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PubMed2001

Clinical analysis of families with heart, midline, and laterality defects.

Disturbances of the normal asymmetric placement of organs, such as polysplenia or situs inversus, have been defined traditionally as laterality defects. However, there is compelling evidence from vertebrate models and human birth defects to hypothesize that defects of the midline, isolated congenital heart defects, and laterality defects are etiologically related. We present the clinical characteristics of three families that exhibit a variety of midline defects and isolated heart defects in addition to laterality defects. These observations suggest that the phenotypic consequences of mutations causing laterality defects include defects of the midline as well as isolated heart defects. To further explore the relationship between midline, heart, and laterality defects, it is imperative that detailed phenotyping of individuals and families with laterality defects be done and a classification system created to facilitate identification of genes causing human laterality disorders.

Blood Vessels↗
PubMed1996

Ultrastructural evidence for altered calcium in motor nerve terminals in amyotropic lateral sclerosis.

Numerous studies of amyotrophic lateral sclerosis have suggested that increased intracellular calcium is a common denominator in motoneuron injury. In experimental models, IgG from patients with amyotrophic lateral sclerosis enhanced calcium entry and induced apoptotic cell death in vitro as well as increased intracellular calcium and induced ultrastructural alterations of the motor nerve terminals in mice in vivo. To determine whether similar increases in intracellular calcium and altered morphology are present in motor nerve terminals of amyotrophic lateral sclerosis patients in vivo, muscle biopsy specimens from 7 patients with amyotrophic lateral sclerosis, 10 nondenervating disease control subjects, and 5 patients with denervating neuropathies were analyzed with ultrastructural techniques, employing oxalate-pyroantimonate fixation to preserve in situ calcium distribution. Motor nerve terminals from amyotrophic lateral sclerosis specimens contained significantly increased calcium, increased mitochondrial volume, and increased numbers of synaptic vesicles compared to any of the disease control groups, without exhibiting excess Schwann envelopment specific to denervating terminals. These results parallel the effect of amyotrophic lateral sclerosis IgG passively transferred to mice, and provide the first demonstration that neuronal calcium is, in fact, increased in amyotrophic lateral sclerosis in vivo.

Adult↗
PubMed1996

Immunoassays fail to detect antibodies against neuronal calcium channels in amyotrophic lateral sclerosis serum.

Recent studies suggested that autoantibodies that bind to voltage-dependent calcium channels and activate calcium entry may play a role in the progressive degeneration of motoneurons in sporadic amyotrophic lateral sclerosis. Immunoassays were performed to assess autoantibody titer in patients with amyotrophic lateral sclerosis or Lambert-Eaton myasthenic syndrome, a disease in which the presence of anti-calcium channel antibodies is well documented. Based on immunoprecipitation assays for antibodies against N-type calcium channels, only 8% (2/25) of amyotrophic lateral sclerosis patients had marginally positive titers, whereas 58% (18/31) of patients with Lambert-Eaton myasthenic syndrome had positive titers. Enzyme-linked immunosorbent assays with purified neuronal N-type calcium channels revealed immunoreactivity in 2 of 25 amyotrophic lateral sclerosis sera and 12 of 31 Lambert-Eaton myasthenic syndrome sera, which is not compatible with suggestions that enzyme-linked immunosorbent assay is a more sensitive technique for the detection of autoantibodies in amyotrophic lateral sclerosis. Furthermore, based on immunoprecipitation assays, amyotrophic lateral sclerosis sera were totally negative for antibodies against L-type calcium channels from skeletal muscle or brain. These data do not support the hypothesis that an autoimmune response against calcium channels plays a primary role in amyotrophic lateral sclerosis.

Amyotrophic Lateral Sclerosis↗
PubMed1997

Presurgical multimodality neuroimaging in electroencephalographic lateralized temporal lobe epilepsy.

