Autologous Fibrin Glue in Microvascular Decompression for Trigeminal Neuralgia and Hemifacial Spasm.

Adhesive materials are widely used in microvascular decompression for treating neurovascular compression syndromes. They play an important role in the critical step of vessel fixation. Recently, completely autologous fibrin glue produced solely from a patient's own plasma was developed.

Photodynamic therapy using talaporfin sodium and semiconductor laser induces dose and time dependent cytocidal effect for human glioma derived stem cells.

One of the key factors contributing to the poor prognosis of glioblastoma is the treatment resistance of glioma stem cells (GSCs). In this study, the efficacy of photodynamic therapy (PDT) using talaporfin sodium (NPe6), a second-generation photosensitizer, in combination with a semiconductor laser approved for clinical use in Japan was evaluated. The evaluation was performed in a patient-derived glioma stem cell (GSC) line, MGG8, which was established from human glioblastoma tissue.

[Surgical Strategy for Cerebellopontine Angle Epidermoid Cysts].

Intracranial epidermoid cysts are congenital benign tumors; however, there is a long-term risk of recurrence if the tumor capsule is left behind perioperatively. Additionally, in cerebellopontine angle surgery, in which cranial nerves and blood vessels are densely concentrated, cranial nerve functions must be preserved besides radical removal of the tumor capsule. Particularly, the optimal surgical field should be obtained under direct visualization to avoid cranial nerve damage due to manipulation over cranial nerves and leaving the tumor behind in the blind spot of the surgical field.

[Facial Nerve Schwannomas].

Facial nerve schwannomas (FNSs) are rare, benign tumors that can arise along segments of the facial nerve, including the cerebellopontine angle, internal auditory canal, middle fossa, and temporal bones. Although traditionally managed with gross total resection and facial nerve reconstruction, the resulting facial nerve palsy has prompted a paradigm shift toward functional preservation. Based on>70 surgical cases, we established a tailored strategy based on preoperative facial nerve function and intraoperative facial nerve electromyograms.

[Overview of Cerebellopontine Angle Tumors].

Cerebellopontine angle tumors are rare, and surgeries for these tumors are challenging. Vestibular schwannomas, which account for 70-80% of cerebellopontine angle tumors, are managed by surgery, stereotactic radiosurgery or radiotherapy, and watchful observation. Surgery for vestibular schwannoma aims for maximal tumor resection while preserving facial and/or hearing function through strict intraoperative neuromonitoring.

Long-term prognosis of preserved hearing function after surgery in patients with cerebellopontine angle tumors other than vestibular schwannoma.

Background: In our previous study on vestibular schwannomas (VSs), we found that preserved useful hearing function in patients immediately after surgery gradually deteriorated in long-term period, and was lost in 13% of patients 5 years after surgery. In this retrospective study, we aimed to investigate the long-term hearing prognosis of patients with cerebellopontine angle (CPA) tumors other than VSs, and clarify whether the phenomenon of hearing deterioration after surgery occurs only in patients with VSs.

Method: Patient backgrounds and otologic data were investigated in 70 patients (meningioma: 37; trigeminal schwannoma: 9; facial nerve schwannoma: 4; jugular foramen schwannoma: 9; and epidermoid cysts: 11) with preserved useful hearing function after surgery (American Academy of Otolaryngology-Head and Neck Surgery classification Class A or B).

Usefulness and pitfalls of neuroendoscopic tumor biopsy for intracranial malignant lymphoma.

Purpose: Neuroendoscopic biopsy has various advantages, such as being able to collect larger tissue samples and achieving more efficient hemostasis compared to needle biopsy. The purpose of this study is to review the surgical techniques, accuracy of pathological diagnosis, and perioperative complications of patients with intracerebral malignant lymphoma who were diagnosed mainly by neuroendoscopic biopsy.

Methods: A total of 65 patients diagnosed as having malignant lymphoma, via mainly neuroendoscopic biopsy, were analyzed retrospectively.

Comparison of Surgical Outcomes in Microscopic and Fully Endoscopic Microvascular Decompression for Hemifacial Spasm.

Fully endoscopic microvascular decompression is increasingly being used to treat hemifacial spasm; however, its efficacy must be validated by comparing it with conventional microscopic microvascular decompression. In this study, we aimed to compare the surgical outcomes of microsurgical and endoscopic microvascular decompression for hemifacial spasm and discuss the usefulness and risks of endoscopic treatment. A total of 40 patients with hemifacial spasm were retrospectively evaluated at a single institution between 2016 and 2022, including 33 patients who underwent microscopic microvascular decompression (microvascular decompression group) and 7 patients who underwent fully endoscopic microvascular decompression group, which was chosen for patients with sufficient space in the cerebellopontine cistern for endoscopic manipulation.

