Orthotopic meningioma rat model exhibits morphological and immunohistochemical congruency and epigenetic concordance with benign primary patient-derived tumors.

Meningiomas are the most common primary central nervous system tumor. Clinical trials have failed to support effective medical treatments, despite initially promising animal studies. A key issue could be that available experimental models fail to mimic the clinical situation.

CRIME-Q-a unifying tool for critical appraisal of methodological (technical) quality, quality of reporting and risk of bias in animal research.

Background: Systematic reviews within the field of animal research are becoming more common. However, in animal translational research, issues related to methodological quality and quality of reporting continue to arise, potentially leading to underestimation or overestimation of the effects of interventions or prevent studies from being replicated. The various tools and checklists available to ensure good-quality studies and proper reporting include both unique and/or overlapping items and/or simply lack necessary elements or are too situational to certain conditions or diseases.

Utilizing retinal arteriole/venule ratio to estimate intracranial pressure.

Purpose: Intracranial pressure (ICP) control is important to avoid secondary brain injury in patients with intracranial pathologies. Current methods for measuring ICP are invasive and carry risks of infection and hemorrhage. Previously we found correlation between ICP and the arteriole-venous ratio (A/V ratio) of retinal vessels in an outpatient setting.

Idiopathic normal pressure hydrocephalus: Validation of the DESH score as a prognostic tool for shunt surgery response.

Objective: Several radiological markers have been linked to clinical improvement after shunt surgery for idiopathic normal pressure hydrocephalus (iNPH). However, iNPH has no pathognomonic feature, and patients are still diagnosed as probable, possible, or unlikely cases based on clinical symptoms, imaging findings, and invasive supplementary tests. The predictive value of the disproportionately enlarged subarachnoid space hydrocephalus (DESH) score is not yet conclusively determined, but it might offer a more accurate diagnostic method.

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Permanent shunt diversion of cerebrospinal fluid away from the central nervous system is a widely recognized neurosurgical procedure. Still, patients with ventricular shunts are at substantial risk of shunt dysfunction, which includes complications like mechanical shunt failure, abnormal shunt drainage and infection. Early detection of shunt dysfunction is essential to proper and timely treatment, and acute shunt dysfunction might require immediate intervention.

Meningioma animal models: a systematic review and meta-analysis.

Background: Animal models are widely used to study pathological processes and drug (side) effects in a controlled environment. There is a wide variety of methods available for establishing animal models depending on the research question. Commonly used methods in tumor research include xenografting cells (established/commercially available or primary patient-derived) or whole tumor pieces either orthotopically or heterotopically and the more recent genetically engineered models-each type with their own advantages and disadvantages.

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This review investigates focused ultrasound for treating neuro-oncological diseases as an emerging treatment modality. The technique is based on focused ultrasound waves guided by MRI. By using high or low-frequency waves, thermoablation of smaller tissue volumes centrally in the brain or a safe, temporary opening of the blood-brain barrier can be carried out for better penetration of chemotherapy.

Ventriculosinus shunt: a pilot study to investigate new technology to treat hydrocephalus and mimic physiological principles of cerebrospinal fluid drainage.

Objective: Devices draining CSF to the intracranial venous sinus for the treatment of hydrocephalus have been tested in the past, and while clinically effective, have not shown efficacy in the long term. The majority of these devices become obstructed within 3 months due to endothelial overgrowth. In this study, the authors investigated a newly developed ventriculosinus (VS) shunt outlet device with the objective of showing it would remain patent for at least 6 months.

Virtual magnetic resonance elastography predicts the intraoperative consistency of meningiomas.

Background And Purpose: Virtual magnetic resonance elastography (vMRE) is an experimental imaging modality designed to non-invasively predict the haptic properties of tissues. The modality is sensitive to tissue stiffness and fibrosis. Information about meningioma consistency prior to resection is of great interest in neurological surgery as the surgical plan and outcome may be affected by the tumor's stiffness.

Orthostatic hypotension after cervicomedullary junction surgery: illustrative case.

Background: Surgery at the cervicomedullary junction carries a risk of damaging vital brainstem functions. Because the nucleus of the solitary tract (NS) is involved in the baroreceptor reflex, damage to its integrity may lead to orthostatic hypotension.

Observations: A 56-year-old man with a medical history of hypertension, von Hippel-Lindau disease, and previous bilateral adrenalectomy due to pheochromocytoma was referred with symptoms of dysphagia and paralysis of the left vocal cord.

Endonasal Endoscopic Approach for Minimally Invasive Orbital Decompression in Nonthyroid Proptosis-A Scoping Review.

