Epilepsia App by Soda Virtual
https://appsto.re/br/XXFiJ.i
https://appsto.re/br/XXFiJ.i
Sunday, January 11, 2015
1.5 Million Lives Spared by Cancer Death Rate Reduction in 20 Years, Study Says
1.5 Million Lives Spared by Cancer Death Rate Reduction in 20 Years, Study Says
National Comprehensive Cancer Network
More than 1.5 million lives were spared thanks to a nationwide decrease in cancer deaths in the past 20 years, according to a new report by the American Cancer Society. This article features commentary from Dr. Michael Neuss, Chief Medical Officer at Vanderbilt-Ingram Cancer Center-one of the 25 NCCN Member Institutions. ...
Original Article: http://abcnews.go.com/Health/15-million-lives-spared-cancer-rate-reduction-20/story?id27925329
Health-related quality of life in lung cancer survivors: Latent class and latent transition analysis
Health-related quality of life in lung cancer survivors: Latent class and latent transition analysis
Cancer
BACKGROUND
Health-related quality of life (HRQOL) heterogeneity among cancer survivors may mask subgroups (classes) with different limitations and long-term outcomes. The authors determined the HRQOL classes that exist among lung cancer survivors, examined transitions among those classes over time, and compared survival outcomes of patients according to the classes present in the initial phase of care.
METHODS
Lung cancer survivors in the Cancer Care Outcomes Research and Surveillance Consortium completed EuroQol 5-domain quality-of-life questionnaires 4.8 months (initial phase) and >1 year (survivorship phase) after diagnosis (n = 1396). Latent class analysis and latent transition analysis were used to determine HRQOL classes and transitions across time. Correlates of class membership were tested using multinomial logistic regression. Kaplan-Meier and Cox regression analyses were used to compare survival across class membership.
RESULTS
Latent class analysis identified 4 classes at diagnosis and follow-up: 1) poor HRQOL, 2) pain-dominant impairment, 3) mobility/usual activities impairment, and 4) good HRQOL. Probabilities of remaining in the same class were .87, .85, .82, and .73 for classes 4, 1, 3, and 2, respectively. Younger age, lower income, lower education, comorbidities, and a history of depression/emotional problems were associated with a greater likelihood of being in classes 1, 2, or 3 at follow-up. Patients in classes 1 and 3 had significantly lower median survival estimates than patients in class 4 (4.8 years, 3.8 years, and 5.5 years, respectively; P < .001).
CONCLUSIONS
Examining the heterogeneity of HRQOL in lung cancer populations allows the identification of classes with different limitations and long-term outcomes and, thus, guides tailored and patient-centered provision of supportive care. Cancer 2015. © 2015 American Cancer Society.
Original Article: http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1002/cncr.29232
Limits on Neuroimaging for Headache Risky?
Limits on Neuroimaging for Headache Risky?
Medscape NeurologyHeadlines
New recommendations that discourage neuroimaging for some patients with headache might lead to delayed or missed diagnosis of brain tumor, neurosurgeons say.
Medscape Medical News
Original Article: http://www.medscape.com/viewarticle/837626?src=rss
Annual Cancer Statistics
Annual Cancer Statistics
Cancer: MedlinePlus
Source: HealthDay -
Original Article: http://www.nlm.nih.gov/medlineplus/videos/news/Annual_Cancer_010714-1.html
The colorectal cancer mortality-to-incidence ratio as an indicator of global cancer screening and care
The colorectal cancer mortality-to-incidence ratio as an indicator of global cancer screening and care
Cancer
BACKGROUND
Disparities in cancer screening, incidence, treatment, and survival are worsening globally. The mortality-to-incidence ratio (MIR) has been used previously to evaluate such disparities.
METHODS
The MIR for colorectal cancer is calculated for all Organisation for Economic Cooperation and Development (OECD) countries using the 2012 GLOBOCAN incidence and mortality statistics. Health system rankings were obtained from the World Health Organization. Two linear regression models were fit with the MIR as the dependent variable and health system ranking as the independent variable; one included all countries and one model had the "divergents" removed.
RESULTS
The regression model for all countries explained 24% of the total variance in the MIR. Nine countries were found to have regression-calculated MIRs that differed from the actual MIR by >20%. Countries with lower-than-expected MIRs were found to have strong national health systems characterized by formal colorectal cancer screening programs. Conversely, countries with higher-than-expected MIRs lack screening programs. When these divergent points were removed from the data set, the recalculated regression model explained 60% of the total variance in the MIR.
