ONLINE ADVANCED BRAIN MAPPING COURSE: ACQUIRING THE MENTAL IMAGERY NECESSARY TO OPERATE THE BRAIN
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ONLINE ADVANCED BRAIN MAPPING COURSE: ACQUIRING THE MENTAL IMAGERY NECESSARY TO OPERATE THE BRAIN
The classical approach to brain tumors consists in the surgical removal of a tumor located within a brain with a definitely fixed functional organization, while preserving structures commonly considered as crucial (e.g. the rolandic, Broca’s and Wernicke’s areas). However, in the last two decades, the integration of four new concepts to glioma management has dramatically changed the approach to these tumors. First, intraoperative electrical stimulation has become the gold standard mapping technique for resection of tumors within eloquent areas, as it had demonstrated to be a safe, accurate and reliable tool to identify and preserve the cortical and subcortical functional boundaries in each step of tumor resection. Second, the inter-individual anatomo-functional variability in the organization of eloquent areas, hence, the necessity to map the brain in order to identify the functional regions in an individual patient. Third, the application of network based models to understand complex cognitive brain functions such as language or memory, therefore, brain connectivity should be taken into account. Fourth, cerebral plasticity, which is the dynamic potential of the brain to reorganize itself following injury. The acquisition, integration and application of these whole new perspective to treat brain tumors can be very challenging. The volume of information is overwhelming as there are thousands of scientific publications, books, meetings, courses, websites, etc. Some professionals decide to spend a long period in a brain mapping specialized center, however, not everyone has the time or resources to complete that training. The present brain mapping program has been designed with the main objective to cover this gap, showing a step by step training in mapping surgery, which is done entirely online by reviewing videos and supplementary material. It has been designed as an on-line experience with two types of activities; asynchronous learning using a Learning Management System, and a synchronous learning through webinars with the instructors. The course has been designed by surgeons at the Hospital Universitario Marqués de Valdecilla and educators from Hospital Virtual Valdecilla in Santander, Spain. The course director is Juan Martino, a neurosurgeon with extensive experience in glioma surgery in eloquent areas. The course also has important contributions from experienced groups in brain mapping around the world. The course is structured into three sections, the fundamental steps to acquire the knowledge to perform brain mapping surgeries: 1-The first part of the course is oriented to the study of the anatomy of the brain white matter. A detailed knowledge of the architectural anatomy of the white matter tracts is paramount, for strategically planning for surgical management of parenchymal brain lesions, such as gliomas. 2-In the second part, the main concepts about brain mapping will be analyzed in detail. Questions such as how a bipolar stimulator works, how to position the patient for awake craniotomy, how to tailor the craniotomy, or how to map language or memory will be addressed in this section. 3-Finally, in the third part, surgical mapping challenging cases are presented. The cases will be reviewed step by step, from the initial diagnosis, surgical planning with tractography reconstruction, neuropsychological evaluation, surgical procedure with cortical and subcortical mapping, to the postoperative oncological and functional results. Juan Martino Course director
COURSE DIRECTOR
Professor Juan Martino
Neurosurgery Department.
Hospital Universitario Marqués de
Valdecilla. Santander. Spain
Mail: juan.martino@hotmail.com
CO-DIRECTORS Professor Rubén Martin-Láez
Neurosurgery Department.
Dr. Carlos Velasquez Hospital Universitario Marqués de
Neurosurgery Department. Valdecilla. Santander. Spain
Hospital Universitario Marqués de
Valdecilla. Santander. Spain
SCIENTIFIC COMMITTEE Elsa Gómez
Neuropsychologist. Psychiatry
Professor Hugues Duffau Department. Hospital Universitario
Neurosurgery Department. Centre Marqués de Valdecilla. Santander.
Hospitalier Universitaire de Montpellier. Spain.
Montpellier. France
Dr. Emmanuel Mandonnet Rosa Ayesa Arriola
Neurosurgery Department. Neuropsychologist. Psychiatry
Hospital Lariboisiere. Paris. France Department. Hospital Universitario
Marqués de Valdecilla. Santander.
Spain.
Dr. Alejandro Fernández-Coello Dr. Carlos Santos
Neurosurgery Department. Neurosurgery Department.
Hospital Universitari de Bellvitge. Hospital Universitario Marqués de
Barcelona. Spain Valdecilla. Santander. Spain
Dr. Pablo González-López Dra. Carla Mora
Neurosurgery Department. Neurosurgery Department.
