Intramedullary spinal cord germinoma clinically mimicking multiple sclerosis: A case report

Hiroshi Kageyama, Takamoto Suzuki, Yukou Ohara

Date of publication: 11-Oct-2019

Background: It is important to differentiate intramedullary neoplastic lesions from nonneoplastic diseases such as multiple sclerosis (MS) and other demyelinating or inflammatory diseases.

Impact of delayed treatment on exacerbations of multiple sclerosis among Puerto Rican patients

Sara Zarei, Irvin Maldonado, Laura Franqui-Dominguez, Cristina Rubi, Yanibel Tapia Rosa, Cristina Diaz-Marty, Guadalupe Coronado, Marimer C. Rivera Nieves, Golnoush Akhlaghipour, Angel Chinea

Date of publication: 11-Oct-2019

Background: There are limited data on multiple sclerosis (MS) patients in underserved groups, including Puerto Rico. In this study, we analyzed the characteristic of MS symptoms and number of relapses in Puerto Rican patients. We then compare these characteristics with MS patients from the US. The number of MS relapses is highly correlated with the treatment onset and adherence. Patients in Puerto Rico have been experiencing lengthy treatment delay. We will discuss the possible causes of such delay and its impact on MS prognosis.

Accelerated cancer aggressiveness by viral oncomodulation: New targets and newer natural treatments for cancer control and treatment

Russell L. Blaylock

Date of publication: 11-Oct-2019


An infectious etiology for a number of cancers has been entertained for over 100 years and modern studies have confirmed that a number of viruses are linked to cancer induction. While a large number of viruses have been demonstrated in a number of types of cancers, most such findings have been dismissed in the past as opportunistic infections, especially with persistent viruses with high rates of infectivity of the world’s populations. More recent studies have clearly shown that while not definitely causing these cancers, these viruses appear capable of affecting the biology of these tumors in such a way as to make them more aggressive and more resistant to conventional treatments. The term oncomodulatory viruses has been used to describe this phenomenon. A number of recent studies have shown a growing number of ways these oncomodulatory viruses can alter the pathology of these tumors by affecting cell-signaling, cell metabolism, apoptosis mechanisms, cell-cell communication, inflammation, antitumor immunity suppression, and angiogenesis. We are also learning that much of the behavior of tumors depends on cancer stem cells and stromal cells within the tumor microenvironment, which participate in extensive, dynamic crosstalk known to affect tumor behavior. Cancer stem cells have been found to be particularly susceptible to infection by human cytomegalovirus. In a number of studies, it has been shown that while only a select number of cells are actually infected with the virus, numerous viral proteins are released into cancer and stromal cells in the microenvironment and these viral proteins are known to affect tumor behavior and aggressiveness.

Atypical variant of Baastrup’s disease with lumbar stenosis and cauda equina syndrome

Kartikeya Shukla, Jaskaran Singh Gosal, Mayank Garg, Suryanarayanan Bhaskar, Deepak Kumar Jha, Sarbesh Tiwari

Date of publication: 11-Oct-2019

Background: Classical Baastrup’s disease is a degenerative disorder of the lumbar spine characterized by the approximation of adjacent spinous processes due to excessive lordosis. This results in edema, sclerosis, cyst, bursitis, and midline epidural fibrosis and is often overlooked as a cause of low back pain. Here, we report a patient with atypical Baastrup’s disease and lumbar spinal stenosis who presented with a cauda equina syndrome.

In defense of the defendant

Fred Cohen, Gary W. Roberts

Date of publication: 11-Oct-2019

Intradural disc herniation at the L1–L2 level: A case report and literature review

Raysa Moreira Aprígio, Ricardo Lourenço Caramanti, Felipe Oliveira Rodrigues Santos, Isabela Pinho Tigre Maia, Fernando Manuel Rana Filipe, Dionei Freitas de Moraes, Eduardo Carlos da Silva, Fabiano Morais Nogueira

Date of publication: 11-Oct-2019

Background: Why are intradural disc herniations (IDHs) (0.3% of all discs) so infrequent? One explanation has been the marked adherence of the posterior longitudinal ligament (PLL) to the ventral wall of the dura. Variability in symptoms and difficulty in interpreting magnetic resonance (MR) images with/without contrast make the diagnosis of an IDH difficult. Here, we reported a patient with an L1–L2 IDH and appropriately reviewed the relevant literature.

