Presentation of a Hemangioblastoma in cavernous sinus: An extremely rare case report

Introduction: Hemangioblastoma (HB) is a benign vascular tumor that accounts for about 2 of intracranial neoplasms. HB of the cavernous sinus (CS) is extremely rare. Only one report was found in the literature. Presentation of case: We present a 29-year-old female with progressive headache and she had right ptosis and right mild oculomotor nerve palsy. The brain Magnetic Resonance Imaging (MRI) revealed a right extra-axial 4 � 4 cm in right CS position. The patient was operated upon microscopically via sub-temporal approach through a right temporal craniotomy. After the subtotal removal of a highly vascular tumor, the patient was referred for adjuvant therapy with Gamma-knife surgery. Discussion: Surgical removal of HB is the most effective treatment of the central nervous system (CNS) HBs. Tumors invading the CS could cause severe bleeding during surgery and HB�because of its vascular origin�had more risk for severe intraoperative bleeding, and in some cases resulted in surgery stop with subtotal resection of tumor. Conclusion: It was recommended to perform a pre-operative brain angiography and selective embolization of these highly vascular lesions that it could result in subsequent complete surgical removal. © 2018 The Author(s

Presentation of a Hemangioblastoma in cavernous sinus: An extremely rare case report

Introduction: Hemangioblastoma (HB) is a benign vascular tumor that accounts for about 2 of intracranial neoplasms. HB of the cavernous sinus (CS) is extremely rare. Only one report was found in the literature. Presentation of case: We present a 29-year-old female with progressive headache and she had right ptosis and right mild oculomotor nerve palsy. The brain Magnetic Resonance Imaging (MRI) revealed a right extra-axial 4 � 4 cm in right CS position. The patient was operated upon microscopically via sub-temporal approach through a right temporal craniotomy. After the subtotal removal of a highly vascular tumor, the patient was referred for adjuvant therapy with Gamma-knife surgery. Discussion: Surgical removal of HB is the most effective treatment of the central nervous system (CNS) HBs. Tumors invading the CS could cause severe bleeding during surgery and HB�because of its vascular origin�had more risk for severe intraoperative bleeding, and in some cases resulted in surgery stop with subtotal resection of tumor. Conclusion: It was recommended to perform a pre-operative brain angiography and selective embolization of these highly vascular lesions that it could result in subsequent complete surgical removal. © 2018 The Author(s

Investigating effective factors on estimated hemorrhage intraoperative in brain meningioma surgery

Introduction: The primary and definitive diagnosis of meningioma is based on histological assessment; however, employing imaging methods, like Magnetic Resonance Imaging (MRI) is very helpful to describe lesion's characteristics. Accordingly, we decided to study the effect of imaging factors, like MRI data on the volume of hemorrhage (estimated blood loss) during meningioma surgery. Methods: This was a cross-sectional, retrospective, and analytical study. The eligible patients were those with meningioma who were candidates for surgery. A total of 40 patients with meningioma were selected and assessed. The preoperative imaging findings were recorded, then estimated blood loss during the surgery was determined Results: A reverse association was revealed between the degree of proximity to the nearest sinus and the rate of bleeding. Furthermore, the size of the mass was positively associated with the rate of bleeding; however, there was no significant correlation between the volume of bleeding and other parameters, including the degree of edema, the volume of mass, the site of the tumor in the brain, and the histological subtype of the tumor. The mean time of operation was strongly correlated with blood loss. The rate of bleeding was more expected in hypertensive versus normotensive patients. Conclusion: Bleeding in various volumes could be a frequent finding in intracranial meningioma surgery. Overall, tumor size, the duration of surgery, a history of hypertension, and distance to the nearest sinuses were the main determinants for the severity of hemorrhage in patients undergoing meningioma surgery. © 2020 Iran University of Medical Sciences. All rights reserved

Genetic and epigenetic contribution to astrocytic gliomas pathogenesis

Astrocytic gliomas are the most common and lethal form of intracranial tumors. These tumors are characterized by a significant heterogeneity in terms of cytopathological, transcriptional, and (epi)genomic features. This heterogeneity has made these cancers one of the most challenging types of cancers to study and treat. To uncover these complexities and to have better understanding of the disease initiation and progression, identification, and characterization of underlying cellular and molecular pathways related to (epi)genetics of astrocytic gliomas is crucial. Here, we discuss and summarize molecular and (epi)genetic mechanisms that provide clues as to the pathogenesis of astrocytic gliomas. (Figure presented.). © 2018 International Society for Neurochemistr

