World Neurosurg
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Opiate addiction remains intractable in a large percentage of patients, and relapse is the biggest hurdle to recovery because of psychological dependence. Multiple studies identify a central role of the nucleus accumbens (NAc) in addiction; several studies note decreased addictive behavior after interventions in this area. ⋯ Although sometimes accompanied by neuropsychological adverse events, stereotactic ablation of NAc may effectively treat opiate addiction. Lesion location has a significant impact on treatment efficacy and requires further study. Because ablation is irreversible, the NAc surgery for addiction should be performed with cautiousness, and deep brain stimulation (DBS) is an ideal alternative.
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Trigeminal neuralgia (TN) surgical treatment with microvascular decompression is highly effective and safe, but for a percentage of patients who undergo this procedure, no vascular compression is found. The purpose of this study was to evaluate the long-term efficacy with trigeminal root compression of the trigeminal nerve in patients with TN refractory to medical treatment who underwent neurosurgical management by a retrosigmoid approach of the cerebellopontine angle and were found to be negative for vascular compression. ⋯ We concluded that trigeminal root compression is a safe and effective option for patients with primary TN without vascular compression.
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NF-E2-related factor 2 (Nrf2) is a transcription factor that is related to tumor cell multidrug resistance and proliferation. Here we studied the involvement of Nrf2 in the migration and invasion of human U251 glioma cells. ⋯ Nrf2 is involved in migration and invasion of U251 cells, which may be related to MMP9.
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The nature of the pituitary adenomas itself exposes the possibility of a recurrence of the tumor. The aim of this study was to evaluate the effectiveness of the endoscopic endonasal transsphenoidal approach for the removal of recurrent and residual pituitary adenomas, already treated by a microscopic or endoscopic transsphenoidal approach or by a transcranial route. ⋯ The endoscopic endonasal approach is a safe and effective procedure for the management of recurrent and/or regrowing pituitary tumors previously treated by either a microsurgical or an endoscopic approach.
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We report a case of an uncommon association of pituitary adenoma with neuronal choristoma that usually is diagnosed at initial surgery. ⋯ The present case report supports the theory that pituitary adenoma with neuronal choristoma might represent the result of neuronal differentiation from pituitary adenoma.