scholarly journals Technical Note: Virtual phantom analyses for preprocessing evaluation and detection of a robust feature set for MRI‐radiomics of the brain

2019 ◽  
Vol 46 (11) ◽  
pp. 5116-5123 ◽  
Author(s):  
Marco Bologna ◽  
Valentina Corino ◽  
Luca Mainardi
Keyword(s):  
Technical Note ◽  
The Brain ◽  
Virtual Phantom

Utility of depth electrode placement in the neurosurgical management of bottom-of-sulcus lesions: technical note

2019 ◽  
Vol 24 (3) ◽  
pp. 284-292
Author(s):  
Eisha A. Christian ◽  
Elysa Widjaja ◽  
Ayako Ochi ◽  
Hiroshi Otsubo ◽  
Stephanie Holowka ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Focal Cortical Dysplasia ◽  
Target Identification ◽  
Cortical Dysplasia ◽  
Technical Note ◽  
Electrode Placement ◽  
Electrode Implantation ◽  
Depth Electrodes ◽  
Intracranial Electrode ◽  
The Brain

OBJECTIVESmall lesions at the depth of the sulcus, such as with bottom-of-sulcus focal cortical dysplasia, are not visible from the surface of the brain and can therefore be technically challenging to resect. In this technical note, the authors describe their method of using depth electrodes as landmarks for the subsequent resection of these exacting lesions.METHODSA retrospective review was performed on pediatric patients who had undergone invasive electroencephalography with depth electrodes that were subsequently used as guides for resection in the period between July 2015 and June 2017.RESULTSTen patients (3–15 years old) met the criteria for this study. At the same time as invasive subdural grid and/or strip insertion, between 2 and 4 depth electrodes were placed using a hand-held frameless neuronavigation technique. Of the total 28 depth electrodes inserted, all were found within the targeted locations on postoperative imaging. There was 1 patient in whom an asymptomatic subarachnoid hemorrhage was demonstrated on postprocedural imaging. Depth electrodes aided in target identification in all 10 cases.CONCLUSIONSDepth electrodes placed at the time of invasive intracranial electrode implantation can be used to help localize, target, and resect primary zones of epileptogenesis caused by bottom-of-sulcus lesions.

scholarly journals A Simple Method to Avoid Brain Shift during Neuronavigation: Technical Note

2020 ◽  
Author(s):  
Jair Leopoldo Raso
Keyword(s):  
Dura Mater ◽  
Brain Area ◽  
Conventional Technique ◽  
Technical Note ◽  
Cortical Surface ◽  
Brain Shift ◽  
Simple Method ◽  
Cortex Area ◽  
Neuronavigation System ◽  
The Brain

Abstract Introduction The precise identification of anatomical structures and lesions in the brain is the main objective of neuronavigation systems. Brain shift, displacement of the brain after opening the cisterns and draining cerebrospinal fluid, is one of the limitations of such systems. Objective To describe a simple method to avoid brain shift in craniotomies for subcortical lesions. Method We used the surgical technique hereby described in five patients with subcortical neoplasms. We performed the neuronavigation-guided craniotomies with the conventional technique. After opening the dura and exposing the cortical surface, we placed two or three arachnoid anchoring sutures to the dura mater, close to the edges of the exposed cortical surface. We placed these anchoring sutures under microscopy, using a 6–0 mononylon wire. With this technique, the cortex surface was kept close to the dura mater, minimizing its displacement during the approach to the subcortical lesion. In these five cases we operated, the cortical surface remained close to the dura, anchored by the arachnoid sutures. All the lesions were located with a good correlation between the handpiece tip inserted in the desired brain area and the display on the navigation system. Conclusion Arachnoid anchoring sutures to the dura mater on the edges of the cortex area exposed by craniotomy constitute a simple method to minimize brain displacement (brain-shift) in craniotomies for subcortical injuries, optimizing the use of the neuronavigation system.

