Neural excitatory rebound induced by valproic acid may predict its inadequate control of seizures.

Background: Valproic acid (VPA) represents one of the most efficient antiseizure medications (ASMs) for both general and focal seizures, but some patients may have inadequate control by VPA monotherapy. In this study, we aimed to verify the hypothesis that excitatory dynamic rebound induced by inhibitory power may contribute to the ineffectiveness of VPA therapy and become a predictor of post-operative inadequate control of seizures.

Methods: Awake craniotomy surgeries were performed in 16 patients with intro-operative high-density electrocorticogram (ECoG) recording.

COVID-19 metabolism: Mechanisms and therapeutic targets.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) dysregulates antiviral signaling, immune response, and cell metabolism in human body. Viral genome and proteins hijack host metabolic network to support viral biogenesis and propagation. However, the regulatory mechanism of SARS-CoV-2-induced metabolic dysfunction has not been elucidated until recently.

Global changes in chromatin accessibility and transcription in growth hormone-secreting pituitary adenoma.

Purpose: Growth hormone-secreting pituitary adenoma (GHPA) is an insidious disease with persistent hypersecretion of growth hormone and insulin-like growth factor 1, causing increased morbidity and mortality. Previous studies have investigated the transcription of GHPA. However, the gene regulatory landscape has not been fully characterized.

The Vascular Architecture of Cavernous Sinus Dural Arteriovenous Fistula and Its Impact on Endovascular Treatment Approach Selection and Outcome.

Background: A cavernous sinus (CS) dural arteriovenous fistula (DAVF) is a form of abnormal arteriovenous communication that can be treated with endovascular embolization. Establishing an optimal access route should be based on vascular architecture. We reviewed 64 patients with CS-DAVF who underwent endovascular embolization and report the endovascular treatment approach selection and outcome.

A phase II open label, single arm study of hypofractionated stereotactic radiotherapy with chemoradiotherapy using intensity-modulated radiotherapy for newly diagnosed glioblastoma after surgery: the HSCK-010 trial protocol.

Background: The most frequently diagnosed primary brain tumor is glioblastoma (GBM). Nearly all patients experience tumor recurrence and up to 90% of which is local recurrence. Thus, increasing the therapeutic ratio of radiotherapy using hypofractionated stereotactic radiotherapy (HSRT) can reduce treatment time and may increase tumor control and improve survival.

How I do it: left posterior cerebral artery P1-2 segment dissecting aneurysm distal clipping via an A1-RAG-P2 bypass.

Background: Posterior cerebral artery (PCA) P1-2 segment dissecting aneurysms are difficult because regular craniectomy aneurysm clipping or intravascular interventional therapy is not applicable.

Method: We report distal clipping of a PCA P1-2 segment dissection aneurysm with an anterior cerebral artery (ACA) A1-radial artery graft-PCA P2 bypass.

Conclusion: This case demonstrates the value of an ACA-RAG-PCA bypass in the therapy of a PCA dissecting aneurysm.

A modified microscopic-endoscopic bilateral transseptal approach for pituitary adenoma.

Background: Endoscopic transnasal surgery for tumors in the sellar region has become popular across the globe. However, postoperative nasal outcomes related to endoscopic transnasal surgery have yet to be described in detail.

Method: Here, we introduce a modified microscopic-endoscopic bilateral transseptal approach for the surgical treatment of tumors in the sellar region.

KDELR1 Is an Independent Prognostic Predictor and Correlates With Immunity in Glioma.

Background: Gliomas are the most malignant central nervous system tumors. With the development of sequencing technology, more potential biomarkers related to the treatment, prognosis, and molecular classification of glioma have been identified. Here, we intend to investigate the potential biological function and clinical value of a new biomarker in glioma.

Clinical Decision on Disorders of Consciousness After Acquired Brain Injury: Stepping Forward.

Major advances have been made over the past few decades in identifying and managing disorders of consciousness (DOC) in patients with acquired brain injury (ABI), bringing the transformation from a conceptualized definition to a complex clinical scenario worthy of scientific exploration. Given the continuously-evolving framework of precision medicine that integrates valuable behavioral assessment tools, sophisticated neuroimaging, and electrophysiological techniques, a considerably higher diagnostic accuracy rate of DOC may now be reached. During the treatment of patients with DOC, a variety of intervention methods are available, including amantadine and transcranial direct current stimulation, which have both provided class II evidence, zolpidem, which is also of high quality, and non-invasive stimulation, which appears to be more encouraging than pharmacological therapy.

Simultaneous Clipping and Superficial Temporal Artery-Middle Cerebral Artery Bypass for Unruptured Middle Cerebral Artery Aneurysm Concomitant with Proximal Stenosis.

Management of unruptured intracranial aneurysms concomitant with proximal stenosis remains challenging. Video 1 demonstrates simultaneous clipping and superficial temporal artery (STA)-middle cerebral artery (MCA) bypass for unruptured MCA aneurysm concomitant with proximal stenosis. A 56-year-old man presented with paroxysmal left limb weakness for 2 years.

The "Deep Subarcuate Fossa" sign and three types of anomalous subarcuate loops encountered during vestibular schwannoma removal.

