To summarize the clinical and radiological outcomes of a novel cerebral revascularization technique based on the superficial temporal artery patency concept (STAPC) in patients with moyamoya disease (MMD). A retrospective review was conducted of adult patientswith MMD treated at Beijing Hospital and Nanjing Drum Tower Hospital between January 2019 and December 2021. The cohort comprised 170 patients who underwent superficial temporal artery-middle cerebral artery bypass with encephalo-duro-arterio-synangiosis (EDAS) (STA-MCA/EDAS), and 133 who underwent EDAS alone. Radiological follow-up included computed tomography (CT) angiography (CTA) to assess bypass patency and CT perfusion (CTP) for hemodynamic staging at 3 and 12 months post-revascularization. Clinical follow-up recorded perioperative complications and recurrent stroke eventsthat occurred > 12months postoperativerly. Of the 303 patients, 37 cases (12.21%) had perioperative complications including 27 cases (15.9%) inthe STA-MCA/EDAS group and 10 cases (7.5%) in the EDAS group. Perfusion improvement was observed in 23.76% ofpatients (25.7% in the STA-MCA/EDAS group and 17.8% in the EDAS group) at 3monthspostsurgical, and in40.17% ofpatients (48.68% in the STA-MCA/EDAS group and 24.39% in the EDAS group) at 12monthspostsurgical. Bypass patency was observed in 95.29% ofpatients (96.1% in the STA-MCA/EDAS group and 93.5% in the EDAS group) at 3monthspostoperative, andin 96.43% patients (95.2% in the STA-MCA/EDAS group and 97.1% in the EDAS group) at 12monthspostoperative. Of the 249 patients with a median follow-up period of 50months (range 12-70months), 40 cases (16.06%, 3.85% per year) had recurrent stroke events including 22 (15.41%, 3.69% per year) in the STA-MCA/EDAS group and 18 (16.67%, 3.91% per year) in the EDAS group. Cerebral revascularization using STAPC is an acceptable surgical strategy for preventing stroke recurrence in patientswith MMD.

BackgroundDetermining the location of paraclinoid aneurysms (PAs) is crucial. We aimed to evaluate the utility of paraclinoid high-resolution MRI (HRMRI) in determining PA locations.MethodsWe enrolled patients with suspected PAs who underwent our HRMRI sequence in 6 months. PAs were categorized into five types based on their origin from the internal carotid artery (ICA): Superior ophthalmic segment (Type S), Ventral ophthalmic segment (Type V), Medial clinoidal segment (Type M), Lateral clinoidal segment Type L, and Posterior clinoidal segment) (Type P). The paraclinoid HRMRI protocol included five main sequences: TOF-MRA, coronal and saggital high-resolution T2-weighted images, coronal and saggital enhanced high-resolution T1-weighted images. We utilized cerebrospinal fluid (CSF) notch and cavernous sinus enhanced signals to determine the location of PAs.ResultsSixty-nine patients with 75 PAs were included. Based on our classification, there were 10 Type S, 2 Type V, 45 Type M, 11 Type L, and 7 Type P PAs. Among the Type S PAs, 9 were fully located within the subarachnoid space, and 1 was in the juncture area. Both Type V PAs were situated within the cavernous sinus. Among the Type M PAs, 34 were located in the cavernous sinus, and 1 was in the juncture. Of the Type L PAs, 5 were within the cavernous sinus, and 1 was in the juncture area. All 7 Type P PAs were located within the cavernous sinus.ConclusionsHRMRI sequences may assist in determining the location of PAs and could provide useful information for clinical decision-making, especially when radiation-free or iodine-free evaluation is preferred.Trial registrationThe clinical trial of China Internal Aneurysm Project (NCT03115905).

