A surgical case of cerebellar tuberculoma caused by a paradoxical reaction while on therapy for tuberculosis spondylitis

Atsuhiko Ninomiya, Atsushi Saito, Tomohisa Ishida, Tomoo Inoue, Takashi Inoue, Masayuki Ezura, Shinsuke Suzuki, Hiroshi Uenohara, Teiji Tominaga

Date of publication: 09-Aug-2019

Background: A paradoxical reaction (PR) is a phenomenon in which the primary tuberculous lesion worsens or another de novo tuberculous lesion appears while on anti-tuberculosis therapy. Here, we report a rare case of cerebellar tuberculoma caused by a PR during therapy for lumbar tuberculous spondylitis (Pott’s disease).

Pituitary carcinomas: Rare and challenging

Georges Sinclair, Martin Olsson, Hamza Benmakhlouf, Yahya Al-saffar, Philippa Johnstone, Mustafa Aziz Hatiboglu, Alia Shamikh

Date of publication: 09-Aug-2019

Background: Pituitary carcinomas (PCs) are defined as adenohypophyseal tumors with metastatic activity within and outside the boundaries of the central nervous system (CNS). The condition is rare and therefore seldom reported; most lesions are hormone producing and have a tendency for complex evolution. As such, the management of PCs remains difficult. We present an illustrative case of PC with a brief review of the recent medical literature.

Viruses and tumor cell microenvironment: A brief summary

Russell L. Blaylock

Date of publication: 09-Aug-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 have 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 cytomegaloviruses. 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 the cancer and stromal cells in the microenvironment and these viral proteins are known to affect tumor behavior and aggressiveness.

Computed tomography perfusion in detecting malignant middle cerebral artery infarct

Chun Lin Lee, Regunath Kandasamy, Mohammed Azman Bin Mohammad Raffiq

Date of publication: 09-Aug-2019

Background: Computed tomography perfusion (CTP) is an emerging modality which produces maps of time-to- peak (TTP), cerebral blood flow (CBF), and cerebral blood volume (CBV), with a computerized automated map of the infarct and penumbra. This modality provides a better evaluation of the extent of infarction, making it a potential method for assessing patients suffering from large middle cerebral artery (MCA) infarctions.

Missed thoracic myelopathy: Do not throw the hammer away yet

Lisa B. E. Shields, Vasudeva G. Iyer, Yi Ping Zhang, Christopher B. Shields

Date of publication: 09-Aug-2019

Background: Spinal stenosis may result in myelopathy, radiculopathy, and neurogenic claudication. It is often difficult to differentiate between these conditions. A comprehensive history and physical examination and a magnetic resonance imaging (MRI) of the entire spine accurately confirm the diagnosis.

Ghost Surgery, Including Neurosurgery and Other Surgical Subspecialties

Nancy E. Epstein

Date of publication: 09-Aug-2019

Discectomía Endoscópica Lumbar Percutánea: Presentación de 60 Casos Intervenidos en Argentina con Pacientes Despiertos

Guillermo Frucella, Daniel Maldonado

Date of publication: 02-Aug-2019

Introducción: La DELP es una técnica mínimamente invasiva que se usa en distintos países desde finales de los ochenta para el tratamiento de las Hernias Discales. Objetivo: describir los resultados de las DELP en una serie de pacientes despiertos, con anestesia peridural y sedación.

Implante de shunt ventrículo peritoneal en el paciente adulto. Un nuevo protocol

Juan F. Villalonga, Sebastián Giovannini, Guido Caffaratti, Emiliano Lorefice, Tomás Ries Centeno, Francisco Marcó del Pont

Date of publication: 02-Aug-2019

Introducción: La colocación de un shunt ventrículo-peritoneal, a pesar de considerarse un procedimiento de baja complejidad, puede devenir en una serie de complicaciones. Nuestro equipo quirúrgico desarrolló e implementó a partir de junio de 2016 un nuevo protocolo. El objetivo del presente trabajo es: describir e ilustrar paso a paso la técnica quirúrgica utilizada y demostrar que el uso del “nuevo protocolo” disminuye significativamente las complicaciones asociadas al procedimiento.

Cervical alignment following laminoplasty for cervical spondylotic myelopathy

Ravi Sharma, Sachin A. Borkar, Manoj Phalak, S. Leve Joseph, Shashank S. Kale

Date of publication: 02-Aug-2019

Background: Laminoplasty can result in the loss of cervical lordosis (LOCL) or the development of kyphosis after surgery. Here, we evaluated the clinical and radiological parameters involved in predicting the postoperative LOCL following laminoplasty in patients with cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL).