ABSTRACT
Treatment of motor disorders by MRI-guided focused ultrasound is an alternative to neuro- and radiosurgery such as stereotactic radiofrequency ablation and thalamotomy with a gamma knife. However, safety, efficacy and feasibility of this technology for intracranial neoplasms are still unclear. The authors report successful hypothalamic hamartoma dissection by MRI-guided focused ultrasound in a 32-year-old woman with drug-resistant gelastic epilepsy and violent laughter and crying attacks. Magnetic resonance imaging revealed type II hypothalamic hamartoma. The last one was detached from surrounding brain tissue by MRI-guided focused ultrasound without side effects. Symptoms regressed immediately after surgery. No laughter and crying attacks were observed throughout 6-month follow-up.
Subject(s)
Drug Resistant Epilepsy , Hamartoma , Hypothalamic Diseases , Female , Humans , Adult , Hypothalamic Diseases/diagnostic imaging , Hypothalamic Diseases/surgery , Hamartoma/diagnostic imaging , Hamartoma/surgery , Magnetic Resonance Imaging , RussiaABSTRACT
OBJECTIVE: To show that effective and safe bilateral MR-guided focused ultrasound (MRgFUS) treatment of essential tremor (ET) is achievable. MATERIAL AND METHODS: Four male patients underwent bilateral thalamotomy. Two patients underwent staged thalamotomy, with the ≥12 month interval between operations. Two patients underwent simultaneous bilateral thalamotomy. RESULTS: After six months, all patients noted a significant reduction in symptoms on both sides: when assessing tremors with the Clinical Rating Scale for Tremor, the severity of hyperkinesis decreased by 57.5-69.7%. We did not observe any complications in any of the cases. CONCLUSION: Our experience indicates that simultaneous bilateral MRI-guided focused ultrasound treatment of ET can be performed safely and effectively. Further research is necessary to estimate the effectiveness and adverse effect rates.
Subject(s)
Essential Tremor , Humans , Male , Essential Tremor/diagnostic imaging , Essential Tremor/surgery , Treatment Outcome , Thalamus/diagnostic imaging , Thalamus/surgery , Tremor , Magnetic Resonance ImagingABSTRACT
Progressive supranuclear palsy (PNP) is a neurodegenerative disease characterized by a combination of progressive akinetic-rigid syndrome, postural instability with frequent falls, supranuclear ophthalmoplegia, pseudobulbar syndrome and frontal dementia. The disease usually develops after the sixth decade of life, and has a progressive course. An own description of the clinical case of progressive supranuclear palsy in a 79-year-old patient with oromandibular hyperkinesis while taking levodopa is presented.
Subject(s)
Dyskinesias , Movement Disorders , Neurodegenerative Diseases , Supranuclear Palsy, Progressive , Aged , Humans , Levodopa/adverse effects , Supranuclear Palsy, Progressive/chemically induced , Supranuclear Palsy, Progressive/drug therapyABSTRACT
Cerebral aneurysms are characterized by pathological expansion and thinning of the wall of vessels on the brain base, which may lead to rupture and subarachnoid hemorrhage (SAH) that is a life-threatening condition. This dictates the need for identification of new biological markers that predict the presence of aneurysms and the risk of their rupture. In the last decade, the role of microRNAs (miRNAs), which are considered to be key regulators of biological processes, has been investigated. miRNAs have been shown to play a role in the development of aneurysms, but today there is little similar data. In this literature review, we analyze the existing data on the role of miRNAs in development, progression, and rupture of cerebral aneurysms. We describe the relationship between miRNA expression profiles and specific molecular and cellular processes leading to the development of aneurysms. Also, we discuss the potential clinical significance of miRNAs for predicting the risk of aneurysm rupture.
Subject(s)
Aneurysm, Ruptured , Intracranial Aneurysm , Subarachnoid Hemorrhage , Brain , Humans , MicroRNAsSubject(s)
Spinal Cord Injuries/complications , Spinal Cord Injuries/diagnosis , Spinal Cord Injuries/therapy , Adult , Female , Humans , MaleABSTRACT
Excretion of glycosaminoglycans (GAG) with urine was 2.7-fold decreased in patients with syringomyelia as compared with healthy persons. Patterns of GAG decreased excretion are genetically determined and inherited as dominant features. Content of GAG was decreased in the patients skin, cerebrospinal fluid and brain by 30%, 40% and 20-40%, respectively; content of GAG was increased by 80% in spinal cord where the pathological process was localized. The data obtained suggest that considerable impairment of connective tissue metabolism occurred in syringomyelia.
