Notes

Metformin takes away irritation via curbing FASN-dependent palmitoylation of Akt.
This minimally invasive technique, enhanced by intraoperative fluorescence, might be a safe and feasible alternative to open surgery in the removal of deeply located gliomas.
The aim of the current study was to investigate the effect of fluid resuscitation and L-arginine administration on oxidant status markers, blood gases, lactate and apoptosis in the brain tissue of a rat model of TBI with hemorrhagic shock.

A total of 60 rats were divided into six groups control, isotonic saline-treated, 7.5% NaCl-treated (hypertonic saline), L-arginine-treated (100 mg/kg), saline + L-arginine-treated and 7.5% NaCl + L-arginine-treated groups. Closed head contusive weight-drop injuries were performed with hemorrhagic shock in all of the groups. Mean arterial pressure (MAP), pulse rate, lactate, malondialdehyde (MDA), total antioxidant capacity (TAC) and apoptosis were investigated.

In a total of 48 rats, MAP levels remained higher than 60 mmHg for 3 hours in all of the treatment groups. The highest MAP values in each group were recorded. Higher MDA and lower TAC levels were observed in the control group than in all of the treatment groups (all p 0.05). The number of apoptotic cells was highest in the control group and lowest in the L-arginine group.

L-arginine administration may be an alternative treatment option for individualized fluid resuscitation in patients with TBI and hemorrhagic shock.
L-arginine administration may be an alternative treatment option for individualized fluid resuscitation in patients with TBI and hemorrhagic shock.
To present a substitute strategy for clipping coil embolization of the ruptured aneurysm followed by intentional, staged clipping.

We treated five cases of ruptured intracranial aneurysms with branches arising from the neck. The mean aneurysm diameter was 4.4 mm. In the acute rupture phase, coiling was performed without adjunctive endovascular techniques with intentional preservation of the neck in all cases. To treat recurrence during follow-up, the previously coiled aneurysm was clipped, which did not occasion any complications. Postoperative imaging showed completely obliterated aneurysms and preserved branches. No rebleeding occurred during the interval between coiling and clipping, and no rebleeding or recurrence occurred after clipping. No treatment-related complications occurred after coiling and clipping.

This two-stage strategy may be effective for hemostasis and branch preservation for small- and medium-sized ruptured aneurysms with a branch arising from the neck. This intentional two-stage strategy can be a substitute strategy for clipping in the acute rupture phase with an acceptable outcome if the patient cannot undergo clipping as the first-line treatment.
This two-stage strategy may be effective for hemostasis and branch preservation for small- and medium-sized ruptured aneurysms with a branch arising from the neck. This intentional two-stage strategy can be a substitute strategy for clipping in the acute rupture phase with an acceptable outcome if the patient cannot undergo clipping as the first-line treatment.
An interthalamic adhesion (ITA) is a midplane rod-like neuroanatomical mass connecting two thalami over the cavity of the third ventricle. It is present in approximately 70-80% of healthy humans. The absence of an ITA has been considered as a midline defect of the brain associated with schizophrenia. The aim of the present study was to determine the prevalence, location, and dimensions of ITAs in Indian brains.

We examined 100 brains (50 cadaveric and 50 MR images) in the midsagittal plane for the presence or absence of ITAs, their location in the lateral wall of the third ventricle, and dimensions.

ITA found in 87 brains (87%), four showed duplication (4%). Both its duplication and absence were more frequent among male. It was most commonly located in the anterosuperior quadrant with posterosuperior extension. The mean of horizontal diameter (7.13±4.31 mm) was longer than the vertical (5.13 ±3.17) in all the brains. Its average area (37.98±41.47 mm2) showed huge variation (ranges between 4.40 mm2 to 203 mm2) and was significantly higher in females (61.23±56.22 mm2) than males (36.44±43.21 mm2) (p = 0.026). No correlation was found between the surface area of the ITA and the length of the third ventricle.

Absence and duplication of ITA are fairly common in Indian brains with significant male predominance. Morphometric data are robust to advocate for the presence of sex differences in the ITA size, although not associated with surrounding thalamic or third ventricle anatomy.
Absence and duplication of ITA are fairly common in Indian brains with significant male predominance. Morphometric data are robust to advocate for the presence of sex differences in the ITA size, although not associated with surrounding thalamic or third ventricle anatomy.Central and peripheral nervous system involvement of COVID-19 has been reported in 25% of cases. COVID-19 is associated with encephalitis and most often presenting with confusion and disorientation, and mortality decreases with early diagnosis and treatment.The patient who was admitted with confusion and fever and found COVID-19 PCR positivity in both cerebrospinal fluid (CSF) and the nasopharyngeal swab is presented here. A 71-year-old female patient who underwent transsphenoidal pituitary tumor surgery 4 months ago, was in an acute confusional state with fluctuations in consciousness and agitation. It was suggested that bilateral temporal areas of the brain and paramedian region of the pons compatible with encephalitis in the T2 and FLAIR axial sections of magnetic resonance imaging (MRI). Nasopharyngeal and CSF SARS-CoV-2 RNA PCR was studied since thorax CT was compatible with COVID-19 pneumonia and in both samples, PCR was found positive. Encephalitis for toxic and metabolic causes was excluded. In this case, COVID-19 encephalitis was treated with dual antiviral (favipiravir and acyclovir) and steroid therapy. The uniqueness of this case is not only the presence of a very few reported cases of both Nasopharyngeal and CSF SARS-CoV-2 RNA PCR positivity but also previous history of transsphenoidal pituitary surgery 4 months ago.
To evaluate the efficacy and safety of combined transforaminal anterior epidural steroid injection (TAESI) and dorsal root ganglion pulsed radiofrequency (DRG-PRF) therapy on the radicular neck pain.

