Medical resistance, a profound expression of intellectual and spiritual strength, was not the only act of defiance against the brutal Nazi oppressor; the Uprising was another, equally powerful form. The healthcare workforce, consisting of physicians, nurses, and others, actively resisted. Their dedication to the ghetto residents transcended their professional responsibilities. They went beyond the usual scope of practice to investigate hunger-related diseases and create a secret medical training program. The Warsaw Ghetto's medical practitioners, through their work, epitomized the triumph of the human spirit against overwhelming odds.

Patients with systemic cancers often suffer from brain metastases (BM), a leading cause of morbidity and mortality. Within the last two decades, there has been a considerable progress in controlling extra-cranial diseases, positively impacting the longevity of patients. However, this trend has caused a rise in the number of patients who live long enough to develop BM. Improvements in neurosurgical and radiotherapy procedures have made surgical resection and stereotactic radiosurgery (SRS) essential tools in addressing patients with 1-4 BM. The broadened therapeutic possibilities, including surgical resection, SRS, whole-brain radiation therapy (WBRT), and the more recent addition of targeted molecular therapy, have resulted in a substantial and sometimes confusing mass of published information.

Improved surgical resection of gliomas has been correlated with better patient outcomes regarding survival, according to multiple studies. To maximize safe tumor resection, modern neurosurgery adopted intraoperative electrophysiology cortical mapping, demonstrating function, as a standard practice, an indispensable tool. This paper chronicles the historical progression of intraoperative electrophysiology cortical mapping, from the initial cortical mapping research in 1870 to the cutting-edge technology of broad gamma cortical mapping currently in use.

Stereotactic radiosurgery, a transformative therapeutic technique, has revolutionized neurosurgery and the management of intracranial tumors over the past several decades. Primarily a single-session, outpatient procedure with no skin cuts, head shaving, or anesthesia, radiosurgery yields tumor control rates exceeding 90% and has minimal, largely transient side effects. Despite the established carcinogenic effect of ionizing radiation, the energy source utilized in radiosurgery, radiosurgery-induced tumors are remarkably rare. The Hadassah group's report, appearing in this issue of Harefuah, presents a case of glioblastoma multiforme that arose from a previous radiosurgical treatment site of an intracerebral arteriovenous malformation. We engage in a process of thoughtful reflection concerning the informative aspects of this severe event.

Intracranial arteriovenous malformations (AVMs) find a minimally invasive solution in stereotactic radiosurgery (SRS). With the accumulation of long-term follow-up data, reports surfaced of some late adverse effects, such as SRS-induced neoplasia. Nevertheless, the precise rate of this adverse reaction remains uncertain. A young patient treated with SRS for an AVM, and the subsequent development of a malignant brain tumor, forms the basis of the analysis and discussion in this article.

Intraoperative electrical cortical stimulation (ECS) mapping of function is the current gold standard in neurosurgical practice. In recent times, high gamma electrocorticography (hgECOG) mapping has produced satisfactory and encouraging findings. Chiral drug intermediate Using hgECOG, fMRI, and ECS, this study plans to compare and contrast motor and language mapping.
For patients who had awake tumor resection procedures between January 2018 and December 2021, a retrospective evaluation of their medical records was performed. For the study group, the initial ten consecutive patients who had undergone ECS and hgECOG for motor and language function mapping were chosen. Analysis utilized pre-operative and intra-operative imaging and electrophysiology information.
714% of patients displayed functional motor areas through ECS mapping, and 857% through hgECOG mapping. The motor areas pinpointed by ECS were subsequently verified using hgECOG. Motor areas, discernible in preoperative fMRI scans of two patients, were not shown using either ECS or hgECOG-based mapping techniques. Of the 15 hgECOG language mapping tasks, 6 (representing 40% of the total) demonstrated agreement with the ECS mapping. In two (133%) cases, language regions identified by ECS were evidenced, plus areas not so identified by the system. Four map presentations (267%) showcased language areas that escaped detection using ECS approaches. Three mappings (20% of the total) failed to demonstrate the functional areas identified by ECS when compared to hgECOG data.
Intraoperative hgECOG mapping of motor and language functions demonstrates a fast and dependable method, safeguarding against the risk of stimulation-induced seizures. Further study is required to assess the functional recovery of patients after undergoing tumor resection that is guided by hgECOG.
The intraoperative use of hgECOG to map motor and language functions constitutes a prompt and reliable approach, safe from the threat of seizures induced by stimulation. Assessment of the functional results for patients who have had their tumors removed by hgECOG-guided procedures necessitates further research.

