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Journal articles on the topic 'Brainstem'

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Author: Grafiati

Published: 4 June 2021

Last updated: 10 March 2023

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1

Theodoroff, Sarah M., and James A. Kaltenbach. "The Role of the Brainstem in Generating and Modulating Tinnitus." American Journal of Audiology 28, no. 1S (April 22, 2019): 225–38. http://dx.doi.org/10.1044/2018_aja-ttr17-18-0035.

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Purpose The purpose of this work is to present a perspective article summarizing ideas pertaining to the brainstem's role in generating and modulating tinnitus. It is organized in 4 sections: Part 1, the role of the brainstem as a tinnitus generator; Part 2, the role of the brainstem in modulating tinnitus; Part 3, the role of the brainstem in nonauditory comorbid conditions associated with tinnitus; and Part 4, clinical implications. In Part 1, well-established neurophysiological models are discussed providing the framework of evidence that auditory brainstem nuclei play a role in generating tinnitus. In Part 2, ideas are presented explaining modulatory effects on tinnitus related to underlying pathways originating from or projecting to brainstem auditory and nonauditory nuclei. This section addresses multiple phenomena including somatic-related, attention-mediated, and emotion-mediated changes in the tinnitus percept. In Part 3, the role of the brainstem in common nonauditory comorbidities that occur in patients with tinnitus is discussed. Part 4 presents clinical implications of these new ideas related to the brainstem's involvement in generating and modulating tinnitus. Impact Knowledge of the brainstem's involvement in generating and modulating tinnitus provides a context for health care professionals to understand the temporal relationship between tinnitus and common nonauditory comorbid conditions.

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2

Párraga, Richard Gonzalo, Lucas Loss Possatti, Raphael Vicente Alves, Guilherme Carvalhal Ribas, Uğur Türe, and Evandro de Oliveira. "Microsurgical anatomy and internal architecture of the brainstem in 3D images: surgical considerations." Journal of Neurosurgery 124, no. 5 (May 2016): 1377–95. http://dx.doi.org/10.3171/2015.4.jns132778.

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OBJECT Brainstem surgery remains a challenge for the neurosurgeon despite recent improvements in neuroimaging, microsurgical techniques, and electrophysiological monitoring. A detailed knowledge of the microsurgical anatomy of the brainstem surface and its internal architecture is mandatory to plan appropriate approaches to the brainstem, to choose the safest point of entry, and to avoid potential surgical complications. METHODS An extensive review of the literature was performed regarding the brainstem surgical approaches, and their correlations with the pertinent anatomy were studied and illustrated through dissection of human brainstems properly fixed with 10% formalin. The specimens were dissected using the fiber dissection technique, under ×6 to ×40 magnification. 3D stereoscopic photographs were obtained (anaglyphic 3D) for better illustration of this study. RESULTS The main surgical landmarks and their relationship with the cerebellum and vascular structures were identified on the surface of the brainstem. The arrangements of the white matter (ascending and descending pathways as well as the cerebellar peduncles) were demonstrated on each part of the brainstem (midbrain, pons, and medulla oblongata), with emphasis on their relationships with the surface. The gray matter, constituted mainly by nuclei of the cranial nerves, was also studied and illustrated. CONCLUSIONS The objective of this article is to review the microsurgical anatomy and the surgical approaches pertinent to the brainstem, providing a framework of its external and internal architecture to guide the neurosurgeon during its related surgical procedures.

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3

Chen, Lin, Tao Chen, Gengsheng Mao, Baodong Chen, Mingchang Li, Hongbo Zhang, Haitao Xi, et al. "Clinical neurorestorative therapeutic guideline for brainstem hemorrhage (2020 China version)." Journal of Neurorestoratology 8, no. 4 (2020): 232–40. http://dx.doi.org/10.26599/jnr.2020.9040024.

