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Article ; Online: Letter to the Editor: Awake Craniotomy for Intracranial Gliomas During Coronavirus Disease 2019 Pandemic.

Núñez-Velasco, Santiago / Mercado-Pimentel, Rodrigo / Rodríguez-Arias, Regina

2020 Volume 140, Page(s) 470–472

MeSH term(s)	Betacoronavirus ; Brain Neoplasms/diagnosis ; Brain Neoplasms/surgery ; COVID-19 ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Craniotomy/methods ; Glioma/diagnosis ; Glioma/surgery ; Humans ; Pandemics/prevention & control ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; SARS-CoV-2 ; Wakefulness
Keywords	covid19
Language	English
Publishing date	2020-05-30
Publishing country	United States
Document type	Letter
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2020.05.219
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Article: Awake Surgery With Visual Pathway Mapping in Low Grade Glioma Surgery.

Sangrador-Deitos, Marcos V / Uribe-Pacheco, Rodrigo / Balcázar-Padrón, Juan C / Díaz-Bello, Sergio / Núñez-Velasco, Santiago

Cureus

2022 Volume 14, Issue 2, Page(s) e22135

Abstract: The visual pathway and its defects have been thoroughly studied in clinical correlation to temporal lobe lesions related to epilepsy and traumatic lesions. Nevertheless, its clinical correlation and other decision-making have not been addressed regarding ...

Abstract	The visual pathway and its defects have been thoroughly studied in clinical correlation to temporal lobe lesions related to epilepsy and traumatic lesions. Nevertheless, its clinical correlation and other decision-making have not been addressed regarding neoplastic lesions. We present a case report of a 28-year-old man with a one-year history of generalized seizures and left superior homonymous quadrantanopia, with no other neurological disturbance on physical examination. According to diffusion tensor imaging tractography, MRI demonstrated a non-enhancing, right temporal lesion disrupting the visual pathway. An awake surgery with direct cortical electrostimulation of visual pathways was performed with subtotal resection of the tumor to preserve visual function, confirmed with postoperative MRI. Histopathological studies revealed a fibrillary astrocytoma. Surgical technique aided with intraoperative cortical and subcortical stimulation involving low-grade gliomas in eloquent areas is an exceptionally suitable procedure for complex cases where the visual pathway is compromised. Our objective is to describe how intraoperative mapping of visual function is performed in our institution and to comment on the relevant technical nuances, which can serve as a practical guideline for young neurosurgeons, as no previous cases have been reported in our country.
Language	English
Publishing date	2022-02-11
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.22135
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Article: Letter to the Editor: Awake Craniotomy for Intracranial Gliomas During Coronavirus Disease 2019 Pandemic

Núñez-Velasco, Santiago / Mercado-Pimentel, Rodrigo / Rodríguez-Arias, Regina

World Neurosurg

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #637213
Database	COVID19

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Article: Frontal aslant tract: Anatomy and tractography description in the Mexican population.

Marian-Magaña, Ricardo / González-González, Andrea C / Miranda-García, Luis A / Villanueva-Solórzano, Pedro / González-González, María E / Mejía-Pérez, Sonia Iliana / Nuñez-Velasco, Santiago

Surgical neurology international

2022 Volume 13, Page(s) 349

Abstract: ... sequences of patients of the National Institute of Neurology and Neurosurgery "Manuel Velasco Suárez." Five ...

Abstract	Background: The aim of the study was to describe the origin, course, and termination of frontal aslant tract (FAT) in the Mexican population of neurosurgical referral centers. Methods: From January 2018 to May 2019, we analyzed 50 magnetic resonance imaging (MRI) studies in diffusion tensor imaging sequences of patients of the National Institute of Neurology and Neurosurgery "Manuel Velasco Suárez." Five brains were fixed by the Klingler method and dissected in the neurosurgery laboratory of the Hospital Civil de Guadalajara to identify the origin, trajectory, and ending of the FAT. Results: FAT was identified in 100% of the MRI and brain dissections. The origin of the FAT was observed in 63% from the supplementary premotor area, 24% from the supplementary motor area, and 13% in both areas. Its ending was observed in the pars opercularis in 81%, pars triangularis in 9%, and in both pars opercularis and ventral premotor area in 10% in the magnetic resonance images, with a left side predominance. In the hemispheres dissections, the origin of FAT was identified in 60% from the supplementary premotor area, 20% from the supplementary motor area, and 20% in both areas. Its ending was observed in the pars opercularis in 80% and the pars triangularis in 20%. It was not identified as an individual fascicle connected with the contralateral FAT. Conclusion: In the Mexican population, FAT has a left predominance; it is originated more frequently in the supplementary premotor area, passes dorsal to the superior longitudinal fascicle II and the superior periinsular sulcus, and ends more commonly in the pars opercularis.
Language	English
Publishing date	2022-08-12
Publishing country	United States
Document type	Journal Article
ISSN	2229-5097
ISSN	2229-5097
DOI	10.25259/SNI_208_2022
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Article ; Online: Analysis of Intraoperative Seizures During Bipolar Brain Mapping in Eloquent Areas: Intraoperative Seizures in brain mapping.