Photodynamic therapy and tumor-treating fields therapy for newly diagnosed glioblastoma.

Introduction And Purpose: Various treatment methods, including photodynamic therapy (PDT), are used for glioblastoma (GBM), which is an intractable tumor. Our therapeutic strategy for glioblastoma has been based on resection (if possible), and PDT. On the other hand, after tumor-treating fields therapy (TTF) became available, we have actively recommended it to our patients who are eligible for it.

Subarachnoid Hemorrhage after Resuscitation from Cardiopulmonary Arrest: A Comparison of Survivor and Dead Cases.

Objective: The prognosis of patients with subarachnoid hemorrhage (SAH) who also develop cardiopulmonary arrest (CPA) is highly unfavorable, and hence they are often not aggressively treated. Presently, the therapeutic indications and factors that affect the prognosis of patients who experienced CPA remain unclear. Therefore, we analyzed SAH patients who experienced CPA, comparing the characteristics of the patients who survived with those who did not.

Effect of epileptiform discharges and hippocampal volume on cognitive dysfunction following clipping of ruptured aneurysms in the anterior circulation.

Introduction: Cognitive dysfunction after aneurysmal subarachnoid hemorrhage (aSAH) remains unclear due to various neurological impairments. This study aimed to evaluate the changes in hippocampal volume, cognitive function, and interictal epileptiform discharges after clipping in patients with aSAH of anterior circulation.

Methods: Patients with modified Rankin Scale scores of 0-3 points who underwent clipping were evaluated.

Preoperative Embolization of Brain Tumors Using a Provocative Test: Evaluating the Safety and Efficacy of Embolization of Test-Positive Vessels.

Purpose: The embolization of vessels potentially involved in the vasa nervorum during brain tumor embolization is often a non-aggressive procedure. In this study, we aimed to investigate the safety and efficacy of embolization of vessels with positive provocative test results.

Methods: Embosphere (Merit Medical Systems, South Jordan, Utah, USA) was the embolization material of choice.

Cytocidal Effects of Interstitial Photodynamic Therapy Using Talaporfin Sodium and a Semiconductor Laser in a Rat Intracerebral Glioma Model.

This preclinical study was conducted to investigate the efficacy of interstitial PDT (i-PDT) for malignant gliomas arising deep within the brain, which are difficult to remove. C6 glioma cells were implanted into the basal ganglia of rats, and 3 weeks later, the second-generation photosensitizer talaporfin sodium (TPS) was administered intraperitoneally. Ninety minutes after administration, a prototype fine plastic optical fiber was punctured into the tumor tissue, and semiconductor laser light was irradiated into the tumor from a 2-mm cylindrical light-emitting source under various conditions.

Efficacy of interstitial photodynamic therapy using talaporfin sodium and a semiconductor laser for a mouse allograft glioma model.

To investigate the therapeutic potential of photodynamic therapy (PDT) for malignant gliomas arising in unresectable sites, we investigated the effect of tumor tissue damage by interstitial PDT (i-PDT) using talaporfin sodium (TPS) in a mouse glioma model in which C6 glioma cells were implanted subcutaneously. A kinetic study of TPS demonstrated that a dose of 10 mg/kg and 90 min after administration was appropriate dose and timing for i-PDT. Performing i-PDT using a small-diameter plastic optical fiber demonstrated that an irradiation energy density of 100 J/cm or higher was required to achieve therapeutic effects over the entire tumor tissue.

A Case of Primary Central Nervous System Lymphoma That Developed in a Patient Receiving Fingolimod Therapy for Multiple Sclerosis.

Fingolimod is an oral medication for the prevention of multiple sclerosis relapse, and its efficacy has been demonstrated in several clinical trials. Fingolimod has various side effects, such as arrhythmia and hepatic dysfunction. In addition, there have been rare reports of the development of lymphoproliferative disorders in patients undergoing fingolimod therapy, including primary central nervous system lymphoma (PCNSL).

Patient with Diffuse Midline Glioma, H3 K27-altered, Carrying an Mutation Who Experienced Thalamic Hemorrhage: A Case Report and Literature Review.

Diffuse midline glioma (DMG), H3 K27M-altered, is a tumor with a poor prognosis mainly found in children. An adolescent patient presented with thalamic hemorrhage, which initially could not be diagnosed as DMG by pathological analysis. A neoplasm in the lateral ventricle close to the previous thalamic hemorrhagic lesion was detected 12 months after the hemorrhage.