Indikace léčby supratentoriálních gliomů je kromě histopatologické diagnózy závislá na výsledcích neurozobrazovacích metod, nejčastěji magnetické rezonance. Konvenční MR však není dostatečně sensitivní a specifická metoda, aby stanovila druh a stupeň mozkového nádoru, což často vyžaduje provedení dalších nákladných vyšetření. Data z metabolického vyšetření mozku budou korelována s výsledky histologického vyšetření a semikvantitativního stanovení počtu nádorových buněk. Tkáň z nádoru bude získána navigovanou biopsií s využitím MR spektroskopických dat. Do studie budou zařazeni nemocní se supratentoriálním gliomem, indikovaní k operačnímu výkonu. Studie zahrne cca 50 pacientů. Projekt otestuje miniinvazivní a ekonomicky nenáročnou diagnostickou metodu, která může být v budoucnu vodítkem pro strategii léčby supratentoriálních gliomů.; The choice of therapeutic strategy in supratentorial gliomas depends on histopathological diagnosis and results of neuroimaging, usually magnetic resonance (MRI). A conventional MRI is neither sensitive, nor specific enough to determine the type and grading of the brain tumor, which requires further costly examinations. The metabolic data will be correlated with the results of histological examination and semi-quantitative assessment of tumor cells count. The tissue sample will be obtained through a navigated biopsy, guided by MRSI data. The patients indicated for surgery will be included in the study. The study sample will include around 50 subjects. The project will test a mini-invasive and economically profitable diagnostic tool, which may provide a guiding for the strategy of treatment in supratentorial gliomas in the future.

• MeSH
• Biopsy MeSH
• Glioma diagnosis   MeSH
• Histology MeSH
• Neurosurgical Procedures MeSH
• Proton Magnetic Resonance Spectroscopy MeSH
• Sensitivity and Specificity MeSH
• Neoplasm Grading MeSH
• Supratentorial Neoplasms diagnosis   MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• neurologie
• neurochirurgie
• NML Publication type
• závěrečné zprávy o řešení grantu IGA MZ ČR

Temporální resekce je nejčastějším epileptochirurgickým zákrokem. Moderní funkční neurozobrazení může hrát důležitou roli v predikci rizika zhoršení kognitivních funkcí, zejména pojmenování, po temporální resekci v řečově dominantní mozkové hemisféře. Cílem projektu je stanovit roli funkční magnetické rezonance (fMR) a kombinované fMR/traktografie v určení organizace řečových funkcí a schopnosti pojmenování u pacientů s temporální epilepsií. Data z funkčního neurozobrazení budou korelována s výsledky neuropsychologických testů rutinních a experimentálních (pojmenování), s klinickými daty a s výsledky MR volumetrie temporálního pólu a hippokampu. Do studie budou zařazeni pacienti s refrakterní epilepsií temporální laloku, indikovaní k operačnímu výkonu.Studie zahrne cca 60 pacientů a 20 kontrolních subjektů. Projekt poskytne kromě důležitých informací stran organizace řečových oblastí u pacientů s temporální epilepsií zejména možnost predikce rizika pooperačního deficitu v pojmenování.; Temporal lobe resection is the most common type of epilepsy surgery. Modern functional neuroimaging may play an important role in prediction of cognitive functions decline, in particular naming abilities, following speech dominant temporal lobe resection. The aim of the project is to assess the role of functional MR (fMR) and fMR seeded tractography in diagnostics of language function and organisation in temporal lobe epilepsy (TLE) patients. The neuroimaging functional data will be correlated to results of neuropsychological testing, both routine and experimental (naming), and to clinical characteristics and MRI volumetric measurements of temporal pole and hippocampus. Patients with refractory TLE indicated for epilepsy surgery will be included in thestudy. The study will include up to 60 patients and 20 controls. The results will provide important information on language areas organisation in TLE patients and also may have potential to predict extent of naming deficit following surgery.

