Tumor treating fields alter local coagulation dynamics in glioblastoma patients.

Glioblastoma (GBM) is a highly aggressive brain tumor, associated with hypercoagulability and thrombosis. Tumor Treating Fields (TTFields), a non-invasive therapy that uses low-intensity, alternating electric fields to disrupt cancer cell division, prolongs survival when used concomitantly with radiochemotherapy. TTFields-treated patients often exhibit distinct recurrence patterns, suggesting a local interaction between TTFields and tumor-associated coagulation, underlying mechanisms remain unclear.

Comparison of the ABC/2 formula with computer-assisted volumetry of ischemic cerebellar stroke.

Introduction: Current guidelines suggest surgical decompression for ischemic cerebellar stroke in case of significant mass effect. Recent research has aimed to identify a possible threshold for mass effect. However, a computer-assisted volumetry in acute setting is time consuming and impracticable, wherefore the aim of this study was to assess the accuracy and clinical applicability of the ABC/2 method in case of ischemic cerebellar stroke.

Surgical indications and techniques in ischemic cerebellar stroke - results from an international survey.

Introduction: Space-occupying ischemic cerebellar stroke (SOCS) is a neurological emergency, often leading to rapid deterioration due to brainstem compression and hydrocephalus.

Research Question: The aim of this survey was to characterize surgical indications and techniques in SOCS.

Methods: An international survey was conducted, comprising 21 items.

Validation of an LC-MS/MS Method for the Simultaneous Intracellular Quantification of the CDK4/6 Inhibitor Abemaciclib and the EZH2 Inhibitors GSK126 and Tazemetostat.

Inhibitors of cyclin-dependent kinases (CDKs) and epigenetic modifier enhancer of zeste homolog 2 (EZH2) have emerged as promising options in the pharmacotherapy of malignant tumors. Recently, we demonstrated synergistic antitumor effects of the CDK4/6 inhibitor abemaciclib and the EZH2 inhibitors GSK126 or tazemetostat in patient-derived glioblastoma (GBM) models. Importantly, all three drugs are substrates of the two most important plasma membrane multidrug transporters ABCB1 and ABCG2, with abemaciclib and tazemetostat also being inhibitors of these proteins.

The Value of Hydrogen Peroxide in Neurosurgery and Its Pathophysiological Effects in Human and Animal Brain Tissues.

: Hydrogen peroxide (HO) is a well-known hemostatic and antiseptic agent in neurosurgical practice. While there are concerns regarding the use of HO due to its potential for neuronal damage, the pathophysiological effect on neuronal cells is not clearly understood. : An online survey concerning the use of HO was conducted in a board-certified platform, and an experimental study was designed to investigate the effect of HO on neuronal and tumor cells.

The velocity of temporalis muscle wasting in cerebral metastasis is prognostic for poor survival.

Purpose: Recently, the temporalis muscle thickness on cranial CT scan was proposed as a surrogate marker for patients' baseline frailty that correlates with outcome in primary and metastatic brain tumor patients. In this study, we investigated whether the velocity of temporalis muscle atrophy (TMA) affects the outcome of patients with cerebral metastases.

Methods: We analyzed radiological and clinical data sets of 96 patients who received craniotomy for cerebral metastasis resection in our institution.

The ATLAS/NOA-29 study protocol: a phase III randomized controlled trial of anterior temporal lobectomy versus gross-total resection in newly-diagnosed temporal lobe glioblastoma.

Background: The discovery of cellular tumor networks in glioblastoma, with routes of malignant communication extending far beyond the detectable tumor margins, has highlighted the potential of supramarginal resection strategies. Retrospective data suggest that these approaches may improve long-term disease control. However, their application is limited by the proximity of critical brain regions and vasculature, posing challenges for validation in randomized trials.

Mossy Fiber Sprouting in Temporal Lobe Epilepsy: The Impact of Netrin-1, DCC, and Gene Expression Changes.