Is gun control really about people control?

James I. Ausman, Miguel A. Faria

Date of publication: 04-Oct-2019


The Second Amendment of the USA Constitution states: “A well-regulated Militia, being necessary to the security of a free state, the right of the people to keep and bear arms, shall not be infringed.” Today around the USA and the world some people are advocating the removal of guns from the citizens, called “Gun Control,” as the solution to violent crime that they associate with guns in the hands of the public, contrary to what the Second Amendment states.

This review provides a factual background to the debate about the issues surrounding the arguments for and against “Gun Control.” The paper documents many factors that lead to violent crimes committed by people. The means used to cause violent crimes cover the history of human civilization. They include weapons of all types, bombs, toxic substances, vehicles of many kinds, and planes, all to cause the death of others. Some who commit or threaten violent crime against others are emotionally disturbed and in many cases are known to the police through screening systems. Family dysfunction, alcohol and drug abuse, an incessant stream of media and entertainment featuring gun violence, and an educational system that does not equip the young with the proper civic and ethical principles to deal with life’s challenges all contribute to violent behavior using guns and other lethal means. With this background of multiple factors leading to the commission of violent crimes against others, the focus has been concentrated on banning firearms from public ownership rather than understanding the reasons for this criminal behavior. Why? There is the overwhelming evidence that disarming the public from using firearms will not reduce violent crimes and will render people defenseless. Other facts indicate that allowing citizens to carry arms will prevent or reduce violent crimes. The debate over Gun Control has become politicized and emotionally based, because the real goal is not stated. In respected scientific journals and in the Media, factual information about the causes and prevention of violent deaths has been misrepresented or is blatantly false. Using censorship, the medical press and the mass media have refused to publish articles or print opposing opinions such as those supporting the rights of citizens to bear arms. There is evidence that tax-exempt foundations and wealthy individuals are financially supporting Gun Control efforts with the goal of disarming the public to establish a centrally controlled government and to eliminate the US Constitution. It is obvious that in the rapidly changing world we need to find answers to the many factors behind Violent Crime in which guns are used. That will take time and patience. In the meantime, is there a gray area for compromise in the Guns and Violence issue? Yes, logically, from all the evidence presented in this review, citizens should be encouraged to carry arms for self, family, and fellow citizen protection, and as a check on government, a right guaranteed by the constitution and endowed by our God-given natural right. The challenges facing us are multifaceted. Is Gun Control really about People Control?

Spontaneous resolution of chronic subdural hematoma: Does only the size matter?

Messias Gonçalves Pacheco Junior, Bruno Lima Pessoa, Jose Alberto Landeiro, Pedro Henrique de Abreu Macedo, Marco Antônio Araújo Leite

Date of publication: 04-Oct-2019

Background: Chronic subdural hematomas (CSDHs) usually occur late in adults and older after mild head trauma. Surgical intervention is the first treatment option in CSDH with conservative management being adopted in few cases.

Clinical and morphological profile of aneurysms of the anterior communicating artery treated at a neurosurgical service in Southern Brazil

Fabiano Pasqualotto Soares, Maira Cristina Velho, Apio Claudio Martins Antunes

Date of publication: 04-Oct-2019

Background: The aim of the study was to characterize the clinical profile of patients with anterior communicating artery (ACoA) aneurysms and examine potential correlations between clinical findings, aneurysm morphology, and outcome.

Safety of the transventricular approach to deep brain stimulation: A retrospective review

Kevin Ray, Mark Krel, Jacob Bernstein, Samir Kashyap, Ajay Ananda

Date of publication: 04-Oct-2019

Background: Anatomically, deep brain stimulation (DBS) targets such as the ventral intermediate and subthalamic nucleus are positioned such that the long axis of the nucleus is often most accessible through a transventricular trajectory. We hypothesize that using this trajectory does not place patients at increased risk of neurologic complications.