Neuroimaging of Brain Tumor Surgery and Epilepsy

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

Deadline for manuscript submissions: closed (25 October 2023) | Viewed by 10378

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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,

A multimodal approach is crucial for the effective treatment of epilepsy and brain tumor surgery. In the clinical situation, we need to integrate the information acquired by multimodal imaging techniques to make the best clinical judgment.

In this Special Issue of Brain Sciences, I would like to collect and share information about neuroimaging of epilepsy and brain tumor surgery, especially new insights obtained from clinical experiences.

For this Special Issue, we welcome submissions of original research, case series, as well as interesting case report regarding epilepsy and brain tumor surgery.

Dr. Takehiro Uda
Guest Editor

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Keywords

  • epilepsy
  • brain tumor surgery
  • epilepsy surgery
  • MRI
  • PET
  • electroencephalography
  • magnetoencephalography

Published Papers (7 papers)

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Editorial

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4 pages, 212 KiB  
Editorial
Neuroimaging of Brain Tumor Surgery and Epilepsy
by Takehiro Uda
Brain Sci. 2023, 13(12), 1701; https://doi.org/10.3390/brainsci13121701 - 10 Dec 2023
Viewed by 889
Abstract
To make the best clinical judgements, surgeons need to integrate information acquired via multimodal imaging [...] Full article
(This article belongs to the Special Issue Neuroimaging of Brain Tumor Surgery and Epilepsy)

Research

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13 pages, 1842 KiB  
Article
Is Hippocampal Resection Necessary for Low-Grade Epilepsy-Associated Tumors in the Temporal Lobe?
by Yutaro Takayama, Naoki Ikegaya, Keiya Iijima, Yuiko Kimura, Kenzo Kosugi, Suguru Yokosako, Yuu Kaneko, Tetsuya Yamamoto and Masaki Iwasaki
Brain Sci. 2022, 12(10), 1381; https://doi.org/10.3390/brainsci12101381 - 12 Oct 2022
Cited by 2 | Viewed by 1574
Abstract
Low-grade epilepsy-associated tumors (LEATs) are common in the temporal lobe and can cause drug-resistant epilepsy. Complete resection of LEATs is sufficient for seizure relief. However, hippocampal resection might result in postoperative cognitive impairment. This study aimed to clarify the necessity of hippocampal resection [...] Read more.
Low-grade epilepsy-associated tumors (LEATs) are common in the temporal lobe and can cause drug-resistant epilepsy. Complete resection of LEATs is sufficient for seizure relief. However, hippocampal resection might result in postoperative cognitive impairment. This study aimed to clarify the necessity of hippocampal resection for seizure and cognitive outcomes in patients with temporal lobe LEATs and a normal hippocampus. The study included 32 patients with temporal lobe LEATs and without hippocampal abnormalities. All patients underwent gross total resection as treatment for drug-resistant epilepsy at our tertiary epilepsy center from 2005 to 2020, followed by at least a 12-month follow-up period. Seizure and cognitive outcomes were compared between patients who underwent additional hippocampal resection (Resected group) and those who did not (Preserved group). Among the participants, 14 underwent additional hippocampal resection and 28 (87.5%) achieved seizure freedom irrespective of hippocampal resection. The seizure-free periods were not different between the two groups. Additional hippocampal resection resulted in a significantly negative impact on the postoperative verbal index. In conclusion, additional hippocampal resection in patients with temporal lobe LEATs without hippocampal abnormalities is unnecessary because lesionectomy alone results in good seizure control. Additional hippocampal resection may instead adversely affect the postoperative language function. Full article
(This article belongs to the Special Issue Neuroimaging of Brain Tumor Surgery and Epilepsy)
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8 pages, 965 KiB  
Article
Visualization of Resected Area in Endonasal Endoscopic Approach versus Transcranial Approach for Skull Base Meningiomas by Voxel-Based-Lesion Mapping
by Hiroshi Uda, Takehiro Uda, Manabu Kinoshita, Haruhiko Kishima, Yuta Tanoue, Atsufumi Nagahama, Toshiyuki Kawashima, Hiroki Ohata, Kosuke Nakajo, Hiroki Morisako and Takeo Goto
Brain Sci. 2022, 12(7), 875; https://doi.org/10.3390/brainsci12070875 - 30 Jun 2022
Cited by 1 | Viewed by 1384
Abstract
Background: We aimed to evaluate the resected area of endonasal endoscopic approach (EEA) and transcranial approach (TCA) for skull base meningiomas (SBMs) using voxel-based-lesion mapping and visualized the appropriate tumor location in each approach. Methods: We retrospectively examined 182 patients with SBMs who [...] Read more.
Background: We aimed to evaluate the resected area of endonasal endoscopic approach (EEA) and transcranial approach (TCA) for skull base meningiomas (SBMs) using voxel-based-lesion mapping and visualized the appropriate tumor location in each approach. Methods: We retrospectively examined 182 patients with SBMs who underwent tumor resection in our hospital between 2014 and 2019. Pre- and post-operative SBMs were manually delineated on MRI to create the voxels-of-interest (VOIpre and VOIpost) and were registered onto the normalized brain (normalized VOIpre and normalized VOIpost). The resected map was created by subtracting normalized VOIpost from the normalized VOIpre divided by the number of cases. The resected maps of TCA and EEA were compared by subtracting them. Results: Twenty patients underwent EEA and 135 patients underwent TCA. The tumor resected map demonstrated that the resected area of EEA frequently accumulated on the central skull base, while that of TCA accumulated near the central skull base. The border of both approaches matched the circle that connects neural foramens at the skull base. Conclusions: The resected area of SBMs by EEA and TCA was well visualized by voxel-based-lesion mapping. The circle connecting the neural foramens was the border of EEA and TCA. Full article
(This article belongs to the Special Issue Neuroimaging of Brain Tumor Surgery and Epilepsy)
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Other

