CSF bone cyst in a cervical vertebra.

A 43 year male patient presented with neck pain, upper limb paraesthesia and right foot weakness. A MRI scan revealed a bone cyst involving C4 spinous process, lamina, pedicles and the posterior part of the vertebral body causing focal spinal stenosis. A C4 laminectomy and C3-C5 lateral mass screw fixation was done. Intra-operatively the cyst was found to contain CSF with an associated dural defect. A CSF cervical vertebral cyst has not been previously reported in the literature. The clinical presentation, radiological features and management of this CSF vertebral cyst is discussed.

Why People Enter and Embrace Violent Groups.

We distinguish two pathways people may follow when they join violent groups: compliance and internalization. Compliance occurs when individuals are coerced to join by powerful influence agents. Internalization occurs when individuals join due to a perceived convergence between the self and the group. We searched for evidence of each of these pathways in field investigations of former members of two renowned terrorist organizations: the Liberation Tigers of Tamil Eelam (LTTE) (Study 1) and Islamist radical groups (Study 2). Results indicated that ex-fighters joined LTTE for reasons associated with both compliance and internalization but that ex-fighters joined Islamist radical groups primarily for reasons associated with internalization. When compliance occurred, it often took the form of coercion within LTTE but involved charismatic persuasion agents within Islamist groups. This evidence of systematic differences in the reasons why fighters enter violent groups suggests that strategies for preventing radicalization and fostering de-radicalization should be tailored to particular groups.

Ventromedial and dorsolateral prefrontal interactions underlie will to fight and die for a cause.

Willingness to fight and die (WFD) has been developed as a measure to capture willingness to incur costly sacrifices for the sake of a greater cause in the context of entrenched conflict. WFD measures have been repeatedly used in field studies, including studies on the battlefield, although their neurofunctional correlates remain unexplored. Our aim was to identify the neural underpinnings of WFD, focusing on neural activity and interconnectivity of brain areas previously associated with value-based decision-making, such as the ventromedial prefrontal cortex (vmPFC) and the dorsolateral prefrontal cortex (dlPFC). A sample of Pakistani participants supporting the Kashmiri cause was selected and invited to participate in an functional magnetic resonance (fMRI) paradigm where they were asked to convey their WFD for a series of values related to Islam and current politics. As predicted, higher compared to lower WFD was associated with increased ventromedial prefrontal activity and decreased dorsolateral activity, as well as lower connectivity between the vmPFC and the dlPFC. Our findings suggest that WFD more prominently relies on brain areas typically associated with subjective value (vmPFC) rather than integration of material costs (dlPFC) during decision-making, supporting the notion that decisions on costly sacrifices may not be mediated by cost-benefit computation.

Neuroimaging 'will to fight' for sacred values: an empirical case study with supporters of an Al Qaeda associate.

Violent intergroup conflicts are often motivated by commitments to abstract ideals such as god or nation, so-called 'sacred' values that are insensitive to material trade-offs. There is scant knowledge of how the brain processes costly sacrifices for such cherished causes. We studied willingness to fight and die for sacred values using fMRI in Barcelona, Spain, among supporters of a radical Islamist group. We measured brain activity in radicalized individuals as they indicated their willingness to fight and die for sacred and non-sacred values, and as they reacted to peers' ratings for the same values. We observed diminished activity in dorsolateral prefrontal cortex (dlPFC), inferior frontal gyrus, and parietal cortex while conveying willingness to fight and die for sacred relative to non-sacred values-regions that have previously been implicated in calculating costs and consequences. An overlapping region of the dlPFC was active when viewing conflicting ratings of sacred values from peers, to the extent participants were sensitive to peer influence, suggesting that it is possible to induce flexibility in the way people defend sacred values. Our results cohere with a view that 'devoted actors' motivated by an extreme commitment towards sacred values rely on distinctive neurocognitve processes that can be identified.

Neural and Behavioral Correlates of Sacred Values and Vulnerability to Violent Extremism.

Violent extremism is often explicitly motivated by commitment to abstract ideals such as the nation or divine law-so-called "sacred" values that are relatively insensitive to material incentives and define our primary reference groups. Moreover, extreme pro-group behavior seems to intensify after social exclusion. This fMRI study explores underlying neural and behavioral relationships between sacred values, violent extremism, and social exclusion. Ethnographic fieldwork and psychological surveys were carried out among 535 young men from a European Muslim community in neighborhoods in and around Barcelona, Spain. Candidates for an fMRI experiment were selected from those who expressed willingness to engage in or facilitate, violence associated with jihadist causes; 38 of whom agreed to be scanned. In the scanner, participants were assessed for their willingness to fight and die for in-group sacred values before and after an experimental manipulation using Cyberball, a toss ball game known to yield strong feelings of social exclusion. Results indicate that neural activity associated with sacred value processing in a sample vulnerable to recruitment into violent extremism shows marked activity in the left inferior frontal gyrus, a region previously associated with sacred values and rule retrieval. Participants also behaviorally expressed greater willingness to fight and die for sacred versus nonsacred values, consistent with previous studies of combatants and noncombatants. The social exclusion manipulation specifically affected nonsacred values, increasing their similarities with sacred values in terms of heightened left inferior frontal activity and greater expressed willingness to fight and die. These findings suggest that sacralization of values interacts with willingness to engage in extreme behavior in populations vulnerable to radicalization. In addition, social exclusion may be a relevant factor motivating violent extremism and consolidation of sacred values. If so, counteracting social exclusion and sacralization of values should figure into policies to prevent radicalization.