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F unctional MRI (fMRI) is increasingly implemented as a practical preoperative planning tool for brain tumor resection, but a considerable discrepancy between its current use and presumed utility remains. A recent survey among neurosurgeons found variability in the present use and assumed utility of fMRI for preoperative surgical planning in patients with brain tumors. This variation includes clinical and radiographic indications for ordering fMRI, functional paradigms to test in specific case studies, and clinical purposes of using fMRI (1).Surgical resection of brain tumors aims to maximize tumor removal while avoiding the onset of permanent postoperative deficits. The extent of tumor resection independently correlates with patient survival (2,3). However, when resective surgery extends too far into infiltrated critical structures, the condition of the patient permanently worsens; this, in turn, compromises both quality of life and survival. Several neurosurgical advances aim to improve patient outcomes. To localize critical brain structures and the tumor, techniques such as preoperative functional neuroimaging, neuronavigation, fluorescent dyes, MRI in the surgical field, and intraoperative stimulation mapping have been used (4). Although meta-analyses have assessed the use of intraoperative stimulation mapping, awake craniotomy, and intraoperative MRI (4-6), the usefulness of these techniques and their effect on neurologic outcomes have not been sufficiently addressed in randomized trials or meta-analyses. These studies suggest that glioma resections that use intraoperative stimulation mapping and awake craniotomy are associated with better surgical outcomes, fewer late severe neurologic deficits, and a higher percentage of gross total resections (4,6). However, a recent meta-analysis of five studies comparing the use of the intraoperative fMRI with standard neuronavigation (5) showed attenuated incidence of postsurgical permanent neurologic deficits, although this finding was not statistically significant.The primary objective of our study was to assess the overall postoperative morbidity within at least a 2-month Background: Preoperative functional MRI (fMRI) is one of several techniques developed to localize critical brain structures and brain tumors. However, the usefulness of fMRI for preoperative surgical planning and its potential effect on neurologic outcomes remain unclear.Purpose: To assess the overall postoperative morbidity among patients with brain tumors by using preoperative fMRI versus surgery without this tool or with use of standard (nonfunctional) neuronavigation. Materials and Methods:A systematic review and meta-analysis of studies across major databases from 1946 to June 20, 2020, were conducted. Inclusion criteria were original studies that (a) included patients with brain tumors, (b) performed preoperative neuroimaging workup with fMRI, (c) investigated the usefulness of a preoperative or intraoperative functional neuroimaging technique and used that technique to resect cerebral tumors...

The disease caused by the new coronavirus, initially described in China in December 2019, became known as coronavirus disease 2019 and quickly spread to countries on all continents, becoming a pandemic with an important global impact. Despite being a virus that typically affects the respiratory tract, some studies have already described neurological manifestations associated with this infection, including acute ischaemic vascular insult. We report a case series including 30 patients, who presented with neurological symptoms during admission to our service, being diagnosed with ischaemic stroke and, concomitantly, coronavirus disease 2019. In the subgroup of patients analysed, a state of hypercoagulability and pro thrombosis was observed through laboratory tests, probably related to the cytokine storm syndrome associated with infection by this virus. With that, we discussed the possibility of this finding being an aggravating factor in the occurrence of stroke in these patients.

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