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Richard D. Penn, Sadek K. Hilal, W. Jost Michelsen, Eli S. Goldensohn, and Jack Driller

electrodes implanted deeply into that lobe. 1–3, 7 This report describes the feasibility of electrical measurements made from within intracranial vessels and demonstrates their local brain origin, as well as the first human intracranial intravascular electroencephalogram (EEG). Method For an experimental model, adult baboons varying from 40 to 60 lbs were chosen because their cerebral vascular circulation resembles that of man and their vessels are large compared to those of small primates. Previous studies established an optimal catheter configuration for advancing

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Yuji Ito, Satoshi Maesawa, Epifanio Bagarinao, Yu Okai, Daisuke Nakatsubo, Hiroyuki Yamamoto, Hiroyuki Kidokoro, Naotaka Usui, Jun Natsume, Minoru Hoshiyama, Toshihiko Wakabayashi, Gen Sobue, and Norio Ozaki

P harmacoresistant epilepsy accounts for approximately 30% of epilepsy cases. 27 , 32 This causes various comorbidities and diminishes quality of life in patients. In patients with intractable focal epilepsy, accurate identification of the epileptogenic network and eloquent cortices is essential for curative surgery. 9 , 24 Although intracranial EEG (icEEG) recordings are usually required for presurgical evaluation, icEEG is invasive and can only cover a limited space. 15 Noninvasive multimodal evaluation prior to the placement of icEEG

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Chien-Chen Chou, Cheng-Chia Lee, Chun-Fu Lin, Yi-Hsiu Chen, Syu-Jyun Peng, Fu-Jung Hsiao, Hsiang-Yu Yu, Chien Chen, Hsin-Hung Chen, and Yang-Hsin Shih

T he semiology and electroencephalography (EEG) patterns of cingulate gyrus epilepsy are difficult to characterize. Clinical findings could be misleading in predicting the localization of seizure onset. 1 , 13 The variations in semiological features can be attributed to the unique cytoarchitecture and neural fiber projections in the various regions of the cingulate gyrus. 6 There are several methods for the division of the cingulate gyrus; 4 , 21 however, the 4-region neurobiological model of the cingulate cortex is the most useful because it is based on

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Hideaki Tanaka, Jean Gotman, Hui Ming Khoo, André Olivier, Jeffery Hall, and François Dubeau

R esective surgery is useful for drug-resistant focal epilepsy. Two randomized clinical trials have demonstrated that anterior temporal lobe resection for patients with refractory temporal lobe epilepsy (TLE) is more effective than drug treatment in achieving seizure control. 6 , 27 Surgical intervention should be performed after comprehensive presurgical evaluation, 4 and scalp electroencephalography (EEG) and intracerebral EEG (iEEG) are important tools to estimate the epileptogenic zone and identify the seizure-onset zone (SOZ). 19 iEEG recording is

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Chad Carlson, Federica Teutonico, Robert E. Elliott, Yaron A. Moshel, Josiane LaJoie, Daniel Miles, Orrin Devinsky, and Howard L. Weiner

initially focused on patients with a single, dominant epileptogenic tuber. However, a significant proportion of patients with TSC have multiple tubers on neuroimaging and nonlateralizing/nonlocalizing findings on interictal and ictal EEG. These multifocal or generalized cases are not well represented in the published literature because these patients do not undergo resective epilepsy surgery, yet are the most severe and disabling forms of epilepsy and are the most challenging to treat. As such, they represent a significant treatment challenge that requires consideration

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Massimo Collice, Orazio Arena, Romero A. Fontana, Manuela Mola, and Nora Galbiati

stump pressure, 16 measurement of regional cerebral blood flow (CBF), 22 and continuous electroencephalographic (EEG) monitoring. 17, 22 A number of aspects concerning the monitoring systems and cross clamping in general remain to be defined. The value of EEG findings as an index of cerebral ischemia arising from cross clamping has been suggested by several studies. A close correlation between EEG findings and CBF measurement has been reported, 4, 19, 25 and clinical experience has demonstrated that patients who do not show EEG changes tolerate temporary carotid

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Rosa Q. So, Vibhor Krishna, Nicolas Kon Kam King, Huijuan Yang, Zhuo Zhang, Francesco Sammartino, Andres M. Lozano, Richard A. Wennberg, and Cuntai Guan

seizure prediction from thalamic recordings and potentially devising a closed-loop stimulation system. 24 Initial evidence suggests that seizures can be detected earlier from thalamic local field potentials (LFPs) than from scalp electroencephalography (EEG). 25 We have extended these preliminary findings in a series of patients with nonresective yet primarily partial epilepsy who underwent anterior nucleus DBS. We used a nonlinear method of predicting seizures by comparing similarity index (SI) between a reference window and the periictal recordings. 17 We

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induced with thiopental and maintained with 1% enflurane and 70% N 2 O. The patient was initially normotensive with a PaCO 2 of 32 torr and an electroencephalographic (EEG) pattern of “light general anesthesia.” During dissection of the aneurysm, hypotension was induced with nitroprusside to a mean arterial blood pressure of 50 torr, and at this point the patient's EEG changed abruptly to a burst-suppression pattern. However, the PaCO 2 measured at the onset of EEG change was decreased to 18 torr, presumably the result of controlled hyperventilation. At this point

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Neurosurgical Forum: Letters to the editor To The Editor Michael M. Todd , M.D. San Diego, California 424 425 Recently, Sullivan, et al. , described electroencephalographic (EEG) changes occurring as a consequence of combined hypocapnia and modest hypotension during aneurysm surgery (Sullivan HG, Keenan RL, Isrow L, et al: The critical importance of PaCO 2 during intracranial aneurysm surgery. Case report. J Neurosurg 52: 426–430, March, 1980). These changes did not occur when CO 2 was raised, even though blood

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Vera Vigo, Domenica Immacolata Battaglia, Paolo Frassanito, Gianpiero Tamburrini, Massimo Caldarelli, and Luca Massimi

resulting in a bilateral parietal cephalohematomas. The left cephalohematoma gradually resorbed within the 1st month of life, whereas the right one became calcified; no operation was advised at that time. The young girl grew up without any relevant physical and psychomotor problems. However, she had some learning disabilities (writing and reading) associated with a mild attention deficit diagnosed based on neuropsychological testing. For this reason, she received serial electroencephalography (EEG) studies over time that did not show abnormalities. The last EEG study