BackgroundIntracranial aneurysm(IA) are among the most common cerebrovascular diseases, and their rupture can lead to severe consequences. Aging plays a significant role in the onset and progression of many diseases, yet it remains understudied in the context of intracranial aneurysms. The aim of this study is to investigate the role of aging-related genes in the development of intracranial aneurysms using public databases, in order to understand the underlying biological mechanisms. MethodsGene expression profiles for intracranial aneurysms were downloaded from the GEO database. Human aging-related genes were obtained from the HAGR website. Differentially expressed gene analysis and WGCNA were used to identify core hub genes. GO and KEGG enrichment analyses were conducted to determine the potential biological functions and pathways that these differentially expressed aging-related genes in intracranial aneurysms might be involved in. Based on the hub genes, co-expression gene networks and Gene-TF-miRNA regulatory networks were constructed. Further exploration of drug-gene interactions was conducted to screen potential target drugs.ResultsThrough the intersection of aging-related genes and differentially expressed genes in IA, 32 common differentially expressed genes were identified, with 20 genes upregulated and 12 genes downregulated. GO enrichment analysis showed that these genes were mainly involved in epithelial cell proliferation and regulation, peptide enzyme activity modulation, and metabolic Homeostasis. KEGG enrichment analysis showed that these genes were primarily involved in the adipocytokine signaling pathway, growth Hormone synthesis,secretion and action, neurotrophin signaling pathway, and longevity regulating pathway. WGCNA was used to identify genes highly correlated with the IA phenotype, and an intersection with the 32 differentially expressed aging-related genes yielded 11 candidate Hub DEARGs. The expression of the candidate Hub DEARGs was validated using an external dataset, ultimately confirming 4 hub DEARGs related to intracranial aneurysms. Among them, NGFR and ADCY5 were downregulated, while BUB1B and SERPINE1 were upregulated. ConclusionsThis study identified four aging-related genes, NGFR, ADCY5, SERPINE1, and BUB1B, that are associated with intracranial aneurysms. This provides new insights into the molecular mechanisms underlying the development of intracranial aneurysms. The identified core genes provide promising leads for further experimental research to explore the pathogenesis of the disease.

BackgroundGliomas represent the most prevalent primary neoplasm in the adult central nervous system. Despite advancements in therapeutic modalities, such as surgical intervention, radiotherapy, chemotherapy, and tumor treatment, the 5-year survival rate of glioma patients remains low. Therefore, there is an urgent need to develop additional treatment methods. Recent studies have suggested that FAM111B is involved in DNA repair, cell cycle regulation, and apoptosis. FAM111B mutations and overexpression are related to cancer.MethodsWe found that FAM111B was significantly overexpressed in glioma tissues compared to the adjacent tissues by analyzing data from the TCGA_GBM&LGG and CGGA databases. Moreover, overexpression of FAM111B was associated with shorter overall survival, and disease-specific survival and tended to increase with disease stage progression. Cellular experiments confirmed these results. These results suggest that overexpression of FAM111B promotes the proliferation, migration, and invasion of glioma cells, whereas the knockdown of FAM111B inhibits these activities. We also found that FAM111B regulated glioma cell proliferation, migration, and invasion via the PI3K/AKT pathway.ResultsFAM111B is capable of enhancing the proliferation, invasion, and migration capabilities of glioma cells and promotes the malignant progression of glioma via the PI3K/Akt signaling pathway.ConclusionsThis is the first study to demonstrate that FAM111B plays a crucial role in the proliferation, migration, and invasion of glioma cells. The malignant phenotype of FAM111B has also been shown to be closely associated with the PI3K/AKT pathway. FAM111B may be a predictive biomarker and a potential therapeutic target for gliomas.

Chronic traumatic Encephalopathy (CTE) has been linked to an increase in the mortality of contact sport athletes in the USA, most especially in the early 2000s due to limited information on its existence. The lack of understanding of its existence resulted in delayed diagnosis and inadequate treatment of the disease for affected individuals.Africa faces a similar gap as awareness and research on CTE remain limited in the region where active participation in contact sports is rising. If no drastic action is taken to mitigate the gap, the region may face similar health consequences in the future.Various challenges responsible for the gap can be attributed to limited infrastructure, limited funding opportunities, and sociocultural factors. To address these challenges, a multifaceted approach is necessary through increasing funding, integrating CTE education into the medical curriculum, improving infrastructure, and resolving sociocultural myths about organ donation.