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Brainstem hemorrhage (mainly pontine hemorrhage caused by hypertension) has the clinical characteristics of acute onset, rapid progress, high mortality, and high disability rate. Due to the complexity of the brainstem’s anatomical structure and functional importance, it is generally recognized that brainstem treatment is difficult and risky, so it has been regarded as a restricted area of surgery. However, in recent years, continuous progress is being made in many areas, including microsurgical technology, stereotactic technology, robot-assisted surgery, neuroendoscopy, and theoretical and clinical practice of neurorestoration, aiding in the understanding, diagnosis, and treatment of brainstem hemorrhage injuries. The Chinese Association of Neurorestoratology (CANR; Preparatory) and the China Committee of International Association of Neurorestoratology (IANR-China Committee) organized relevant experts to formulate this clinical guideline to diagnose and restore damaged nerves after brainstem hemorrhages, promote a standardized diagnosis, and neurorestoratologically treat this disease.

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4

Weiss, Alessandro, Paolo Perrini, Matteo De Notaris, Guadalupe Soria, Alarcon Carlos, Maura Castagna, Lodovico Lutzemberger, et al. "Endoscopic Endonasal Transclival Approach to the Ventral Brainstem: Anatomic Study of the Safe Entry Zones Combining Fiber Dissection Technique with 7 Tesla Magnetic Resonance Guided Neuronavigation." Operative Neurosurgery 16, no. 2 (May 10, 2018): 239–49. http://dx.doi.org/10.1093/ons/opy080.

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Abstract BACKGROUND Treatment of intrinsic lesions of the ventral brainstem is a surgical challenge that requires complex skull base antero- and posterolateral approaches. More recently, endoscopic endonasal transclival approach (EETA) has been reported in the treatment of selected ventral brainstem lesions. OBJECTIVE In this study we explored the endoscopic ventral brainstem anatomy with the aim to describe the degree of exposure of the ventral safe entry zones. In addition, we used a newly developed method combining traditional white matter dissection with high-resolution 7T magnetic resonance imaging (MRI) of the same specimen coregistered using a neuronavigation system. METHODS Eight fresh-frozen latex-injected cadaver heads underwent EETA. Additional 8 formalin-fixed brainstems were dissected using Klingler technique guided by ultra-high resolution MRI. RESULTS The EETA allows a wide exposure of different safe entry zones located on the ventral brainstem: the exposure of perioculomotor zone requires pituitary transposition and can be hindered by superior cerebellar artery. The peritrigeminal zone was barely visible and its exposure required an extradural anterior petrosectomy. The anterolateral sulcus of the medulla was visible in most of specimens, although its close relationship with the corticospinal tract makes it suboptimal as an entry point for intrinsic lesions. In all cases, the use of 7T-MRI allowed the identification of tiny fiber bundles, improving the quality of the dissection. CONCLUSION Exposure of the ventral brainstem with EETA requires mastering surgical maneuvers, including pituitary transposition and extradural petrosectomy. The correlation of fiber dissection with 7T-MRI neuronavigation significantly improves the understanding of the brainstem anatomy.

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5

Oliveira, Francine Hehn de, Edson Rodrigues Neto, Mariana Kumaira Fonseca, André Silvestre Reitz da Costa, Marcio Aloisio Bezerra Cavalcanti Rockenbach, Renata dos Santos Padilha, Liana Lisboa Fernandez, and Arlete Hilbig. "Neurodegenerative changes in the brainstem and olfactory bulb in people older than 50 years old: a descriptive study." Arquivos de Neuro-Psiquiatria 73, no. 7 (July 2015): 569–77. http://dx.doi.org/10.1590/0004-282x20150066.

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With the increase in life expectancy in Brazil, concerns have grown about the most prevalent diseases in elderly people. Among these diseases are neurodegenerative diseases, such as Alzheimer’s and Parkinson’s diseases. Protein deposits related to the development of these diseases can pre-date the symptomatic phases by years. The tau protein is particularly interesting: it might be found in the brainstem and olfactory bulb long before it reaches the limbic cortex, at which point symptoms occur. Of the 14 brains collected in this study, the tau protein was found in the brainstems of 10 (71.42%) and in olfactory bulbs of 3 out 11. Of the 7 individuals who had a final diagnosis of Alzheimer’s disease (AD), 6 presented tau deposits in some region of the brainstem. Our data support the idea of the presence of tau protein in the brainstem and olfactory bulb in the earliest stages of AD.

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6

Kong, Lingmei, Gengpeng Lian, Wenbin Zheng, Huimin Liu, Haidu Zhang, and Ruowei Chen. "Effect of Alcohol on Diffuse Axonal Injury in Rat Brainstem: Diffusion Tensor Imaging and Aquaporin-4 Expression Study." BioMed Research International 2013 (2013): 1–9. http://dx.doi.org/10.1155/2013/798261.

