.. On the following day, a right temporal parietal craniotomy was performed and the lesion was entirelyremoved using the operating microscope (Figure 4g). Postoperative angiography confirmed complete resection of the AVM (Figures 4h and 4i).The patient recovered well from the

surgery apart from a generalized convulsion 48 hours postoperatively and a temporary left inferior homonymous quadrantanopia. Case history 3 A 28-year-old technician in a cardiac hemodynamic laboratory was admitted 48 hours after a generalized convulsion. ACT scan showed a 1.5-cm hemorrhaglc lesion in the left parietal lobe (Figure 5a). MRI confirmed the presence of a 1.5-cm CM located within the white Inhibitors,research,lifescience,medical matter just below the dominant supramar-ginal gyrus with signs of a recent perilesional bleed (Figures 5b and 5c). Preoperalively. an activated positron emission tomography (PET) scan was performed using intra-arterial injection of an 15O-loaded saline bolus. Using several functional tests of language Inhibitors,research,lifescience,medical including synonym generation and calculation, it was possible to detect increased cerebral blood flow (CBF) in the left superior

parietal lobule quite remote from the lesion (Figure 5d). Additional tasks of reading and synonym Inhibitors,research,lifescience,medical generation in response to visual presentation showed a CBF increase in the left parietal region close to the area previously lighting up for calculation (Figures 5e and 5f). Figure 5. a. Computed tomography scan 48 hours after a generalized convulsion showing a small left parietal hemorrhagic lesion (case 3). b. and c. Magnetic resonance imaging (MRI) scan in T2-weighted and Inhibitors,research,lifescience,medical T1 with gadolinium showing cavernous angioma with recent … Using integration of PET scanning

and MRI data, a left parietal mini-craniotomy was performed using neu-ronavigational frameless stereotaxy guidance (Allegro-Viewing Wand System ISO. Toronto. Canada). After selecting the most appropriate Inhibitors,research,lifescience,medical cortical landmark (Figures 5g and 5h). the mTOR inhibitor cortex was incised, the lesion appropriately identified (Figures 5i and 5j), and resected using the operating microscope. The postoperative course was very satisfactory and the patient was discharged home on the fifth postoperative day without any deficits. Discussion Functional neuroimaging and neuronavigation Preoperative 3-mercaptopyruvate sulfurtransferase assessment of vascular malformations located within or near highly functional areas of the brain can be achieved using various mapping techniques including functional MRI, magnetoencephalography, PET, single photon emission tomography, and transcutaneous magnetic stimulation (Table III).13,14 Table III. Surgical adjuncts for cerebral vascular malformations. Functional areas of the brain, such as primary motor cortex or primary somatosensory cortex, can be precisely located and their topographical relationships may be integrated on MRI or CT scan and translated into 3D reconstruction images using frameless stereotaxy with high spatial accuracy.