Novel application of robot-guided stereotactic technique on biopsy diagnosis of intracranial lesions.

Introduction: This study was performed to examine whether there is a link between the application of three types of robot-guided stereotactic biopsy techniques and the diagnostic rate of intracranial lesion biopsy. Methods: The study involved 407 patients who underwent robot-guided stereotactic intracranial lesion biopsy at Xuanwu Hospital of Capital Medical University from January 2019 to December 2021. Age, sex, lesion characteristics, lesion distribution, surgical method, and target path depth were assessed for their impact on the biopsy diagnostic rate. Results: The patients' mean age was 42.1 years (range, 6 months-82 years). All patients underwent robot-assisted stereotactic brain biopsy using one of three different systems: a ROSA robotic system (n=35), the CAS-R-2 (n=65), or the REMEBOT domestic robotic system (n=307). No significant difference was found in the diagnostic rate of positive histopathological findings or the mean time of surgery among the three biopsy modalities. The diagnostic rate was 93.86%. Multiple linear regression analysis showed that age, sex, and biopsy modality did not affect the diagnostic rate n>0.05), whereas enhancing lesions and smaller-volume lesions (≤l cm3) were significantly correlated with the diagnostic rate (p = 0.01). Lesions located in the suprasellar and pineal regions were significantly associated with the negative diagnostic rate (p<0.05). Conclusion: The presence of enhancing lesions, lesion location, and lesion volume significantly affected the diagnostic rate of brain biopsy. Age, sex, lesion depth, and biopsy modality did not significantly affect the diagnostic rate. All three procedures had high safety and effectiveness.

Successful stereoelectroencephalography-guided radiofrequency thermocoagulation in the treatment of a patient with mesial frontal region-originated mirthful gelastic seizure.

Gelastic seizures (GS), characterized by automatic bouts of unnatural stereotyped laughter and commonly recognized as the hallmark of hypothalamic hamartoma, is rarely associated with cortical epileptogenic focus. Whether there is a dissociation of the motor program of laughter and the experience of mirth and the symptomatogenic zone for ictal laughter with or without mirth are still unclear. We report a patient with drug-resistant mirthful GS who receive a comprehensive investigation of stereoelectroencephalography recording and electrocortical stimulation. Mirthful GS were confirmed to originate from the mesial region of the right superior frontal gyrus, not involving the mesial temporal lobe structures. The patient has been entirely seizure-free after stereoelectroencephalography-guided radiofrequency thermocoagulation. We conclude that the superior frontal gyrus serves as the symptomatogenic zone of ictal laughter and GS with or without mirth share a common neural network.

Application of pasta matrix reaching task in rats for forelimb motor function test after stroke / 中华行为医学与脑科学杂志

Objective To construct a scientific behavioral research of pasta matrix reaching task (PMRT) and comprehensively evaluate sensory-motor dysfunction caused by brain injury.Methods Twenty-one SD rats were subjected to 14-days pasta matrix grasping training and then were randomly divided into model group (11 rats) and sham group (6 rats).Motor cortex ischemia was induced by injection of endothelin-1 in SD rats.The number of pasta grabed by the injured forelimb and the location in matrix were evaluated daily 7 days after surgery.The infarct volume was measured by Nissl staining at the 7 days,14 days,and 28 days after stroke.Results The number of pasta obtained by rats was reduced from (33.43± 1.02) to (20.57±0.57) at 7 days post stroke in model group,and then increased to (26.85±0.98) at 28 days post stroke,although there was a significant difference between sham group (32.33± 1.45) and ischemic group (t=3.198,P＜0.05).The frequency of retrieval from each slot of the pasta matrix represented that sham group demonstrated a significant gain in performance in the antero quadrant of the matrix compared to ischemic rats by the fourth week after stroke.The stroke volume was decreased from (37.82± 1.17)mm3 at 7 days post-stroke to (24.35±0.38)mm3 at 28 days post-stroke,indicating brain recovery from ischemic injury.Conclusion The pasta matrix reaching task can function as a versatile and sensitive behavioral assay that permits experimenters to collect accurate outcome data and manipulate limb use to mimic human clinical phenomena including compensatory strategies and focused rehabilitative training after stroke.

