Valuable Experience in Clinical Neurology and Neurosurgery

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurosurgery and Neuroanatomy".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 5199

Special Issue Editor


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Guest Editor
Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine 1-4-3, Asahi-machi, Abeno-ku, Osaka City 545-8585, Osaka, Japan
Interests: general neurosurgery; epilepsy; brain tumor surgery; functional neurosurgery
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Special Issue Information

Dear Colleagues,

In the field of neurology and neurosurgery, clinical experiences in each situation are important. To share these experiences from all over the world, we are launching this Special Issue. The title of the Special Issue is “Valuable Experience in Clinical Neurology and Neurosurgery”. To collect many manuscripts from all fields of clinical neurology and neurosurgery, all types of manuscripts, such as case reports with literature review, original articles and review articles, are welcome.

Dr. Takehiro Uda
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • general neurosurgery
  • epilepsy
  • brain tumor surgery
  • functional neurosurgery
  • vascular neurosurgery

Published Papers (5 papers)

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10 pages, 3965 KiB  
Article
Adventitia Layer-Focused Microsurgical Flow Reconstruction for Long-Segment Tubular Stenosis of the Cervical Segment (C1) Internal Carotid Artery: Clinical Valuable Experience in 20 Cases
by Efecan Cekic and Mehmet Erkan Ustun
Brain Sci. 2024, 14(3), 289; https://doi.org/10.3390/brainsci14030289 - 19 Mar 2024
Cited by 2 | Viewed by 836
Abstract
To evaluate the efficacy of perivascular sympathectomy in managing adventitia layer-related long-segment tubular stenosis of cervical segment (C1) internal carotid arteries (ICAs) in a cohort where conventional medical and endovascular interventions were not viable options, we retrospectively analyzed 20 patients (8 males, 12 [...] Read more.
To evaluate the efficacy of perivascular sympathectomy in managing adventitia layer-related long-segment tubular stenosis of cervical segment (C1) internal carotid arteries (ICAs) in a cohort where conventional medical and endovascular interventions were not viable options, we retrospectively analyzed 20 patients (8 males, 12 females, aged 41–63 years) who underwent perivascular sympathectomy for long-segment (>5 cm) tubular cervical ICA stenosis (non-atherosclerotic, non-intima related, and nondolichoarteriopathic) between 2017 and 2023. The procedure aimed to alleviate symptoms such as hemiparesis, pulsatile tinnitus, and migraines associated with transient ischemic attacks (TIAs). Preoperative and postoperative symptoms were assessed, and patient follow-up was conducted by MR angiography and perfusion studies. Postoperatively, 10 out of 11 migraine sufferers (90.9%) reported complete cessation of symptoms, while one patient (9.09%) experienced reduction in frequency and intensity. In cases of tinnitus, six out of nine patients (66.6%) reported complete resolution, two (22.2%) had reduced symptoms, and one (11.1%) saw no change. Regarding motor function, all 12 patients (100%) with initial hemiparesis (30–40% loss of motor function) showed complete recovery postoperatively. There was no TIA attack among the patients after the procedure in the mean two-year follow-up. Perivascular sympathectomy has shown promising results in alleviating symptoms and preventing recurrent cerebrovascular events in long-segment tubular stenosis of cervical ICAs. Full article
(This article belongs to the Special Issue Valuable Experience in Clinical Neurology and Neurosurgery)
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11 pages, 728 KiB  
Article
Determinants of the Quality of Life in Patients with Drug-Resistant Temporal Lobe Epilepsy: A Comparison of the Results before and after Surgery
by Aleksandra Bala, Agnieszka Olejnik, Michał Kułak, Andrzej Rysz, Tomasz Dziedzic, Arkadiusz Nowak, Andrzej Marchel and Przemysław Kunert
Brain Sci. 2024, 14(3), 241; https://doi.org/10.3390/brainsci14030241 - 29 Feb 2024
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Abstract
Drug-resistant temporal lobe epilepsy is associated with a reduction in the quality of life of patients. The aim of this study was to compare the quality of life before and after the surgical treatment of epilepsy and to assess factors that may affect [...] Read more.