CONCLUSIONS
The MIR proved useful for identifying disparities in cancer screening and treatment internationally. It has potential as an indicator of the long-term success of cancer surveillance programs and may be extended to other cancer types for these purposes. Cancer 2015. © 2015 American Cancer Society.
Original Article: http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1002/cncr.29228
Neuroimaging Clinics of North America: Genetic Patterns in Neuroimaging
Neuroimaging Clinics of North America: Genetic Patterns in Neuroimaging
AJNR Blog
Hygino da Cruz Jr L, guest ed. Mukherji SK, consulting ed. Genetic Patterns in Neuroimaging. Elsevier; February 2015. Neuroimaging Clinics of North America; vol. 25, no. 1; pgs. 1–158; $360.00
The increasing emphasis on relating alterations in genetic makeup to various disease states makes it important to gain understanding of how chromosomal abnormalities relate to what we observe on neuroimaging studies. As medical school recedes into the distant past of our formal medical training, many of the critical facts for appreciating genetics and disease are forgotten (or maybe never learned). Enter the newest addition to the Neuroimaging Clinics of North America, edited by Dr. L. Celso Hygino de Cruz, entitled "Genetic Patterns in Neuroimaging". This 158-page book features 10 chapters, with 24 authors, international in makeup, though predominately from Brazil. A word of appreciation is due to Dr. Mukherji, the Consulting Editor, for choosing this topic for the newest volume of the NICNA.
The ten chapters in the February 2015 issue of the NICA are: Understanding Genetics; Molecular Imaging in Genetics; Brain Imaging and Genetic Risk—Inherited Metabolic Diseases; Brain Imaging and Genetic Risk—Congenital Malformations of the CNS; Genetics and Cerebrovascular Malformations; Phenotypes in MS; Genetics of Glioblastomas; Genomics of Brain Tumor Imaging; Genetic Influence in Treating Brain Neoplasms; Imaging Glioblastomas—A Bridge Between Genomics and Neuroradiology. All of these chapters are rich with neuroimaging (except for the first chapter), so the reader can quickly relate genetic alterations to neuroradiology cases, examples of which are seen nearly on a routine basis.
Most radiologists, with few exceptions, who interpret neuroimaging studies rarely simultaneously give a thought to the possible underlying genetic aberrations that might underlie the pathology. Although presentations at national radiology meetings are highlighting such findings, they continue to be less appreciated than the future will dictate. For example, aside from polycystic kidney disease or multiple cavernous, the common tendency is to not reflect on the possible genetic underpinnings of cerebrovascular malformations. With the material in this chapter we can begin to assimilate such information into our thinking of the abnormalities. Of course, the same pertains to all other diseases (inherited metabolic, congenital, tumoral) covered in this book.
To begin this issue with a review of basic genetics was wise, not only because most of us need such a review but because it sets the table for information contained in ensuing chapters. The term radiogenomics is used in the book, and while it is a term foreign to most of us, it is one we will hear with increasing frequency, particularly when discussing the treatment of brain tumors.
Every practicing neuroradiologist should be aware of this particular issue of NICNA and should be ready to consult it, because it will consume more and more of our thoughts, especially when discussing abnormalities with our neuroscience colleagues. "Genetic Patterns in Neuroimaging" is highly recommended.
The post Neuroimaging Clinics of North America: Genetic Patterns in Neuroimaging appeared first on AJNR Blog.
Original Article: http://www.ajnrblog.org/2015/01/09/neuroimaging-clinics-north-america-genetic-patterns-neuroimaging/
Livros em Revista: Após um tumor Cerebral - Julio Pereira, Neurocirurgião
Systematically tracking subtle brain mutations
Systematically tracking subtle brain mutations
Neurology News & Neuroscience News from Medical News Today
Original Article: http://www.medicalnewstoday.com/releases/287762.php
Prevention better than cure for pediatric brain injury
Prevention better than cure for pediatric brain injury
Neurology News & Neuroscience News from Medical News Today
Original Article: http://www.medicalnewstoday.com/releases/287775.php
Saturday, January 3, 2015
[Review] Outcomes and endpoints in cancer trials: bridging the divide
[Review] Outcomes and endpoints in cancer trials: bridging the divide
The Lancet Oncology
Cancer is not one disease. Outcomes and endpoints in trials should incorporate the therapeutic modality and cancer type because these factors affect clinician and patient expectations. In this Review, we discuss how to: define the importance of endpoints; make endpoints understandable to patients; improve the use of patient-reported outcomes; advance endpoints to parallel changes in trial design and therapeutic interventions; and integrate these improvements into trials and practice. Endpoints need to reflect benefit to patients, and show that changes in tumour size either in absolute terms (response and progression) or relative to control (progression) are clinically relevant.
