World Neurosurg
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The transorbital endoscopic approach has been increasingly employed in the management of skull base disease.1-4 We present a case of a 48-year-old woman with a 2-month history of progressively worsening headache referred to our neurosurgery division after a new-onset generalized seizure. On examination, she was found to have diminished olfaction with no additional findings, including no visual or cognitive deficits. Preoperative imaging revealed a large anterior fossa mass originating at the left olfactory groove with leftward extension and prominent anterior and posterior ethmoidal arterial feeders. ⋯ Postoperative imaging confirmed gross total tumor resection without evidence of recurrence. This case highlights the application of the transorbital endoscopic approach in the management of anterior cranial base tumors. Advantages of this approach include minimal invasive access, avoidance of brain retraction, and ease for early tumor devascularization.
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Infantile choroid plexus papilloma (CPP) associated with multiple peritumoral cysts is a rare variant of CPP, and clinical course and optimal management are largely unknown. A 9-month-old boy presented with a large solid tumor in the left lateral ventricle associated with multiple peritumoral cysts, arachnoid cysts, and hydrocephalus containing xanthochromic fluid with high protein content. ⋯ Follow-up magnetic resonance imaging 12 months after surgery revealed that these cysts remained stable. CPP with nonenhancing peritumoral cysts can be managed by resection of only the solid part of the tumor without permanent cerebrospinal fluid diversion.
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The objective of the study was to quantify the effect of cage material (titanium-alloy vs. polyetheretherketone or PEEK) and design (porous vs. solid) on subsidence and osseointegration. ⋯ The choice of material and design is critical to cage mechanical and biological performances. A porous titanium cage can reduce subsidence risk and generate biological stability through bone on-growth and ingrowth.
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C1/2 facet configurations and clivus-canal-angles (CXAs) have been proposed as criteria for posterior fusion in Chiari I malformation (CMI). ⋯ For adult CMI without BI, C1/2 facet configurations and CXA are irrelevant. FMD alone provides excellent long-term outcomes. In CMI with BI, anterior C1 facet displacements indicate C1/2 instability. Posterior fusions can be reserved for patients with ventral compression or C1/2 instability.
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Neuroinflammation triggers sequelae after spinal cord injury (SCI). Inhibition of inflammation promotes recovery after SCI. MicroRNAs regulate many pathophysiological processes, including inflammation. Any role for miR-181a-5p in the inflammatory response after SCI remains unclear. Thus, we evaluated the effects of miR-181a-5p on inflammation in PC12 cells and the underlying mechanism in play. ⋯ miR-181a-5p attenuated the inflammatory response of LPS-induced PC12 cells by directly inhibiting HMGB1; thus, miR-181a-5p may serve as a therapeutic target in SCI.