Application of pasta matrix reaching task in rats for forelimb motor function test after stroke / 中华行为医学与脑科学杂志

Objective@#To construct a scientific behavioral research of pasta matrix reaching task (PMRT) and comprehensively evaluate sensory-motor dysfunction caused by brain injury.@*Methods@#Twenty-one SD rats were subjected to 14-days pasta matrix grasping training and then were randomly divided into model group (11 rats) and sham group (6 rats). Motor cortex ischemia was induced by injection of endothelin-1 in SD rats. The number of pasta grabed by the injured forelimb and the location in matrix were evaluated daily 7 days after surgery. The infarct volume was measured by Nissl staining at the 7 days, 14 days, and 28 days after stroke.@*Results@#The number of pasta obtained by rats was reduced from (33.43±1.02) to (20.57±0.57) at 7 days post stroke in model group, and then increased to (26.85±0.98) at 28 days post stroke, although there was a significant difference between sham group(32.33±1.45) and ischemic group (t=3.198, P<0.05). The frequency of retrieval from each slot of the pasta matrix represented that sham group demonstrated a significant gain in performance in the antero quadrant of the matrix compared to ischemic rats by the fourth week after stroke.The stroke volume was decreased from (37.82±1.17)mm3 at 7 days post-stroke to (24.35±0.38)mm3 at 28 days post-stroke, indicating brain recovery from ischemic injury.@*Conclusion@#The pasta matrix reaching task can function as a versatile and sensitive behavioral assay that permits experimenters to collect accurate outcome data and manipulate limb use to mimic human clinical phenomena including compensatory strategies and focused rehabilitative training after stroke.

Patched Closure of Dural Outlet of External Ventricular Drainage Catheter: Better Way to Prevent Cerebrospinal Fluid Leakage.

Postoperative continuous bloody cerebral spinal fluid drainage with external ventricular drainage catheter could decrease the incidence of inflammation. But the drainage catheter left in place will interrupt the watertight dura matter closure. To prevent the related cerebrospinal fluid leakage and subgaleal pseudomeningocele after the catheter removal, we developed a patched closure method to seal the dural outlet of the drainage catheter with a favorable clinical outcome.

Resection of glioblastomas located in sensorimotor cortex and language area via the transsylvian-opercular approach / 中华显微外科杂志

Objective To find out more optimal surgical approach for glioblastoma located in sensofimotor cortex and language area. Methods A respective review of 27 cases of glioblastomas located in sensorimotor and language area were operated, via the transsylvian-opercular approach, ineluding outcomes of microneurosurgery between January 2005 to December 2007. Results Among of 27 cases, tumors in 21 cases were covered by opereular cotex and were totally resected, tumors protruded into sylvian and wrapped around middle cerebral artery in 6 cases. 3 of them were totally removed, others were subtotally. Neurofunction of 26 cases were preserved of one were injuried. Conclusion Transsylvian-opercnlar approach for resection of glioblastomas located in subcortex of sensorimotor and language area is more optimal surgical approach, which not only ensure tumor resection with great degree, but preserve neurofunction well.

Diagnosis and treatment of spinal cord cavernous angioma / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the diagnosis and treatment of patients with spinal cord cavernous angioma.</p><p><b>METHODS</b>Clinical data on 23 patients with intramedually cavernous angiomas were analyzed. The function of the spinal cord was evaluated before and after treatment using the Aminoff & Logue scale.</p><p><b>RESULTS</b>All patients underwent resection of spinal cord cavernous angioma except two patients who refused surgical treatment. Complete removal was achieved in 18 patients, and subtotal removal in 3. Twenty-one patients with spinal cavernous angioma were confirmed pathologically. The postoperative neurological status was improved in 15 patients, remained unchanged in 4, and aggravated in 2. No deaths occurred.</p><p><b>CONCLUSIONS</b>MRI is specific in diagnosis of intramedually cavernous angioma. The outcome of surgical treatment is better. Surgical treatment is suitable for patients with symptoms.</p>