Middle meningeal artery embolization and pediatric chronic subdural hematoma: a systematic review of the literature.

Chronic subdural hematoma (CSDH) is a disease commonly found in the elderly and not a typical finding in pediatric population. History of shunt surgery, child abuse, and blood disorder are some of the common causes of pediatric CSDH (pCSDH). There is growing evidence about the role of middle meningeal artery embolization (MMAE) to manage CSDH in the elderly population with a high risk of rebleeding. However, the evidence in the pediatric population is still sparse. A systematic literature search was conducted on PubMed, Scopus, and Web of Science database from January, 2023, to March, 2023. Search strings were generated based on the combination of modified search terms, such as CSDH, MMA embolization, and child. Risk of bias was assessed using the Cochrane Risk of Bias in Nonrandomized Study for Intervention. Nine articles were included in this review. The success rate of MMA embolization in pediatric CSDH was 88.8%. Histories of ventriculoperitoneal shunt, blood coagulation disorder, and trauma were the causes of CSDH. Time to achieve success was varied from 2 to 9 months. No study with low risk of bias was found. This systematic review found no high-quality evidence regarding the role of MMA embolization in the management of pCSDH. However, due to its high success rate, MMAE could be a promising approach to treat pCSDH.

Comparison of direct cortical stimulation and transcranial magnetic stimulation in brain tumor surgery: systematic review and meta analyses.

INTRODUCTION: Brain malignancy and, at the same time central nervous system malignancy are two of the most difficult problems in the oncology field of practice. Brain tumors located near or within eloquent areas may represent another challenge toward neurosurgeon treatment. As such, electrical stimulation, either directly or through other methods, may prove necessary as proper mapping of the eloquent area thus may create a proper resection guide. Minimal resection will hopefully preserve patient neurological function and ensure patient quality of life. METHODS: This research is a systematic review and meta-analysis that aim to compare outcomes, primarily adverse event analysis, between direct cortical stimulation and transcortical magnetic stimulation. RESULTS: Fourteen studies were identified between 2010 and the 2023 interval. While this number is sufficient, most studies were not randomized and were not accompanied by blinding. Meta-analysis was then applied as a hypothesis test, which showed that TMS were not inferior compared to DCS in terms of motoric and lingual outcome which were marked subjectively by diamond location and objectively through a p-value above 0.05. CONCLUSION: TMS is a noninvasive imaging method for the evaluation of eloquent brain areas that is not inferior compared to the invasive gold-standard imaging method (DCS). However its role as adjuvant to DCS and alternative only when awake surgery is not available must be emphasized.

Prevention of sports-related concussion in soccer: a comprehensive review of the literature.

Concussion is a common complaint among adult and adolescent athletes around the world and poses a safety risk in competitive, recreational, and noncontact sports. It is estimated that concussions occur at a rate of 0.5 per 1000 playing hours; however, the precision of this estimate is uncertain due to variations in the interpretation and reporting of concussions. Athletes with a history of concussions are more likely to sustain additional concussions, which can result in cognitive decline, depression, and early degenerative change. In order to lessen the likelihood of future difficulties, this study compiles the research on preventing sports-related concussion in soccer and presents a summary of the findings. Material and Methods: We performed a literature search on PubMed, EBSCO (Elton B. Stephens Company), DOAJ (Directory of Open Access Journals), and Cochrane for the past 20 years. The search strategy was using Boolean terms based on any of the search terms of sports-related-concussion, soccer, and prevention. The studies were included based on inclusion and exclusion criteria. Results: This research identified three systematic reviews, seven literature reviews, five cross-sectional studies, one randomized controlled trial, three prospective studies, and one retrospective study. As concussion prevention measures in soccer, several strategies can be implemented, including concussion education, rule/regulation changes, proper heading technique, behavioral skills training, vision training to improve sensory and anticipation, the use of supplements to prevent severe concussion and accelerate recovery, as well as prevention in youth sports and head impact detection. Conclusion: Good education, good technique, good training, and a good strengthening program can be implemented to prevent concussions in soccer. To determine the relationship between prevention and concussion, however, additional research is required.

A Critical Analysis of Intracranial Hemorrhage as a Fatal Complication of Dengue Fever.

Dengue fever is the most rapidly spreading mosquito-borne virus in the world, infecting about 100 million individuals. A rare but possibly dangerous consequence of dengue illness is intracranial hemorrhage (ICH). Currently, the pathogenesis of ICH is unknown. A number of studies have found a variety of risk factors for ICH in dengue. In addition, studies have reported the use of emergency surgery while monitoring thrombocytopenia in the therapy of dengue ICH. This review enumerates the potential predictors of ICH in dengue, discusses the use of brain imaging, and mentions the possibility of emergency surgery.

