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Albakr A, Sader N, Lama S, Sutherland GR. Interhemispheric arachnoid cyst. Surg Neurol Int 2021; 12:125. [PMID: 33880230 PMCID: PMC8053473 DOI: 10.25259/sni_660_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 02/24/2021] [Indexed: 11/04/2022] Open
Abstract
Background Interhemispheric arachnoid cysts are uncommon and typically associated with other midline neurodevelopmental disorders, such as complete or partial agenesis of the corpus callosum. Case Description We report a case of a 27-year-old woman with worsening headache, memory deficit, and radiological progression of an interhemispheric arachnoid cyst. The treatment consisted of craniotomy for interhemispheric cyst fenestration into both the interhemispheric cistern and lateral ventricle. The postoperative course was unremarkable, with considerable clinical improvement and significant reduction in cyst size. Conclusion We successfully treat a patient with an enlarging arachnoid cyst and associated progressive symptoms with microsurgical fenestration.
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Affiliation(s)
- Abdulrahman Albakr
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Surgery, Division of Neurosurgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nicholas Sader
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Sanju Lama
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Clinical Neurosciences, Hotchkiss Brain Institute, Canada.,Department of Clinical Neurosciences, Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Canada
| | - Garnette R Sutherland
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Clinical Neurosciences, Hotchkiss Brain Institute, Canada.,Department of Clinical Neurosciences, Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Canada
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Nishimura M, Okanishi T, Itamura S, Homma Y, Sakakura K, Ichikawa N, Limotai C, Yamada S, Baba S, Masuda Y, Enoki H, Fujimoto A. Seizure focus in the frontal interhemispheric fissure leads to ipsilateral isolated eye deviation. Epilepsy Behav 2021; 116:107772. [PMID: 33556862 DOI: 10.1016/j.yebeh.2021.107772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Few studies have examined the localization of seizures presenting with ictal eye deviation (ED) in the absence of other motor symptoms. We aimed to investigate differences in the localization of the ictal onset zone (IOZ) between patients with isolated ED and those with ED plus head turning (HT) during focal seizures. METHODS We reviewed intracranial video-EEG data for 931 seizures in 80 patients with focal onset epilepsy in whom the IOZ could be confirmed. The 233 seizures in 49 patients with ED were classified into two semiological groups based on initial ED and the presence/absence of HT: (1) isolated ED (i.e., ED without HT), and (2) ED + HT (i.e., ED with HT). We analyzed the localization and lateralization of IOZs in each semiological group. We performed multivariate logistic regression analysis using a mixed-effects to determine the associations between IOZs and isolated ED/ED + HT. RESULTS A total of 183 IOZs in 24 patients were included in the isolated ED group, while a total of 143 IOZs in 31 patients were included in the ED + HT group. Sixty-eight IOZs of eight patients in the isolated ED group were located in the ipsilateral frontal interhemispheric fissure (F-IHF). Only ipsilateral F-IHF was significantly associated with isolated ED (odds ratio [OR], 2.43; 95% confidence interval [CI], 0.37-4.49; P = 0.021). The contralateral lateral frontal cortex (latF) (P = 0.007) and ipsilateral mesial temporal region (mT) (P = 0.029) were significantly associated with ED + HT. CONCLUSION The present study is the first to demonstrate that seizures with an F-IHF focus tend to present with initial ipsilateral isolated ED. This finding may aid in identifying the seizure focus in patients with isolated ED prior to resection.
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Affiliation(s)
- Mitsuyo Nishimura
- Department of Clinical Laboratory, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki 3058576, Japan; Department of Clinical Laboratory, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 4308558, Japan
| | - Tohru Okanishi
- Division of Child Neurology, Brain and Neuroscience, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, Tottori 683-8503, Japan; Department of Child Neurology, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 4308558, Japan.
| | - Shinji Itamura
- Department of Child Neurology, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 4308558, Japan
| | - Yoichiro Homma
- Department of General Internal Medicine, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 4308558, Japan.
| | - Kazuki Sakakura
- Department of Epilepsy and Neurosurgery, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 4308558, Japan
| | - Naoki Ichikawa
- Department of Epilepsy and Neurosurgery, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 4308558, Japan
| | - Chusak Limotai
- Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Henri Dunant Road, Pathumwan, Bangkok 10330, Thailand
| | - Saki Yamada
- Department of Clinical Laboratory, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 4308558, Japan. sk-
| | - Shimpei Baba
- Department of Child Neurology, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 4308558, Japan
| | - Yosuke Masuda
- Department of Neurosurgery, Comprehensive Epilepsy Center, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki 3058576, Japan.
| | - Hideo Enoki
- Department of Child Neurology, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 4308558, Japan.
| | - Ayataka Fujimoto
- Department of Epilepsy and Neurosurgery, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, Shizuoka 4308558, Japan.
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Altun A, Çokluk C. The Microneurosurgical Training Model for Intrinsic and Extrinsic Brain Tumor Surgery Using Polyurethane Foam and Fresh Cadaveric Cow Brain: An Experimental Study. World Neurosurg X 2019; 4:100039. [PMID: 31309184 PMCID: PMC6606969 DOI: 10.1016/j.wnsx.2019.100039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 05/19/2019] [Accepted: 05/20/2019] [Indexed: 11/08/2022] Open
Abstract
Objective To evaluate the feasibility of an experimentally designed brain tumor model consisting of polyurethane foam and fresh cadaveric cow brain for the surgical training of the technique for tumor ablation. Methods A laboratory-training model was created for microneurosurgical intervention of intrinsic brain tumor ablation covering microdissection of the brain tissue and opening of the pia mater, dissection and separation of the sulcal and cisternal structures, and dissection and removal of the tumor tissue. The left front parietal lobe was used as the area of interest for this experimental study. One-centimeter cube polyurethane foam was injected 2-cm deep inside the brain tissue using a plastic injection tube. After 5 minutes, the model was ready to use under the operating microscope for dissection, separation, and removal of the tumor tissue. The compatibility of the training model also was evaluated as poor, acceptable, and perfect. Results Ten stripped fresh cadaveric cow brains were used in this experimental feasibility study. The compatibility of the model was evaluated as poor, acceptable, and perfect in 1, 6, and 3 subjects, respectively. Conclusions In intrinsic brain tumor ablation, surgical manipulations of sulcal, cisternal, and fissural dissection must be undertaken while preserving vital neural and vascular structures. We believe that our model holds promise in developing the technical skills of neurosurgeons in training.
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Affiliation(s)
- Adnan Altun
- Department of Neurosurgery, Medical Faculty, Karatay University, Konya, Turkey
| | - Cengiz Çokluk
- Department of Neurosurgery, Medical Faculty, Ondokuzmayis University, Samsun, Turkey
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Nishimura M, Okanishi T, Fujimoto A, Kanai S, Sasaki Y, Homma Y, Otsubo H, Enoki H. Three phase-ictal scalp EEG patterns in patients with seizures arising from the cortex facing the interhemispheric fissure. Epilepsy Res 2018; 143:105-112. [PMID: 29475788 DOI: 10.1016/j.eplepsyres.2018.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 01/22/2018] [Accepted: 02/11/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Ictal scalp EEG patterns have been reported to vary across onset regions. We assessed the sequential EEG changes during seizure events on scalp EEG, and tested our hypothesis that patients with focal seizures arising from the cortex facing the interhemispheric fissure (IHF cortex) would be specifically characterized by 3 phase-EEG patterns (3Ph-EEG). METHODS Patient inclusion criteria were: 1) focal epilepsy and 2) ictal onset records on scalp and intracranial video-EEG. Patients were classified into one of the three groups: the IHF group, mesial temporal (MT) group, or lateral convexity (LC) group, based on the localization of the ictal onset zone (IOZ) on intracranial video-EEG. We defined 3Ph-EEG on ictal scalp EEG as follows: phase 1, brief spike/fast wave burst; phase 2, diffuse attenuation; and phase 3, focal rhythmic activity with evolution. We determined if the occurrence ratios of 3Ph-EEG and each of the three phases differed between the groups (IHF and others). RESULTS We studied 36 patients aged 8-59 years (mean, 30 years). Ten patients were classified as IHF, 16 as MT, and 10 as LC group from 303 ictal events on intracranial EEG. 193 seizures on scalp EEG consisted of 79 seizures in IHF; 58 in MT; 56 in LC group. Sixty-nine seizures (92%) in nine patients (90%) in IHF group showed 3Ph-EEG, whereas none of the seizures in MT and LC groups showed the 3Ph-EEG. Multivariate logistic regression analysis suggested that the presence of 3Ph-EEG (p < 0.01) and phase 2 (p = 0.03) components were predictive of IHF scalp EEG onset. SIGNIFICANCE The 3Ph-EEG may be observed preferentially in patients with focal seizures from IHF cortex. Observation of the ictal phases on scalp EEG may warrant consideration of intracranial EEG sampling for the presurgical evaluation.
