Expression of Stem Cell Marker Nestin and MicroRNA-21 in Meningiomas.

AIM: Meningiomas are one of the most common benign intracranial tumors, making up nearly one third of all primary intracranial tumors. The majority of meningiomas have benign histological features and total resection is associated with favourable prognosis. Atypical and malignant meningiomas are associated with increased risk of recurrence. In the present study we set out to investigate the role of nestin mRNA levels and miR-21 in meningiomas. MATERIAL AND METHODS: We studied 17 patients with meningiomas that were treated surgically in our institute. Clinical variables that were analyzed were age, sex and histology. The expression of stem cell marker nestin mRNA levels and miR-21 was investigated in tissue samples by qRT-PCR. RESULTS: Considerable levels of both miR-21 and nestin mRNA were found. Atypical and anaplastic meningiomas had higher expression of both miR-21 and nestin compared to benign tumors. Furthermore, a trend towards a positive correlation between miR-21 and nestin mRNA levels was also found. CONCLUSION: Increased miR-21 and nestin mRNA levels were found in anaplastic meningiomas, in which recurrence is common, and the role of miR-21 and Nestin in meningiomas therefore warrants further investigation.

Indirect traumatic optic neuropathy following head injury: report of five patients and review of the literature.

BACKGROUND: Indirect traumatic optic neuropathy (ITON) is a rare occurrence in patients with head injuries, mostly affecting young people. Loss of vision is a feared consequence. Its natural history and optimal care remain undetermined. Randomized controlled studies are missing. Treatment alternatives include mere observation, corticosteroid administration, or surgical decompression of the optic canal. Among these options, an individual approach is considered. CASE REPORTS: We report five patients with head injury and ITON: a 63-year-old woman was left permanently blind after a fall; a 33-year-old man lost his vision of the left eye immediately after a car accident; and three young men (aged 26, 21, and 22 years) who were intubated after a road accident noted loss of vision from one eye after they became conscious. The 26-year-old patient in the last group regained his sight 1 month later, whereas the other two never had it returned. All of our patients were treated conservatively: Methylprednisolone was administrated. CONCLUSION: Patients with ITON are managed on an individual basis. Informed consent must be obtained for mere observation or administration of corticosteroids and/or optic canal decompression. The natural history of this disorder is unknown. Only randomized controlled studies can fix standard guidelines of care. Preventive measures to decrease the incidence of head injured patients are mandatory.