Hospital General de Alicante. Alicante. Hospital Universitario Marqués de
Spain Valdecilla. Santander. Spain.
Dr. David Mato Dra. Mª Angeles Martínez Martínez
Neurosurgery Department. Neurophysiology Department.
Hospital Universitario Marqués de Hospital Universitario Marqués de
Valdecilla. Santander. Spain Valdecilla. Santander. Spain.
Dr. Roberto Ocón Quintial Dr. Enrique Marco de Lucas
Neurophysiology Department. Radiology Department. Hospital
Hospital Universitario Marqués de Universitario Marqués de Valdecilla.
Valdecilla. Santander. Spain. Santander. Spain.
Dr. Cristian de Quintana Schmidt
Neurosurgery Department.
Hospital de la Santa Creu i Sant Pau.
Barcelona. Spain
MAXIMAL NUMBER OF PARTICIPANTS PER COURSE: 20
COURSE DATES:
• The course lasts 12 weeks.
• The course starts on Monday, January 11th, 2021, and finishes on Monday, April 5th 2021.
• First Webinar: Monday, January 11th, 2021 at 12:00 (GMT), (14:00 pm in Spain). The aim of this first webinar is to introduce the
course, participants, and professors.
• Second Webinar: Monday, February 8th 2021 at 12:00 (GMT), (14:00 pm in Spain). Professors will answer questions of the first
part of the course (Brain anatomy and surgical approaches in the cadaver).
• Third Webinar: Monday, March 8th 2021 at 12:00 (GMT), (14:00 pm in Spain). Professors will answer questions of the second part
of the course (Brain mapping).
• Fourth Webinar: Monday, April 5th 2021 at 12:00 (GMT), (14:00 pm in Spain). Professors will answer questions of the third part
of the course (Real surgical cases).
COURSE MATERIALS:
• Around 60 hours of online videos with lectures, white matter dissections and surgical procedures.
• Surgical videos with a detail explanation of the procedure by the surgeon. In order to improve learning of brain anatomy, some
of the videos are presented in three dimensions, however, the same videos will be available in two dimensions.
• Mentoring support: in order to improve your learning experience, a mentoring support through Slack platform will be provided
by instructors.
• Four Webinars, with direct online interaction between participants and professors will be available.
• Supplementary material such as Power Point surgical tasks, that can be directly downloaded from the course website.
• In order to evaluate learning, test exams will be performed at the end of each section. The course certificate will be only issued
if at least 60% of the questions are correctly answered.
ACCREDITATION:
• This learning program is in process of accreditation by the Commission for Continuing Education of the Health Professions of
the Community of Cantabria.
• The scientific and educational content of this event has been endorsed by the Sociedad Española de Neurocirugía (SENEC).
TARGET AUDIENCE:
This activity has been designed for Neurosurgeons, Neurologists, Neuroradiologists, Residents/Fellows in these specialties, and
Neuro-nurses.
LEARNING OBJECTIVES:
After the conclusion of this activity, participants will be able to:
• Identify the anatomy of the white matter fiber tracts.
• Comprehensive understanding of the 3D anatomical relationships between the white matter connections.
• Understand in detail the basic elements to perform an awake brain mapping surgery.
• Understand the theoretical models that underlie complex cognitive functions such as language or memory and learn the
technique to map them during surgery.
• Evaluate surgical approaches to challenging areas: the dominant insular lobe, the posterior left temporal lobe, or the superior
parietal lobe.
• Discuss surgical cases and analyze different treatment options of tumors located within eloquent areas.
REGISTRATION FEES:
Full hands-on registration: 950 €. Included full access to the course content for a 12 weeks period.
