Corrigendum to "Experience and lessons learned from blunt cerebrovascular injuries: A case report" [Heliyon 9 (3) (March 2023) Article e13968].

[This corrects the article DOI: 10.1016/j.heliyon.2023.e13968.].

Experience and lessons learned from blunt cerebrovascular injuries: A case report.

Background: Blunt cerebrovascular injuries are rare and serious complications of trauma that can lead to cerebral vascular dissection or aneurysm. Improving awareness of blunt cerebrovascular injuries and using computed tomography angiography to pre-screen patients at high risk is recommended by current guidelines to prevent the occurrence of ischemic stroke complications. Case description: A 32-year-old male patient was admitted to the hospital following neck trauma accompanied by stroke symptoms. Imaging revealed intimal injury of the right common carotid artery and acute cerebral infarction. After an endarterectomy and repair, the vascular lumen obstruction resolved, blood flow was restored, and the patient's condition stabilized. Conclusion: Blunt cerebrovascular injury has been seriously neglected in clinical practice. Delayed or under-diagnosis of blunt cerebrovascular injury can result large strokes. Standardized treatment protocols, which include the screening and grading of blunt cerebrovascular injury, may reduce the risk of permanent neurological dysfunction, and even death, in patients.

Internal carotid artery dissection with different interventions and outcomes: two case reports.

Spontaneous internal carotid artery dissection (ICAD) is a rare disease and an important cause of stroke in young patients. The presentation of ICAD is variable and atypical. We have used three-dimensional T1-weighted volume isotropic turbo spin-echo acquisition to help diagnose ICAD. ICAD should be considered in young patients presenting with relevant symptoms in an emergency setting. We herein report ICAD with an unexplained onset in two patients. Neither had a history of large or small cervical trauma, but both had a history of hypertension. The first patient was a 33-year-old man who presented with upper extremity numbness and mobility impairment, and the second patient was a 40-year-old man with onset of visual impairment. There were no obvious triggers in either case. Both patients were diagnosed with ICAD by blood vessel examination. However, their prognoses differed. The first patient recovered after endovascular therapy, whereas the second patient was successfully managed with medical treatment. ICAD can cause different symptoms depending on where the dissection occurs. Clinicians must be aware of the different clinical manifestations of ICAD, make the correct diagnosis in a timely manner, make appropriate treatment plans according to the patient's condition, and strive for timely recanalization of the blood vessels.

Imaging features of internal maxillary artery and extracranial middle meningeal artery and their relationships on head CTA.

BACKGROUND: The internal maxillary artery and extracranial middle meningeal artery are vitally important. Anatomical studies of the relationship of between them using computed tomography angiography are rare. MATERIAL AND METHODS: This study assessed 75 cases involving 150 sides. And the vascular diameters and lengths of the internal maxillary artery and middle meningeal artery were measured using a GE workstation. The distance between the zygomatic arch midpoint and the internal maxillary artery, the angle between the internal maxillary artery and middle meningeal artery were measured, and the middle meningeal artery branch and internal maxillary artery aneurysm were recorded. The internal maxillary artery course classifications were recorded. All of these parameters were statistically analysed. RESULTS: Ages ranged from 18 to 72 (average 40.2) years, and there were 30 women (40%, 30/75) and 45 men (60%, 45/75). Internal maxillary artery length from its origin to middle meningeal artery origin was 1.37 ± 0.59 cm. The extracranial middle meningeal artery length was 1.79 ± 0.48 cm. The vessel diameters of internal maxillary artery origin, middle meningeal artery origin, and middle meningeal artery at the skull base were 2.93 ± 0.52 mm, 1.58 ± 0.43 mm, and 1.33 ± 0.43 mm, respectively. Among the 150 sides of internal maxillary artery course type, there were 138 superficial (92%, 138/150) and 12 (8%, 12/150) deep course cases. The angle between the internal maxillary artery and middle meningeal artery was 116.2 ± 35.76°. CONCLUSIONS: The findings of this study elucidate the imaging features of the internal maxillary artery and extracranial middle meningeal artery and their relationships, which are helpful for the extracranial-intracranial bypass and endovascular treatment via the internal maxillary artery and middle meningeal artery.

CT angiographic study of the cerebral deep veins around the vein of Galen.

