Central vein sign and paramagnetic rim sign: From radiologically isolated syndrome to multiple sclerosis.

The widespread use of magnetic resonance imaging (MRI) has led to an increase in incidental findings in the central nervous system. Radiologically isolated syndrome (RIS) is a condition where imaging reveals lesions suggestive of demyelinating disease without any clinical episodes consistent with multiple sclerosis (MS). The prognosis for RIS patients is uncertain, with some remaining asymptomatic while others progress to MS. Several risk factors for disease progression have been identified, including male sex, younger age at diagnosis, and spinal cord lesions. This article reviews two promising biomarkers, the central vein sign (CVS) and the paramagnetic rim sign (PRS), and their potential role in the diagnosis and prognosis of MS and RIS. Both CVS and PRS have been shown to be accurate diagnostic markers in MS, with high sensitivity and specificity, and have been useful in distinguishing MS from other disorders. Further research is needed to validate these findings and determine the clinical utility of these biomarkers in routine practice.

Preclinical Models and Technologies in Glioblastoma Research: Evolution, Current State, and Future Avenues.

Glioblastoma is the most common malignant primary central nervous system tumor and one of the most debilitating cancers. The prognosis of patients with glioblastoma remains poor, and the management of this tumor, both in its primary and recurrent forms, remains suboptimal. Despite the tremendous efforts that are being put forward by the research community to discover novel efficacious therapeutic agents and modalities, no major paradigm shifts have been established in the field in the last decade. However, this does not mirror the abundance of relevant findings and discoveries made in preclinical glioblastoma research. Hence, developing and utilizing appropriate preclinical models that faithfully recapitulate the characteristics and behavior of human glioblastoma is of utmost importance. Herein, we offer a holistic picture of the evolution of preclinical models of glioblastoma. We further elaborate on the commonly used in vitro and vivo models, delving into their development, favorable characteristics, shortcomings, and areas of potential improvement, which aids researchers in designing future experiments and utilizing the most suitable models. Additionally, this review explores progress in the fields of humanized and immunotolerant mouse models, genetically engineered animal models, 3D in vitro models, and microfluidics and highlights promising avenues for the future of preclinical glioblastoma research.

Navigating the Neurosurgery Match Process: Insights from the National Resident Matching Program - Program Director Surveys.

OBJECTIVE: Neurosurgery is one of the most competitive specialties and navigating the match process is often challenging for aspiring applicants. Here, we analyze insights from the National Resident Matching Program (NRMP) Program Director Surveys, illustrating evolving trends in applicant selection for interviews and for the ranking process, and providing a comparison with other specialties. METHODS: We evaluated seven surveys administered from 2012 to 2022. Six biennial surveys reported on factors influencing interview and ranking processes, while all seven surveys included data about the program director (PD)'s attitude towards USMLE test scores. RESULTS: The response rate of PDs decreased over the years. The most cited for interviews included specialty-specific recommendation letters (95%), USMLE Step 1 scores (91%), and interest in research (78%). A recent decline in emphasis on USMLE Step 1 scores coincided with a growing reliance on USMLE Step 2 scores. Award in basic science held significant esteem to a subset of programs. Personal characteristics dominated for ranking, with faculty interaction (89%), interpersonal skills (89%), and house staff interaction (85%) being the most important. Yet, PDs reported a difficulty in assessing interpersonal skills through virtual interviews. CONCLUSION: Our analysis revealed the pervasive importance of specialized endorsements and academic achievements when screening applicants for the interview process. A shift in emphasis towards the USMLE step 2 became apparent. Personal characteristics, on the other hand, seemed crucial to make a match and rank high among the pool of interviewed applicants. We uncovered difficulties in assessing these characteristics through virtual interviews.

Synovial Cyst in the Setting of an Interspinous Fusion Device.

Synovial cysts of the spine are degenerative cystic lesions that can lead to severe symptoms secondary to compression of the spinal cord, individual nerve roots, and/or the cauda equina. Some believe the etiology of this entity is related to increased motion across the facet joint and instability. We report a case of a lumbar synovial cyst located at the same level as a previously inserted spinous process fusion device. This case illustrates that, unlike a transpedicular instrumented fusion where the risk of synovial cyst formation is zero, a spinal process fusion can still lead to synovial cyst formation likely due to persistent micromotion across that segment.

Normative Data for the Montreal Cognitive Assessment in a Lebanese Older Adult Population.

INTRODUCTION: The Montreal Cognitive Assessment (MoCA), a neuropsychological tool for cognitive decline screening is widely used. In the absence of normative data in Lebanon, this study offers normative data for the MoCA in Lebanese community-dwelling older people and compare scores to those of other countries. METHODS: 164 literate subjects aged 60 and above were recruited to complete the MoCA. RESULTS: The mean MoCA score observed (24.20 points) was lower than that for normal controls (27.4 points) in the original validation study of the MoCA. Regression analysis showed that fewer years of education were associated with lower MoCA scores (p < .000). CONCLUSIONS: This study presents normative data and the findings suggest that cultural differences are evident in cognitive testing.