The purpose of this study was to compare 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), hippocampal volumetry (HV), T2 relaxometry, and proton magnetic resonance spectroscopic imaging (1H-MRSI) in the presurgical neuroimaging lateralization of patients with nonlesional, electroencephalogram (EEG)-defined unilateral temporal lobe epilepsy (TLE). Twenty-five patients were prospectively studied, along with age-matched controls. T2 relaxometry examinations were performed in 13 patients. Comparison of FDG-PET, HV, and 1H-MRSI was possible in 23 patients. FDG-PET lateralized 87% of patients, HV 65%, N-acetyl aspartate (NAA)/(choline [Cho] + creatine [Cr]) 61%, and [NAA] 57%. Combined HV and NAA/(Cho + Cr) results lateralized 83% of the patients, a value similar to PET. Of 10 patients with normal magnetic resonance imaging (MRI) scans, 2 were lateralized with HV, 6 with FDG-PET, 4 with NAA/(Cho + Cr), and 3 with [NAA]. T2 relaxometry lateralized no patients without hippocampal atrophy. Bilateral abnormality was present in 29 to 33% of patients with 1H-MRSI measures and 17% with HV. Only hippocampal atrophy correlated with postoperative seizure-free outcome. FDG-PET remains the most sensitive imaging method to correlate with EEG-lateralized TLE. Both FDG-PET and 1H-MRSI can lateralize patients with normal MRI, but only the presence of relative unilateral hippocampal atrophy is predictive of seizure-free outcome. Bilaterally abnormal MRI and 1H-MRSI measures do not preclude good surgical outcome.

Adult↗
PubMed2006

fMRI study of language lateralization in children and adults.

Language lateralization in the brain is dependent on family history of handedness, personal handedness, pathology, and other factors. The influence of age on language lateralization is not completely understood. Increasing left lateralization of language with age has been observed in children, while the reverse has been noted in healthy young adults. It is not known whether the trend of decreasing language lateralization with age continues in the late decades of life and at what age the inflection in language lateralization trend as a function of age occurs. In this study, we examined the effect of age on language lateralization in 170 healthy right-handed children and adults ages 5-67 using functional MRI (fMRI) and a verb generation task. Our findings indicate that language lateralization to the dominant hemisphere increases between the ages 5 and 20 years, plateaus between 20 and 25 years, and slowly decreases between 25 and 70 years.

Adolescent↗
PubMed1990

Excitotoxic lesions of the lateral hypothalamus made by N-methyl-d-aspartate in the rat: behavioural, histological and biochemical analyses.

The purpose of this study was to determine whether the excitotoxin N-methyl-d-aspartate (NMDA) could be used to make lesions within the lateral hypothalamus and what effect they had on regulatory behaviour. Larger doses of NMDA were effective in the lateral hypothalamus but tended to spread into adjacent structures; smaller doses made lesions which were contained within the lateral hypothalamus and zona incerta. Lesions which damaged the lateral hypothalamus and surrounding tissue had no effect on the concentration of dopamine (or its metabolites) in the dorsal or ventral striatum. The large lesions, including extrahypothalamic damage, were associated with long-term deficits in lab chow and water intake, but rats with lesions restricted to the lateral hypothalamus made good recoveries, eating and drinking normally from around the tenth day post-operation. Body weight gain was normal in these rats, though there was a long-term loss of body weight compared to controls. Unoperated rats with food intake yoked to lesioned rats showed identical long-term changes in body weight, suggesting that the changes in body weight of lesioned rats may be a reflection of changes in eating and drinking rather than a disruption of a body weight set-point mechanism. Motor deficits were not found; all rats were able to consume without difficulty saccharin solutions. All lateral hypothalamic lesioned rats failed to respond to dehydrating, dipsogenic or glucoprivic challenges. It is concluded that NMDA is an effective toxin in the rat lateral hypothalamus, sparing ascending dopamine fibres, and that the main effect of such lesions is an impairment in responding to physiological challenges.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1992

N-methyl-D-aspartate lesions of the lateral hypothalamus do not reduce amphetamine or fenfluramine anorexia but enhance the acquisition of eating in response to tail pinch in the rat.

These experiments examine the acquisition of tail pinch-induced eating and responses to the anorectic agents d-amphetamine and d,l-fenfluramine by rats bearing N-methyl-D-aspartate (NMDA) lesions of the lateral hypothalamus. Lesioned rats lost weight following surgery but had no significant eating or drinking difficulties in the home cage (Clark et al. 1990). The acquisition of eating in response to tail pinch was enhanced in lateral hypothalamic-lesioned rats: they ate on earlier test sessions than controls and less pressure was required to elicit eating. Home cage food intake over the period when tail pinch was being examined was not affected by the lateral hypothalamic lesions. There were no significant differences between lateral hypothalamic-lesioned and control rats in terms of their anorectic responses to either d-amphetamine or d,l-fenfluramine, though the lesioned rats had a lower baseline intake. These data suggest that the lateral hypothalamus is not an important site for the mediation of amphetamine or fenfluramine anorexia but is involved in the acquisition of tail pinch-induced eating. The disinhibition of responding to tail pinch by lateral hypothalamic lesions is discussed in terms of the possible role the lateral hypothalamus plays in regulating cortical activity. The role of the medial hypothalamus and non-hypothalamic systems in the response to anorectic drugs and tail pinch is discussed.

