World Neurosurg
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The vertebral artery-posterior inferior cerebellar artery (VA-PICA) aneurysm poses a technical challenge for microsurgical clipping due to its anatomical complexity, which requires dissection of lower cranial nerves. Endovascular treatment is regarded as a feasible first-line therapeutic option for VA-PICA aneurysm because it has an acceptable aneurysm occlusion rate and is less invasive. However, microsurgical clipping remains an effective treatment option. ⋯ As shown in this video, unilateral cerebellomedullary fissure opening combined with adequate removal of the condylar fossa provides a wide operative field in the cerebellomedullary cistern while avoiding strong retraction of the cerebellum. We believe that this technique makes VA-PICA aneurysm clipping safe and successful. Patient consent was obtained to perform the surgery and to publish the surgical video (Video 1).
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Inducing the differentiation of glioma cells into neuron-like cells may be an effective strategy to combat glioma. The histone deacetylase 1/RE-1 silencing transcription factor (HDAC1/REST) complex regulates the expression of multiple neuronal genes. In this study, we analyzed the presence and significance of this regulatory effect in glioma based on bioinformatics methods. ⋯ This study suggested that HDAC1/REST may be involved in maintaining the malignant phenotype of glioma cells and the stem cell status of glioma stem cells by inhibiting the expression of neuronal markers, which promote the progression of glioma.
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The Tubridge flow diverter is a device widely used in China aimed at reconstructing parent artery and occluding complex aneurysm. The experience of the Tubridge in treating unruptured vertebrobasilar artery dissecting aneurysms is still limited. In this study, we aimed to evaluate the safety and efficacy of the Tubridge flow diverter for the treatment of vertebrobasilar artery dissecting aneurysms. ⋯ Our preliminary experience suggests that the Tubridge flow diverter might be a safe and effective tool for dissecting cerebral aneurysms. Branch arteries were well protected and mild asymptomatic cerebral infarction occurred in some patients. Adequate evidence is required to clear the definite indications and complications in a multicenter randomized controlled trial with a long-term follow-up.