World Neurosurg
-
High-throughput sequencing technologies can expand our understanding of the pathologic basis of intracranial aneurysms (IAs). Our study was aimed to decipher the gene expression signature and genetic factors associated with IAs. ⋯ Two-dimensional genomic data from transcriptome and whole genome sequencing indicated that no somatic mutations occurred in DEGs. In addition, 3 DEGs (IKBKG, ACTB, and MKI67IP) and 2 mutant genes (MUC3B and BLM) were essential in IAs.
-
Case Reports
Fourth ventricle outlet obstruction with expanding space on the surface of cerebellum: A case report.
Hydrocephalus is classified as noncommunicating and communicating based on whether all ventricular and subarachnoid spaces are communicating. Although the diagnosis between the two different states is crucial, it is difficult in certain conditions. In particular, communicating hydrocephalus and noncommunicating hydrocephalus owing to fourth ventricle outlet obstruction are highly misdiagnosed. We describe a case of fourth ventricle outlet obstruction of unknown origin that was initially misdiagnosed as communicating hydrocephalus. ⋯ Enlargement of the whole ventricular system with an expanded space between the lower cranial nerves and cerebellar hemisphere can be caused by fourth ventricle outlet obstruction. In such cases, preoperative evaluation of anatomic architecture and cerebrospinal fluid obstruction using MRI cisternography is essential and leads to a successful endoscopic strategy.
-
A 56-year-old man was admitted to our hospital with intermittent right facial numbness for 1 year and instability on walking for 6 months. Magnetic resonance imaging revealed an ovoid and well-demarcated intra-axial pontine lesion. ⋯ Preoperative symptoms resolved completely 3 months after surgery and no evidence of recurrence was found during 3 years of follow-up. Although total resection of enterogenous cysts is recommended, cyst fenestration may be useful if the cyst is adherent to vital neurovascular structures.
-
The nomenclature adopted for endoscopic medial maxillectomies (EMMs) is exceedingly heterogeneous. The aim of this study was to objectively measure surgical exposure in a preclinical anatomic setting to validate a classification for modular EMMs. ⋯ This modular classification of EMMs, based on quantitative analysis in a preclinical setting, should allow for better personalized preoperative surgical planning and provides standardization of nomenclature.
-
Stress-induced hyperglycemia (SIH) after acute cerebrovascular disease is common and is associated with adverse clinical outcomes. The incidence of SIH after spontaneous subarachnoid hemorrhage (SAH) and its role in shunt placement have not been systematically investigated. The present study is designed to investigate the incidence of SIH after spontaneous SAH and its determinants. The role of SIH and premorbid hyperglycemia (using glycated hemoglobin [HbA1c]) in predicting external ventricular drainage (EVD) and ventriculoperitoneal shunt (VPS) placement is also investigated. ⋯ SIH is common after aSAH. In nonhydrocephalic aSAH, both SIH and premorbid uncontrolled hyperglycemia determine EVD but not VPS placement.