scholarly journals Prosopagnosia associated with brain metastasis near the inferior longitudinal fasciculus in the nondominant temporal lobe: illustrative case

2021 ◽  
Vol 2 (10) ◽  
Author(s):  
Hannah K. Weiss ◽  
Donato R. Pacione ◽  
Steven Galetta ◽  
Douglas Kondziolka
Keyword(s):  
Brain Metastasis ◽  
Temporal Lobe ◽  
Visual Processing ◽  
Diffusion Tensor ◽  
Gamma Knife Radiosurgery ◽  
Preoperative Imaging ◽  
Illustrative Case ◽  
Dominant Female ◽  
Breast Cancer Brain Metastasis ◽  
Inferior Longitudinal Fasciculus

BACKGROUND Disruptions of the inferior longitudinal fasciculus (ILF) in the nondominant temporal lobe can lead to the rare but significant higher visual-processing disturbance of prosopagnosia. Here, the authors describe a 57-year-old right hand-dominant female with a large breast cancer brain metastasis in the right temporal lobe who underwent resection and subsequent Gamma Knife radiosurgery. She presented with difficulty with facial recognition, but following surgical intervention, the prosopagnosia became more profound. OBSERVATIONS Even in nondominant cortex, significant deficits can arise when operating near higher visual-processing centers, including the ILF. LESSONS This case highlights the utility of imaging-based tractography obtained from preoperative imaging for resective surgical planning even when operating in areas that do not involve what is traditionally considered elegant areas of the brain. To optimize neurological outcomes in metastatic tumor resection, awareness and diffusion tensor imaging of neighboring, displaced white matter tracts may prevent permanent deficits in higher visual processing.

scholarly journals Prosopagnosia following nonlanguage dominant inferior temporal lobe low-grade glioma resection in which the inferior longitudinal fasciculus was disrupted preoperatively: illustrative case

2021 ◽  
Vol 2 (10) ◽  
Author(s):  
Jacob S. Young ◽  
Ramin A. Morshed ◽  
John P. Andrews ◽  
Soonmee Cha ◽  
Mitchel S. Berger
Keyword(s):  
Temporal Lobe ◽  
Visual Processing ◽  
Young Female ◽  
Illustrative Case ◽  
Low Grade ◽  
Diffuse Glioma ◽  
Inferior Longitudinal Fasciculus ◽  
The Right ◽  
Complication Of Surgery ◽  
Glioma Resection

BACKGROUND Prosopagnosia is a rare neurological condition characterized by the impairment of face perception with preserved visual processing and cognitive functioning and is associated with injury to the fusiform gyrus and inferior longitudinal fasciculus (ILF). Reports of this clinical impairment following resection of right temporal lobe diffuse gliomas in the absence of contralateral injury are exceedingly scarce and not expected as a complication of surgery. OBSERVATIONS The authors describe the case of a young female patient found to have an incidental diffuse glioma in the right inferior temporal lobe despite evidence of preoperative ILF disruption by the tumor. Following resection of the lesion, despite the preoperative disruption to the ILF by the tumor, the patient developed prosopagnosia. There was no evidence of contralateral, left-sided ILF injury. LESSONS Given the significant functional impairment associated with prosopagnosia, neurosurgeons should be aware of the exceedingly rare possibility of a visual-processing deficit following unilateral and, in this case, right-sided inferior temporal lobe glioma resections. More investigation is needed to determine whether preoperative testing can determine dominance of facial-processing networks for patients with lesions in the right inferior posterior temporooccipital lobe and whether intraoperative mapping could help prevent this complication.

Prognostic value of pretreatment MRI texture features in breast cancer brain metastasis treated with Gamma Knife radiosurgery

2020 ◽  
pp. 028418512095629
Author(s):  
Yingyan Zheng ◽  
Daoying Geng ◽  
Tonggang Yu ◽  
Wei Xia ◽  
Dejun She ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastasis ◽  
Gamma Knife ◽  
Prognostic Value ◽  
Gamma Knife Radiosurgery ◽  
Texture Features ◽  
Progression Free Survival ◽  
Target Lesion ◽  
Prognostic Models ◽  
Breast Cancer Brain Metastasis

