scholarly journals Russian Intraoperative Naming Test: a Standardized Tool to Map Noun and Verb Production during Awake Neurosurgeries

2016 ◽  
Vol 3 (4) ◽  
pp. 4-25 ◽  
Author(s):  
Olga Dragoy ◽  
◽  
Anna Chrabaszcz ◽  
Valeria Tolkacheva ◽  
Svetlana Buklina
Keyword(s):  
Tumor Tissue ◽  
Tumor Resection ◽  
Linguistic Knowledge ◽  
Language Function ◽  
Extensive Resection ◽  
Eloquent Areas ◽  
Communication Disabilities ◽  
Brain Tumor Resection ◽  
Mapping Language ◽  
Naming Test

To minimize permanent postoperative deficits, functional mapping with direct electrical stimulation (DES) is becoming a gold standard when a brain tumor resection must be performed near or within eloquent areas. Due to the devastating impact of communication disabilities, language is one of the most commonly mapped functions. However, standardized linguistic protocols for intraoperative use are still scarce. Here we present the first Russian standardized naming test for mapping noun and verb production during awake neurosurgeries. Its development has been informed by modern (psycho)linguistic knowledge and DES requirements. The test was clinically piloted in a sample of 23 patients who underwent awake craniotomy, with results showing high relevance of the test in combination with DES for mapping language-relevant cortical and subcortical sites. The use of the test intraoperatively enabled extensive resection of tumor tissue while preserving language function in most of the tested patients. The test materials and protocols are freely available online

scholarly journals Cortical plasticity catalyzed by prehabilitation enables extensive resection of brain tumors in eloquent areas

2017 ◽  
Vol 126 (4) ◽  
pp. 1323-1333 ◽  
Author(s):  
Paola A. Rivera-Rivera ◽  
Marcos Rios-Lago ◽  
Sandra Sanchez-Casarrubios ◽  
Osman Salazar ◽  
Miguel Yus ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Tumor Resection ◽  
Extent Of Resection ◽  
Behavioral Training ◽  
Brain Areas ◽  
Extensive Resection ◽  
Who Grade ◽  
Stimulation Intensity ◽  
Eloquent Areas ◽  
Cortical Electrical Stimulation

OBJECTIVE The extent of resection is the most important prognostic factor following brain glioma surgery. However, eloquent areas within tumors limit the extent of resection and, thus, critically affect outcomes. The authors hypothesized that presurgical suppression of the eloquent areas within a tumor by continuous cortical electrical stimulation, coupled with appropriate behavioral training (“prehabilitation”), would induce plastic reorganization and enable a more extensive resection. METHODS The authors report on 5 patients harboring gliomas involving eloquent brain areas within tumors as identified on intraoperative stimulation mapping. A grid of electrodes was placed over the residual tumor, and continuous cortical electrical stimulation was targeted to the functional areas. The stimulation intensity was adjusted daily to provoke a mild functional impairment while the function was intensively trained. RESULTS The stimulation intensity required to impair function increased progressively in all patients, and all underwent another operation a mean of 33.6 days later (range 27–37 days), when the maximal stimulation voltage in all active contacts induced no functional deficit. In all cases, a substantially more extensive resection of the tumor was possible. Intraoperative mapping and functional MRI demonstrated a plastic reorganization, and most previously demonstrated eloquent areas within the tumor were silent, while there was new functional activation of brain areas in the same region or toward the contralateral hemisphere. CONCLUSIONS Prehabilitation with continuous cortical electrical stimulation and appropriate behavioral training prior to surgery in patients with WHO Grade II and III gliomas affecting eloquent areas accelerate plastic changes. This can help maximize tumor resection and, thus, improve survival while maintaining function.

scholarly journals Neuronavigation for Intracranial Meningiomas

2018 ◽  
Vol 22 (4) ◽  
pp. 143-149
Author(s):  
Erasmo Barros Da Silva ◽  
Lucas Alves Aurich ◽  
Luis Fernando Moura Da Silva Junior ◽  
Jerônimo Buzetti Milano ◽  
Ricardo Ramina
Keyword(s):  
Brain Tumor ◽  
Surgical Treatment ◽  
Tumor Resection ◽  
Intracranial Meningioma ◽  
Tumor Localization ◽  
Eloquent Areas ◽  
Brain Tumor Resection ◽  
Meningioma Surgery ◽  
Neurovascular Structures ◽  
Deep Brain

