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Background: Past studies found that cerebral developmental venous anomaly (DVA) is often concurrent with cavernous malformation (CM). But the reason of the concurrency remains unknown. The purpose of this study was to confirm whether angioarchitectural factors relate to the concurrence and which angioarchitectural factors can induce the concurrency. Methods: DVA cases were selected from the records of the same 3.0 T MR. The DVA cases was divided into two group which are DVA group and DVA concurrent with CM group. 8 angioarchitectural factors of the DVAs were selected and measured. Statistical analysis was performed by the Pearson chi-square statistic,analysis of variance (ANOVA) and multi-factor logistic regression analysis. Results: Five hundred three DVA lesions were found and 76 CM lesions coexisting with DVA. In the single factor analysis, all the 8 angioarchitectural factors of DVA were related to the concurrency. In the multivariate analysis, 6 angioarchitectural factors. Result of multi-factor logistic regression analysis is Logit(P) = -4.858-0.932(Location) + 1.616(Direction) + 1.757(Torsion) + 0.237(Number) + 2.119(Stenosis rate of medullary vein)-0.015(Angle), goodness of fit is 90.1 %. Conclusions: The angioarchitectural factors of DVA are related to the concurrency of DVA and CM. 6 angioarchitectural factors may induce the concurrency. [ABSTRACT FROM AUTHOR]

Background and objective: Mirror-like intracranial aneurysms (MirAn) occur symmetrically at the corresponding intracranial arteries and are a subgroup of multiple intracranial aneurysms. The aim of this study was to analyze the risk factors, treatment, and prognosis of MirAn. Methods: We retrospectively analyzed 43 cases of MirAn diagnosed between January 2000 and December 2009. The control groups comprised patients with non-mirror-like multiple aneurysms (nMirAn) and single aneurysms (SingAn). Sex, age, localization of MirAn, hypertension, diabetes, smoking, and rupture were identified as potential risk factors for MirAn. Results: The male to female ratio of the MirAn patients was 1.0:5.1, which was significantly different from that of the nMirAn patients (1.0:1.9, P=0.037) and SingAn patients (1.0:1.3, P=0.001). There was no difference in age (P=0.8741), smoking (P=0.301), diabetes (P=0.267), or hypertension (P=0.874) between the MirAn and nMirAn patients. The aneurysms in 28 MirAn patients (65.1%) involved the internal carotid-posterior communicating arteries; in these patients, the rupture risk was significantly higher for larger aneurysms compared with smaller aneurysms (P=0.05). Conclusion: More women suffered from MirAn than nMirAn or SingAn. The most common MirAn sites were the internal carotid-posterior communicating arteries. Our results suggest that MirAn was not associated with age, smoking, hypertension, or diabetes. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the levels of vascular endothelial growth factor (VEGF)-antagonizing cytokines and VEGF-influenced vascular stabilizing cytokines in patients with moyamoya disease (MMD) and the association with postoperative collateral vessel formation. The study population included 53 MMD patients that had undergone indirect bypass surgery and 50 healthy controls. Serum levels of VEGF, thrombospondin-1 (TSP-1), TSP-2, soluble VEGF receptor-1 (sVEGFR-1), sVEGFR-2, endostatin, angiopoietin-1 (Ang-1) and Ang-2 were measured at the baseline (preoperative) and at day seven following surgery. Postoperative collateralization assessment was conducted upon the six-month follow-up cerebral angiography. Cytokine levels were compared between patients with good or poor collateral formation. Compared with the healthy controls, MMD patients exhibited lower baseline levels of sVEGFR-1 (P<0.0001) and sVEGFR-2 (P<0.0001), but higher VEGF expression (P<0.0001). Ang-1 and Ang-2 levels did not exhibit any difference between the two groups. On day seven following surgery, MMD patients exhibited an almost unchanged sVEGFR-1 and sVEGFR-2 expression level, but upregulated expression of VEGF (P<0.0001), Ang-1 (P<0.0001) and TSP-2 (P<0.0001). The six-month follow-up angiographies revealed that 21 patients (45.65%) that had undergone the same surgical procedure achieved good collateralization. Patients with good collateral formation appeared to have lower sVEGFR-1 and sVEGFR-2 levels prior to (P=0.029 and P=0.045, respectively) and at day seven (P=0.044 and P=0.047, respectively) following bypass surgery when compared with the patients with worse collateralization Therefore, sVEGFR-1 and sVEGFR-2 may play a role in the pathogenesis of MMD. Lower levels of sVEGFR-1 and sVEGFR-2 indicated better postoperative collateralization in the six months following indirect bypass surgery. However, Ang-1 and Ang-2 may not be specifically involved in the course of MMD. [ABSTRACT FROM AUTHOR]

