A modular system for the synchronized multimodal data acquisition during Awake Surgery: towards the emergence of a dedicated clinical database.

Awake Surgery (AS) is considered the best treatment for brain tumors located in or near eloquent areas. During this intervention, Direct Electrical Stimulations (DES) are delivered by the surgeon on the patient's brain in order to obtain an accurate brain mapping of the patient. The patient is asked to perform various tasks (e.g. counting, object naming, emotion recognition) through neuropsychological tests during these stimulations. These DES may cause a reversible lesion inducing deficits on the patient which can be observed during these tasks by the medical staff. The resection is then performed or not according to the patient's response. The intraoperative deficits can take several forms and can be difficult to analyze and identify. The development of new solutions allowing the automatic detection of these deficits could be therefore essential. However, still today, no structured and organized AS dedicated database is available that could be used to train and test these algorithms. We propose a modular system allowing the synchronized multimodal acquisition of various information including physiological measurements, DES signals and parameters, and task-related data to create such database.Clinical relevance- Acquiring synchronized multimodal data during AS will allow the creation of a dedicated database that could then be used to reveal new correlations between DES and the patient's response, and to develop and test new algorithms for the automatic detection of deficits.

A Collet-Sicard syndrome due to internal carotid artery dissection associated with cerebral amyloid angiopathy-related inflammation.

BACKGROUND: Cerebral amyloid angiopathy-related inflammation is a rare condition with approximately 100 reported cases. Its clinical manifestations are varied. We report here a novel presentation of this disease. CASE PRESENTATION: A 61-year-old Caucasian man presented with rapidly progressive paralysis of the IX, X, XI and XII right cranial nerves associated with right central facial nerve palsy. Brain computed tomography angiography and cerebral catheter angiography found a focal fusiform enlargement of the distal cervical portion of the right internal carotid artery, related to a pseudo-aneurysm suggesting an evolution of a dissection and intra-cranial vessel dysplasia. Brain magnetic resonance imaging showed multiple asymmetrical subcortical regions of hyperintensity on T2 fluid-attenuated inversion recovery sequences. Punctiform cortical hyposignals on T2-weighted gradient echo magnetic resonance imaging sequences were mostly congruent with the white matter hyperintensities. There was a decreased cerebral perfusion at the frontal hyperintense fluid-attenuated inversion recovery region. Spectrometry identified a lactate-lipid peak. A brain biopsy showed intravascular amyloid deposits. Corticosteroid therapy was initiated, leading to a dramatic improvement of both clinical condition and magnetic resonance imaging brain lesions. CONCLUSION: This case report suggests that extra-cranial vasculitis and dysplasia can exceptionally be found in patients satisfying cerebral amyloid angiopathy-related inflammation criteria.