Mamani, Rocio / Jacobo, Javier A / Mejia, Sonia / Nuñez-Velasco, Santiago / Aragon-Arreola, Jorge / Moreno, Sergio

Clinical neurology and neurosurgery

2020 Volume 199, Page(s) 106304

Abstract: Objectives: Awake Craniotomy (AC) is a very well described technique that is performed to make an adequate tumor resection preserving the functionality of the patient. Intraoperative Seizures (IS) are reported as a failure of such procedure. We analyze ... ...

Abstract	Objectives: Awake Craniotomy (AC) is a very well described technique that is performed to make an adequate tumor resection preserving the functionality of the patient. Intraoperative Seizures (IS) are reported as a failure of such procedure. We analyze the incidence and risk factor during AC. Methods: We made a review of the database of the National Institute of Neurology and Neurosurgery between January 2017 and May 2019 for intrinsic tumors located in eloquent areas of the brain. An analysis of ISconcerning the clinical history, clinical presentation, imaging techniques, histological findings and surgical technique was made. The factors associated with Mapping Failure (MF) were also evaluated. Results: 45 patients were included of whom 7 patients (15.6%) developed IS after cortical-subcortical stimulation, 5 presented partial motor seizures (11.1%) and 2 experimented generalized secondary seizures (4.5%). Of the patients that had a MF, one patient (14%) was due to generalized tonic-clonic seizures which couldn't be managed by cold saline irrigation and administration of anti-seizures drugs and was then converted to a general anesthetic technique. We observed that the patients that had a bigger tumoral volume (112.2 cm3 85.3, P = 0,07) had a bigger positive relation in presenting IS, having a peak sensibility and specificity above 70 cc (ROC). Conclusions: In our analysis IS are more common in patients with high presurgical tumor volume. Even though the majority of the patients that presented IS didn't develop MF, it is important to acknowledge that the multidisciplinary group in the operating room must be prepared to detect these complications, treat them promptly and avoid MF.
MeSH term(s)	Adult ; Aged ; Brain Mapping/methods ; Brain Neoplasms/complications ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/surgery ; Databases, Factual ; Female ; Humans ; Intraoperative Neurophysiological Monitoring/methods ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Retrospective Studies ; Seizures/diagnostic imaging ; Seizures/etiology ; Seizures/surgery ; Tumor Burden/physiology
Language	English
Publishing date	2020-10-13
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2020.106304
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Article ; Online: Awake surgery with cortical-subcortical mapping in diffuse gliomas adjacent to central lobe. Report of two cases and literature review.

Núñez-Velasco, Santiago / Avendaño-Méndez-Padilla, Javier / García-Iturbide, Ricardo / Pech-Cervantes, Claudio H / Molina-Martínez, Cristian A / Mejía-Pérez, Sonia

Cirugia y cirujanos

2019 Volume 87, Issue 4, Page(s) 459–465

Abstract: Introduction: Diffuse gliomas are brain neoplasms with an infiltrative growing pattern to cortical and subcortical structures, frequently adjacent to eloquent areas; direct cortical and subcortical stimulation in awake craniotomy is a useful tool to ... ...