Background: An anomalous subarcuate loop (SL) of the anteroinferior cerebellar artery (AICA) is a rare anatomic variation, which increases the complexity and risk of vestibular schwannoma (VS) removal. However, preoperative diagnosis of this anomaly remains difficult. The aim of this study was to report three types of anomalous SLs encountered during VS removal and to describe the "Deep Subarcuate Fossa (SF)" sign and its significance in the diagnosis and treatment of an osseous-penetrating SL.

The Anti-Glioma Effect of Juglone Derivatives through ROS Generation.

Juglone has been extensively reported as a natural antitumor pigment. However, it is easy to be oxidized due to active hydroxy in the quinone. Here, we designed some new juglone derivatives, as the hydroxy was replaced by methyl (D1), allyl (D2), butyl (D3), and benzyl (D4) groups.

The Intraoperative Utilization of Multimodalities Could Improve the Prognosis of Adult Glioblastoma: A Single-Center Observational Study.

Objective: In recent years, numerous neurosurgical multimodal techniques have been utilized to maximize tumor resection safely and effectively. However, the synergetic effects of neurosurgical multimodalities on the survival of glioblastoma patients remain unclear. This study evaluated the role of intraoperative utilization of multimodalities in glioblastoma patients.

Ferroptosis in brain microvascular endothelial cells mediates blood-brain barrier disruption after traumatic brain injury.

Ferroptosis is a newly recognized form of regulated cell death. Recently, growing evidence has shown that ferroptosis is involved in the pathogenesis of traumatic brain injury (TBI). However, less attention has been paid to its role in brain microvascular endothelial cells (BMVECs) and blood-brain barrier (BBB) damage, the central pathological process in secondary brain injury of TBI.

Perioperative Risk Factors Associated with Unplanned Neurological Intensive Care Unit Events Following Elective Infratentorial Brain Tumor Resection.

Background: Our aim of this study was to identify risk factors and develop a prediction model for unplanned neurological intensive care unit (NICU) events after elective infratentorial brain tumor resection in order to propose an individualized admission to the NICU tailored to patient needs.

Methods: Patients admitted to our NICU between September 2018 and May 2021 after elective infratentorial brain tumor resection were reviewed. Prolonged NICU stays and unplanned NICU admissions were defined as unplanned NICU events.

Deep Learning-Based Prediction of Hematoma Expansion Using a Single Brain Computed Tomographic Slice in Patients With Spontaneous Intracerebral Hemorrhages.

Objectives: We aimed to predict hematoma expansion in intracerebral hemorrhage (ICH) patients by using the deep learning technique.

Methods: We retrospectively collected data from ICH patients treated between May 2015 and May 2019. Head computed tomography (CT) scans were performed at admission, and 6 hours, 24 hours, and 72 hours after admission.

How I do it: superficial temporal artery to middle cerebral artery bypass for moyamoya disease.

Background: Moyamoya disease (MMD) is a chronic progressive disease leading to recurrent stroke due to occlusion of the terminal internal carotid arteries. Surgical revascularization for symptomatic MMD is an effective treatment for preventing further stroke. However, direct revascularization of advanced MMD remains challenging due to small caliber of the recipient vessel and perforators.

Mitochondria transfer and transplantation in human health and diseases.

Mitochondria are dynamic organelles responsible for energy production and cell metabolism. Disorders in mitochondrial function impair tissue integrity and have been implicated in multiple human diseases. Rather than constrained in host cells, mitochondria were recently found to actively travel between cells through nanotubes or extracellular vesicles.

Distinct spatiotemporal patterns of syntactic and semantic processing in human inferior frontal gyrus.

Human languages are based on syntax, a set of rules which allow an infinite number of meaningful sentences to be constructed from a finite set of words. A theory associated with Chomsky and others holds that syntax is a mind-internal, universal structure independent of semantics. This theory, however, has been challenged by studies of the Chinese language showing that syntax is processed under the semantic umbrella, and is secondary and not independent.

How I do it? Resection of residual petrous apex chordoma with combined endoscopic endonasal and contralateral transmaxillary approaches.

Background: The petrous apex is one of the most challenging areas of the skull base to access.

Method: We present a case of residual petrous apex chordoma posterolateral to the paraclival segment of the internal carotid artery (ICA) resected with combined endoscopic endonasal and contralateral transmaxillary (CTM) approaches, without lateralization of the ICA.

Conclusion: This case demonstrates the value of the CTM corridor in resecting petrous apex lesions that are posterolateral to the paraclival segment of the ICA.

Abnormal default mode network could be a potential prognostic marker in patients with disorders of consciousness.

Objectives: The study aimed to investigate disorders of consciousness (DOC) mechanisms of patients with severe traumatic brain injury (sTBI) related to default mode network (DMN) and to introduce a machine learning model that predicts the prognosis of these patients for 6 months.

Methods: The sTBI patients suffering from DOC and healthy controls underwent functional magnetic resonance imaging. We defined patients with Extended Glasgow Outcome Score ≥ 5 as good outcome group, otherwise they were poor outcome group.

Exosomes Derived From Mesenchymal Stem Cells: Novel Effects in the Treatment of Ischemic Stroke.

Ischemic stroke is defined as an infarction in the brain, caused by impaired cerebral blood supply, leading to local brain tissue ischemia, hypoxic necrosis, and corresponding neurological deficits. At present, revascularization strategies in patients with acute ischemic stroke include intravenous thrombolysis and mechanical endovascular treatment. However, due to the short treatment time window (<4.