Microvascular Compressicaude by Slinging a Tortuous Vertebrobasilar Artery to the Petrous Dura in Hemifacial Spasm: Technical Note

2018 ◽  
Vol 37 (04) ◽  
pp. 352-361
Author(s):  
Forhad Chowdhury ◽  
Mohammod Haque ◽  
Jalal Rumi ◽  
Monir Reza
Keyword(s):  
Vertebral Artery ◽  
Free Flap ◽  
Hemifacial Spasm ◽  
Technical Note ◽  
Taxi Driver ◽  
Treatment Technique ◽  
Entry Zone ◽  
Temporal Fascia ◽  
Vertebrobasilar Artery ◽  
The Brain

Objective In cases of hemifacial spasm caused by a tortuous vertebrobasilar artery (TVBA), the traditional treatment technique involves Teflon (polytetrafluoroethylene), which can be ineffective and fraught with recurrence and neurological complications. In such cases, there are various techniques of arteriopexy using adhesive compositions, ‘suspending loops’ made of synthetic materials, dural or fascial flaps, surgical sutures passed around or through the vascular adventitia, as well as fenestrated aneurysmal clips. In the present paper, we describe a new technique of slinging the vertebral artery (VA) to the petrous dura for microvascular decompression (MVD) in a patient with hemifacial spasm caused by a TVBA. Method A 50-year-old taxi driver presented with a left-sided severe hemifacial spasm. A magnetic resonance imaging (MRI) scan of the brain showed a large tortuous left-sided vertebral artery impinging and compressing the exit/entry zone of the 7th and 8th nerve complex. After a craniotomy, a TVBA was found impinging and compressing the entry zone of the 7th and 8th nerve complex. Arachnoid bands attaching the artery to the nerve complex and the pons were released by sharp microdissection. Through the upper part of the incision, a 2.5 × 1 cm temporal fascia free flap was harvested. After the fixation of the free flap, a 6–0 prolene suture was passed through its length several times using the traditional Bengali sewing and stitching techniques to make embroidered quilts called Nakshi katha. The ‘prolenated’ fascia was passed around the compressing portion of the VA. Both ends of the fascia were brought together and stitched to the posterior petrous dura to keep the TVBA away from the 7th and 8th nerves and the pons. Result The patient had no hemifacial spasm immediately after the recovery from the anesthesia. A postoperative MRI of the brain showed that the VA was away from the entry zone of the 7th and 8th nerves. Conclusion The ‘prolenated’ temporal fascia slinging technique may be a very good option of MVD in cases in which the causative vessel is a TVBA.

scholarly journals The accuracy of linear indices of ventricular volume in pediatric hydrocephalus: technical note

2015 ◽  
Vol 15 (6) ◽  
pp. 547-551 ◽  
Author(s):  
Dustin K. Ragan ◽  
Jonathon Cerqua ◽  
Tiffany Nash ◽  
Robert C. McKinstry ◽  
Joshua S. Shimony ◽  
...  
Keyword(s):  
Ventricular Volume ◽  
Brain Parenchyma ◽  
Technical Note ◽  
Congenital Hydrocephalus ◽  
Ventricular Size ◽  
Brain Volumes ◽  
Pediatric Hydrocephalus ◽  
Evans Index ◽  
The Relationship ◽  
The Brain

Assessment of ventricular size is essential in clinical management of hydrocephalus and other neurological disorders. At present, ventricular size is assessed using indices derived from the dimensions of the ventricles rather than the actual volumes. In a population of 22 children with congenital hydrocephalus and 22 controls, the authors evaluated the relationship between ventricular volume and linear indices in common use, such as the frontooccipital horn ratio, Evans' index, and the bicaudate index. Ventricular volume was measured on high-resolution anatomical MR images. The frontooccipital horn ratio was found to have a stronger correlation with both absolute and relative ventricular volume than other indices. Further analysis of the brain volumes found that congenital hydrocephalus produced a negligible decrease in the volume of the brain parenchyma.

scholarly journals Endoscopic Assistance in the Deep and Narrow Spaces of the Brain—Microscopic Tumor Surgery Supported by the New Micro-Inspection Tool QEVO® (Technical Note)

