Neurosurgery
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The stability of the joints connecting the cranium to the upper cervical spine is of vital importance. The ligaments of this region, for the most part, have been thoroughly investigated, with the exception of the accessory atlantoaxial ligament. ⋯ The accessory atlantoaxial ligament seems to participate in craniocervical stability and perhaps should be renamed the accessory alar ligament or accessory atlantoaxialoccipital ligament; both of these terms better denote its anatomic characteristics. Perhaps in the future, better magnetic resonance imaging techniques and machines will be able to identify this structure so as to appreciate its integrity after upper cervical spine trauma.
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To investigate the contribution of high-field intraoperative magnetic resonance imaging (iMRI) for further reduction of tumor volume in glioma surgery. ⋯ Despite extended resections, introduction of high-field iMRI in conjunction with functional navigation did not translate into an increased risk of postoperative deficits. The use of high-field iMRI increased radicality in glioma surgery without additional morbidity.
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Comparative Study
Tumor necrosis factor alpha expression and protein levels after fluid percussion injury in rats: the effect of injury severity and brain temperature.
Tumor necrosis factor alpha (TNFalpha) is elevated in some models of traumatic brain injury (TBI). However, it is unclear how TNFalpha messenger ribonucleic acid (mRNA) expression and protein levels are affected by injury severity and posttraumatic temperature modification. This study determined the regional and temporal profile of TNFalpha levels after moderate and severe TBI and assessed the effects of posttraumatic hypothermia or hyperthermia on this proinflammatory cytokine. ⋯ Rapid and marked increase in TNFalpha mRNA expression and protein levels follows moderate and severe TBI. Injury severity and posttraumatic temperature play a modest but significant role on TNFalpha expression and protein levels. These findings suggest that the effects of posttraumatic temperature on histopathological and behavioral outcome primarily may involve secondary mediators that do not operate directly through their effect on TNFalpha.