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The aim of this study is to assess the effects of alcohol on traumatic brain injury by using diffusion tensor imaging (DTI) and evaluate aquaporin-4(AQP4) expression changes in rat brainstems following acute alcohol intoxication with diffuse axonal injury (DAI). We further investigated the correlation between the AQP4 expression and DTI in the brain edema. Eighty-five rats were imaged before and after injury at various stages. DTI was used to measure brainstem apparent diffusion coefficient (ADC) and fractional anisotropy (FA), with immunostaining being used to determine AQP4 expression. After acute alcoholism with DAI, ADC values of the brainstem first decreased within 6 h and then elevated. FA values began to decline by 1 h, reaching a minimum at 24 h after trauma. There was a negative correlation between ADC values and brainstem AQP4 expression at 6 h and positive correlation at 6 h to 24 h. Changes of ADC and FA values in DAI with acute alcoholism indicate the effects of ethanol on brain edema and the severity of axonal injury. The correlations between ADC values and the brainstem AQP4 expression at different time points suggest that AQP4 expression follows an adaptative profile to the severity of brain edema.

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7

Faught, E., and S. J. Oh. "Brainstem auditory evoked responses in brainstem infarction." Stroke 16, no. 4 (July 1985): 701–5. http://dx.doi.org/10.1161/01.str.16.4.701.

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8

Quester, Ralf, and Roland Schröder. "Topographic anatomy of the cochlear nuclear region at the floor of the fourth ventricle in humans." Journal of Neurosurgery 91, no. 3 (September 1999): 466–76. http://dx.doi.org/10.3171/jns.1999.91.3.0466.

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Object. The development of appropriate methods to stimulate the dorsal and ventral cochlear nucleus by means of an auditory brainstem implant in patients with acquired bilateral anacusis requires a detailed topoanatomical knowledge both of the location and extension of the nuclear surface in the fourth ventricle and lateral recess and of its variability. The goal of this study was to provide that information. Anatomically, it is possible to use a midline surgical approach to the fourth ventricle rather than the translabyrinthine and suboccipital routes of access used hitherto. This is especially useful if severe scarring, which occurs as a result of tumor removal in the cerebellopontine angle, make the orientation and placement of an auditory brainstem implant via a lateral surgical approach difficult. There have been only a few studies, involving single cases and small series of patients, in which the focus was the exact extension of the cochlear nuclei, whose microsurgically relevant position in relation to the surface structures is not known in detail.Methods. Landmarks that are important for the placement of an auditory brainstem implant through the fourth ventricle were examined and measured in a large series of 28 formalin-fixed human brainstems. In all cases, these examinations were supplemented by addition of a histological section series. For the first time values of unfixed fresh brainstem tissue were determined. Anatomical features are discussed with regard to their possible neurosurgical relevance, taking into account inter- and intraindividual variability.Conclusions. The midline approach would provide an opportunity to stimulate the whole area of the dorsal as well as the ventral cochlear nucleus with an auditory brainstem implant.

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9

Wongthida, Phonphimon, Matthew R. Schuelke, Christopher B. Driscoll, Timothy Kottke, Jill M. Thompson, Jason Tonne, Cathy Stone, et al. "Ad-CD40L mobilizes CD4 T cells for the treatment of brainstem tumors." Neuro-Oncology 22, no. 12 (May 27, 2020): 1757–70. http://dx.doi.org/10.1093/neuonc/noaa126.