2021 ◽  
Vol 8 ◽  
Author(s):  
Karl-Michael Schebesch ◽  
Christian Doenitz ◽  
Julius Höhne ◽  
Amer Haj ◽  
Nils Ole Schmidt
Keyword(s):  
Time Frame ◽  
Foramen Magnum ◽  
Technical Note ◽  
Intracranial Lesions ◽  
Endoscopic Assistance ◽  
Surgical Field ◽  
Rhomboid Fossa ◽  
The Brain ◽  
Anatomical Area ◽  
Endoscopic Device

Introduction: To evaluate the feasibility and efficacy of the innovative micro-inspection tool QEVO® (Carl Zeiss Meditec, Oberkochen, Germany) as an endoscopic adjunct to microscopes for better visualization of the surgical field in complex deep-seated intracranial tumors in infants and adults.Materials and Methods: We retrospectively assessed the surgical videos of 25 consecutive patients with 26 complex intracranial lesions (time frame 2018–2020). Lesions were classified according to their anatomical area: 1 = sellar region (n = 6), 2 = intra-ventricular (except IV.ventricle, n = 9), 3 = IV.ventricle and rhomboid fossa (n = 4), and 4 = cerebellopontine angle (CPA) and foramen magnum (n = 7). Indications to use the QEVO® tool were divided into five “QEVO® categories”: A = target localization, B = tailoring of the approach, C = looking beyond the lesion, D = resection control, and E = inspection of remote areas.Results: Overall, the most frequent indications for using the QEVO® tool were categories D (n = 19), C (n = 17), and E (n = 16). QEVO® categories B (n = 8) and A (n = 5) were mainly applied to intra-ventricular procedures (anatomical area 2).Discussion: The new micro-inspection tool QEVO® is a powerful endoscopic device to support the comprehensive visualization of complex intracranial lesions and thus instantly increases intraoperative morphological understanding. However, its use is restricted to the specific properties of the respective anatomical area.

scholarly journals Embedding Brains In Egg Yolk For Cryosectioning

1998 ◽  
Vol 6 (5) ◽  
pp. 16-17
Author(s):  
Karen Ayyad
Keyword(s):  
Rat Brain ◽  
Brain Tissue ◽  
Egg Yolk ◽  
Technical Note ◽  
Ice Crystals ◽  
Whole Brain ◽  
Dog Brain ◽  
Chicken Eggs ◽  
The Brain

Fifteen years ago, I learned from a neurologist how to embed perfused, glutaraldehyde-fixed rat brain in egg yolk (from store-bought, separated chicken eggs). The original technical note by Adoff (reference below) for whole dog brain tissue was used, and we adapted the procedure for rat brain.1) Fix the whole brain, minus the meningas, in 10% formalin or glutaraldehydesucrose (1 % glutaraldehyde + 30% sucrose), then place in a specimen container of 30% sucrose, 10% formalin and 0.9% NaCl, The brain is left in this solution until it sinks (less than a week). This step prevents formation of ice crystals when freezing (The meninges must be removed, or the brain will not adhere to the egg yolk.).

Scaled Suction for Microneurosurgery: Technical Note

2005 ◽  
Vol 57 (suppl_4) ◽  
pp. ONS-E413-ONS-E413 ◽  
Author(s):  
Yoshikazu Okada ◽  
Takakazu Kawamata ◽  
Mikhail F. Chernov ◽  
Tomokatsu Hori
Keyword(s):  
Brain Tumor ◽  
Tumor Size ◽  
Lesion Size ◽  
Technical Note ◽  
Suction Device ◽  
Aneurysm Neck ◽  
Neck Width ◽  
The Brain

Abstract OBJECTIVE: We have developed scaled suction to facilitate the measurement of aneurysm neck width and tumor size during operations. METHODS: We constructed a new suction device scaled every 1 mm from the tip to 3 cm and every 5 mm from 3 to 5 cm. The scaled suction devices have been used in 50 aneurysm and brain tumor operations. RESULTS: The new suction device permits easy measurement of aneurysm neck width, tumor size, the extent of internal decompression of tumor, and depth from the surface of the brain to the lesion. CONCLUSION: Our scaled suction device is a simple and useful navigator for continuously measuring intraoperative variables such as lesion size and distance between the lesion and the surrounding vital structures.