Background: Some studies reported that cerebral developmental venous anomaly (DVA) is often concurrent with cavernous malformation (CM). But there is lack of statistical evidence and study of bulk cases. The factors associated with concurrency are still unknown. The purpose of this study was to determine the prevalence of concomitant DVA and CM using observational data on Chinese patients and analyze the factors associated with the concurrency. Methods: The records of all cranial magnetic resonance imaging (MRI) performed between January 2001 and December 2012 in Beijing Tiantan Hospital were reviewed retrospectively. The DVA and CM cases were selected according to imaging reports that met diagnostic criteria. Statistical analysis was performed using the Pearson chi-square statistic for binary variables and multivariable logistic regression analysis for predictors associated with the concurrent CM. Results: We reviewed a total of 165,230 cranial MR images performed during the previous 12 year period, and identified 1,839 cases that met DVA radiographic criteria. There were 205 patients who presented concomitant CM among the 1,839 DVAs. The CM prevalence in DVA cases (11.1%) was significantly higher than that in the non-DVA cases (2.3%) (P<0.01). In the multivariate analysis, we found that DVAs with three or more medullary veins in the same MRI section (adjusted OR = 2.37, 95% CI: 1.73-3.24), infratentorial DVAs (adjusted OR = 1.71, 95% CI: 1.26-2.33) and multiple DVAs (adjusted OR = 2.08, 95% CI: 1.04-4.16) have a higher likelihood of being concomitant with CM. Conclusions: CM are prone to coexisting with DVA. There is a higher chance of concurrent CM with DVA when the DVA has three or more medullary veins in the same MRI scanning section, when the DVA is infratentorial, and when there are multiple DVAs. When diagnosing DVA cases, physicians should be alerted to the possibility of concurrent CM. [ABSTRACT FROM AUTHOR]

