Cell Proliferation and Apoptosis-Key Players in the Lung Aging Process.

Currently, the global lifespan has increased, resulting in a higher proportion of the population over 65 years. Changes that occur in the lung during aging increase the risk of developing acute and chronic lung diseases, such as acute respiratory distress syndrome, chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, and lung cancer. During normal tissue homeostasis, cell proliferation and apoptosis create a dynamic balance that constitutes the physiological cell turnover. In basal conditions, the lungs have a low rate of cell turnover compared to other organs. During aging, changes in the rate of cell turnover in the lung are observed. In this work, we review the literature that evaluates the role of molecules involved in cell proliferation and apoptosis in lung aging and in the development of age-related lung diseases. The list of molecules that regulate cell proliferation, apoptosis, or both processes in lung aging includes TNC, FOXM1, DNA-PKcs, MicroRNAs, BCL-W, BCL-XL, TCF21, p16, NOX4, NRF2, MDM4, RPIA, DHEA, and MMP28. However, despite the studies carried out to date, the complete signaling pathways that regulate cell turnover in lung aging are still unknown. More research is needed to understand the changes that lead to the development of age-related lung diseases.

Identification of the Remains of an Adult Using DNA from Their Deciduous Teeth as a Reference Sample.

In many forensic cases, the identification of human remains is performed by comparing their genetic profile with profiles from reference samples of relatives, usually the parents. Here, we report, for the first time, the identification of the remains of an adult using DNA from the person's deciduous teeth as a reference sample. Fragments of a skeletonized and burned body were found, and a short tandem repeat (STR) profile was obtained. A woman looking for her missing son went to the authorities. When the DNA profile of the woman was compared to a database, a positive match suggested a first-degree kinship with the person to whom the remains belonged. The woman had kept three deciduous molars from her son for more than thirty years. DNA typing of dental pulp was performed. The genetic profiles obtained from the molars and those from the remains coincided in all alleles. The random match probability was 1 in 2.70 × 1021. Thus, the remains were fully identified. In the routine identification of human remains, ambiguous STR results may occur due to the presence of null alleles or other mutational events. In addition, erroneous results can be produced by false matches with close family members or even with people who are completely unrelated to the victim, such that, in some cases, a probability of paternity greater than 99.99% does not necessarily indicate biological paternity. Whenever possible, it is preferable to use reference samples from the putative victim as a source of DNA for identification.

Back to the Basics: Usefulness of Naturally Aged Mouse Models and Immunohistochemical and Quantitative Morphologic Methods in Studying Mechanisms of Lung Aging and Associated Diseases.

Aging-related molecular and cellular alterations in the lung contribute to an increased susceptibility of the elderly to devastating diseases. Although the study of the aging process in the lung may benefit from the use of genetically modified mouse models and omics techniques, these approaches are still not available to most researchers and produce complex results. In this article, we review works that used naturally aged mouse models, together with immunohistochemistry (IHC) and quantitative morphologic (QM) methods in the study of the mechanisms of the aging process in the lung and its most commonly associated disorders: cancer, chronic obstructive pulmonary disease (COPD), and infectious diseases. The advantage of using naturally aged mice is that they present characteristics similar to those observed in human aging. The advantage of using IHC and QM methods lies in their simplicity, economic accessibility, and easy interpretation, in addition to the fact that they provide extremely important information. The study of the aging process in the lung and its associated diseases could allow the design of appropriate therapeutic strategies, which is extremely important considering that life expectancy and the number of elderly people continue to increase considerably worldwide.

Nestin-Expressing Cells in the Lung: The Bad and the Good Parts.

Nestin is a member of the intermediate filament family, which is expressed in a variety of stem or progenitor cells as well as in several types of malignancies. Nestin might be involved in tissue homeostasis or repair, but its expression has also been associated with processes that lead to a poor prognosis in various types of cancer. In this article, we review the literature related to the effect of nestin expression in the lung. According to most of the reports in the literature, nestin expression in lung cancer leads to an aggressive phenotype and resistance to chemotherapy as well as radiation treatments due to the upregulation of phenomena such as cell proliferation, angiogenesis, and metastasis. Furthermore, nestin may be involved in the pathogenesis of some non-cancer-related lung diseases. On the other hand, evidence also indicates that nestin-positive cells may have a role in lung homeostasis and be capable of generating various types of lung tissues. More research is necessary to establish the true value of nestin expression as a prognostic factor and therapeutic target in lung cancer in addition to its usefulness in therapeutic approaches for pulmonary diseases.

Involución espontánea de meningioma. Caso clínico y revisión de la literatura / Spontaneus involution of meningioma. Case report and literature review

Los meningiomas son tumores de las meninges cerebrales, de crecimiento lento y generalmente benignos, cuyo tratamiento es esencialmente quirúrgico. Presentan receptores de progesterona, y en menor medida de estrógeno, lo que les hace a veces tener crecimiento o disminución ligada a tratamiento hormonal. Es extremadamente raro que presenten involución espontánea. Presentamos el caso de un varón con un meningioma del planum esfenoidal. Como antecedentes tenía diabetes mellitus, miastenia gravis y un cáncer de próstata. Como tratamiento médico recibía, entre otros, análogos de la gonadotropina (leuprorelina), antiandrogénico (bicalutamida), agonistas β3 y bloqueantes α1. A los 15 meses del bloqueo hormonal se objetivó una reducción del tumor del 90% de su volumen. Los casos publicados previamente muestran que el tratamiento con análogos de la GnRH produce un crecimiento en algunos meningiomas. Existen otros casos publicados sobre reducción en pacientes diabéticos y en tratamiento con bloqueantes α1. Se revisa la literatura sobre meningiomas con involución espontánea (AU)

Meningiomas are tumors of the cerebral meninges, with slow growth and usually benign, whose treatment is essentially surgery. They have progesterone receptors, and to a lesser extent estrogen, which sometimes causes them to have growth or involution linked to hormonal treatment. Its spontaneous involution is extremely rare. We present the case of a male with a meningioma of the sphenoid planum. He had a history of diabetes mellitus, myasthenia gravis and prostate cancer. He was in treatment with analogs of GnRH (leuprorelin), antiandrogen (bicalutamide), β3 agonists and α1 blockers. 15 months after the hormonal blockade, a reduction of the tumor of approximately 90% of its volume was detected. Previous reports show that treatment with gonadotropin analogues produces growth in some meningiomas. Other reports of spontaneous involution affect diabetic patients and patients in treatment with α1 blockers. Literature focus on meningiomas with spontaneous involution is reviewed (AU)

Neurologically Asymptomatic Lumbar Traumatic Dislocation With Vascular Compression in a Patient With Ankylosing Spondylitis: Case Report.

BACKGROUND: Ankylosing spondylitis (AS) is associated with high rates of severe thoracolumbar fractures, in many cases with neurological deficits. It is currently a point of debate as to whether the optimal surgical treatment is posterior fixation and fusion or combined approaches. Vascular injuries in this kind of fracture are a challenging issue to solve in the management of these patients. METHODS: We are reporting the case of a 65-year-old man who presented an L4 traumatic fracture-dislocation. He had a long history of symptomatic AS. No neurological deficits were detected during the initial exploration. During the preoperative work-up, a lumbar spine computed tomography (CT) scan was taken with vascular reconstruction of the abdominal vessels. It confirmed the compression of the abdominal aorta, which had caused more than 90% stenosis. A posterior approach, an open reduction, and fixation with pedicle screws were performed, without hemodynamic or neurological changes. A postoperative angiography demonstrated a complete recovery of the vessel caliber, without contrast leaks. RESULTS: After a 2-year follow-up, the patient was pain free and the CT scan revealed bone fusion. CONCLUSIONS: The vascular structures involved in severe thoracolumbar fractures present a dangerous situation that should be considered in the choice of the surgical approach. The posterior approach alone may be a good option in the absence of vascular damage. However, due to risk of vessel rupture during the fracture reduction, vascular surgeons must take part in the surgery. LEVEL OF EVIDENCE: 5. CLINICAL RELEVANCE: The article provides help for surgeons who have to treat severe fractures in the context of ankylosing spondylitis.

The Convoluted Tubules of the Nephron Must Be Considered Elliptical, and Not Circular, in Stereological Studies of the Kidney.

INTRODUCTION: The diameter and area of the proximal convoluted tubule (PCT) and the distal convoluted tubule (DCT) are of the main parameters analyzed in stereological studies of the kidney. However, there is no consensus about if the PCT and DCT should be considered circular or elliptical in shape. OBJECTIVE: To analyze if there are significant differences in the diameter and area of the PCT and DCT, depending on whether they are considered circular or elliptical. METHODS: Paraffin-embedded sections of kidneys from CD1 mice were stained with hematoxylin and eosin and examined using a light microscope. Images were captured using a camera linked to image analysis software. A short diameter (d) and a long diameter (D) were measured in both PCT and DCT. A small circular area (SCA), a large circular area (LCA), and an elliptical area (EA) were calculated with mathematical formulas that incorporate d and D values, while a program area (PA) was provided by the software. RESULTS: There was a significant difference between d and D in both PCT (F = 1.354, Sig = 0.000) and DCT (F = 4.989, Sig = 0.000). Also, there were significant differences in the tubular areas in both PCT (F = 34.843, Sig = 0.000) and DCT (F = 22.390, Sig = 0.000); circular areas were different from elliptical areas (SCA and LCA vs. EA and PA). CONCLUSION: The convoluted tubules of the nephron must not be considered circular, but rather elliptical; care should be taken every time the tubules are analyzed in stereological studies of the kidney, especially when evaluating their diameters and areas.

Toxicity and Anticancer Potential of Karwinskia: A Review.

Karwinskia genus consists of shrubs and small trees. Four toxic compounds have been isolated from Karwinskia plants, which were typified as dimeric anthracenones and named T496, T514, T516, and T544. Moreover, several related compounds have been isolated and characterized. Here we review the toxicity of the fruit of Karwinskia plants when ingested (accidentally or experimentally), as well as the toxicity of its isolated compounds. Additionally, we analyze the probable antineoplastic effect of T514. Toxins cause damage mainly to nervous system, liver, lung, and kidney. The pathophysiological mechanism has not been fully understood but includes metabolic and structural alterations that can lead cells to apoptosis or necrosis. T514 has shown selective toxicity in vitro against human cancer cells. T514 causes selective and irreversible damage to peroxisomes; for this reason, it was renamed peroxisomicine A1 (PA1). Since a significant number of malignant cell types contain fewer peroxisomes than normal cells, tumor cells would be more easily destroyed by PA1 than healthy cells. Inhibition of topoisomerase II has also been suggested to play a role in the effect of PA1 on malignant cells. More research is needed, but the evidence obtained so far indicates that PA1 could be an effective anticancer agent.

Spontaneus involution of meningioma. Case report and literature review. / Involución espontánea de meningioma. Caso clínico y revisión de la literatura.

Meningiomas are tumors of the cerebral meninges, with slow growth and usually benign, whose treatment is essentially surgery. They have progesterone receptors, and to a lesser extent estrogen, which sometimes causes them to have growth or involution linked to hormonal treatment. Its spontaneous involution is extremely rare. We present the case of a male with a meningioma of the sphenoid planum. He had a history of diabetes mellitus, myasthenia gravis and prostate cancer. He was in treatment with analogs of GnRH (leuprorelin), antiandrogen (bicalutamide), ß3 agonists and α1 blockers. 15 months after the hormonal blockade, a reduction of the tumor of approximately 90% of its volume was detected. Previous reports show that treatment with gonadotropin analogues produces growth in some meningiomas. Other reports of spontaneous involution affect diabetic patients and patients in treatment with α1 blockers. Literature focus on meningiomas with spontaneous involution is reviewed.

Peroxisomicine A1, a potential antineoplastic agent, causes micropexophagy in addition to macropexophagy.

Peroxisomicine A1 (PA1) is a potential antineoplastic agent with high and selective toxicity toward peroxisomes of tumor cells. Pexophagy is a selective autophagy process that degrades damaged peroxisomes; this process has been studied mainly in methylotrophic yeasts. There are two main modes of pexophagy in yeast: macropexophagy and micropexophagy. Previous studies showed that peroxisomes damaged by a prolonged exposition to PA1 are eliminated by macropexophagy. In this work, Candida boidinii was grown in methanol-containing media, and PA1 was added to the cultures at 2 µg/mL after they reached the mid-exponential growth phase. Samples were taken at 5, 10, 15, 20, and 25 min after the addition of PA1 and processed for ultrastructural analysis. Typical morphological characteristics of micropexophagy were observed: the direct engulfment of peroxisomes by the vacuolar membrane and the presence of the micropexophagic membrane apparatus (MIPA), which mediates the fusion between the opposing tips of the vacuole to complete sequestration of peroxisomes from the cytosol. In conclusion, here we report that, in addition to macropexophagy, peroxisomes damaged by PA1 can be eliminated by micropexophagy. This information is useful to deepen the knowledge of the mechanism of action of PA1 and of that of pexophagy per se.

Morphometric analysis of the non-epithelial areas of mouse bronchioles through the normal aging process.

Aging is associated with changes in the structure and function of the lung that may increase susceptibility to chronic lung diseases. The aim of this study was the morphometric assessment of the non-epithelial areas of the bronchioles of mouse through the normal aging process. Lungs from CD1 mice at the age of 2, 6, 12, 18, or 24 months were fixed in neutral-buffered formalin and paraffin-embedded. Sections were cut, stained with Masson trichrome, and examined using a light microscope. High-resolution color images were captured using a camera linked to image analysis software to measure areas and lengths. We observed in the bronchioles through the aging process an increase of the total area, an increase of the lumen area, and a decrease of the wall area. In conclusion, our results revealed structural changes in the bronchioles of mouse through the normal aging process. These alterations are likely to contribute to development of chronic lung diseases.

Situación actual del uso de redes sociales en Neurocirugía en España / Current use of Social Media in Neurosurgery in Spain

Objetivo: Analizar la situación actual en España del uso de redes sociales en Neurocirugía. Materiales y métodos: Se realiza un estudio transversal y observacional entre febrero y marzo de 2017, mediante una búsqueda estructurada de las cuentas en Twitter, Facebook y YouTube de los servicios y unidades de Neurocirugía, sociedades científicas, publicaciones y asociaciones de pacientes relacionadas con la Neurocirugía. Se clasificaron según su popularidad. Resultados: Según nuestro estudio solo 5 servicios de Neurocirugía de la red pública tienen presencia en redes sociales, siendo inferior su popularidad a la de las unidades privadas. Las sociedades científicas y revistas neuroquirúrgicas tienen una presencia marginal, más aún en comparación con las de otras especialidades médicas. La popularidad de las asociaciones y grupos de apoyo es alta, sobre todo entre los pacientes, encontrándose mayor información sobre enfermedades que en las cuentas corporativas. Conclusiones: El uso en España de las redes sociales en Neurocirugía es bajo, en comparación con otras especialidades médicas. Existe un amplio campo de actuación para mejorar la popularidad de las cuentas, la difusión de la sociedad científica y la revista Neurocirugía y realizar funciones de promoción de la salud