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Affiliation(s)
- Mitsuyo Nishimura
- Department of Clinical Laboratory, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Tohru Okanishi
- Department of Child Neurology, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, 430-8558, Japan.
| | - Ayataka Fujimoto
- Epilepsy and Neurosurgery, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Sotaro Kanai
- Department of Child Neurology, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Yuki Sasaki
- Department of Clinical Laboratory, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, 430-8558, Japan; Department of Clinical Laboratory, St Luke's International Hospital, Akashi, Chuo-ku, Tokyo, 104-8560, Japan
| | - Yoichiro Homma
- Department of General Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Hiroshi Otsubo
- Department of Neurophysiology, Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, M5G 1X8, Canada
| | - Hideo Enoki
- Department of Child Neurology, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, 430-8558, Japan
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Monroy-Sosa A, Nathal E, Rhoton AL Jr. Operative Management of Distal Anterior Cerebral Artery Aneurysms Through a Mini Anterior Interhemispheric Approach. World Neurosurg 2017; 108:519-28. [PMID: 28919562 DOI: 10.1016/j.wneu.2017.09.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/05/2017] [Accepted: 09/06/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Distal anterior cerebral artery (DACA) aneurysms, also known as pericallosal artery aneurysms, are present in 1.5%-9% of all intracranial aneurysms. Here we characterize the important microsurgical anatomy of DACAs; describe the surgical approach to treating these aneurysms with a minimally invasive surgical technique, the mini anterior interhemispheric approach (MAIA); and examine the nuances of aneurysm clipping in this region. METHODS This was a retrospective and descriptive analysis of a series of aneurysm surgeries performed at the National Institute of Neurology and Neurosurgery in Mexico City. Cadaveric dissections were used to demonstrate relevant cerebrovascular anatomy. We analyzed patient demographic data and aneurysm characteristics. Patients' neurologic grade was evaluated using the Hunt and Kosnik (H-K) scale, and surgical outcomes were evaluated using the Glasgow Outcome Scale (GOS). Other variables were analyzed using the χ2 test. RESULTS We analyzed a total of 32 DACA aneurysms (10 nonruptured and 22 ruptured), representing 5.8% of all aneurysms. The study cohort was 64.3% females and 35.7% males. H-K grade II was the most frequent classification (32.4%); 42.8% of patients presented with a Fisher grade IV aneurysm. Aneurysm location was classified as supra-genu, genu, or infra-genu. Eight patients had multiple aneurysms, among which 50% were located at the bifurcation of the middle cerebral artery. CONCLUSIONS Surgical clipping through a MAIA approach is an excellent treatment option for pericallosal artery aneurysms.
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Yamaguchi J, Watanabe T, Nagatani T. Endoscopic approach via the interhemispheric fissure: the role of an endoscope in a surgical case of multiple falcine lesions. Acta Neurochir (Wien) 2017; 159:1243-1246. [PMID: 28283869 DOI: 10.1007/s00701-017-3129-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 02/16/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND For treating a patient with multiple falcine and parasagittal lesions, we believe that it is beneficial to resect the maximum possible number of lesions during one operation, even if some lesions are asymptomatic. This practice can potentially reduce the total number of operations during a patient's lifetime. METHODS We provide an introduction of a concurrent endoscopic approach via the interhemispheric fissure. CONCLUSIONS Applying this endoscopic approach concurrently with conventional microscopic surgery can enable the safe resection of as many lesions as possible during one operation.
