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nucleus accumbens stereotactic surgery: Achieving accuracy through area M

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World Journal of neurology 2013年第2期3卷 7-9页

作者： ioannis n mavridis Medical office of the Command of the Hellenic navy General Staff (naval Hospital of Athens) 15561 Athens Greece

The nucleus accumbens(nA), a major pleasure center of the human brain, is a limbic-motor interface involved in several neurological and psychiatric disorders. During the last decade, this nucleus is also a deep brain stimulation target for selected patients. Purpose of this paper is to comment on the article entitled "Stereotactic anatomy of the human nucleus accumbens: from applied mathematics to microsurgical accuracy" which was recently published in "Surgical and Radiologic Anatomy" and is one of the latest articles on nA anatomy and surgery. The described results included a probabilitybased guide for in vivo(side-depended) stereotactic localization of the human nA and a standard for the nA, specific stereotactic zone of the human brain(which can be used in combination for an accurate stereotactic nA targeting). Furthermore, two specific stereotactically standard nA areas were found which could be used as abundant stereotactic guides for targeting of the anterior limb of the internal capsule, with electrode's contact 0(lowest) placed in the vicinity of the nA. However, the most important finding of this paper was standard area M(mavridis' area), which is the most reliable stereotactically standard area of the human nA, regardless of side or gender, useful for highly accurate stereotacticnA targeting.

关键词： mavridis'area Deep brain stimulation neuropsychiatric disorders nucleus accumbens Stereotactic surgery Surgical accuracy

Anterior communicating artery aneurysm associated with duplicated hypoplastic right A1 segment

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World Journal of neurology 2013年第2期3卷 10-13页

作者： ioannis n mavridis Sophia Anagnostopoulou Department of Anatomy University of Athens School of Medicine11527 Athens Greece

Variations of the anterior cerebral artery(ACA)-anterior communicating artery(ACo A) complex are commonly observed when associated with a symptomatic intracranial aneurysm. We report an asymptomatic ACo A aneurysm associated with duplicated hypoplastic A1 segment of the right ACA, observed in a 70-year-old female cadaver. Furthermore, the aneurysm, practically substituting the ACo A, caused a remarkable depression on the internal surface of the right frontal lobe, anterior to the optic chiasm. Aneurysms and other anomalies of the ACA and ACo A are common and their microvascular surgical management requires sound knowledge of the normal and variant vascular anatomy. Persistence of some embryonic vessels that normally disappear, disappearance of vessels that would normally persist or sprouting of new vessels due to hemodynamic and genetic factors are the usual causes for such anomalies. The high incidence of coexisting vascular anomalies and aneurysm suggests that such abnormalities predispose to aneurysm formation due to changes in the regional blood flow. A1 segment duplication has been reported to occur in 4% of subjects in cadaveric studies and in up to 0.5%-9.7% of cases of ACo A aneurysm surgery. Angiographic hypoplasias and aplasias of the A1 seg-ment have been also correlated with ACo A aneurysm patients.

关键词： Anterior cerebral artery Anterior communicating artery Aneurysm Duplication Hypoplasia

mavridis' atrophy in Parkinson's disease-five years later: Future perspectives

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World Journal of neurology 2015年第1期5卷 1-4页

作者： ioannis n mavridis Efstratios-Stylianos Pyrgelis Department of neurosurgery "K.A.T.-N.R.C." General Hospital of Attica Department of neurology "K.A.T.-N.R.C." General Hospital of Attica

mavridis' atrophy(MA) is called the human nucleus accumbens(nA) atrophy in Parkinson's disease(PD).MA begins in early-stage PD patients and is correlated with psychiatric symptoms that occur in PD, mainly apathy and impulsive behavior. It is also associated with cognitive PD symptoms. Purpose of this editorial was to discuss the future perspectives of MA as apathological and imaging finding. MA is obviously part of the degeneration of the dopaminergic nigrostriatal system that occurs in PD and this also explains the fact that MA precedes clinical phenotype. But does the human nA follow the same pattern of degeneration? It would be quite interesting to have a post-mortem pathological study focused on the nA of parkinsonic individuals. Further questions that remain to be answered are whether all parkinsonics suffer MA and whether this phenomenon is also associated with motor PD symptoms. MA as an imaging finding could be a risk factor for the expression and/or severity of specific PD symptoms. It has therefore to be tested whether the presence of MA is related, for example, with the expression and/or severity of motor PD symptoms and whether the severity of MA affects the severity of specific psychiatric symptoms(apathy, compulsive behavior) of parkinsonic individuals. Such clinical studies, that could provide answers to these vital questions, can be easily preformed given the high frequency of PD in modern populations. Future research efforts are mandatory to enrich our knowledge of MA, namely its underlying mechanisms, its pathological features and its clinical consequences.

