This article provides a review of Blood Oxygen Level Dependent functional magnetic resonance imaging(BOLD fMRI)applications for presurgical mapping in patients with brain tumors who are being considered for lesion res...This article provides a review of Blood Oxygen Level Dependent functional magnetic resonance imaging(BOLD fMRI)applications for presurgical mapping in patients with brain tumors who are being considered for lesion resection.Initially,the physical principle of the BOLD effect is discussed,followed by a general overview of the aims of presurgical planning.Subsequently,a review of sensorimotor,language and visual paradigms that are typically utilized in clinical fMRI is provided,followed by a brief description of studies demonstrating the clinical impact of preoperative BOLD fMRI.After this thorough introduction to presurgical fMRI,a detailed explanation of the phenomenon of neurovascular uncoupling(NVU),a major limitation of fMRI,is provided,followed by a discussion of the different approaches taken for BOLD cerebrovascular reactivity(CVR)mapping,which is an effective method of detecting NVU.We then include one clinical case which demonstrates the value of CVR mapping in clinical preoperative fMRI interpretation.The paper then concludes with a brief review of applications of CVR mapping other than for presurgical mapping.展开更多
Acute neurologic injuries represent a common cause of morbidity and mortality in children presenting to the pediatric intensive care unit.After primary neurologic insults,there may be cerebral brain tissue that remain...Acute neurologic injuries represent a common cause of morbidity and mortality in children presenting to the pediatric intensive care unit.After primary neurologic insults,there may be cerebral brain tissue that remains at risk of secondary insults,which can lead to worsening neurologic injury and unfavorable outcomes.A fundamental goal of pediatric neurocritical care is to mitigate the impact of secondary neurologic injury and improve neurologic outcomes for critically ill children.This review describes the physiologic framework by which strategies in pediatric neurocritical care are designed to reduce the impact of secondary brain injury and improve functional outcomes.Here,we present current and emerging strategies for optimizing neuroprotective strategies in critically ill children.展开更多
文摘This article provides a review of Blood Oxygen Level Dependent functional magnetic resonance imaging(BOLD fMRI)applications for presurgical mapping in patients with brain tumors who are being considered for lesion resection.Initially,the physical principle of the BOLD effect is discussed,followed by a general overview of the aims of presurgical planning.Subsequently,a review of sensorimotor,language and visual paradigms that are typically utilized in clinical fMRI is provided,followed by a brief description of studies demonstrating the clinical impact of preoperative BOLD fMRI.After this thorough introduction to presurgical fMRI,a detailed explanation of the phenomenon of neurovascular uncoupling(NVU),a major limitation of fMRI,is provided,followed by a discussion of the different approaches taken for BOLD cerebrovascular reactivity(CVR)mapping,which is an effective method of detecting NVU.We then include one clinical case which demonstrates the value of CVR mapping in clinical preoperative fMRI interpretation.The paper then concludes with a brief review of applications of CVR mapping other than for presurgical mapping.
文摘Acute neurologic injuries represent a common cause of morbidity and mortality in children presenting to the pediatric intensive care unit.After primary neurologic insults,there may be cerebral brain tissue that remains at risk of secondary insults,which can lead to worsening neurologic injury and unfavorable outcomes.A fundamental goal of pediatric neurocritical care is to mitigate the impact of secondary neurologic injury and improve neurologic outcomes for critically ill children.This review describes the physiologic framework by which strategies in pediatric neurocritical care are designed to reduce the impact of secondary brain injury and improve functional outcomes.Here,we present current and emerging strategies for optimizing neuroprotective strategies in critically ill children.