Background: The clinical profiles of cerebellar cavernous malformations (CCMs) with and without associated developmental venous anomalies (DVAs) are not well known. The aims of this study were to analyze the clinical and radiological characteristics of CCMs and to assess the various therapeutic strategies. Methods: A consecutive series of 41 patients with identified CCMs were retrospectively reviewed. Of these, 11 patients (26.8%) were found to have associated DVAs. We compared the clinical profile of the two groups of patients (CCMs with and without DVAs). The CCMs with DVAs cases underwent radical resection of the CCMs, and the distal radicles of the DVAs that directly drain from the CCMs were coagulated and dissected at the length of the CCMs. Results: There were no statistically significant differences between the two groups with regard to age, sex, location and size of lesions, multiplicity, and surgical prognosis. The patients with CCMs with DVAs did not experience any brain swelling or hemorrhagic tendency intraoperatively. The postoperative course was uneventful for all of the 36 surgical patients with the exception of two of the patients with CCMs with associated DVAs, who suffered from serious cerebellar edema, and one of these two patients underwent an emergency suboccipital decompression craniotomy. With the exception of three patients who were lost to follow-up (mean, 22.3 months), all of the CCMs patients exhibited good long-term prognosis (modified Rankin scale values of 0-2) and no reoccurrence. Conclusions: It is not rare that associated DVAs occur in CCMs. The total removal of the CCM combined with the coagulation and dissection of the distal radicles of DVA at the length of the associated CCM may result in good long-term prognosis in patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate the long term outcomes after conservative and surgical treatment for haemorrhagic moyamoya disease. Methods: 97 consecutive patients with haemorrhagic moyamoya disease from 1997 to 2009 were enrolled in this study (mean age 31±10 years; range 5-56 years). We reviewed the clinical charts and radiographs of patients at the first bleeding episode. Follow-up was obtained prospectively by questionnaires and radiographic examinations. Outcomes were compared based on initial treatment (conservative vs surgical). Results: After a median follow-up of 7.1 years, 21 of the 97 (21.7%) patients developed a second episode of bleeding, and six patients (6.2%) died of intracranial rebleeding. The median interval from initial episode to subsequent rebleeding was 9.1 years (0.1-23.2 years). 17 of 43 (37.1%) conservatively treated patients and four of 54 (7.4%) surgically treated patients experienced a rebleeding event (OR 8.1; 95% CI 2.4 to 26.8; p<0.001). There was a difference in the KaplaneMeier curve of rebleeding between the two groups (Breslow test p=0.047; log rank test p=0.05). The rebleeding ratio in patients who underwent direct bypass was lower than that in patients treated with indirect bypass alone (0% vs 28.5%, 95% CI 1.0 to 1.9; p=0.002). No significant correlation was found between rebleeding and the patient's age, sex, location of haemorrhage, hypertension status or presence of cerebral aneurysm (p>0.05). Conclusions: There is a high risk of rebleeding after the first haemorrhagic episode in Chinese patients with haemorrhagic moyamoya disease. Revascularisation surgery can improve regional blood flow and have greater efficacy at preventing rebleeding than conservative treatment. [ABSTRACT FROM AUTHOR]

The article presents a study which discusses the changes of excitatory amino acid in the brains of rhesus monkeys associated with selective cerebral deep hypothermia and blood flow occlusion. Topics include the enhanced brain tolerance to ischemia and hypoxia, prevention of cardiopulmonary complications in monkeys, and the use of microdialysis and transmission electron microscope (TEM) to identify the release of glutamic acid in the extracellular fluid in the brain frontal lobe.

Migration-proliferation dichotomy is a common mechanism in gliomagenesis; however, an understanding of the exact molecular mechanism of this "go or grow" phenomenon remains largely incomplete. In the present study, we first found that microRNA-9 (miR-9) is highly expressed in glioma cells. MiR-9 inhibited the proliferation and promoted the migration of glioma cells by directly targeting cyclic AMP response element-binding protein (CREB) and neurofibromin 1 (NF1), respectively. Our data also suggested a migration-inhibitory role for CREB through directly regulating the transcription of NF1. Furthermore, we found that the transcription of miR-9-1 is under CREB's control, forming a negative feedback minicircuitry. Taken together, miR-9 inhibits proliferation but promotes migration, whereas CREB plays a pro-proliferative and anti-migratory role, suggesting that the CREB-miR-9 negative feedback minicircuitry plays a critical role in the determination of "go or grow" in glioma cells. [ABSTRACT FROM AUTHOR]

Gliomas are the most common and deadly type of primary brain tumor. In this study, we showed that cAMP response element-binding protein (CREB), a proto-oncogenic transcription factor that is overexpressed in gliomas, can promote gliomagenesis by modulating the expression of oncogenic microRNA-23a (mir-23a). First, we found that CREB is highly expressed in glioma tissues and cell lines. CREB is also essential for glioma cell growth and cell survival in vitro and is critical for gliomagenesis in vivo. Second, microRNA microarray, ChlP-chip, ChlP-quantitative PCR, and luciferase reporter assays showed that CREB directly binds to the regulatory sequences of mir-23a and enhance the expression of mir-23a. Moreover, mir-23a was confirmed as a functional downstream target of CREB in glioma cell growth and cell survival. Finally, using computational prediction followed by experimental confirmation, we identified PTEN, which is frequently silenced in gliomas, as a downstream target of mir-23a. Taken together, we propose that CREB promotes gliomagenesis and acts as a modulator of oncogenic mir-23a, which represses the tumor suppressor PTEN. [ABSTRACT FROM AUTHOR]

