Mirror Neurons & Autism

Have you ever seen someone take a bite out of a red juicey apple and almost tasted it youself. That is the work of your “mirror neurons” doing their job. They were first discovered in the early 1990s, when a team of Italian researchers found individual “mirrror neurons” in the brains of macaque monkeys that fired both when the monkeys grabbed an object and also when the monkeys watched another primate grab the same object. Disgust, embarassment, and lust are based on a uniquely human mirror neuron system found in a part of the brain called the insula.
There has been new research done into the area of these mirror cells and Autism. Ever since autism was identified It has been a struggle to find out what causes it. We know It can be inherited, but the enviroment may also play some part. In people with autism their main signs are lack of eye contact and absence of empathy. They may also have problems understanding metaphors, sometimes taking them literally. Another very unusual behavior is an extreme dislike or complete aversion to certain sounds or noises that sets off bells in their heads. This Is A GREAT article by
Vilayanur S. Ramachandran and Lindsay M. Oberman in Scientific American
about Autistic children and the reserch done on the mirror cells. I could not stop reading.
I hope Every one likes it.

paramagnetic effects of supplemental oxygen on FLAIR images

This is an Intersting paper on the effects oxygen has on the FLAIR sequences. Oxygen can have an effect on CSF on patiens recieveing oxygen during an MR exam. http://www.ajnr.org/cgi/reprint/25/2/274.pdf
****Since I first posted this article I have witnessed this first hand sevral times now. The patients have been on ventilators with high levels of oxygen and the Rads have refered back to this article when reading the brain scan.**** Thanks again to the contributors of the article
Yoshimi Anzai, Makiko Ishikawa, Dennis W. W. Shaw, Alan Artru,
Vasily Yarnykh, and Kenneth R. Maravilla.

WHEN THE BONE FLAP HITS THE FLOOR

I Had to post this ………….I saw this Info online I thought I would Share with everyone.

When the Bone Flap Hits the Floor. Neurosurgery. 59(3):585-590, September 2006.Brian T. Jankowitz, M.D.; Douglas S. Kondziolka, M.D.

Links: Abstract HTML PDF (447 K)
Abstract: OBJECTIVE: There is no published data in the neurosurgical literature describing the incidence, treatment, or outcome of contaminating a bone flap. We reviewed our departmental experience to determine methods of prevention and assess our treatment strategies.
METHODS: We retrospectively reviewed all incidents of dropped bone flaps during a craniotomy at a single medical center during a 16-year period. In addition, a questionnaire was mailed to neurosurgeons in the United States and abroad asking their own experience and method of management.
RESULTS: Fourteen incidents of dropped bone flaps occurred during a 16-year period. Follow-up varied from 2 to 176 months. The bone flap was dropped while elevating the bone (n = 4), when handing the bone off the field (n = 4), and during plating (n = 4). The context was unknown in two cases. Management included soaking the flap in betadine and/or antibiotic solution (n = 8), autoclaving (n = 2), or discarding the bone flap and replacing with a mesh cranioplasty (n = 3). The treatment remains unknown in one case. No instances of infection were noted in follow-up. In response to the survey, 66% (33 out of 50) of the polled neurosurgeons had experienced this complication during their practice, and 83% would replace the bone flap after disinfection.

CONCLUSION: Dropping a bone flap during neurosurgery remains an uncommon but preventable complication. Treatment options include discarding the bone followed by cranioplasty versus replacing the bone after treatment with antibiotic irrigation, betadine, and/or autoclaving. Replacement after disinfection is an appropriate option for contaminated bone flaps that avoids the expense and time of cranioplasty.
Copyright (C) by the Congress of Neurological Surgeons