Objective: To analyze the current situation in Spain of the use of Social Media in Neurosurgery. Materials and methods: We made an observational transversal study between February and March 2017, with a systematic search of the Facebook, Twitter and Youtube accounts from public and private neurosurgical units, scientific societies, peer-reviewed publications and patients groups in relation with Neurosurgical pathologies. We rank them according their popularity. Results: According of our search only 5 public neurosurgical services have social media accounts, being their popularity inferior to the private units accounts. In relation with the scientific societies and neurosurgical publications their presence in social media is marginal, even more in comparison to the accounts of other medical specialities. The popularity of associations of patients and supporting groups is high, especially among patients, finding there more information about their disease. Conclusions: The use in Spain of Social Media about Neurosurgery is low in comparison to other medical specialities. There is a huge field to improve the popularity of the accounts, making in them promotion of health and extend the diffusion of the scientific society and the peer-reviewed publication Neurocirugía

Current use of Social Media in Neurosurgery in Spain. / Situación actual del uso de redes sociales en Neurocirugía en España.

OBJECTIVE: To analyze the current situation in Spain of the use of Social Media in Neurosurgery. MATERIALS AND METHODS: We made an observational transversal study between February and March 2017, with a systematic search of the Facebook, Twitter and Youtube accounts from public and private neurosurgical units, scientific societies, peer-reviewed publications and patients groups in relation with Neurosurgical pathologies. We rank them according their popularity. RESULTS: According of our search only 5 public neurosurgical services have social media accounts, being their popularity inferior to the private units accounts. In relation with the scientific societies and neurosurgical publications their presence in social media is marginal, even more in comparison to the accounts of other medical specialities. The popularity of associations of patients and supporting groups is high, especially among patients, finding there more information about their disease. CONCLUSIONS: The use in Spain of Social Media about Neurosurgery is low in comparison to other medical specialities. There is a huge field to improve the popularity of the accounts, making in them promotion of health and extend the diffusion of the scientific society and the peer-reviewed publication Neurocirugía.

Efecto de la edad en el pronóstico de pacientes con traumatismo craneoencefálico sometidos a craneotomía: análisis de una serie quirúrgica / The effect of age on the prognosis of patients with traumatic brain injury who undergo a craniotomy: analysis of a surgical series

Introducción. En nuestro entorno, el envejecimiento poblacional ha convertido el manejo del traumatismo craneoencefálico (TCE) en etapas avanzadas de la vida en un problema de frecuencia creciente.Objetivo. Valorar la asociación entre la edad y el pronóstico vital y funcional de pacientes intervenidos por TCE. Pacientes y métodos. Analizamos retrospectivamente una serie de 404 pacientes intervenidos en nuestro centro entre los años 2000 y 2015: 144 jóvenes (12-44 años), 77 adultos (45-64 años), 148 pacientes geriátricos (65-79 años) y 26 supergeriatricos (> 80 años). Revisamos las características demográficas y nosológicas de la población, y el pronóstico vital y funcional (escala pronostica de Glasgow, GOS) en el momento del alta y a los seis meses. Resultados. La edad presenta asociación lineal positiva tanto con la mortalidad intrahospitalaria como con la proporción de pacientes con pronóstico desfavorable (GOS 1-3) en el alta y a los seis meses (p < 0,001). Tomando como referencia la población de jóvenes, el riesgo relativo para pronostico desfavorable a los seis meses fue de 1,5 (IC 95%: 1,04-2,19) para los adultos, 2,37 (IC 95%: 1,77-3,17) para los geriátricos y 3,5 (IC 95%: 2,63-4,70) para los supergeriatricos. Estos últimos presentan una mortalidad durante el ingreso del 77,78% y un porcentaje de mal pronóstico funcional a los seis meses del 94,44%. Conclusión. El aumento de la edad es un factor determinante negativo mayor en el pronóstico de pacientes sometidos a craneotomía por TCE. Un conocimiento preciso de estos resultados y una adecuada discusión preoperatoria con la familia resultaran de gran ayuda en el proceso de toma de decisiones (AU)