Research on the anatomy of cerebral deep veins (CDVs) around the vein of Galen (VG) is very important and has fundamental clinical significance. Large-scale anatomical studies of CDVs using computed tomography angiography (CTA) are rarely reported. A retrospective study of the CDVs around the VG was conducted in Chinese patients of Han nationality. One hundred cases were included in the final analysis. The patients were aged from 17 to 78 years (mean: 42.3 years). Also, 46% of the patients were female. The diameter of the internal cerebral vein (ICV) at its beginning and termination points ranged from 0.4 to 2.8 mm (1.49 ± 0.39 mm) and 0.4 to 3.5 mm (2.05 ± 0.47 mm), respectively. There was statistical significance regarding the diameter of the ICV at its beginning and termination points (P <0.01). The ICV length ranged from 28.5 to 47.9 mm (36.86 ± 3.74 mm). The length of the straight sinus (SS) ranged from 30.2 to 57.8 mm (43.6 ± 6.37 mm). The length of the VG ranged from 1.5 to 41.8 mm (9.30 ± 4.76 mm). The angle at the VG and SS transition area ranged from 25.4 to 110.6° (77.2 ± 18.0°). This study was a meaningful attempt to conduct anatomical research of CDVs using CTA. Preoperative familiarity with the normal venous structure and its variation around the VG would be helpful for endovascular treatment.

SOX2 Regulates lncRNA CCAT1/MicroRNA-185-3p/FOXP3 Axis to Affect the Proliferation and Self-Renewal of Cervical Cancer Stem Cells.

It has been presented the role of long non-coding RNAs (lncRNAs) in cervical cancer (CC). We aim to discuss the effect of sex-determining region Y-box 2 (SOX2)/lncRNA colon cancer-associated transcript-1 (CCAT1)/microRNA-185-3p (miR-185-3p)/forkhead box protein 3 (FOXP3) on the proliferation and self-renewal ability of CC stem cells. MiR-185-3p, SOX2, CCAT1 and FOXP3 expressions were tested in CC tissues and cells. The relationship between SOX2/CCAT1 expression and clinicopathological features in CC patients was verified. Loss- and gain-of-function investigations were conducted in CD44+HeLa cells to discuss biological functions and self-renewal capacity. Finally, the relationships among SOX2, CCAT1, FOXP3 and miR-185-3p were verified. miR-185-3p expression was decreased, while SOX2, CCAT1 and FOXP3 expressions were increased in CC tissues and cells. SOX2 and CCAT1 expressions were linked to tumor size, lymph node metastasis and international federation of gynecology and obstetrics stage of CC. Down-regulating SOX2 or CCAT1 and up-regulating miR-185-3p resulted in inhibition of proliferation, invasion, migration and cell sphere number as well as apoptosis acceleration of CD44+HeLa cells. SOX2 could bind to CCAT1 which affected miR-185-3p expression, and FOXP3 was targeted by miR-185-3p.

Cerebral Hemangioblastoma Without Von Hippel-Lindau Syndrome: A Report of 6 Cases.

Background. Hemangioblastoma occurs mainly in the cerebellum and rarely in the cerebrum. Objective. The present study aimed to analyze the clinical manifestations and radiological and pathological features of cerebral hemangioblastoma, and to improve the recognition of this tumor and avoid misdiagnosis. Methods. The characteristics of 6 patients with cerebral hemangioblastoma were analyzed, and a retrospective review of cerebral hemangioblastoma reported in the literature was performed. Results. All 6 patients were female, aged from 22 to 70 years (55 years on average), and all cases were wild-type sporadic, in which 4 cases occurred in the frontal lobe and 2 cases occurred in the parietal lobe. Imaging revealed a solid tumor in 4 cases, a cystic tumor in 1 case, and a mixed tumor in 1 case. Microscopically, the morphology and immunophenotype of tumor cells were not different from those of classical hemangioblastoma. All 6 patients survived tumor free during the follow-up period. Conclusions. Cerebral hemangioblastoma often simulates the imaging characteristics of meningioma or glioma. Enough attention should be paid to differential diagnosis before the operation, and exact diagnosis relies on the pathological examination.

MLL1 promotes migration and invasion of fibroblast-like synoviocytes in rheumatoid arthritis by activating the TRIF/NF-κB signaling pathway via H3K4me3 enrichment in the TLR4 promoter region.

