scholarly journals Transient Hemiglossal Denervation during Acute Internal Capsule Infarct in the Setting of Dysarthria−Clumsy Hand Syndrome

2009 ◽  
Vol 31 (7) ◽  
pp. 1266-1267 ◽  
Author(s):  
D.S. Titelbaum ◽  
N.B. Sodha ◽  
M. Moonis
Keyword(s):  
Internal Capsule

Deep brain stimulation of the posterior limb of the internal capsule in the treatment of central poststroke neuropathic pain of the lower limb: case series with long-term follow-up and literature review

2020 ◽  
Vol 133 (3) ◽  
pp. 830-838 ◽  
Author(s):  
Andrea Franzini ◽  
Giuseppe Messina ◽  
Vincenzo Levi ◽  
Antonio D’Ammando ◽  
Roberto Cordella ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Lower Limb ◽  
Internal Capsule ◽  
Posterior Limb ◽  
Vas Score ◽  
The Mean ◽  
Deep Brain ◽  
Stimulation Of

OBJECTIVECentral poststroke neuropathic pain is a debilitating syndrome that is often resistant to medical therapies. Surgical measures include motor cortex stimulation and deep brain stimulation (DBS), which have been used to relieve pain. The aim of this study was to retrospectively assess the safety and long-term efficacy of DBS of the posterior limb of the internal capsule for relieving central poststroke neuropathic pain and associated spasticity affecting the lower limb.METHODSClinical and surgical data were retrospectively collected and analyzed in all patients who had undergone DBS of the posterior limb of the internal capsule to address central poststroke neuropathic pain refractory to conservative measures. In addition, long-term pain intensity and level of satisfaction gained from stimulation were assessed. Pain was evaluated using the visual analog scale (VAS). Information on gait improvement was obtained from medical records, neurological examination, and interview.RESULTSFour patients have undergone the procedure since 2001. No mortality or morbidity related to the surgery was recorded. In three patients, stimulation of the posterior limb of the internal capsule resulted in long-term pain relief; in a fourth patient, the procedure failed to produce any long-lasting positive effect. Two patients obtained a reduction in spasticity and improved motor capability. Before surgery, the mean VAS score was 9 (range 8–10). In the immediate postoperative period and within 1 week after the DBS system had been turned on, the mean VAS score was significantly lower at a mean of 3 (range 0–6). After a mean follow-up of 5.88 years, the mean VAS score was still reduced at 5.5 (range 3–8). The mean percentage of long-term pain reduction was 38.13%.CONCLUSIONSThis series suggests that stimulation of the posterior limb of the internal capsule is safe and effective in treating patients with chronic neuropathic pain affecting the lower limb. The procedure may be a more targeted treatment method than motor cortex stimulation or other neuromodulation techniques in the subset of patients whose pain and spasticity are referred to the lower limbs.

scholarly journals Longitudinal deterioration of white-matter integrity: heterogeneity in the ageing population

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Konstantinos Poulakis ◽  
Robert I Reid ◽  
Scott A Przybelski ◽  
David S Knopman ◽  
Jonathan Graff-Radford ◽  
...  
Keyword(s):  
White Matter ◽  
Internal Capsule ◽  
Population Based ◽  
White Matter Integrity ◽  
Ageing Population ◽  
White Matter Tract ◽  
Imaging Data ◽  
Cognitive Assessments ◽  
Longitudinal Imaging ◽  
Systemic Health

Abstract Deterioration in white-matter health plays a role in cognitive ageing. Our goal was to discern heterogeneity of white-matter tract vulnerability in ageing using longitudinal imaging data (two to five imaging and cognitive assessments per participant) from a population-based sample of 553 elderly participants (age ≥60 years). We found that different clusters (healthy white matter, fast white-matter decliners and intermediate white-matter group) were heterogeneous in the spatial distribution of white-matter integrity, systemic health and cognitive trajectories. White-matter health of specific tracts (genu of corpus callosum, posterior corona radiata and anterior internal capsule) informed about cluster assignments. Not surprisingly, brain amyloidosis was not significantly different between clusters. Clusters had differential white-matter tract vulnerability to ageing (commissural fibres > association/brainstem fibres). Identification of vulnerable white-matter tracts is a valuable approach to assessing risk for cognitive decline.

scholarly journals How I do it: parietal trans-sulcal para-fascicular approach to lateral thalamic/internal capsule cavernous malformation

2021 ◽  
Author(s):  
Michael Amoo ◽  
Kieron J. Sweeney ◽  
Ronan Kilbride ◽  
Mohsen Javadpour
Keyword(s):  
White Matter ◽  
Cavernous Malformation ◽  
Internal Capsule ◽  
Complete Resection ◽  
Brain Lesions ◽  
Tubular Retractor ◽  
Surgical Technology ◽  
Feasible Alternative ◽  
Traditional Approaches ◽  
Deep Brain

Abstract Background The surgical management of deep brain lesions is challenging, with significant morbidity. Advances in surgical technology have presented the opportunity to tackle these lesions. Methods We performed a complete resection of a thalamic/internal capsule CM using a tubular retractor system via a parietal trans-sulcal para-fascicular (PTPF) approach without collateral injury to the nearby white matter tracts. Conclusion PTPF approach to lateral thalamic/internal capsule lesions can be safely performed without injury to eloquent white matter fibres. The paucity of major vessels along this trajectory and the preservation of lateral ventricle integrity make this approach a feasible alternative to traditional approaches.