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Affiliation(s)
- Junya Yamaguchi
- Department of Neurosurgery, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho Showa-ku, Nagoya-shi, Aichi, 466-8650, Japan
| | - Tadashi Watanabe
- Department of Neurosurgery, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho Showa-ku, Nagoya-shi, Aichi, 466-8650, Japan.
| | - Tetsuya Nagatani
- Department of Neurosurgery, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho Showa-ku, Nagoya-shi, Aichi, 466-8650, Japan
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Gobius I, Suárez R, Morcom L, Paolino A, Edwards TJ, Kozulin P, Richards LJ. Astroglial-mediated remodeling of the interhemispheric midline during telencephalic development is exclusive to eutherian mammals. Neural Dev 2017; 12:9. [PMID: 28558801 PMCID: PMC5450091 DOI: 10.1186/s13064-017-0086-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 05/12/2017] [Indexed: 01/10/2023] Open
Abstract
The corpus callosum forms the major interhemispheric connection in the human brain and is unique to eutherian (or placental) mammals. The developmental events associated with the evolutionary emergence of this structure, however, remain poorly understood. A key step in callosal formation is the prior remodeling of the interhemispheric fissure by embryonic astroglial cells, which then subsequently act as a permissive substrate for callosal axons, enabling them to cross the interhemispheric midline. However, whether astroglial-mediated interhemispheric remodeling is unique to eutherian mammals, and thus possibly associated with the phylogenetic origin of the corpus callosum, or instead is a general feature of mammalian brain development, is not yet known. To investigate this, we performed a comparative analysis of interhemispheric remodeling in eutherian and non-eutherian mammals, whose lineages branched off before the evolution of the corpus callosum. Whole brain MRI analyses revealed that the interhemispheric fissure is retained into adulthood in marsupials and monotremes, in contrast to eutherians (mice), in which the fissure is significantly remodeled throughout development. Histological analyses further demonstrated that, while midline astroglia are present in developing marsupials, these cells do not intercalate with one another through the intervening interhemispheric fissure, as they do in developing mice. Thus, developing marsupials do not undergo astroglial-mediated interhemispheric remodeling. As remodeling of the interhemispheric fissure is essential for the subsequent formation of the corpus callosum in eutherians, our data highlight the role of astroglial-mediated interhemispheric remodeling in the evolutionary origin of the corpus callosum.
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Affiliation(s)
- Ilan Gobius
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, 4072, Australia.
| | - Rodrigo Suárez
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, 4072, Australia
| | - Laura Morcom
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, 4072, Australia
| | - Annalisa Paolino
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, 4072, Australia
| | - Timothy J Edwards
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, 4072, Australia.,Faculty of Medicine, The University of Queensland, Herston, Brisbane, 4006, Australia
| | - Peter Kozulin
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, 4072, Australia
| | - Linda J Richards
- Queensland Brain Institute, The University of Queensland, St Lucia, Brisbane, 4072, Australia. .,School of Biomedical Sciences, The University of Queensland, St Lucia, Brisbane, 4072, Australia.
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Vasudeva A, Nayak SS, Kadavigere R, Girisha KM, Shetty J. Middle Interhemispheric Variant of Holoprosencephaly - Presenting as Non-Visualized Cavum Septum Pellucidum and An Interhemispheric Cyst in A 19-Weeks Fetus. J Clin Diagn Res 2015; 9:QD11-3. [PMID: 26500966 DOI: 10.7860/jcdr/2015/14076.6525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 07/08/2015] [Indexed: 11/24/2022]
Abstract
Middle Interhemispheric variant (MIH) is a rare subtype of holoprosencephaly (HPE), also known as syntelencephaly. We present a case of MIH, which was diagnosed as an interhemispheric cyst on antenatal sonography at 19 weeks, but later diagnosed as MIH variant of holoprosencephaly after a postabortal MRI and perinatal autopsy.
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Affiliation(s)
- Akhila Vasudeva
- Associate Professor, Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University , Manipal, India
| | - Shalini S Nayak
- Junior Research Fellow, Department of Medical Genetics, Kasturba Medical College, Manipal University , Manipal, India
| | - Rajagopal Kadavigere
- Professor and HOD, Department of Radiology, Kasturba Medical College, Manipal University , Manipal, India
| | - Katta M Girisha
- Professor and HOD, Department of Medical Genetics, Kasturba Medical College, Manipal University , Manipal, India
| | - Jyothi Shetty
- Additional Professor and Chief of Unit 4, Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University , Manipal, India
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