Original Article: http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(14)70380-8/fulltext?rss=yes
[Review] Outcomes and endpoints in trials of cancer treatment: the past, present, and future
[Review] Outcomes and endpoints in trials of cancer treatment: the past, present, and future
The Lancet Oncology
Cancer treatment should allow patients to live better or longer lives, and ideally, both. Trial endpoints should show clinically meaningful improvements in patient survival or quality of life. Alternative endpoints such as progression-free survival, disease-free survival, and objective response rate have been used to identify benefit earlier, but their true validity as surrogate endpoints is controversial. In this Review we discuss the measurement, assessment, and benefits and limitations of trial endpoints in use for cancer treatment.
Original Article: http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(14)70375-4/fulltext?rss=yes
[News] : a genetic link for familial glioma
[News] : a genetic link for familial glioma
The Lancet Oncology
Mutations in POT1 are associated with familial glioma, new research suggests. Familial glioma accounts for less than 5% cases of glioma, the most common type of brain tumour that includes various subtypes.
Original Article: http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(14)71178-7/fulltext?rss=yes
[News] Oncology drug market worth predicted to increase
[News] Oncology drug market worth predicted to increase
The Lancet Oncology
The global pharmaceutical market will be worth US$1·3 trillion by 2018, an increase of 30% from 2013, according to a new report by IMS Health, an information, services, and technology company.
Original Article: http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(14)71164-7/fulltext?rss=yes
Therapeutic targeting of tumor suppressor genes
Therapeutic targeting of tumor suppressor genes
Cancer
Carcinogenesis is a multistep process attributable to both gain-of-function mutations in oncogenes and loss-of-function mutations in tumor suppressor genes. Currently, most molecular targeted therapies are inhibitors of oncogenes, because inactivated tumor suppressor genes have proven harder to "drug." Nevertheless, in cancers, tumor suppressor genes undergo alteration more frequently than do oncogenes. In recent years, several promising strategies directed at tumor suppressor genes, or the pathways controlled by these genes, have emerged. Here, we describe advances in a number of different methodologies aimed at therapeutically targeting tumors driven by inactivated tumor suppressor genes. Cancer 2014. © 2014 American Cancer Society.
Original Article: http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1002/cncr.29140
Factors affecting survival in 37 consecutive patients undergoing de novo stereotactic radiosurgery for contiguous sites of vertebral body metastasis from renal cell carcinoma
Factors affecting survival in 37 consecutive patients undergoing de novo stereotactic radiosurgery for contiguous sites of vertebral body metastasis from renal cell carcinoma
Journal of Neurosurgery: Journal of Neurosurgery: Spine: Table of Contents
Journal of Neurosurgery: Spine, Volume 22, Issue 1, Page 52-59, January 2015.
