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Neural Regeneration Research 2016年第5期11卷 729-730页

作者： Eugenio Scarnati Flora Vitale Annamaria Capozzo Paolo Mazzone Department of Biotechnological and Applied Medical Sciences (DISCAB) University of L’Aquila-L’Aquila Operative Unit for Stereotactic and Functional Neurosurgery RegionalCenter for Functional Neurosurgery and DBS

Deep brain stimulation（DBS）is a well established electrophysiological treatment initially applied to treat medication-refractory motor symptoms in Parkinson＇s disease（PD）,and is now being explored for several neurological and psychiatric disorders.The specific physiological mechanisms underlying the effectiveness of DBS are not fully understood.

关键词： Cholinergic input from the pedunculopontine nucleus to the cerebellum implications for deep brain stimulation in Parkinson’s disease deep

Treatment for paraganglioma with stereotactic radiotherapy

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World Journal of Clinical Cases 2024年第16期12卷 2729-2737页

作者： Antonio Pontoriero Paola Critelli Marco Zeppieri Filippo Flavio Angileri Tamara Ius Radiation Oncology unit Department of BiomedicalDental Science and Morphological and Functional ImagesUniversity of MessinaMessina 98125Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy neurosurgery unit Department of BiomedicalDental Science and Morphological and Functional ImagesUniversity of MessinaMessina 98125Italy neurosurgery unit Head-Neck and NeuroScience DepartmentUniversity Hospital of UdineUdine 33100Italy

BACKGROUND Paragangliomas(PG)are rare neoplasms of neuroendocrine origin that tend to be highly vascularized,slow-growing,and usually sporadic.To date,common treatment options are surgical resection(SR),with or without radiation therapy(RT),and a watch-and-wait approach.AIM To evaluate the local control and effectiveness of exclusive fractionated stereotactic RT(FSRT)treatment in unresectable PG(uPG).METHODS We retrospectively evaluated patients with uPG(medically inoperable or refused SR)treated with FSRT with a Cyberknife System(Accuray Incorporated,Sunnyvale,California).Toxicity and initial efficacy were evaluated.RESULTS From May 2009 to January 2023,6 patients with a median age of 68(range 20-84)were treated with FSRT.The median delivered dose was 21 Gy(range 20-30 Gy)at a median isodose line of 75.5%(range 70%-76%)in 4 fractions(range 3-5 fractions).The median volume was 13.6 mL(range 12.4-65.24 mL).The median cumulative biological effective dose and equivalent dose in 2-Gy fractions were 70 Gy and 37.10 Gy respectively.Site of origin involved were the timpa-nojugular glomus(4/6),temporal bone,and cervical spine.In 1 of the 6 patients,the follow-up was insufficient;5 of 6 patients showed a 5-year overall survival and 5-year progression-free survival of 100%.We observed negligible toxicities during and after RT.The majority of patients showed stable symptoms during follow-up.Only 1 patient developed spine metastases.CONCLUSION Our preliminary results on this small cohort of patients suggest that FSRT could be an effective and safe alternative to SR.

关键词： Unresectable paraganglioma Fractionated stereotactic radiation therapy Cyberknife neurosurgery Metastasis

Endoscopic Surgery versus External Ventricular Drainage Surgery for Severe Intraventricular Hemorrhage

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Current Medical Science 2018年第5期38卷 880-887页

作者： Ping SONG Fa-liang DUAN Qiang CAI Jing-lei WU Xiao-bin CHEN Yuan WANG Cong-gang HUANG Ji-qiang LI Zhu-qiang HE Qiao-chun HUANG Mei LIU Yan-gao ZHANG Ming LUO Department of neurosurgery the First Hospital of WuhanWuhan 430022China Department of neurosurgery Renmin Hospital of Wuhan UniversityWuhan 430060China Intensive Care unit the First Hospital of WuhanWuhan 430022China

