World Neurosurg
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The pathophysiology of cerebral aneurysm formation remains to be elucidated. Estrogen is thought to be protective against the development of aneurysms. The aim of this study is to identify differentially expressed genes in the estrogen receptor pathway that may be linked to the development of cerebral aneurysms. ⋯ The analysis of 6 GEO databases revealed 4 differentially expressed genes (PIK3R1, HBEGF, ADCY7, and ADCY9) in cerebral aneurysm tissue that are associated with the estrogen receptor pathway. Further analysis of estrogen-associated differentially expressed genes may provide information about the protective effects of estrogen on cerebral aneurysm development.
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Surgeries for deep and eloquent cerebral lesions require a detailed knowledge of normal brain anatomy and accurate planning. Important parts of brain anatomy are the cerebral blood supply and collateral circulation system. In addition to well-known cortical and basal (circle of Willis) anastomoses, there is also a deep interarterial anastomotic circle that is not described in the literature. ⋯ Epithalamic anastomoses provide an additional mechanism of blood distribution that may play a role during surgical interventions or stroke.
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Revascularization before infarct development after cerebral ischemia may affect morbidity. The success of revascularization can be less than expected because of spontaneous thrombosis or restenosis with intimal hyperplasia. The aim of this study was to compare dabigatran etexilate, a direct thrombin inhibitor, with bemiparin sodium, a second-generation low-molecular-weight heparin, after carotid artery anastomosis. ⋯ Bemiparin reduced intimal hyperplasia and prevented thrombosis angiogenesis, but dabigatran did not prevent intimal hyperplasia, and its anticoagulation effect was more than the antithrombotic effect.
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Primitive neuroectodermal tumors (PNETs) are rare malignant neoplasms in the spinal cord that comprise undifferentiated or poorly differentiated neural crest cells. PNETs imaging findings lack specificity, making diagnosis difficult. ⋯ This paper reports a very rare case of PNETs with multiple lesions in the spinal cord that mimicked acute myelitis and emphasizes that multiple PNETs lesions detected by magnetic resonance imaging could have an initial acute myelitis-like presentation, which should be considered a differential diagnosis.
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The deficit in access to neurosurgical care worldwide remains a challenge, particularly in the developing economies such as Nigeria, where the neurosurgeon density is low. The concern that arguably subsists in sub-Saharan Africa is the decline in the number of recruited candidates into surgical specialty training programs, including neurosurgery, despite increasing burden of surgical cases. This study assessed the perception and willingness of medical undergraduates regarding neurosurgery career and determined the factors influencing their choice. This understanding will be critical to advancing ways of motivating them toward a neurosurgery career. ⋯ Our study indicated that the proportion of final-year medical students willing to choose neurosurgery career was low and there was sex disparity in the willingness to pursue a neurosurgical career.