Recent Update on the Anti-Inflammatory Activities of Propolis.

In recent years, research has demonstrated the efficacy propolis as a potential raw material for pharmaceuticals and nutraceuticals. There is limited report detailing the mechanisms of action of propolis and its bioactive compounds in relation to their anti-inflammatory properties. Thus, the aim of the present review is to examine the latest experimental evidence (2017-2022) regarding the anti-inflammatory properties of propolis. A systematic scoping review methodology was implemented. After applying the exclusion criteria, a total of 166 research publications were identified and retrieved from Scopus, Web of Science, and Pubmed. Several key themes related to the anti-inflammatory properties of propolis were subsequently identified, namely in relation to cancers, oral health, metabolic syndrome, organ toxicity and inflammation, immune system, wound healing, and pathogenic infections. Based on the latest experimental evidence, propolis is demonstrated to possess various mechanisms of action in modulating inflammation towards the regulatory balance and anti-inflammatory environment. In general, we summarize that propolis acts as an anti-inflammatory substance by inhibiting and downregulating TLR4, MyD88, IRAK4, TRIF, NLRP inflammasomes, NF-κB, and their associated pro-inflammatory cytokines such as IL-1ß, IL-6, IFN-γ, and TNF-α. Propolis also reduces the migration of immune cells such as macrophages and neutrophils, possibly by downregulating the chemokines CXCL9 and CXCL10.

Case report: Implantation metastasis following stereotactic biopsy of pineal parenchymal tumor of intermediate differentiation in an adult patient: An exceptionally rare complication.

Implantation metastasis following stereotactic biopsy in the brain had been reported as a rare complication. A 36-years-old female patient was treated with ventriculoperitoneal (VP) shunt and stereotactic biopsy of a pineal parenchymal tumor of intermediate differentiation (PPTID) with hydrocephalus. The patient underwent five cycles of radiotherapy on the pineal area. Seven years after the procedure, the patient developed left hemiparesis with the brain MRI findings showing an enhanced mass along the biopsy tract. Craniotomy tumor removal was carried out and the pathological assessment was consistent with those of the PPTID. Radiation on metastase area and craniospinal was subsequently performed. The patient was disease-free during the 2-year follow-up assessments. The potential occurrence of implantation metastasis following the stereotactic biopsy of PPTID should be considered in the treatment plan and follow-up assessments and evaluations. Expanding the radiation area to cover the entire biopsy tract may be favorable to lower the risk of implantation metastasis.

Spontaneous epidural hematoma induced by rivaroxaban: A case report and review of the literature.

Background: Trauma is the most frequent reason for epidural bleeding. However, numerous investigation had discovered that anticoagulants such as rivaroxaban could cause epidural hematoma. Here, we present a case of epidural hematoma in young man who got rivaroxaban as treatment of deep vein thrombosis. Case Description: A 27-year-old male with a history of deep vein thrombosis and one month of rivaroxaban medication presented with seizure and loss of consciousness following a severe headache. A CT scan of the head revealed epidural bleeding, and emergency blood clot removal was performed. As a reversal, prothrombin complex was utilized. Conclusion: Rivaroxaban has the potential to cause an epidural hemorrhage. Reversal anticoagulant should be administered before doing emergency surgery.

Paroxysmal sympathetic hyperactivity syndrome in tuberculous meningitis with paradoxical reaction.

INTRODUCTION AND IMPORTANCE: Paroxysmal sympathetic hyperactivity syndrome is frequently reported in traumatic brain injury. However, it may occur in non-traumatic brain injury, such as tuberculous meningitis with hydrocephalus. CASE PRESENTATION: We reported a 38-year-old male who presented with acute decrease of consciousness and hemiparesis that was developed during antitubercular drugs therapy. CT Scan showed hydrocephalus and granuloma lesion. Emergency ventriculoperitoneal shunting were performed. During treatment, the patient developed paroxysmal sympathetic syndrome during treatment that was controlled based on symptom elimination and prevention. CLINICAL DISCUSSION: Brain tuberculosis remains a difficult problem for clinicians. Even when antitubercular drugs are administered according to protocol, paradoxical reactions can occur. If hydrocephalus develops, ventriculoperitoneal shunting is one of the options for lowering intracranial pressure. Paroxysmal sympathetic hyperactivity may occur in brain tuberculosis and should be detected as soon as possible to avoid serious morbidity. CONCLUSION: Paroxysmal sympathetic hyperactivity may be developed in brain tuberculosis. Early identification and treatment are mandatory.

Spontaneous acute subdural hematoma in dengue fever: Case report and review of the literature.

