World Neurosurg
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PI3K-Akt signaling has been proved to be closely related to atherosclerosis, and hypertension has been shown to be an important risk factor for atherosclerosis. Studies have shown that genetic susceptibility is important in the etiology of symptomatic intracranial atherosclerotic stenosis (sICAS). However, few candidate genes have been identified. In the present study, we explored latent connections between single nucleotide polymorphisms (SNPs) of PI3K-Akt-related genes and sICAS with hypertension in Han Chinese subjects. ⋯ The variant of the INSR rs3745551 loci might be crucial to the pathogenesis of sICAS with hypertension in Chinese Han populations. Furthermore, the C allele at this locus might be a potentially harmful variant in sICAS with hypertension.
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Current methods of neuromodulation have been shown to reduce seizures in patients with drug-resistant epilepsy, and in a small percentage of patients it has rendered them seizure-free when surgical resection is not feasible. While polytherapy with antiseizure medication is not uncommon, dual neurostimulation has received limited attention. We set out to identify trends and changes in the use of dual neurostimulation to understand choosing device combinations. ⋯ The ability to localize was the primary decision-maker in prompting RNS versus DBS. RNS surgery was more likely to be preceded by invasive electroencephalographic monitoring. Previous VNS responsiveness was more prominent in patients with DBS. Dual therapy was safe. Prospective multicenter studies of dual-device neuromodulation are needed.
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In this article, we aimed to describe some of the currently most challenging problems in neurosurgical management of hydrocephalus and how these can be reasons for inspiration for and development of research. We chose 4 areas of focus: 2 dedicated to improvement of current treatments (shunt implant surgery and endoscopic hydrocephalus surgery) and 2 dedicated to emerging future treatment principles (molecular mechanisms of cerebrospinal fluid secretion and hydrocephalus genetics).
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Large animal models of cerebral ischemia have the potential to increase the translational value of stroke research. This study aims to measure early changes of brain tissue oxygen pressure (ptiO2) and cerebral blood flow (CBF) to characterize a porcine model of sequential middle cerebral artery occlusion (MCAO) and common carotid artery occlusion (CCAO). ⋯ Intraparenchymal multiparametric measurements of acute changes in ptiO2 and CBF were variable after MCAO. Bilateral CCAO led to a consistent decrease in ptiO2 and correlated with early degenerative histologic changes, but CBF did not. Real-time procedural ptiO2 monitoring could provide useful guidance in large animal ischemia models. Feasibility in the context of global cerebral hypoperfusion is demonstrated.