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Abstract Background Diffuse midline glioma, formerly DIPG (diffuse intrinsic pontine glioma), is the deadliest pediatric brainstem tumor with median survival of less than one year. Here, we investigated (i) whether direct delivery of adenovirus-expressing cluster of differentiation (CD)40 ligand (Ad-CD40L) to brainstem tumors would induce immune-mediated tumor clearance and (ii) if so, whether therapy would be associated with a manageable toxicity due to immune-mediated inflammation in the brainstem. Methods Syngeneic gliomas in the brainstems of immunocompetent mice were treated with Ad-CD40L and survival, toxicity, and immune profiles determined. A clinically translatable vector, whose replication would be tightly restricted to tumor cells, rAd-Δ24-CD40L, was tested in human patient–derived diffuse midline gliomas and immunocompetent models. Results Expression of Ad-CD40L restricted to brainstem gliomas by pre-infection induced complete rejection, associated with immune cell infiltration, of which CD4+ T cells were critical for therapy. Direct intratumoral injection of Ad-CD40L into established brainstem tumors improved survival and induced some complete cures but with some acute toxicity. RNA-sequencing analysis showed that Ad-CD40L therapy induced neuroinflammatory immune responses associated with interleukin (IL)-6, IL-1β, and tumor necrosis factor α. Therefore, to generate a vector whose replication, and transgene expression, would be tightly restricted to tumor cells, we constructed rAd-Δ24-CD40L, the backbone of which has already entered clinical trials for diffuse midline gliomas. Direct intratumoral injection of rAd-Δ24-CD40L, with systemic blockade of IL-6 and IL-1β, generated significant numbers of cures with readily manageable toxicity. Conclusions Virus-mediated delivery of CD40L has the potential to be effective in treating diffuse midline gliomas without obligatory neuroinflammation-associated toxicity.

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10

Scott, R. Michael. "Brainstem tumors." Journal of Neurosurgery: Pediatrics 1, no. 5 (May 2008): 381. http://dx.doi.org/10.3171/ped/2008/1/5/381.

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11

Wei, Pengxu, Zhi Lan, Zeping Lv, and Yubo Fan. "Brainstem fMRI." Encyclopedia 1, no. 1 (December 22, 2020): 4–11. http://dx.doi.org/10.3390/encyclopedia1010003.

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The human brainstem plays important roles in maintaining basic vital functions. In comparison with brain functional magnetic resonance imaging (fMRI), only a few fMRI studies investigating the brainstem have been reported because of a number of technical challenges. This entry briefly introduces technical difficulties, recent advances, and further directions of brainstem fMRI in humans.

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12

Millichap, J. Gordon. "Brainstem Malformations." Pediatric Neurology Briefs 22, no. 1 (January 1, 2008): 3. http://dx.doi.org/10.15844/pedneurbriefs-22-1-3.

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13

Farmer, Jean-Pierre, José Luis Montes, Carolyn R. Freeman, Kathleen Meagher-Villemure, Mason C. Bond, and Augustin M. O’Gorman. "Brainstem Gliomas." Pediatric Neurosurgery 34, no. 4 (2001): 206–14. http://dx.doi.org/10.1159/000056021.

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14

Jeret, J. S. "Brainstem infarct." Neurology 41, no. 10 (October 1, 1991): 1708. http://dx.doi.org/10.1212/wnl.41.10.1708.

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15

Thadani, V. "Brainstem infarct." Neurology 41, no. 10 (October 1, 1991): 1708. http://dx.doi.org/10.1212/wnl.41.10.1708-a.

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16

Mpairamidis, Evriviadis, George A. Alexiou, Kalliopi Stefanaki, George Sfakianos, and Neofytos Prodromou. "Brainstem Ganglioglioma." Journal of Child Neurology 23, no. 12 (September 4, 2008): 1481–83. http://dx.doi.org/10.1177/0883073808319316.

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17

Rodin, E., S. Tahir, D. Austin, and L. Andaya. "Brainstem Death." Clinical Electroencephalography 16, no. 2 (April 1985): 63–71. http://dx.doi.org/10.1177/155005948501600202.

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18

Karakis, Ioannis. "Brainstem Mapping." Journal of Clinical Neurophysiology 30, no. 6 (December 2013): 597–603. http://dx.doi.org/10.1097/01.wnp.0000436892.39727.5b.

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19

Johnston, Andrew J., and Basil F. Matta. "Brainstem Death." Surgery (Oxford) 21, no. 4 (April 2003): 96–99. http://dx.doi.org/10.1383/surg.21.4.96.14289.

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20

Ramos, Ana, Amaya Hilario, Alfonso Lagares, Elena Salvador, Angel Perez-Nuñez, and Juan Sepulveda. "Brainstem Gliomas." Seminars in Ultrasound, CT and MRI 34, no. 2 (April 2013): 104–12. http://dx.doi.org/10.1053/j.sult.2013.01.001.

