World Neurosurg
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Sporadic vestibular schwannoma (VS) is a benign primary tumor that arises from the vestibular nerve. Growing VS can negatively compress the brain stem, which can lead to death. MicroRNAs (miRNAs) can negatively regulate target genes at the post-transcriptional level and are critical in tumorigenesis. Studies have demonstrated the tumor suppressive function of microRNA-205-5p (miR-205) across many cancers, but no studies have evaluated the role of miR-205 in sporadic VS. We conducted this study to examine the role of miR-205 in sporadic VS cell proliferation. ⋯ These findings suggested that miR-205 suppressed sporadic VS proliferation by targeting CDK14 and may be considered as a potential drug therapy for sporadic VS treatment in the future.
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Sellar arachnoidocele is a term used to define the herniation of the subarachnoid space to the sella.1 This is a rare radiologic finding that, in most cases, does not require treatment.2-5 When symptoms appear, the term empty sella syndrome is used. Two varieties exist: primary and secondary empty sella syndrome.2 The aim of this 3-dimensional operative video (Video 1) is to demonstrate the extradural microsurgical remodeling of the sellar fossa with autologous bone in 2 cases of primary empty sella syndrome. Both patients signed an informed consent for the procedures and agree with the use of their images for research purposes. ⋯ Our team considers this procedure to be useful, technically simple, and low cost. Being autologous, rejection possibilities are almost null. This 3D video serves as a complement to illustrate the technique.
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There are many approaches to the cerebellopontine angle, all of which involve different degrees of disruption of the normal anatomy. The retromastoid craniotomy has stood the test of time for the efficiency, panoramic exposure, and flexibility it provides while allowing excellent control over the vital cerebrovascular structures including the brainstem. This approach allows the surgeon not to get distracted by how to get there but instead to focus on what to do when he or she is there. Herein, I discuss the nuances of this simple approach with its "extended" variations.
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Lenticulostriate middle cerebral artery (MCA) aneurysms are rare and often involve perforating vessels, making endovascular treatment difficult. When projecting superiorly, aneurysm rupture can likely cause intraparenchymal hemorrhage in basal ganglia. Consequently, surgical clip ligation requires control not to aggressively elevate the frontal lobe to avoid intraoperative injury. ⋯ Postoperative angiogram confirmed complete aneurysm ligation. The patient clinically did well and was discharged home on postoperative day 2. Our video demonstrates safe and effective surgical treatment of a rare aneurysm2 through a small LSO craniotomy approach (Video 1).