Pressure-mounted Cottonoids: Technical Note

Neurosurgery ◽  
1982 ◽  
Vol 11 (6) ◽  
pp. 786-786
Author(s):  
Ehud Arbit
Keyword(s):  
Negative Pressure ◽  
Technical Note ◽  
Suction Device ◽  
The Face ◽  
The Brain ◽  
High Aspiration

Abstract A newly designed cottonoid is fixed to the tip of the suction device by the negative pressure. It is especially useful during microsurgical procedures in areas crowded with neurovascular elements. The advantage of pressure-mounted cottonoids lies in the protection provided to the brain and neurovascular elements during suction, even in the face of high aspiration pressure, and in the simplicity of their use.

The Use of Semitranslucent Rubber Pledgets During Microsurgical Dissection of Cerebellopontine Angle Tumors: Technical Note

2017 ◽  
Vol 14 (1) ◽  
pp. 6-9
Author(s):  
Marcus D Mazur ◽  
Richard Gurgel ◽  
Joel D MacDonald
Keyword(s):  
Cerebellopontine Angle ◽  
Cranial Nerves ◽  
Technical Note ◽  
Anatomical Structures ◽  
Tumor Capsule ◽  
Latex Gloves ◽  
Neural Tissues ◽  
Brain Interface ◽  
Surgical Field ◽  
The Brain

Abstract BACKGROUND AND IMPORTANCE Dissection of cerebellopontine angle (CPA) tumors that abut or adhere to the brainstem or cranial nerves can be a challenging surgical endeavor. We describe the use of semitranslucent latex rubber pledgets in the tumor–brain interface as a method to improve visualization and protection of vital tissue during microsurgical dissection of CPA masses. The rubber pledgets are fashioned by cutting circular discs out of the cuff portion of talc-free, partially opaque latex gloves. These pledgets provide a semitranslucent, nonadherent membrane that can be placed between vital neural tissues and a tumor capsule to minimize trauma during dissection. The semitranslucent latex enables visualization of the underlying anatomical structures while also providing a protective surface onto which a suction device can be rested to facilitate clearance of the surgical field. CLINICAL PRESENTATION A 56-yr-old woman with left ear tinnitus presented with a 3-cm CPA meningioma. During microsurgical dissection, rubber pledgets were used to preserve the interface between the brain stem, cranial nerves, and tumor capsule. The use of the rubber pledgets appeared to secure the interface between to tumor and the brain while at the same time protecting the cranial nerves, brainstem, and cerebellum. CONCLUSION Semitranslucent rubber pledgets may facilitate microsurgical dissection of CPA tumors.

scholarly journals A technical note

2020 ◽  
pp. 321-325
Author(s):  
Samer S. Hoz ◽  
Zaid Aljuboori ◽  
Zahraa F. Al-Sharshahi
Keyword(s):  
Technical Note ◽  
Lamina Terminalis ◽  
Anterior Circulation ◽  
Critical Part ◽  
Aneurysm Clipping ◽  
Lumbar Drain ◽  
Specific Setting ◽  
Brain Relaxation ◽  
The Brain

The Liliequist membrane is a critical membrane located at the base of the brain separating the supratentorial from the infratentorial cisterns. The advantages of Liliequist membrane fenestration as a critical part of the pterional trans-Sylvian approach for ruptured anterior circulation aneurysm clipping is not well established. We demonstrated that the fundamental role of Liliequist membrane fenestration is brain relaxation through the egress of CSF that is not usually gained from other modalities (e.g., placement of a lumbar drain, fenestration of lamina terminalis) in this specific setting.

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