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21

Jeret, J. S., and H. Augenstein. "Brainstem AVM." Neurology 46, no. 2 (February 1, 1996): 591. http://dx.doi.org/10.1212/wnl.46.2.591.

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22

Demetriou, G. A. "Brainstem tuberculosis." Case Reports 2013, jul18 1 (July 18, 2013): bcr2013010359. http://dx.doi.org/10.1136/bcr-2013-010359.

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23

Johnston, Andrew J., and Basil F. Matta. "Brainstem death." Surgery (Oxford) 25, no. 3 (March 2007): 134–37. http://dx.doi.org/10.1016/j.mpsur.2007.02.002.

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24

Packer, Roger J., H. Stacy Nicholson, L. Gilbert Vezina, and Dennis L. Johnson. "Brainstem Gliomas." Neurosurgery Clinics of North America 3, no. 4 (October 1992): 863–79. http://dx.doi.org/10.1016/s1042-3680(18)30632-6.

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25

O'Sullivan, Fin, and Barbara Miles. "Brainstem death." Anaesthesia & Intensive Care Medicine 13, no. 6 (June 2012): 249–51. http://dx.doi.org/10.1016/j.mpaic.2012.03.007.

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26

Joob, Beuy, and Viroj Wiwanitkit. "Brainstem tuberculomas." Acta Neurochirurgica 159, no. 5 (March 14, 2017): 899. http://dx.doi.org/10.1007/s00701-017-3144-x.

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27

Jallo, George I., Ann Biser-Rohrbaugh, and Diana Freed. "Brainstem gliomas." Child's Nervous System 20, no. 3 (March 1, 2004): 143–53. http://dx.doi.org/10.1007/s00381-003-0870-6.

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28

Jallo, George. "Brainstem gliomas." Child's Nervous System 22, no. 1 (November 26, 2005): 1–2. http://dx.doi.org/10.1007/s00381-005-1267-5.

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29

Williams, Marion, M. D. Dominic Bell, and Edward Moss. "Brainstem death." BJA CEPD Reviews 3, no. 6 (December 2003): 161–66. http://dx.doi.org/10.1093/bjacepd/mkg161.

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30

Kim, Bong-Soo, Karl Kothbauer, and George Jallo. "Brainstem Astroblastoma." Pediatric Neurosurgery 40, no. 3 (2004): 145–46. http://dx.doi.org/10.1159/000079860.

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31

Yong, William H., Maryam Shabihkhani, Keng C. Su, Bowen Wei, Gregory M. Lucey, Sergey Mareninov, Lydia E. Kuo-Bonde, Whitney B. Pope, and Timothy F. Cloughesy. "Brainstem Gliomas." Pathology Case Reviews 18, no. 5 (2013): 237–42. http://dx.doi.org/10.1097/pcr.0b013e3182a9ac78.

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32

Chakrabarti, Dhritiman, Venkatapura J. Ramesh, and Nitin Manohar. "Brainstem Contusion." Journal of Neurosurgical Anesthesiology 28, no. 4 (October 2016): 429–30. http://dx.doi.org/10.1097/ana.0000000000000215.

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33

Molloy, Patricia, Leslie Sutton, Anthony T. Yachnis, and Susan Rebsamen. "Brainstem Neoplasms." Medical and Pediatric Oncology 24, no. 6 (June 1995): 379–87. http://dx.doi.org/10.1002/mpo.2950240608.

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34

Martin, Lynn D., Allen M. Kaplan, Lucy S. Hernried, and Barry J. Fisher. "Brainstem gangliogliomas." Pediatric Neurology 2, no. 3 (May 1986): 178–82. http://dx.doi.org/10.1016/0887-8994(86)90014-7.

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35

Kashiwagi, Shiro, Seisho Abiko, and Hideo Aoki. "Brainstem abscess." Surgical Neurology 28, no. 1 (July 1987): 63–66. http://dx.doi.org/10.1016/0090-3019(87)90208-4.

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36

Duffield, Curtis, Jennifer Jocson, and Sandra L. Wootton-Gorges. "Brainstem disconnection." Pediatric Radiology 39, no. 12 (August 11, 2009): 1357–60. http://dx.doi.org/10.1007/s00247-009-1378-3.

