Acta neurochirurgica
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Acta neurochirurgica · Aug 2012
Surgical treatment of symptomatic cerebral cavernous malformations in eloquent brain regions.
Despite the increased risk of hemorrhage and deteriorating neurological function of once-bled cerebral cavernous malformations (CM), the management of eloquently located CMs remains controversial. ⋯ Despite the high postoperative transient morbidity, the majority improved profoundly during follow-ups. Compared with natural history, surgical treatment should be considered for all eloquent symptomatic CMs. Dorsal brainstem location and poor preoperative neurological status are associated with an increased postoperative morbidity.
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Superficial temporal artery to middle cerebral artery (STA-MCA) bypass is a time-honored, crucial procedure employed in the management of well-selected patients with cerebrovascular ischemic disease, particularly moyamoya. In addition, its application to complex cerebral aneurysms and neoplasms requiring vessel sacrifice for complete resection continues to stand the test of time. ⋯ With careful attention to the surgical nuances of STA-MCA bypass, this indispensable procedure is a hemisphere-preserving technique that can be performed with high patency and low morbidity rates.
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Acta neurochirurgica · Aug 2012
Inhibition of c-Jun N-terminal kinase prevents blood-brain barrier disruption and normalizes the expression of tight junction proteins clautin-5 and ZO-1 in a rat model of subarachnoid hemorrhage.
The c-Jun N-terminal kinase (JNK) proteins are encoded by three genes (JNK1, JNK2, and JNK3), giving rise to multiple isoforms via alternative splicing. JNK inhibition using a chemical inhibitor SP600125 confers neuroprotection in an animal model of subarachnoid hemorrhage (SAH). The aim of this study is to investigate whether the protective effects of SP600125 were associated with modulation of tight junction proteins including claudin-5 and ZO-1 and to define which JNK isoforms were involved in the early brain injury after SAH. ⋯ Our data demonstrate that the JNK signaling plays an important role in the regulation of tight junction proteins and BBB integrity, and thus represents a promising target against brain injuries after SAH.