Frameless ROSA® Robot-Assisted Lead Implantation for Deep Brain Stimulation: Technique and Accuracy.

Background: Frameless robotic-assisted surgery is an innovative technique for deep brain stimulation (DBS) that has not been assessed in a large cohort of patients.

Objective: To evaluate accuracy of DBS lead placement using the ROSA® robot (Zimmer Biomet) and a frameless registration.

Methods: All patients undergoing DBS surgery in our institution between 2012 and 2016 were prospectively included in an open label single-center study.

Operation and Chemotherapy: Prognostic Factors for Lung Cancer With One Synchronous Metastasis.

Background: Stage IV non-small cell lung cancer (NSCLC) is considered incurable; however, some patients with only few metastases may benefit from treatment with a curative intent. We aimed to identify the prognostic factors for stage IV NSCLC with synchronous solitary M1.

Methods: A database constructed from our weekly multidisciplinary thoracic oncology meetings was retrospectively screened from 1993 to 2012.

Masson's tumor revealed by an intracerebral hematoma. Case report and a review of the literature.

We report the case of a 56-year-old woman who underwent total resection of a Masson's tumor or intravascular papillary endothelial hyperplasia (IPEH), which was discovered due to a left temporal intracerebral hematoma revealed by aphasia. IPEH is more often localized on cutaneous and subcutaneous locations, intracranial IPEH are rare and only approximately twenty cases have been published to date. These tumors are a benign vascular lesion composed of papillary intravascular proliferation of epithelial cellular associated thrombosis with fibrin deposits responsible for vascular lumen obliteration.

Modulation of motor inhibition by subthalamic stimulation in obsessive-compulsive disorder.

High-frequency deep brain stimulation of the subthalamic nucleus can be used to treat severe obsessive-compulsive disorders that are refractory to conventional treatments. The mechanisms of action of this approach possibly rely on the modulation of associative-limbic subcortical-cortical loops, but remain to be fully elucidated. Here in 12 patients, we report the effects of high-frequency stimulation of the subthalamic nucleus on behavior, and on electroencephalographic responses and inferred effective connectivity during motor inhibition processes involved in the stop signal task.

Stimulation of subgenual cingulate area decreases limbic top-down effect on ventral visual stream: A DBS-EEG pilot study.

Deep brain stimulation (DBS) of the subgenual cingulate gyrus (area CG25) is beneficial in treatment resistant depression. Though the mechanisms of action of Cg25 DBS remain largely unknown, it is commonly believed that Cg25 DBS modulates limbic activity of large networks to achieve thymic regulation of patients. To investigate how emotional attention is influenced by Cg25 DBS, we assessed behavioral and electroencephalographic (EEG) responses to an emotional Stroop task in 5 patients during ON and OFF stimulation conditions.

Microsurgical neurovascular anastomosis: the example of superficial temporal artery to middle cerebral artery bypass. Technical principles.

The superficial temporal artery to the middle cerebral artery (STA-MCA) bypass is a good example of cerebrovascular anastomosis. In this article, we describe the different stages of the procedure: patient installation, superficial temporal artery harvesting, recipient artery exposure, microsurgical anastomosis, and closure of the craniotomy. When meticulously performed, with the observance of important details at each stage, this technique offers a high rate of technical success (patency>90%) with a very low morbi-mortality (respectively 3% and 1%).

[Familial colloid cyst of the third ventricle: case report and review of the literature].

Colloid cysts of the third ventricle are rare benign lesions. We report here an exceptional familial case defined by the evidence of two colloid cysts in two relatives of the first degree, a mother and her daughter in our description. Only 15 cases are reported in the literature.

[Basal ganglia deep-brain stimulation for treatment of drug-resistant epilepsy: review and current data].

The surgical treatment of intractable epilepsies involving eloquent areas of the cortex is still challenging. Deep-brain stimulation could be an alternative to resective surgery because it can modulate the remote control systems of epilepsy, such as the thalamus and basal ganglia. The surgical experience acquired in the field of movement disorder surgery and the low morbidity of this technic could allow one to apply DBS to intractable epilepsies, such as generalized, motor and bitemporal epilepsies.

[Extra-hippocampal temporal lesions inducing symptomatic drug-resistant epilepsies. Which surgical procedure?].

In partial symptomatic epilepsy due to discrete brain lesion, total removal of the epileptogenic lesion generally yields major reduction of seizures, achieved in 85% of the patients. However, prognosis is worse in patients with symptomatic temporal lobe epilepsy. Implication of the temporo-mesial structures in the seizures genesis is generally considered.

[Origin and consequences of the hypodensity surrounding spontaneous intracerebral hemorrhage in the acute phase].

In the acute phase, spontaneous intracerebral hemorrhage is surrounded by hypodensity, the origin of which is controversial. Its clinical consequences are still under evaluation. Surrounding cerebral ischemia was suggested as its main etiology, but no experimental or clinical data currently supports this etiology.

Nonredundant role of Bax and Bak in Bid-mediated apoptosis.

Animal models suggest that Bax and Bak play an essential role in the implementation of apoptosis and as a result can hinder tumorigenesis. We analyzed the expression of these proteins in 50 human glioblastoma multiforme (GBM) tumors. We found that all the tumors expressed Bak, while three did not express Bax.