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37

Willey, JZ, DM Harrison, and HC Schumacher. "Early spontaneous brainstem hemorrhage following widespread brainstem ischemia." Journal of Postgraduate Medicine 54, no. 4 (2008): 336. http://dx.doi.org/10.4103/0022-3859.43527.

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38

FUSE, TAKEO. "Auditory brainstem response in ischemic state of brainstem." AUDIOLOGY JAPAN 29, no. 5 (1986): 437–38. http://dx.doi.org/10.4295/audiology.29.437.

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39

Weston, P. F., J. I. Manson, and K. J. Abbott. "Auditory brainstem-evoked response in childhood brainstem glioma." Child's Nervous System 2, no. 6 (December 1986): 301–5. http://dx.doi.org/10.1007/bf00271943.

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40

Nozaki, Kazuhiko, Nobuo Hashimoto, Ken-ichiro Kikuta, Yasushi Takagi, and Haruhiko Kikuchi. "Surgical Applications To Arteriovenous Malformations Involving The Brainstem." Operative Neurosurgery 58, suppl_4 (April 1, 2006): ONS—270—ONS—279. http://dx.doi.org/10.1227/01.neu.0000210001.75597.81.

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Abstract Objective: To evaluate possible applications of microsurgical extirpation to arteriovenous malformations (AVMs) involving the brainstem. Methods: We retrospectively reviewed clinical records of 25 patients with AVMs involving brainstems who were admitted to our institute from 1984 to 2004. We defined a brainstem AVM as an AVM in which some part was located within the brainstem. The main location of the nidus was classified into ventral midbrain (n = 3), dorsal midbrain (n = 10), pons (n = 5), cerebellopontine angle (n = 6), and medulla oblongata (n = 1). Bleeding risks from the AVMs were calculated, and applied treatment modalities, respectability, and clinical outcomes were analyzed. Results: The annual bleeding and rebleeding risks of brainstem AVMs were 15.1 and 14.2%, respectively. Total resection was successfully performed in 0 out of 3, 6 out of 10,2 out of 5,6 out of 6, and 0 out of 1 in each of the groups, respectively. Stereotactic radiosurgery was applied as a main treatment modality in three patients (two ventral midbrain AVMs and one pontine AVM), and after microsurgery in one patient with a medulla oblongata AVM. Microsurgery-related permanent neurological complications were observed in five patients (one postoperative bleeding, one hemiparesis, three hearing deterioration, one abducens nerve palsy). During a follow-up period of 8 years (range, 8 mo-15 yr), one patient with an untreated pontine AVM died owing to hemorrhage and one patient with a subtotally resected dorsal midbrain AVM died owing to an unknown etiology 4 years later. Conclusion: Surgical resection can be applied with considerable, but acceptable, morbidity and mortality in some groups of brainstem AVMs with hemorrhagic presentation, particularly dorsal midbrain and cerebellopontine angle types, in which most parts of the nidus located sub- or extrapially.

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Park, Keun Young, Jung Yong Ahn, Jun Hyung Cho, Young Chul Choi, and Kyu Sung Lee. "Neuromyelitis optica with brainstem lesion mistaken for brainstem glioma." Journal of Neurosurgery: Pediatrics 107, no. 3 (September 2007): 251–54. http://dx.doi.org/10.3171/ped-07/09/251.

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42

Boyd, S. G., and A. Harden. "Neonatal auditory brainstem response cannot reliably diagnose brainstem death." Archives of Disease in Childhood 60, no. 4 (April 1, 1985): 396. http://dx.doi.org/10.1136/adc.60.4.396.

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43

Dear, P. R., and D. J. Godfrey. "Neonatal auditory brainstem response cannot reliably diagnose brainstem death." Archives of Disease in Childhood 60, no. 1 (January 1, 1985): 17–19. http://dx.doi.org/10.1136/adc.60.1.17.

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44

Hu, C. J., K. Y. Chan, T. J. Lin, S. H. Hsiao, Y. M. Chang, and S. M. Sung. "Traumatic brainstem deafness with normal brainstem auditory evoked potentials." Neurology 48, no. 5 (May 1, 1997): 1448–51. http://dx.doi.org/10.1212/wnl.48.5.1448.

