Candida parapsilosis Infection of Ventriculoperitoneal Shunt in Adult: Case Report and Literature Review.

Background: Candida parapsilosis is an incredibly rare cause of ventriculoperitoneal (VP) shunt infections, with only 1 adult case reported in the literature to date.

Case Description: We describe the case of a 45-year-old man admitted for a traumatic fall and subsequently treated with VP shunt placement for obstructive hydrocephalus secondary to a cerebellar contusion and intraventricular hemorrhage. Eight months following VP shunt placement, the patient presented with a 2-month history of clear fluid leakage through a dehiscent surgical abdominal wound overlying the distal VP shunt.

Laser-Assisted Excision of Coil Mass While Clipping Recurrent Intracranial Aneurysms After Prior Endovascular Coiling: Our Initial Experience.

Background: Excision of coil mass during clipping of recurrent or residual aneurysms after prior endovascular coiling is challenging. We evaluated the use of the carbon dioxide laser for safe and effective removal of coils during aneurysm surgery. Two cases are presented.

In Situ Left Azygous Anterior Cerebral Artery to Right Pericallosal Artery Bypass for Treatment of a Giant Right A1/2 Aneurysm: 2-Dimensional Operative Video.

Here we present a 46-yr-old man with recurrent syncopal episodes thought to be of cardiac origin. He was eventually found to harbor a giant, partially thrombosed, saccular aneurysm arising from the A1/A2 segment of the right anterior cerebral artery with foramen of Monro obstruction and a trapped left-sided ventricular system. An azygous left A2 artery segment supplied both callosomarginal arteries.

Lower airway disease and pituitary surgery: Is there an association with postoperative cerebrospinal fluid leak?

Objectives/hypothesis: To explore the relationship between lower airway disease and postoperative cerebrospinal fluid (CSF) rhinorrhea among patients undergoing pituitary surgery STUDY DESIGN: Retrospective review.

Methods: A retrospective review of the Healthcare Cost and Utilization Project's 2013 National Inpatient Sample was conducted to characterize the hospital stay and surgical outcomes of patients undergoing pituitary surgery. Patients with lower airway disease (including chronic obstructive pulmonary disease and asthma) were compared to a disease-free population identifying demographics and complications over-represented in the lower airway group.

Reduced Apoptosis by Ethanol and Its Association with PKC-δ and Akt Signaling in Ischemic Stroke.

Along with thrombolytic therapy, which has a number of limitations, stroke outcome may be improved with neuroprotective therapies that disrupt ischemic cell death. Recent research has shown a neuroprotective role of ethanol administration during ischemic stroke, such as its ability to reduce infarct volume and neurologic deficit. In order to investigate this further, we assessed the hypothesis that ethanol's neuroprotective effect is through reduction of apoptosis and the modulation of the important apoptotic PKC-δ and Akt signaling pathway.

A novel technique for pedicled nasoseptal flap takedown in revision skull base surgery.

Objective To describe a novel technique of using the CO2 laser for a revision pedicled nasoseptal flap (PNSF) takedown. Patient Patient with a pituitary adenoma recurrence that had undergone an endoscopic skull base resection with a nasoseptal flap repair 3 years prior. Procedure Flap edges and bony defect are examined using an image-guidance probe to identify the full extent of the defect.

Reduced apoptosis by combining normobaric oxygenation with ethanol in transient ischemic stroke.

Background And Purpose: The effect of normobaric oxygen (NBO) on apoptosis remains controversial. The present study evaluated the effect of NBO on ischemia-induced apoptosis and assessed the potential for improved outcomes by combining NBO administration with another neuroprotective agent, ethanol, in a rat stroke model.

Methods: Rats were subjected to right middle cerebral artery occlusion (MCAO) for 2h.

Gamma Knife radiosurgery in the management of brainstem metastases.

Background: Metastases to the brainstem portend a poor prognosis and present a challenge in clinical management. Surgical resection is rarely a viable option.

Methods: Post-treatment MRI scans of patients with brainstem metastases treated with radiosurgery were used to determine local control and disease progression.

At low doses ethanol maintains blood-brain barrier (BBB) integrity after hypoxia and reoxygenation: a brain slice study.

Post-ischemia ethanol (EtOH) treatments have been shown to exhibit neuroprotective effects in stroke. However, the mechanisms underlying these effects and those on blood-brain barrier (BBB) integrity have yet to be elucidated. In the present study, we determined whether administering differing concentrations of EtOH alter the expressions of BBB integral proteins, including aquaporins-4 and -9 (AQP-4, AQP-9), matrix metallopeptidases-2 and -9 (MMP-2, MMP-9), zonula occludens-1 (ZO-1), and basal lamina (laminin).

Preischemic exercise reduces brain damage by ameliorating metabolic disorder in ischemia/reperfusion injury.