The article presents a study which established that an imbalance of matrix metalloproteinase-9 and matrix metalloproteinase tissue inhibitor-1 may be the underlying mechanism of hemorrhage in cerebellar arteriovenous malformations or primary epilepsy. Expression levels of matrix metalloproteinase-2 and -9 and matrix metalloproteinase tissue inhibitor-1 and -2 in patients presented with cerebellar arteriovenous malformations were examined.

The primary aim of this study is to assess the value of intraoperative near-infrared indocyanine green videoangiography (ICGA) during intracranial aneurysm surgery. Altogether, 129 patients harboring 152 intracranial aneurysms were recruited in this study between March 2007 and December 2008 and the clinical data were retrospectively analyzed. Intraoperative ICGA was performed to examine the completeness of the aneurysm clipping and the patency of the parent arteries in all cases. The intraoperative findings were compared with that of postoperative digital subtraction angiography (DSA). On all of the patients, 276 successful ICGA investigations were performed intraoperatively. The image quality and resolution were excellent, allowing real-time assessment of the cerebral circulation. Indocyanine green (ICG) angiographic results could be divided into arterial, capillary, and venous phases, comparable to those observed with postoperative DSA. In all cases, the postoperative angiographic results corresponded to the intraoperative ICGA findings. In three cases, the information provided by intraoperative ICG angiography significantly changed the surgical procedure. Intraoperative ICG videoangiography may be a useful tool in real-time evaluation of the aneurysm clipping. Its simplicity and easy reproducibility all suggest it to be carried out as a routine procedure during aneurysm surgery. [ABSTRACT FROM AUTHOR]

We report an extremely rare case of multiple saccular aneurysms of the extracranial and intracranial internal carotid artery associated with convexobasia of the left temporal region and arachnoid cyst in a 6-year-old boy. A 6-year-old male patient was admitted to the hospital with chief complaint of ptosis and engorgement of the left eyelid for 50 days. A 4 × 10-cm bony protuberance of the left temporal region with hemangiectasia was observed to beat with pulse without vascular murmur. computed tomographic angiography (CTA) showed two saccular aneurysms of the left internal carotid artery. The first one which was about 3 cm in length and 2 cm in maximum diameter was located in the middle of the petrous portion (including parts of C2 and C3). The second one which was about the same size was located from the middle of the cavernous portion to the upper end of the left internal carotid artery. Computed tomography showed an arachnoid cyst in the left temporal region and abnormality of the left temporal bone. According to the specific circumstances of this patient, we believe that surgical treatment is rather risky and the loss might outweigh the gain. Therefore, we suggested to the parents that the child should be followed up for the coming years for monitoring and possible treatment. Multiple saccular aneurysms of extracranial and intracranial internal carotid artery in children are extremely rare. According to this case, the child had congenital bony protuberance of the left temporal region with hemangiectasia, which made this case particularly specific. Besides all those discovered abnormalities, this child was a healthy boy. Due to the difficulty and high risk of possible surgical treatment, we suggested that no further treatment be performed at the moment and the child should be followed up for a long period of time. Worthy examinations such as CT, CTA, and MRI are recommended for reviewing the development of aneurysms and CNS of this boy. Further treatment might be performed in the future. We welcome all forms of discussion about this case and similar cases around the globe. [ABSTRACT FROM AUTHOR]

The authors report their experience on one patient with hypersexuality from resection of left occipital arteriovenous malformation. To the best of our knowledge, this is the first case reported in the literature. A 35-year-old right-handed female farmer suffered a sudden left occipital hemorrhage with subarachnoid and subdural hemorrhages of the left hemisphere. Transient left uncal herniation occurred at the onset and was released by conservative treatment. Digital subtraction angiography showed a brain left occipital arteriovenous malformation. After microsurgical resection of the arteriovenous malformation, the patient developed hypersexual behavior. Positron emission tomography showed hypermetabolism in the left frontal region and left posterior hippocampal gyrus and hypometabolism in the left anterior hippocampal gyrus and the left occipital surgical area. Theories concerning normal pressure perfusion breakthrough and specific areas in the brain responsible for the human sexual response are discussed. [ABSTRACT FROM AUTHOR]