OBJECT Palliative resection of renal cell carcinoma (RCC) spinal metastasis is indicated in cases of neurological compromise or mechanical instability, whereas conventional external beam radiotherapy (EBRT) is commonly used for pain control. Recently, spinal stereotactic radiosurgery (SRS) has emerged as a safe alternative, delivering higher therapeutic doses of radiation to spinal metastases. To better understand factors affecting survival in patients undergoing spinal SRS for metastatic RCC, the authors performed a retrospective analysis of a consecutive series of cases at a tertiary cancer center. METHODS Patients harboring contiguous sites of vertebral body involvement from metastatic RCC who received upfront spinal SRS treatment at The University of Texas MD Anderson Cancer Center between 2005 and 2012 were identified. Demographic data, pain scores, radiographic data, overall survival, complications, status of systemic disease, neurological and functional status, and time between primary diagnosis and diagnosis of metastasis (systemic and spinal) were analyzed to determine their influence on survival. RESULTS Thirty-seven patients receiving treatment for 40 distinct, contiguous sites of disease were included. The median overall survival after spinal SRS was 16.3 months (range 7.4–25.3 months). Univariate analysis revealed several factors significantly associated with improved overall survival. Local progression after spinal SRS was associated with worse overall survival compared with sustained local control (HR 3.4, 95% CI 1.6–7.4, p = 0.002). Median survival in patients with a Karnofsky Performance Scale (KPS) score ≥ 70 was longer than in patients with a KPS score < 70 (HR 4.7, 95% CI 2.1–10.7, p < 0.001). Patients with neurological deficits at the time of spinal SRS had a shorter median survival than those without (HR 4.2, 95% CI 1.4–12.0, p = 0.008). Individuals with nonprogressive systemic disease at the time of spinal SRS had a longer median survival than those with systemic progression at the time of treatment (HR 8.3, 95% CI 3.3–20.7, p < 0.001). Median survival in patients experiencing any metastasis < 12 months after primary RCC diagnosis was shorter than in patients experiencing any metastasis > 12 months after primary diagnosis, a difference that approached but did not attain significance (HR 1.9, 95% CI 0.90–4.1, p = 0.09). On multivariate analysis, local progression of disease after spinal SRS, metastasis < 12 months after primary, KPS score ≤ 70, and progression of systemic disease at time of spinal SRS all remained significant factors influencing survival (respectively, HR 3.7, p = 0.002; HR 2.6, p = 0.026; HR 4.0, p = 0.002; and HR 13.2, p < 0.001). CONCLUSIONS We identified several factors associated with survival after spinal SRS for RCC metastases, including local progression, time between first metastasis and primary RCC diagnosis, KPS score, presence of neurological deficits, and progressive metastatic disease. These factors should be taken into consideration when considering a patient for spinal SRS for RCC metastases.
Original Article: http://thejns.org/doi/abs/10.3171/2014.9.SPINE1482?ai=rt&mi=0&af=R
Functional preoperative and intraoperative mapping and monitoring: increasing safety and efficacy in glioma surgery
Functional preoperative and intraoperative mapping and monitoring: increasing safety and efficacy in glioma surgery
Journal of Neurosurgery: Neurosurgical FOCUS: Table of Contents
Neurosurgical Focus, Volume 38, Issue 1, Page E3, January 2015.
Greater extent of resection (EOR) of low-grade gliomas is associated with improved survival. Proximity to eloquent cortical regions often limits resectability and elevates the risk of surgery-related deficits. Therefore, functional localization of eloquent cortex or subcortical fiber tracts can enhance the EOR and functional outcome. Imaging techniques such as functional MRI and diffusion tensor imaging fiber tracking, and neurophysiological methods like navigated transcranial magnetic stimulation and magnetoencephalography, make it possible to identify eloquent areas prior to resective surgery and to tailor indication and surgical approach but also to assess the surgical risk. Intraoperative monitoring with direct cortical stimulation and subcortical stimulation enables surgeons to preserve essential functional tissue during surgery. Through tailored pre- and intraoperative mapping and monitoring the EOR can be maximized, with reduced rates of surgery-related deficits.
Original Article: http://thejns.org/doi/abs/10.3171/2014.10.FOCUS14611?ai=rw&mi=3ba5z2&af=R
Resection of cerebral gangliogliomas causing drug-resistant epilepsy: short- and long-term outcomes using intraoperative MRI and neuronavigation
Resection of cerebral gangliogliomas causing drug-resistant epilepsy: short- and long-term outcomes using intraoperative MRI and neuronavigation
Journal of Neurosurgery: Neurosurgical FOCUS: Table of Contents
Neurosurgical Focus, Volume 38, Issue 1, Page E5, January 2015.