关键词： Parkinson’s disease mavridis’atrophy nucleus accumbens neuroimaging neuropathology Substantia nigra

Clinical consequences of centipede bite:Is it neurotoxic?

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World Journal of neurology 2016年第2期6卷 23-29页

作者： ioannis n mavridis Maria Meliou Efstratios-Stylianos Pyrgelis Department of neurosurgery "K.A.T.-N.R.C."General Hospital of Attica Department of Internal Medicine "Sotiria" General Hospital of Chest Diseases Department of neurology "K.A.T.-N.R.C."General Hospital of Attica

The primary purpose of this article was to review the current literature regarding the clinical consequences of centipede envenomation in humans,in order to determine whether the bite of these arthropods is neurotoxic to humans or not. A thorough search of the literature regarding the clinical consequences of centipede bites in humans was applied,with great respect to neurological symptoms potentially caused by such bites. Centipede bite commonly causes only local reactions,which usually resolve within a few days without sequelae. The patients in the majority of centipede envenomations describe a painful but benign syndrome. However,mild constitutional symptoms are relatively frequent. Remarkably,centipedes can rarely cause severe systematic reactions such as anaphylaxis or even hypotension and myocardial ischemia. Factors such as patient age,comorbidity,anatomic site of envenomation,and size/species of centipede should be considered when evaluating a centipede envenomation victim. According to the current literature,the centipede bite does not seem to be neurotoxic to humans. However,it commonly causes symptoms mediated by the nervous system. These include local and generalized symptoms,with the first dominated by sensory disturbances and the second by non-specific symptoms such as headache,anxiety and presyncope. Based on our results,the answer to our study's question is negative. The centipede bite is not neurotoxic to humans. However,it commonly causes symptoms mediated by the nervous system,which include primarily local pain and sensory disturbances,as well as generalized non-specific symptoms such as headache,anxiety and vagotonia.

关键词： Centipedes Pain Sensory disturbances Envenomation Scolopendra

Thickness-based correlations of cortical areas involved in senses, speech and cognitive processes

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World Journal of neurology 2013年第3期3卷 67-74页

作者： ioannis mavridis Konstantinos Lontos Sophia Anagnostopoulou Department of Anatomy University of Athens School of Medicine 11527 Athens Greece

AIM: To explore the existence of potential correlations of cortical thickness between different functional brain ***: Our material consisted of 38 formalinfixated human cerebral hemispheres from twenty males and three females, cadaver donors for students' education. We selected the following cortical areas at each hemisphere to examine: supramarginal gyrus(S), angular gyrus(A), area of colors recognition(F), area of names recognition(n), area of auditory attention(H), area of place memory(M), cortex of the superior wall of the calcarine sulcus(V1) and cortex of the inferior wall of the calcarine sulcus(V2). We measured the thickness of each cortical area and statistically analyzed our ***: We found a significant difference of the mean value of the V1(P n right and left hemispheres, as well as very significant correlations(P n the following cortical areas: n and F, A and F, S and F, A and S, A and n, S and n. We also found significant correlations(P n the following areas: S and M, S and H, n and H, as well asbetween the following areas(P nd V2, M and F, M and n, A and H. COnCLUSIOn: Our results suggest that there could be a potentially stronger impact for objects placed in the left inferior quarter of the visual field. Our study revealed several thickness-based correlations among different functional cortical areas. Most of them seem to have a more or less rational explanation.

关键词： Anatomy Cerebral cortex Correlations Cortical thickness Functional areas