BackgroundThe extubation time is critical during the intensive care unit stay in aneurysmal subarachnoid hemorrhage (aSAH) patients. The current conventional parameters for predicting extubation failure (EF) and extubation time may not be suitable for this population. Here, we aimed to identify factors associated with EF in aSAH patients.MethodsFrom a single-center observational study on aSAH patients with computed tomography angiography from 2019 to 2021, patients who received microsurgery were enrolled and divided into two groups according to whether EF occurred. Multivariable logistic regression was conducted to evaluate disease severity, medical history, and extubation time differences between patients with and without EF.ResultsOf 335 patients included, EF occurred with a rate of 0.14. Delayed cerebral ischemia (67.4% vs. 13.5%) and acute hydrocephalus (6.5% vs. 1.4%) were frequently observed in patients with EF. Also, patients who develop EF presented higher disability (65.9% vs. 17.4%) and mortality (10.9% vs. 0.7%) rates. Multivariable analysis demonstrated that age (OR 1.038; 95% CI 1.004–1.073; P = 0.028), onset to admission time (OR 0.731; 95% CI 0.566–0.943; p = 0.016), WFNS grade > 3 (OR 4.309; 95% CI 1.639–11.330; p = 0.003), and extubation time < 24 h (OR 0.097; 95% CI 0.024–0.396; p = 0.001) were significantly associated with EF occurrence.ConclusionsThese data provide further evidence that older aSAH patients with onset to admission time < 2 days and WFNS grade > 3 have a high risk of developing EF, which is amplified by the ultra-early extubation. Moreover, in patients with two or more risk factors, a prolonged intubation recommendation requires consideration to avoid the EF.

Following publication of the original article [1], the authors reported that the order of the references needed to be modified. The original article [1] has been corrected.

Tumor-related trigeminal neuralgia (TN) is a deeply debilitating condition that severely impacts patient quality of life. Two principal treatment methods in use are open surgical resection of the causative tumor or the use of stereotactic radiosurgery (SRS). In this letter, we aim to evaluate the use of both treatment methods and highlight that in patients with commensurate anatomy, open surgical resection continues to provide greater rates of symptomatic relief, lower rates of recurrence, and complication compared to stereotactic radiosurgery.

BackgroundHigh-grade gliomas (HGGs) have a rapid relapse and short survival. Studies have identified many clinical characteristics and biomarkers associated with progression-free survival (PFS) and over-survival (OS). However, there has not yet a comprehensive study on survival after the first progression (SAP).MethodsFrom CGGA and TCGA, 319 and 308 HGGs were confirmed as the first progression. The data on clinical characteristics and biomarkers were analyzed in accordance with OS, PFS, and SAP.ResultsAnalysis of 319 patients from CGGA, significant predictors of improved OS/PFS/SAP were WHO grade, MGMT promoter methylation, and Ki-67 expression in univariate analysis. Further multivariate analysis showed MGMT promoter methylation and Ki-67 expression were independent predictors. However, an analysis of 308 patients from TCGA found MGMT promoter methylation is the only prognostic marker. A longer SAP was observed in patients with methylated MGMT promoter after standard chemoradiotherapy. In our data, HGGs could be divided into low, intermediate, and high-risk groups for SAP by MGMT methylation and Ki-67 expression.ConclusionsPatients with MGMT promoter methylation have a prolonger SAP after standard chemoradiotherapy. HGGs could be divided into low, intermediate, and high-risk groups for SAP according to MGMT status and Ki-67 expression.

BackgroundSpinal surgery is a common procedure associated with significant postoperative pain, and identifying effective interventions to manage this pain is crucial for optimizing patient outcomes. This review assesses the existing literature to determine the overall impact of vitamin C supplementation on spinal postoperative pain.Vitamin C, also known as ascorbic acid, is an essential nutrient that plays a vital role in numerous physiological processes. It functions as a potent antioxidant, neutralizing free radicals and reducing oxidative stress within the body. Furthermore, vitamin C is a cofactor in collagen synthesis, a crucial component of connective tissues, including those found in the spinal structures. Given its antioxidant and collagen-promoting properties, vitamin C has piqued interest as a potential therapeutic option for postoperative spinal pain.Based on the available evidence, vitamin C may have a beneficial effect on postoperative spinal pain, including reducing pain scores, analgesic consumption, and the incidence of complications such as complex regional pain syndrome. However, more research is needed to fully understand the optimal dosage and duration of vitamin C supplementation for postoperative pain management.ConclusionVitamin C could be considered a potentially beneficial adjunctive therapy for managing spinal postoperative pain, but its routine use requires further investigation.