Background: Temporal lobe epilepsy (TLE) is the most common form of drug-resistant epilepsy, often associated with hippocampal sclerosis (HS), which involves selective neuronal loss in the Cornu Ammonis subregion 1 CA1 and CA4 regions of the hippocampus. Granule cells show migration and mossy fiber sprouting, though the mechanisms remain unclear. Microglia play a role in neurogenesis and synaptic modulation, suggesting they may contribute to epilepsy.

Enhancing Surgical Education for Medical Students Through Virtual Reality: The Digital Surgical Operating Theatre Tour.

Objective: Although the operating theatre offers unique didactic opportunities, it can be perceived as an uncomfortable environment by medical students due to the lack of theatre etiquette, time pressure and parallel work of different disciplines. We investigated whether virtual reality (VR) training can significantly reduce some of these fears and improve surgical education for medical students.

Methods: We randomly divided a group of 24 medical students and investigated the effects of a VR application (digitally recreated operating theatre tour) and compared it with currently-in-use written instructions for operational tasks in the operating theatre.

Impact of seizure outcome and extent of neocortical resection on emotional well-being in patients with epilepsy one year after temporal lobe surgery.

Background: Seizure frequency and cognitive function are common parameters in assessing epilepsy surgery outcomes. However, psychobehavioral outcomes, such as symptoms of depression and quality of life (QOL), have not found equal attention yet.

Objective: To assess the effect of seizure frequency, the extent of resection, and cognitive function on the psychobehavioral outcome of patients after temporal lobe surgery for pharmacoresistant epilepsy.

Cranioplasty after Decompressive Craniectomy (DC) in a Patient with Intracerebral Hemorrhage after SARS-CoV-2 Vaccination-Related Vaccine-Induced Thrombotic Thrombocytopenia (VITT)-Proposal of a Management Protocol for This Rare Pathological Condition.

The COVID-19 (coronavirus disease) pandemic had a severe impact on public health worldwide. A rare but serious complication after administration of adenoviral vaccines against SARS-CoV-2 (AstraZeneca-Oxford and Johnson & Johnson) is vaccine-induced immune thrombotic thrombocytopenia and thrombosis (VITT), which can lead to serious complications such as cerebral venous sinus thrombosis (CVST). CVST itself can cause subarachnoid hemorrhage (SAH) and/or intracerebral hemorrhage (ICH), leading to high mortality due to herniation of brain parenchyma.

Combined inhibition of EZH2 and CDK4/6 perturbs endoplasmic reticulum-mitochondrial homeostasis and increases antitumor activity against glioblastoma.

He, we show that combined use of the EZH2 inhibitor GSK126 and the CDK4/6 inhibitor abemaciclib synergistically enhances antitumoral effects in preclinical GBM models. Dual blockade led to HIF1α upregulation and CalR translocation, accompanied by massive impairment of mitochondrial function. Basal oxygen consumption rate, ATP synthesis, and maximal mitochondrial respiration decreased, confirming disrupted endoplasmic reticulum-mitochondrial homeostasis.

A glutamatergic biomarker panel enables differentiating Grade 4 gliomas/astrocytomas from brain metastases.

Background: The differentiation of high-grade glioma and brain tumors of an extracranial origin is eminent for the decision on subsequent treatment regimens. While in high-grade glioma, a surgical resection of the tumor mass is a fundamental part of current standard regimens, in brain metastasis, the burden of the primary tumor must be considered. However, without a cancer history, the differentiation remains challenging in the imaging.

Bilateral Foramina Parietalia Permagna - A Calvarial Defect Caused by Haploinsufficiency of the Msh Homeobox 2 Gene: A Case Report and Current Literature Review.

Foramina parietalia permagna (FPP) is a rare anatomical defect that affects the parietal bones of the human skull. FPP is characterized by symmetric perforations on either side of the skull, which are caused by insufficient ossification during embryogenesis. These openings are typically abnormally large and can range from a few millimeters to several centimeters in diameter.

