Interest of awake surgery for ruptured cerebral arteriovenous malformations close to speech areas - Surgical note.

BACKGROUND: Cerebral arteriovenous malformations (AVMs) are rare, with incidence of 1.12-1.42 cases per 100,000 person-years (Ozpinar et al., 2017). Few studies report applications of awake surgery. The goal of this report was to assess the interest of awake surgery in complete resection of cortical AVMs located close to eloquent speech areas, enabling detection of real functional cortical reorganization due to the AVM and parenchymal hematoma. CASE REPORT: A 38-year-old right-handed patient was admitted to the University Hospital of Besançon for dysphasia due to a ruptured left temporal arteriovenous malformation. The patient underwent asleep-awake-asleep surgery. Intraoperative cortical mapping revealed the presence of functional language areas in uncommon locations compared to known neuro-functional anatomy. DISCUSSION: In this patient, speech areas were redistributed, probably due to neuroplasticity after cerebral hemorrhage, leading to a new cortical architecture, which would have been unrecognized based on preoperative radiological imaging alone. CONCLUSION: We report the interest of awake surgery to achieve complete safe resection of ruptured AVMs located close to eloquent speech areas, using intraoperative cortical mapping.

Reproductive Variability of Field Populations of Meloidogyne spp. on Grape Rootstocks.

Variability in penetration, development, and reproduction of two resistance-breaking field pathotypes (pt.) of Meloidogyne arenaria, M. incognita, and a population of mixed Meloidogyne spp. virulent to grape hosts were compared on two resistant Vitis rootstocks 'Freedom' and 'Harmony' in separate tests. 'Cabernet Sauvignon' was included as a susceptible host to all four nematode populations. Secondstage juveniles (J2) of the mixed population failed to penetrate Freedom roots. By contrast, 6% of J2 in the M. incognita population penetrated Freedom roots but did not develop beyond the swollen J2 stage. The two resistance-breaking populations of M. arenaria differed in their virulence except on susceptible roots of Cabernet Sauvignon. More J2 of M. arenaria pt. Freedom penetrated Freedom roots and reached adult stage than did M. arenaria pt. Harmony. Later life stages of M. arenaria pt. Freedom occurred earlier and in greater numbers in Harmony roots than did M. arenaria pt. Harmony. Reproduction of M. arenaria pt. Freedom was greater in Freedom and Harmony roots than M. arenaria pt. Harmony. Thus, one population of M. arenaria is highly virulent and the other is moderately virulent.