The efficacy and applied value of endoscopic hematoma evacuation vs. external ventricular drainage (EVD) in the treatment of severe ventficular hemorrhage (IVH) were explored and compared.From Jan.2015 to Dec.2016,the clinical data of 42 cases of IVH were retrospectively analyzed,including 18 patients undergoing endoscopic hematoma evacuation (group A),and 24patients receiving EVD (group B).The hematoma clearance rate was calculated by 3D Slicer software,and complications and outcomes were compared between the two groups.There were no significant differences in age,sex and Graeb score between groups A and B (P>0.05).The hematoma clearance rate was 70.81%±27.64% in group A and 48.72%±36.58% in group B with a statistically significant difference (Poperative time in groups A and B was 72.45±25.26 min and 28.54±15.27min,respectively (Poperatively in group A,and from 8.25±2.62 at baseline to 10.79±4.12 at 1 week postoperatively in group B (P<0.05).The length of hospital stay was 12.67±5.97 days in group A and 17.33±8.91 days in group B with a statistically significant difference (P<0.05).The GOS scores at 6 months after surgery were 3.83±1.12 in group A,and 2.75±1.23 in group B (P<0.05). These results suggested that endoscopic hematoma evacuation has an advantage of a higher hematoma clearance rate,fewer complications and better outcomes in the treatment of severe IVH,indicating it is a safe,effective and promising approach for severe IVH.

关键词： endoscopic surgery severe intraventricular hemorrhage external ventricular drainage

Evaluation of lordosis recovery after lumbar arthrodesis and its clinical impact

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Chinese Neurosurgical Journal 2023年第3期9卷 177-182页

作者： Gabriel Tchachoua Jiembou Hermann Adonis Nda Meleine Landry Konan Department of neurosurgery University Hospital of Toulouse31300 ToulouseFrance Department of neurosurgery University Hospital Yopougon21 BP 632 AbidjanIvory Coast Training and Research unit of Medical Sciences University Felix Houphouet Boigny01 BPV 34 AbidjanIvory Coast

Background Posterior lumbar arthrodesis has become a widely used therapeutic option to correct sagittal imbalances in patients suffering from degenerative lumbar conditions.However,in western Africa,there is no study have reported long-term outcome of posterior lumbar arthrodesis.The aim of this study was to investigate the relationship between the restoration of adequate lordosis and the patient’s postoperative quality of life.Method The study was retrospective.From January 2012 to December 2019,80 patients who underwent posterior lumbar arthrodesis for lumbar degenerative diseases were included with a mean follow-up of 43.2 months.Mean age was 50.8 years(SD=12.2).Preoperative and postoperative patients'symptoms were assessed by the visual analog scale(VAS),Oswestry Disability Index(ODI),and 12-item Short Form(SF-12).Pre-and post-operative radiographic evaluation included lumbar lordosis measured(LLm),pelvic incidence(PI),sacral slope(SS),and pelvic stilt(PS).Theoretical lumbar lordosis(LLt)was defined by the following:LL=0.54×PI+27.6.Data analysis was done using the statistical software"R."The risk of error was 5%(poperative and postoperative lumbar lordosis(p=0.2567).There was no statistical difference between preoperative and post-operative PI-LL(p=0.179).There was a statistically significant difference between the pre and postoperative clinical scores(p<0.001).Statistical analysis showed a correlation between recovery of lumbar lordosis and improvement in physical component of SF-12(PCS)(p<0.05)and lumbar and radicular VAS(p<0.05)for the subgroup of narrow lumbar spine.There was a statistical relationship between the restoration of lumbar lordosis and improvement in PCS(p=0.004)and VAS(p=0.003)for the subgroup of isthmic lysis spondylolisthesis.Discussion The root decompression performed in most patients could explain the clinical improvement regardless of recovery of lordosis.The failure to consid

关键词： Posterior lumbar arthrodesis Sagittal alignment Lumbar lordosis Clinical outcomes

Probabilistic tractography of the posterior subthalamic area in Parkinson’s disease patients

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Journal of Biomedical Science and Engineering 2013年第3期6卷 381-390页

作者： M.G.GarcIa-Gomar Luis Concha S.Alcauter J.Soto Abraham J.D.Carrillo-Ruiz G.Castro Farfan Francisco Velasco Campos Neurobiology Institute UNAM Campus JuriquillaJuriquillaQueretaroMexico National Institute of Psychiatry“Ramón de la Fuente Muniz” México CityMéxico unit for stereotactic and functional neurosurgery and Radiosurgery México General HospitalMéxico CityMéxico