5-ALA fluorescence-guided resection, a key component in the current treatment of primary malignant brain tumors, is vital for optimal outcomes. 5-ALA, after being metabolized in tumor cells to create fluorescent Protoporphyrin-IX, observable under UV microscope, enables the visual distinction between the tumor, which appears pink, and its normal brain tissue surroundings. Superior tumor removal, a direct consequence of the real-time diagnostic feature, translated to improved patient survival. Despite the high sensitivity and specificity reported for this technique, other disease processes involve the metabolism of 5-ALA, resulting in fluorescence patterns comparable to those of a malignant glial tumor.

In children, drug-resistant epilepsy is associated with negative health outcomes, including developmental regression and death. Over the recent years, a growing appreciation of the surgical approach to refractory epilepsy has arisen, influencing both diagnostic procedures and treatment, leading to a decrease in the number and severity of seizures. Technological advancements in surgical techniques have facilitated the minimization of invasive procedures, thereby reducing post-operative complications associated with surgery.
In a retrospective analysis of our cranial surgery for epilepsy cases, spanning the period from 2011 to 2020, we detail our experiences. Data collection included specifics on the seizure disorder, the associated surgery, any complications arising from the surgery, and the subsequent course of the epileptic condition.
In a span of ten years, 93 children had 110 cranial surgeries performed on them. The chief etiologies observed included cortical dysplasia (29), Rasmussen encephalitis (10), genetic disorders (9), tumors (7), and tuberous sclerosis (7). Lobectomies (32), focal resections (26), hemispherotomies (25), and callosotomies (16) constituted the primary surgical interventions. Laser interstitial thermal treatment (LITT) was performed, using MRI guidance, on two children. local infection Hemispherotomy or tumor resection procedures yielded the most notable postoperative advancements in every child (100% each). The surgical correction of cortical dysplasia led to a substantial improvement of 70%. In a substantial portion (83%) of children who underwent callosotomy, no further drop seizures were observed. The concept of mortality did not apply.
Significant improvement, and even a potential cure for epilepsy, can sometimes result from epilepsy surgery. LY3295668 The field of epilepsy surgery includes many different types of procedures. Early referral of children with treatment-resistant epilepsy for surgical assessment can substantially diminish developmental harm and enhance functional results.
Surgical management of epilepsy may lead to considerable improvement and even a complete cure. Numerous epilepsy surgical procedures are performed. A timely surgical assessment for children with drug-resistant epilepsy can potentially reduce developmental impairments and enhance functional outcomes.

Establishing a new team focused on endoscopic endonasal skull base surgery (EES) mandates a period of adjustment and acculturation. Comprising surgeons with a history of surgical practice, our team was created four years ago. We intended to explore the learning curve inherent in the creation of such a collaborative unit.
A retrospective analysis was undertaken on all patients that had undergone EES operations within the timeframe of January 2017 to October 2020. The initial forty patients were designated the 'early group', and the final forty constituted the 'late group'. Utilizing both electronic medical records and surgical videos, the data was accessed. A comparative assessment of surgical groups, focusing on the level of surgical complexity (II to V, based on the EES scale; excluding level I cases), alongside surgical success and complication rates, was undertaken.
'Early group' cases were treated with surgery 25 months after the initial diagnosis, and 'late group' cases were operated on 11 months later. Level II complexity surgeries, which chiefly involved pituitary adenomas, were the most common type of surgery in both groups (77.5% and 60%, respectively). The 'late group' showed a higher prevalence of functional adenomas and repeat surgeries. Surgeries categorized as levels III to V, demonstrating advanced complexity, displayed increased frequency in the 'late group', with a rate of 40% versus 225%, and level V surgeries limited to this specific group. Surgical outcomes and complications exhibited no discernible variations; however, cerebrospinal fluid leaks post-operatively were less prevalent in the 'late group' (25% versus 75%).