OBJECT Cerebral gangliogliomas (GGs) are highly associated with intractable epilepsy. Incomplete resection due to proximity to eloquent brain regions or misinterpretation of the resection amount is a strong negative predictor for local tumor recurrence and persisting seizures. A potential method for dealing with this obstacle could be the application of intraoperative high-field MRI (iopMRI) combined with neuronavigation. METHODS Sixty-nine patients (31 female, 38 male; median age 28.5 ± 15.4 years) suffering from cerebral GGs were included in this retrospective study. Five patients received surgery twice in the observation period. In 48 of the 69 patients, 1.5-T iopMRI combined with neuronavigational guidance was used. Lesions close to eloquent brain areas were resected with the implementation of preoperative diffusion tensor imaging tractography and blood oxygenation level–dependent functional MRI (15 patients). RESULTS Overall, complete resection was accomplished in 60 of 69 surgical procedures (87%). Two patients underwent biopsy only, and in 7 patients, subtotal resection was accomplished because of proximity to critical brain areas. Excluding the 2 biopsies, complete resection using neuronavigation/iopMRI was documented in 33 of 46 cases (72%) by intraoperative imaging. Remnant tumor mass was identified intraoperatively in 13 of 46 patients (28%). After intraoperative second-look surgery, the authors improved the total resection rate by 9 patients (up to 91% [42 of 46]). Of 21 patients undergoing conventional surgery, 14 (67%) had complete resection without the use of iopMRI. Regarding epilepsy outcome, 42 of 60 patients with seizures (70%) became completely seizure free (Engel Class IA) after a median follow-up time of 55.5 ± 36.2 months. Neurological deficits were found temporarily in 1 (1.4%) patient and permanently in 4 (5.8%) patients. CONCLUSIONS Using iopMRI combined with neuronavigation in cerebral GG surgery, the authors raised the rate of complete resection in this series by 19%. Given the fact that total resection is a strong predictor of long-term seizure control, this technique may contribute to improved seizure outcome and reduced neurological morbidity.
Original Article: http://thejns.org/doi/abs/10.3171/2014.10.FOCUS14616?ai=rw&mi=3ba5z2&af=R
Survival and low-grade glioma: the emergence of genetic information
Survival and low-grade glioma: the emergence of genetic information
Journal of Neurosurgery: Neurosurgical FOCUS: Table of Contents
Neurosurgical Focus, Volume 38, Issue 1, Page E6, January 2015.
Significant gaps exist in our understanding of the causes and clinical management of glioma. One of the biggest gaps is how best to manage low-grade (World Health Organization [WHO] Grade II) glioma. Low-grade glioma (LGG) is a uniformly fatal disease of young adults (mean age 41 years), with survival averaging approximately 7 years. Although LGG patients have better survival than patients with high-grade (WHO Grade III or IV) glioma, all LGGs eventually progress to high-grade glioma and death. Data from the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute suggest that for the majority of LGG patients, overall survival has not significantly improved over the past 3 decades, highlighting the need for intensified study of this tumor. Recently published research suggests that historically used clinical variables are not sufficient (and are likely inferior) prognostic and predictive indicators relative to information provided by recently discovered tumor markers (e.g., 1p/19q deletion and IDH1 or IDH2 mutation status), tumor expression profiles (e.g., the proneural profile) and/or constitutive genotype (e.g., rs55705857 on 8q24.21). Discovery of such tumor and constitutive variation may identify variables needed to improve randomization in clinical trials as well as identify patients more sensitive to current treatments and targets for improved treatment in the future. This article reports on survival trends for patients diagnosed with LGG within the United States from 1973 through 2011 and reviews the emerging role of tumor and constitutive genetics in refining risk stratification, defining targeted therapy, and improving survival for this group of relatively young patients.
Original Article: http://thejns.org/doi/abs/10.3171/2014.10.FOCUS12367?ai=rw&mi=3ba5z2&af=R
Meningiomas: knowledge base, treatment outcomes, and uncertainties. A RANO review
Meningiomas: knowledge base, treatment outcomes, and uncertainties. A RANO review
Journal of Neurosurgery: Journal of Neurosurgery: Table of Contents
Journal of Neurosurgery, Volume 122, Issue 1, Page 4-23, January 2015.
Evolving interest in meningioma, the most common primary brain tumor, has refined contemporary management of these tumors. Problematic, however, is the paucity of prospective clinical trials that provide an evidence-based algorithm for managing meningioma. This review summarizes the published literature regarding the treatment of newly diagnosed and recurrent meningioma, with an emphasis on outcomes stratified by WHO tumor grade. Specifically, this review focuses on patient outcomes following treatment (either adjuvant or at recurrence) with surgery or radiation therapy inclusive of radiosurgery and fractionated radiation therapy. Phase II trials for patients with meningioma have recently completed accrual within the Radiation Therapy Oncology Group and the European Organisation for Research and Treatment of Cancer consortia, and Phase III studies are being developed. However, at present, there are no completed prospective, randomized trials assessing the role of either surgery or radiation therapy. Successful completion of future studies will require a multidisciplinary effort, dissemination of the current knowledge base, improved implementation of WHO grading criteria, standardization of response criteria and other outcome end points, and concerted efforts to address weaknesses in present treatment paradigms, particularly for patients with progressive or recurrent low-grade meningioma or with high-grade meningioma. In parallel efforts, Response Assessment in Neuro-Oncology (RANO) subcommittees are developing a paper on systemic therapies for meningioma and a separate article proposing standardized end point and response criteria for meningioma.
