Identification of Preoperative Language Tracts for Intrinsic Frontotemporal Diseases: A Pilot Reconstruction Algorithm in a Middle-Income Country

Ordóñez-Rubiano, Edgar G.; Valderrama-Arias, Francisco A.; Forbes, Jonathan A.; Johnson, Jason M.; Younus, Iyan; Marín-Muñoz, Jorge H.; Sánchez-Montaño, Mariana; Angulo, Diego A.; Cifuentes-Lobelo, Hernando A.; Cortes-Lozano, William; Pedraza, Mauricio; Bello-Dávila, May Leonardo; Patiño-Gómez, Javier G.; Ordóñez-Mora, Edgar G.

doi:10.1016/j.wneu.2019.01.163

Cited by 6 publications

(15 citation statements)

References 38 publications

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“…Regarding surgical treatment, availability for renting neuronavigation systems and the access to advanced neuroimaging including diffusion tensor imaging have allowed some progress aiming to reduce neurological decline after procedures. 9 Most likely, rapid progression of disease is produced by the notable advanced stages when these tumors are detected and not directly related to the procedure itself. We hope this case series will add remarkable information and will promote the initiative to improve clinical care of this neglected disease in MICs.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical features were described previously. 9 The following data were collected: sex, age, clinical presentation at diagnosis, histopathological classification, tumor localization, as well as surgical and adjuvant treatments. The primary outcomes were the postoperative Lansky play-performance scale (LPPS) for children score, hospital length of stay (LOS), and OS.…”

Section: Methodsmentioning

confidence: 99%

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Treatment Limitations for Pediatric Diffuse Intrinsic Pontine Gliomas in a Middle-Income Country

Baquero-Herrera

Ardila-Martínez

Abdala-Vargas

et al. 2022

JNRP

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Objectives To evaluate the surgical management outcomes in pediatric patients with diffuse intrinsic pontine gliomas (DIPGs) who underwent intended biopsies and partial resections in a middle-income country, highlighting the barriers and challenges of these procedures for further investigation. Methods A retrospective review of a prospective acquired series of patients who underwent biopsy or resection for DIPG between January 2012 and June 2018 at our institution was performed. Results A total of 43 patients with posterior fossa tumors were identified. From these, seven pediatric DIPG cases were enrolled. Five were males. The median age was 5 years (range: 1–12 years). Only one patient (14.3%) had a ganglioglioma, while the others presented pilocytic and diffuse astrocytomas. Two (28.6%) patients had an intentional biopsy, and the other five (71.4%) had a partial resection. In the three (28.6%) patients who presented with associated hydrocephalus, the endoscopic third ventriculostomy was performed in the same surgical time. The median preoperative Lansky play-performance scale (LPPS) was 80 (range: 60–100), while the median postoperative LPPS was 23 (range: 7–52). Conclusion A decrease in overall survival was noted compared with data reported in other series. Multifactorial barriers were discussed including the social, geographic, and economic features that may influence on final outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Treatment Limitations for Pediatric Diffuse Intrinsic Pontine Gliomas in a Middle-Income Country

Baquero-Herrera

Ardila-Martínez

Abdala-Vargas

et al. 2022

JNRP

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“…The lateral margin of the hippocampus and PHG can be separated from the occipital-temporal gyrus by making a cut from the lateral sulcus of the temporal horn to the collateral sulcus inferiorly (Figure 4 some degree of disconnection of the inferior longitudinal fasciculus, which passes lateral to the temporal horn. 16 The lateral disconnection can be continued anteriorly to circumscribe the anterior region of the entorhinal area (PHG) and uncinate gyrus. The PHG and uncus can be gently elevated off the inferior pia and continued medially until the hippocampal sulcus is encountered.…”

Section: Review Of Vanderbilt Surgical Procedures and Relevant Anatomymentioning

confidence: 99%

“…Two-year Engel outcome data were available for 168 patients, of which 73% (123/168) had Engel I outcomes. Engel II outcomes were reported in 16.6% (28/168), III in 4.7% (8/168), and IV in 5.3% (9/168). Our review of literature showed that this is comparable to the seizure freedom rates reported by other groups.…”

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confidence: 99%

Experience From 211 Transcortical Selective Amygdalohippocampectomy Procedures: Relevant Surgical Anatomy and Review of the Literature

