https://repositorio.fleni.org.ar/xmlui/handle/123456789/3 Sun, 05 Apr 2026 18:55:23 GMT 2026-04-05T18:55:23Z https://repositorio.fleni.org.ar/xmlui/handle/123456789/1469 Introducing e-Motions: a novel intraoperative test for social cognition mapping. Triple validation in normative, schizophrenia, and autism spectrum disorder populations Martín-Fernández, Jesús; Caballero-Estebaranz, Nayra; Félez, Esteban; Pérez Del Rosario, Pedro; Rodríguez Pulido, Francisco; Navarro-Peris, Natalia; Martínez, Fernando; Cervio, Andrés Eduardo; Martín-Monzón, Isabel Background: Social cognition is essential for daily functioning, as it influences quality of life, return to work, and interpersonal communication. While schizophrenia and autism spectrum disorder (ASD) have been the paradigmatic conditions in which social cognition is markedly impaired, emerging evidence suggests that up to 30% patients with brain tumors may experience persistent deficits in this domain. Despite its clinical relevance, social cognition remains insufficiently studied in neuro-oncology and lacks dedicated intraoperative assessment tools specifically tailored for its use during awake brain surgery. Method: This study introduces e-Motions, a new test designed ad hoc to address this gap. The e-Motions test comprises 34 four-second video stimuli depicting two hyper-realistic avatars (one male, one female) expressing complex emotions. These avatars were developed using an AI-based facial motion capture system applied to 60 professional actors. Validation was performed in three groups: (1) healthy adults (n = 226), (2) individuals with schizophrenia (n = 33), and (3) ASD (n = 30). Results: Internal consistency (KR-20), test-retest reliability (ICC), and correlations with established social cognition tools (Reading the Mind in the Eyes [RMET], Ekman-60 faces test [Ekman-60F], and the Movie for the Assessment of Social Cognition [MASC]) were evaluated. The e-Motions test demonstrated high global internal consistency (KR-20 = 0.86) and good test-retest reliability (ICC₂,₁ = 0.73). Scores showed positive moderate correlations with both lower-level mentalizing tests (RME: ρ = 0.44; Ekman-60F: ρ = 0.48) and higher-level mentalizing test (MASC: ρ = 0.57). Discriminative power was strong for distinguishing healthy participants from individuals with schizophrenia (AUC = 0.89) and ASD (AUC = 0.79). Conclusions: e-Motions test is the first AI-based test created ad hoc for awake brain mapping. Its good internal consistency and significant correlation with low-level and high-level mentalizing tests make this tool a novel, ecological and promising way to identify critical regions involved in social cognition during awake brain mapping. Future studies should be performed to demonstrate its validity preserving this complex higher-order cognitive construct during and after brain tumor surgery. Tue, 30 Sep 2025 00:00:00 GMT https://repositorio.fleni.org.ar/xmlui/handle/123456789/1469 2025-09-30T00:00:00Z https://repositorio.fleni.org.ar/xmlui/handle/123456789/1452 “En Plaque Meningioma” masked by Chronic Serous Otitis Media with Effusion Ruella, Mauro Emiliano; Villamil, Facundo; Marengo, Ricardo; Carnevale, Martín Diego; Cervio, Andrés Eduardo Objective To highlight a rare but clinically significant cause of persistent unilateral otitis media with effusion (OME) through a case series of patients ultimately diagnosed with skull base “en plaque” meningioma. Emphasis is placed on the otologic presentation, its diagnostic approach and management. Methods Single-center, retrospective study of a cohort of patients with persistent unilateral OME ultimately diagnosed as en plaque meningiomas involving the temporal bone. A review of medical records, images, and operative videos was conducted. Results Five patients (4 females, 1 male; age 45–70) presented with longstanding and refractory hypoacusia, aural fullness tinnitus and othorrea. Delay between symptom onset and referral to our center reached 2 years. CT scans and MRIs showed evidence of sphenotemporal and middle-ear involvement. Prior management included unsuccessful procedures such as VTs, mastoidectomy, and exploratory myringotomy. Four patients underwent biopsy confirming WHO grade I meningioma. Neurosurgical decompression was required in three cases. Adjuvant therapy was employed in selected cases. Conclusion Persistent unilateral OME that is refractory to treatment should prompt suspicion for underlying skull base lesions, including meningioma en plaque. Awareness of this association helps expedite diagnosis. Otolaryngologists play a pivotal role in early recognition