scholarly journals A Case of Anterior Choroidal Artery Occlusion and Stroke Secondary to External Compression

2021 ◽  
pp. 369-374
Author(s):  
Satya Narayana Patro ◽  
Khawaja Hassan Haroon ◽  
Khansabegum Tamboli ◽  
Abdulaziz Zafar ◽  
Suhail Hussain ◽  
...  
Keyword(s):  
Medial Temporal Lobe ◽  
Optic Tract ◽  
Internal Capsule ◽  
Cerebral Peduncle ◽  
Anterior Choroidal Artery ◽  
Vessel Occlusion ◽  
External Compression ◽  
Posterior Limb ◽  
Anterior Choroidal ◽  
Choroidal Artery

The anterior choroidal artery (AChA) is a small artery commonly arising from the supraclinoid segment of the internal carotid artery (ICA). The significance of the AChA is related to its strategic supply to various important structures of the brain, such as the optic tract, the posterior limb of the internal capsule, the cerebral peduncle, the lateral geniculate body, medial temporal lobe, medial area of pallidum, and the choroid plexus [<i>J Neurol</i>. 1988;235:387–91]. The AChA syndrome in its complete form consists of the triad of hemiplegia, hemisensory loss, and hemianopia. However, incomplete forms are more frequent in clinical practice [<i>Stroke</i>. 1994;25:837–42]. Isolated infarction in the AChA territory is relatively rare. The presumed pathogenic mechanisms of AChA infarction are cardiac emboli, large-vessel atherosclerosis, dissection of the ICA, small-vessel occlusion, or other determined or undetermined causes [<i>Stroke</i>. 1994;25:837–42 and <i>J Neurol Sci</i>. 2009;281:80–4].

scholarly journals LINC-06. OBSERVATION ONLY IN A PATIENT WITH SUSPECTED LOW GRADE GLIOMA. SHOULD NEUROSURGERY ALWAYS BE THE FIRST STEP IN LOW AND MIDDLE INCOME COUNTRIES?

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii379-iii379
Author(s):  
Carlos Leal - Cavazos ◽  
Jose Arenas-Ruiz ◽  
Oscar Vidal-Gutierrez
Keyword(s):  
Brain Mri ◽  
Internal Capsule ◽  
Pediatric Brain Tumor ◽  
Clinical History ◽  
Low Grade ◽  
Large Tumor ◽  
Middle Income ◽  
Dismal Prognosis ◽  
Close Observation ◽  
The Right

Abstract BACKGROUND Low grade gliomas (LGGs) are the most frequent pediatric brain tumor and they comprise a variety of histologies. Complete surgery is curative but sometimes its location makes it difficult. Recent publications highlight the excellent long-term outcomes of patients with LGGs with complete and incomplete resected tumors. Current strategies are focused on reducing risks of treatment related sequelae. METHOD We describe a patient with a suspected LGG managed by close observation. We describe the case of a 6 year old female with 5 months history of focal onset seizures. During this time a brain MRI was requested and tumor was evidenced. After “tumor diagnosis” was made family visited a handful of private neurosurgeons with a uniformly dismal prognosis and high risk morbidity from procedures offered. When first seen at our Hospital, the clinical history seemed compatible with a LGG and seizures well controlled with antiepileptic drugs. Neurological examination was completely normal. MRI showed a large tumor (7x5x5 cm) hypointense on T1, hyperintense on T2, without contrast enhancement, involving the right temporal lobe white matter, insula, internal capsule, hipoccampus, thalamus and mesencephalus with middle cerebral artery encasement. Interval imaging was proposed and after 4.5 years since diagnosis the tumor has been stable and patient clinically excellent. CONCLUSION Overall survival in pediatric LGGs is excellent and risk of sequelae should always be part of multidisciplinary team considerations. In centers with significant neurosurgical morbidity, biopsy of large tumors that are compatible with LGG may not be required in selected cases.

scholarly journals VI. A record of the results obtained, by electrical excitation of the so-called motor cortex and internal capsule in an orang-outang (Simia satyrus)

1890 ◽  
Vol 181 ◽  
pp. 129-158 ◽  
Keyword(s):  
Motor Cortex ◽  
Comparative Study ◽  
Motor Function ◽  
Trinity College ◽  
Internal Capsule ◽  
Electrical Excitation ◽  
Trinity College Dublin ◽  
Bonnet Monkey ◽  
Correct Estimate

Having been occupied with the study of the minute representation of motor function in the cortex of the Bonnet Monkey ( Macacus sinicus ), it seemed to us extremely necessary to investigate the character of such representation in the cortex of an anthropoid Ape, in order that we might form a more correct estimate of the mode of localisation in Man. A comparative study of the brains and habits of the more easily obtainable anthropoids showed clearly that for our object the Orang was more suitable than the Chimpanzee, in being likely to afford results nearer to those presumed to exist in Man. We therefore procured a young Orang which, in the opinion of Professor D. J. Cunningham, of Trinity College, Dublin, was about 21/2 years old. In addition to excitation of the cortex, we also investigated the movements obtained by stimulating the fibres of the internal capsule.

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