Background:Infrared thermography (IT) is a noninvasive, real-time diagnostic method that requires no contact with the patient and has a broad spectrum of potential applications in neurosurgery. It has been previously demonstrated the high sensitivity and specificity that IT has to detect brain blood flow changes.Case Description:The case is based on a 64-year-old diabetic and hypertensive male, to whom an anterior communicating artery (ACoA) incidental aneurysm was discovered. We performed the basal infrared thermography mapping (ITM) and immediately after the transitory clip placement in both A1 segments of the anterior cerebral artery (A1-ACA), we performed a second ITM of the exposed brain cortex. After the definitive clip placement in the neck of the ACoA aneurysm, we removed the transitory clips of both A1-ACA and performed a third ITM of the cortical surface, without finding any cortical cooling or significative temperature differences (Ϫt) compared to the basal ITM. The postoperatory computed tomography (CT) and angio-CT did not show any ischemic damage and confirmed the accurate aneurysm clipping.Conclusions:The ITM seems to be a real-time, safe, and useful brain mapping method to identify different temperature zones and temperature dispersion gradients in the human brain cortex. More studies are needed to evaluate the potential applications of IT mapping of the human brain and its use in neurosurgery and vascular neurosurgery.
RESUMENPrácticamente cualquier neoplasia intra-o extraaxial puede causar epilepsia en el humano, independientemente de su estirpe histológica. El término epileptoma es usado conceptualmente para definir aquéllos tumores que requieren una estrategia neuroquirúrgica más amplia, que abarca un abordaje oncológico en conjunto con técnicas especializadas de cirugía de epilepsia, para obtener idealmente una resección completa del tumor y la libertad de crisis a largo plazo para el paciente, poniendo énfasis en obtener una supervivencia sin epilepsia y no sólo un control tumoral. Existen varios tipos histológicos y localizaciones de los epileptomas y un conocido subgrupo altamente epileptogénico son los tumores asociados a epilepsia a largo plazo. Dependiendo de cada caso en particular, debe decidirse qué estudios preoperatorios deben realizarse, considerando en algunos casos técnicas neurofisiológicas avanzadas como la colocación de electrodos por estereoelectroencefalografía y/o subdurales para realizar un monitoreo prolongado que arroje suficientes datos para hacer la más adecuada planeación con convergencia de conceptos de neurooncología y de cirugía de epilepsia.
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