Objective: To demonstrate the accuracy of magnetic resonance tractograpghy (MRT) in localizing the cortical spinal tract (CST) close to brain tumours by using intraoperative electric subcortical stimulation.
Methods: Nine patients with intra-axial brain tumours underwent neurosurgery. Planning was based on analysis of the course of streamlines compatible with the CST. After tumour removal, intraoperative MRT was reacquired. Sites at various distance from the CST were repeatedly stimulated to assess whether registered motor evoked potential (MEP) could be elicited. All patients were assessed clinically both pre- and postoperatively.
Results: The motor function was preserved in all patients. In all patients intraoperative MRT demonstrated shift of the bundle position caused by the surgical procedure. The distance between the estimated intraoperative CST and the point of elicited MEP was 1 cm or less in all nine patients. At distances greater than 2 cm, no patient reported positive MEP.
Conclusion: Intraoperative MRT is a reliable technique for localization of CST. In all patients MEP were elicited by direct subcortical electrical stimulation at a distance below 1 cm from the CST as represented by MRT. Brain shifting might impact this evaluation since CST position may change during surgery in the range of 8 mm.
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http://dx.doi.org/10.1007/s00330-010-1806-7 | DOI Listing |
Med J Islam Repub Iran
May 2024
Caspian University, International School of Medicine, Almaty, Kazakhstan.
Zh Vopr Neirokhir Im N N Burdenko
September 2023
Russian Medical Academy of Continuous Professional Education, Moscow, Russia.
Background: Effectiveness of surgical revascularization in patients with chronic cerebral ischemia depends on restoration of circulation in the damaged artery. Modern methods do not take into account dynamic changes in cerebral perfusion after extra-intracranial microvascular anastomosis (EICMA) and do not allow timely localizing the areas of persistent perfusion deficit. We propose a new method for determining the tactics of surgical cerebral revascularization based on intraoperative MRI (iMRI) perfusion data.
View Article and Find Full Text PDFOrthopadie (Heidelb)
February 2023
Departement für Obere Extremität/MRT, Sportklinik Stuttgart, Taubenheimstr. 8, 70327, Stuttgart, Deutschland.
With the increasing number of primary arthroplasties, revisions of anatomical prostheses are becoming increasingly important. The most common reasons for revision are glenoid loosening, including protrusion, rotator cuff insufficiency, including instability, and early/late infection. The reconstruction of glenoid defects can be done with an autograft or allograft.
View Article and Find Full Text PDFCurr Oncol
September 2022
Department of Neurosurgery, Ulm University, Lindenallee 2, 89312 Günzburg, Germany.
The aim of the study was to assess the quality, accuracy and benefit of navigated 2D and 3D ultrasound for intra-axial tumor surgery in a prospective study. Patients intended for gross total resection were consecutively enrolled. Intraoperatively, a 2D and 3D iUS-based resection was performed.
View Article and Find Full Text PDFBMC Neurol
March 2022
Department of Clinical Science-Neurosciences, Umeå University, 90187, Umeå, Sweden.
Background: Only a few earlier publications on intrasellar pressure (ISP) have not been able to fully clarify any association between ISP and pituitary adenoma size and growth pattern. The aim of the study was to determine if intrasellar pressure (ISP) is elevated in patients with pituitary adenoma, and if the pressure is associated with tumour size and growth pattern.
Methods: The study included 100 patients operated for suspected pituitary adenoma, who have had their ISP measured intraoperatively.
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