Introduction. In our setting, the ageing of the population has led to management of traumatic brain injury (TBI) in the later stages of life becoming an increasingly frequent problem. Aim. To evaluate the association between age and the functional and survival prognosis of patients who have undergone surgery due to TBI. Patients and methods. We performed a retrospective analysis of a series of 404 patients submitted to surgery between the years 2000 and 2015: 144 youngsters (12-44 years), 77 adults (45-64 years), 148 geriatric patients (65-79 years) and 26 'super geriatric' patients (> 80 years). We reviewed the demographic and nosological characteristics of the population, the survival and functional prognosis (Glasgow Outcome Scale, GOS) on discharge and at six months. Results. Age presents a positive linear association with both intra-hospital mortality and the proportion of patients with an unfavourable prognosis (GOS 1-3) on hospital discharge and at six months (p < 0.001). Taking the population of youngsters as a reference, the relative risk for an unfavourable prognosis at six months was 1.5 (95% CI: 1.04-2.19) for adults; 2.37 (95% CI: 1.77-3.17) for the geriatric patients; and 3.5 (95% CI: 2.63-4.7) for the ‘super geriatric’ patients. These latter present a mortality rate while in hospital of 77.78% and a percentage of poor functional prognosis at six months of 94.44%. Conclusion. Increased age is a major negative determining factor in the prognosis of patients who undergo a craniotomy due to TBI. More precise knowledge of these outcomes and an adequate pre-operative discussion with the family will be an invaluable aid in the decision-making process (AU)

Anterior sacral meningocele presenting as intracystic bleeding.

PURPOSE: To report a case of anterior sacral meningocele with intralesional bleeding secondary to sacrococcygeal trauma. Likewise, there is a discussion about the physiopathology and the surgical approach to these types of lesions. METHODS: A 43-year-old man diagnosed with Marfan syndrome suffered sacrococcygeal trauma. He was admitted to the emergency room due to symptoms of headache, nausea, and lower limb subjective weakness. CT and MRI showed a large retroperitoneal mass with hemorrhagic content close to the sacrum. Likewise, the MRI showed an image compatible with subarachnoid hemorrhage in the thoracic spinal area, cerebral convexity, and the basal cisterns. The patient went into surgery for an anterior abdominal approach in the midline to reduce the content of the lesion, and subsequently, in the same act, a posterior approach was done with an S1-S2 laminectomy and obliteration of the pedicle. Postoperative MRI 5 months later showed resolution of the ASM. RESULTS: Anterior sacral meningocele is characterized by herniation of the dura mater and the arachnoid mater outside the spinal canal through a defect of the sacrum. We add the risk of bleeding after trauma-never seen in the literature-as one of the possible inherent complications of this lesion. CONCLUSIONS: This report highlights a complication never seen in the literature of a relatively rare condition. In our case, the combined approach was effective for both clinical control and lesion regression.

C3435T polymorphism in the MDR1 gene and breast cancer risk in northeastern Mexico.

The multidrug resistance gene 1 (MDR1) encodes a membrane-bound phosphoglycoprotein (P-gp). It functions as a transmembrane efflux pump for various structurally unrelated carcinogens and toxins. Polymorphism C3435T of MDR1 has been investigated for its association with breast cancer in different populations. However, the results are inconsistent and inconclusive. The objective of this study was to determine whether an association exists between the MDR1 C3435T polymorphism and the risk of breast cancer in a population from northeastern Mexico, which displays ethnic characteristics that differentiate it from other populations of the country. Genotypes were determined for 243 women with histologically confirmed breast cancer and 118 control subjects. Polymorphism of MDR1 C3435T was analyzed by DNA microarray. We found an increased breast cancer risk associated with CT and CC genotypes (OR = 1.88, 95% CI: 1.04-3.39, P = 0.033 for CT vs. TT; OR = 2.91, 95% CI: 1.48-5.74, P = 0.001 for CC vs. TT). Furthermore, there was significantly increased risk of breast cancer associated with the C allele (OR = 1.59, 95% CI: 1.16-2.18, P = 0.003). In conclusion, we found an association between the MDR1 C3435T polymorphism and risk of breast cancer in subjects from northeastern Mexico. Identification of inter-individual variability in this polymorphism may be useful for individualizing breast cancer genetic screening and therapeutic intervention.