Deep brain stimulation (DBS) is a non-pharmacological treatment for Parkinson’s disease (PD), and its efficacy depends largely on which anatomical structure (target) is stimulated. The subthalamic nucleus (STN) is one of the most commonly used targets, but stimulation of new targets within the posterior sub-thalamic area (PSA), comprising a group of white matter fibers known as prelemniscal radiations (Raprl), as well as the caudal zonaincerta nucleus (Zic), have proven to be superior at improving certain clinical symptoms. Despite their clinical usefulness, their anatomical connectivity has not been completely described in humans. We performed constrained spherical deconvolution of the signal in diffusion-weighted images and subsequent tractography as a means to non-invasively define the connectivity of the Raprl and Zic in a group of five patients with PD. Further, we used track-density imaging, a novel method to improve the spatial resolution of the acquired images, in order to visualize the small subregions that comprise the PSA with a voxel resolution of 0.2 × 0.2 × 0.2 mm3. Both Raprl and Zic demonstrated high probability of connectivity with the dorsal brainstem, cerebellum, subcortical nuclei (globus pallidum ventral, lateral thalamic nuclei), and cortical areas (orbitofrontal cortex, primary and supplementary motor cortex areas). The connectivity patterns were re-producible between patients and were discretely organized as the tracts entered/exited the PSA, depending on their end points. These findings indicate that the PSA is part of the neuronal circuitry controlling movement, and the precise characterization of its connectivity will aid in our understanding of the net-works involved in PD and how they can be modulated with DBS in order to alleviate symptoms.

关键词： Parkinson Disease(PD) Posterior Subthalamic Area(PSA) Tractography Track-Density Images(TDI)

Unusual Posterior Traumatic Hip Dislocations at Yopougon/Abidjan Teaching Hospital

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Open Journal of Orthopedics 2016年第4期6卷 71-77页

作者： Alidou Traoré Leopold Koffi Krah Daouda Kanaté Soumaro Rebecca Eva Boka Christelle Mobiot-Aka Alban Slim Mbende Mamadou Dosso Kader Sy Jean Baptiste Sie Essoh Insa Bamba Yves Lambin Trauma and Orthopaedic Surgery unit Yopougon Teaching Hospital Abidjan Ivory Coast neurosurgery unit Yopougon Teaching Hospital Abidjan Ivory Coast

Traumatic dislocation of the hip is quite rare and accounts for 2% - 5% of all dislocations. We report on a case of a bilateral posterior hip dislocation associated with symmetric acetabular fracture and two cases of infracotyloid dislocation. The report included 2 men and one woman. The mean age of patients was 33 years. All dislocations followed a road traffic accident. Non-operative closed reduction was achieved within 19 hours of admission. The average follow-up time was 15 months. The hips were stable, mobile, and painless;and there was no radiographic sign of avascular necrosis of the femoral head.

关键词： Hip Dislocation Posterior Infracotyloid Posterior Wall

Intentional Penetrating Craniocerebral Injury Caused by a Nail: Clinical Presentation and Management of Three Cases

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Open Journal of Modern neurosurgery 2020年第4期10卷 458-463页

作者： Olatoundji Holden Fatigba Luphin Hodé Christian Padonou unit of neurosurgery Faculty of Medicine of Parakou University Parakou Benin unit of neurosurgery Teaching Hospital of Hubert Koutoukou Maga Cotonou Benin

The authors report on their experience in the medical and surgical management of three cases of penetrating craniocerebral injuries caused by a nail. In all three cases, it was an aggression. Two of the three patients were male. The cranial locations affected were respectively left parietal, right temporal and right frontal. The Glasgow coma score (GCS) was between 9 and 13. None of the patients had a motor deficit. A plain skull radiographs was performed for each patient. All patients underwent surgery and all received antibiotic therapy and tetanus vaccination. In two cases, post-operative outcome was simple. Recovery was complete without sequelae. The patient with a GCS of 9 died the day after surgery.

