World Neurosurg
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Case Reports
Three Applications of 5-Aminolevulinic Acid (5-ALA) for Microsurgical Resection of Meningiomas.
Fluorescence-guided resection of brain tumors using 5-aminolevulinic acid (5-ALA) has been established for high-grade gliomas. Recently, its application for the resection of low grade tumors and benign lesions including meningioma has been suggested in the literature.1 Achieving a Simpson grade I resection in meningioma surgery is associated with a lower rate of recurrence.2,3 Although meningiomas are mostly benign and well-circumscribed lesions, they can be locally aggressive, invading brain parenchyma and other critical structures. In these cases, 5-ALA-guided resection may help maximize the extent of tumor resection and limit disruption of normal structures. ⋯ The second patient is a 72-year-old man with recurrent left occipital parietal meningioma who underwent a parietal craniotomy. The third case was a 62-year-old woman with a foramen magnum meningioma encircling the left vertebral artery. These cases demonstrate the utility of 5-ALA in a variety of challenges associated with resection of meningiomas (Video 1).
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A large body of evidence has suggested that the disruptions of neural plasticity in the brain play a pivotal role in major depressive disorder (MDD). Electroacupuncture (EA) therapy has been shown to be an effective treatment modality for MDD. However, the mechanism underling the antidepressive effect of EA treatment has not been clearly elucidated. This study aimed to investigate the antidepressant-like effects of EA associated with its protection effect of synaptic structural plasticity. ⋯ These results suggest that EA has a potent antidepressant effect, likely through upregulated expression of the AMPAR and protected neural plasticity in CUMS-treated rats.
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Case Reports
Primary CNS lymphoma in a patient on Adalimumab (Humira) therapy for chronic plaque psoriasis.
Adalimumab (Humira) is a recombinant human monoclonal antibody against tumor necrosis factor alpha, which works by blocking the interaction of tumor necrosis factor alpha with its cell-surface receptors, thereby limiting the progression of inflammatory pathways. Its use is approved for several autoimmune conditions, including chronic plaque psoriasis, for which it has been prescribed as a first-line biologic treatment. Increased risks of malignancy, particularly nonmelanoma skin cancer and non-central nervous system lymphomas, have been reported with use of this drug; however, there have been no reports of central nervous system lymphomas. ⋯ We report the first case to our knowledge showing a possible association of central nervous lymphoma and adalimumab.
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Posterior cerebral artery (PCA) aneurysms comprise <2% of all intracranial aneurysms and are usually located on the P1 and P2 segments. Aneurysms of the P3 segment of the PCA are even rarer, and despite their proximity to the cerebral aqueduct, presentation with hydrocephalus is exceptional. This video demonstrates the case of a 28-year-old female patient who presented acute hydrocephalus due to a partially thrombosed, giant P3 segment PCA aneurysm. ⋯ The patient made an excellent recovery, and she was discharged on postoperative day 3 (Video 1). This case demonstrates the efficacy of microsurgical clipping for a giant thrombotic P3 segment PCA aneurysm that caused a mass effect. Surgery excluded the aneurysm from the circulation and decompressed the cerebral aqueduct, obviating the need for a permanent ventriculoperitoneal shunt.
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This study aimed to investigate OIP5-AS1 effects on microangiopathy in diabetic mouse. ⋯ OIP5-AS1 attenuated microangiopathy in diabetic mouse by regulating miR-200b/ACE2.