Spontaneous pseudoaneurysm of the superficial temporal artery in neurofibromatosis type 1: illustrative case.

Background: A pseudoaneurysm of the superficial temporal artery is an uncommon clinical entity that has largely been linked with direct traumatic causes. Neurofibromatosis type 1 (NF1)-related vasculopathy is a rare cause of idiopathic arterial bleeding in the craniofacial region.

Observations: A 46-year-old male with clinical features of NF1 presented to the hospital with an enlarging and tender right temporal mass without a history of trauma.

A rare case report of infratentorial cisternal angiolipoma with review of literature.

Angiolipomas are slow-growing benign mesenchymal-derived tumors consisting of mature adipocytes and thin-walled blood vessels. While the majority of angiolipomas are found in subcutaneous tissues, rarely there are case reports of intracranial lesions. We present a case of cisternal angiolipoma in a 10-year-old female.

Absorbable Artificial Dura Versus Nonabsorbable Artificial Dura in Decompressive Craniectomy for Severe Traumatic Brain Injury: A Retrospective Cohort Study in Two Centers.

Background: Severe traumatic brain injury (TBI) patients usually need decompressive craniectomy (DC) to decrease intracranial pressure. Duraplasty is an important step in DC with various dura substitute choices. This study aims to compare absorbable dura with nonabsorbable dura in duraplasty for severe TBI patients.

Giant Pediatric Supratentorial Tumor: Clinical Feature and Surgical Strategy.

Purpose: To analyze the clinical character of giant pediatric supratentorial tumor (GPST) and explore prognostic factors.

Materials And Methods: We analyzed the clinical data comprising of 35 cases of GPST from a single center between January 2015 and December 2020. The tumor volume was measured by 3D slicer software based on preoperative magnetic resonance imaging (MRI).

Case Report: Whole-Exome Sequencing of Hypothalamic Hamartoma From an Infant With Pallister-Hall Syndrome Revealed Novel Mutation in the .

GLI-Kruppel family member 3 (GLI3), a zinc finger transcription factor of the sonic hedgehog pathway, is essential for organ development. Mutations in cause several congenital conditions, including Pallister-Hall syndrome (PHS), which is characterized by polydactyly and hypothalamic hamartoma. Most patients are diagnosed soon after birth, and surgical removal of hypothalamic hamartoma in the very young is rarely performed because of associated risks.

Rapid Clot Reduction with Direct Aspiration via 8-F Guide Catheter for Cardioembolic Extracranial Carotid Artery Occlusion: A Guide Catheter Aspiration Technique.

This study reported data that were collected from 11 consecutive patients undergoing treatment for acute cardioembolic extracranial carotid artery (ECCA) occlusion with extensive clot burden via the guide catheter aspiration (GCA) technique. The GCA technique was performed as a direct aspiration using 2 60-mL syringes simultaneously through an 8-F guide catheter. Successful reperfusion was achieved in all 11 patients at the end of thrombectomy, and successful reperfusion was observed in 4 patients after a single GCA procedure pass.

Successful treatment of pyogenic ventriculitis caused by extensively drug-resistant with multi-route tigecycline: A case report.

Background: Pyogenic ventriculitis caused by extensively drug-resistant () is one of the most severe complications associated with craniotomy. However, limited therapeutic options exist for the treatment of ventriculitis due to the poor penetration rate of most antibiotics through the blood-brain barrier.

Case Summary: A 68-year-old male patient with severe traumatic brain injury developed pyogenic ventriculitis on postoperative day 24 caused by extensively drug-resistant susceptible to tigecycline only.

Simvastatin pretreatment ameliorates t-PA-induced hemorrhage transformation and MMP-9/TIMP-1 imbalance in thromboembolic cerebral ischemic rats.

