knit used as a cranioplasty material.

Material: Between year 1980 and 2002 275 cranioplastic procedures using the polypropylene-polyester plates Codubix were carried out in the Department of Neurosurgery of the Medical University of Łódź. There were 146 patients who primarily sustained head injuries and 129 non-traumatic patients with craniectomies carried out for various other reasons.

[Supplementation of cranial defects by an autologous bone flap stored in the abdominal wall].

Background And Purpose: The aim of this paper is to present an alternative method of cranioplasty with the use of an autologous cranial bone flap stored between primary and restorative surgery in the subcutaneous pocket in the lateral hypogastric region.

Material And Methods: Between January 1999 and April 2002, in the Department of Neurosurgery of Medical University of Łódź we performed 36 procedures of the bone flap implantation into the abdominal subcutaneous fat tissue. These procedures followed craniectomy, mainly in cases of acute subdural hematomas and ruptured intracranial aneurysms.

[Intraoperative assessment of cognitive and executive functions in patients with brain tumors].

Background And Purpose: The aim of this paper was to evaluate the usefulness of selected methods of intraoperative neuropsychological assessment. In order to investigate the influence of the direct cortical stimulation and tumor resection on the patients' intraoperative performance, we examined selected areas of cerebral cortex involved in cognitive activity in patients undergoing awake craniotomy for brain tumors.

Material And Methods: The analyzed group consisted of 21 patients (11 men, 10 women) with tumors located in eloquent areas of the left hemisphere.

[Hemifacial spasm as an early symptom of posterior fossa meningioma].

A rare case of a 47-year old female with hemifacial spasm of the one-year duration as the initial and only symptom of posterior fossa meningioma is reported. At first the patient did not consent to surgery and was unsuccessfully treated with anticonvulsants. A month prior to her admission she started to complain of headache and balance disorder, and developed sensory loss to light touch in II and III branches of the right V nerve.

Colloid-like cyst located in the prepontine region.

Background: The term "colloid cysts" refers to nonneoplastic lesions located in the anterior part of the third ventricle. However, cysts morphologically identical to colloid cysts are found, albeit extremely rarely, through the neuraxis.

Case Description: We report a case of a 44-year-old man with a short history of headache and 5 years of bilateral hearing loss.

[Trigeminal neuralgia due to lengthy AVM treatment. A case report].

The authors presented a case of iatrogenic trigeminal neuralgia in a 46-year-old man with a dural arteriovenous malformation (AVM) previously treated by means of intravascular embolization. At first, microvascular decompression (MVD) in the posterior fossa was performed, but unfortunately the pain persisted. Subsequently, percutaneous stereotactic radiofrequency rhizotomy was carried out.

[Awake craniotomy and brain mapping for eloquent cortex in patients with supratentorial tumors: a preliminary report].

Malignant brain tumours are incurable at present. Since none of the hitherto used treatment methods allows to significantly extend these patients' survival time, the basic aim is to improve their quality of life. Intraoperative brain mapping seems to be an approach enabling to minimize the risk of irreversible damages to functionally important structures of the brain.

[Sixteen-year experience in the treatment of trigeminal neuralgia by percutaneous retrogasserian thermorhizotomy].

The authors present a series of 143 consecutive patients with trigeminal neuralgia who were treated with percutaneous retrogasserian thermorhizotomy between 1984 and 2000. Long time results (follow-up of 16 years) revealed full pain relief in 80% of patients, mainly in those with postoperative sensory deficit, 16% suffered pain recurrence and required additional treatment.

[Use of needle electromyography for diagnosis of radiculopathies].

Radiculopathy is sometimes evaluated with needle electromyography as additional examination to radiographic imaging. The purpose of this study was to determine the optimal needle electromyography protocol and the use of needle electromyography in the diagnosis of radiculopathy. The authors analysed English language writings from years 1981-2000.

[Pituitary adenoma penetrating the sphenoidal sinus and nasal cavity: a case report].

We describe a case of pituitary adenoma penetrating to the sphenoidal sinus and nasal cavity in a patient with recurrent nasal polyps. Histopathological examination of the removed polyps revealed transitional carcinoma. CT and MRI of the head showed a solid tumour filling the spheniodal sinus and the sella, penetrating to posterior ethmoid cells and superior nasal duct.

[Intraoperative facial nerve monitoring. Practical remarks].

Objective: Even the most experienced surgeon may have difficulties in identifying and preserving the facial nerve, particularly when the operation is complicated, for example, by size and localization of tumour, trauma or anatomic variations. The aim of this study is to present indications, technics and interpretation of intraoperative facial nerve monitoring.

Methods: This study bases on literature review and our own experience in intraoperative facial nerve monitoring.

[The effect of general anesthesia during operation on the central nervous system on the pattern of somatosensory evoked potentials -- preliminary communication].

During monitoring of somatosensory evoked potentials (SEP) during operation for intracranial aneurysm disappearance of cortical response can alarm the neurosurgeons and suggest the necessity of removal of temporary clipping. As a rule, 50% fall of amplitude and/or 10% prolongation of N13-N20 interlatence are accepted as a criterion for alarming the operating team. However, a considerable part of changes in SEP tracings is caused by factors other than surgical manipulations.

[Cerebral cysticercosis. Case report].

The authors present a case of a long course of disseminated cerebral cysticercosis. Diagnosis of cysticercosis was confirmed by serial magnetic resonance examinations.

[Results of treatment of giant cerebral aneurysm in patients at the Department Neurosurgery, Academy of Medicine, in Lodz].

The authors discuss the results of surgical treatment of 45 patients with giant intracranial aneurysms calling attention to more frequent occurrence of subarachnoid haemorrhage as the presenting signs, and to the most effective treatment method that is closing of aneurysm neck with a clip, especially in aneurysms of the internal carotid artery. Ligation of aneurysm neck, non-radical operations, other location of the aneurysm, serious condition of the patient and repeated subarachnoid haemorrhages worsen the therapeutic results.

[Hyponatremia after subarachnoid hemorrhage caused by ruptured intracranial aneurysm].

Hyponatremia developed both prior to and after surgery in 30.5% and 23.4% out of 164 patients with ruptured intracranial aneurysms.

[Computerized tomography in the diagnosis of hemorrhage caused by ruptured intracranial aneurysm].

The authors presented current views on usefulness of computed tomography (CT) for diagnosing the bleeding from a ruptured intracranial aneurysm. CT should be done in every such case, whereas the lumbar puncture remains the diagnostic method of choice, when CT is not available or in those patients in whom CT shows no haemorrhage. Sensitivity of CT decreases with time that elapsed from the stroke; false negative results are the least likely to occur within the first 48 hours after bleeding episode to subarachnoid space.

[Various problems related to the occurrence of hydrocephalus after subarachnoid hemorrhage caused by ruptured cerebral aneurysm].

A CT scan done on admission showed widening of the ventricular system in 56 (34%) out of 164 patients with a ruptured intracranial aneurysm. 82% of the patients were admitted within 5 days after the bleeding. Those with hydrocephalus were often in a poor clinical condition (grades 3-5 Hunt and Hess, p less than 0.

[Computerized tomography in aneurysms of the posterior cranial fossa].

The authors discuss the clinical usefulness of CT scan in patients with ruptured posterior fossa aneurysms. Among 164 patients after SAH, in 17 the bleeding was caused by aneurysms located in posterior fossa. The exact diagnosis of the bleeding during 5 days after SAH was possible in 94% of the patients, that is similar as in supratentorial aneurysms.