The choice of surgical treatment for meningiomas is affected by the subtype and clinical characteristics. Therefore, an accurate preoperative diagnosis is essential. Current magnetic resonance imaging (MRI) technology is unable to distinguish between meningioma subtypes. In the present study, we compared and evaluated the utility of conventional MRI, magnetic resonance fingerprinting (MRF), and diffusion-weighted imaging (DWI) in differentiating World Health Organization grade I transitional and fibrous meningiomas from meningothelial meningiomas.Forty-six patients with pathologically confirmed meningiomas (15 meningothelial, 18 transitional, and 13 fibrous) were enrolled in the present study. All patients underwent conventional MRI, MRF, and DWI scans before surgery using a 3T scanner. The Jonckheere-Terpstra test was used to analyze differences in the signal and enhancement characteristics of the three groups from T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI). To investigate the difference in quantitative T1 and T2 values derived from MRF and apparent diffusion coefficient (ADC) values between the three groups using the Kruskal-Wallis test, regions of interest (ROIs) were manually drawn on the parenchymal portion of the tumors; P<0.017 was considered statistically significant after Bonferroni correction for multiple comparison. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performances of the different parameters.Meningothelial meningiomas had significantly higher T1 and T2 values than transitional and fibrous meningiomas (all P<0.017). ROC analysis results revealed that the combination of T1 and T2 values had the largest area under the curve (AUC). The AUC for the combination of T1 and T2 values was 0.826 between meningothelial and transitional meningiomas, and the AUC for the combination of T1 and T2 values between meningothelial and fibrous meningiomas was 0.903. No significant differences were found in the T1 and T2 values between transitional and fibrous meningiomas. There were also no statistically significant differences in the conventional MRI (including T1WI, T2WI, and contrast-enhanced T1WI) and ADC values between the three meningioma subtypes (all P>0.05).MRF may provide more quantitative information than either conventional MRI or DWI for differentiating transitional and fibrous meningiomas from meningothelial meningiomas. T1 and T2 values derived from MRF may distinguish transitional and fibrous meningiomas from meningothelial meningiomas, and the combination of T1 and T2 values provides the highest diagnostic efficacy.
Abstract The Circle of Willis perforation (cWp) mouse model is a key tool in subarachnoid hemorrhage (SAH) research; however, inconsistent bleeding volumes can challenge experimental reliability. To address this issue, we introduced the ROB Scoring System, a novel protocol integrating Rotarod Tests (RT), Open-field Tests (OT) video analysis, and daily Body Weight Loss (BWL) monitoring to precisely categorize SAH severity. Forty C57BL/6 mice underwent cWp SAH induction, categorized by ROB into severity subgroups (severe, moderate, mild). Validation compared ROB trends in subgroups, and ROB outcomes with autopsy results on postoperative days three and seven for acute and sub-acute evaluations. Mortality rates were analyzed via the survival log-rank test, revealing a significant difference among SAH subgroups ( P < 0.05). Strong correlations between ROB grades and autopsy findings underscored its precision. Notably, the severe group exhibited 100% mortality within 4 days post SAH onset. Single parameters (RT, OT, BWL) were insufficient for distinguishing SAH severity levels. The ROB score represents a significant advancement, offering an objective method for precise categorization and addressing inherent bleeding variations in the cWp SAH model. This standardized protocol enhances the reliability and effectiveness of the SAH translational research, providing a valuable tool for future investigations into this critical area.
Treating complex middle cerebral artery (MCA) trifurcation aneurysms requires a delicate balance between achieving aneurysm obliteration and preserving vascular integrity. Various cerebral revascularization techniques, including bypass, and clip reconstruction are considered individually or in combination. This case report outlines a successful repair of a ruptured neck and base of MCA trifurcation aneurysm using a suturing-clip reconstruction technique. Temporary aneurysm trapping was implemented, with maintained elevated blood pressure to ensure collateral perfusion during repair of ruptured base and neck of MCA aneurysm. The suturing-clip reconstruction exhibited long-term radiological stability, emerging as a valuable alternative for managing challenging MCA trifurcation aneurysms.