Ali¹,

Englot²,

Yu³

et al. 2021

ONSURG

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BACKGROUND Selective amygdalohippocampectomy (SelAH) is designed to treat medically refractory mesial temporal lobe epilepsy with reduced morbidity compared to standard anterior temporal lobectomy. At our institution, we perform SelAH via a transcortical approach via small corticectomy in the middle temporal gyrus. OBJECTIVE To discuss the surgical anatomy and nuances of SelAH, share our institutional experience, and perform a review of literature. METHODS Institutional experience was recorded by collecting demographic and outcome data from 1999 to 2017 under an Institutional Review Board protocol in a prospective manner using a REDCap database. RESULTS A total of 211 SelAH procedures were performed at our institution between 1999 and 2017. Of these patients, 54% (113/211) were females. The average age at surgery was 39.4 yr. Two-year Engel outcome data were available for 168 patients, of which 73% (123/168) had Engel I outcomes. Engel II outcomes were reported in 16.6% (28/168), III in 4.7% (8/168), and IV in 5.3% (9/168). Our review of literature showed that this is comparable to the seizure freedom rates reported by other groups. We then reviewed our surgical methodology based on operative reports and created illustrations of the surgical anatomy of temporal lobe approach. These illustrations were compared with postoperative magnetic resonance imaging to provide a better 3D understanding of the complex architecture of mesial temporal structures. CONCLUSION SelAH is a minimally invasive, safe, and effective approach for the treatment of medically refractory epilepsy with good surgical outcomes and low morbidity. We feel that mastering the complex anatomy of this approach helps achieve successful outcomes.

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“…[ 18 ] Many different tools have been developed to achieve this goal, including advanced imaging and surgical techniques for brain mapping. [ 10 , 16 - 18 , 23 - 25 , 27 , 29 , 32 , 35 , 38 , 41 , 50 ] Despite significant efforts, the overall survival rates have not changed significantly in the past decade. [ 9 ]…”

Section: Introductionmentioning

confidence: 99%

Preoperative tractography algorithm for safe resection of tumors located in the descending motor pathways zone

Ordonez-Rubiano,

Johnson,

Abdalá-Vargas

et al. 2023

Surgical Neurology International

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Background: Diffusion tensor imaging (DTI) tractography facilitates maximal safe resection and optimizes planning to avoid injury during subcortical dissection along descending motor pathways (DMPs). We provide an affordable, safe, and timely algorithm for preoperative DTI motor reconstruction for gliomas adjacent to DMPs. Methods: Preoperative DTI reconstructions were extracted from a prospectively acquired registry of glioma resections adjacent to DMPs. The surgeries were performed over a 7-year period. Demographic, clinical, and radiographic data were extracted from patients’ electronic medical records. Results: Nineteen patients (12 male) underwent preoperative tractography between January 1, 2013, and May 31, 2020. The average age was 44.5 years (range, 19–81 years). A complete radiological resection was achieved in nine patients, a subtotal resection in five, a partial resection in three, and a biopsy in two. Histopathological diagnoses included 10 patients with high-grade glioma and nine with low-grade glioma. A total of 16 perirolandic locations (10 frontal and six frontoparietal) were recorded, as well as two in the insula and one in the basal ganglia. In 9 patients (47.3%), the lesion was in the dominant hemisphere. The median preoperative and postoperative Karnofsky Performance Scores were 78 and 80, respectively. Motor function was unchanged or improved over time in 15 cases (78.9%). Conclusion: This protocol of DTI reconstruction for glioma removal near the DMP shows good results in low-term neurological functional outcomes.

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Identification of Preoperative Language Tracts for Intrinsic Frontotemporal Diseases: A Pilot Reconstruction Algorithm in a Middle-Income Country

Cited by 6 publications

References 38 publications

Treatment Limitations for Pediatric Diffuse Intrinsic Pontine Gliomas in a Middle-Income Country

Treatment Limitations for Pediatric Diffuse Intrinsic Pontine Gliomas in a Middle-Income Country

Experience From 211 Transcortical Selective Amygdalohippocampectomy Procedures: Relevant Surgical Anatomy and Review of the Literature

Preoperative tractography algorithm for safe resection of tumors located in the descending motor pathways zone

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