Cannabinoid treatments in epilepsy and seizure disorders.

Cannabis has been used to treat convulsions and other disorders since ancient times. In the last few decades, preclinical animal studies and clinical investigations have established the role of cannabidiol (CBD) in treating epilepsy and seizures and support potential therapeutic benefits for cannabinoids in other neurological and psychiatric disorders. Here, we comprehensively review the role of cannabinoids in epilepsy.

Freehand external ventricular drain insertion - is there a learning curve?

Background: Accuracy of freehand insertion of external ventricular drains (EVDs) is influenced by many factors including etiology and presence of midline shift. We sought to assess if junior neurosurgical trainees' performance in accurately inserting EVDs improves with experience, using a radiological grading system.

Methods: EVD insertion procedures from the first 3 years of training were identified from the operative logbooks of three trainees.

A multiorganism pipeline for antiseizure drug discovery: Identification of chlorothymol as a novel γ-aminobutyric acidergic anticonvulsant.

Objective: Current medicines are ineffective in approximately one-third of people with epilepsy. Therefore, new antiseizure drugs are urgently needed to address this problem of pharmacoresistance. However, traditional rodent seizure and epilepsy models are poorly suited to high-throughput compound screening.

UK neurosurgical workforce planning. What changes have occurred in the consultant body 2014-2018?

The British Neurosurgery Trainee Association aimed to investigate the amount of trainees qualifying through the British national training scheme and the rate at which potential consultant posts became available from 2014 to 2018. A survey was sent to representatives from each neurosurgical unit and deanery across the United Kingdom to ask about the changes in consultant numbers and those who had attained CCT (Completion of Certificate of Training) over 5 years. At the end of 2018, there were 416.

Review: Molecular characteristics of long-term epilepsy-associated tumours (LEATs) and mechanisms for tumour-related epilepsy (TRE).

Brain tumours are the second most common cause of seizures identified in epilepsy surgical series. While any tumour involving the brain has the potential to cause seizures, specific subtypes are more frequently associated with epilepsy. Tumour-related epilepsy (TRE) has a profound impact on patients with brain tumours and these seizures are often refractory to anti-epileptic treatments, resulting in long-term disability and patient morbidity.

Ventriculitis from a pituitary prolactinoma: bacterial or chemical?

We report the case of a 70-year-old man presenting with pituitary apoplexy from a macroprolactinoma and ventriculitis. It was not possible to distinguish a bacterial or chemical origin, on the basis of his clinical presentation, laboratory studies and imaging, highlighting the importance of prompt imaging and attainment of CSF cultures, in making the diagnosis.

Trigeminal neuralgia from an Arteriovenous malformation: An intra-operative diagnosis.

We report the case of a 72-year-old lady with a magnetic resonance imaging (MRI) occult arteriovenous malformation (AVM) causing trigeminal neuralgia (TN). The possibility of an AVM when managing patients with TN should be borne in mind. Where possible, decompression of the trigeminal nerve should be attempted, as first-line therapy.

Split mesencephalon: diplomyelia of the basicranium.

We report a novel case of congenitally split mesencephalon, in a 3-year old with hydrocephalus. We speculate that the ontogenetic mechanism is shared with split cord malformations (SCM). Our case adds to the two other cases of basicranial SCM which involved more caudal brainstem.

Descending necrotising mediastinitis: a case report illustrating a trend in conservative management.

The mortality rate from descending necrotising mediastinitis (DNM) has declined since its first description in 1938. The decline in mortality has been attributed to earlier diagnosis by way of contrast-enhanced computed tomographic (CT) scanning and aggressive surgical intervention in the form of transthoracic drainage. We describe a case of DNM with involvement of anterior and posterior mediastinum down to the diaphragm, managed by cervicotomy and transverse cervical drainage with placement of corrugated drains and a pleural chest drain, with a delayed mediastinoscopy and mediastinal drain placement.

Terson's syndrome diagnosed by CT.

We report a case of Terson's syndrome diagnosed by a CT head scan. The presence of vitreous haemorrhage may not be appreciated clinically in unwell patients with a subarachnoid haemorrhage. Therefore features of vitreous haemorrhage should be sought on CT head imaging in patients presenting with a subarachnoid haemorrhage.

Management of glioblastoma multiforme in pregnancy.

Glioblastoma multiforme presenting during pregnancy presents unique challenges to the clinician. In planning treatment, potential benefits to the mother must be balanced against the risks to the fetus. In addition, evidence relating to timing of surgery and the use of radiotherapy and chemotherapy in pregnancy is limited.

Why the confusion in Hashimoto's encephalopathy?

A 13-year-old girl presented with an afebrile seizure followed by prolonged confusion and visual hallucinations. Initial investigations in the form of blood tests, cerebrospinal fluid analysis and head imaging by CT, were normal. She represented with two further episodes within a period of 3 weeks.

Structure-property correlations in solid solutions of (CuI)8P12-xAsx, 2.4< or = x < or =6.6.

A series of P/As mixed pnicogen phases of composition (CuI)(8)P(12-x)As(x), in which x = 2.4, 4.2, 4.

Liberation of pnicogen chains from Cu(2)P(1.8)As(1.2)I(2): synthesis and characterization of a new allotrope of P--As.

Removal of CuI from Cu(2)P(1.8)As(1.2)I(2) results in a novel P--As allotrope.

Toward an arsenic analogue of Hittorf's phosphorus: mixed pnicogen chains in Cu(2)P(1.8)As(1.2)I(2).

The new compound Cu(2)P(1.8)As(1.2)I(2), with neutral, mixed pnicogen chains, has been synthesized from a stoichiometric combination of CuI, P, and As heated in vacuo at 550 degrees C.

Stroke subtypes in Sri Lanka--a hospital based study.

Aim: Data on stroke subtypes in Sri Lanka are limited, mainly due to the unavailability of brain imaging facilities in most government hospitals. In two leading private hospitals in Colombo, a high proportion of stroke patients have computerised tomography (CT) scanning. Hence we studied stroke patients admitted to these two hospitals to determine the stroke subtypes.