and timely referral can prevent progression. Imaging with CT and MRI aids diagnosis. Individualized approach is required. Surgery may be considered for histologic confirmation and decompression of neural structures with or without postoperative adjuvant therapies. However, total resection is difficult and often achieved at the expense of significant morbidity. Conservative management and surveillance are often the best alternative for asymptomatic lesions. Wed, 30 Jul 2025 00:00:00 GMT https://repositorio.fleni.org.ar/xmlui/handle/123456789/1452 2025-07-30T00:00:00Z https://repositorio.fleni.org.ar/xmlui/handle/123456789/1435 Global Rostral Midbrain Syndrome (GRMS) and Corpus callosum infarction in the context of shunt overdrainage Villamil, Facundo; Varela, Francisco José; Caffaratti, Guido; Ricciardi, Mario Emiliano; Cammarota, Ángel Norberto; Cervio, Andrés Eduardo We report 3 cases of Global rostral midbrain syndrome (GRMS) and Corpus Callosum (CC) infarction, in the context of hydrocephalus followed by shunt dysfunction and slit ventricles. Prior shunt implantation had been indicated for adult-onset hydrocephalus secondary to aqueductal stenosis of varying causes. All three patients had been stable for months before developing repeated shunt dysfunctions, ultimately progressing to parkinsonism, Parinaud syndrome, akinetic mutism, pyramidal signs, cognitive impairment, CC infarction and slit ventricles, in the context of CSF overdrainage. Parkinsonism-related symptoms responded to dopa in all cases, but Parinaud syndrome and cognitive impairment persisted. Although GRMS has been described in the context of a transtentorial pressure gradient after shunt blockage, in these three cases with similar clinical presentation, reverse transtentorial pressure gradient and slit ventricles due to shunt overdrainage was the likely cause. The authors discuss the role of CC infarction and provide a detailed analysis after gathering previously described data, to unify information under a recognizable clinical entity and better understand the underlying pathophysiology, treatment options and outcome. Sun, 26 Dec 2021 00:00:00 GMT https://repositorio.fleni.org.ar/xmlui/handle/123456789/1435 2021-12-26T00:00:00Z https://repositorio.fleni.org.ar/xmlui/handle/123456789/1426 Education and training in microsurgery: a current global Villanueva, Pablo Javier; Marcó Del Pont, Francisco; Bozkurt, Ismail; Baldoncini, Matias; Lausada, Natalia Raquel; Sugiyama, Taku; Akelina, Yelena; Scalia, Gianluca; Roka, Yam Bahadur; Chaurasia, Bipin Objective: Microsurgical skills are challenging to acquire and maintain, also presenting significant educational differences among practitioners. By exploring the current state of microsurgical training from the surgeon’s perspective, (including demographics, education experience and infrastructure details), this paper aims to give a first piece of information to enrich and promote debate and research. Methods: A comprehensive literature review was conducted to synthesize pre-published data on microsurgical training. Following this initial step and adhering to international guidelines for survey research, a new survey was designed to update existing information and address identified data gaps. The survey was distributed via personal contacts and scientific forums, ensuring respondent anonymity. It included exploratory questions across the following descriptive areas: a) respondent demographics; b) training experiences; c) microsurgical knowledge; and d) training center characteristics. Results: The survey gathered responses from 72 individuals across 25 countries and 9 specialties. Expertise of the participants was evenly distributed: 36.2% were trainees or recent graduates, 33.3% had an intermediate level, and 30.4% were experienced professionals. A unanimous consensus was reached on the superior efficacy of team training. Nearly half (43%) reported a lack of training facilities in their cities, while 15% identified financial constraints and 14% accessibility issues as major obstacles. Most participants (85%) expressed that microsurgical technique learning/training should be a priority. Conclusion: This exploratory international survey offers an initial glimpse into the underexamined field of microsurgical training. Based on a modest sample, the findings reveal disparities in access, infrastructure, and instructional methods. Though preliminary, the data aim to spark discussion and guide future, more comprehensive research efforts. Thu, 18 Sep 2025 00:00:00 GMT https://repositorio.fleni.org.ar/xmlui/handle/123456789/1426 2025-09-18T00:00:00Z