REGISTRATION PROCESS:
Course registration
Rebeca Ruiz: rruiz@hvvaldecilla.es
Hospital Virtual Valdecilla
Av. Valdecilla s/n, 39008 Santander, Cantabria
Phone: + 34 942 20 38 95
http://www.hvvaldecilla.es
V4-202009
Sponsoring company
19MK109
1. BRAIN ANATOMY AND SURGICAL APPROACHES IN THE CADAVER
1.1 WHITE MATTER AND CORTICAL ANATOMY
1.1.1 How to prepare the brains for fiber dissection
(David Mato)
1.1.2 Hands-on dissection: brains preparation for fiber dissection (2D and 3D videos available)
(Juan Martino)
1.1.3 Cortical anatomy and dorsal associative tracts
(Juan Martino)
1.1.4 Functional role of the dorsal associative tracts
(Alejandro Fernandez-Coello)
1.1.5 Hands-on dissection of the dorsal associative tracts (2D and 3D videos available)
(Juan Martino)
1.1.6 Ventral associative tracts
(Juan Martino)
1.1.7 Functional roles of the ventral associative tracts
(Alejandro Fernandez-Coello)
1.1.8 Hands-on dissection of the ventral associative tracts (2D and 3D videos available)
(Juan Martino)
1.1.9 Intraoperative mapping of associative tracts
(Hugues Duffau)
1.1.10 Anatomy of the brain isthmus and the temporal stem: a crucial anatomical concept that
is often forgotten
(Dr. Carlos Velasquez and Dr. Pablo Gonzalez)
1.1.11 Diffusion tensor imaging tractography
(Christian de Quintana Schmidt)
1.1.12 DTI tractography as an important tool to study the subcortical anatomy and presurgical
planning of glioma surgery
(Enrique Marco de Lucas)
1.2 SURGICAL APPROACHES IN THE CADAVER
1.2.1 Surgical approaches to limbic and paralimbic tumors
(Pablo Gonzalez)
1.2.2 How to simulate a surgical approach in the laboratory
(Emmanuel Mandonnet)
1.2.3 Insula glioma surgery
(Hugues Duffau)
1.2.4 Insula glioma case 1: case presentation (2D and 3D videos available)
(Juan Martino)
1.2.5 Insula glioma case 1: surgical approach
(Hugues Duffau)
1.2.6 Insula glioma case 2: surgical approach. (2D and 3D videos available)
(Hugues Duffau)
1.2.7 Superior parietal glioma case: case presentation. (2D and 3D videos available)
(Juan Martino)
1.2.8 Superior parietal glioma case: surgical approach. (2D and 3D videos available)
(Hugues Duffau)
2. BRAIN MAPPING
2.1 INITIAL INTRAOPERATIVE MAPPING CONCEPTS
2.1.1 Basic mapping concepts
(Patient position, local anesthesia infiltration, operating room setup, etc).
2.1.2 Intraoperative task protocol
2.1.3 Anesthesia management in brain mapping surgeries
2.2 NEUROPSYCHOLOGICAL EVALUATION
2.2.1 Neuropsychological evaluation
2.2.2 Preoperative neuropsychological evaluation: an example
2.3 MOTOR MAPPING
2.3.1 Neural basis of motor mapping
2.3.2 Intraoperative motor mapping
2.4 SENSORY AND SPATIAL COGNITION MAPPING
2.4.1 Neural basis of sensory and spatial cognition function
2.4.2 Intraoperative sensory and spatial cognition mapping
2.5 VISUAL MAPPING
2.5.1 Neural basis of visual function
2.5.2 Intraoperative visual mapping
2.6 LANGUAGE MAPPING
2.6.1 The localizationist classical model of language
2.6.2 The network based model of language
2.6.3 Intraoperative language mapping
2.7 MEMORY MAPPING
2.7.1 Neural basis of memory
2.7.2 Intraoperative memory mapping
2.8 SOCIAL AND EMOTIONAL COGNITION MAPPING
2.8.1 Neural basis of social and emotional cognition
2.8.2 Intraoperative social and emotional cognition mapping
2.9 DECISION MAKING MAPPING
2.9.1 Neural basis of value based decision making
2.10 CALCULATION PROCESSING MAPPING
2.10.1 Neural basis of calculation processing
2.10.2 Intraoperative calculation mapping
2.11 MUSICAL PROCESSING MAPPING
2.11.1 Neural basis of musical processing
2.11.2 Intraoperative musical mapping
3. REAL SURGICAL CASES 3.1 SURGICAL POSITION 3.1.1 Patient surgical position for awake surgery 1: left lateral decubitus 3.1.2 Patient surgical position for awake surgery 2: right lateral decubitus 3.1.3 Patient surgical position for awake surgery 3: supine position 3.2 LEFT FRONTO-INSULAR GLIOMA 3.2.1 Case presentation and surgery planning 3.2.2 Intraoperative awake mapping and tumor resection 3.2.3 Postoperative evaluation 3.3 RIGHT PARIETAL GLIOMA 3.3.1 Case presentation and surgery planning 3.3.2 Intraoperative awake mapping and tumor resection 3.3.3 Postoperative evaluation 3.4 RIGHT FRONTAL GLIOMA 3.4.1 Case presentation and surgery planning 3.4.2 Intraoperative awake mapping and tumor resection 3.4.3 Postoperative evaluation
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