World Neurosurg
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Spontaneous intracerebral hemorrhage (ICH) is a common and severe neurological disorder that has been associated with high rates of mortality and morbidity. It is urgent to find new biomarkers for the early diagnosis and prevention of ICH. In recent years, micro-RNAs (miRNAs) have been proved to play an important role in vascular damage and inflammation in cerebrovascular diseases, including ICH. In the peripheral blood, circulating miRNAs will be present at a remarkably steady level. In the present study, we explored the circulating plasma microRNA (miR)-181b, miR-223, miR-155, and miR-145 as new potential biomarkers for the diagnosis of ICH. ⋯ Our results have shown that measurement of circulating miR-181b, miR-223, miR-155, and miR-145 in plasma samples could serve as a potential noninvasive tool for ICH detection.
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Meningiomas are common central nervous system tumors with a wide range of morphologic variants, the pathogenesis being their complex embryogenesis. Intracranial meningiomas with heterogenous histopathology in the same lesion are common in low-grade meningiomas but less frequent in recurrent and high-grade variants. ⋯ To date there are no case reports in current literature with such rare combinations in a recurrent meningioma. This highlights the multipotency of phenotypic transformation of primary meningothelial cells. The presence of papillary features, even if focal, should be quantified in the diagnosis. This is of importance because the most current literature suggests that meningioma harboring a papillary component has an increased risk of recurrence and progression to aggressive behavior.
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Good short- and mid-term clinical efficacy of percutaneous cervical nucleoplasty (PCN) for cervical degenerative diseases (CDD) with neck pain has been reported. However, few studies have assessed its long-term influence in patients with both neck pain and cervical vertigo. This study aimed to evaluate the curative efficacy of PCN for CDD with neck pain and cervical vertigo with minimum of 6 years of follow-up. ⋯ PCN in patients with CDD neck pain and cervical vertigo showed satisfactory clinical efficacy at short- and mid-term FU, and it was fair at long-term FU. Thus, PCN could be a complementary operation for CDD.
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Giant serpentine aneurysms that occur in the distal anterior cerebral artery are extremely rare and challenging to manage because of their complex structure. In this case, we show an aneurysm resection performed after in situ side-to-side A3-A3 bypass to treat a giant serpentine distal anterior cerebral artery aneurysm. ⋯ Anterior cerebral artery giant serpentine aneurysms are rare and usually present with headache and mass effect. Aneurysm resection and distal flow protection are issues that we must consider. The sequential procedure of anastomosis and aneurysm resection is a feasible and safe option.
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Diverse clinical manifestations have characterized reports of central nervous system involvement in Behcet disease. There is a limited number of published case reports of neuro-Behcet disease mimicking brain tumor. ⋯ We recommend management of neuro-Behcet disease based on perceived natural history risks, with the understanding that no data exist on this within patients population. A multidisciplinary team approach is always recommended because neuro-Behcet disease is an uncommon condition, especially in neurosurgical practice.