Drug-resistant temporal lobe epilepsy is associated with a reduction in the quality of life of patients. The aim of this study was to compare the quality of life before and after the surgical treatment of epilepsy and to assess factors that may affect the well-being of patients after surgery. The study involved 168 patients with drug-resistant temporal lobe epilepsy. All of them were examined twice: once before and again one year after surgery. Two questionnaires were used in the study: the Quality of Life in Epilepsy Inventory-Patient-Weighted and Hospital Anxiety and Depression Scale and one that collected data on selected demographic and clinical variables. The results showed that patients scored significantly higher in quality of life and lower in depression and anxiety after surgery; however, this only applied to patients with a good outcome of treatment (Engel Class I and Class II). Patients with an unfavorable outcome of surgical treatment (Engel Class III and Class IV) achieved significantly worse results in all examined variables. Correlational analysis showed a relationship between select aspects of quality of life and the level of depression and anxiety, as well as the frequency of seizures and age at epilepsy onset. There was no significant relationship with age, sex, education, or number of prescribed antiepileptic drugs. The study confirms the significant relationship between the quality of life and the effectiveness of surgical treatment, indicating the relationship between patients’ well-being and selected clinical indicators. Full article
(This article belongs to the Special Issue Valuable Experience in Clinical Neurology and Neurosurgery)
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27 pages, 10921 KiB  
Article
Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging-Tractography in Resective Brain Surgery: Lesion Coverage Strategies and Patient Outcomes
by Vasileios Kokkinos, Athanasios Chatzisotiriou and Ioannis Seimenis
Brain Sci. 2023, 13(11), 1574; https://doi.org/10.3390/brainsci13111574 - 9 Nov 2023
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Abstract
Diffusion tensor imaging (DTI)-tractography and functional magnetic resonance imaging (fMRI) have dynamically entered the presurgical evaluation context of brain surgery during the past decades, providing novel perspectives in surgical planning and lesion access approaches. However, their application in the presurgical setting requires significant [...] Read more.
Diffusion tensor imaging (DTI)-tractography and functional magnetic resonance imaging (fMRI) have dynamically entered the presurgical evaluation context of brain surgery during the past decades, providing novel perspectives in surgical planning and lesion access approaches. However, their application in the presurgical setting requires significant time and effort and increased costs, thereby raising questions regarding efficiency and best use. In this work, we set out to evaluate DTI-tractography and combined fMRI/DTI-tractography during intra-operative neuronavigation in resective brain surgery using lesion-related preoperative neurological deficit (PND) outcomes as metrics. We retrospectively reviewed medical records of 252 consecutive patients admitted for brain surgery. Standard anatomical neuroimaging protocols were performed in 127 patients, 69 patients had additional DTI-tractography, and 56 had combined DTI-tractography/fMRI. fMRI procedures involved language, motor, somatic sensory, sensorimotor and visual mapping. DTI-tractography involved fiber tracking of the motor, sensory, language and visual pathways. At 1 month postoperatively, DTI-tractography patients were more likely to present either improvement or preservation of PNDs (p = 0.004 and p = 0.007, respectively). At 6 months, combined DTI-tractography/fMRI patients were more likely to experience complete PND resolution (p < 0.001). Low-grade lesion patients (N = 102) with combined DTI-tractography/fMRI were more likely to experience complete resolution of PNDs at 1 and 6 months (p = 0.001 and p < 0.001, respectively). High-grade lesion patients (N = 140) with combined DTI-tractography/fMRI were more likely to have PNDs resolved at 6 months (p = 0.005). Patients with motor symptoms (N = 80) were more likely to experience complete remission of PNDs at 6 months with DTI-tractography or combined DTI-tractography/fMRI (p = 0.008 and p = 0.004, respectively), without significant difference between the two imaging protocols (p = 1). Patients with sensory symptoms (N = 44) were more likely to experience complete PND remission at 6 months with combined DTI-tractography/fMRI (p = 0.004). The intraoperative neuroimaging modality did not have a significant effect in patients with preoperative seizures (N = 47). Lack of PND worsening was observed at 6 month follow-up in patients with combined DTI-tractography/fMRI. Our results strongly support the combined use of DTI-tractography and fMRI in patients undergoing resective brain surgery for improving their postoperative clinical profile. Full article
(This article belongs to the Special Issue Valuable Experience in Clinical Neurology and Neurosurgery)
