World Neurosurg
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Spinal artery aneurysms are rare lesions that can occur in isolation or may be attributed to a variety of secondary causes. Chronic bilateral vertebral artery occlusion is an exceedingly rare cause of anterior spinal artery aneurysm, with only one previous case reported in the literature. Surgical treatment of ventrally located anterior spinal artery aneurysms situated at the craniocervical junction presents particular challenges related to the operative approach, which may entail high cervical anterior exposure, posterolateral complete facetectomy/pediculectomy, or far lateral skull base approaches, among others. ⋯ This report highlights an exceedingly rare cause of anterior spinal artery aneurysm and emphasizes the utility and technical aspects of the posterior approach with spinal cord rotation.
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The transsphenoidal approach was initially developed in neurosurgical practice as an operative approach to the pituitary gland. The introduction of the operating endoscope has improved the versatility of the transsphenoidal approach, broadening the spectrum of lesions that can be treated effectively with this operative strategy. ⋯ Although initially devised in neurosurgical practice for tumors of the pituitary gland, developments in technology now make the transsphenoidal approach an effective operative strategy for a wide range of anterior skull base lesions.
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A few reports have addressed the sex-related efficacy of deep brain stimulation (DBS) in the subthalamic nucleus (STN) to treat advanced Parkinson disease (PD). The present study evaluates the sex-related prognostic factors for STN-DBS outcomes. ⋯ STN-DBS therapy is equally beneficial for both sexes. Sex-related differences exist with regard to favorable prognostic predictors for early surgical outcomes.
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Decreased 3'-5'-cyclic adenosine monophosphate (cAMP), protein kinase A (PKA), and increased N-methyl-d-aspartate (NMDA) related apoptosis were observed in traumatic brain injury (TBI). It is of interest to examine the effect of magnesium lithospermate B (MLB) on cAMP/PKA pathway and NMDAR in TBI. ⋯ This study showed that MLB exerted an antioxidant effect on the enhancement of cytoplasm cAMP and PKA. This compound also decreased NMDA-2β levels, which may correspond to its neuroprotective effects. This finding lends credence to the presumption that MLB modulates the NMDA-2β neurotoxicity through a cAMP-dependent mechanism in the pathogenesis of TBI.