Amphetamine↗
PubMed2005

Hydrodynamic detection by cupulae in a lateral line canal: functional relations between physics and physiology.

In the present review, signal-processing capabilities of the canal lateral line organ imposed by its peripheral architecture are quantified in terms of a limited set of measurable physical parameters. It is demonstrated that cupulae in the lateral line canal organ can only partly be described as canal fluid velocity detectors. Deviation from velocity detection may result from resonance, and can be characterized by the extent to which a single dimensionless resonance number, N ( r ), exceeds 1. This number depends on four physical parameters: it is proportional to cupular size, cupular sliding stiffness and canal fluid density, and inversely proportional to the square of fluid viscosity. Situated in a canal, a cupula may benefit from its resonance by compensating for the limited frequency range of water motion that is efficiently transferred into the lateral line canal. The peripheral transfer of hydrodynamic signals, via canal and cupula, leads to a nearly constant sensitivity to outside water acceleration in a bandwidth that ranges from d.c. to a cut-off frequency of up to several hundreds of Hertz, significantly exceeding the cut-off frequency of the lateral line canal. Threshold values of hydrodynamic detection by the canal lateral line organ are derived in terms of water displacement, water velocity, water acceleration and water pressure gradients and are shown to be close to the detection limits imposed by hair cell mechano-transduction in combination with the physical constraints of peripheral lateral line signal transfer. The notion that the combination of canal- and cupular hydrodynamics effectively provides the lateral line canal organ with a constant sensitivity to water acceleration at low frequencies so that it consequently functions as a low-pass detector of pressure gradients, supports the appropriateness of describing it as a sense organ that "feels at a distance" (Dijkgraaf in Biol Rev 38:51-105, 1963).

Animals↗
PubMed1986

Effects of ibotenic acid lesion in the basal forebrain on electrical self-stimulation in the middle part of the lateral hypothalamus.

The aim of the present study was to analyse the involvement of neurons located in some basal forebrain areas in electrical self-stimulation elicited from the middle part of the lateral hypothalamus. The anterior hypothalamic region was unilaterally lesioned by local injection of ibotenic acid. Ten to 20 days later 4 electrodes were implanted bilaterally, two at the lesion level and two in the middle lateral hypothalamus. A small but significant self-stimulation deficit was observed in the lesioned area, while self-stimulation on the contralateral side was normal. At the middle lateral hypothalamic level, no deficit was observed when stimulation was applied either ipsilaterally or contralaterally to the anterior lesioned side. In most cases the lesion destroyed the dorsolateral part of the lateral preoptic area, the ventral pallidum-substantia innominata complex and the lateral part of the bed nucleus of the stria terminalis. Given the fact that these regions are known to project massively to the middle lateral hypothalamic area, our data suggest that descending influences originating in the damaged regions are not involved in self-stimulation elicited from the middle hypothalamus.

Animals↗
PubMed1996

Lateralization of rotational behavior in developing and adult hamsters.

Rotational asymmetries were studied in developing and adult hamsters, and compared to verify if early lateralization is a predictor of the animals' later performance. Animals were divided into two groups: group I (GI) was tested from P46 (P1 = day of birth) to P62, and group II (GII) was tested daily from P2 to P60. They were placed in a cylindric arena for 5 min under video recording, and their 90 degree right and left displacements were counted and normalized. Since adult animals of both groups did not differ significantly in the distribution of asymmetries, the data were pooled together: 38.8% were non-lateralized (NL), 39.4% were right-rotators (RR), and 21.8% were left-rotators (LR). No significant difference was discerned between males and females. Distribution of asymmetries in GII animals between P2 and P10 showed a predominance of lateralized (64.7% RR and 21.5% LR) over NL animals (13.8%). The proportion of pups that maintained their classification into adulthood was only 46%, and the kappa coherence coefficient for these data was only 0.09. We conclude that: (1) most adults are lateralized, RR being more frequent; (2) the proportion of lateralized adults is not significantly altered by early testing; (3) there is no significant difference between males and females; (4) most developing hamsters are lateralized, right-rotators being more frequent; and (5) the animals' early classification is not a good predictor of their preference as adults.