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8 pages, 2562 KiB  
Case Report
Applied Fence-Post Techniques Using Deep Electrodes Instead of Catheters for Resection of Glioma Complicated with Frequent Epileptic Seizures: A Case Report
by Shunsuke Nakae, Masanobu Kumon, Takao Teranishi, Shigeo Ohba and Yuichi Hirose
Brain Sci. 2023, 13(3), 482; https://doi.org/10.3390/brainsci13030482 - 13 Mar 2023
Cited by 1 | Viewed by 1207
Abstract
Fence-post catheter techniques are used to use tumor margins when resecting gliomas. In the present study, deep electrodes instead of catheters were used as fence-posts. The case of a 25-year-old female patient whose magnetic resonance images (MRI) revealed a tumor in the left [...] Read more.
Fence-post catheter techniques are used to use tumor margins when resecting gliomas. In the present study, deep electrodes instead of catheters were used as fence-posts. The case of a 25-year-old female patient whose magnetic resonance images (MRI) revealed a tumor in the left cingulate gyrus is presented in this study. She underwent daily seizures without loss of consciousness under the administration of anti-seizure medications. Despite video electroencephalography (EEG) monitoring, the scalp inter-ictal EEG did not show obvious epileptiform discharges. We were consequently uncertain whether such frequent seizures were epileptic seizures or not. As a result, deep electrodes were used as fence-posts: three deep electrodes were inserted into the tumor’s anterior, lateral, and posterior margins using a navigation-guided method. The highest epileptic discharge was detected from the anterior deep electrode. As a result, ahead of the tumor was extendedly resected, and epileptic discharges were eliminated using EEG. The postoperative MRI revealed that the tumor was resected. The patient has never experienced seizures after the surgery. In conclusion, when supratentorial gliomas complicated by frequent seizures are resected, intraoperative EEG monitoring using deep electrodes as fence-posts is useful for estimating epileptogenic areas. Full article
(This article belongs to the Special Issue Neuroimaging of Brain Tumor Surgery and Epilepsy)
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8 pages, 5367 KiB  
Case Report
Intraparenchymal and Subarachnoid Hemorrhage in Stereotactic Electroencephalography Caused by Indirect Adjacent Arterial Injury: Illustrative Case
by Toshiyuki Kawashima, Takehiro Uda, Saya Koh, Vich Yindeedej, Noboru Ishino, Tsutomu Ichinose, Hironori Arima, Satoru Sakuma and Takeo Goto
Brain Sci. 2023, 13(3), 440; https://doi.org/10.3390/brainsci13030440 - 04 Mar 2023
Cited by 2 | Viewed by 1439
Abstract
The complication rate of stereotactic electroencephalography (SEEG) is generally low, but various types of postoperative hemorrhage have been reported. We presented an unusual hemorrhagic complication after SEEG placement. A 20-year-old man presented with suspected frontal lobe epilepsy. We implanted 11 SEEG electrodes in [...] Read more.
The complication rate of stereotactic electroencephalography (SEEG) is generally low, but various types of postoperative hemorrhage have been reported. We presented an unusual hemorrhagic complication after SEEG placement. A 20-year-old man presented with suspected frontal lobe epilepsy. We implanted 11 SEEG electrodes in the bilateral frontal lobes and the left insula. Computed tomography after implantation showed intraparenchymal hemorrhage in the left temporal lobe and insula and subarachnoid hemorrhage in the left Sylvian cistern. Later, the point of vessel injury was revealed from the identification of a pseudoaneurysm, but this location was not along the planned or actual electrode trajectory. The cause of hemorrhage was suggested to be indirect injury from stretching of the arachnoid trabeculae by the puncture needle. Full article
(This article belongs to the Special Issue Neuroimaging of Brain Tumor Surgery and Epilepsy)
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6 pages, 1641 KiB  