• MeSH
• Diffusion Magnetic Resonance Imaging MeSH
• Epilepsy, Temporal Lobe diagnosis   surgery   MeSH
• Quality of Life MeSH
• Magnetic Resonance Imaging MeSH
• Speech Production Measurement MeSH
• Neuropsychological Tests MeSH
• Postoperative Complications MeSH
• Anterior Temporal Lobectomy MeSH
• Harm Reduction MeSH
• Stereotaxic Techniques MeSH
• Outcome and Process Assessment, Health Care MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• neurologie
• NML Publication type
• závěrečné zprávy o řešení grantu IGA MZ ČR

BACKGROUND AND PURPOSE: White matter changes assessed by DTI typically reflect tract functionality. This study aimed to investigate DTI parameter alterations in important regions pre- and postshunt implantation in patients with idiopathic normal pressure hydrocephalus (iNPH), alongside assessing the relationship between DTI parameters and clinical improvement. MATERIALS AND METHODS: Patients with probable iNPH underwent prospective preoperative MRI and comprehensive clinical work-up between 2017-2022. Patients with clinical symptoms of iNPH, positive result on a lumbar infusion test, and/or gait improvement after 120-hour lumbar drainage were diagnosed with iNPH and underwent shunt-placement surgery. Fractional anisotropy and mean diffusivity values for individual regions of interest were extracted from preoperative and postoperative MRI. These values were correlated with the clinical picture of individual patients. RESULTS: A total of 32 patients (73.59 ± 4.59 years) with definite iNPH were analyzed. Preoperative DTI characteristics of internal capsule and corona radiata correlated with the 1-year improvement in the Dutch Gait Scale postoperatively (all P < .036). Cognitive domain improvement after surgery in memory and psychomotor speed correlated with preoperative DTI values of cingulate gyrus (P = .050), uncinate fasciculus (P = .029), superior longitudinal fasciculus (P = .020), or corpus callosum (P < .045). CONCLUSIONS: DTI characteristics of white matter regions reflect clinical improvement after shunt surgery in patients with iNPH. They tend to improve toward physiologic DTI values, thus further accentuating the benefit of shunt surgery in both clinical and radiologic pictures.

• MeSH
• Anisotropy MeSH
• White Matter diagnostic imaging   MeSH
• Middle Aged MeSH
• Humans MeSH
• Hydrocephalus, Normal Pressure * surgery   diagnostic imaging   MeSH
• Prospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Cerebrospinal Fluid Shunts * MeSH
• Treatment Outcome MeSH
• Diffusion Tensor Imaging * methods   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

UNLABELLED: PURPOSE : Phase contrast magnetic resonance imaging (PC-MRI) represents an opportunity to non-invasively investigate cerebral spinal fluid (CSF) flow in patients with idiopathic normal pressure hydrocephalus (iNPH). Studies in recent years have explored the diagnostic and prognostic value of PC-MRI derived parameters. This review aims to identify all PC-MRI studies of iNPH published since 2010, synthesise a review based on collated results, and analyse specific flow parameters identified in the selected studies. METHODS: Our protocol was prospectively registered on PROSPERO [CRD42020180826]. We systematically searched four databases: Pubmed, Web of Science, Ovid, and Cochrane library to identify all eligible studies. Quality assessment was performed using a modified Newcastle-Ottawa Scale [19]. Systematic review was conducted according to Prisma guidelines. A random-effects model was used to perform meta-analysis on the available flow parameters. RESULTS: Eighteen records were identified for inclusion. Five studies were eligible for meta-analysis, representing 107 iNPH patients and 82 controls. CSF flow parameters available for analysis were stroke volume and peak velocity. Both were significantly higher than controls (p = 0.0007 and p = 0.0045 respectively) according to our random-effects analysis, consistent with a model of hyper-dynamic CSF in iNPH. Our systematic review revealed average stroke volumes in iNPH ranging from 43uL to over 200uL. Peak velocity values ranged from 5.9 cm/s to 12.8 cm/s. CONCLUSION: Significant increases in stroke volume and peak velocity values in iNPH patients suggest a place for PC-MRI as supplementary evidence in the diagnostic work-up of iNPH. Although shunting reduces aqueductal stroke volume and peak velocity, the ability of pre-shunt values to reliably predict treatment response remains complicated. We suggest that it may be more appropriate to consider a range of values that reflect varying probabilities of shunt success. We recommend that future studies should prioritise standardising PC-MRI protocols, and before then PC-MRI findings should be considered supportive rather than determinative.

• MeSH
• Humans MeSH
• Magnetic Resonance Imaging * methods   MeSH
• Hydrocephalus, Normal Pressure * diagnostic imaging   physiopathology   surgery   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Meta-Analysis MeSH
• Review MeSH
• Systematic Review MeSH

• MeSH
• Cognition physiology   MeSH
• Cognitive Dysfunction psychology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Neuropsychological Tests MeSH
• Hydrocephalus, Normal Pressure * surgery   diagnosis   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Letter MeSH
• Comparative Study MeSH