INTRODUCTION AND IMPORTANCE: A very uncommon dengue fever consequence is subdural hematoma. IgG positivity, increased AST, and ALT levels may all be risk factors for bleeding in dengue fever patients. CASE PRESENTATION: We report the case of a 65-year-old man who presented with dengue fever symptoms and developed altered consciousness and focal neurological deficits. The findings of the tests showed thrombocytopenia, increased AST and ALT, positive anti-dengue IgG, and subdural hematoma on brain imaging. The urgent operations were completed satisfactorily. CLINICAL DISCUSSION: Dengue-related intracerebral haemorrhage is still a complicated condition. Thrombocytopenia and leukopenia are the first symptoms that point to dengue. Some risk factors, such as thrombocytopenia and increased AST and ALT, have been identified as bleeding factors in dengue fever. For a possible intracerebral haemorrhage, radiological imaging should be performed. In an emergency neurosurgery setting, thrombocyte administration could be used to monitor thrombocytopenia. CONCLUSION: Subdural hematoma is a possible dengue fever complication. If the patient's symptoms with thrombocytopenia and elevated liver enzymes indicate the possibility of intracranial haemorrhage, immediate radiological imaging should be performed.

The Potential Use of Propolis as a Primary or an Adjunctive Therapy in Respiratory Tract-Related Diseases and Disorders: A Systematic Scoping Review.

Propolis is a resinous beehive product that is collected by the bees from plant resin and exudates, to protect and maintain hive homeostasis. Propolis has been used by humans therapeutically to treat many ailments including respiratory tract-related diseases and disorders. The aim of the present systematic scoping review is to evaluate the experimental evidence to support the use of propolis as a primary or an adjunctive therapy in respiratory tract-related diseases and disorders. After applying the exclusion criteria, 158 research publications were retrieved and identified from Scopus, Web of Science, Pubmed, and Google Scholar. The key themes of the included studies were pathogenic infection-related diseases and disorders, inflammation-related disorders, lung cancers, and adverse effects. Furthermore, the potential molecular and biochemical mechanisms of action of propolis in alleviating respiratory tract-related diseases and disorders are discussed. In conclusion, the therapeutic benefits of propolis have been demonstrated by various in vitro studies, in silico studies, animal models, and human clinical trials. Based on the weight and robustness of the available experimental and clinical evidence, propolis is effective, either as a primary or an adjunctive therapy, in treating respiratory tract-related diseases.

Clinicopathological associations and prognostic values of IDH1 gene mutation, MGMT gene promoter methylation, and PD-L1 expressions in high-grade glioma treated with standard treatment.

INTRODUCTION: the objective was to evaluate the impact of IDH1 R132H mutation, MGMT methylation and PD-L1 expression in high grade glioma that received standard therapy (surgery, radiation and chemotherapy) to overall survival (OS). METHODS: this is a retrospective study of 35 high grade glioma cases. Genotyping of IDH1 gene alteration on the mutation hotspot R132 (Sanger sequencing method with Applied Biosystems 3500 Genetic Analyzer), EZ DNA Methylation-Gold kit (Zymo Research) is used to study the methylation, Cell line BT549 (ATCC HTB-122) and HCT-116 (ATCC CCL-247) were used as unmethylated control and partially methylated control respectively. Anti-human PD-L1 antibody clone E1L3N®from Cell Signalling Technology (USA) and Rabbit XP®were used to see PDL-1 expression. RESULTS: anaplastic astrocytoma cases had more MGMT promoter methylation (50%) than glioblastoma multiforme (GBM) (20%), more IDH1 R132H mutation (42%) than GBM (4.3%). Immunohistochemistry tumor proportion score method (TPS) identified 17% and 8.7% were PD-L1 positive in AA and GBM groups, respectively. Cases with IDH1 R132H mutation and MGMT methylation still showed better OS although with high PD-L1 expression. CONCLUSION: IDH1 R132H mutation and MGMT methylation were good prognostic markers. High expression of PD-L1 apparently might not indicate poor overall survival in the presence of IDH1 R132 mutation and MGMT methylation.

Neuroendoscopic aspiration and lavage of intraventricular empyema following shunt infection in infants.

Bacterial ventriculitis is one of the most common and serious complications of shunt placement. Shunt infection has varied management and is difficult to treat neurosurgically. We report a case of intraventricular empyema due to shunt infection. Standard management was failed for this case and reaccumulation of pus in the both ventricles. Neuroendoscopic surgery with intraventricular lavage and aspiration using cannula nasogastric tube (NGT) through a single burr hole, has successfully decreased the accumulation of intraventricular empyema. After lavage and aspiration, antibiotic can be distributed effectively to the affected area. Follow up imaging and cerebrospinal fluid (CSF) culture shown a good result and shorter length of stay in the hospital. Neuroendoscopy appears effective and safe for the management of bacterial ventriculitis due to shunt infection in infant. The strategy described in this report might be useful to treat intraventricular empyema.