Aging↗
PubMed1995

The imbalance of brain large-chain aminoacid availability in amyotrophic lateral sclerosis patients treated with high doses of branched-chain aminoacids.

Following the report of an increased mortality among patients with amyotrophic lateral sclerosis given high daily doses of branched-chain aminoacids, we assessed the plasma concentrations of large neutral aminoacids and glutamic acid and the large neutral aminoacid brain influx in 24 amyotrophic lateral sclerosis patients receiving placebo or branched-chain aminoacids (L-leucine 12 g, L-isoleucine 6 g, L-valine 6 g daily), in 15 untreated amyotrophic lateral sclerosis patients and in 15 healthy volunteers. The branched-chain aminoacid plasma concentrations increased three- to six-fold in the treated group compared to the patients receiving placebo or no treatment and to the healthy controls. Plasma glutamic acid concentrations in healthy volunteers were 51.59 +/- 7.53 nmol/ml while in the amyotrophic lateral sclerosis patients receiving no treatment, placebo or branched-chain aminoacids were 92.33 +/- 12.15 nmol/ml, 91.21 +/- 15.86 nmol/ml and 95.08 +/- 17.96 nmol/ml respectively. The glutamic acid concentration was significantly higher (P < 0.01) in amyotrophic lateral sclerosis patients than in healthy individuals. Plasma phenylalanine and tyrosine were lower in the amyotrophic lateral sclerosis patients than in healthy controls, regardless of treatment, whereas tryptophan levels were not significantly different. The branched-chain aminoacid brain influx of the treated group was 110-140% of that measured in the patients receiving placebo and in the healthy controls. The aromatic aminoacid brain influx was lower in the treated group than in the placebo group or healthy controls. An impairment of brain large neutral aminoacid availability might possible contribute to enhancing the progression of symptoms in patients with amyotrophic lateral sclerosis.

Adult↗
PubMed1991

Hormonal effects on the development or cerebral lateralization.

The morphology of cerebral cortical laterality patterns differs between the sexes. In the male Long-Evans rat, the thickness of the cerebral cortex is, in general, greater on the right side than on the left, with many areas showing statistically significant differences. In the female Long-Evans rat, the left side is thicker more often than the right, but the differences, in general, are not statistically significant. These laterality patterns are maintained throughout the lifetime of the animal with few variations. Some of the male and female laterality patterns reverse with old age. The numbers of neurons and glial cells in the area sampled, area 39, support the direction of cortical thickness measurements in male and female rats. Removal of the testes or ovaries at birth alters the usual cortical laterality patterns, illustrating that the sex steroid hormones play some role in determining laterality. In the neonates of both sexes, estrogen receptors are found in the cerebral cortex, but the concentration is greater in the left male cortex than in the right, the opposite being true for the female. Factors other than the sex steroid hormones, such as stress, can alter cortical laterality. Many studies indicate that plasticity of laterality is a factor to be considered when dealing with cortical morphology and, in turn, behavior.

Animals↗
PubMed1983

Efferent projections from the lateral hypothalamus in the guinea pig: an autoradiographic study.

Autoradiography was employed to investigate the efferent projections from the lateral hypothalamus in the guinea pig. Lateral hypothalamic axons were traced along the medial forebrain bundle in both ascending and descending directions. Anteriorly, the label was traced along the medial forebrain bundle in both ascending and descending directions. Anteriorly, the label was traced to the lateral preoptic area, diagonal band of Broca, and septal nuclei. Posterior projections included the ventral tegmental area of Tsai, central gray matter and the reticular formation throughout the brain stem. Laterally, the lateral hypothalamic efferents were found in the stria terminalis, amygdala and globus pallidus. Dorsally, the lateral hypothalamic axons projected to the midline nuclei of the thalamus and bilaterally to the lateral habenular nuclei. Projections to the medial hypothalamus included a labeled fiber bundle to the internal layer of the median eminence and to the posterior lobe of the pituitary gland. Labeled fibers and diffuse label were also found in some areas contralateral to the injection site.

