Thalamic parcellation for target identification in trans-cranial MR-guided Focused UltraSound (tcMRgFUS) thalamotomies: a preliminary probabilistc tractography study

Background: Trans-cranial MR-guided Focused UltraSound (tcMRgFUS) allows a neurofunctional exploration of thalamic nuclei to confirm and optimize the target before inducing a permanent brain lesion. However, the choice of the target is based on stereotactic coordinates that do not take into account the anatomical variability of each single patient. Thus, the optimization of the treatment target is based on the patient's feedback during lower power sonications. The aim of this work is to retrospectively evaluate the possible role of thalamic parcellation for the identification of the intermediate ventral nucleus (VIM) in patients undergoing tcMRgFUS. Materials and Methods: A 1.5T MR scanner …

Multidrug-resistant Gram-negative post-neurosurgical meningitis and the role of intraventricular colistin: a case series

: The aim of this study was to report the clinical experience of intraventricular colistin for the treatment of multi-resistant Gram-negative post-surgical meningitis in a tertiary hospital. Post-neurosurgical meningitis (PNM) is one of the life-threatening complications of neurosurgical procedures, and is frequently sustained by Acinetobacter baumannii and Klebsiella pneumoniae. Here we describe our experience of five cases of PNM caused by gram-negative multi-drug resistant (MDR) bacteria, treated with intraventricular (IVT) colistin, admitted to the Neurosurgery Unit of A.R.N.A.S. Civico of Palermo, Italy, from January 2016 to June 2020. In four patients the cerebrospinal fluid (CSF) cul…

A rare case of extra-intramedullary dorsal tanycitic ependymoma, radically removed with intraoperative neurophysiological monitoring

Introduction: Tanycitic dorsal extra and intramedullary ependymoma is a rare form of tumor. From the histological point of view, these tumors show several aspects that make difficult the differential diagnosis from schwannomas and pilocytic astrocytomas. Tanycytic variant, often occurs in the thoracic tract of the spinal cord, and it is constituted by tanycites, that are typical elongated and bipolar cells that give to the tumor fibrillary aspects. Tanycitic variant has been recently characterized as a variant of ependymoma, since the 2000 World Health Organization (WHO) system. Case presentation: A 57 years old woman presented with intractable back pain often radiating to the left leg. Neu…

Enfisema sottocutano cervico-facciale e pneumomediastino dopo chirurgia cervicale con approccio anteriore: management diagnosticoterapeutico di una grave complicanza.

Different methods for anatomical targeting.

AIM: Several procedures are used in the different neurosurgical centers in order to perform stereotactic surgery for movement disorders. At the moment no procedure can really be considered superior to the other. We contribute with our experience of targeting method. METHODS: Ten patients were selected, in accordance to the guidelines for the treatment of Parkinson disease, and operated by several methods including pallidotomy, bilateral insertion of chronic deep brain electrodes within the internal pallidum and in the subthalamic nucleus (18 procedures). Interventions: in each patient an MR scan was performed the day before surgery. Scans were performed axially parallel to the intercommissu…