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Shih-Tseng Lee, Tai-Ngar Lui, Chen-Nen Chang, and Wen-Chun Cheng

T he occurrence of seizures immediately or during the 2 weeks after supratentorial surgery has been well recognized both in the literature and in daily neurosurgical practice. The development of seizures in patients after posterior fossa surgery is a rather uncommon phenomenon. 2, 3, 7, 9, 16 Most studies of early postoperative seizures have included all intracranial operations or only patients with supratentorial surgery. 1–3, 5, 7–9, 13, 14, 16–20 In our department, no prophylactic anticonvulsant agent is given to patients either before or after posterior

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Joseph R. Thompson, Philip R. Weinstein, and Charles R. Simmons

A rterial dolichoectasia (elongation-distension) is an uncommon condition that may involve intracranial arteries, but rarely causes gigantic enlargement. When severe enlargement does occur, it involves the arteries at the base of the brain. This entity usually presents symptoms like those of an intracranial tumor. 8 Our search of the literature has not revealed a previous case involving cerebral arteries with the exclusion of the carotid or basilar arteries. The occurrence of migraine headache complicated by hemiplegia and the presentation with a seizure adds

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Trisha P. Gupte, Chang Li, Lan Jin, Kanat Yalcin, Mark W. Youngblood, Danielle F. Miyagishima, Ketu Mishra-Gorur, Amy Y. Zhao, Joseph Antonios, Anita Huttner, Declan McGuone, Nicholas A. Blondin, Joseph N. Contessa, Yawei Zhang, Robert K. Fulbright, Murat Gunel, Zeynep Erson-Omay, and Jennifer Moliterno

M eningiomas are the most common central nervous system tumors, and approximately 30%–40% of patients with meningioma have seizures. 1 , 2 Uncontrolled seizures can significantly affect the quality of life of patients with brain tumors and result in cognitive deterioration. 3–6 While seizure freedom can be achieved in approximately 80% of meningioma patients after surgery, some can experience a recurrence, and nearly 20% of meningioma patients without preoperative seizures can develop seizures postoperatively. 3 , 5 , 7 , 8 Given that worse patient outcomes

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Jonathan Roth, Or Bercovich, Ashton Roach, Francesco T. Mangano, Arvind C. Mohan, Guillermo Aldave, Howard L. Weiner, Ulrich-Wilhelm Thomale, Andreas Schaumann, Shimrit Uliel-Sibony, and Shlomi Constantini

“W hat is the chance my child will have seizures following surgery?” is a common question parents ask, both for children with no history of seizures and for those presenting with seizures. Seizures are a frequent comorbidity in both low- and high-grade tumors, seen at presentation in up to 40% of children 1–4 and with increased risk during long-term follow-up. 2 , 3 , 5 As to low-grade gliomas (LGGs), seizures are the most frequent presenting symptom in children and result in a significant decrease in quality of life. 1 , 6 About 50% of cases of LGG

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Paige J. Ostahowski, Nithya Kannan, Mark S. Wainwright, Qian Qiu, Richard B. Mink, Jonathan I. Groner, Michael J. Bell, Christopher C. Giza, Douglas F. Zatzick, Richard G. Ellenbogen, Linda Ng Boyle, Pamela H. Mitchell, Monica S. Vavilala, and for the PEGASUS (Pediatric Guideline Adherence and Outcomes) Study

T raumatic brain injury (TBI) is a serious health problem among children in the United States, resulting in over 250,000 emergency department (ED) visits and up to 13,500 hospitalizations annually. 23 Posttraumatic seizures are a common complication associated with TBI, particularly in cases of severe TBI. 17 , 18 , 21 Since they can cause hypoxia, increased intracranial pressure, increased metabolite production, and higher metabolic demands, seizures may result in secondary brain injury that can have detrimental long-term developmental effects. 1 , 12

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Neil Klinger and Sandeep Mittal

E pilepsy has an estimated lifetime prevalence of 7.6 cases per 1000 persons and an incidence of 68 cases per 100,000 individuals internationally. 19 In the 2010 Global Burden of Disease Study, epilepsy was found to have a worldwide burden second only to migraine headaches among neurological disorders. 48 The International League Against Epilepsy defines drug-resistant epilepsy as a failure to achieve sustained seizure freedom after two appropriately chosen, tolerated, and scheduled antiepileptic drugs (AEDs), whether they are given as monotherapy or in

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Taylor J. Abel, Royce W. Woodroffe, Kirill V. Nourski, Toshio Moritani, Aristides A. Capizzano, Patricia Kirby, Hiroto Kawasaki, Matthew Howard III, and Mary Ann Werz

T emporal lobe epilepsy (TLE) is the most common type of surgically remediable intractable epilepsy in adults. Of the appropriately selected patients with medically intractable TLE who undergo cortico-amygdalohippocampectomy (CAH), 60%–80% demonstrate long-term seizure freedom and up to 95% have improvement in seizure control. 16 , 23 , 34 In a significant proportion of patients with TLE, seizures arise from the mesial temporal lobe, which is associated with a syndrome defined as mesial temporal lobe epilepsy (MTLE). This syndrome is typified by neuroimaging

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David Satzer, James X. Tao, and Peter C. Warnke

invasive alternative to SelAH with no need for craniotomy and lateral temporal manipulation. In large studies, at 1 year after surgery the rate of Engel class I outcome, defined as freedom from disabling seizures, was 53%–58% for SLAH, 6 , 7 compared with 59%–71% for SelAH 8 , 9 and 58%–66% for ATL. 9 , 10 Despite these surgical advances, it remains unclear which structures need to be resected or ablated in order to achieve seizure freedom. While standard techniques for ATL and SelAH are well established, there is considerable variation in actual extent of resection

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Tal Gonen, Rachel Grossman, Razi Sitt, Erez Nossek, Raneen Yanaki, Emanuela Cagnano, Akiva Korn, Daniel Hayat, and Zvi Ram

A wake craniotomy with intraoperative mapping and monitoring is a well-established surgical technique to achieve maximal tumor resection when the tumor is located within or adjacent to eloquent brain regions. Awake craniotomy has been shown to minimize the risk of permanent postoperative neurological deficits and to better preserve the patient's quality of life. 1 , 2 , 6 , 18 , 20 , 22 , 23 Seizures are a common presenting symptom in patients with brain tumors. Previous studies have reported that 30%–50% of patients with brain tumors experience a seizure

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Katharina Hess, Dorothee Cäcilia Spille, Alborz Adeli, Peter B. Sporns, Caroline Brokinkel, Oliver Grauer, Christian Mawrin, Walter Stummer, Werner Paulus, and Benjamin Brokinkel

I mproving the prediction of perioperative seizures remains crucial in the neurosurgical and neurological care of patients with meningioma. 4 Brain invasion by meningiomas is characterized by tonguelike infiltration of tumor cells into the underlying parenchyma and breakdown of the arachnoid layer. 15 , 20 Several studies have found a subsequent strong astrocytic response and alterations of the adjacent cortex, 7 , 13 , 17 , 18 , 24 and brain invasion was found to correlate with increased peritumoral brain edema (PTBE); 11 both of these factors possibly