Title translation	Cirugía despierta con mapeo cortico-subcortical en gliomas difusos adyacentes al lóbulo central. Reporte de dos casos y revisión de la literatura.
Abstract	Introduction: Diffuse gliomas are brain neoplasms with an infiltrative growing pattern to cortical and subcortical structures, frequently adjacent to eloquent areas; direct cortical and subcortical stimulation in awake craniotomy is a useful tool to achieve a gross total resection with the least neurological deficit. Presentation of cases: A 24 years old male presented with tonic-clonic seizures. The magnetic resonance imaging (MRI) showed a left parietal glioma. Awake craniotomy was performed using neuronavigation system and brain mapping with cortical and subcortical stimulation. Functional areas were found at the rostral margin of the tumor; however, the rest of the tumor was almost totally resected. Patient was discharged without neurological deficit. A 29 years old male presented in two occasions generalized tonic-clonic seizures, with right hemiparesis. The MRI showed a left parietal glioma. Awake craniotomy was performed using neuronavigation system and brain mapping with cortical and subcortical stimulation, achieving a gross total resection. Patient was discharged without neurological deficit. Conclusions: Awake craniotomy with brain mapping by cortical and subcortical stimulation and neuronavigation, are the best assets to treat diffuse gliomas and achieve a gross total resection, ensuring the major disease-free interval and preserving the function of eloquent areas.
MeSH term(s)	Adult ; Brain Mapping ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/pathology ; Brain Neoplasms/physiopathology ; Brain Neoplasms/surgery ; Craniotomy/methods ; Disease-Free Survival ; Glioma/diagnostic imaging ; Glioma/pathology ; Glioma/physiopathology ; Glioma/surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Neuronavigation/methods ; Seizures/etiology ; Wakefulness ; Young Adult
Language	English
Publishing date	2019-07-02
Publishing country	Mexico
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	730699-4
ISSN	2444-054X ; 0009-7411
ISSN (online)	2444-054X
ISSN	0009-7411
DOI	10.24875/CIRU.18000753
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Article ; Online: Response to SARS-CoV-2 Pandemic in a Non-COVID-19 Designated Latin-American Neurosurgery Department.

Núñez-Velasco, Santiago / Mercado-Pimentel, Rodrigo / Ochoa-Plascencia, Miguel / Rodríguez-Arias, Regina / Lopez-Espinoza, Gerardo / González-González, Maria Elena / Estrella-Sánchez, Carlos / Ramírez-Huerta, Carlos

World neurosurgery

2020 Volume 142, Page(s) 506–512

Abstract: Background: Mexico declared the first case of novel coronavirus disease (COVID-19) in February 2020. At the time we write this article, our country is facing a community spread phase, expecting a rapid increase in the number of cases and fatalities. The ...

Abstract	Background: Mexico declared the first case of novel coronavirus disease (COVID-19) in February 2020. At the time we write this article, our country is facing a community spread phase, expecting a rapid increase in the number of cases and fatalities. The Fray Antonio Alcalde Civil Hospital of Guadalajara has been declared a non-COVID-19 hospital with the mission of providing care to patients already registered and also those transferred from neurosurgical departments of neighboring centers, which have been converted into COVID-19 only hospitals. Methods: An organized response regarding personnel, surgical case selection, operating room behavior, and facility reorganization were designed to prevent an internal coronavirus outbreak in the neurosurgery department at the Fray Antonio Alcalde Civil Hospital of Guadalajara. Results: Distancing actions by the staff and residents, including ward case discussions, neurosurgery rounds, and classes, will be carried out virtually. We classified neurosurgical patients into 4 groups depending on whether their condition demands care in 0-6 hours, 6-48 hours, 48 hours to 14 days, and >14 days. Subsequently, a questionnaire with epidemiologic, radiologic, clinical, and serologic criteria will be applied to determine the risk of COVID-19 infection to define to which area they are going to be transferred according to the different risk zones in our facility. Conclusions: Despite not being a COVID-19 center, we consider all patients at the neurosurgical ward and staff members as asymptomatic carriers or infected in the preclinical period. Specific measures must be taken to ensure the safety and care of neurosurgical patients and medical staff during the community spread phase.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Environment Design ; Hospital Departments ; Hospital Units ; Humans ; Mexico/epidemiology ; Neurosurgery ; Neurosurgical Procedures ; Operating Rooms ; Pandemics ; Personal Protective Equipment ; Personnel Staffing and Scheduling ; Pneumonia, Viral/epidemiology ; Risk Assessment ; SARS-CoV-2 ; Triage
Keywords	covid19
Language	English
Publishing date	2020-05-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2020.05.019
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Article ; Online: Response to SARS-CoV-2 Pandemic in a Non-COVID-19 Designated Latin-American Neurosurgery Department

