World Neurosurg
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Infratentorial multinodular lesions resembling multinodular and vacuolating neuronal tumor of the cerebrum (MVNT) have been indicated in literature with 2 different names reflecting alternative perspectives: multinodular and vacuolating posterior fossa lesions of unknown significance (MV-PLUS), suggesting that these lesions may belong to a new entity, and MVNT of the brain, assuming that they actually correspond to infratentorial MVNT. Because of the limited number of cases reported and the absence of histopathologic data, it is unclear which denomination should be used. ⋯ Infratentorial lesions show nodules with cystic or cyst-like signal intensity on MRI, a feature infrequently reported in supratentorial MVNT, and may involve the cortex. No variations were noted during a prolonged follow-up supporting the benign behavior of these lesions.
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Review Case Reports
Chronic epidural hematoma caused by traumatic intracranial pseudoaneurysm of the middle meningeal artery: review of the literature with a focus on this unique entity.
Pseudoaneurysms of the middle meningeal artery represent fewer than 1% of all intracranial aneurysms; it can be associated with different patterns of intracranial hemorrhages. A chronic epidural hematoma (CEDH) caused by post-traumatic pseudoaneurysm of the middle meningeal artery (MMA) has not yet been reported. ⋯ Pseudoaneurysms are considered unstable because of the poor support of the aneurysmal wall. They tend to progressively increase in size and ultimately rupture, leading to delayed intracranial bleeding. A univocal definition of the interval of time between the acute head trauma and the diagnosis to classify the CEDH is still debated. To our knowledge, this is the first case described of a CEDH secondary to a pseudoaneurysm of the MMA. In our study we suggest defining CEDHs as extradural hematomas diagnosed and/or treated 21 days or more after a head injury.
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Review Case Reports
Symptomatic Brain Hemorrhages from Cavernous Angioma Following Botulinum Toxin Injections, a role of TLR/MEKK3 Mechanism? A Case Report and Review of the Literature.
Cavernous angiomas (CAs) are vascular malformations that may result in stroke. ⋯ Recently, bacterial lipopolysaccharide has been reported to contribute to CA development through Toll-like receptor signaling, causing hemorrhagic angiogenic proliferation. Lipopolysaccharide and Btx share a common intracellular signaling pathway driving CA development and hemorrhage. Significance of these observations is demonstrated by previous works on plasma molecules showing prognostic associations with symptomatic hemorrhages in human CA, related to the same canonical pathways. Authors suggest careful tracking of the association of Btx and hemorrhage in CA patients.
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Review Meta Analysis
Use of Focused Ultrasound (Sonication) for the Diagnosis of Infections in Neurosurgical Operations: a Systematic Review and Meta-Analysis.
Postoperative infections are one of the most devastating complications in neurosurgery, and their results are even more disastrous when biocompatible implants are involved. As the application of these implants increases, the need for a sensitive and efficient method to detect pathogens becomes imperative. The application of sonication appears to be a viable option. ⋯ Regardless of the potential of sonication, it is still not a panacea. Additional studies are expected to provide significant insight into the indications and limitations of this technique.