World Neurosurg
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Review Case Reports
Granulomatous amoebic encephalitis caused by Balamuthia mandrillaris in an immunocompetent girl.
Balamuthia mandrillaris is a recently recognized cause of a rare, devastating infection, granulomatous amoebic encephalitis (GAE). Presenting symptoms of GAE are nonspecific and can last for months before becoming clinically significant. Once the infection involves the central nervous system, death often results within days to weeks. A high degree of clinical suspicion is needed to correctly diagnose this infection because definitive diagnostic tests are presently limited, and even then there are only sparse data concerning effective treatment. The importance of early diagnosis is emphasized because delay likely contributes to the extremely high mortality with this infection. ⋯ GAE should be considered for a patient with atypical encephalitis and single or multiple lesions with surrounding edema evident on neurodiagnostic imaging.
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Review Comparative Study
C2 nerve root sectioning in posterior atlantoaxial instrumented fusions: a structured review of literature.
To review published series describing C1-2 posterolateral instrumentation, comparing outcomes in patients who had and did not have C2 nerve sacrifice. ⋯ Sacrifice of the C2 nerve root to aid in the insertion of C1 lateral mass screws when performing posterior atlantoaxial instrumented fusions is a treatment option (class III). It may decrease blood loss and operative duration, potentially advantageous in elderly or frail patients. Numbness occurred in roughly 12% of patients, an outcome that may be unacceptable to certain patient populations, but neuropathic pain was nearly absent in reported studies with nerve section. C2 nerve preservation and retraction for C1 screw placement may have higher incidence of neuropathic pain (~5%). Rates of fusion are universally high independent of C2 nerve technique.
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Review Case Reports
Posttraumatic Benedikt's syndrome: a rare entity with unclear anatomopathological correlations.
This study sought to present a very rare case of a posttraumatic midbrain lesion producing a debilitating constellation of symptoms identified as Benedikt's syndrome. ⋯ Benedikt's syndrome is a very rare condition, usually of vascular etiology. Our case is just the second one of traumatic pathogenesis ever reported, the first in the English language literature.
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Comparative Study
Novel animal glioma models that separately exhibit two different invasive and angiogenic phenotypes of human glioblastomas.
Invasive behaviors of malignant gliomas are fundamental traits and major reasons for treatment failure. Delineation of invasive growth is important in establishing treatment for gliomas and experimental neuro-oncology could benefit from an invasive glioma model. In this study, we established two new cell line-based animal models of invasive glioma. ⋯ These animal models histologically recapitulated two invasive and angiogenic phenotypes, namely angiogenesis-dependent and angiogenesis-independent invasion, also observed in human glioblastoma. These cell lines provided a reproducible in vitro and in vivo system to analyze the mechanisms of invasion and angiogenesis in glioma progression.