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Mathias Kunz, Philipp Karschnia, Ingo Borggraefe, Soheyl Noachtar, Joerg-Christian Tonn, and Christian Vollmar

E pilepsy surgery is a well-proven and powerful treatment option in drug-resistant focal epilepsy. 1 , 2 After careful presurgical evaluation and patient selection, most patients achieve postsurgical improvement in seizure burden, 3 – 5 cognition, 6 quality of life, 7 and social outcomes. 8 The boundary of the surgical target depends on the location and extent of the epileptogenic zone (EZ) but may be limited by adjacent eloquent structures. A detailed presurgical evaluation is therefore indispensable and includes noninvasive and invasive video

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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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Tomer Gazit, Fani Andelman, Yifat Glikmann-Johnston, Tal Gonen, Aliya Solski, Irit Shapira-Lichter, Moran Ovadia, Svetlana Kipervasser, Miriam Y. Neufeld, Itzhak Fried, Talma Hendler, and Daniella Perry

A crucial aspect of neurosurgery within or close to eloquent cortex is the preoperative identification of brain regions involved in a number of cognitive, sensory, or motor tasks. In the presurgical assessment of language, both the localization 38 and lateralization 28 , 32 of functional areas are essential for the prevention of postoperative deficits such as aphasia and dysarthria. More specifically, assessing language lateralization in patients with epilepsy is challenging and complex because of their atypical language network. Language structure

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Hesheng Liu, Randy L. Buckner, Tanveer Talukdar, Naoaki Tanaka, Joseph R. Madsen, and Steven M. Stufflebeam

. 5 , 49 However, normal variation and distortions due to the brain lesion make it difficult to localize functional areas precisely based on anatomical landmarks alone. 4 , 26 , 35 , 41 In response to these challenges, functional mapping in individual patients has become an important procedure for surgical planning and risk assessment. Invasive cortical mapping is often considered the gold standard for functional mapping. 12 , 21 , 27 , 37 , 48 Direct cortical stimulation is managed perioperatively in the awake patient or in the presurgical patient with

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Tianyi Qian, Wenjing Zhou, Zhipei Ling, Shangkai Gao, Hesheng Liu, and Bo Hong

I nformation about the anatomical relationship between eloquent cortex and the area to be excised is extremely valuable in neurosurgical treatment. In neurosurgical patients, not only the cortical anatomy but also the locations of functional networks are often distorted due to various pathological changes. 2 , 20 , 44 , 51 , 55 To map the eloquent cortices, invasive cortical stimulation is often managed perioperatively in the awake patient or in the presurgical patient with subdural grids implanted. 14 , 23 , 29 , 45 , 60 Presurgical mapping based on ECS

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Austin K. Mattox, Ankit I. Mehta, Peter M. Grossi, Thomas J. Cummings, and D. Cory Adamson

(stained with DAPI). Preoperative Chemotherapy Based on the cytogenetic results and a prior report of activity of imatinib (a PDGFRβ-targeted small-molecule inhibitor) against DFSP, we started the patient on a course of imatinib (400 mg twice daily). 34 The goal of presurgical chemotherapy was to decrease the risk of hemorrhagic complications, making resection safer and more feasible. Within days, the patient noted significantly reduced bleeding, and 2 weeks after treatment, a head CT revealed a marked decrease in tumor mass. Treatment was continued for 6 weeks

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Anna Miserocchi, Beatrice Cascardo, Chiara Piroddi, Dalila Fuschillo, Francesco Cardinale, Lino Nobili, Stefano Francione, Giorgio Lo Russo, and Massimo Cossu

epilepsy surgery, including that for TLE, results from an appropriate selection of candidates and from an accurate presurgical evaluation aimed at the identification of the EZ, which is defined as the area of ictal onset and primary organization of the ictal discharge. 24 Traditionally, the localization of the EZ requires concordance among presurgical clinical, electrophysiological, and neuroradiological data. Despite the increased localizing power provided by highresolution MRI of the brain, which may also identify subtle potentially epileptogenic lesions, 41 the

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Savannah K. Gibbs, Stephen Fulton, Basanagoud Mudigoudar, Frederick A. Boop, and Shalini Narayana

Presurgical mapping of eloquent cortex is especially critical in pediatric patients with brain tumors in whom in addition to being an effective treatment, early surgical intervention has the potential to minimize cognitive and neuropsychiatric sequelae and improve overall quality of life. 1–4 Given that nearly 22% of American children speak a language other than English at home, 5 with two-thirds of the world’s population speaking two or more languages, 6 an increasing number of neurosurgical candidates present with language-specific concerns best

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Massimo Cossu, Francesco Cardinale, Nadia Colombo, Roberto Mai, Lino Nobili, Ivana Sartori, and Giorgio Lo Russo

foramen ovale electrodes. 44 Authors pf several papers report on indications for, results of, and deaths associated with subdural recordings in children. 8, 20, 26, 33, 41, 48 On the other hand, a number of studies on clinical series include pediatric patients who were evaluated presurgically with intracerebral electrodes, 9, 15, 31, 40 but an exhaustive study fully addressing the issue of using these tools in children is still lacking. The aim of the present work is to report on the use of stereotactically implanted multilead intracerebral electrodes placed

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Marco Losa, Pietro Mortini, Laura Urbaz, Paolo Ribotto, Tristana Castrignanò, and Massimo Giovanelli

(all in Group 2). Postoperative diabetes insipidus, lasting at least 2 months, developed in 10 patients (3.5%). Its occurrence was similar in Group 1 and 2 patients (2.8 and 4.2%, respectively; p = 0.74). Postoperative worsening of pituitary function was quite uncommon: hypogonadism occurred in one (Group 1) of the 156 patients at risk, hypothyroidism in two (both Group 2) of the 246 patients at risk, and hypoadrenalism in two (both Group 2) of the 276 patients at risk. Discussion Previous Results of Presurgical Treatment As chronic therapy with