Functional brain neuroimaging-guided repetitive transcranial magnetic stimulation in neurodevelopmental disorders: The case of a schizencephaly-related spastic dystonia

International audienceSpastic dystonia is defined as tonic involuntary muscle activation at rest superimposed over spastic paresis [1]. It occurs in different pathological conditions, ranging from dopamine-dependent dystonia [2] to post-stroke deforming spastic hemiparesis [1]. Even though important burden is associated to spastic dystonia, therapeutic options are scarce and mostly limited to intramuscular botulinum toxin injection and surgical partial nerve section. Repetitive transcranial magnetic stimulation (rTMS) has been proposed as an interesting therapeutic option, but with inconsistent results [3]. We suggest that optimized targeting based on functional brain imaging could enhance the results of rTMS in schizencephaly-related dystonia and improve our knowledge about the technical procedure to become more widely applicable in neurodevelopmental disorders

Gamma knife surgery for facial nerve schwannomas.

Radical resection of facial nerve schwannomas classically implies a high risk of severe facial palsy. Owing to the rarity of facial palsy after gamma knife surgery (GKS) of vestibular schwannomas, functional evaluation after GKS seems rational in this specific group of patients. To our knowledge, no previous similar evaluation exists in the literature

Interest and feasibility of a modified supine position for posterior cranial fossa surgical procedures.

The sitting position is considered as a gold standard for posterior fossa surgical procedures. However, in order to decrease the incidence rate of cerebral venous air embolisms, we presently described a modified supine position allowing performance of posterior fossa surgical procedures. Such position is easy and quickly performed with light variations of blood pressure: patients are placed supine with paddings inserted under ipsilateral shoulder and buttock, and head turned to other side of surgical site. Dural tension estimated by the surgeon was always considered as good. We performed more than 100 surgical procedures in this position without any complication for 10 years

Cervical tumoral calcium pyrophosphate dihydrate deposition disease 28 years after suboccipital craniotomy: case report.

To describe a rare case of tumoral cervical chondrocalcinosis that appeared 28 years after the patient had undergone suboccipital craniotom

Intramedullary spinal cord cavernous angioma in children: case report and literature review

Introduction Intramedullary cavernous angiomas (ImCA) of the spinal cord are very uncommon malformations especially in the pediatric population where only ten cases have yet been reported within the available literature. Case report In this paper, the authors report the case of a 12- year-old girl presenting with a T11 level hematomyelia because of a cavernous angioma. Microsurgical excision was performed with good clinical outcome and no magnetic resonance imaging evidence of residual cavernoma 30months later. Discussion Despite the small number of cases reported in children, this one contributes to the literature identifying special features of presentation and management of ImCA for pediatric patients. Because a higher risk of recurrent bleeding has been demonstrated for ImCA, with dramatic clinical consequences, microsurgical removal remains the only definitive treatment

Acquired aqueductal stenosis in preterm infants: an indication for neuroendoscopic third ventriculostomy

Abstract Object: The object of this study is to demonstrate the delayed occurrence of aqueductal stenosis in preterm infants who have suffered from intraventricular hemorrhage (IVH) and to try to explain the mechanisms of this stenosis. Method: From January 1996 to June 2002, 1,046 premature infants were admitted to our institution. Thirty-six neonates suffered from grade 3 or 4 intraventricular hemorrhage (Papile grading), of whom 16 died. Twenty patients survived and a ventriculoperitoneal shunt was inserted in 7 infants. Four patients underwent a neuroendoscopic third ventriculostomy. Follow-up was carried out, twice a month during the first 2 months and subsequently twice a year. Conclusion: In 2 children NTV was an effective treatment for hydrocephalus with an average follow-up of 29 months. The specific pattern concerning these patients is the long delay before obstructive hydrocephalus and the visualization of de novo obstruction with MRI. The biological explanation must be investigated. Keywords Premature newborn · Intraventricular hemorrhage · Hydrocephalus · Neuroendoscopy · Aqueductal stenosis · Acquired obstructive hydrocephalus · Transforming growth factor b

Clostridial brain abscess after glioblastoma resection: case report and critical review of the literature

Clostridium perfringens is rare in neurosurgery. The source of clostridial brain abscess is usually a penetrating head injury. We report the case of a 57-year-old man who had parietal glioblastoma resection with local carmustine chemotherapy and who presented a clostridial brain abscess three weeks later. Progression was especially brutal, leading to patient's death in few hours. We discuss the etiology and progression of this case compared to the data reported in the literature