According to its location, the surgical treatment of intracranial meningioma can be of considerable challenge for the neurosurgeon. The aplication of neuronavigation for meningioma surgery is commonly related to tumor localization. However, this concept is applied only to convexity located lesions. Its usage can range from a simple craniotomy flap localization to a deep brain tumor resection respecting tract fibers, eloquent areas and neurovascular structures. In some cases, neuronavigation may not be necessary, but, ifavaliable, it should promotes a safer surgery, as it has yet to become an integral part of intracranial procedures. The aim of this article is show how to enhance the neuronavigation usage for meningioma surgery.

scholarly journals Utility of Intraoperative Cortico-Cortical Evoked Potentials for the Evaluation of Language Function During Brain Tumor Resection

2020 ◽  
pp. 1-4
Author(s):  
Jesús Pastor Gómez ◽  
Lorena Vega-Zelaya ◽  
Marta Navas ◽  
Pilar Martín ◽  
Jesús Pastor Gómez
Keyword(s):  
Evoked Potentials ◽  
Language Impairment ◽  
High Reliability ◽  
Tumor Resection ◽  
Language Function ◽  
Cortical Evoked Potentials ◽  
Good Spatial Resolution ◽  
Brain Tumor Resection ◽  
Language Area ◽  
The Relationship

The cortico-cortical evoked potentials (CCEP) are a relatively recent intraoperative monitoring tool that has shown high reliability in detecting the functional language area and its connections. In this work we describe a patient with a tumor located in the language area who underwent tumor resection. A neurophysiological intraoperative mapping of the frontal and posterior language area with the anesthetized patient was carried out. Then the patient was awaked. To demonstrate the relationship between language function and CCEP, the Ojemann’s stimulation technique was used in the same electrodes were CCEPs were obtained. An alteration in the emission of language had been found on the electrodes where CCEP was obtained and in adjacent electrodes. During tumor resection we used a double check for language function: neurological evaluation and CCEPs. We obtained a biunivocal relationship between warning criteria in the CCEP and immediate language impairment on neurological examination. We always observed a significant decrease in the CCEP associated with language impairment. The CCEP are able to obtain information in real time with a good spatial resolution of the language function. Future studies should be carried out in order to analyse the robustness of this technique to perform it in anesthetized patients.

scholarly journals A poor prognostic metastatic nongestational choriocarcinoma of the ovary: a case report and the literature review

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Kimihiro Nishino ◽  
Eiko Yamamoto ◽  
Yoshiki Ikeda ◽  
Kaoru Niimi ◽  
Toshimichi Yamamoto ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Tumor Resection ◽  
Left Lung ◽  
Str Analysis ◽  
Case Presentation ◽  
Gestational Choriocarcinoma ◽  
Mucosal Cells ◽  
Malignant Germ Cell Tumor ◽  
Brain Tumor Resection ◽  
Short Tandem

Abstract Background Pure ovarian choriocarcinoma can be gestational or nongestational in origin. Nongestational pure ovarian choriocarcinoma is extremely rare and the prognosis is thought to be worse than that of the gestational type in patients with metastatic disease. We present a case of metastatic pure ovarian choriocarcinoma with poor prognosis in which the origin was identified as nongestational by DNA short tandem repeat (STR) analysis. Case presentation A nulliparous woman in her thirties with metastatic choriocarcinoma was referred to our hospital after initial treatment proved unsuccessful. Two months earlier, she had undergone brain tumor resection and histological examination confirmed choriocarcinoma. Serum human chorionic gonadotropin (hCG) concentration at initial diagnosis was 5030 IU/L. Two cycles of a combination chemotherapy regimen of methotrexate, etoposide, and actinomycin-D (MEA therapy), which is commonly used for gestational choriocarcinoma, was administered. However, the disease could not be controlled. Imaging modalities at presentation revealed tumor present in the left ovary and left lung, but not in the uterus, which led us think that the choriocarcinoma was nongestational. Bleomycin, etoposide, and cisplatin (BEP therapy) which is commonly used for nongestational choriocarcinoma (malignant germ cell tumor) and surgical resection of the uterus, bilateral ovaries, and an affected part of the left lung led to the nadir level of hCG, but the tumor relapsed and levels of hCG again increased. To investigate the origin of choriocarcinoma, we performed DNA STR analysis of tumor cells and oral mucosal cells. Analysis revealed the origin of the choriocarcinoma as nongestational, as the genotype of tumor cells entirely corresponded with that of oral mucosal cells. BEP therapy and chemotherapy regimens administered for nongestational choriocarcinoma and gestational choriocarcinoma proved ineffective, and the patient died 21 months after diagnosis of metastatic choriocarcinoma. Conclusion Metastaic nongestational pure choriocarcinoma of ovary is an extremely rare and an aggressive disease, frequently resulting in poor outcome.

