World Neurosurg
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To investigate 10 candidate single nucleotide polymorphisms (SNPs) in 5 genes (CASP8, XRCC1, WRN, NF2, and BRIP1) to confirm the association between the 5 genes and the meningioma risk in a Chinese population. ⋯ This study indicated a role for BRIP1 gene variations in meningioma and may be informative for future genetic or biological studies of meningioma. These findings will assist in further understanding the genetic cause for meningiomas and guide more effective biological interventions to facilitate meningiomas.
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A standard post-concomitant radiochemotherapy involving adjuvant temozolomide (TMZ) was stopped after 6 cycles for high-grade gliomas (HGG). Several studies demonstrated that prolonged TMZ treatment increased survival for these patients. ⋯ During adjuvant TMZ treatment, tumor volume decreased significantly (P = 0.042, and P = 0.005, respectively) in patients with GBM and AA. Prolonged TMZ administration improved OS, without increased toxicity.
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Orbital lymphaticovenous malformations (LVMs) are congenital vascular lesions that are typically infiltrative in nature. There have been reports of orbital LVMs extending intracranially through orbital fissures, but there have been no reports of intradural extension. ⋯ This case highlights the importance of an interdisciplinary approach when managing infiltrative orbital LVMs, as both ophthalmologic and neurosurgical expertise were critical in the success of the surgery.
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The most common pathology associated with an intraluminal carotid thrombus is underlying atherosclerosis. In rare cases, it may be associated with thrombocytosis. Currently there are no clear recommendations for the treatment of ischemic stroke associated with thrombocytosis. Our present case illustrates the use of plateletpheresis for the acute management of thrombocytosis complicated by an internal carotid artery thrombus resulting in a right middle cerebral artery stroke. ⋯ The role for plateletpheresis in treating secondary thrombocytosis is not well established. In cases with extreme thrombocytosis, immediate surgical thrombectomy may be contraindicated owing to a high risk of rethrombosis. Urgent cytoreduction with correction of the putative mechanism for thrombocytosis should be undertaken to provide optimal management.
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Although the primary goal of treatment of type II odontoid fracture is bony union, some advocate continued nonsurgical management of minimally symptomatic older patients who have fibrous union or minimal fracture motion. The risk of this strategy is unknown. We reviewed our long-term outcomes after dens nonunion to define the natural history of Type II odontoid fractures in elderly patients managed nonoperatively. ⋯ Orthosis removal despite fracture nonunion may be reasonable in elderly patients with Type II dens fractures.