The objective of this study is to investigate the characteristics of rare meningiomas occurring during childhood and adolescence specially demography, locations, radiological findings, pathological features, and outcome; 34 patients can be followed up and analyzed. Fifty-nine patients with meningiomas were treated during the period of 2000–2007 at the Department of Neurosurgery, Beijing Tiantan Hospital. Thirty-four cases which can be followed up were analyzed by retrospective method. Clinical presentation, anatomical distribution, radiological findings, clinical behavior, outcome, and follow-up are summarized. All cases had been performed microsurgical treatment including 20 cases totally resection. Eleven cases have been achieved subtotal resection. Two patients have been performed biopsy because of giant tumor volume. One patient has been partially resected for internal carotid artery involved. The operative mortality is zero. The average follow-up period is 4 years long. There was recurrence in seven and metastasis in two. Adjuvant radiotherapy has been performed on residual, malignant, and recurrent tumors. Six patients are dead. The sex predominance is not similar to that in adults. Increased ICP, decreased visual acuity, and seizure are the common presentation. There is a higher incidence of intraventricle and skull base region. Larger size and frequent abnormal tumor calcification and cyst appear not relative to pathological subtypes. The higher incidence of atypical histopathological features than adult is affirmative. The prognosis is good if the tumor can be totally removed and adjuvant radiotherapy not to be significant beneficial after incomplete excision. [ABSTRACT FROM AUTHOR]

Abstract Objectives  The objective was to describe the clinical features of intracranial aneurysm in children and evaluate the efficacy and safety of different treatment approaches for children with intracranial aneurysms. Materials and methods  Clinical data of 13 child patients with intracranial aneurysms that were diagnosed and treated in our hospital in the past 16 years were reviewed. Long-term follow-up data were also collected and reported. Results  Direct surgical treatment was performed on eight out of all 13 patients; among them, seven achieved good recovery and one died. The remaining five patients were treated with Guglielmi detachable coils (GDC). The aneurysm was successfully sealed off in one case and achieved good postoperative recovery. Residual aneurysm was detected in two cases; a second resection surgery was performed on one patient who died after the operation and on another with neck occlusion who recovered well. Two cases experienced aneurysm recanalization after interventional therapy; among them, one was treated with a second embolotherapy but had recanalization once again and was finally cured by aneurysm resection surgery. Conclusion  Aneurysmal surgery is proved to be a safe and effective treatment for children with intracranial aneurysm. Although requiring a long-term follow-up period to determine the clinical outcome, GDC is also shown to be safe for a child having acute bleeding. Once a residual aneurysm or recanalization occurs, microsurgery is recommended. [ABSTRACT FROM AUTHOR]

Background. There is evidence suggesting that genetic variants in the chondroitin sulfate proteoglycan2 (CSPG2, also known as versican) gene are involved in the pathogenesis of intracranial aneurysms (IAs). Some authors have demonstrated that single nucleotide polymorphisms (SNPs) rs173686 and rs251124 in the promoter region of the CSPG2 gene are associated with IAs. We performed a case-control study to investigate whether these SNPs might affect the development of IAs in Chinese Han nationality. Methods. The study group comprised 240 Chinese Han nationality patients with at least one intracranial aneurysm and 240 healthy Han nationality controls. Genomic DNA was isolated from blood leukocytes. The SNPs rs173686 and rs251124 were genotyped by PCR amplification and DNA sequencing. Differences in genotype and allele frequencies between patients and controls were tested by the chi-square method. Results. Genotype and allele frequencies of the SNPs rs173686 and rs251124 were both demonstrated to be in Hardy-Weinberg equilibrium. No significant difference in genotype or allele frequencies between case and control groups was detected at either of the two SNPs. Conclusions. The data do not support the hypothesis that the two SNPs (rs173686 and rs251124) in the promoter region of the CSPG2 gene influence the development of intracranial aneurysms in Chinese Han nationality. [ABSTRACT FROM AUTHOR]