The use of thrombolysis with tissue-plasminogen activator (t-PA) in patients with acute ischemic stroke (AIS) is limited by increased levels of matrix metalloproteinase-9 (MMP-9) and by the increased risk of hemorrhagic transformation (HT). In this study, we investigated the effects of simvastatin pretreatment on t-PA-induced MMP-9/tissue inhibitor of metalloproteinase-1 (TIMP-1) imbalance and HT aggravation in a rat AIS model. The rat AIS model was established by autologous blood emboli.

Whole exome sequencing of multiple meningiomas with varying histopathological presentation in one patient revealed distinctive somatic mutation burden and independent clonal origins.

Although meningiomas are common intracranial tumors, multiple meningiomas (MMs) are rare entities in patients without neurofibromatosis type 2. Previous studies suggest most sporadic MMs are of monoclone in origin. To elucidate the clonal relationship between two sporadic meningiomas from the same patient by using the next-generation sequencing (NGS) platform.

Titanium mesh cranioplasty in pediatric patients after decompressive craniectomy: Appropriate timing for pre-schoolers and early school age children.

Purpose: There is little knowledge on the growth of cranial defects, appropriate timing and outcomes of application of titanium mesh for cranioplasty in the pediatric population, especially pre-school age (2-5 years old) and school age (6-12 years old) children. We hypothesised that cranioplasty for pre-schoolers could be delayed to school age due to the expected cranium growth, whereas, for the school age group, it is better to perform routine cranioplasty (3-6 months) to protect the brain and therefore ensure their timely return to school life.

Materials And Methods: A retrospective review of pediatric patients (2-12 years old) who underwent titanium mesh cranioplasty for cranial defects from 2006 to 2012 was performed.

Solitaire Stent Permanent Implantation as an Effective Rescue Treatment for Emergency Large Artery Occlusion.

Background: In this study, we present our experiences on the feasibility of rescue permanent Solitaire stent placement for failed mechanical thrombectomy (MT) and our protocol to avoid ineffective stent placement.

Methods: We retrospectively evaluated the data for consecutive patients admitted into the Second Affiliated Hospital of Wenzhou Medical University and 2 collaboration hospitals from August 2014 to May 2018 for emergency large artery occlusion. The baseline clinical characteristics and radiologic assessment, interventional data, clinical outcome, and angiographic follow-up data were assessed.

Epigallocatechin Gallate Preferentially Inhibits O-Methylguanine DNA-Methyltransferase Expression in Glioblastoma Cells Rather than in Nontumor Glial Cells.

Objective: O-methylguanine (O6-meG) DNA-methyltransferase (MGMT) is a main regulator of temozolomide (TMZ) resistance in glioblastomas. Some MGMT inhibitors have been studied in clinical trials but with very little success, because their inhibiting effects were not tumor-selective, and often cause severe toxicity in normal tissues in the presence of TMZ. The goal of this study is to explore whether Epigallocatechin gallate (EGCG), a natural small molecule, could preferentially modulate MGMT in glioblastoma cells.

The effects of tumor size and postoperative radiotherapy for patients with adult low-grade (WHO grade II) infiltrative supratentorial astrocytoma/oligodendroglioma: A population-based and propensity score matched study.

Background: The update of 2018 NCCN guidelines (central nervous system cancers) recommended the risk classification of postoperative patients diagnosed as adult low-grade (WHO grade II) infiltrative supratentorial astrocytoma/oligodendroglioma (ALISA/O) should take tumor size into consideration. Moreover, the guidelines removed postoperative radiotherapy (PORT) for low risk patients. Our study aimed to explore the specific tumor size to divide postoperative patients into relatively low- or high risk subgroups and the effect of PORT for ALISA/O patients.

FM19G11 inhibits O -methylguanine DNA-methyltransferase expression under both hypoxic and normoxic conditions.

FM19G11 is a small molecular agent that inhibits hypoxia-inducible factor-1-alpha (HIF-1α) and other signaling pathways. In this study, we characterized the modulating effects of FM19G11 on O -methylguanine DNA-methyltransferase (MGMT), the main regulator of temozolomide (TMZ) resistance in glioblastomas. This study included 2 MGMT-positive cell lines (GBM-XD and T98G).

