World Neurosurg
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Frontotemporal dermal sinus tracts with associated dermoid cysts are very rare, with only 1 found in the largest series to date and 10 total documented case reports. ⋯ We review of the literature and argue for early identification and prophylactic surgical resection to avoid complications associated with infection and to mitigate risk of subtotal resection.
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Flow-diverting stents (FDS) are relatively safe and highly efficacious in treating cerebral aneurysms; however, a small subset of patients experience devastating hemorrhagic complications owing to presumed alterations in local aneurysm and distal cerebral blood flow. The downstream effects of FDS on distal cerebral blood flow is not well understood, but isolated reports of hyperperfusion injury have been described in the literature. We investigate the incidence and clinical factors contributing to abnormal cerebral blood flow after FDS placement. ⋯ This study yielded several novel findings. We demonstrate that cerebral blood flow alterations will occur in a significant subset of patients undergoing FDS treatment. We also provide new evidence that aneurysm volume and history of smoking may predict the developing of postoperative perfusion anomalies. Future studies are needed to evaluate the clinical ramifications of cerebral blood flow disruption in large prospective studies.
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Neuronal apoptosis plays a pivotal role in spinal cord injury (SCI)-induced secondary cellular events. Caspase-dependent and -independent pathways are involved in neuronal apoptosis. Caspase-3 is the final effector of caspase-dependent apoptosis, whereas poly-ADP-ribose polymerase-1 (PARP-1) and apoptosis-inducing factor (AIF) are key executors of caspase-independent apoptosis. However, it remains unclear whether simultaneous inhibition of the 2 apoptosis pathways will be more beneficial for neuronal survival. Therefore, this study investigated the ability of coadministration of the PARP-1 inhibitor 3-aminobenzamide (3-AB) and caspase-3 inhibitor z-DEVD-fmk to attenuate apoptosis in a rat SCI model. ⋯ These results suggest that combination therapy is beneficial for neuronal function recovery in rats with SCI. The underlying mechanism may be associated with cosuppression of caspase-dependent and caspase-independent apoptosis pathways.
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The craniovertebral junction (CVJ) may be affected by several diseases. It is an anatomically complex region, involving the osteoligamentous, vascular, and nervous structures, which makes surgery challenging. In a case of ventral compression, an anterior approach is preferable, although posterior fixation is often required. Anterior transmucosal approaches are associated with high rates of complications. However, decompression and fixation by the use of retropharyngeal extramucosal approaches may be challenging. ⋯ A single- stage anterior extramucosal SM approach for decompression and stabilization of the CVJ is feasible and could result in shorter surgical duration, avoiding the complications related to both the transmucosal approach and the prone position, although specific related risks exist. Mechanical investigation of this hybrid system and in vivo studies are needed to confirm our results.
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Primary extracranial meningiomas are uncommon neoplasms. In particular, meningioma involving the hypoglossal canal is extremely rare, with only 4 cases reported in the literature so far. Given that each of these meningiomas originated in the juxtacondyle region with involvement of the hypoglossal canal, to the best of our knowledge, a meningioma that exists only within the hypoglossal canal has yet to be reported. ⋯ In this extremely rare case of hypoglossal canal meningioma, total tumor removal via a transcondylar approach resulted in the recovery of hypoglossal nerve function.