The objective of this study was to retrospectively investigate the surgical indications, operation methods, and postoperative results of patients with cavernous malformations (CMs) and the use of neuronavigation. Seventy patients with CMs were operated on in our hospital. The initial symptoms were hemorrhage in 31 cases, seizures in 29 cases, focal neurological deficit in 4 cases, and headache in 5 cases. Only one asymptomatic case was incidentally identified by radiological examination. The size of CMs ranged from 5 to 50 mm (mean: 21 mm). The CMs in 39 patients were located within the white matter of the hemispheres, 11 within the basal ganglia or thalamus, 5 within the cerebellum, and 6 in multiple locations. Prior to the operation, five fiducial markers were placed on the scalp and magnetic resonance imaging (MRI) was performed. Data were transferred to the neuronavigation workstation, a profile of tumors was drawn up, and a three-dimensional reconstruction was completed. The foci were separated and resected under a microscope through a sulci and fissures approach. All the lesions were resected totally. No residual foci were found by postoperative computed tomography (CT)/MRI examination, and there was no operative death. The disability rate was 8.6%; four patients had a new transitory neurological deficit within 1 month after the operation, and one patient with thalamic CMs developed facial paralysis. All patients, however, recovered in 6 months. Twenty-four patients with preoperative epilepsy were followed up for 6–24 months (mean: 19.4 months). After the operation, seizures disappeared in 19 patients and symptoms improved in 5. CMs can be determined in patients even if patients are asymptomatic. Surgical treatment should be considered if bleeding occurs. An operation with the guidance of neuronavigation is safe and can decrease the occurrence of disability following the procedure. [ABSTRACT FROM AUTHOR]

The utility of a neuronavigation system in the transsphenoidal surgery of pituitary macroadenoma was evaluated, and improvement of the surgical outcome is discussed. From 1997 to 2003, a total of 63 patients (male:female=41:22, mean age 58.3 years) with pituitary macroadenoma were treated surgically via transsphenoidal approach using a neuronavigation system in Beijing Tiantan Hospital. Image data for computed tomography or magnetic resonance were obtained and analyzed by the navigation system to make a three-dmensional reconstruction. During the operation, the tumor and its surrounding structures of the sellar region could be located accurately at any time. Among these cases, the tumors were removed totally in 26 cases (41.3%), subtotally in 36 cases (57.1%) and partially in one case (1.6%). Postoperative neurological complications occurred in 15 cases (23.8%). One patient died, the operative mortality was 1.6%. During the operation, the accuracy of the neuronavigation system was 2.3±1.1 mm. The neuronavigation system is quite helpful for transsphenoidal surgery of pituitary macroadenoma. Its accuracy of location is very useful and important in determining anatomical structure and protecting normal tissues and vessels. Moreover, fluoroscopy was not required during the surgery. [ABSTRACT FROM AUTHOR]

Atherosclerosis (AS) is a common underlying pathology of coronary artery disease, peripheral artery disease, and stroke. The characteristics of immune cells within plaques and their functional relationships with blood are crucial in AS. In this study, Mass cytometry (CyTOF), RNA-sequencing and immunofluorescence were combined to comprehensively analyze plaque tissues and peripheral blood from 25 AS patients (22 for Mass cytometry and 3 for RNA-sequencing), as well as blood from 20 healthy individuals. The study identified a complexity of leukocytes in the plaque, including both defined anti-inflammatory and pro-inflammatory subsets such as M2-like CD163+ macrophages, Natural killer T cells (NKT), CD11b+ CD4+ T effector memory cells (Tem), and CD8+ terminally differentiated effector memory cells (TEMRA). Functionally activated cell subsets were also found in peripheral blood in AS patients, highlighting the vivid interactions between leukocytes in plaque and blood. The study provides an atlas of the immune landscape in atherosclerotic patients, where proinflammatory activation was found to be a major feature of peripheral blood. The study identified NKT, CD11b+ CD4+ Tem, CD8+ TEMRA and CD163+ macrophages as key players in the local immune environment. [ABSTRACT FROM AUTHOR]

