Cortical mapping with navigated transcranial magnetic stimulation in low-grade glioma surgery

Transcranial magnetic stimulation (TMS) is a promising method for both investigation and therapeutic treatment of psychiatric and neurologic disorders and, more recently, for brain mapping. This study describes the application of navigated TMS for motor cortex mapping in patients with a brain tumor located close to the precentral gyrus

Grade I meningiomas with atypical characteristics: a worse prognosis

ABSTRACT The study reviewed the histology of cases of grade I meningiomas with spontaneous necrosis, grade I without necrosis and grade II meningiomas, to evaluate the histological and immunohistochemical factors of the patients’ prognosis, while correlating the clinicopathological features with the clinical follow-up of the patients. A review of 47 cases from the Department of Pathology of UNIFESP was performed and the samples were submitted to immunohistochemical examination with the p53 protein, Ki-67 cell proliferation factor and progesterone receptor markers. A greater expression was found in the progression of several degrees of aggressiveness for p53 and Ki-67, and a higher frequency of progesterone receptors in the lower degrees. The group of grade I meningiomas with spontaneous necrosis showed histological and immunohistochemical indexes that approximate those of the grade II meningioma. This suggests a worse prognosis for grade I meningiomas with necrosis

Intravenous Grafts of Human Amniotic Fluid-Derived Stem Cells Reduce Behavioral Deficits in Experimental Ischemic Stroke

Amniotic fluid has been investigated as new cell source for stem cells in the development of future cell-based transplantation. This study reports isolation of viable human amniotic fluid-derived stem cells, labeled with multimodal iron oxide nanoparticles, and its effect on focal cerebral ischemia–reperfusion injury in Wistar rats. Middle cerebral artery occlusion of 60 min followed by reperfusion for 1 h, 6 h, and 24 h was employed in the present study to produce ischemia and reperfusion-induced cerebral injury in rats. Tests were employed to assess the functional outcome of the sensorimotor center activity in the brain, through a set of modified neurological severity scores used to assess motor and exploratory capacity 24 h, 14, and 28 days after receiving cellular therapy via tail vein. In our animal model of stroke, transplanted cells migrated to the ischemic focus, infarct volume decreased, and motor deficits improved. Therefore, we concluded that these cells appear to have beneficial effects on the ischemic brain, possibly based on their ability to enhance endogenous repair mechanisms

Meningiomas anteriores e antero-laterais do forame magno Anterior and lateral foramen magnum meningiomas

Relatamos nossa experiência com 11 pacientes portadores de meningiomas do forame magno, oito cranioespinhais e três espinocraniais. A média de idade foi 50,8 anos, o sintoma mais comum foi cefaléia occipital com duração média de 18,6 meses. Os principais achados neurológicos foram tetraparesia e comprometimento dos nervos cranianos baixos. O tratamento foi cirúrgico, sempre com exposição da artéria vertebral em sua entrada na dura-máter da fossa posterior e ressecção de parte do côndilo occipital apenas em três casos. Ressecção total foi possível em sete pacientes e parcial nos demais, devido às aderências a vasos e nervos. O prognóstico esteve relacionado com as condições neurológicas pré-operatórias.<br>We report our experience with 11 cases of foramen magnum meningiomas, eight originating inside the posterior fossa and three in the caudal region. The mean age of the patients was 50.8 years and the main complaint was cervical headache for at least 18.6 months and at the neurological examination, tetraparesis and deficit of the lower cranial nerves were very often observed. All patients were submitted to surgical treatment, always with exposition of the vertebral artery at the entry zone in the duramater of the posterior fossa, with partial removal of the occipital condyle in only three cases. Total resection was obtained in seven patients and partial removal in the other four due to adherences to vessels and nerves. The prognostic was related to the neurological condition before surgery