Methamphetamine and the Synthetic Cathinone 3,4-Methylenedioxypyrovalerone (MDPV) Produce Persistent Effects on Prefrontal and Striatal Microglial Morphology and Neuroimmune Signaling Following Repeated Binge-like Intake in Male and Female Rats.

Psychostimulants alter cellular morphology and activate neuroimmune signaling in a number of brain regions, yet few prior studies have investigated their persistence beyond acute abstinence or following high levels of voluntary drug intake. In this study, we examined the effects of the repeated binge-like self-administration (96 h/week for 3 weeks) of methamphetamine (METH) and 21 days of abstinence in female and male rats on changes in cell density, morphology, and cytokine levels in two addiction-related brain regions-the prefrontal cortex (PFC) and dorsal striatum (DStr). We also examined the effects of similar patterns of intake of the cocaine-like synthetic cathinone derivative 3,4-methylenedioxypyrovalerone (MDPV) or saline as a control. Robust levels of METH and MDPV intake (~500-1000 infusions per 96 h period) were observed in both sexes. We observed no changes in astrocyte or neuron density in either region, but decreases in dendritic spine densities were observed in PFC pyramidal and DStr medium spiny neurons. The microglial cell density was decreased in the PFC of METH self-administering animals, accompanied by evidence of microglial apoptosis. Changes in microglial morphology (e.g., decreased territorial volume and ramification and increased cell soma volume) were also observed, indicative of an inflammatory-like state. Multiplex analyses of PFC and DStr cytokine content revealed elevated levels of various interleukins and chemokines only in METH self-administering animals, with region- and sex-dependent effects. Our findings suggest that voluntary binge-like METH or MDPV intake induces similar cellular perturbations in the brain, but they are divergent neuroimmune responses that persist beyond the initial abstinence phase.

External Iliac Artery Endofibrosis: A Discussion on Two Unique Cases.

Iliac artery endofibrosis (IAE), as the name suggests, involves subintimal fibrosis of the iliac artery. IAE is most commonly associated with competitive athletics, particularly cycling, and remains a rather underappreciated diagnosis in the clinical setting. We present two unique and distinct presentations of IAE in competitive athletes. The first case involves a 38-year-old male cyclist who initially presented with complaints of a bulge at the right groin and acute onset monoplegia and paresthesia associated with exertion of the right lower extremity. This patient was referred to vascular surgery and underwent right common iliac artery and proximal common femoral artery endarterectomy with patch angioplasty and Fogarty embolectomy. Case 2 involves a 50-year-old female triathlete who presented with left lower extremity claudication of a more chronic course, with symptoms beginning approximately four years prior. The pain radiated to her upper thigh and was associated with exertion, restricting her exercise tolerance and return to training. After a diagnosis of IAE was made, she was referred to vascular surgery for a left iliofemoral bypass.

Ectopic Recurrence of a Craniopharyngioma.

Craniopharyngiomas are rare, solid or mixed solid, cystic tumors that generally occur in the sellar and suprasellar regions of the central nervous system along the pituitary stalk near the optic chiasm. Although benign, patients clinically present with symptoms from mass effect or the resultant increase in intracranial pressures. The recurrence rate of craniopharyngiomas is high. When present, recurrence is typically at the site of the primary tumor bed. Here, we present a case of a 27-year-old male who was found to have a suprasellar mass on enhanced CT imaging. The mass was resected and a ventriculoperitoneal shunt was placed. The lesion was identified as a craniopharyngioma, and the patient completed treatment and was discharged appropriately. Ten years later, the patient presented with headaches and on enhanced CT imaging was found to have a radiopaque mass originating from the right lateral ventricle and extending into the splenius of the corpus callosum. This new lesion was identified as a craniopharyngioma. Ectopic recurrence of a craniopharyngioma is a rare phenomenon and is thought to be the result of direct seeding along the site of surgical resection or via cerebrospinal fluid circulation.

Imaging of Malar Silastic Implant Complications.

Facial cosmetic implants are utilized for definition enhancements in the malar, mandibular, and nasal regions. Though these implants are safe in the majority of patients, notable complications such as implant malpositioning may be seen. More rare but serious complications such as infection, abscess, and intrasinus migration may also occur, such as in this case reported on a 69-year-old female with a history of bilateral malar silicone implants. Imaging findings on this patient, whom initially presented with complaints of erythema and edema in the left malar region, were notable for edema and soft tissue signs of infection around a well-visualized crescent shaped maxillary implant. Penetration of the implant into the left maxillary sinus was also noted. Diagnostic imaging played a key role in determining the cause and severity of this patient's condition. Thus, the case reported is with an aim to familiarize radiologists with identifying and interpreting the complications of malar cosmetic implants on diagnostic imaging.