Quantification of white matter fibre pathways disruption in frontal transcortical approach to the lateral ventricle or the interventricular foramen in diffusion tensor tractography

Szmuda, Tomasz; Słoniewski, Paweł; Szmuda, Marta; Waszak, Przemysław; Starzyńska, A.

doi:10.5603/fm.2013.0063

Cited by 11 publications

(6 citation statements)

References 49 publications

(62 reference statements)

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“…22,84,119 Although previous studies reported postoperative hemiparesis in the anterior transcallosal and anterior transcortical approaches, Szmuda et al found only a 1% incidence of damage to the upper motor axons resulting from the transcortical approach. 95 Based on these findings, postoperative hemiparesis was attributed to indirect damage of the thalamus, basal ganglia, internal capsule, motor cortex, supplementary motor area, or corticospinal tract, caused by compression from the tumor, perioperative retraction, or damage to venous drainage or arterial supply. 95 The anterior transcortical approach can result in speech and facial apraxia, neuropsychological deficit, memory dysfunction, agraphia, or spatial neglect (Table 3), 22,70,77,82,95,119 which, based on our dissections, may damage the anterior part of the SLF II, AF, IFOF, and corona radiata (claustrocortical and frontopontine fibers, superior frontal thalamic radiations), and the ventral callosal fibers in the genu and body (Table 3).…”

Section: 8590mentioning

confidence: 99%

“…95 Based on these findings, postoperative hemiparesis was attributed to indirect damage of the thalamus, basal ganglia, internal capsule, motor cortex, supplementary motor area, or corticospinal tract, caused by compression from the tumor, perioperative retraction, or damage to venous drainage or arterial supply. 95 The anterior transcortical approach can result in speech and facial apraxia, neuropsychological deficit, memory dysfunction, agraphia, or spatial neglect (Table 3), 22,70,77,82,95,119 which, based on our dissections, may damage the anterior part of the SLF II, AF, IFOF, and corona radiata (claustrocortical and frontopontine fibers, superior frontal thalamic radiations), and the ventral callosal fibers in the genu and body (Table 3). Extending the approach through the superior frontal gyrus may damage the anteromedial part of the SLF I, the anterior part of the cingulum, and the dorsal part of the genu and body of the corpus callosum.…”

Section: 8590mentioning

confidence: 99%

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The white matter tracts of the cerebrum in ventricular surgery and hydrocephalus

Güngör¹,

Baydın²,

Middlebrooks

et al. 2017

JNS

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S urgical approaches to the lateral ventricle always require passage through one and often multiple fiber tracts to reach their target. These approaches remain a challenge because of the deep location and variable shape and size of the ventricles, their covering mantle of tracts, and relationships to important neural structures such as the thalamus and internal capsule. 55,75,84 In addition, a number of tracts course in the walls of the ventricle where they are separated from the cerebrospinal fluid by only a thin layer of ependyma and would likely be exposed to the greatest possibility of damage by hydrocephalus.84,124 Recent studies have focused on the relationships of the fiber tracts to eloquent cortical areas and avoiding the optic radiations in approaches to the lateral ventricle. 16,41,48,59,63,75,89,92,94,125 The aim of the present study was to explore the relationships of the tracts to the lateral ventricles and the various surgical approaches to the ventricles and to examine the anatomy and syndromes related to ventricular enlargement. MethodsForty adult human formalin-fixed cadaveric hemispheres (20 brains) were examined under magnification that ranged from ×6 to ×40. The dura, pia, arachnoid, and surface vessels were gently removed. All specimens were frozen in water for at least 2 weeks at -16°C, as described by Klingler, to separate the tracts and facilitate dissection. 51 After freezing, the specimens were thawed and rinsed of formalin under tap water for at least 1 hour. Prior OBJECTIVEThe relationship of the white matter tracts to the lateral ventricles is important when planning surgical approaches to the ventricles and in understanding the symptoms of hydrocephalus. The authors' aim was to explore the relationship of the white matter tracts of the cerebrum to the lateral ventricles using fiber dissection technique and MR tractography and to discuss these findings in relation to approaches to ventricular lesions. METHODS Forty adult human formalin-fixed cadaveric hemispheres (20 brains) and 3 whole heads were examined using fiber dissection technique. The dissections were performed from lateral to medial, medial to lateral, superior to inferior, and inferior to superior. MR tractography showing the lateral ventricles aided in the understanding of the 3D relationships of the white matter tracts with the lateral ventricles. RESULTS The relationship between the lateral ventricles and the superior longitudinal I, II, and III, arcuate, vertical occipital, middle longitudinal, inferior longitudinal, inferior frontooccipital, uncinate, sledge runner, and lingular amygdaloidal fasciculi; and the anterior commissure fibers, optic radiations, internal capsule, corona radiata, thalamic radiations, cingulum, corpus callosum, fornix, caudate nucleus, thalamus, stria terminalis, and stria medullaris thalami were defined anatomically and radiologically. These fibers and structures have a consistent relationship to the lateral ventricles. CONCLUSIONS Knowledge of the relationship of the white matter tracts o...