Rheumatoid arthritis (RA) is the most common inflammatory arthritis and is a major cause of disability. Interestingly, the histone methyltransferase mixed-lineage leukemia 1 (MLL1) has been linked to many inflammation-related diseases. Moreover, toll-like receptor 4 (TLR4) has been reported to induce migration and invasion in RA-fibroblast-like synoviocytes (FLSs). This study intended to delineate the functional relevance of MLL1 in RA progression, which implicates the regulation of TLR4. First, clinical synovial tissues were collected from RA patients and patients with severe joint trauma to isolate FLSs. We identified highly expressed MLL1 and TLR4 in synovial tissues of RA patients, and the expression of them was positively correlated in RA-FLSs. More importantly, silencing of MLL1 and TLR4 resulted in suppressed migration and invasion of RA-FLSs, accompanied by reduced inflammation. Additionally, mechanistic investigations showed that MLL1 upregulated TLR4 expression by inducing H3K4me3 in the promoter region of TLR4. Functional assays revealed that overexpression of MLL1 activated the TRIF/NF-κB signaling pathway, resulting in accelerated migration and invasion, and inflammation of RA-FLSs in vitro. TLR4 knockdown could compromise the effects of MLL1 overexpression. The in vivo assays in a collagen-induced arthritis rat model validated the in vitro findings. Taken together, histone methyltransferase MLL1 induces TLR4 expression by mediating H3K4me3 in the TLR4 promoter, thus activating the TRIF/NF-κB signaling pathway, which thereby promotes the migration and invasion of RA-FLSs and ultimately exacerbates the progression of RA.

Targeted endovascular treatment for ruptured brain arteriovenous malformations.

Currently, endovascular treatment (EVT) is recommended for ruptured brain arteriovenous malformation (BAVM). When performing EVT for ruptured BAVM, curative complete embolization without complications is the ideal goal, but, more often than not, it is difficult, impossible, and dangerous. Therefore, EVT targeted toward ruptured focal weak structures plays a very important role. No previous study has comprehensively reviewed the use of targeted EVT for ruptured BAVMs. Therefore, the current paper reviews the available literature on this subject. In BAVM, the ruptured focal weak structures may include flow-related aneurysms, intranidal venous dilated structures, intranidal fistula, and venous varices or ectasia. These ruptured focal weak structures have direct and indirect imaging presentations. The indirect imaging presentations indicate various intracranial hemorrhages. In direct imaging presentations, digital subtraction angiography (DSA) has the highest degree resolution for showing ruptured focal weak structures. In addition, some magnetic resonance (MR) sequences can be useful to identify ruptured focal weak structures. Of all ruptured focal weak structures, flow-related aneurysms are considered the highest risk and require urgent occlusion. Other ruptured weak structures also need to undergo targeted EVT. After targeted EVT, a good prognosis can be obtained. Therefore, the use of targeted EVT for ruptured BAVM is promising.

99mTc-3PRGD2 SPECT Predicts the Outcome of Endostar and Cisplatin Therapy in Xenograft Animals.

AIMS: Our study was designed to investigate the usefulness of 99mTc-3PRGD2 single-photon emission computed tomography (SPECT) for noninvasively monitoring the response of integrin αvß3 expression to antiangiogenic treatment with endostar and cisplatin in xenograft animals. METHODS: 99mTc-3PRGD2 SPECT imaging was performed at days 0, 7, 14, and 21. Tumors were harvested at all imaging time points for Western blotting and histopathological analysis. RESULT: In 99mTc-3PRGD2 SPECT imaging, the radioactivity accumulation of NaCl group rised gradually in the first half and dispersed on day 21 due to the necrosis of the tumor. While the radioactivity accumulation of treated groups gradually decreased throughout the course. The downtrend of tumor to nontumor ratio in endostar-treated group was more remarkable than cisplatin-treated group. The expression of intergrin αvß3 of treated groups was lower than NaCl group from day 14. The expression of intergrin αvß3 of endostar-treated group was significantly lower than cisplatin-treated group from baseline onward. CONCLUSION: It's demonstrated that the 99mTc-3PRGD2 could noninvasively visualize and semiquantify tumor angiogenesis in the xenograft model and monitor the response to the antiangiogenic therapy of endostar and cisplatin effectively. It also can predict the outcome of endostar and cisplatin therapy in xenograft animals.

Brain arteriovenous malformation with transdural blood supply: Current status.

