The mechanisms of motor recovery through the transcallosal pathway remain poorly understood. The present study reports on a hemiplegic patient with corona radiata infarct; it attempts to confirm motor recovery through...The mechanisms of motor recovery through the transcallosal pathway remain poorly understood. The present study reports on a hemiplegic patient with corona radiata infarct; it attempts to confirm motor recovery through the transcallosal motor pathway, from the affected motor cortex to the affected hand, using diffusion tensor tractography and transcranial magnetic stimulation. A 54-year-old, male patient and eight age-matched, normal subjects were enrolled in the study. The patient＇s right hand was initially completely paralyzed, but slowly recovered over 6 months. In the control subjects and the unaffected hemisphere （right） of the patient, the corticospinal tracts originated from the motor cortex and descended along the known corticospinal tract pathway. However, the corticospinal tract of the affected hemisphere was disrupted at the upper pons. Following transcranial stimulation of the affected （left） motor cortex, motor evoked potential from the affected （right） abductor pollicis brevis muscle exhibited longer latency than opposite motor evoked potential. Results from the present study suggest that motor function of the affected （right） hand recovered via the transcallosal motor pathway from the affected （left） motor cortex in this patient.展开更多
Hypothalamic hamartoma(HH) is usually associated with refractory epilepsy, cognitive impairment, and behavioral disturbance. There is now increasing evidence that HH can be treated effectively with a variety of neuros...Hypothalamic hamartoma(HH) is usually associated with refractory epilepsy, cognitive impairment, and behavioral disturbance. There is now increasing evidence that HH can be treated effectively with a variety of neurosurgical approaches. Treatment options for intractable gelastic seizure in HH patients include direct open surgery with craniotomy, endoscopic surgery, radiosurgery with gamma knife and stereotactic radiofrequency thermocoagulation. Selection of treatment modalities depends on type and size of the HH and the surgeon's preference. Two surgical techniques, resection and disconnection, had been described with favorable outcomes. Pretreatmentevaluation, patient selection, surgical techniques, complications, and possible selection of treatment are discussed.展开更多
Background and Importance: Cavernomas of the septum pellucidum represent an extremely rare subtype of CNS cavernous angiomas which are a rare subtype of CNS tumors. Intraventricular cavernomas of the body of the later...Background and Importance: Cavernomas of the septum pellucidum represent an extremely rare subtype of CNS cavernous angiomas which are a rare subtype of CNS tumors. Intraventricular cavernomas of the body of the lateral ventricle are usually treated by the transcallosal approach. Clinical Presentation: We present a case of a fifty-eight year old man with a septum pellucidum cavernoma successfully treated operatively by means of the inferior parietal transcortical transventricular approach. This unusual and scarcely documented tumor was situated at the posterior third of the septum pellucidum. The patient had a good recovery with no focal deficit. Conclusion: Septum pellucidum cavernomas are extremely rare lesions. Inferior parietal transcortical approach is a safe alternative to the commonly used transcallosal approach for lesions of the posterior half of the septum pellucidum.展开更多
基金the National Research Foundation of Korea Grant Funded by the Korean Government,No.KRF-2008-314-E00173
文摘The mechanisms of motor recovery through the transcallosal pathway remain poorly understood. The present study reports on a hemiplegic patient with corona radiata infarct; it attempts to confirm motor recovery through the transcallosal motor pathway, from the affected motor cortex to the affected hand, using diffusion tensor tractography and transcranial magnetic stimulation. A 54-year-old, male patient and eight age-matched, normal subjects were enrolled in the study. The patient＇s right hand was initially completely paralyzed, but slowly recovered over 6 months. In the control subjects and the unaffected hemisphere （right） of the patient, the corticospinal tracts originated from the motor cortex and descended along the known corticospinal tract pathway. However, the corticospinal tract of the affected hemisphere was disrupted at the upper pons. Following transcranial stimulation of the affected （left） motor cortex, motor evoked potential from the affected （right） abductor pollicis brevis muscle exhibited longer latency than opposite motor evoked potential. Results from the present study suggest that motor function of the affected （right） hand recovered via the transcallosal motor pathway from the affected （left） motor cortex in this patient.
文摘Hypothalamic hamartoma(HH) is usually associated with refractory epilepsy, cognitive impairment, and behavioral disturbance. There is now increasing evidence that HH can be treated effectively with a variety of neurosurgical approaches. Treatment options for intractable gelastic seizure in HH patients include direct open surgery with craniotomy, endoscopic surgery, radiosurgery with gamma knife and stereotactic radiofrequency thermocoagulation. Selection of treatment modalities depends on type and size of the HH and the surgeon's preference. Two surgical techniques, resection and disconnection, had been described with favorable outcomes. Pretreatmentevaluation, patient selection, surgical techniques, complications, and possible selection of treatment are discussed.
文摘Background and Importance: Cavernomas of the septum pellucidum represent an extremely rare subtype of CNS cavernous angiomas which are a rare subtype of CNS tumors. Intraventricular cavernomas of the body of the lateral ventricle are usually treated by the transcallosal approach. Clinical Presentation: We present a case of a fifty-eight year old man with a septum pellucidum cavernoma successfully treated operatively by means of the inferior parietal transcortical transventricular approach. This unusual and scarcely documented tumor was situated at the posterior third of the septum pellucidum. The patient had a good recovery with no focal deficit. Conclusion: Septum pellucidum cavernomas are extremely rare lesions. Inferior parietal transcortical approach is a safe alternative to the commonly used transcallosal approach for lesions of the posterior half of the septum pellucidum.