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45

Chen, X., J. Grimm, B. R. Baker, J. Son, C. Siu, K. J. Redmond, C. Bettegowda, M. Lim, and L. R. Kleinberg. "Fractionated Stereotactic Radiosurgery for Brainstem Metastasis and Brainstem Tolerance." International Journal of Radiation Oncology*Biology*Physics 105, no. 1 (September 2019): E72—E73. http://dx.doi.org/10.1016/j.ijrobp.2019.06.2328.

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46

Dellaretti, Marcos, Gustavo Touzet, Nicolas Reyns, François Dubois, Sebastião Gusmão, Júlio Leonardo Barbosa Pereira, and Serge Blond. "Correlation among magnetic resonance imaging findings, prognostic factors for survival, and histological diagnosis of intrinsic brainstem lesions in children." Journal of Neurosurgery: Pediatrics 8, no. 6 (December 2011): 539–43. http://dx.doi.org/10.3171/2011.9.peds1167.

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Object The aim of this study was to compare MR imaging characteristics with histopathological findings of intrinsic brainstem lesions and also to show the prognostic factors in patients with diffuse brainstem glioma. Methods Between February 1988 and August 2007, 44 brainstem biopsies were performed at the Roger Salengro Hospital in Lille, France, in children with intrinsic brainstem lesions not amenable to excision. Twenty-six were female and 18 male, and the mean age was 6 years. Results Histological evaluation revealed diffuse brainstem glioma in all patients with diffuse nonenhancing brainstem lesions. Diffuse brainstem glioma was found in 18 patients (90%) with diffuse enhancing brainstem lesions. Pathological entities different from diffuse glioma were verified in 2 patients (10%)—1 with ependymoma and 1 with ganglioglioma. In 4 of 5 patients with a focal nonenhancing brainstem lesion, the histopathological diagnosis was diffuse low-grade glioma. In 6 of 10 patients with focal enhancing brainstem lesion, the diagnosis was diffuse brainstem glioma, and pathological entities different from diffuse brainstem glioma were verified in 2 (20%), both with pilocytic astrocytoma. The mean 1-year actuarial survival rates for patients classified with low-grade and high-grade glioma were 80.4% ± 0.08% and 48.6% ± 0.14%, respectively. Conclusions The impact of stereotactic biopsy on intrinsic brainstem lesions was greater in patients with MR imaging–documented enhancing lesions in whom the diagnosis of diffuse glioma was less frequent. Patients with low-grade glioma seem to have longer survival than those with high-grade glioma.

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47

Haspula, Dhanush, and Michelle A. Clark. "Contrasting Roles of Ang II and ACEA in the Regulation of IL10 and IL1β Gene Expression in Primary SHR Astroglial Cultures." Molecules 26, no. 10 (May 19, 2021): 3012. http://dx.doi.org/10.3390/molecules26103012.

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Angiotensin (Ang) II is well-known to have potent pro-oxidant and pro-inflammatory effects in the brain. Extensive crosstalk between the primary Ang II receptor, Ang type 1 receptor (AT1R), and the cannabinoid type 1 receptor (CB1R) has been demonstrated by various groups in the last decade. Since activation of glial CB1R has been demonstrated to play a key role in the resolution of inflammatory states, we investigated the role of Ang II (100 nM) and/or ACEA (10 nM), a potent CB1R-specific agonist in the regulation of inflammatory markers in astrocytes from spontaneously hypertensive rats (SHR) and Wistar rats. Astrocytes were cultured from brainstems and cerebellums of SHR and Wistar rats and assayed for IL1β and IL10 gene expression and secreted fraction, in treated and non-treated cells, by employing qPCR and ELISA, respectively. mRNA expression of both IL10 and IL1β were significantly elevated in untreated brainstem and cerebellar astrocytes isolated from SHR when compared to Wistar astrocytes. No changes were observed in the secreted fraction. While ACEA-treatment resulted in a significant increase in IL10 gene expression in Wistar brainstem astrocytes (Log2FC ≥ 1, p < 0.05), its effect in SHR brainstem astrocytes was diminished. Ang II treatment resulted in a strong inhibitory effect on IL10 gene expression in astrocytes from both brain regions of SHR and Wistar rats (Log2FC ≤ −1, p < 0.05), and an increase in IL1β gene expression in brainstem astrocytes from both strains (Log2FC ≥ 1, p < 0.05). Co-treatment of Ang II and ACEA resulted in neutralization of Ang II-mediated effect in Wistar brainstem and cerebellar astrocytes, but not SHR astrocytes. Neither Ang II nor ACEA resulted in any significant changes in IL10 or IL1β secreted proteins. These data suggest that Ang II and ACEA have opposing roles in the regulation of inflammatory gene signature in astrocytes isolated from SHR and Wistar rats. This however does not translate into changes in their secreted fractions.