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Section: 8590mentioning

confidence: 99%

Section: 8590mentioning

confidence: 99%

The white matter tracts of the cerebrum in ventricular surgery and hydrocephalus

Güngör¹,

Baydın²,

Middlebrooks

et al. 2017

JNS

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“…For neurosurgeons, the fibres originating at the precentral gyrus are the most crucial while planning any surgical access near the pyramidal tracts [7,8,19,20]. A study suggests that the remainder of the CST fibres come from the FL, mainly from the superior frontal gyrus [3].…”

Section: Discussionmentioning

confidence: 99%

Tractography-guided surgery of brain tumours: what is the best method to outline the corticospinal tract?

et al. 2021

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Background: Diffusion tensor imaging (DTI) is the imaging technique used in vivo to visualize white matter pathways. The corticospinal tract (CST) belongs to one of the most often delineated tracts preoperatively, although, the optimal DTI method has not been established yet. Considering that various regions of interests (ROIs) could be selected, the reproducibility of CST tracking among different centres is low. We aimed to select the most reliable tractography method for outlining the CST for neurosurgeons. Materials and methods: Our prospective study consisted of 32 patients (11 males, 21 females) with a brain tumour of various locations. DTI and T1-weighed image series were acquired prior to the surgery. To draw the CST, the posterior limb of the internal capsule (PLIC) and the cerebral peduncle (CP) were defined as two main ROIs. Together with these main ROIs, another four cortical endpoints were selected: the frontal lobe (FL), the supplementary motor area (SMA), the precentral gyrus (PCG) and the postcentral gyrus (POCG). Based on these ROIs, we composed ten virtual CSTs in DSI Studio. The fractional anisotropy, the mean diffusivity, the tracts' volume, the length and the number were compared between all the CSTs. The degree of the CST infiltration, tumour size, the patients' sex and age were examined. Results: Significant differences in the number of tracts and their volume was observed when the PLIC or the CP stood as a single ROI comparing with the two-ROIs method (all p<0.05). The mean CST volume was 40054U; SD ±12874 and the number of fibres was 259.3; SD ±87.3 when the PLIC was a single ROI. When the CP was a single ROI, almost a half of fibres (147.6; SD ±64.0) and half of the CST volume (26664U; SD ±10059U) was obtained (all p<0.05). There were no differences between the various CSTs in terms of fractional anisotropy, mean diffusivity, the apparent diffusion coefficient, radial diffusivity and the tract length (p>0.05). The CST was infiltrated by a growing tumour or edema in 17 of 32 patients; in these cases, the mean and apparent diffusion of the infiltrated CST was significantly higher than in uncompromised CSTs (p=0.04). CST infiltration did not alter the other analysed parameters (all p>0.05). Conclusions: A universal method of DTI of the CST was not developed. However, we found that the CP or the PLIC (with or without FL as the second ROI) should be used to outline the CST.

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“…Some studies have demonstrated that the port redistributes pressure more equally in the surrounding tissue, and it causes less direct cutting and/or tearing trauma to the surrounding brain tissue [18,19]. Also, patient morbidity can decrease thanks to the decrease in potential injury to the critical white matter tracts and vascular pedicles of both cortical and subcortical structures [20].…”

Section: Discussionmentioning

confidence: 99%

Intraoperative MRI-assisted neuro-port surgery for the resection of cerebral intraparenchymal cavernous malformation

Zhao

Liang

et al. 2019

Chin Neurosurg Jl

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Background: Intraparenchymal cerebral cavernous malformation is difficult to localize intraoperatively with conventional frameless navigation due to the "brain shift" effect. We conducted this study to evaluate the efficacy and safety of intraoperative magnetic resonance image (iMRI)-assisted neuro-port surgery for the resection of cerebral intraparenchymal cavernous malformation. Methods: Between April 2016 and December 2017, 54 consecutive patients with intraparenchymal cerebral cavernous malformation who get surgical treatment in our hospital were enrolled into this study. Twenty-one patients were treated using iMRI-assisted neuro-port surgery (experiment group), and 33 patients underwent treatment by conventional microsurgery (control group). The iMRI was used in all cases for the compensation of the "brain shift" effect and keeping the navigation system up-to-date. The surgical resection rate, the total operation time, and the preoperative and postoperative Karnofsky Performance Status (KPS) scores were determined to evaluate the operative procedures. Results: There were no significant differences between the two groups in mean age, gender ratio, and volume of lesions (P > 0.05). For the experiment group, the average duration of the procedure was 188.8 min with total resection of the lesions achieved in all 21 cases. For the control group, the average duration of the procedure was 238.2 min with total resection of the lesions achieved in 25 of 33 cases. The differences in the average duration of the procedure and the number of totally resected lesions between the two groups were statistically significant (P < 0.05). Regarding postoperative neurological function, postoperative KPS scores for the experiment group were significantly higher than those of the control group (P = 0.018). Conclusion: Our results show that iMRI-assisted neuro-port surgery is helpful for intraparenchymal cerebral cavernous malformation surgery. The method provides high accuracy and efficiency for lesion targeting and permits excellent anatomic orientation. With the assistance of iMRI technology, we achieved a higher resection rate and a lower incidence of postoperative neurological deficits. Additionally, iMRI is helpful for the compensation of the "brain shift" effect, and it can update the navigation system.

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Quantification of white matter fibre pathways disruption in frontal transcortical approach to the lateral ventricle or the interventricular foramen in diffusion tensor tractography

Cited by 11 publications

References 49 publications

The white matter tracts of the cerebrum in ventricular surgery and hydrocephalus

The white matter tracts of the cerebrum in ventricular surgery and hydrocephalus

Tractography-guided surgery of brain tumours: what is the best method to outline the corticospinal tract?

Intraoperative MRI-assisted neuro-port surgery for the resection of cerebral intraparenchymal cavernous malformation

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