Thermography mapping patterns in temporal lobe epilepsy surgery

Abstract

Background: In several epilepsy etiologies, the macroscopic appearance of the epileptogenic tissue is identical to the normal, which makes it hard to balance between how much cytoreduction or disconnection and brain tissue preservation must be done. A strategy to tackle this situation is by evaluating brain metabolism during surgery using infrared thermography mapping (IrTM). Methods: In 12 epilepsy surgery cases that involved the temporal lobe, we correlated the IrTM, electrocorticography, and neuropathology results. Results: Irritative zones (IZ) had a lower temperature in comparison to the surrounding cortex with normal electric activity (difference in temperature (ΔT) from 1.2 to 7.1, mean 3.40°C standard deviation ± 1.61). The coldest zones correlated exactly with IZ in 9/10 cortical dysplasia (CD) cases. In case 3, the coldest area was at 1 cm away from the IZ. In 10/10 dysplasia cases (cases 1–4, 6–11), there was a radial heating pattern originating from the coldest cortical point. In 2/2 neoplasia cases, the temporal lobe cortical temperature was more homogeneous than in the CD cases, with no radial heating pattern, and there were no IZ detected. In case 8, we found the coldest IrTM recording in the hippocampus, which correlated to the maximal irritative activity recorded by strip electrodes. The ΔT is inversely proportional to epilepsy chronicity. Conclusion: IrTM could be useful in detecting hypothermic IZ in CD cases. As the ΔT is inversely proportional to epilepsy chronicity, this variable could affect the metabolic thermic patterns of the human brain.

Localization of irritative zones in epilepsy with thermochromic silicone

“…is can be even more difficult, if the appearance of healthy tissue is the same as that of diseased tissue to the naked eye, as occurs very frequently in epilepsy surgery since cortical dysplasias are the etiologies most frequently responsible for drug-resistant epilepsy and its gross appearance is indistinguishable from healthy brain tissue. To make surgeries more precise, effective, and safe, we have developed the ITM protocol [1][2][3] and the TTS that allow real-time assessment of brain metabolism without using stains, contrasts, lights, radiation, or special filters, with a significantly low cost compared to ECoG, which would favor its use in emerging economies like ours. We believe that this facilitates decision-making for the neurosurgeon Figure 4: Graphs of the measurements with the laser pointer thermometer of the first stage of the infrared thermography mapping.…”

“…Our research team has proven the usefulness of these new intraoperative evaluation methods in other pathologies, such as tumor surgery, cavernomas, and abscesses, among others, in addition to their use in epilepsy surgery. [1][2][3] In this series of 10 consecutive cases, there were no complications associated with the use of any of the methods described. ere was a 100% correlation between ITM, TTS, and ECoG in detecting IZs in drug-resistant temporal lobe epilepsy.…”

“…e samples of the tissues obtained were sent to pathology. [1][2][3] e purpose of performing the three stages of ITM previously described is to verify the consistency in the identification of hypothermic areas of the brain by the three methods and subsequently compare them with the results of the ECoG.…”

Uso De Azitromicina Em Associação Com Hidroxicloroquina No Desfecho Do Paciente Com Covid-19: Uma Revisão Integrativa

“…Com o objetivo de atender à necessidade presente nos testes de ruptura do ponto de quebra e de absorção (testes estes a serem apresentados na seção 4.2.1, "Testes de manuseio do swab", subseções "Teste de ruptura do ponto de quebra do swab" e "Teste de absorção com o swab fabricado, utilizando o tubo projetado nessa pesquisa"), foi projetado um componente semelhante a um tubo de ensaio, que possui diâmetro constante próximo ao do meato nasal inferior (região por onde passa o swab) [21] e de comprimento dentro da faixa de valores comum da distância entre a narina e a nasofaringe (sendo esta última a região de coleta do muco nasal) [22], como pode ser visto na Figura 11.…”

“…Sua imagem térmica permite o desenvolvimento de uma fisiologia comparativa de fenômenos, que incluem termogênese, ajustes de fluxo sanguíneo periférico, resfriamento evaporativo e fisiologia respiratória [19]. Sendo assim, a termografia por infravermelho se torna muito importante para a detecção precoce de câncer, detecção e tratamentos de hipertermia [18], detecção de reações alérgicas, uso na angiologia, reumatologia e cirurgias plásticas [20], avaliação do metabolismo cerebral durante neurocirurgias [21] e tratamentos terapêuticos [22].…”