World Neurosurg
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To study the prevalence of OTX1 and OTX2 gene expression in 60 medulloblastoma specimen samples and to establish correlations between gene expression and clinical and histopathological aspects. ⋯ The relative expression of OTX1 and OTX2 was dependent on patient age, tumor location, and histological variant. In addition, OTX2 expression might be a predictive factor for leptomeningeal metastases of medulloblastoma. The OTX pathway should be consider as an important venue for medulloblastomas development.
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Stent thrombosis (ST) is a known complication after intracranial stent implantation. The pathophysiology of ST is multifactorial, and standardized treatments for ST remain uncertain. ⋯ In case of refractory ST, high-flow extracranial-to-intracranial bypass proved to be in this case a feasible and effective rescue option.
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To investigate the mechanism of dexmedetomidine (Dex) in improving brain damage induced by cerebral ischemia-reperfusion injury in rats. ⋯ Dex improved ischemic brain damage by promoting signal transduction of the ERK/CREB pathway, which may provide new ways for clinical treatment of cerebral ischemia-reperfusion injury.
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Schizencephaly is a rare congenital central nervous system malformation characterized by linear, thickened clefts of the cerebral mantle. Recently, germline mutations in collagen type IV alpha 1 (COL4A1) have been reported to be a genetic cause of schizencephaly as a result of prenatal stroke. Patients with COL4A1 mutation demonstrate a variety of disease phenotypes. However, little is known about the potential complications of patients with COL4A1 mutations before and after neurologic surgery. ⋯ To our knowledge, malignant hyperthermia and cerebral venous thrombosis have not been reported in the literature in patients with COL4A1 mutations after surgery. Schizencephaly arising from COL4A1 mutations might be a disease prone to these adverse effects because this mutation is known to be associated with venous tortuosity, venous vulnerability, and muscle spasms due to basement membrane protein abnormalities. We need to better understand the wide spectrum of clinical phenotypes of COL4A1 mutations and potential complications in order to better manage surgery of patients with schizencephaly.
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Recently, full endoscopic transforaminal decompression surgery (FETDS) under local anesthesia has been used to treat symptomatic lumbar spinal stenosis (SLSS) in selective patients. Considering the minimal injury associated with this technique, it has a potential advantage for geriatric patients. In addition, combining thorough preoperative assessments and preparations with this technique to achieve a safer and more effective outcome for geriatric patients with SLSS is necessary. ⋯ FETDS was effective and safe in the treatment of SLSS in geriatric patients, with minimal physiologic impact, taking advantage of the current protocol of thorough assessments and appropriate preoperative preparation.