We sought to describe the cognitive profile of patients with Idiopathic Normal Pressure Hydrocephalus (iNPH) using a comprehensive neuropsychological battery. Based on age and education correlated norms, we aimed to compare performance in each measured cognitive domain: executive functions (EFs), verbal memory (VM), non-verbal memory (nVM), visuoconstructional abilities (VA) and attention/psychomotor speed (A/PS). Patients diagnosed with iNPH underwent comprehensive neuropsychological evaluation before shunting. Their performance was compared to the age and education correlated norms. Correlation of different cognitive domains in iNPH profile was performed. A total of 53 iNPH patients (73.21 ± 5.48 years) were included in the study. All of the measured cognitive domains were significantly damaged. The most affected domains were EFs and VM (p<0.001 and p<0.001, respectively). A/PS domain was affected milder than EFs and VM (p<0.001). The least affected domains were nVM (p<0.001) and VA (p<0.001). Patients with iNPH are affected in all cognitive domains and the cognitive decline is uneven across these domains. The impairment of memory was shown to depend on the presented material. VM was shown to be much more severely affected than nVM and along with VM, EFs were shown to be the most affected. A/PS speed was shown to be less affected than VM and EFs and the least affected domains were nVM and VA.

• MeSH
• Executive Function MeSH
• Cognition MeSH
• Cognitive Dysfunction * MeSH
• Humans MeSH
• Neuropsychological Tests MeSH
• Hydrocephalus, Normal Pressure * diagnosis   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

PURPOSE: Literature dedicated to growth patterns and growth rate influencing factors of radiation-induced meningiomas (RIMs) is limited. To deliver new insights into the topic, a volumetric growth analysis of RIMs was performed. METHODS: This single-center, retrospective cohort study included patients diagnosed with intracranial meningioma who received radiation treatment at least > 5 years before the RIM diagnosis. Volumetric analysis of individual RIMs was performed using 3D volumetry at the time of RIM diagnosis and during follow-up. RIM growth was determined by calculating absolute (AGR), and relative (RGR) growth rates. Prognostic factors associated with RIM growth were evaluated. RESULTS: A total of 26 patients with 33 meningiomas were enrolled in the study and radiologically/clinically followed up during a median duration of 5.6 years (IQR 3.9-8.8 years). Median AGR was 0.19 cm3 per year and the median RGR was 34.5% per year. Surgically managed RIMs were more likely fast-growing compared to observed ones based on the AGR (p < 0.002). The recurrence rate after total resection was 14.3%. Younger age at RIM diagnosis was associated with higher tumor growth (RGR ≥ 30%, p = 0.040). A significant correlation was found between the length of latency period and the RGR (p = 0.005). CONCLUSION: To diagnose RIM as early as possible comprehensive MRI surveillance is required. Younger patients with shorter latency periods may profit from shortened MRI intervals, with further management being dependent on the growth rate and eventual symptomatology.

• MeSH
• Humans MeSH
• Meningeal Neoplasms * diagnostic imaging   radiotherapy   pathology   MeSH
• Meningioma * diagnostic imaging   radiotherapy   pathology   MeSH
• Prognosis MeSH
• Retrospective Studies MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

The accurate identification and preservation of the facial nerve (FN) during vestibular schwannoma (VS) surgery is crucial for maintaining facial function. Investigating the application of diffusion tensor imaging (DTI) in preoperative planning for large VS surgery is provided. PubMed, Cochrane Library, Science Direct, ISI Web of Science, Embase, and additional sources were searched to identify cohort studies about the preoperative DTI usage for the FN tracking before large VS (≥ 2.5 cm) surgery published between 1990 and 2023. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed; the Newcastle-Ottawa Scale was used to assess the risk of bias and to evaluate limitations based on selection/outcome biases. A total of 8 publications yielding 149 VS (mean size 3.66 ± 0.81 cm) were included. Surgical concordance with preoperative DTI FN tracking was 91.67% (range 85-100%). Overall DTI reliability was 88.89% (range 81.81-95.83%). Larger tumor size predicted either DTI inaccurate finding or complete DTI failure (p = 0.001). VS size above > 3.5 cm was associated with a higher risk of DTI failure (p = 0.022), with a higher risk of inaccurate DTI finding preoperatively (p = 0.033), and with a higher House-Brackman score postoperatively (p = 0.007). Application of DTI in larger VS surgery is a valuable FN identification along with electrophysiological monitoring and neuronavigation, therefore also in its preservation and in lowering risk of complications. DTI represents a valuable adjunct to electrophysiological monitoring and neuronavigation in FN identification, applicable not only for smaller, but also larger VS.