Background Gamma Knife radiosurgery (GKS) was recommended for treating patients with breast cancer brain metastasis (BCBM), but predictions of the existing prognostic models for therapeutic responsiveness vary substantially. Purpose To investigate the prognostic value of pretreatment clinical, MRI radiologic, and texture features in patients with BCBM undergoing GKS. Material and Methods The data of 81 BCBMs in 44 patients were retrospectively reviewed. Progressive disease was defined as an increase of at least 20% in the longest diameter of the target lesion or the presence of new intracranial lesions on contrast-enhanced T1-weighted (CE-T1W) imaging. Radiomic features were extracted from pretreatment CE-T1W images, T2-weighted (T2W) images, and ADC maps. Cox proportional hazard analyses were performed to identify independent predictors associated with BCBM-specific progression-free survival (PFS). A nomogram was constructed and its calibration ability was assessed. Results The cumulative BCBM-specific PFS was 52.27% at six months and 11.36% at one year, respectively. Age (hazard ratio [HR] 1.04; 95% confidence interval [CI] 1.01–1.06; P = 0.004) and CE-T1W-based kurtosis (HR 0.72; 95% CI 0.57–0.92; P = 0.008) were the independent predictors. The combination of CE-T1W-based kurtosis and age displayed a higher C-index (C-index 0.70; 95% CI 0.63–0.77) than did CE-T1W-based kurtosis (C-index 0.65; 95% CI 0.57–0.73) or age (C-index 0.63; 95% CI 0.56–0.70) alone. The nomogram based on the combinative model provided a better performance over age ( P < 0.05). The calibration curves elucidated good agreement between prediction and observation for the probability of 7- and 12-month BCBM-specific PFS. Conclusion Pretreatment CE-T1W-based kurtosis combined with age could improve prognostic ability in patients with BCBM undergoing GKS.

scholarly journals Management of brain metastasis from eccrine porocarcinoma: illustrative case

2021 ◽  
Vol 1 (26) ◽  
Author(s):  
Ryuichi Noda ◽  
Tomohiro Inoue ◽  
Sho Tsunoda ◽  
Masafumi Segawa ◽  
Yoshio Masuda ◽  
...  
Keyword(s):  
Brain Metastasis ◽  
Clinical Course ◽  
Case Reports ◽  
Multidisciplinary Treatment ◽  
Brain Lesion ◽  
Gamma Knife Radiosurgery ◽  
Skin Tumor ◽  
Illustrative Case ◽  
Malignant Skin ◽  
Eccrine Porocarcinoma

BACKGROUND Eccrine porocarcinoma (EP) is a rare malignant skin neoplasm, and there are still many unknowns regarding its natural history and treatment. Due to its scarcity, associated brain metastasis is a far rarer condition. OBSERVATIONS A 71-year-old-woman with a history of EP was diagnosed with brain metastasis. In her clinical course, the patient underwent tumor removal surgery twice and Gamma Knife radiosurgery (GKRS) four times. The tumor showed a good response to radiotherapy. The histopathological findings of the brain tumor were consistent with those of the primary skin tumor. LESSONS There are only a few case reports referring to the detailed treatment, especially with GKRS, of brain metastasis from EP. Few reports have presented a detailed histopathological comparison between the primary skin lesion and the metastatic brain lesion. Herein, the authors have described the clinical course, histological features, and results of multidisciplinary treatment for brain metastasis of EP.

scholarly journals Dissociable roles of the inferior longitudinal fasciculus and fornix in face and place perception

eLife ◽  
2015 ◽  
Vol 4 ◽  
Author(s):  
Carl J Hodgetts ◽  
Mark Postans ◽  
Jonathan P Shine ◽  
Derek K Jones ◽  
Andrew D Lawrence ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Scene Perception ◽  
Diffusion Tensor ◽  
Blood Oxygen Level Dependent ◽  
Blood Oxygen ◽  
Bold Response ◽  
Blood Oxygen Level ◽  
Inferior Longitudinal Fasciculus ◽  
Healthy Participants

We tested a novel hypothesis, generated from representational accounts of medial temporal lobe (MTL) function, that the major white matter tracts converging on perirhinal cortex (PrC) and hippocampus (HC) would be differentially involved in face and scene perception, respectively. Diffusion tensor imaging was applied in healthy participants alongside an odd-one-out paradigm sensitive to PrC and HC lesions in animals and humans. Microstructure of inferior longitudinal fasciculus (ILF, connecting occipital and ventro-anterior temporal lobe, including PrC) and fornix (the main HC input/output pathway) correlated with accuracy on odd-one-out judgements involving faces and scenes, respectively. Similarly, blood oxygen level-dependent (BOLD) response in PrC and HC, elicited during oddity judgements, was correlated with face and scene oddity performance, respectively. We also observed associations between ILF and fornix microstructure and category-selective BOLD response in PrC and HC, respectively. These striking three-way associations highlight functionally dissociable, structurally instantiated MTL neurocognitive networks for complex face and scene perception.

