3 research outputs found
The impacts of tumor and tumor associated epilepsy on subcortical brain structures and long distance connectivity in patients with low grade glioma
Low grade gliomas in cerebral cortex often cause symptoms related to higher cerebral functions such as attention, memory and executive function before treatment is initiated. Interestingly, focal tumors residing in one cortical region can lead to a diverse range of symptoms, indicating that the impact of a tumor is extended to multiple brain regions. We hypothesize that the presence of focal glioma in the cerebral cortex leads to alterations of distant subcortical areas and essential white matter tracts. In this study, we analyzed diffusion tensor imaging scans in glioma patients to study the effect of glioma on subcortical gray matter nuclei and long-distance connectivity. We found that the caudate nucleus, putamen and thalamus were affected by cortical glioma, displaying both volumetric and diffusion alterations. The cerebellar cortex contralateral to the tumor side also showed significant volume decrease. Additionally, tractography of the cortico-striatal and cortico-thalamic projections shows similar diffusion alterations. Tumor associated epilepsy might be an important contributing factor to the found alterations. Our findings indeed confirm concurrent structural and connectivity abrasions of brain areas distant from brain tumor, and provide insights into the pathogenesis of diverse neurological symptoms in glioma patients
The Impacts of Tumor and Tumor Associated Epilepsy on Subcortical Brain Structures and Long Distance Connectivity in Patients With Low Grade Glioma
Low grade gliomas in cerebral cortex often cause symptoms related to higher cerebral functions such as attention, memory and executive function before treatment is initiated. Interestingly, focal tumors residing in one cortical region can lead to a diverse range of symptoms, indicating that the impact of a tumor is extended to multiple brain regions. We hypothesize that the presence of focal glioma in the cerebral cortex leads to alterations of distant subcortical areas and essential white matter tracts. In this study, we analyzed diffusion tensor imaging scans in glioma patients to study the effect of glioma on subcortical gray matter nuclei and long-distance connectivity. We found that the caudate nucleus, putamen and thalamus were affected by cortical glioma, displaying both volumetric and diffusion alterations. The cerebellar cortex contralateral to the tumor side also showed significant volume decrease. Additionally, tractography of the cortico-striatal and cortico-thalamic projections shows similar diffusion alterations. Tumor associated epilepsy might be an important contributing factor to the found alterations. Our findings indeed confirm concurrent structural and connectivity abrasions of brain areas distant from brain tumor, and provide insights into the pathogenesis of diverse neurological symptoms in glioma patients
Extracranial Trigger Site Surgery for Migraine
Introduction: The headache phase of migraine could in selected cases potentially
be treated by surgical decompression of one or more “trigger sites,” located at
frontal, temporal, nasal, and occipital sites. This systematic review with subsequent
meta-analysis aims at critically evaluating the currently available evidence for the surgical
treatment of migraine headache and to determine the effect size of this treatment in a
specific patient population.
Methods: This study was conducted following the PRISMA guidelines. An online
database search was performed. Inclusion was based on studies published between
2000 and March 2018, containing a diagnosis of migraine in compliance with the
classification of the International Headache Society. The treatment must consist of one or
more surgical procedures involving the extracranial nerves and/or arteries with outcome
data available at minimum 6 months.
Results: Eight hundred and forty-seven records were identified after duplicates were
removed, 44 full text articles were assessed and 14 records were selected for inclusion.
A total number of 627 patients were included in the analysis. A proportion of 0.38 of
patients (random effects model, 95% CI [0.30–0.46]) experienced elimination of migraine
headaches at 6–12 months follow-up. Using data from three randomized controlled
trials, the calculated odds ratio for 90–100% elimination of migraine headaches is 21.46
(random effects model, 95% CI [5.64–81.58]) for patients receiving migraine surgery
compared to sham or no surgery.
Conclusions: Migraine surgery leads to elimination of migraine headaches in 38% of
the migraine patients included in this review. However, more elaborate randomized trials
are needed with transparent reporting of patient selection, medication use, and surgical
procedures and implementing detailed and longer follow-up times