Original Article: http://thejns.org/doi/abs/10.3171/2014.7.JNS131644?ai=ru&mi=0&af=R
Improved preservation of function during acoustic neuroma surgery
Improved preservation of function during acoustic neuroma surgery
Journal of Neurosurgery: Journal of Neurosurgery: Table of Contents
Journal of Neurosurgery, Volume 122, Issue 1, Page 24-33, January 2015.
OBJECT Restoration of cranial nerve functions during acoustic neuroma (AN) surgery is crucial for good outcome. The effects of minimizing the injury period and maximizing the recuperation period were investigated in 89 patients who consecutively underwent retrosigmoid unilateral AN surgery. METHODS Cochlear nerve and facial nerve functions were evaluated during AN surgery by use of continuous auditory evoked dorsal cochlear nucleus action potential monitoring and facial nerve root exit zone–elicited compound muscle action potential monitoring, respectively. Factors affecting preservation of function at the same (preoperative) grade were analyzed. RESULTS A total of 23 patients underwent standard treatment and investigation of the monitoring threshold for preservation of function; another 66 patients underwent extended recuperation treatment and assessment of its effect on recovery of nerve function. Both types of final action potential monitoring response and extended recuperation treatment were associated with preservation of function at the same grade. CONCLUSIONS Preservation of function was significantly better for patients who received extended recuperation treatment.
Original Article: http://thejns.org/doi/abs/10.3171/2014.8.JNS132525?ai=ru&mi=0&af=R
Neuroendoscopic biopsy of brain lesions: accuracy and complications
Neuroendoscopic biopsy of brain lesions: accuracy and complications
Journal of Neurosurgery: Journal of Neurosurgery: Table of Contents
Journal of Neurosurgery, Volume 122, Issue 1, Page 34-39, January 2015.
OBJECT The authors conducted a study to analyze the accuracy of neuroendoscopic biopsies of ventricular and periventricular lesions and record any difficulties or complications of the neuroendoscopic biopsy procedure. METHODS A total of 50 patients with different diseases consecutively underwent endoscopic biopsy procedures. The biopsy result was considered diagnostic if the pathologist reported any specific finding on which clinicians could base decisions about treatment or observation. The biopsy result was referred to as accurate if the results matched results of a sample obtained later or if the treatment response and disease evolution were compatible with the diagnosis. The biopsy result was considered inaccurate if results showed any relevant differences from those of the later sample or if the patient's disease did not evolve as expected. Complications were recorded and compared with those found in a literature review. RESULTS For 2 patients, the procedure had to be terminated. The biopsy diagnostic rate was 89.6%, and the accuracy rate was 86%. Complications associated with the procedure were 3 hemorrhages (6%), 2 infections (4%), and 1 death (2%); no reoperations were needed. CONCLUSIONS Endoscopic biopsy seems to be an accurate procedure with acceptable morbidity and mortality rates.
Original Article: http://thejns.org/doi/abs/10.3171/2014.9.JNS132648?ai=ru&mi=0&af=R
Primary glioblastoma of the trigeminal nerve root entry zone: case report
Primary glioblastoma of the trigeminal nerve root entry zone: case report
Journal of Neurosurgery: Journal of Neurosurgery: Table of Contents
Journal of Neurosurgery, Volume 122, Issue 1, Page 78-81, January 2015.
Gliomas of the cranial nerve root entry zone are rare clinical entities. There have been 11 reported cases in the literature, including only 2 glioblastomas. The authors report the case of a 67-year-old man who presented with isolated facial numbness and was found to have a glioblastoma involving the trigeminal nerve root entry zone. After biopsy the patient completed treatment with conformal radiation and concomitant temozolomide, and at 23 weeks after surgery he demonstrated symptom progression despite the treatment described. This is the first reported case of a glioblastoma of the trigeminal nerve root entry zone.
Original Article: http://thejns.org/doi/abs/10.3171/2014.10.JNS14449?ai=ru&mi=0&af=R
Intracranial inertial cavitation threshold and thermal ablation lesion creation using MRI-guided 220-kHz focused ultrasound surgery: preclinical investigation
Intracranial inertial cavitation threshold and thermal ablation lesion creation using MRI-guided 220-kHz focused ultrasound surgery: preclinical investigation
Journal of Neurosurgery: Journal of Neurosurgery: Table of Contents
Journal of Neurosurgery, Volume 122, Issue 1, Page 152-161, January 2015.