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Fernandes Cabral, David T., Georgios A. Zenonos, Maximiliano Nuñez, Pinar Celtikci, Carl Snyderman, Eric Wang, Paul A. Gardner, and Juan C. Fernandez-Miranda. "Endoscopic Endonasal Transclival Approach for Resection of a Pontine Glioma: Surgical Planning, Surgical Anatomy, and Technique." Operative Neurosurgery 15, no. 5 (March 12, 2018): 589–99. http://dx.doi.org/10.1093/ons/opy005.

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Abstract BACKGROUND The endoscopic endonasal approach (EEA) has been proposed as a potential alternative for ventral brainstem lesions. The surgical anatomy, feasibility, and limitations of the EEA for intrinsic brainstem lesions are still poorly understood. OBJECTIVE To describe the surgical planning, anatomy, and technique of an intrinsic pontine glioma operated via EEA. METHODS Six-human brainstems were prepared for white matter microdissection. Ten healthy subjects were studied with high-definition fiber tractography (HDFT). A 56-yr-old female with right-hemiparesis underwent EEA for an exophytic pontine glioma. Pre- and postoperative HDFTs were implemented. RESULTS The corticospinal tracts (CSTs) are the most eloquent fibers in the ventral brainstem. At the pons, CSTs run between the pontine nuclei and the middle cerebellar peduncle (MCP). At the lower medulla, the pyramidal decussation leaves no room for safe ventral access. In our illustrative case, preoperative HDFT showed left-CST displaced posteromedially and partially disrupted, right-CST posteriorly displaced, and MCP severely disrupted. A transclival exposure was performed achieving a complete resection of the exophytic component with residual intra-axial tumor. Immediately postop, patient developed new left-side abducens nerve palsy and worse right-hemiparesis. Ten days postop, her strength returned to baseline. HDFT showed preservation and trajectory restoration of the CSTs. CONCLUSION The EEA provides direct access to the ventral brainstem, overcoming the limitations of lateral approaches. For intrinsic pathology, HDFT helps choosing the most appropriate surgical route/boundaries for safer resection. Further experience is needed to determine the indications and limitations of this approach that should be performed by neurosurgeons with high-level expertise in EEA.

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Veronese, Sheila, Marco Cambiaghi, and Andrea Sbarbati. "New Protocol for Auditory Brainstem Implant Positioning." Neuroscience and Neurological Surgery 9, no. 5 (November 24, 2021): 01–07. http://dx.doi.org/10.31579/2578-8868/203.

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Background: Surgery for applying the auditory brainstem implant is an otoneurosurgery that requires careful intraoperative monitoring to optimize the placement of the electrode paddle. This study aimed to validate a new method capable of increasing the accuracy of electrode array placement, reducing channel interaction, electrical artefacts, and saturation effects, and providing the largest number of electrodes that can be activated with the lowest possible electric charge. Materials and methods: Thirty-six subjects aged between 1.42 and 69.92 years were tested during surgery for auditory brainstem implantation. We recorded auditory electrical responses of the brainstem using the implant supplier's suggested stimulation protocol and the new protocol. Results: Saturations effects and electric artefacts were noticed respectively in 81.85% and 53.25% of recordings using implant supplier's method, while in 70.34% and 24.75% of recordings using the new method, with a percentage variation of 11.51% and 28.50%. Considering the amount of charge required to activate the electrodes, with the implant supplier's method an average charge of 14 nC was needed, while with the new protocol an average charge of 8 nC was necessary. Conclusions: The new method improves the coupling between the auditory brainstem implant and the surface of the cochlear nucleus.

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Nigam, Jyoti, Leena Jain, and Ashish Shrivastava. "Brainstem Auditory Evoked Potential in Primary Hypertension." Scholars Journal of Applied Medical Sciences 4, no. 7 (July 2016): 2593–95. http://dx.doi.org/10.21276/sjams.2016.4.7.61.

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