Arterial blood supply to a brain arteriovenous malformation (BAVM) is mainly derived from the internal carotid artery (ICA) and vertebral basilar artery (VBA) system. However, in certain cases, arteries supplying the meninges may also contribute to the blood supply of the BAVM, resulting in the formation of a BAVM with transdural blood supply (TBS). To review the current status of BAVM with TBS, a literature search was performed in the PubMed database. Articles were screened for relevance and suitability of data. According to recent studies, the mechanisms by which TBS to a BAVM forms are mainly classified into the congenital and acquired type. BAVM with TBS is common in elderly patients and is characterized by intracranial hemorrhage, epilepsy, chronic headache and increased intracranial pressure. Digital subtraction angiography is the gold standard for diagnosing BAVM with TBS. Superselective angiography is also important. Treatments for BAVM with TBS include surgical resection, endovascular treatment (EVT), stereotactic radiosurgery and combined treatment. Surgical resection is difficult to perform. EVT has become the major therapy for treating BAVM with TBS due to its low procedural invasiveness. Combination of surgical resection and EVT may be a good option. In addition, stereotactic radiosurgery is frequently used as a complementary treatment to surgical and endovascular interventions. The prognosis of BAVM with TBS is not favorable, as the defect involves a complex arterial supply system.

Mechanism of Metformin on LPS-Induced Bacterial Myocarditis.

AIMS: Metformin is commonly used to treat type 2 diabetes mellitus; however, in recent years, it was found to play a potential role in the protection of myocardial injury. In this study, we intended to investigate whether metformin had protective effects on bacterial myocarditis. METHODS AND RESULTS: We stimulated rat cardiac myoblast H9c2 cells with lipopolysaccharide (LPS) and administrated with metformin. The results showed that cell viability after LPS stimulation was greatly reduced. The expression levels of phosphorylated p38 mitogen-activated protein kinases (MAPK) and c-Jun N-terminal kinases (JNK), nuclear factor (NF)-κB (NF-κB), BAX, and cleaved Caspase3 were significantly increased, while the expression of antiapoptotic protein Bcl-2 showed a prominent decrease compared to control. Nevertheless, the cells activity increased remarkably after metformin administration, and the expression levels of intracellular related proteins showed the opposite trend to that of the LPS group. CONCLUSION: We demonstrate that LPS stimulation may activate intracellular MAPK/JNK and NF-κB signaling pathways and thus induce cell apoptosis. In contrast, metformin reduced apoptosis by inhibiting this signaling pathway and increasing the expression level of Bcl-2. Moreover, it was found that metformin could enhance the ability of cells to antagonize redox damage by regulating the activities of superoxide dismutase and lactate dehydrogenase and subsequently promote the recovery of cardiomyocyte function.

Current status of endovascular treatment for dural arteriovenous fistulae in the anterior cranial fossa: A systematic literature review.

Anterior cranial fossa (ACF) dural arteriovenous fistulae (DAVFs) are rare, and a systematic review of the literature is lacking. Such a review is necessary, however, so a systematic PubMed search of related studies was performed. Twenty-four studies were identified, reporting on 48 patients, of whom 39 had definite age and sex information and 33 (84.6%, 33/39) were male. The afflicted patients were between 37 and 80 years old (mean 55.6). Among the 48 patients, 28 (58.3%, 28/48) primarily presented with intracranial hemorrhage, 47 (97.9%, 47/48) had feeding arteries from the anterior ethmoidal artery (AEA) of the ophthalmic artery (OA), and 40 (83.3%, 40/48) had bilateral feeding arteries. All of the cases had high-grade Cognard classifications (III-IV). Among the 48 patients, 43 (89.6%, 43/48) had drainage into the superior sagittal sinus (SSS). In addition, 36 (75%, 36/48) patients were treated via transarterial embolization (TAE). Of these patients, 28 (77.8%, 28/36) were managed via the AEA of the OA. Another 12 (25%, 12/48) patients were treated via transvenous embolization (TVE), 11 of whom (91.7%, 11/12) were treated with the trans-SSS approach. Complete angiographic cure was achieved in 44 (91.7%, 44/48) patients, with 4 (8.3%, 4/48) patients suffering from postprocedural complications. All 48 patients had clear descriptions of follow-up outcomes, with 45 (93.8%, 45/48) patients having a good outcome. Thus, when treating ACF DAVFs, endovascular treatment (EVT) can completely obliterate the fistula point and correct the venous shunting. EVT is therefore an effective treatment for ACF DAVF. Although many complications can occur, this approach achieves good outcomes in most cases.