Browsing by Author "Mery Muñoz, Francisco Javier"

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    Resección de lesiones cerebrales con asistencia de mapeo cortical intraoperatorio
    (2010) Mery Muñoz, Francisco Javier; Zárate Azócar, Adrián; Fadic Ruiz, Ricardo Julio Nicolás; Lorenzoni Santos, José Guillermo; Elgueta Le-Beuffe, María Francisca; Villanueva Garín, Pablo Rodrigo; Rojas Valdivia, Ricardo; Tagle Madrid, Patricio
    Introducción: Se ha demostrado que la resección extensa de tumores intracraneanos intra-axiales malignos mejora la sobrevida. Esto no siempre es posible dada la eventual ubicación de estos tumores en o cercanos a áreas elocuentes, como corteza motora primaria o de lenguaje. En estas circunstancias, el desafío es evitar secuelas neurológicas. Uno de los métodos para disminuir dicho riesgo es el mapeo cortical intraoperatorio (MCI). El presente trabajo describe la técnica de mapeo cortical intraoperatorio de áreas elocuentes, al igual que su factibilidad y complementariedad con otras técnicas de localización tumoral. Método: Se analizan 7pacientes operados, portadores de lesiones cercanas a áreas elocuentes. Se utilizó neuronavegación y MCI (estimulación directa de corteza y registro de potenciales evocados somatosensoriales). Se analizó la localización, tamaño y tipo de la lesión, grado de resección y estado neurológico pre y postoperatorio. Resultados: En todos los pacientes el MCI fue efectivo en localizar corteza motora primaria. Hubo 6 pacientes en los que se pudo resecar el área tumoral no asociada a funcionalidad, logrando en 5 de ellos resección completa o superior al 90%. En un paciente la lesión correspondió a una malformación arteriovenosa profunda ubicada en corteza motora primaria en que el MCI permitió una vía de abordaje por corteza no elocuente para su resección completa. No hubo déficit neurológico agregado postoperatorio con seguimiento de 12 meses. Conclusión: El MCI es útil y localiza en forma efectiva, simple y reproducible áreas de corteza funcional, haciendo posible realizar resecciones extensas de tumores en áreas elocuentes. Esta técnica es complementaria a otros métodos de ubicación anatómica y fisiológica pudiendo contribuir a una cirugía más segura y efectiva.
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    Right hemisphere engagement in language abilities in older adults: indication of compensation rather than decline
    (2025) Solomons, Daniel; Rodríguez Fernández, María; Mery Muñoz, Francisco Javier; Arraño Carrasco, Leonardo Marcelo; Toloza Ramírez, David Isaias; Sahli Costabal, Francisco; Méndez Orellana, Carolina Patricia
    Introduction: Structural brain changes during aging have been used as specific markers to distinguish normal aging from dementia. Changes in specific cognitive abilities such as episodic memory, processing speed, and executive functions, are observed in healthy aging. Limited evidence reports changes in linguistic functions alongside structural and functional brain changes. This study investigates correlations between language performance, gray matter volume (GMV), and neural activity in language regions, adjusted for demographic factors, in healthy older adults. Methods: Twenty-seven right-handed participants aged 60–87 were evaluated for overall linguistic performance using the Spanish version of ScreeLing (SCL) test and phonemic fluency and semantic verbal fluency tasks (PF and SF). Participants also underwent an MRI session during which they performed a functional MRI language task. T1-weighted MRI scans were used to measure GMV in specific language-related regions and assess language lateralization. Correlational analyses were conducted between language scores, GMV, years of education, age, sex, and fMRI lateralization. Results: In the right hemisphere (RH), significant positive correlations were found between SCL scores and GMV in the orbital inferior frontal gyrus (r = 0.5402; p = 0.0044) and the superior temporal gyrus (r = 0.516; p = 0.007). Furthermore, SCL and Phonemic fluency positively correlated with years of education, indicating that higher education enhances speech performance. No significant correlations were found in the left hemisphere (LH). Age, sex, and fMRI lateralization did not significantly correlate with specific linguistic scores. Discussion: These results challenge the current view of the role of the right hemisphere in language performance as increased GMV in specific right hemisphere language regions is associated with better language performance, highlighting the role of the right hemisphere in supporting language skills during healthy aging.
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    Surpass flow diverter in the treatment of intracranial aneurysms : a prospective multicenter study
    (2015) Wakhloo, A. K.; Lylyk, P.; De Vries, J.; Taschner, C.; Lundquist, J.; Biondi, A.; Hartmann, M.; Szikora, I.; Pierot, L.; Mery Muñoz, Francisco Javier
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    The potential use of crossed cerebro-cerebellar activation to evaluate language reorganization: A case study of recurrent malignant glioma
    (2023) Julio Ramos, Teresa Paz; Toloza-Ramirez, David; Arraño Carrasco Leonardo Marcelo; Mery Muñoz, Francisco Javier; Méndez Orellana, Carolina Patricia
    Background: The crossed cerebro-cerebellar (CCC) language activation guides the determination of language dominance because it is generally undisturbed by a lesion localized in supratentorial language areas. Limited evidence suggests brain plasticity could underly language recovery after tumor resection surgery. A recent study revealed two patterns of language reorganization; however, language lateralization was determined after visual inspection of a single task (phonemic fluency). Aim: To describe eventual changes of language lateralization as part of a reorganization in a tumor brain patient with recurrent malignant glioma.