STTModule_v2.ppsx

Brain, 2001

The question whether the spinothalamic and The area of partial sensory loss is due to transection of the fibres that are crossing the cord at that level. Owing spinoreticular fibres cross the cord transversely or to the craniocaudal extent of the branches of the dorsal diagonally was investigated in cases of anterolateral roots, there is an overlap of their collaterals that results cordotomy and in a case of thrombosis of the anterior in every spinothalamic neurone receiving an input from spinal artery. The pattern of sensory loss following several dorsal roots. The narrow cordotomy incision thus transection of the anterolateral quadrant of the cord divides the few fibres crossing at that level, causing consists of a narrow area of decreased nociception and diminished noxious and thermal sensibility over a few thermanalgesia at the level of the incision; it extends for segments above and below the incision. These facts can 1-2 segments cranial and cordal to the incision. This area be accounted for only on the assumption that these is immediately cranial to the area of total loss of these spinothalamic fibres are crossing the cord transversely. modalities. This pattern of sensory loss is explained as This evidence of transverse crossing was found in the follows. The cordotomy incision transects two groups of cervical, thoracic and lumbar segments. There were three fibres: those that are already within the anterior and of 63 cordotomies for which this explanation of the anterolateral funiculi and those that are crossing the cord. partial sensory loss could not be maintained. Although The area of total thermanaesthesia and analgesia is due no explanation has been suggested, this is unlikely to be due to the fibres crossing the cord diagonally. to transection of fibres that are already within this region.

The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques, 2018

Pain, 1989

Prior work has indicated the existence of a major spinal cord pathway made up of lamina I cell axons ascending in the dorsolateral funiculus in both rat and cat. In cat, a portion of this lamina I dorsolateral funiculus pathway terminates in the thalamus. The purpose of this report is to demonstrate that a similar dorsolateral spinothalamic tract exists in macaque monkey. Retrograde transport of horseradish peroxidase, injected into the somatosensory thalamus of monkeys, was used to identify the cells of origin of the spinothalamic tract in the cervical and lumbar enlargements. In order to determine the funicular courses of the axons contributing to the spinothalamic pathway, thalamic injections of horseradish peroxidase were combined with ipsilateral ventral or dorsolateral thoracic spinal cord lesions. The results indicate that in macaque monkey many lamina I cell axons ascend to the thalamus in the dorsolateral funiculus, contralateral to their parent cells. Some lamina I cell axons as welt as the majority of axons of spinothalamic cells located in deeper laminae ascend in the contralateral ventral quadrant to terminate in the thalamus. The existence in macaque of a dorsolateral spinothalamic pathway comprised of lamina I cell axons strongly implies the presence of a similar pathway in humans and has important implications regarding the mechanisms underlying both clinical and experimental nociception.

Epilepsia, 2017

Radiographics, 2007

The Journal of Comparative Neurology, 1989

The cells of origin of the dorsolateral (DSTT) and the ventral (VSTT) spinothalamic tracts were studied in 11 monkeys. The spinothalamic tract cells were retrogradely labeled by horseradish peroxidase (HRP) injected in the thalamus. All animals also received a midthoracic spinal cord lesion on the side ipsilateral to the thalamic injections.

Neurosurgical Focus, 2014

The Journal of Comparative Neurology, 1989

The termination sites of the dorsolateral (DSTT) and ventral (VSTT) spinothalamic pathways were determined by using anterograde transport of horseradish peroxidase from the lumbar spinal cord in primates. One animal had no spinal cord lesion, while of two other animals, one received a midthoracic dorsolateral funiculus lesion, and the other received a midthoracic ventral quadrant lesion contralateral to the injection. The thalamic label in the animal with no spinal cord lesion was much less than the label in the two animals with spinal lesions. Moreover, in the animals with spinal lesions, HRPlabeled cells were found within the thalamus. Therefore, the remaining six animals received ipsilateral hemisections and bilateral dorsal column lesions, irrespective of the contralateral lesions.

Neuroscience Letters, 1987

Neuroscience Letters, 81 (1987) The descending projection sites of the anterior, central (or tuberal) and posterior regions of the lateral hypothalamic area ,~ere studied by anterograde axonal transport after local injection of tritiated amino acids. The results show that the neurons of the anterior regions project to the lateral mammillary nucleus, the ventral tegmental area, the midbrain central gray and the anterior parts of the dorsal raphe nucleus. The neurons of the central region project in the same structures and extend a projection into the dorsal legmentum at the level of the pontine central gray, the midbrain and pontine reticular nuclei. In the ventral tegmenlum region, the substantia nigra pars compacta, the inlerpeduncular nucleus and the anterior group of raphe nuclei were also found to be labelled. The neurons of the posterior region of the lateral hypothalamic area extend a projection to the level of the prepositus hypoglossi nucleus and to the nucleus of solilary tract. In the ventral tegmenlum they project at the level of posterior group of the raphe nuclei and Ihe inferior oliwlry complex.

2011

H ypotHalamic hamartomas are rare CNS nonneoplastic lesions composed of hyperplastic neural tissue 3,24 associated with 2 patterns of presentation. The Delalande classification classifies HHs based on size, and amount of and laterality of attachment to the hypothalamus. 4 Children with HHs that are significantly attached to and involved with the hypothalamus become symptomatic with gelastic seizures (Delalande Types II, III, and IV). These lesions are usually resistant to medication and if left untreated devolve into more sinister epileptic patterns as the child grows. 21,23 Furthermore, children with these lesions may develop problems with social interaction, including frequent rage attacks. In contrast, Delalande Type I HH can cause central precocious puberty and may be treated medically with excellent results. 4 This type of HH seldom manifests with epilepsy or behavioral problems, and microsurgical excision tends to be curative. 5,14 The Barrow Hypothalamic Hamartoma Program was established late in 2003. Thus far, we have treated many patients with HH. 1,3,5-10,13,15-21,23,25 The goal of this manuscript is to describe, in a single, free, online, easily accessible publication, the current methods of resection and to share pitfalls and pearls that we have learned during the process. The approaches used can be classified as endoscopic, transcallosal, or skull base. We also review data previously published by our group on the outcomes and complications associated with this challenging group of patients. This project is ongoing and continues to accrue data. Methods Between late 2003 and late 2010, the Barrow Hypothalamic Hamartoma Program has treated 165 patients with a symptomatic HH. The patients have come from many states and countries. The program operates under the approval of the institutional review board of St. Jo