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Background: Cerebrospinal fluid (CSF) shunting refers to the surgical drainage of excess CSF, which arises due to outflow obstruction or a reduction in absorption. Although rare, the dissemination of neoplastic cells along ventriculoperitoneal shunts is well documented, a gap in knowledge exists regarding differences in the direction of neoplastic dissemination along CSF shunts. The aim of this systematic review was to comparatively assess the nature of antegrade and retrograde metastatic spread along CSF shunts. Methodology: A dual systematic review in six major databases was conducted for articles until June 15, 2023, without language restrictions following PRISMA 2020 guidelines and the Cochrane Handbook for Interventional Systematic Reviews. The study focused on the metastasis of both CNS malignancy to extra-neural sites and the retrograde metastasis of extra-neural tumours to the CNS along CSF shunts. Inclusion criteria were case reports with patient characteristics and clinical outcomes. Data were extracted using a standardised table and qualitatively analysed. The JBI case report critical appraisal tool assessed reporting quality. Grey literature was not included. Results: A total of 106 reports of antegrade metastasis were identified representing 121 cases. Patients were most commonly children, with the primary tumour and shunt type being germinomas. Six reports detailing retrograde metastasis met our inclusion criteria with an overall high quality of reporting. All primary tumours were in the abdomen or pelvic cavity with treatment from metastasis depending on patient characteristics. Generally, the prognosis was poor, with one patient succumbing to peritonitis, four cases showing residual disease, and one patient receiving palliative care. Discussion and Conclusion: This updated systematic review noted similar demographic trends regarding the metastasis of CNS malignancy to extra-neural sites through CSF shunts reported by Xu et al. (2018); yet, due to data inaccessibility, updated statistics could not be inferred. Germinomas remained the most common tumour pathology, warranting increased vigilance in patients with germinomas and a CSF shunt. Moreover, this review identified that extra-neural malignancy retrograde CSF shunt metastasis is extremely rare. This study proposes standardised nomenclature for classifying metastasis through CSF shunts for easier clinical identification. [ABSTRACT FROM AUTHOR]

Purpose: Sella turcica bridging (STB) has significant implications during neurosurgery, since it alters regional anatomy; however, no studies have investigated the global prevalence of STB. Our systematic review aimed to establish the global prevalence of STB, in specimens/individuals with and without comorbidities, in males and females, and of partial, complete, unilateral, and bilateral bridging. Methods: A literature search was conducted in MEDLINE/PubMed, ScienceDirect, and Google Scholar with various key words relating to Sella turcica bridging. Quantitative data were extracted and statistically analysed. Results: Eighty-two studies satisfied our inclusion criteria. The mean prevalence of STB was 26.54%, and most prevalent in Europe. STB was detected more frequently using radiological investigations. STB was less prevalent in healthy individuals (21.12%) when compared to individuals with comorbidities (33.31%). Partial STB was found to be the more prevalent in both individuals with (41.06%) and without (21.55%) comorbidities. The prevalence of unilateral and bilateral STB was only studied in healthy individuals, with unilateral bridging being the more prevalent (6.26% vs 3.84%). Conclusion: The global overall prevalence of Sella turcica bridging in the general population was found to be higher than previously thought. Anatomical and embryological textbooks should consider including information on STB in their texts, due to its considerable prevalence and effects to the regional anatomy. [ABSTRACT FROM AUTHOR]

It is hypothesised that the inhibition of the non-canonical Wnt/PCP intracellular signalling cascade by potato glycoalkaloids, α -solanine and α -chaconine, results in an increased risk of neural tube defects (NTDs). One very prominent intracellular signalling pathway with substantial implications in the development and closure of the neural tube is the Wnt/PCP pathway. Experimental inhibition of this results in NTDs. A vital element of this signalling cascade is JNK, which controls the transcription of DNA, which controls cell polarity and directional cell migration. JNK inhibition also results in NTDs experimentally. Through their use in cancer research, α -solanine and α -chaconine were found to inhibit metastasis by inhibiting JNK, among other intracellular signalling molecules. Thus, this shows that potato glycoalkaloids increase the likelihood of causing NTDs by inhibiting the proper functioning of JNK in the Wnt/PCP pathway, resulting in defective neural tube closure. [ABSTRACT FROM AUTHOR]