World Neurosurgery

2020 Volume 142, Page(s) 506–512

Keywords	Surgery ; Clinical Neurology ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2020.05.019
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Article: Response to SARS-CoV-2 Pandemic in a Non-COVID-19 Designated Latin-American Neurosurgery Department

World Neurosurg

Abstract	Background: Mexico declared the first case of novel coronavirus disease (COVID-19) in February 2020. At the time we write this article, our country is facing a community spread phase, expecting a rapid increase in the number of cases and fatalities. The Fray Antonio Alcalde Civil Hospital of Guadalajara has been declared a non-COVID-19 hospital with the mission of providing care to patients already registered and also those transferred from neurosurgical departments of neighboring centers, which have been converted into COVID-19 only hospitals. Methods: An organized response regarding personnel, surgical case selection, operating room behavior, and facility reorganization were designed to prevent an internal coronavirus outbreak in the neurosurgery department at the Fray Antonio Alcalde Civil Hospital of Guadalajara. Results: Distancing actions by the staff and residents, including ward case discussions, neurosurgery rounds, and classes, will be carried out virtually. We classified neurosurgical patients into 4 groups depending on whether their condition demands care in 0-6 hours, 6-48 hours, 48 hours to 14 days, and >14 days. Subsequently, a questionnaire with epidemiologic, radiologic, clinical, and serologic criteria will be applied to determine the risk of COVID-19 infection to define to which area they are going to be transferred according to the different risk zones in our facility. Conclusions: Despite not being a COVID-19 center, we consider all patients at the neurosurgical ward and staff members as asymptomatic carriers or infected in the preclinical period. Specific measures must be taken to ensure the safety and care of neurosurgical patients and medical staff during the community spread phase.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #232523
Database	COVID19

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Article: Predicting Regions of Local Recurrence in Glioblastomas Using Voxel-Based Radiomic Features of Multiparametric Postoperative MRI.

Cepeda, Santiago / Luppino, Luigi Tommaso / Pérez-Núñez, Angel / Solheim, Ole / García-García, Sergio / Velasco-Casares, María / Karlberg, Anna / Eikenes, Live / Sarabia, Rosario / Arrese, Ignacio / Zamora, Tomás / Gonzalez, Pedro / Jiménez-Roldán, Luis / Kuttner, Samuel

Cancers

2023 Volume 15, Issue 6

Abstract: The globally accepted surgical strategy in glioblastomas is removing the enhancing tumor. However, the peritumoral region harbors infiltration areas responsible for future tumor recurrence. This study aimed to evaluate a predictive model that identifies ... ...

Abstract	The globally accepted surgical strategy in glioblastomas is removing the enhancing tumor. However, the peritumoral region harbors infiltration areas responsible for future tumor recurrence. This study aimed to evaluate a predictive model that identifies areas of future recurrence using a voxel-based radiomics analysis of magnetic resonance imaging (MRI) data. This multi-institutional study included a retrospective analysis of patients diagnosed with glioblastoma who underwent surgery with complete resection of the enhancing tumor. Fifty-five patients met the selection criteria. The study sample was split into training (N = 40) and testing (N = 15) datasets. Follow-up MRI was used for ground truth definition, and postoperative structural multiparametric MRI was used to extract voxel-based radiomic features. Deformable coregistration was used to register the MRI sequences for each patient, followed by segmentation of the peritumoral region in the postoperative scan and the enhancing tumor in the follow-up scan. Peritumoral voxels overlapping with enhancing tumor voxels were labeled as recurrence, while non-overlapping voxels were labeled as nonrecurrence. Voxel-based radiomic features were extracted from the peritumoral region. Four machine learning-based classifiers were trained for recurrence prediction. A region-based evaluation approach was used for model evaluation. The Categorical Boosting (CatBoost) classifier obtained the best performance on the testing dataset with an average area under the curve (AUC) of 0.81 ± 0.09 and an accuracy of 0.84 ± 0.06, using region-based evaluation. There was a clear visual correspondence between predicted and actual recurrence regions. We have developed a method that accurately predicts the region of future tumor recurrence in MRI scans of glioblastoma patients. This could enable the adaptation of surgical and radiotherapy treatment to these areas to potentially prolong the survival of these patients.
Language	English
Publishing date	2023-03-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15061894
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