Aberrant Arterial Anatomy at the Floor of the Third Ventricle: Video Case Report.

A 65-year-old woman presented with a 2-month progressive history of forgetfulness, headaches, and decline in mobility. Imaging showed a large, enhancing pineal region tumor with triventricular hydrocephalus. She underwent an endoscopic third ventriculostomy and biopsy after appropriate consent was gained. Video 1 demonstrates the endoscopic procedure during which 2 aberrant arteries were identified at the floor of the third ventricle. The endoscopic third ventriculostomy was performed between these 2 arteries with great care to preserve them. The patient improved postoperatively with resolution of the hydrocephalus. Histology showed a metastatic malignant melanoma. To the best of our knowledge, no similar anatomy has been shown in an endoscopic procedure. We speculate that these are perforating arteries from the posterior communicating artery (premamillary artery) or a branch from the first part of the posterior cerebral artery P1 (thalamoperforators). Other options include perforators from the ophthalmic segment of the internal carotid artery, the communicating segment of the internal carotid artery, the superior hypophyseal artery, or a branch of the medial posterior choroidal arteries. We look at each in turn.

Human Immunodeficiency Virus in Adults Undergoing Surgery for Brain Tumors.

Introduction Early diagnosis and treatment of human immunodeficiency virus (HIV) can improve outcomes. HIV prevalence in brain tumor patients and the impact of an HIV diagnosis on patient outcomes are poorly understood. Materials and methods This was a prospective study of 100 consecutive brain tumor patients admitted to a Greater London Tertiary Neurosurgical center for surgery between January 2021 and October 2021. All brain tumors were included. All patients have appropriately consented. Blood was tested to detect HIV antibodies and p24 antigen. Outcomes were noted at 30-day postoperative follow-up. Results In 100 patients, there was one case of a known HIV-positive, seronegative patient, and no new diagnosis was made, giving a prevalence of 1%. The mean age of patients included was 61.7 ± 13.3, with 57% female. The patient with HIV suffered a postoperative pseudomonas infection, requiring intensive care, additional surgery, and antibiotics. This resulted in an inpatient stay of 55 days - an increase of 274% compared to patients without HIV. Conclusion Literature regarding the prevalence of HIV in glioma patients is inconclusive, of low quality, and primarily out-of-date. Our literature search found no similar study of rates of HIV in brain tumor patients in the United Kingdom. The incidence of both HIV and brain tumors, particularly glioblastomas, is low.

Molecular Pathogenesis of Glioblastoma in Adults and Future Perspectives: A Systematic Review.

Glioblastoma (GBM) is the most common and malignant tumour of the central nervous system. Recent appreciation of the heterogeneity amongst these tumours not only changed the WHO classification approach, but also created the need for developing novel and personalised therapies. This systematic review aims to highlight recent advancements in understanding the molecular pathogenesis of the GBM and discuss related novel treatment targets. A systematic search of the literature in the PubMed library was performed following the PRISMA guidelines for molecular pathogenesis and therapeutic advances. Original and meta-analyses studies from the last ten years were reviewed using pre-determined search terms. The results included articles relevant to GBM development focusing on the aberrancy in cell signaling pathways and intracellular events. Theragnostic targets and vaccination to treat GBM were also explored. The molecular pathophysiology of GBM is complex. Our systematic review suggests targeting therapy at the stemness, p53 mediated pathways and immune modulation. Exciting novel immune therapy involving dendritic cell vaccines, B-cell vaccines and viral vectors may be the future of treating GBM.

A case report of uncommon paratesticular liposarcoma of spermatic cord presenting as a scrotal mass.

Paratesticular liposarcomas are uncommon malignancies, often misdiagnosed preoperatively, that present as a painless scrotal mass. There is no universal consensus on their management due to scarcity of reported cases. Early detection and prompt surgical intervention provide the best disease outcome. We present the case of a 74-year-old man with a painless left testicular mass. Ultrasound and CT scan showed a paratesticular tumour. He underwent left high inguinal orchidectomy. Histopathological, immunohistochemical and cytogenetics studies confirmed the diagnosis of a Grade 2 well differentiated paratesticular liposarcoma with clear surgical margins. The case was referred to our regional sarcoma centre and currently undergoes regular follow-up.

Effect of maternal status and breastfeeding practices on infant nutritional status - a cross sectional study in the south-west region of Bangladesh.

INTRODUCTION: The aim of this study was to address the current scenario of LBW and infant nutritional and to analyze the effect of maternal status and pattern of their breast feeding practices on perinatal and postnatal infant development. METHODS: Cross-sectional study design with structured questionnaires was used among 510 mother-infant pair to collect data. Maternal anthropometric, socio-economic and demographic characteristics and breast feeding practice were used as independent variable and birth weight and infant growth status as dependent variable. Descriptive and crosstab analysis were used to analyze the effect. RESULTS: The study revealed that about 29.4% infants were born with low birth weight (LBW). Mother with no education and from low income family were more likely (OR: 3.484, 95%CI: 1.993-6.089 and OR: 2.078, 95% CI: 1.274-3.387) to have LBW infant compared with mother with higher education and from higher income family. Similarly, lower maternal height, weight and MUAC (< 150 cm, <50 kg and < 22 cm respectively) were shown to have more risk of having LBW compared with higher height, weight and MUAC (RR: 1.628, 2.375 and 2.115; 95%CI: 1.250- 2.120, 1.844- 3.059, 1.623- 2.757). The prevalence of exclusive breastfeeding was found among 45% mother. Postnatal growth and development of infant was not found significantly different (P > 0.05) among those who breast feed exclusively and non-exclusively. CONCLUSION: The study confirms that lower level of maternal education; family income and anthropometric measurement significantly increase the risk of LBW. The prevalence of exclusive breastfeeding practice was not found satisfactory.