• MeSH
• Humans MeSH
• Facial Nerve diagnostic imaging   surgery   pathology   MeSH
• Facial Nerve Injuries * etiology   MeSH
• Reproducibility of Results MeSH
• Neuroma, Acoustic * diagnostic imaging   surgery   complications   MeSH
• Diffusion Tensor Imaging methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Systematic Review MeSH

BACKGROUND: Tumors of the fourth ventricle are frequently treated pathologies in pediatric neurosurgery. Data regarding predictors for permanent neurological deficits, long-term functional outcomes, cerebellar mutism (CM), the extent of resection (EOR), and oncological outcomes are scarce. We attempt to contribute to this topic with an analysis of our institutional cohort. METHODS: A retrospective single-center study of patients aged ≤ 19 years who underwent primary surgical resection of a fourth ventricular tumor over a 15-year period (2006-2021). Predictors analyzed included age, gender, surgical approach, anatomical pattern, tumor grade, EOR, tumor volume, and others as appropriate. RESULTS: One hundred six patients were included (64 males, mean age 7.3 years). The rate of permanent neurological deficit was 24.2%; lateral tumor extension (p = 0.036) and tumor volume greater than 38 cm3 (p = 0.020) were significant predictors. The presence of a deficit was the only significant predictor of reduced (less than 90) Lansky score (p = 0.005). CM occurred in 20.8% of patients and was influenced by medulloblastoma histology (p = 0.011), lateral tumor extension (p = 0.017), and male gender (p = 0.021). No significant difference between the transvermian and telovelar approach in the development of CM was detected (p = 0.478). No significant predictor was found for the EOR. EOR was not found to be a significant predictor of overall survival for both low-grade and high-grade tumors; however, gross total resection (GTR) was protective against tumor recurrence compared to near-total or subtotal resection (p < 0.001). In addition, survival was found to be better in older patients (≥ 7.0 years, p = 0.019). CONCLUSION: The overall rate of postoperative complications remains high due to the eloquent localization. Older patients (> 7 years) have been found to have better outcomes and prognosis. Achieving GTR whenever feasible and safe has been shown to be critical for tumor recurrence. CM was more common in patients with medulloblastoma and in patients with tumors extending through the foramen of Luschka. The telovelar approach uses a safe and anatomically sparing corridor; however, it has not been associated with a lower incidence of CM and neurological sequelae in our series, showing that each case should be assessed on an individual basis.

• MeSH
• Fourth Ventricle diagnostic imaging   surgery   MeSH
• Child MeSH
• Humans MeSH
• Neoplasm Recurrence, Local surgery   MeSH
• Medulloblastoma * surgery   MeSH
• Cerebellar Neoplasms * surgery   etiology   MeSH
• Neurosurgical Procedures adverse effects   MeSH
• Postoperative Complications epidemiology   etiology   surgery   MeSH
• Retrospective Studies MeSH
• Aged MeSH
• Treatment Outcome MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Publication type
• Journal Article MeSH

The aim of this study was to investigate whether white matter changes as measured by diffusion tensor imaging (DTI) can help differentiate shunt-responsive idiopathic normal pressure hydrocephalus (iNPH) patients from patients with other causes of gait disturbances and/or cognitive decline with ventriculomegaly whose clinical symptoms do not improve significantly after cerebrospinal fluid derivation (non-iNPH). Between 2017 and 2022, 85 patients with probable iNPH underwent prospective preoperative magnetic resonance imaging (MRI) and comprehensive clinical workup. Patients with clinical symptoms of iNPH, positive result on lumbar infusion test, and gait improvement after 120-h lumbar drainage were diagnosed with iNPH and underwent shunt-placement surgery. Fractional anisotropy (FA) and mean diffusivity (MD) values for individual regions of interest were extracted from preoperative MRI, using the TBSS pipeline of FSL toolkit. These FA and MD values were then compared to results of clinical workup and established diagnosis of iNPH. An identical MRI protocol was performed on 13 age- and sex-matched healthy volunteers. Statistically significant differences in FA values of several white matter structures were found not only between iNPH patients and healthy controls but also between iNPH and non-iNPH patients. ROI that showed best diagnostic ability when differentiating iNPH among probable iNPH cohort was uncinate fasciculus, with AUC of 0.74 (p < 0.001). DTI methods of white matter analysis using standardised methods of ROI extraction can help in differentiation of iNPH patients not only from healthy patients but also from patients with other causes of gait disturbances with cognitive decline and ventriculomegaly.

• MeSH
• Diffusion Magnetic Resonance Imaging methods   MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Hydrocephalus, Normal Pressure * diagnostic imaging   surgery   MeSH
• Prospective Studies MeSH
• Diffusion Tensor Imaging methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH