Arteries to the proximal part of the olfactory tract

Destruction of the vascularisation of the olfactory structures during fronto-orbital surgical approaches to the sellar region may result in anosmia as a complication. The goal of this study was to describe the sources of blood supply to the proximal olfactory tract and the macroscopic distribution of these vessels. 20 human brains fixed in formalin with arteries injected with ink-coloured gelatine were studied using a surgical microscope and the micro-dissection technique. The vessels running along the olfactory tract posteriorly and anteriorly on its inferior and superior surface were observed. These arteries and arterioles were most often branches of the constant artery supplying the posterior part of the straight gyrus and orbital gyri (38/40). Similarly, as branches of the medial orbitofrontal artery (7/40), they were found on the superior aspect of the tract. Branches of the distal medial striate artery directed to the olfactory structures were observed on the basal surface of the tract (20/40)

The choroid plexus of the fourth ventricle and its arteries

The choroid plexus of the fourth ventricle consists of two symmetrical parts located in the roof of the ventricle and protruding through its openings, the foramina of Luschka and Magendie. The arteries supplying the choroid plexus of the fourth ventricle are difficult to approach because of their deep location within the cerebellopontine angles and the cerebellomedullary fissure. They originate from multiple sites on the cerebellar arteries, and pass near the vital structures of the pons and medulla. The increasing use of the operating microscope and endoscopy during operations in the posterior cranial fossa has created a need for better understanding of the microsurgical anatomy of the plexus and its arteries. The arteries of 15 human brain-stems with cerebelli were injected with coloured gelatine and fixed in 10% formaldehyde solution. The specimens were studied under an operating microscope. The choroids plexus on each side of the midline was divided into four segments, the medial and lateral horizontal segments and the rostral and caudal sagittal segments, in order to facilitate the description of their blood supply. The anterior inferior cerebellar artery (AICA), the posterior inferior cerebellar artery (PICA) and the superior cerebellar artery (SCA) were the main supplying vessels. AICA supplied the portion of the plexus in the cerebellopontine angles and the adjacent part of the lateral recess of the fourth ventricle through the foramina of Luschka. PICA supplied most of the choroid plexus in the roof and the median opening of the fourth ventricle

Recommendations of the Polish Association of Neuropathologists on performing post-mortem examination of the brain and spinal cord

Neuropathological central nervous system (CNS) post-mortem examination is a highly specialistic element of the autopsy procedure with methodological specificity. Herein we propose updated recommendations for CNS autopsy for pathologists and neuropathologists. The protocol includes the compendium of neuroanatomy with current nomenclature, consecutive steps of gross examination, as well as appropriate sampling algorithms in different clinical and pathological settings. The significance of pathoclinical cooperation in differential diagnosis is exposed. We believe it is essential to create and promote the guidelines to improve the quality of CNS post-mortem examination at the national level

Comparative genomic analysis of intracranial germ cell tumors – the preliminary study focused on Sonic Hedgehog signaling pathway

Aim of the study : Examination of copy number changes in a group of intracranial germ cell tumors (GCTs) with particular focus on putative aberrations of the main genes coding SHh pathway proteins. Material and methods : The study was performed on DNA isolated from fresh-frozen tumor tissue samples from eight GCTs, including six intracranial GCTs. The intracranial group consisted of three germinomas, two mature teratomas and one mixed germ cell tumor. Comparative genomic profiling analysis was carried out using microarray-CGH method (Cytosure ISCA UPD 4×180k, OGT). The results were analyzed with Feature Extraction (Agilent Technologies) and Nexus Copy Number (BioDiscovery) softwares. Results and conclusions : Chromosomal aberrations were found in two intracranial germinomas. These tumors were characterized by complex genomic profiles encompassing chromosomes 7, 8, 9, 10, 11, 12, 16, 17 and 19. Common findings were gain at 12p13.33p11.1 of 35 Mbp and gain at 17q11.1q25.3 of 55 Mbp. In one tumor, also SHh (7q36.3), SMO (7q32.1) and GLI3 (7p14.1) copy gains occurred together with 9q21.11q34.3 loss, including PTCH1 , all being elements of SHh signaling pathway. Moreover, both tumors showed various copy gain of genes being ligands, regulators, receptors or target genes of SHh ( MTSS1; PRKACA and FKBP8 ) as well as gain of genes of SHh coopting WNT pathway ( WNT3 , WNT5B , WNT9B in both tumors; WNT16 , WNT2 in pineal lesion). Further studies on larger group are needed to characterize SHh-related gene alterations in intracranial GCTs and for searching genotype-phenotype relations

Germinoma Mimicking Brain Inflammation: A Case Report

The authors report a case of a germinoma of the brain in the child with symptoms restricted to central nervous system. Ten-year-old girl presented initially with sight deterioration, learning difficulties, abnormal behavior, polydipsia, and polyuria. Brain magnetic resonance examination revealed T2 hyperintensity of the corpus callosum, anterior commissure, and caudate nuclei. Brain biopsy revealed extensive macrophage infiltration. Given these results and positive antinuclear antibodies in the blood, immunosuppressive and immunomodulatory treatment was implemented but it was not effective. The patient developed progressive quadriparesis, sleep disturbances, and dementia. Second brain biopsy was performed and it revealed germinoma cells. Chemotherapy was administered, but the girl died due to disseminated intravascular coagulation syndrome. The reported case shows an unusual coexistence of germinoma with prominent inflammation in the brain and highlights the importance of brain biopsy in such complex cases