Neuroapraxia of Trigeminal Nerve Controlled by Neuromonitoring During Microvascular Decompression in Multiple Sclerosis Patients Affected by Drug-Resistant Trigeminal Neuralgia Recurrent After Previous Operations.

Background And Importance: Trigeminal neuralgia (TN) can complicate the clinical course of multiple sclerosis (MS) and can be very difficult to treat. Usually, these patients experience multiple recurrences after surgical procedures with a poor overall outcome. To the best of our knowledge, we report the first 3 cases of drug-resistant MS-related TN recurrent after previous operations in which intraoperative neuromonitoring controlled neuroapraxia of trigeminal nerve was performed.

A white matter-centered approach to investigate recurrence pathways in high-grade gliomas: a single-center retrospective study.

Background And Aim: High-grade gliomas (HGGs) are aggressive primary brain tumors with inevitable recurrence. This single-center retrospective study investigates whether the anatomical proximity of HGGs to major white matter tracts influences progression and recurrence. The study explores the association between tumor location and recurrence type-local, remote, or ependymal-and whether recurrences align with adjacent white matter tracts.

Usefulness of 3T MR in surgical planning for deep brain stimulation surgery: a systematic literature review.

Magnetic resonance imaging (MRI) allows direct visualization and targeting of the subthalamic nucleus (STN) and the globus pallidus interna (GPi) during deep brain stimulation (DBS) surgery for Parkinson's disease (PD). Compared to standard 1.5T MRI, the availability of MRI machines with higher magnetic field strength, as 3T MRI, could provide surgical advantages for DBS surgery.

Psychological assessment in patients affected by trigeminal neuralgia. A systematic review.

The aim of the present study was to conduct a systematic review regarding the presence and type of psychological comorbidities in patients with trigeminal neuralgia and to determine the potential impact of surgical treatments on these conditions. We reviewed the literature following PRISMA guidelines to identify and critically examine relevant studies. The review question was formulated according to the PICO framework as follows: "For patients affected by trigeminal neuralgia (P) undergoing neuropsychological assessments (I) and potentially undergoing reassessment after surgical treatment (C), is there a correlation between psychological issues and trigeminal neuralgia, and does the treatment of trigeminal neuralgia improve psychological well-being (O)?".

Understanding Neovascularization in Glioblastoma: Insights from the Current Literature.

Glioblastomas (GBMs), among the most aggressive and resilient brain tumors, characteristically exhibit high angiogenic potential, leading to the formation of a dense yet aberrant vasculature, both morphologically and functionally. With these premises, numerous expectations were initially placed on anti-angiogenic therapies, soon dashed by their limited efficacy in concretely improving patient outcomes. Neovascularization in GBM soon emerged as a complex, dynamic, and heterogeneous process, hard to manage with the classical standard of care.

Education paths in neuro-oncology: combining technical skills with multidisciplinary care. A survey from the AINO (Italian Association for Neuro-Oncology) Youngster Committee.

Purpose: Neuro-oncology is a multidisciplinary subspecialty that has evolved and expanded tremendously over the last 20 years. In Europe, notwithstanding a number of commendable initiatives, neither a specific neuro-oncology training curriculum nor a consensus on the ideal training tools have been set. In this context, the Youngster Committee of the Italian Association for Neuro-Oncology (AINO) has run a nationwide survey to take a snapshot of the current situation of neuro-oncology education in Italy.

The utility of diffusion tensor imaging in the assessment of trigeminal neuralgia pathophysiology and clinical outcome: a systematic review.

Trigeminal neuralgia (TN) is a prevalent and debilitating condition. Despite significant advancements in the management of TN, its etiopathogenesis remains unclear, and predicting clinical outcomes following surgical or radiosurgical interventions continues to pose challenges. Diffusion tensor imaging (DTI) has emerged as a valuable tool in various neurosurgical domains, offering insights into the myelination, inflammation, and infiltration of neural fibers, including cranial nerves.

Real-world impact of intrathecal baclofen therapy: the benefits of neteka on patient outcomes, caregiver burden, and cost efficiency.

Background: Intrathecal baclofen therapy (ITB) is a well-established treatment modality for severe spasticity, but it is burdened by the need for periodic pump refills. The introduction of a new formulation of baclofen with an extended stability of 180 days (Neteka, Nordic Group BV) could decrease the frequency of refills. We aimed at analyzing the clinical and economic impact of Neteka introduction in our outpatient facility.