Trephination mini-craniectomy for traumatic posterior fossa epidural hematomas in selected pediatric patients.

Purpose: Posterior fossa epidural hematomas (PFEDH) are uncommon in children but usually require timely surgical intervention due to the risk of life-threatening brainstem compression. We attempt to make the surgical procedure less invasive by treating selected pediatric patients with trephination mini-craniectomy.

Methods: We retrospectively reviewed the clinical courses, radiological findings, surgical procedures, and prognoses of the pediatric patients who were treated in our departments for traumatic PFEDH from January 2010 to January 2015.

Traumatic open depressed cranial fracture causing occlusion of posterior superior sagittal sinus: Case report.

Rationale: The superior sagittal sinus (SSS) is the major dural sinuses that receive a considerable amount of venous drainage. Interruption of its posterior third has been suggested to cause intracranial hypertension and lead to potentially fatal consequences.

Patient Concerns: We presented a 22-year-old man with a severe headache and scalp bleeding after a head chop wound.

Delayed surgical repair of cranial burst fracture without strict dura closure: a prudent choice in selected patients?

Objectives: Surgical management of cranial burst fracture (CBF) usually involves craniotomy to remove the devitalized brain tissues, followed by watertight repair of dural tears. However, there were times when the dural tear was so extensive that a substantially large bone flap would have to be removed in order to expose the retracted dural margins before it could be repaired. In such cases, strict dural repair would incur a significantly higher risk of damages to the surrounding neural tissues and severe bleeding, especially when the fracture was in the vicinity of eloquent cortical areas and sinus.

Spinal epidermoid cyst formation after spinal fracture operation: a case report.

Acquired spinal epidermoid cysts are extremely rare. There are only a few reports on the formation of epidermoid cysts after lumbar puncture or spinal trauma. In this report, we present a patient who was diagnosed with epidermoid cyst after operation for spinal fracture.

Comparison of covered stents with detachable balloons for treatment of posttraumatic carotid-cavernous fistulas.

Treatment of posttraumatic direct carotid-cavernous fistula (DCCF) with detachable balloons (DB) is associated with relatively low complete occlusion rates. We aimed to compare the angiographic and clinical results of treatment with covered stents with the results of treatment with DB. Thirty-four patients with posttraumatic DCCF were selected for treatment with DB (n=19, group A) or covered stents (n=15, group B).

[Role of modified external ventricular drainage in the management of children with tuberculous meningitis hydrocephalus].

Objective: To explore the role of modified external ventricular drainage (mEVD) in the treatment of tuberculous meningitis obstructive hydrocephalus in children.

Methods: The records were retrospectively reviewed for 30 pediatric patients of tuberculous meningitis with hydrocephalus (TBMH) undergoing surgery between January 2007 and December 2010. The procedures included ventricular abdomen subcutaneous drainage (mEVD) (n = 6), Ommaya reservoir (n = 9) and ventriculoperitoneal shunt (VPS) (n = 15).

Decompressive craniectomy in addition to hematoma evacuation improves mortality of patients with spontaneous basal ganglia hemorrhage.

We conducted a retrospective study to assess the effect of decompressive craniectomy on outcome of patients with spontaneous basal ganglia hemorrhage (SBH). A review of a hospital database was performed to search for patients with a diagnosis of SBH who received hematoma evacuation with (N=38) or without (N=46) decompressive craniectomy in our institute from January 2005 to January 2008. Descriptive statistics revealed that patients in the decompressive craniectomy group were in poorer clinical condition before surgery.

Magnesium sulphate in the management of patients with aneurysmal subarachnoid haemorrhage: a meta-analysis of prospective controlled trials.

Primary Objective: Experimental and clinical studies have suggested that magnesium has neuroprotective and vasodilatation properties. A meta-analysis was conducted to assess the effectiveness and safety of intravenous magnesium therapy in patients with aneurysmal subarachnoid haemorrhage (SAH).

Research Design: Meta-analysis.