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13 pages, 3575 KiB  
Article
Combined Depth and Subdural Electrodes for Lateralization of the Ictal Onset Zone in Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis
by Junhyung Kim, Joong Koo Kang, Sang Ahm Lee and Seok Ho Hong
Brain Sci. 2023, 13(11), 1547; https://doi.org/10.3390/brainsci13111547 - 3 Nov 2023
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Abstract
(1) Objective: This study aimed to explore the efficacy of conventional invasive techniques in confirming unilateral seizure onset localization in mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) and to investigate the association between electrode type and intracranial electroencephalography (EEG) pattern. (2) Methods: [...] Read more.
(1) Objective: This study aimed to explore the efficacy of conventional invasive techniques in confirming unilateral seizure onset localization in mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) and to investigate the association between electrode type and intracranial electroencephalography (EEG) pattern. (2) Methods: This retrospective study encompasses patients diagnosed with MTLE-HS who underwent an invasive study prior to an anterior temporal lobectomy (ATL). Intracranial EEG features were assessed for 99 seizure events from 25 selected patients who achieved seizure remission with ATL after an invasive study using bilateral combined depth and subdural electrodes. Their findings were compared to those of 21 seizure events in eight patients who exhibited suboptimal seizure outcomes. (3) Results: For the distribution of electrodes that recorded the ictal onset, hippocampal depth electrodes recorded 96% of all seizure events, while subdural electrodes recorded 52%. Among the seizures recorded in subdural electrodes, 49% were localized in medial electrodes, with only 8% occurring in lateral electrodes. The initiation of seizures exclusively detected in hippocampal depth electrodes was associated with successful seizure remission, whereas those solely recorded in the lateral strip electrodes were often linked to refractory seizures after ATL. (4) Conclusions: These findings emphasize the importance of employing a combination of depth and subdural electrodes in invasive studies for patients with MTLE-HS to enhance the accuracy of lateralization. This also cautions against sole reliance on subdural electrodes without depth electrodes, which could lead to inaccurate localization. Full article
(This article belongs to the Special Issue Valuable Experience in Clinical Neurology and Neurosurgery)
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11 pages, 1796 KiB  
Brief Report
Clivus-Cervical Stabilization through Transoral Approach in Patients with Craniocervical Tumor: Three Cases and Surgical Technical Note
by Gervith Reyes-Soto, Alfonso Corona De la Torre, Kaori Guadalupe Honda Partida, Renat Nurmukhametov, Manuel De Jesus Encarnacion Ramirez and Nicola Montemurro
Brain Sci. 2024, 14(3), 254; https://doi.org/10.3390/brainsci14030254 - 5 Mar 2024
Viewed by 854
Abstract
Craniocervical tumors lead to cervical pain, instability, and neurological symptoms, reducing the quality of life. Effective surgical intervention at the craniocervical junction (CCJ) is critical and complex, involving comprehensive approaches and advanced reconstructive techniques. This study, conducted at Mexico City’s National Institute of [...] Read more.
Craniocervical tumors lead to cervical pain, instability, and neurological symptoms, reducing the quality of life. Effective surgical intervention at the craniocervical junction (CCJ) is critical and complex, involving comprehensive approaches and advanced reconstructive techniques. This study, conducted at Mexico City’s National Institute of Cancerology, focused on three surgical cases that occurred in 2023 involving tumors at the CCJ: two chordomas and one prostate adenocarcinoma. We utilized a specialized technique: clivus-cervical stabilization reinforced with a polymethylmethacrylate (PMMA)-filled cervical mesh. Postoperatively, patients showed marked neurological recovery and reduced cervical pain, with enhanced Karnofsky and Eastern Cooperative Oncology Group (ECOG) scores indicating improved life quality. The surgical technique provided excellent exposure and effective tumor resection, utilizing PMMA-filled cervical mesh for stability. Tumoral lesions at the CCJ causing instability can be surgically treated through a transoral approach. This type of approach should be performed with precise indications to avoid complications associated with the procedure. Full article
(This article belongs to the Special Issue Valuable Experience in Clinical Neurology and Neurosurgery)
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