Objective: The endoscopic endonasal approach (EEA) was originally performed to treat thyroid orbitopathy and proptosis. Since then, this approach also has been used to treat other causes of proptosis. This review systematically identifies surgical outcome and complication rates in patients without thyroid proptosis who underwent endoscopic endonasal orbital decompression.

Diagnosis, treatment, and outcome of primary CNS lymphoma-a single-center experience.

Background: Primary CNS lymphoma (PCNSL) is a highly aggressive non-Hodgkin lymphoma (NHL) that occurs in the CNS (e.g. brain, meninges, spinal cord, cerebrospinal fluid, or intraocular involvement) in the absence of systemic NHL.

Magnetic Resonance Elastography in Intracranial Neoplasms: A Scoping Review.

Background: Magnetic resonance elastography (MRE) allows noninvasive assessment of intracranial tumor mechanics and may thus be predictive of intraoperative conditions. Variations in the use of technical terms complicate reading of current literature, and there is need of a review using consolidated nomenclature.

Objectives: We present an overview of current literature on MRE relating to human intracranial neoplasms using standardized nomenclature suggested by the MRE guidelines committee.

Effect of 5-Aminolevulinic Acid and Sodium Fluorescein on the Extent of Resection in High-Grade Gliomas and Brain Metastasis.

Surgery is essential in the treatment of high-grade gliomas (HGG) and gross total resection (GTR) is known to increase the overall survival and progression-free survival. Several studies have shown that fluorescence-guided surgery with 5-aminolevulinic acid (5-ALA) increases GTR considerably compared to white light surgery (65% vs. 36%).

Preclinical cerebral cryoablation in non-tumor bearing pigs.

Patients with brain metastases, the most common intracranial tumor, have an average survival ranging from a few months to 40 months, and new treatment initiatives are needed. Cryoablation is a minimally invasive, well-tolerated, and effective procedure commonly applied for treatment of renal tumors and certain other malignancies. We aimed to examine the clinical usefulness of this procedure in a step-by-step program starting with cerebral cryoablation in healthy pigs.

Idiopathic normal pressure hydrocephalus; treatment and outcome in the Region of Southern Denmark.

Objective: Idiopathic normal pressure hydrocephalus (iNPH) is a prevalent and cost-effective disease to treat. However, no gold standard exists to confidently select patients for shunt surgery. The aim of this study was to investigate how patients with suspected iNPH at our center responded to shunt surgery and to compare pre-surgical variables between shunt responders and non-responders.

[Endoscopic evacuation of deep intracerebral spontaneous haematoma].

Deep-seated intracerebral spontaneous haematomas (ICHs) pose a neurosurgical challenge in decision-making process as summarised in this review. No studies have been able to demonstrate a significant effect on surgical removal. The challenge to surgical removal is the damage the surgery causes to the healthy brain in connection with the surgical procedure.

Magnetic resonance elastography in normal pressure hydrocephalus-a scoping review.

Background: Magnetic resonance elastography (MRE) of the brain allows quantitative measurement of tissue mechanics. Multiple studies are exploring possible applications in normal pressure hydrocephalus (NPH) in clinical and paraclinical contexts. This is of great interest in neurological surgery due to challenges related to diagnosis and prediction of treatment effects.

[Magnetic resonance elastography of the brain].

Magnetic resonance elastography (MRE) is a novel imaging modality allowing quantification of tissue consistency. Multiple trials have focused on the use of MRE to describe meningioma consistency prior to surgery and on improving diagnostic accuracy of normal pressure hydrocephalus and other dementias. MRE shows promising results, but still lacks direct clinical translational value.

[Intracranial pressure and non-invasive pressure modalities].

As summarised in this review, the need for intracranial neuromonitoring is crucial in patients with elevated intracranial pressure (ICP) regardless of aetiology and geographic location. ICP monitoring still relies heavily on invasive measure modalities. Non-invasive pressure modalities would exclude some of the difficulties of the invasive: procedure-related complications and accessibility.

[Intraoperative neuromonitoring during brain surgery].

Intraoperative neuromonitoring is a perioperative method, supplementary to stealth navigation and fluorescence microscopic imaging in brain surgery. It allows cortical and subcortical mapping, hence real time identification of eloquent brain areas through electrical stimulation of the cerebral cortex and subcortical areas. The method allows for functional guidance during both awake and asleep neurosurgery and aids in optimizing the extent of resection of the relevant pathology while preserving neurological function as summarised in this review.