ABSTRACT
BACKGROUND: Burst-patterned pallidal deep brain stimulation (DBS) in an animal model of Parkinson's disease (PD) yields significantly prolonged therapeutic benefit compared to conventional continuous DBS, but its value in patients remains unclear. OBJECTIVES: The aims were to evaluate the safety and tolerability of acute (<2 hours) burst DBS in PD patients and to evaluate preliminary clinical effectiveness relative to conventional DBS. METHODS: Six PD patients were studied with DBS OFF, conventional DBS, and burst DBS. Unified Parkinson's Disease Rating Scale III (UPDRS-III) and proactive inhibition (using stop-signal task) were evaluated for each condition. RESULTS: Burst and conventional DBS were equally tolerated without significant adverse events. Both stimulation patterns provided equivalent significant UPDRS-III reduction and increased proactive inhibition relative to DBS OFF. CONCLUSIONS: This pilot study supports the safety and tolerability of burst DBS, with acute effects similar to conventional DBS. Further larger-scale studies are warranted given the potential benefits of burst DBS due to decreased total energy delivery. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
ABSTRACT
INTRODUCTION: Calcification in brain metastasis occurs rarely so it is reported in approximately 1% of surgical and 6.6% of autopsy specimens. Here we report a new case of brain metastasis with calcification. CASE PRESENTATION: A 44-year-old woman presented with a generalized tonic-clonic seizure with no neurological deficit on physical examination. Brain imaging demonstrated a hyperdense lesion on computed tomography scan and hyposignal and rim enhancement on T1, T2 and T1 with gadolinium injection sequence images in the right parieto-occipital lobe. Intraoperatively, there was a well-defined solid homogenous calcified mass within brain parenchyma. The lesion that resembled a meningioma was totally resected. The histopathological examination revealed metastatic adenocarcinoma. CONCLUSION: Metastatic brain lesions should be in the differential diagnosis of a solitary calcified brain mass, although it occurs rarely. It is important to differentiate it radiologically from intralesional haemorrhage.
Subject(s)
Adenocarcinoma/secondary , Brain Neoplasms/secondary , Calcinosis/pathology , Colonic Neoplasms/pathology , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/surgery , Adult , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/surgery , Calcinosis/diagnostic imaging , Calcinosis/surgery , Contrast Media , Diagnosis, Differential , Female , Humans , Magnetic Resonance Imaging , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Remote cerebellar hemorrhage (RCH) is a rare complication after supratentorial craniotomies, which usually presents as linear hemorrhages on the surface of the cerebellum; the exact mechanism of it is not established yet. CASE DESCRIPTION: In case one, a 57-year-old patient demonstrated hemorrhage in the cerebellar sulci in favor of RCH 2 days after craniotomy for sphenoidal wing meningioma resection. He was asymptomatic and showed good prognosis after conservative treatment. However, in the second case, a 21-year-old man presented with symptomatic RCH just after the surgery for resection of huge intraaxial parietooccipital lesion. He had a poor prognosis despite the treatment and died ultimately. CONCLUSION: Although some studies reported the good prognosis for this type of hemorrhage, it can cause neurological and clinical deterioration and result to patient death.