Infrared thermography brain mapping surveillance in vascular neurosurgery for anterior communicating artery aneurysm clipping.

BACKGROUND: Infrared thermography (IT) is a noninvasive, real-time diagnostic method that requires no contact with the patient and has a broad spectrum of potential applications in neurosurgery. It has been previously demonstrated the high sensitivity and specificity that IT has to detect brain blood flow changes. CASE DESCRIPTION: The case is based on a 64-year-old diabetic and hypertensive male, to whom an anterior communicating artery (ACoA) incidental aneurysm was discovered. We performed the basal infrared thermography mapping (ITM) and immediately after the transitory clip placement in both A1 segments of the anterior cerebral artery (A1-ACA), we performed a second ITM of the exposed brain cortex. After the definitive clip placement in the neck of the ACoA aneurysm, we removed the transitory clips of both A1-ACA and performed a third ITM of the cortical surface, without finding any cortical cooling or significative temperature differences (Ϫt) compared to the basal ITM. The postoperatory computed tomography (CT) and angio-CT did not show any ischemic damage and confirmed the accurate aneurysm clipping. CONCLUSIONS: The ITM seems to be a real-time, safe, and useful brain mapping method to identify different temperature zones and temperature dispersion gradients in the human brain cortex. More studies are needed to evaluate the potential applications of IT mapping of the human brain and its use in neurosurgery and vascular neurosurgery.

[Clinical stabilisation in neurodegenerative diseases: clinical study in phase II]. / Estabilización clínica en enfermedades neurodegenerativas: estudio clínico en fase II.

INTRODUCTION: Neurodegenerative disorders, such as Parkinson's disease (PD), Alzheimer's disease (AD) and multiple sclerosis (MS), are progressive pathological conditions in which current treatments have not proved to be effective at curbing their progress (clinical stabilisation). Although they have very different clinical characteristics, they share the same pathophysiological mechanisms of progression. We developed a compound designed to obtain clinical stabilisation which acts by controlling cell damage due to aberrant apoptosis, oxidation, abnormal deposits of metals and proteins, and pathophysiological enzymatic pathways, such as that of caspases and the MAPK system. PATIENTS AND METHODS: Forty-two patients with AD, PD and MS were included in the study. The compound was administered to them every 12 hours and they were given appointments every three months for a clinical evaluation and a review of general lab analyses. RESULTS: Subjects were submitted to a follow-up of between 3 and 24 months (mean: 8.85 +/- 5.99 months). No clinical side effects were recorded and there were only some slight alterations in the lab test results, although they were not clinically relevant. Clinical stabilisation was achieved in all the patients (100%) with MS and the scores on the Expanded Disability Status Scale improved in four patients (40%); clinical stabilisation in 17 patients (100%) with PD and improvements in the score on the Unified Parkinson's Disease Rating Scale in 15 of them (88.2%); and clinical stabilisation in 12 patients (100%) with AD, and an increase in the score obtained on the minimental test in nine cases (75%). CONCLUSIONS: The compound is safe and a promising therapeutic option, since there is a clear tendency towards clinical stabilisation when it is being used. An experimental study needs to be conducted in order to determine the therapeutic scope of the compound and its possible preventive effects, as well as to evaluate other indications.

[Binocular and monocular visors for neuroendoscopy and endoscopy-assisted neurosurgery]. / Visores binoculares y monoculares para neuroendoscopia y neurocirugía asistida por endoscopia.

This paper reports the testing of a lightweight wearable stereoscopic display during neuroendoscopies and endoscope assisted neurosurgeries. The viewers tested were a binocular (for the surgeon) and a monocular system (for the instrumenting nurse), whose optics are specially designed for wearable, portable applications and comprise a color corrected refractive magnifying system.