OBJECT In biological tissues, it is known that the creation of gas bubbles (cavitation) during ultrasound exposure is more likely to occur at lower rather than higher frequencies. Upon collapsing, such bubbles can induce hemorrhage. Thus, acoustic inertial cavitation secondary to a 220-kHz MRI-guided focused ultrasound (MRgFUS) surgery is a serious safety issue, and animal studies are mandatory for laying the groundwork for the use of low-frequency systems in future clinical trials. The authors investigate here the in vivo potential thresholds of MRgFUS-induced inertial cavitation and MRgFUS-induced thermal coagulation using MRI, acoustic spectroscopy, and histology. METHODS Ten female piglets that had undergone a craniectomy were sonicated using a 220-kHz transcranial MRgFUS system over an acoustic energy range of 5600–14,000 J. For each piglet, a long-duration sonication (40-second duration) was performed on the right thalamus, and a short sonication (20-second duration) was performed on the left thalamus. An acoustic power range of 140–300 W was used for long-duration sonications and 300–700 W for short-duration sonications. Signals collected by 2 passive cavitation detectors were stored in memory during each sonication, and any subsequent cavitation activity was integrated within the bandwidth of the detectors. Real-time 2D MR thermometry was performed during the sonications. T1-weighted, T2-weighted, gradient-recalled echo, and diffusion-weighted imaging MRI was performed after treatment to assess the lesions. The piglets were killed immediately after the last series of posttreatment MR images were obtained. Their brains were harvested, and histological examinations were then performed to further evaluate the lesions. RESULTS Two types of lesions were induced: thermal ablation lesions, as evidenced by an acute ischemic infarction on MRI and histology, and hemorrhagic lesions, associated with inertial cavitation. Passive cavitation signals exhibited 3 main patterns identified as follows: no cavitation, stable cavitation, and inertial cavitation. Low-power and longer sonications induced only thermal lesions, with a peak temperature threshold for lesioning of 53°C. Hemorrhagic lesions occurred only with high-power and shorter sonications. The sizes of the hemorrhages measured on macroscopic histological examinations correlated with the intensity of the cavitation activity (R2 = 0.74). The acoustic cavitation activity detected by the passive cavitation detectors exhibited a threshold of 0.09 V·Hz for the occurrence of hemorrhages. CONCLUSIONS This work demonstrates that 220-kHz ultrasound is capable of inducing a thermal lesion in the brain of living swines without hemorrhage. Although the same acoustic energy can induce either a hemorrhage or a thermal lesion, it seems that low-power, long-duration sonication is less likely to cause hemorrhage and may be safer. Although further study is needed to decrease the likelihood of ischemic infarction associated with the 220-kHz ultrasound, the threshold established in this work may allow for the detection and prevention of deleterious cavitations.
Original Article: http://thejns.org/doi/abs/10.3171/2014.9.JNS14541?ai=ru&mi=0&af=R
Tumor resection with carmustine wafer placement as salvage therapy after local failure of radiosurgery for brain metastasis
Tumor resection with carmustine wafer placement as salvage therapy after local failure of radiosurgery for brain metastasis
ScienceDirect Publication: Journal of Clinical Neuroscience
Publication date:
Source:Journal of Clinical Neuroscience
Author(s): Frank Mu , John T. Lucas Jr. , Jonathan M. Watts , Annette J. Johnson , J. Daniel Bourland , Adrian W. Laxton , Michael D. Chan , Stephen B. Tatter
Original Article: http://rss.sciencedirect.com/action/redirectFile?&zone=main¤tActivity=feed&usageType=outward&url=http://www.sciencedirect.com/science?_ob=GatewayURL&_origin=IRSSSEARCH&_method=citationSearch&_piikey=S0967586814005980&_version=1&md5=b5d63de960e6ff51763a803dd3b44751
TODAY: Neurosurgical.TV Hangout held on 3rd Jan 2015
|
Thursday, January 1, 2015
Headache App
Headache App by Soda Virtual
https://appsto.re/br/iizeG.i
https://appsto.re/br/iizeG.i
Neuro Exam App
Neuro Exam App
https://appsto.re/br/ZKa2J.i
https://appsto.re/br/ZKa2J.i
Subscribe to:
Posts (Atom)