Effect of modafinil administration on the level of consciousness in patients with brain injuries of moderate severity

Background: With regards to the importance of traumatic brain injury (TBI) and its high incidence rate in Iran as well as its severe consequences, it is important to determine the safety and efficiency of modafinil to increase the level of consciousness in hospitalized TBI patients. Methods: This double-blind randomized controlled trial was done during 2016. Sixty patients with TBI and moderate GCS score between 9 and 13 had the inclusion criteria and entered the study and were divided into two groups. Patients in the treatment group received 200 mg of modafinil once a day and the control group received the placebo. Overall, 24 hours after admission, defined as base day, modafinil was prescribed for 196 hours after admission and GCS scores were recorded: this period was defined as the last day. Level of consciousness in both treatment and control groups was assessed by the GCS score. Data were analyzed by SPSS version 21 software using the independent t-test with intention-to-treat approach. Results: Among 60 patients, there were 34 (56.66) males and 26 (43) females; 45 (75) survived. The ITT analysis was employed to assess changes in the level of consciousness (LOC) after prescribing modafinil and placebo. Based on the findings, modafinil prescription was not associated with significant differences in LoC in the first time period (24 hours after) and the last day (196 hours) (P > 0.05). Conclusions: Prescribing modafinil was not associated with significant changes in LoC in comparison with the placebo. Copyright © 2018, Author(s)

Genetic and epigenetic contribution to astrocytic gliomas pathogenesis

Astrocytic gliomas are the most common and lethal form of intracranial tumors. These tumors are characterized by a significant heterogeneity in terms of cytopathological, transcriptional, and (epi)genomic features. This heterogeneity has made these cancers one of the most challenging types of cancers to study and treat. To uncover these complexities and to have better understanding of the disease initiation and progression, identification, and characterization of underlying cellular and molecular pathways related to (epi)genetics of astrocytic gliomas is crucial. Here, we discuss and summarize molecular and (epi)genetic mechanisms that provide clues as to the pathogenesis of astrocytic gliomas. (Figure presented.). © 2018 International Society for Neurochemistr

Genetic and epigenetic contribution to astrocytic gliomas pathogenesis

Astrocytic gliomas are the most common and lethal form of intracranial tumors. These tumors are characterized by a significant heterogeneity in terms of cytopathological, transcriptional, and (epi)genomic features. This heterogeneity has made these cancers one of the most challenging types of cancers to study and treat. To uncover these complexities and to have better understanding of the disease initiation and progression, identification, and characterization of underlying cellular and molecular pathways related to (epi)genetics of astrocytic gliomas is crucial. Here, we discuss and summarize molecular and (epi)genetic mechanisms that provide clues as to the pathogenesis of astrocytic gliomas. (Figure presented.). © 2018 International Society for Neurochemistr

Genetic and epigenetic contribution to astrocytic gliomas pathogenesis

Astrocytic gliomas are the most common and lethal form of intracranial tumors. These tumors are characterized by a significant heterogeneity in terms of cytopathological, transcriptional, and (epi)genomic features. This heterogeneity has made these cancers one of the most challenging types of cancers to study and treat. To uncover these complexities and to have better understanding of the disease initiation and progression, identification, and characterization of underlying cellular and molecular pathways related to (epi)genetics of astrocytic gliomas is crucial. Here, we discuss and summarize molecular and (epi)genetic mechanisms that provide clues as to the pathogenesis of astrocytic gliomas. (Figure presented.). © 2018 International Society for Neurochemistr

Spontaneous regression of a large extruded disc herniation

Many cases of regressed disc herniation have been reported but most of them are sequestrated or free fragment disc herniation; so regression of a large herniated disk extrusion is rare. A 34-year-old man presented S1 dermatome radicular pain and paresthesia with no neurological deficit. Lumbosacral spine magnetic resonance imaging (MRI) showed huge disk extrusion in L5/S1 level compressing left S1 root. Conservative management began. Six months later, the symptoms has been improved dramatic. The follow-up MRI showed significant decrease in disk herniation volume. Performing a lumbosacral MRI in the patients suffer from radicular pain and paresthesia, not only can demonstrates the probable cause of patients� symptoms, also can predict the probability of regression of disk herniation. In the cases of large disk extrusion, despite disk volume, conservative treatment should be the first step because of greater potential for spontaneous regression and resolution of these situations. © 2018 EDIZIONI MINERVA MEDICA