Panta rei - said Heraklitus, everything in in this world is constantly changing. This is especially true of living organisms. Their ability to adapt themselves to changes within and without is very remarkable, and it provides the best possible way of life and reproduction. [...]

It was a stroke of good fortune that Camillo Golgi, in 1872, examined some pieces of brain which were hardened in Muller's fluid and afterwards dipped in silver nitrate solution. As a result of this, Golgi developed a new method which was to bring about a new era in the investigation of the nervous system. [...]

The tract of Lissauer has long been associated with pain, but the exact pathway of this important sensation has been far from clear. [...]

Perhaps it is fair to say that since the commencement of the study of neuropathology, one of the main problems occuping the minds of investigators has been the healing of cerebral wounds. During the first half of the 20th century this field became a practical clinical problem of paramount importance, due in large measure to the development and expansion of neurosurgical technique and the association of cerebral wounds with a high incidence of epileptic seizures following the two world wars. [...]

The neurophysiology of respiration has been the subject of intensive investigation for well over a century. Early in this period it became apparent that the most fundamental respiratory centres were located within the brain stem, and that the activity of such centres was influenced directly or indirectly by humoral factors and by afferent stimuli from many sources including centres situated more rostrally in the central nervous system. [...]

Activation or "arousal" of the EEG is ordinarily thought to be brought about by stimulation, usually by various sensory modalities, of the reticular activating system; this in turn exerts a diffuse influence upon the electrical activity recorded from the entire cortex (Magoun, 1955). [...]

The development of science is illumined at fortunately frequent intervals by the unmistakeable emergence of men who provide their field of endeavor, if not all of science, with a formulation, a concept or a law that synthesizes the tomes of unfathomably scattered 'facts' elaborated by their predecessors. [...]

The morbidity and mortality associated with acute lesions of the brain are often the result of a diffuse or localized increase of cerebral tissue fluid, usually termed either cerebral swelling or cerebral edema. [...]

The purpose of the study was to investigate whether interictal stereotactic EEG data recorded during surgical implantation of depth electrodes can be used to predict the seizure focus in patients with epilepsy. We retrospectively studied 21 patients who underwent invasive stereotactic EEG monitoring and surgical treatment at Boston Children’s Hospital. Interictal data were analyzed using the method of Granger Causality (GC) statistics to calculate causal interactions between brain regions. In 10 cases, intraoperative GC analysis accurately identified the seizure focus, as supported by their statistically significant rank order sum P values. The remaining 11 cases failed to achieve statistical significance for intraoperative GC analysis. When we examined the visual representations of the causality network described by GC, we observed that despite insignificant rank order P values, GC analysis could still be valuable in revealing the seizure network. It is apparent that there needs to be additional, more in-depth investigations regarding the value of using intraoperative interictal EEG data for defining the seizure focus. Future studies should focus on identifying clinical factors that may affect the utility of intraoperative GC analysis and also on experimenting how GC analysis could aid in decision-making during electrode implantation. / 2022-06-05T00:00:00Z

Brain tumours are the second most common malignancy in children(1) (2), and despite some advancements being made over the last 2 decades, patient outcomes in general remain poor when compared with other childhood cancers. Optimal treatment of children with brain tumours is challenging and expertise and resources are not widely available in South Africa. This is important because the outcomes of children with brain tumours depend critically on the expertise and resources of a multidisciplinary team tasked with their treatment. Despite the importance of paediatric brain tumours though, little is known about childhood brain tumours in South Africa as limited data have been published and there have been no funded studies to support research in this area. In addition, we know very little about the resources available across the country to treat these children. In international centres of excellence the best outcomes are achieved by combining good epidemiological data, strong multidisciplinary teams, centralization or regionalization of services, available resources, and a research foundation. To start, we need to know more about the patients presenting to us with brain tumours. PURPOSE The overall aim of this project was to collect epidemiological data for childhood brain tumours at a tertiary paediatric hospital in South Africa with a dedicated multidisciplinary team. METHODS Study design: A retrospective review of records of patients diagnosed with a primary brain tumour and who presented to Red Cross Children’s Hospital (RCCH) system from 1 January 1996 to 31 December 2017. 2 Patient selection & data collection: Patients were identified by combining databases and admission logs from paediatric neurosurgery, oncology, radiotherapy, histopathology and radiology. Data collected included: age at diagnosis, sex, province of referral, tumour site and diagnosis. RESULTS A total of 554 paediatric patients with primary brain tumours were identified over the study period. Tumours were more common among males (55.4%) and were located in the supratentorial compartment in 52%. The median age at diagnosis was 5.92 years. The commonest tumours were astrocytomas (n=114 patients; 20.3%), followed by medulloblastomas (incl. PNETs) (n=107 patients; 19.1%), and craniopharyngiomas (n=55; 9.8%). As expected, most patients referred and seen at RCCH/GSH were from the expected drainage area in the Western Cape (73%), but a significant number of referrals (27%) were from outside the province referrals, especially in the last 10 years. CONCLUSION Our findings were largely consistent with the published literature in terms of histological diagnosis, sex profile and age ranges for children diagnosed with brain tumours with some small differences possibly related to referral bias. More patients than expected were referred from outside of the province, which emphasizes the need for establishing an ongoing tumour database registry and co-ordinating patient care across institutions. A follow-up study to assess patient management and outcomes is of critical importance to assess resource availability and patient outcomes.