关键词： Penetrating Injury Craniocerebral Injury Nail

Intra-operative mapping and language protection in glioma

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Chinese Medical Journal 2021年第20期134卷 2398-2402页

作者： Shi-Meng Weng Sheng-Yu Fang Lian-Wang Li Xing Fan Yin-Yan Wang Tao Jiang Beijing Neurosurgical Institute Capital Medical UniversityBeijing 100070China Department of neurosurgery Beijing Tiantan HospitalCapital Medical UniversityBeijing 100070China Research unit of Accurate Diagnosis Treatmentand Translational Medicine of Brain TumorsChinese Academy of Medical SciencesBeijing 100070China

The demand for acquiring different languages has increased with increasing globalization.However,knowledge of the modification of the new language in the neural language network remains insufficient.Although many details of language function have been detected based on the awake intra-operative mapping results,the language neural network of the bilingual or multilingual remains unclear,which raises difficulties in clinical practice to preserve patients’full language ability in neurosurgery.In this review,we present a summary of the current findings regarding the structure of the language network and its evolution as the number of acquired languages increased in glioma patients.We then discuss a new insight into the awake intra-operative mapping protocol to reduce surgical risks during the preservation of language function in multilingual patients with glioma.

关键词： Glioma Intra-operative mapping Language function Language protection

Selective dorsal rhizotomy in cerebral palsy spasticity-a newly established operative technique in Slovenia: A case report and review of literature

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World Journal of Clinical Cases 2019年第10期7卷 1133-1141页

作者： Tomaz Velnar Peter Spazzapan Zoran Rodi Natasa Kos Roman Bosnjak Department of neurosurgery University Medical Centre LjubljanaLjubljana 1000Slovenia AMEU-ECM Maribor Ljubljana 1000Slovenia Department of Neurophysiology University Medical Centre LjubljanaLjubljana 1000Slovenia Medical Rehabilitation unit University Medical Centre LjubljanaLjubljana 1000Slovenia

BACKGROUND Spasticity affects a large number of children,mainly in the setting of cerebral palsy,however,only a few paediatric neurosurgeons deal with this problem.This is mainly due to the fact that until 1979,when Fasano has published the first series of selective dorsal rhizotomy(SDR),neurosurgeons were able to provide such children only a modest help.The therapy of spasticity has made a great progress since then.Today,peroral drugs,intramuscular and intrathecal medicines are available,that may limit the effects of the disease.In addition,surgical treatment is gaining importance,appearing in the form of deep brain stimulation,peripheral nerve procedures and SDR.All these options offer the affected children good opportunities of improving the quality of life.CASE SUMMARY A 15-year old boy is presented that was surgically treated for spasticity as a result of cerebral palsy.Laminotomy at L1 level was performed and L1 to S1 nerve roots were isolated and divided in smaller fascicles.Then,the SDR was made.CONCLUSION We describe a patient report and surgical technique of SDR that was performed in Slovenia for the first time.

关键词： Cerebral palsy Spasticity Selective dorsal rhizotomy Operation Case report

Late Post-Traumatic Cerebrospinal Rhinorrhoea

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Open Journal of Modern neurosurgery 2017年第3期7卷 103-111页

作者： Fulbert Kouakou Romuald Kouitcheu Alban Slim Mbende Dominique N’Dri Oka Guy Varlet neurosurgery unit Yopougon Teaching Hospital Abidjan Ivory Coast

Cerebrospinal fluid (CSF) rhinorrhoea results from anatomical breach between the subarachnoid space and air sinus cavities of the skull base and traumatic CSF rhinorrhoea accounts for 80% - 90% of all cases of CSF leaks. We sought to report the case of a 16-year-old patient with a history of head injury following a fall from a tree, who developed a post-traumatic CSF rhinorrhoea after an onset of meningitis. The patient sustained a fall from a 6-meter tree in 2008, and was reviewed by our neurosurgical team in February 2016 for a 1-month history of progressive headaches associated with fever, asthenia and left CSF rhinorrhoea. Clinical examination revealed frank meningism and abundant CSF leak from the left nostril. CT scanning showed fractures of the left frontal bone and sinus wall associated with a massive pneumocephalus. The patient benefited from surgical repair of the tear and post-operative lumbar punctures at day 15. The patient’s guardian was informed that non-identifiable information from the case would be submitted for publication and he provided consent.

关键词： Post-Traumatic Cerebrospinal Rhinorrhoea Meningitis Surgical Repair