World Neurosurg
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Traditional wound closure techniques include skin sutures and metal clips. Cyanoacrylate has good neovascularization, epithelialization, and antimicrobial activity properties and a fast application procedure. This study presents our long-term experience. ⋯ With additional research, we can confirm that cyanoacrylate glue may be a valid and useful alternative to traditional techniques for wound closure in brain surgery, carrying several advantages. However, a randomized controlled trial with a large number of patients is warranted to confirm our findings.
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Case Reports
Endovascular treatment of Vertebral-Venous Fistula with flow diverting stent: A Case Report.
Vertebral-venous fistulas (VVFs) are a rare vascular condition and are commonly associated with trauma but may also be idiopathic, spontaneous, or congenital. A current literature review reveals there is no level 1 evidence or established guidelines on optimal treatment for VVF. Diagnosis is often confirmed by catheter cerebral angiogram. Treatment goals are complete occlusion of the fistula, which can be achieved by both endovascular closure and/or surgical ligation treatment. Telescopic Pipeline flow-diversion stents are a common treatment modality for aneurysms and have also been described to successfully treat different types of cranial arteriovenous fistulas including carotid-cavernous fistulas.There is, however, no English literature available regarding its use in the management of VVFs, which are rare entities. ⋯ This case report highlights the potential of flow-diversion stents in the treatment of VVF. This technique was shown to be a safe and effective method of treatment for VVF. Important limitations, however, need to be considered before this form of treatment for VVF, including the need for multiple devices, extended duration of treatment, and associated increased costs involved.
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In several situations, the stability of the subaxial cervical spine is damaged and involves the lateral mass of 1 side; in these cases, a pedicle screw (PS) or lateral mass screw (LMS) may not be suitable for placement on the affected side. Therefore, salvage short-segment fixation with satisfactory stability is needed when bilateral fixation is not feasible. ⋯ Fixation with the hybrid UPS+CTLS construct performed as well as BMS fixation in our biomechanical tests and may play a clinical role when BPS or BMS placement is not feasible for short-segment fixation.
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The etiology of Chiari I malformation (CMI) has not been fully elucidated. Therefore, we performed a genetic study of a Turkish family in which 3 sisters had a diagnosis of CMI with or without syringomyelia. ⋯ This family with 3 sisters having CMI suggested a possible autosomal recessive single-gene etiology. Cases of familial CMI are unusual but important to study because they could reveal the specific genes involved in posterior fossa/foramen magnum structure and function and provide insights into the cause of sporadic cases.
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Hypoxia-inducible factor (HIF) plays a major role in tumorigenesis and cancer progression. In hypoxic conditions, HIF is upregulated and has been shown to activate multiple genes required for cells to adapt to hypoxia. AT-rich interactive domain-containing protein 1A (ARID1A), a SWI/SNF (switch/sucrose nonfermentable) chromatin remodeling gene has context-dependent tumor-suppressive and oncogenic roles in cancer. We assessed the correlations between the expression and mutations of HIF1A and ARID1A in histopathologically confirmed pituitary adenomas. ⋯ In our patient cohort, we found that most pituitary adenomas expressed HIF1A. To the best of our knowledge, we are the first to assess the presence of ARID1A loss in pituitary adenomas, which occurred in 28.2% of cases. No individual demographic, imaging, or histopathological feature was predictive of ARID1A. Likewise, with the exception of an increased incidence of cavernous sinus invasion, no correlation was found with HIF1A. Given the prognostic value of these markers in other malignancies, their frequency in pituitary adenomas warrants further exploration of their potential role in pituitary adenoma treatment and outcome.