Reliability of high-quantity human brain organoids for modeling microcephaly, glioma invasion and drug screening.

Brain organoids offer unprecedented insights into brain development and disease modeling and hold promise for drug screening. Significant hindrances, however, are morphological and cellular heterogeneity, inter-organoid size differences, cellular stress, and poor reproducibility. Here, we describe a method that reproducibly generates thousands of organoids across multiple hiPSC lines.

Abnormal electromyographical trigeminal activation through stimulation of the offending artery (Z-L response): An intraoperative tool during microvascular decompression for trigeminal neuralgia.

Background: There are currently no intraoperative neurophysiological tools to assess the effectiveness of trigeminal nerve decompression during microvascular decompression surgery for drug-resistant trigeminal neuralgia. In microvascular decompression surgery for hemifacial spasm, an abnormal electromyographic activation of facial muscles after stimulation of the offending vessel was identified and named 'Z-L response'.

Methods: We adapted a neurophysiological protocol to elicit a Z-L response during microvascular decompression surgery for trigeminal neuralgia and applied it to a prospective series of 18 surgical patients.

Optimizing surgical technique in microvascular decompression for hemifacial spasm - Results from a surgical series with contemporary use of neuronavigation and intraoperative neuromonitoring.

Background: Microvascular decompression (MVD) through a retrosigmoid approach is considered the treatment of choice in cases of hemifacial spasm (HFS) due to neurovascular conflict (NVC). Despite the widespread of neuronavigation and intraoperative neuromonitoring (IONM) techniques in neurosurgery, their contemporary application in MVD for HFS has been only anecdotally reported.

Methods: Here, we report the results of MVD performed with a combination of neuronavigation and IONM, including lateral spread response (LSR) in 20 HFS patients.

Risk factors and significance of post-operative edema in Parkinson Disease patients submitted to deep brain stimulation. A ten-year case series.

Background: Peri-electrode edema after deep brain stimulation (DBS) surgery for Parkinson Disease (PD) has been reported in up to 100% of cases. The clinical significance of this finding is unclear, with most papers suggesting a benign course. The risk factors are also poorly defined.

Long-Term Outcome in Adult Patients with Drug-Resistant Epilepsy Submitted to Vagus Nerve Stimulation.

Epilepsy treatment primarily involves antiseizure medications (ASMs) to eliminate seizures and improve the quality of life, but many patients develop drug-resistant epilepsy (DRE), necessitating alternative interventions. This study aimed to evaluate the long-term efficacy and safety of vagus nerve stimulation (VNS) in managing DRE. We retrospectively analyzed data from 105 adult patients treated at Agostino Gemelli Hospital from 1994 to 2022.

Intraoperative microelectrode recording during asleep deep brain stimulation of subthalamic nucleus for Parkinson Disease. A case series with systematic review of the literature.

The use of microelectrode recording (MER) during deep brain stimulation (DBS) for Parkinson Disease is controversial. Furthermore, in asleep DBS anesthesia can impair the ability to record single-cell electric activity.The purpose of this study was to describe our surgical and anesthesiologic protocol for MER assessment during asleep subthalamic nucleus (STN) DBS and to put our findings in the context of a systematic review of the literature.

A systematic review on the efficacy of adjunctive surgical strategies during microvascular decompression for trigeminal neuralgia without intraoperative evidence of neurovascular conflict.

Aim of the present study was to conduct a comprehensive review of surgical strategies that can be offered to patients with trigeminal neuralgia undergoing microvascular decompression (MVD) surgery and without intraoperative evidence of neurovascular conflict, with a high pre-operative suspicion of conflict lacking intraoperative confirmation, or individuals experiencing recurrence after previous treatment. This systematic review followed established guidelines (PRISMA) to identify and critically appraise relevant studies. The review question was formulated according to the PICO (P: patients; I: intervention; C: comparison; O: outcomes) framework as follows.

Personalized Medicine in Brain Tumors.

Personalizing clinical, diagnostic and therapeutic approaches in neuro-oncology is a huge challenge [...

Regorafenib and glioblastoma: a literature review of preclinical studies, molecular mechanisms and clinical effectiveness.

Glioblastoma IDH wild type (GBM) is a very aggressive brain tumour, characterised by an infiltrative growth pattern and by a prominent neoangiogenesis. Its prognosis is unfortunately dismal, and the median overall survival of GBM patients is short (15 months). Clinical management is based on bulk tumour removal and standard chemoradiation with the alkylating drug temozolomide, but the tumour invariably recurs leading to patient's death.