The third branch of the superior longitudinal system.

One of the major associative fiber pathways in the brain is the superior longitudinal system. This review discusses the current knowledge gained from studies on the third branch of the superior longitudinal system (SLS) regarding its anatomy, functional role in healthy individuals, results from lesion-symptom mapping studies and intraoperative electrostimulation studies. The results of these studies clearly indicate that the third branch of the SLS is a distinct pathway, as seen both from a functional and anatomical perspective. The third branch of the SLS should be distinguished from the long segment of the arcuate fasciculus, that courses along its trajectory but seems implicated in different functions. Moreover, these studies also provide substantial evidence that the right and left third branch of the SLS have different functional roles. Finally, a hypothesis for an integrated anatomo-functional model is proposed, that describes three subcomponents of the third branch of the superior longitudinal system.

Functionality of glioma-infiltrated precentral gyrus: experience from 14 patients.

BACKGROUND: In this study we reviewed our experience with surgical removal of gliomas that infiltrated the precentral gyrus. METHODS: From a consecutive series of 100 patients that were operated with intraoperative monitoring, 14 patients were retrospectively selected and analyzed for results of (sub)cortical electrical stimulation, extent of resection and temporary or permanent neurological deficits. RESULTS: In 10 of 14 patients there were no neurological deficits prior to surgery despite tumor-infiltrated precentral gyrus. Resection of these tumors was (severely) limited in 6 patients due to cortical or subcortical responses from precentral gyrus or corticospinal tract. These responses reflected limb or speech/language functions. In 2 patients the tumor was not resected or only partially removed due to the confounding influence of seizures during the operation. Overall, 4 tumors were completely resected. In one patient this resulted in a new and permanent minor motor deficit of the foot. CONCLUSIONS: We conclude from our study that the chance that a glioma can be resected from the upper parts of the precentral gyrus is low, especially in those cases where tumor margins are diffuse. Possible exceptions are gliomas that are hypointense on T1-weighted images and have sharp margins; these patients should a priori not be excluded from surgery. We could confirm previous reports in the literature that gliomas in the face area of the non-dominant hemisphere can be resected without permanent morbidity.

Transient paresis associated with cat-scratch disease: case report and literature review of vertebral osteomyelitis caused by Bartonella henselae.

Cat-scratch disease (CSD) rarely presents as vertebral osteomyelitis. We describe a case with paresis of the arm with total recovery after antibiotic and neurosurgical therapy. We reviewed 20 other cases of CSD vertebral osteomyelitis in the literature. This diagnosis should be considered in patients with systemic symptoms, back pain, and cat contact. The prognosis is generally good.