Case Report
Vagus Nerve Visualization Using Fused Images of 3D-CT Angiography and MRI as Preoperative Evaluation for Vagus Nerve Stimulation
by Shunsuke Nakae, Masanobu Kumon, Akio Katagata, Kazuhiro Murayama and Yuichi Hirose
Brain Sci. 2023, 13(3), 396; https://doi.org/10.3390/brainsci13030396 - 25 Feb 2023
Cited by 1 | Viewed by 1416
Abstract
Vagus nerve stimulation (VNS) is an effective surgical option for intractable epilepsy. Although the surgical procedure is not so complicated, vagus nerve detection is sometimes difficult due to its anatomical variations, which may lead to surgical manipulation-associated complications. Thus, this study aimed to [...] Read more.
Vagus nerve stimulation (VNS) is an effective surgical option for intractable epilepsy. Although the surgical procedure is not so complicated, vagus nerve detection is sometimes difficult due to its anatomical variations, which may lead to surgical manipulation-associated complications. Thus, this study aimed to visualize the vagus nerve location preoperatively by fused images of three-dimensional computed tomography angiography (3D-CTA) and magnetic resonance imaging (MRI). This technique was applied to two cases. The neck 3D-CTA and MRI were performed, and the fused images were generated using the software. The vagus nerve and its anatomical relationship with the internal jugular vein (IJV) and common carotid artery were clearly visualized. The authors predicted that the vagus nerve was detected by laterally pulling the IJV according to the images. Intraoperatively, the vagus nerve was located as the authors predicted. The time of the surgery until the vagus nerve detection was <60 min in both cases. This novel radiological technique for visualizing the vagus nerve is effective to quickly detect the vagus nerve, which has anatomical variations, during the VNS. Full article
(This article belongs to the Special Issue Neuroimaging of Brain Tumor Surgery and Epilepsy)
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5 pages, 1240 KiB  
Case Report
Frontal Encephalocele Plus Epilepsy: A Case Report and Review of the Literature
by Ken Yamazaki, Kohei Kanaya, Takehiro Uda, Tetsuhiro Fukuyama, Makoto Nishioka, Yumi Hoshino, Tomoki Kaneko, Ridzky Firmansyah Hardian, Daisuke Yamazaki, Haruki Kuwabara, Kohei Funato and Tetsuyoshi Horiuchi
Brain Sci. 2023, 13(1), 115; https://doi.org/10.3390/brainsci13010115 - 09 Jan 2023
Cited by 2 | Viewed by 1507
Abstract
An encephalocele is a pathological brain herniation caused by osseous dural defects. Encephaloceles are known to be regions of epileptogenic foci. We describe the case of a 44-year-old woman with refractory epilepsy associated with a frontal skull base encephalocele. Epilepsy surgery for encephalocele [...] Read more.
An encephalocele is a pathological brain herniation caused by osseous dural defects. Encephaloceles are known to be regions of epileptogenic foci. We describe the case of a 44-year-old woman with refractory epilepsy associated with a frontal skull base encephalocele. Epilepsy surgery for encephalocele resection was performed; however, the epilepsy was refractory. A second epilepsy surgery for frontal lobectomy using intraoperative electroencephalography was required to achieve adequate seizure control. Previous reports have shown that only encephalocele resection can result in good seizure control, and refractory epilepsy due to frontal lobe encephalocele has rarely been reported. To the best of our knowledge, this is the first report of frontal encephalocele plus epilepsy in which good seizure control using only encephalocele resection was difficult to achieve. Herein, we describe the possible mechanisms of encephalocele plus epilepsy and the surgical strategy for refractory epilepsy with encephalocele, including a literature review. Full article
(This article belongs to the Special Issue Neuroimaging of Brain Tumor Surgery and Epilepsy)
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