Nodular intracerebral lesions can reveal an asymptomatic systemic lymphoma.

Object: To investigate whether a systemic workup is useful to assess the primary or secondary nature of brain lymphoma in immunocompetent patients suffering from nodular intracerebral lesions.

Methods: We retrospectively studied a consecutive series of 62 immunocompetent patients suffering from non-Hodgkin's brain lymphoma and analyzed two parameters: (1) the results of a partial systemic workup and (2) the pattern of relapse for all patients who are currently followed up or were so until death.

Results: The workup was conducted with chest X-ray and blood analysis in all cases, total body CT scan in 31 cases, bone marrow biopsy in 30 and serum lactate dehydrogenase in 29.

[Physiopathology of chronic subdural hematoma].

Coagulation, fibrinolysis and kinin-kallicrein system disorders could explain chronic subdural hematoma pathophysiology. The marked decrease in antithrombin III in the hematoma suggest that the decreased levels of clotting factors were caused by excessive coagulation resulting in clotting factors consumption. The decrease in alpha 2-antiplasmin with the increase of fibrin degradation products suggest that hyperfibrinolytic activity of the subdural hematoma.

Dysautonomia syndrome in the acute recovery phase after traumatic brain injury: relief with intrathecal Baclofen therapy.

In the initial phase of severe head injury, dysautonomic abnormalities are frequent. Within the framework of a prospective study, evaluating the efficacy of continuous intrathecal Baclofen therapy (CIBT) on hypertonia during the initial recovery phase of severe head injury, the authors report on the preliminary results of this treatment on paroxysmal dysautonomia about four patients. Continuous intrathecal Baclofen infusion was first delivered, for a test period, continuously for 6 days.

[Postoperative morbidity and mortality after microsurgical exclusion of cerebral arteriovenous malformations. Current data and analysis of recent literature].

Background And Purpose: Microsurgical exclusion of a cerebral arteriovenous malformation (AVM) can compare favorably with radiosurgery. We sought to assess its rate of morbidity-mortality as it is presently reported in the literature, and to discuss some of its current and worthwhile indications.

Methods: Through Medline and additional searches by hand, we retrieved studies reporting the clinical and angiographic results after microsurgical excision of an AVM published between january 1990 and december 2000.

[The role of surgery in the treatment of glial tumors].

Indications for surgery in the management of glial tumors is twofold. Surgery provides a pathology-based diagnosis that is mandatory in every patient with a clinical diagnosis of glial tumor. However, its role in duration of survival is controversial.

[Apoptosis and pathologies of the central nervous system].

The program of cell death called apoptosis is a biochemical and genetical pathway which has been well conserved throughout evolution. In the past years, the involvement of apoptosis has been shown not only during the embryonic development of the nervous system, but also in neurodegenerative diseases. Moreover, resistance to apoptosis is clearly an important factor in tumor growth and seems to be, at least partially, a major process in chemo- and radio-resistance.

[Chronic bilateral subdural hematomas].

Background And Purpose: Are chronic bilateral subdural hematomas different from unilateral forms in terms of delay of diagnosis, clinical presentation and post-operative recovery or recurrence?

Methods: Etiological, clinical, and radiological aspects and management outcome of bilateral chronic subdural hematomas consecutively managed from 1990 to 1995 were retrospectively analyzed and compared with unilateral forms managed in the same neurosurgical unit during the same period of time.

Results: There were 236 cases. Bilateral subdural hematomas occurred in 41 patients (17.

[Primary central nervous system lymphomas. Diagnostic and prognostic effect of steroid-induced remission].

Purpose: Non-AIDS primary central nervous system lymphomas may respond totally or partially to corticosteroids. These corticoid-induced remissions seems to be very specific for this disease. They have been proposed as diagnostic test.

[Radiosurgery of cerebral arteriovenous malformations. Therapeutic strategies].

Modalities of management of arterio-venous malformations are discussed according to natural history and size of lesion, patient clinical status, and potential side effects of available techniques (microsurgery, radiosurgery, ambolization). Clinical cases illustrate this discussion.

Callosotomy for intractable epilepsy: overall outcome.

The effectiveness of callosotomy to the control of medically intractable epilepsy is still discussed fifty years after the first reported cases. Nevertheless patient selection, type of seizures and epileptic syndromes are now better determined. Atonic and tonic astatic seizures characterized both by clinical and electroencephalographical specific patterns, are the most responsive.

[Prognosis of gliomas].

In a given patient harbouring a glioma, prognosis is simply a question of survival duration rather than projecting the course of illness. The marked variability among glioma patients is due to prognosis factors. That are currently divided into four broad categories: characteristics of the host, characteristics of the tumor, factors related to the influence of the tumor on the host and factors related to treatment.

Low-grade astrocytomas: prognosis factors and elements of management.

Background: The literature provides information concerning prognosis of low-grade astrocytomas, but the series are quite heterogeneous in terms of clinical material, neuropathological evaluation, and statistical methods of analysis. Therapeutical indications are poorly defined. The last World Health Organization (WHO) histological classification provided a very precise definition of low-grade gliomas.