Physical exercise preconditioning is known to ameliorate stroke-induced injury. In addition to several other mechanisms, the beneficial effect of preischemic exercise following stroke is due to an upregulated capacity to maintain energy supplies. Adult male Sprague-Dawley rats were used in exercise and control groups.

Synergetic neuroprotection of normobaric oxygenation and ethanol in ischemic stroke through improved oxidative mechanism.

Background And Purpose: Normobaric oxygenation (NBO) and ethanol both provide neuroprotection in stroke. We evaluated the enhanced neuroprotective effect of combining these 2 treatments in a rat stroke model.

Methods: Sprague-Dawley rats were subjected to middle cerebral artery occlusion for 2 hours.

Acute administration of ethanol reduces apoptosis following ischemic stroke in rats.

In recent studies, acute ethanol administration appears to play a neuroprotective role during ischemic stroke. We sought to confirm these findings by identifying if ethanol-derived neuroprotection is associated with a reduction in apoptosis. Ethanol at 0.

Neuroprotection conferred by post-ischemia ethanol therapy in experimental stroke: an inhibitory effect on hyperglycolysis and NADPH oxidase activation.

Ethanol provides neuroprotection following ischemia/reperfusion. This study assessed ethanol's effect on hyperglycolysis and NADPH oxidase (NOX) activation. Adult, male Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) for 2 h.

Peritumoral edema following Gamma Knife radiosurgery as the primary treatment for intraventricular meningiomas.

Intraventricular meningiomas represent a small proportion of intracranial meningiomas. Stereotactic radiosurgery (SRS) as a primary treatment for intraventricular meningiomas has been reported only recently. We present two patients with trigonal meningiomas who developed peritumoral edema 5months and 12months following SRS.

Post-operative diabetes insipidus after endoscopic transsphenoidal surgery.

Diabetes insipidus (DI) after endoscopic transsphenoidal surgery (ETSS) can lead to increased morbidity, longer hospital stays, and increased medication requirements. Predicting which patients are at high risk for developing DI can help direct services to ensure adequate care and follow-up. The objective of this study was to review our institution's experience with ETSS and determine which clinical/laboratory variables are associated with DI in this patient population.

Reduction of brain edema and expression of aquaporins with acute ethanol treatment after traumatic brain injury.

Object: Previous studies have demonstrated that traumatic brain injury (TBI) causes brain edema by allowing excessive water passage through aquaporin (AQP) proteins. To establish the potential neuroprotective properties of ethanol as a post-TBI therapy, in the present study the authors determined the effect of ethanol on brain edema, AQP expression, and functional outcomes in a post-TBI setting.

Methods: Adult male Sprague-Dawley rats weighing between 425 and 475 g received a closed head TBI in which Maramarou's impact-acceleration method was used.

Ethanol reduces expression of apoptotic proteins after hypoxia/reoxygenation in a brain slice model.

Objectives: Acute administration of ethanol is associated with neuroprotection in rat with transient cerebral ischemia. To investigate the molecular mechanism of ethanol-induced neuroprotection, we determined the effect of ethanol on expression levels of apoptotic proteins, including caspase-3, Bcl-2-associated X protein (Bax), and apoptosis-inducing factor (AIF). To assess overall cell viability following ethanol treatment, ADP/ATP ratio was measured.

Glycerol accumulation in edema formation following diffuse traumatic brain injury.

Traumatic brain injury (TBI) induces brain edema via water and glycerol transport channels, called aquaporins (AQPs). The passage of glycerol across brain cellular compartments has been shown during edema. Using a modified impact/head acceleration rodent model of diffuse TBI, we assessed the role of hypoxia inducible factor (HIF)-1alpha in regulating AQP9 expression and glycerol accumulation during the edema formation.

Novel strategy to treat a case of recurrent lymphocytic hypophysitis using rituximab.

Lymphocytic hypophysitis is an uncommon autoimmune condition that often results in significant morbidity. Although most cases resolve spontaneously or after a short course of steroids, rarely, refractory cases can cause persistent neurological deficits despite aggressive medical and surgical management. A 41-year-old woman presented with progressive visual loss in the left eye and was found to have a sellar mass.

Peripheral ophthalmic artery aneurysm associated with multiple intracranial aneurysms: a case report.

Peripheral intraorbital ophthalmic artery aneurysms are rare. We here present a case of intraorbital ophthalmic artery aneurysm, associated with multiple anterior circulation aneurysms. The asymptomatic ophthalmic artery aneurysm was not treated.

Endovascular management of a giant aneurysm through saphenous vein graft after extracranial-intracranial bypass: case report and literature review.

It is known that giant intracerebral aneurysms have a high rupture and mortality rate. Furthermore, their optimal treatment method is not straightforward. While traditionally they have been managed with surgical clipping, it is not always possible.