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Background: Acquisition of neurosurgical anatomy knowledge requires the progressive construction of a 3-dimensional (3D) mental image from the study of 2-dimensional pictures. Tridimensional neuroimaging modeling and 3D pictures and videos have facilitated a better understanding of intricate brain anatomy. One of the main limitations of these methods however is that the user is unable to freely change his or her own point of view of the observed structures. The objective of this paper was to develop a 3D reconstruction method to facilitate learning and teaching of neurosurgery., Methods: We developed a 3D reconstruction method by using 3D photogrammetry to convert intraoperative images into a fully explorable 3D textured model. We also developed a mobile application to navigate the virtual scenario by using the gyroscopic technology of mobile devices to simulate the different movements of the surgical microscope. We named this process 3D virtual intraoperative reconstruction (VIR)., Results: We report the detailed methodology for picture acquisition, 3D reconstruction, and visualization with some surgical examples since the first applications in 2015. We also demonstrate how these navigable models can be used to buildup hybrid images derived by the fusion of 3D intraoperative scenarios with neuroimaging-derived 3D models., Conclusions: 3D VIR is a digital reconstruction method developed with the goal of facilitating the teaching and learning of neurosurgical anatomy by allowing the user to directly explore a surgical field and anatomic structures. The result is an interactive navigable 3D textured model for the analysis of the surgical approach and regional anatomy and for reconstruction of hybrid 3D scenarios., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Purpose: The practical management of cavernous angioma located within eloquent brain area before, during and after surgical resection is poorly documented. We assessed the practical pre-operative, intra-operative, and post-operative management of cavernous angioma located within eloquent brain area., Method: An online survey composed of 61 items was sent to 26 centers to establish a multicenter international retrospective cohort of adult patients who underwent a surgical resection as the first-line treatment of a supratentorial cavernous angioma located within or close to eloquent brain area., Results: 272 patients from 19 centers (mean 13.6 ± 16.7 per center) from eight countries were included. The pre-operative management varied significantly between centers and countries regarding the pre-operative functional assessment, the pre-operative epileptological assessment, the first given antiepileptic drug, and the time to surgery. The intra-operative environment varied significantly between centers and countries regarding the use of imaging systems, the use of functional mapping with direct electrostimulations, the extent of resection of the hemosiderin rim, the realization of a post-operative functional assessment, and the time to post-operative functional assessment. The present survey found a post-operative improvement, as compared to pre-operative evaluations, of the functional status, the ability to work, and the seizure control., Conclusions: We observed a variety of practice between centers and countries regarding the management of cavernous angioma located within eloquent regions. Multicentric prospective studies are required to solve relevant questions regarding the management of cavernous angioma-related seizures, the timing of surgery, and the optimal extent of hemosiderin rim resection., (Copyright © 2019 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)

Objectives: To estimate the prevalence rate of silent cranial and intracranial lesions in a series of Ollier-Maffucci patients., Patients and Methods: Cerebral MRI was routinely performed in Ollier-Maffucci patients followed-up in our tertiary centers. Patients with previous history of skull base or intracranial tumors were excluded from the study. Clinical and radiological datas were retrospectively collected. The occurrence rate and nature of abnormal cerebral MRIs were determined., Results: Twelve patients were included. A glioma-looking lesion was found in one patient (8%), while skull base lesions were evidenced in 3 others (25%). A regular MRI follow-up was recommended for each patient, with a time interval varying between 1year and 3years depending on the likelihood of tumoral evolutivity, as infered from the MRI findings., Conclusion: All in all, the high rate of intracranial and skull base lesions with a malignant potential warrants to include cerebral MRI in the routine follow-up of Ollier-Maffucci patients., (Copyright © 2017. Published by Elsevier B.V.)

Although surgery is not curative for the majority of intracranial gliomas, radical resection has been demonstrated to influence survival and delay tumor progression. Because gliomas are very frequently located in eloquent or more generally critical areas, surgeons must always balance the maximizing resection with the need to preserve neurological function. In this overview, we tried to summarize the recent literature and our personal experience about (1) the benefits and limits of using preoperative anatomical and functional neuroimaging (anatomical MRI, DTI fiber tracking, and functional MRI), (2) the issues to consider in planning the surgical strategy, (3) the need to thoroughly understand microsurgical techniques that enable a maximal resection (subpial dissection, vascular manipulation, etc.), (4) the importance of individualizing surgical strategy especially in patients with gliomas in eloquent areas (the role of neuropsychological evaluation in redefining eloquent and non-eloquent areas), and (5) how to use intraoperative mapping techniques and understand why and when to use them. Through this paper, the reader should become more familiar with a comprehensive panel of techniques and methodologies but more importantly become aware that these recent technical advances facilitate a conceptual change from classical surgical paradigms toward a more patient-specific approach.

Background: A key aspect of neurosurgery is the challenge of ensuring adequate visualization through brain retraction whilst ensuring that underlying brain remains protected. Self-retaining retractors (SRR) are specially designed for this purpose. Their limitation however is the potential for ischaemic damage that accompanies any pressure on the cerebral cortex., Methods and Technique: We use balloon tips of Fogarty catheters to provide gentle brain retraction during surgery for skull base and midline tumours as well as aneurysms of anterior circulation. Following completion of the craniotomy and dural opening, the balloon tip is inserted under the frontal or temporal lobes or into the interemispheric fissure, and then inflated. This results in distension of the arachnoid, thereby favouring the dissection process., Conclusion: Diverting the brain from operative view with a more elastic, less traumatic, and easily adjustable Fogarty catheter balloon tip is a safe and effective tool that can either act as a substitute for SRR or alternatively minimise their duration of use.

We describe a female infant with a previously unreported combination of manifestations characterized by aplasia cutis, skull defect, brain heterotopia, mild congenital lymphedema, and intestinal lymphangiectasia. The association of intestinal lymphangiectasia and aplasia cutis, and the association of intestinal lymphangiectasia with brain heterotopia in the lymphedema-lymphangiectasia-mental retardation syndrome have been described in single reports. In one family, the association of cortical dysplasia and congenital lymphedema have been related to mutations in the RELN gene.