Neuralgia del trigémino secundaria a endostosis del hueso temporal / Trigeminal neuralgia secondary to petrous endostosis

La compresión neurovascular de origen arterial se postula como principal mecanismo de producción de la neuralgia primaria del trigémino. A pesar de ser la causa más frecuente, existen otras patologías, como los tumores localizados en el ángulo pontocerebeloso, capaces de producir dolor trigeminal. Presentamos el caso de una paciente de 44años con neuralgia del trigémino derecha sin respuesta al tratamiento médico. La RM cerebral previa no muestra signos de patología estructural. Durante la descompresión microvascular del nervio trigémino se encuentra endostosis de la cara interna del peñasco que provocaba compresión del V par. Tras el fresado completo y la descompresión microvascular desaparece de manera completa el dolor en el postoperatorio inmediato, manteniendo asintomática al año de la cirugía. La endostosis del hueso temporal es una causa muy infrecuente de neuralgia del trigémino. Una adecuada revisión de los estudios preoperatorios permitiría la optimización del manejo quirúrgico definitivo

Arterial neurovascular compression is hypothesised to be the main cause of primary trigeminal neuralgia. Although it is the most common cause, other pathologies, such as tumours in the cerebellopontine angle, can cause trigeminal pain. We report a case of a 44-year-old female patient with right trigeminal neuralgia without satisfactory response to medical treatment. Cerebral MRI showed no structural injuries. During microvascular decompression of the trigeminal nerve, endostosis of the internal aspect of the petrous bone was found to compress the trigeminal nerve. The pain disappeared completely in the early postsurgical period, after the complete drilling of the endostosis and microvascular decompression. The patient remains asymptomatic one year later. Endostosis of the petrous bone is a rare cause of trigeminal neuralgia. A proper review of preoperative studies would enable the definitive surgical approach to be optimised

Treatment of chronic traumatic C7-T1 grade III spondylolisthesis with mild neurological deficit: case report.

Traumatic cervical severe spondylolisthesis is a rare and severe lesion which is typically associated with a spinal cord injury. Nevertheless, it occasionally has a pauci-symptomatic course which may delay its diagnosis. The authors report an exceptional case of a 33-year-old woman who had mild spasticity in her lower limbs and neck pain 9 months after a traffic accident. The computed tomographic scan and magnetic resonance image revealed C7-T1 grade III spondylolisthesis and spinal cord signal change. The initial cervical traction did not obtain a spinal realignment. An anterior-posterior approach was performed to achieve a correct spinal fusion. After 18 months of follow-up care, the patient's symptoms improved significantly and she began to lead a normal life again. The case underlines the importance of performing a correct initial diagnostic workup upon a patient. This would improve surgical management by avoiding a worsening of the initial neurological deficit during the realignment maneuvers in the chronic grade III, IV or V spondylolisthesis.

[Trigeminal neuralgia secondary to petrous endostosis]. / Neuralgia del trigémino secundaria a endostosis del hueso temporal.

Arterial neurovascular compression is hypothesised to be the main cause of primary trigeminal neuralgia. Although it is the most common cause, other pathologies, such as tumours in the cerebellopontine angle, can cause trigeminal pain. We report a case of a 44-year-old female patient with right trigeminal neuralgia without satisfactory response to medical treatment. Cerebral MRI showed no structural injuries. During microvascular decompression of the trigeminal nerve, endostosis of the internal aspect of the petrous bone was found to compress the trigeminal nerve. The pain disappeared completely in the early postsurgical period, after the complete drilling of the endostosis and microvascular decompression. The patient remains asymptomatic one year later. Endostosis of the petrous bone is a rare cause of trigeminal neuralgia. A proper review of preoperative studies would enable the definitive surgical approach to be optimised.