Amygdala↗
PubMed2005

Impact of acute cadmium exposure on the trunk lateral line neuromasts and consequences on the "C-start" response behaviour of the sea bass (Dicentrarchus labrax L.; Teleostei, Moronidae).

Behavioural responses of sea bass Dicentrarchus labrax were investigated after exposure to cadmium ions in laboratory-controlled conditions. The aim of this study was to discover whether environmental exposure to cadmium ions inactivates fish lateral line system neuromasts, and to determine the behavioural consequences of such a sensory blockage. For this, fish escape behaviour in response to an artificial water jet was recorded using a 25-frames s(-1) analog video camera before and after cadmium exposure. Experimental set up was tested with fish whose lateral line system was artificially inactivated by antibiotics (gentamicin and streptomycin). Histological analyses with scanning electron microscopy showed antibiotic treatment destroyed lateral line system neuromasts. In addition, these fish did not respond to stimulations provoked by the water jet after antibiotic treatment. Fish escape behaviour was then recorded before and after cadmium exposure at two different concentrations. When fish were exposed to the first concentration of cadmium tested (0.5 microg l(-1), which represents the maximal cadmium concentration encountered in contaminated estuaries), no alteration in neuromast tissue was observed. In addition, before cadmium exposure, fish responded positively in 98.41 +/- 4.95% of lateral line system stimulations (escape behaviour in response to the water jet). After cadmium exposure, no behavioural modification could be detected: the fish responded positively in 95.16 +/- 9.79% of stimulations (chi(2) = 2.464, p = 0.116). In contrast, the high cadmium concentration used (5 microg l(-1), which represents 10 times the concentration occurring in highly polluted estuarine areas) involved severe neuromast tissue damage. Just after such cadmium exposure, fish showed only 41.67 +/- 35.36% of positive responses to their lateral line system stimulations, while they responded positively in 95.93 +/- 9.10% of stimulations under control conditions (chi(2) = 24.562, p < 0.0001). Their lateral line system neuromasts seemed to regenerate about 1 month after cadmium exposure. Associated with this regeneration, from the 21st day after cadmium exposure, their escape behaviour had recovered and was not significantly different from that recorded under control conditions (86.74 +/- 20.82%, chi(2) = 2.876, p = 0.090). This study shows that although 5 microg l(-1) cadmium is able to damage lateral line system neuromasts and causes fish behavioural alterations, fish exposed to 0.5 microg l(-1) cadmium displayed neither tissue neuromast nor behavioural modification.

Animals↗
PubMed2006

Lateral masking, levels of processing and stimulus category: a comparative study between normal and dyslexic readers.

The lateral masking effect results in lower performance on letter recognition when items are flanked by other stimuli. Using a new paradigm based on discrimination (feature analysis) and categorization (memory access) tasks, we investigated the influence of level of processing (as addressed, respectively, by these two tasks) and stimulus type (Latin letters, Korean letters and geometrical figures) on lateral masking. In addition, performance of dyslexic and non-dyslexic adult readers was compared. The non-dyslexic participants demonstrated a classical lateral masking effect with lower performance for flanked items than isolated ones. In addition, lateral masking was stronger in the categorization than in the discrimination task and was restricted to familiar items, i.e., Latin letters and geometrical figures. Dyslexic participants showed poorer performance than non-dyslexics on processing isolated items, and the pattern of decrease in performance for lateral masking was similar to non-dyslexics. However, they also showed a stronger decrease in performance in categorization and a stronger decrease related to the lateral masking for this categorization task. Our results in normal readers suggest that lateral masking relies on the interference between the target and the flankers during feature integration that may result in marked impairment of memory access (categorization task). Poorer performance in dyslexic readers may reflect impaired parafoveal/peripheral low-level processing during feature integration that may have worsened during the flanked condition due to a target selection/spatial-attentional disorder. Moreover, dyslexic subjects presented an additional categorization deficit that may relate to a specific left-hemispheric disorder.

Adult↗
PubMed2005

A cocaine-and-amphetamine-regulated-transcript peptide projection from the lateral hypothalamus to the ventral tegmental area.