Abstract Background Solitary fibrous tumor (SFT) is an uncommon spindle cell neoplasm primarily observed in the pleura. Instances of intracranial solitary fibrous tumors are exceedingly rare. Achieving accurate preoperative diagnosis remains challenging. This report aims to enhance the understanding of this rare disease, shedding light on diagnostic intricacies, and therapeutic considerations. Case presentation Herein, we present a case involving an enormous SFT situated at the anterior skull base, initially misdiagnosed as meningioma. Comprehensive scrutiny of preoperative images, intraoperative observations, pathological analyses, and subsequent treatment strategies is detailed. Conclusion Intracranial SFT, frequently misdiagnosed radiologically as meningiomas, may originate in the subarachnoid region, emphasizing the necessity of surgical resection and the potential benefit of postoperative radiotherapy to enhance treatment efficacy.
Abstract Glioma is one of the most commonly observed tumours, representing approximately 75% of brain tumours in the adult population. Generally, glioma therapy includes surgical resection followed by radiotherapy and chemotherapy. The transcription factor STAT3 (signal transducer and activator of transcription 3) is a promising target for the treatment of cancer and several other diseases. At nanomolar concentrations, SD‐36 induces rapid cellular degradation of STAT3 but cannot degrade other STAT proteins. The current study demonstrates the therapeutic efficacies of the STAT3 degraders SD‐36 against glioma, as well as understanding the elucidating mechanisms and identifying molecular markers that determine cell sensitivity to STAT3 degraders. Glioma cell lines possessed similar response patterns to SD‐36 but different responses to the STAT3 inhibitor Stattic. SD‐36 potently induced apoptosis in glioma cells along with a reduction in Mcl‐1 levels, which are critical for mediating the induction of apoptosis and enhancing TMZ‐induced apoptosis. Accordingly, SD‐36 sensitizes the antitumour effect of TMZ in patient‐derived xenograft. In addition, the downregulation of Mcl‐1 expression‐mediated antitumour effect of SD‐36 was analysed in cell‐derived xenograft. These observations need to be validated clinically to confirm the efficacy of STAT3 degraders in glioma.
Objective To obtain structural and functional visualization of facial nerve (FN)by preoperative identification with diffusion tensor tracking (DTT) and intraoperative electrophysical monitoring (IOM) and explore the effect of these techniques on preservation of facial nerve in large vestibular schwannoma (extrameatal diameter≥ 30 mm,VS) surgery.Methods Fifteen patients habouring large VS were adopted in this retrospective study.Structural and functional visualization of FN was conducted in each patient.Correlation of FN location between preoperative identification and intraoperative inspection was analysed.Postoperative FN function was evaluated in each patient periodically.Results FN was identified by DTT in 13 cases.Seven FNs located at the anterior middle third of the tumor,3 at the anterior inferior third,2 at the anterior superior third,and 1 at the inferior pole.The locations agreed to intraoperative findings and monitoring in all the 13 cases.Gross total resection was achived in 11 cases and subtotal in the other 4 cases.IOM was helpful to locate and protect the FN.All FNs were anatomically preserved.House-Brackmann grade Ⅰ of FN function was achieved in 8 cases,grade Ⅱ in 6,and grade Ⅳ in one.Conclusion Structural visualization by preoperative DTT and functional visualization by IOM of FN contribute to lacating and preserving FN in large VS surgery.
Key words:
Vestibular schwannoma; Facial nerve; Diffusion tensor tracking; Intraoperative electrophysical monitoring; Microsurgery
Abstract Background In recent years, due to increased cranial imaging more and more small sized (diameter <2.5cm) meningiomas are diagnosed. If symptomatic then most of them need surgical removal. Exact location of the lesion is extremely important to tailor the craniotomy especially if the neuro-navigation system is not available. Many under developed countries cannot afford high costs of neuro-navigation. Hence, is relevant to discover low cost associated and effective methods to exactly locate the lesions for the surgery. Methods By using localization markers, we can acquire preoperative CT images of the patients, reconstruct these images into Three Dimensional (3D) virtual graphs using a computer, measure the spatial distance of the tumor from the markers, and in turn calculate the projection location of the tumor on the scalp by the Triangle Pythagorean theorem. Thereby achieving preoperative precise localization of intracranial microlesions. Results The location of the tumor was consistent with that of the preoperative virtual image, and the craniotomy was exact. The patient was discharged 3 days later without any neurological deficits. Conclusion This method is simple and reliable, inexpensive, and accurate in location of small sized lesion, which can partially compensate lack of neuro-navigationand is suitable for widespread application in hospitals in third world countries.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)