Temporal disconnection between pain relief and trigeminal nerve microstructural changes after Gamma Knife radiosurgery for trigeminal neuralgia

2020 ◽  
Vol 133 (3) ◽  
pp. 727-735
Author(s):  
Peter Shih-Ping Hung ◽  
Sarasa Tohyama ◽  
Jia Y. Zhang ◽  
Mojgan Hodaie
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Pain Intensity ◽  
Gamma Knife ◽  
Trigeminal Nerve ◽  
Diffusion Tensor ◽  
Gamma Knife Radiosurgery ◽  
Time Points ◽  
Microstructural Effect

OBJECTIVEGamma Knife radiosurgery (GKRS) is a noninvasive surgical treatment option for patients with medically refractive classic trigeminal neuralgia (TN). The long-term microstructural consequences of radiosurgery and their association with pain relief remain unclear. To better understand this topic, the authors used diffusion tensor imaging (DTI) to characterize the effects of GKRS on trigeminal nerve microstructure over multiple posttreatment time points.METHODSNinety-two sets of 3-T anatomical and diffusion-weighted MR images from 55 patients with TN treated by GKRS were divided within 6-, 12-, and 24-month posttreatment time points into responder and nonresponder subgroups (≥ 75% and < 75% reduction in posttreatment pain intensity, respectively). Within each subgroup, posttreatment pain intensity was then assessed against pretreatment levels and followed by DTI metric analyses, contrasting treated and contralateral control nerves to identify specific biomarkers of successful pain relief.RESULTSGKRS resulted in successful pain relief that was accompanied by asynchronous reductions in fractional anisotropy (FA), which maximized 24 months after treatment. While GKRS responders demonstrated significantly reduced FA within the radiosurgery target 12 and 24 months posttreatment (p < 0.05 and p < 0.01, respectively), nonresponders had statistically indistinguishable DTI metrics between nerve types at each time point.CONCLUSIONSUltimately, this study serves as the first step toward an improved understanding of the long-term microstructural effect of radiosurgery on TN. Given that FA reductions remained specific to responders and were absent in nonresponders up to 24 months posttreatment, FA changes have the potential of serving as temporally consistent biomarkers of optimal pain relief following radiosurgical treatment for classic TN.

Emerging Drugs for the Treatment of Breast Cancer Brain Metastasis: A Review of Patent Literature

2018 ◽  
Vol 13 (3) ◽  
pp. 348-359 ◽  
Author(s):  
Maricruz Anaya-Ruiz ◽  
Cindy Bandala ◽  
Patricia Martinez-Morales ◽  
Gerardo Landeta ◽  
Rebeca D. Martinez-Contreras ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastasis ◽  
Breast Cancer Brain Metastasis ◽  
Patent Literature

scholarly journals Microstructural Measures of the Inferior Longitudinal Fasciculus Predict Later Cognitive and Language Development in Infants Born With Extremely Low Birth Weight

2021 ◽  
pp. 088307382110198
Author(s):  
Matthew C. Bugada ◽  
Julia E. Kline ◽  
Nehal A. Parikh
Keyword(s):  
Diffusion Tensor Imaging ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Language Development ◽  
Fractional Anisotropy ◽  
Diffusion Tensor ◽  
Structural Mri ◽  
Extremely Low Birth Weight ◽  
Extremely Preterm ◽  
Inferior Longitudinal Fasciculus

Objective: Extremely preterm children are at high risk for adverse neurodevelopmental outcomes. Identifying predictors of discrete developmental outcomes early in life would allow for targeted neuroprotective therapies when neuroplasticity is at its peak. Our goal was to examine whether diffusion magnetic resonance imaging (MRI) metrics of the inferior longitudinal and uncinate fasciculi early in life could predict later cognitive and language outcomes. Study Design: In this pilot study, 43 extremely low-birth-weight preterm infants were scanned using diffusion MRI at term-equivalent age. White matter tracts were assessed via diffusion tensor imaging metrics of fractional anisotropy and mean diffusivity. The Language and Cognitive subscale scores of the Bayley Scales of Infant & Toddler Development-III at 18-22 months corrected age were our outcomes of interest. Multiple linear regression models were created to assess diffusion metrics of the inferior longitudinal and uncinate fasciculi as predictors of Bayley scores. We controlled for brain injury score on structural MRI, maternal education, birth weight, and age at MRI scan. Results: Of the 43 infants, 36 infants had high-quality diffusion tensor imaging and returned for developmental testing. The fractional anisotropy of the inferior longitudinal fasciculus was associated with Bayley-III scores in univariate analyses and was an independent predictor of Bayley-III cognitive and language development over and above known predictors in multivariable analyses. Conclusions: Incorporating new biomarkers such as the fractional anisotropy of the inferior longitudinal fasciculus with structural MRI findings could enhance accuracy of neurodevelopment predictive models. Additional research is needed to validate our findings in a larger cohort.

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