The results of 84 patients with cervical radicular pain who underwent combined DRG-PRF and TAESI under fluoroscopy were evaluated retrospectively. Primer outcome is the pain measurements of the patients before and after the procedure at the 1st, 3rd, and 6th months were evaluated with the Verbal Pain Scale (VPS). Our secondary outcome was the evaluation of patient satisfaction in the 1st, 3rd, and 6th months after the interventional treatment, and it was considered significant if it was evaluated as "good" above 50%.

We found statistically significant decrease in the pain scores of the patients in the 1st, 3rd, and 6th months compared to the pre-intervention (VPS 0) (p 0.001). After the procedure, the patients expressed their satisfaction level as 69.1% at the 1st month, 71.5% at the 3rd month, and 72.6% at the 6th month as "very good/good". While the operation was mostly performed at the C5-6 level on both sides, it was seen that 61.9% of the operations were applied from the right side and 38.1% from the left side. Lanifibranor agonist No adverse effects or fatal neurological complications were observed.

Although the efficacy and complications of cervical TAESI and DRG-PRF treatment are controversial in the literature, we think that this combined treatment can provide effective pain palliation in experienced hands with appropriate patient selection, considering the profit-loss ratio.
Although the efficacy and complications of cervical TAESI and DRG-PRF treatment are controversial in the literature, we think that this combined treatment can provide effective pain palliation in experienced hands with appropriate patient selection, considering the profit-loss ratio.
To investigate the current practice of neurosurgeons and their perception of complications related to the securement of external drainage (ED) to the skin.

We created a 24-points English language questionnaire on Google Forms covering the five main domains of care. The survey was distributed among members of the European Society for Pediatric Neurosurgery (ESPN) in April 2020.

The results were entirely self-reported, without any independent validation. Fifty-one neurosurgeons practising in different centres worldwide participated in this survey. Despite well-known complications and drawbacks, sutures are still the most commonly used method to secure cerebrospinal fluid (CSF) ventricular ED (49 out of 51 respondents) and spinal ED (37 out of 51) to the skin. Perception of the risk of pullout is estimated as < 1% by 25.5% of the respondents, 1-5% by 39.2%, 5-10% by 17.6% and 10% by 11.8% > . Twenty out of fifty-one respondents acknowledge that their method of securement has drawbacks, and 49% believe that it may also affect the risk of infection. Factors eventually affecting the risk of pullout are young age (62.7%), aetiology (25.5%), neurological status (90.2%), occipital exit site (37.3%), inadequate length of the subcutaneous tunnel (58%), the duration of ED (70.6%), and hospital stay in service (84.3%). 39.2% of respondents agree that the paediatric population deserves a different device or technique to secure ED to the skin. 21.6% of respondents underestimate the risk of accidental pullout. 86.3% of respondents have never read about the 'sutureless subcutaneous anchoring device'.

Complications associated with the securement method, such as the risk of pullout and infection, are most likely underestimated. More research is needed to implement effective guidelines in this field.
Complications associated with the securement method, such as the risk of pullout and infection, are most likely underestimated. More research is needed to implement effective guidelines in this field.
To evaluate all serum biomarkers in sports-related concussion injury (SRC) to determine diagnostic validity, changes with symptom severity, and return to play, as well as detect early changes in serum concentration.

Studies were searched in various electronic databases (MEDLINE/PubMed, EMBASE, CINAHL, Scopus and Cochrane databases) from their commencement to May 2021. Studies were included if athletes aged 12 years and older were diagnosed with a concussion injury and evaluated using serum biomarkers. Studies including athletes with injuries other than concussion injuries were excluded. Articles with fewer than 20 concussed athletes were excluded. There were 1782 articles identified.

After exclusion a total of 17 articles qualified for systematic review. S100 calcium binding protein ? (S-100?) and ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1) showed promising results in distinguishing concussed athletes from contact sports and non-athlete controls. Most of the serum biomarkers increased within 6 hours of SRC. Serum neurofilament light protein (NFL) positively correlated with the severity of post-concussion symptoms. NFL, tau and Interleukins (IL-1 Ra and IL-6) have the potential to determine return to play.

Serum biomarker measurement is an objective tool that aids in early diagnosis and predicts the severity and prognosis of injury.
Serum biomarker measurement is an objective tool that aids in early diagnosis and predicts the severity and prognosis of injury.
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