Functional Outcomes in Conservatively vs Surgically Treated Cerebellar Infarcts.

Importance: According to the current American Heart Association/American Stroke Association guidelines, decompressive surgery is indicated in patients with cerebellar infarcts that demonstrate severe cerebellar swelling. However, there is no universal definition of swelling and/or infarct volume(s) available to support a decision for surgery.

Objective: To evaluate functional outcomes in surgically compared with conservatively managed patients with cerebellar infarcts.

Efficacy and safety of bedside percutaneous three-millimeter twist-drill trephination under local anesthesia-a retrospective study of 1000 patients.

Purpose: Percutaneous 3-mm twist-drill trephination (TDT) under local anesthesia as a bedside operative technique is an alternative to the conventional open surgical trephination in the operating theatre. The aim of this study was to verify the efficacy and safety of this minimal invasive procedure.

Methods: This retrospective study comprises 1000 patients who were treated with TDT under local anesthesia at bedside due to chronic subdural hematoma (cSDH), intracerebral hemorrhage (ICH), and hydrocephalus (HYD) as a result of subarachnoid hemorrhage or non-hemorrhagic causes, increased intracranial pressure (IIP) in traumatic brain injury or non-traumatic brain edema, and other pathologies (OP) requiring drainage.

Leveraging artificial intelligence in neurosurgery-unveiling ChatGPT for neurosurgical discharge summaries and operative reports.

Purpose: Chat generative pre-trained transformer (GPT) is a novel large pre-trained natural language processing software that can enable scientific writing amongst a litany of other features. Given this, there is a growing interest in exploring the use of ChatGPT models as a modality to facilitate/assist in the provision of clinical care.

Methods: We investigated the time taken for the composition of neurosurgical discharge summaries and operative reports at a major University hospital.

Frailty in Traumatic Brain Injury-The Significance of Temporal Muscle Thickness.

Background: Temporal muscle thickness (TMT) on cranial CT scans has recently been identified as a prognostic imaging parameter for assessing a patient's baseline frailty. Here, we analyzed whether TMT correlates with Traumatic brain injury (TBI) severity and whether it can be used to predict outcome(s) after TBI.

Methods: We analyzed the radiological and clinical data sets of 193 patients with TBI who were admitted to our institution and correlated the radiological data with clinical outcomes after stratification for TMT.

Combining ultrasound and microelectrode recordings for postoperative localization of subthalamic electrodes in Parkinson's disease.

Objective: To assess transcranial sonography (TCS) as stand-alone tool and in combination with microelectrode recordings (MER) as a method for the postoperative localization of deep brain stimulation (DBS) electrodes in the subthalamic nucleus (STN).

Methods: Individual dorsal and ventral boundaries of STN (n = 12) were determined on intraoperative MER. Postoperatively, a standardized TCS protocol was applied to measure medio-lateral, anterior-posterior and rostro-caudal electrode position using visualized reference structures (midline, substantia nigra).

Molecular Determinants of Calcitriol Signaling and Sensitivity in Glioma Stem-like Cells.

Glioblastoma is the most common primary brain cancer in adults and represents one of the worst cancer diagnoses for patients. Suffering from a poor prognosis and limited treatment options, tumor recurrences are virtually inevitable. Additionally, treatment resistance is very common for this disease and worsens the prognosis.

Frailty in cerebellar ischemic stroke-The significance of temporal muscle thickness.

While comprising only 2% of all ischemic strokes, cerebellar strokes are responsible for substantial morbidity and mortality due to their subtle initial presentation and the morbidity of posterior fossa swelling. Furthermore, low temporal muscle thickness (TMT) has recently been identified as a prognostic imaging parameter to assess patient frailty and outcome. We analyzed radiological and clinical data sets of 282 patients with cerebellar ischemic stroke.