Personality and behavioral changes after brain tumor resection: a lesion mapping study

2021 ◽  
Vol 163 (5) ◽  
pp. 1257-1267 ◽  
Author(s):  
Anne-Laure Lemaitre ◽  
Guillaume Herbet ◽  
Hugues Duffau ◽  
Gilles Lafargue
Keyword(s):  
Brain Tumor ◽  
Tumor Resection ◽  
Behavioral Changes ◽  
Mapping Study ◽  
Lesion Mapping ◽  
Brain Tumor Resection

Neurosurgical virtual reality simulation metrics to assess psychomotor skills during brain tumor resection

2014 ◽  
Vol 10 (5) ◽  
pp. 603-618 ◽  
Author(s):  
Hamed Azarnoush ◽  
Gmaan Alzhrani ◽  
Alexander Winkler-Schwartz ◽  
Fahad Alotaibi ◽  
Nicholas Gelinas-Phaneuf ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Brain Tumor ◽  
Tumor Resection ◽  
Psychomotor Skills ◽  
Virtual Reality Simulation ◽  
Brain Tumor Resection

Perioperative Glycemia Management in Patients Undergoing Craniotomy for Brain Tumor Resection: a Global Survey of Neuroanesthesiologists’ Perceptions and Practices

2021 ◽  
Author(s):  
Shaun E. Gruenbaum ◽  
Christian S. Guay ◽  
Benjamin F. Gruenbaum ◽  
Aidos Konkayev ◽  
Andrea Falegnami ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Tumor Resection ◽  
Global Survey ◽  
Brain Tumor Resection

Three-dimensional Force Perception of Robotic Bipolar Forceps for Brain Tumor Resection

2021 ◽  
Author(s):  
Xiu-Heng Zhang ◽  
Heng Zhang ◽  
Zhen Li ◽  
Gui-Bin Bian
Keyword(s):  
Brain Tumor ◽  
Real Time ◽  
Force Measurement ◽  
Measurement Techniques ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Contact Forces ◽  
Surgical Instruments ◽  
Force Perception ◽  
Brain Tumor Resection

Abstract Three-dimensional force perception is critically important in the enhancement of human force perception to minimize brain injuries resulting from excessive forces applied by surgical instruments in robot-assisted brain tumor resection. And surgeons are not responsive enough to interpret tool-tissue interaction forces. In previous studies, various force measurement techniques have been published. In neurosurgical scenarios, there are still some drawbacks to these presented approaches to forces perception. Because of the narrow, and slim configuration of bipolar forceps, three-dimensional contact forces on forceps tips is not easy to be traced in real-time. Five fundamental acts of handling bipolar forceps are poking, opposing, pressing, opening, and closing. The first three acts independently correspond to the axial force of z, x, y. So, in this paper, typical interactions between bipolar forceps and brain tissues have been analyzed. A three-dimensional force perception technique to collect force data on bipolar forceps tips by installing three Fiber Bragg Grating Sensors (FBGs) on each prong of bipolar forceps in real-time is proposed. Experiments using a tele-neurosurgical robot were performed on an in-vitro pig brain. In the experiments, three-dimensional forces were tracked in real-time. It is possible to experience forces at a minimum of 0.01 N. The three-dimensional force perception range is 0-4 N. The calibrating resolution on x, y, and z, is 0.01, 0.03, 0.1 N, separately. According to our observation, the measurement accuracy precision is over 95%.

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