live webcast

MRI-Guided Brain Tumor Removal With Cortical Mapping
Children’s intraoperative MRI system is the 1st and only system of its kind in a pediatric hospital
October 25, 2006 at 1:00 PM EDT (17:00 UTC)
From Children’s Hospital Boston
Neurosurgery Webcast: Neurosurgeons at Children’s Hospital Boston to perform MRI- guided brain tumor removal with cortical mapping on a 13-year-old during live Webcast
On Wednesday, Oct. 25, at 1:00 p.m. EDT, neurosurgeons at Children’s Hospital Boston will remove a brain tumor employing functional mapping of the cortex on a 13-year-old pediatric patient during a live Webcast. Children’s hosts three to four Webcasts annually to showcase its pioneering care and technology to specialists and referring physicians around the world, and to educate consumers on the latest and MORE…
Neurosurgery Webcast: Neurosurgeons at Children’s Hospital Boston to perform MRI- guided brain tumor removal with cortical mapping on a 13-year-old during live Webcast
On Wednesday, Oct. 25, at 1:00 p.m. EDT, neurosurgeons at Children’s Hospital Boston will remove a brain tumor employing functional mapping of the cortex on a 13-year-old pediatric patient during a live Webcast. Children’s hosts three to four Webcasts annually to showcase its pioneering care and technology to specialists and referring physicians around the world, and to educate consumers on the latest and most innovative medical treatments available.
The Webcast will feature Children’s intraoperative MRI system, known as the MR-OR, the first and only system of its kind at a pediatric hospital in the country. Developed by IMRIS, the iSPACE surgical imaging suite captures digital images through a unique, ceiling-mounted, movable MRI scanner that can be used to take high-resolution, real-time patient scans before, during and after a surgical procedure. This advanced technology allows surgeons to determine the extent of a tumor while the patient is undergoing surgery to ensure its accurate removal.
“Unlike other intraoperative MR machines, the mobile MRI lets surgeons use their usual metal surgical tools because the unit is moved into the shielded garage when surgeons are operating,” says Joseph R. Madsen, MD, a neurosurgeon in the Department of Neurosurgery at Children’s Hospital Boston and associate professor of Surgery at Harvard Medical School.
Dr. Madsen will operate on a patient with oligodendroglioma, a low-grade tumor arising from glial cells in the central nervous system. The tumor lies near motor and sensory areas of the brain, which will require electrocorticography and physiological tests to map the normal brain around the tumor before the surgery. Once the mapping has been completed, Dr. Madsen will then perform a microsurgical resection of the tumor.
Brain tumors are the most common solid tumors in children—approximately 1,800 are diagnosed in the United States each year. Today, more than half of all children diagnosed with a brain tumor will be cured of the disease. The most effective form of treatment is the surgical removal of all or part of the tumor without jeopardizing any of the brain’s critical functions. In order to decide which areas of the tumor can safely be removed, neurosurgeons use the technique of brain mapping.
“The cutting edge of neurosurgery is to identify and remove as much of the undesirable pathologically damaging brain tissue without disturbing the functioning areas of the brain,” says Dr. Madsen. “Through the use of physiological mapping and the MR-OR, we are able to achieve this and assure our patients the best possible surgical outcomes.”
Dr. Madsen will be assisted by neurologist Frank H. Duffy, MD, radiologist Carolyn Robson, MB, ChB, and associate anesthesiologist-in-chief Mark A. Rockoff, MD. They will also serve as Webcast commentators, providing additional information about the procedure throughout the surgery.
Moderating the live broadcast will be neurosurgeon Mark R. Proctor, MD. Neurosurgeon-in-chief R. Michael Scott, MD, will introduce the Webcast and offer insight into pediatric brain tumors. Liliana C. Goumnerova, MD, and Mark Kieran, MD, PhD, the surgical and medical directors of the Brain Tumor Clinic, a collaborative program with Dana-Farber Cancer Institute, will also be on-hand to discuss the neuro-oncological aspects of the procedure, while Craig D. McClain, MD, and Keith Ligon, MD, will comment on the anesthesia and neuropathology, respectively. An 11-year-old brain tumor patient, who recently underwent a similar procedure in the MR-OR, and his family will also answer questions during the Webcast.
View CBS4 Boston news story with Dr. Goumnerova regarding a successful brain surgery on a 13 year old girl. Click Here
Founded in 1869 as a 20-bed hospital for children, Children’s Hospital Boston today is the nation’s leading pediatric medical center, the largest provider of health care to Massachusetts children, and the primary pediatric teaching hospital of Harvard Medical School. In addition to 347 pediatric and adolescent inpatient beds and comprehensive outpatient programs, Children’s houses the world’s largest research enterprise based at a pediatric medical center, where its discoveries benefit both children and adults. More than 500 scientists, including eight members of the National Academy of Sciences, nine members of the Institute of Medicine and 11 members of the Howard Hughes Medical Institute comprise Children’s research community. For more information about the hospital visit: http://www.childrenshospital.org/newsroom
IMRIS Inc. designs and manufactures advanced surgical imaging systems for use in cranial, spinal and general surgery applications. IMRIS is focused exclusively on providing fully integrated surgical imaging solutions that support the effectiveness of the surgical team. For more information about the IMRIS iSPACE™ solution visit: www.imris.com

MR Angiography

MR angiography has come such a long way in such a short time. We are doing so many MRA runoff’s. We have been doing many MRA’s from the ER for cold legs, becuase of the speed of which the procedure can be done. We are will do an MRA first then the DR will decide weather to take the patient to Surgery or to the Angio suite for angioplasty. The Radiologist like this becuase they don’t have to do an angiogram anymore, unless they already know for sure they will be putting in stents doing angioplasty.