World Neurosurg
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According to the 2016 World Health Organization classification of central nervous system tumors, meningiomas are classified into 3 grades: I, II, and III. It has been reported that 2%-10% of meningiomas exhibit aggressive behavior, and 0.1%-1% of all patients with primary meningiomas develop distant metastases. Past studies have shown that genomic instability is strongly correlated with the risk of meningioma recurrence. Because of the rarity of this tumor, few papers have reported the prognosis and treatment of anaplastic meningioma. Under these circumstances, we present a case of multiple pulmonary and pleural metastases from a recurrent intracranial meningioma with some genetic changes. ⋯ The molecular characterization of meningiomas has identified genetic biomarkers that influence tumor characteristics, such as tumor behavior, malignancy, and location. The combined analyses of genetic and epigenetic changes in meningiomas may allow researchers to unveil a more comprehensive understanding of tumor progression mechanisms.
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Spinal dural arteriovenous fistulas (DAVFs) are usually associated with neurologic dysfunction adjacent to the shunt point; however, the symptoms are uncommon far from the site of the fistula. To our knowledge, this is the first report of a patient with rapidly progressive isolated pseudobulbar palsy because of thoracic DAVF. ⋯ Although rare, thoracic DAVFs may present symptoms resembling brainstem infarction. Prompt surgical intervention is necessary for patients with thoracic DAVF presenting with rapidly progressive pseudobulbar palsy.
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Ventriculostomy-related infection with multidrug-negative strains are challenging to treat. We report the use of new antibiotics in such a case. ⋯ We observed than even in the case of mild meningeal inflammation, ceftaroline penetration in CSF, although moderate, enabled efficient bacterial clearance and clinical efficacy, in adjunction to correct ventriculoperitoneal shunt management.
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Allicin can suppress liver and cardiac fibrosis; thus, we hypothesized that it might prevent scar tissue from extensive epidural fibrosis after laminectomy. ⋯ Allicin can suppress human epidural scar fibroblast migration, induce cell apoptosis, and block cell proliferation at S phase and G2 phase.
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To determine the rate and anatomical location of dural tears associated with spinal surgery using a percutaneous biportal endoscopic surgery (PBES) technique. We investigated the relationship between dural tears and the type of procedure and type of instrument used. ⋯ Most cases of incidental dural tear during PBES were treated with an endoscopic procedure. The incidence of dural tear was no greater than that associated with microscopic surgery. Our management strategy for incidental dural tears during PBES has been shown to be safe and effective.