Cocaine-and-amphetamine-regulated-transcript peptides play a role in the modulation of feeding and psychomotor stimulant-like behaviors. The ventral tegmental area and the lateral hypothalamus are likely structures where cocaine-and-amphetamine-regulated-transcript peptides mediate both of these functions. Although lateral hypothalamus inputs to the ventral tegmental area have long been known, the chemical nature of this pathway remains poorly understood. To address this issue, we tested the possibility that cocaine-and-amphetamine-regulated-transcript peptide-containing neurons in the lateral hypothalamus project to the ventral tegmental area using the retrograde transport of cholera toxin subunit B combined with cocaine-and-amphetamine-regulated-transcript peptide immunostaining. The largest density of retrogradely-labeled neurons in the hypothalamus after cholera toxin subunit B injection in the ventral tegmental area was found, ipsi- and contralaterally, in the lateral hypothalamus/perifornical area, although substantial numbers of retrogradely-labeled cells were also found in the medial preoptic area, lateral preoptic area, paraventricular nucleus, dorsomedial hypothalamus and ventromedial hypothalamus. More than 80% of the retrogradely-labeled cocaine-and-amphetamine-regulated-transcript peptide-immunoreactive neurons in the hypothalamus were found in the lateral hypothalamus/perifornical area both ipsilateral and contralateral to the injection sites. Although retrogradely-labeled neurons were seen in the amygdala, locus coeruleus, and raphe nucleus, none of them displayed cocaine-and-amphetamine-regulated-transcript peptide immunoreactivity. Therefore, the hypothalamic projection to the ventral tegmental area provides a substrate whereby cocaine-and-amphetamine-regulated-transcript peptides could mediate the rewarding aspects of feeding and psychomotor stimulant-like behaviors. These findings, combined with the fact that the lateral hypothalamus receives strong inputs from the shell of the nucleus accumbens and ventral pallidum, suggest that these structures are part of integrative functional loops that control reward and appetitive behaviors.

Animals↗
PubMed2005

Childhood laterality and adult schizophrenia spectrum disorders: a prospective investigation.

Left or mixed-handedness, footedness, and eye dominance are thought to indicate abnormalities in lateralization related to schizophrenia. Increased left or mixed-dominance in schizophrenia suggests possible hemispheric abnormalities associated with the disorder. A related body of research suggests that some indications of lateralization abnormalities may be evident prior to the onset of schizophrenia, suggesting that disruptions in lateralization are inherent to the developmental course of the disorder. We attempted to replicate and extend upon findings indicating differences in lateralization between children who later developed a schizophrenia spectrum disorder (n = 26) and those who did not develop a schizophrenia spectrum disorder (n = 216), among a high-risk and control, longitudinal sample. The rate of left or mixed-footedness, eye dominance, and any anomalous lateralization, but not handedness, discriminated between those who developed schizophrenia spectrum disorders and those who did not. Left or mixed-laterality appears to signal neurological disruption relevant to the development of schizophrenia spectrum disorders.

Adolescent↗
PubMed2006

Surgical approaches to the atrium of the lateral ventricle: microsurgical anatomy.

BACKGROUND: Managing lesions situated in the atrium of the lateral ventricle remains a challenging neurosurgical problem. The purposes of this study were to examine the microsurgical anatomy of the atrium of the lateral ventricle and the optic radiation and to define the differences in the exposure obtained by various surgical approaches. METHODS: Fifteen adult cadaveric specimens were studied using magnification x3 to x40 after perfusion of the arteries and veins with colored silicone. The microsurgical anatomy of the atrium of the lateral ventricle was examined. The relationship between the optic radiation and the atrium was studied using the white matter fiber dissection technique. Surgical approaches to the atrium of the lateral ventricle were examined in stepwise dissection. RESULTS: The medial and inferior walls of the atrium were free from optic radiation fibers. Surgical approaches to the atrium of the lateral ventricle are divided into 3 routes: (1) anterior approach: transsylvian approach, (2) posterior approaches: posterior transcortical, posterior transcallosal, occipital, and supracerebellar transtentorial approaches, and (3) lateral approaches: transtemporal and subtemporal approaches. CONCLUSION: Knowledge of the microsurgical anatomy of the atrium of the lateral ventricle and surrounding vital structures and the choice of an appropriate surgical approach will help surgeons perform safe and minimally invasive surgery.

Adult↗