Aims: To assess differences in the clinical prognosis between different treatment timings in poor-grade (Hunt and Hess grade 4–5) aneurysmal subarachnoid hemorrhage patients. Methods: The treated 127 poor-grade aneurysmal subarachnoid hemorrhage patients were divided into three groups: early treatment within 2 days, treatment on days 3 to 10, and treatment for more than 10 days after the hemorrhage. Odd ratios with a 95% confidence interval were calculated in logistic regression for different timing strategies regarding delayed cerebral ischemia and poor prognosis at 3 months. Subgroup analyses were conducted to determine whether the different timing strategies affect the prognosis. Results: Patients who received the treatment on days 3 to 10 were prone to develop delayed cerebral ischemia and poor prognosis at 3 months. Postponing treatment in patients older than 55 years or diagnosed with an intraventricular hematoma on the initial computed tomography scan may lead to poor prognosis, with the early intervention group as a reference. Conclusions: Early intervention in poor-grade aneurysmal subarachnoid hemorrhage is suggested to be implemented. The treatment on 3 to 10 days harbored the highest risk of poor prognosis; patients might benefit more from early intervention, especially for ones older than 55 years or diagnosed with an intraventricular hematoma. [ABSTRACT FROM AUTHOR]

The article presents a study which examined the relationship of intraoperative hemodynamic factors with the initiation and rupture of middle cerebral artery (MCA) aneurysms. Using an intraoperative 16 MHz probe installed in a Multi-Dop TCD8X4 device, researchers measured hemodynamic indices. They found that the presence of short-term high-velocity blood flow allowed the initiation and rupture of aneurysms at the bifurcation of MCA.

PCBP2 is a member of the poly(C)-binding protein (PCBP) family, which plays an important role in posttranscriptional and translational regulation by interacting with single-stranded poly(C) motifs in target mRNAs. Several PCBP family members have been reported to be involved in human malignancies. Here, we show that PCBP2 is upregulated in human glioma tissues and cell lines. Knockdown of PCBP2 inhibited glioma growth in vitro and in vivo through inhibition of cell-cycle progression and induction of caspase-3-mediated apoptosis. Thirty-five mRNAs were identified as putative PCBP2 targets/interactors using RIP-ChIP protein-RNA interaction arrays in a human glioma cell line, T98G. Four-and-a-half LIM domain 3 (FHL3) mRNA was downregulated in human gliomas and was identified as a PCBP2 target. Knockdown of PCBP2 enhanced the expression of FHL3 by stabilizing its mRNA. Overexpression of FHL3 attenuated cell growth and induced apoptosis. This study establishes a link between PCBP2 and FHL3 proteins and identifies a new pathway for regulating glioma progression. [ABSTRACT FROM AUTHOR]

The article describes the case of a 62-year-old woman who underwent a computed tomography scan (CT) and magnetic resonance imaging (MRI) at the age of 59. The woman complained of moderate left-sided numbness and no other symptoms. The patient was suffering from a progressively enlarging intracerebral arachnoid cyst.

Purpose: In this study, we determined serum 25-hydroxyvitamin D [25(OH) D] levels in serum, and investigated their associations with risk of recurrent stroke and mortality in a 24-month follow up study in Chinese patients with first-ever ischemic stroke., Methods: In this preplanned post hoc analysis, serum levels of 25(OH) D and NIH stroke scale (NIHSS) were measured at the time of admission in a cohort of patients with ischemic stroke. We used logistic regression model to assess the relationship between 25(OH) D levels and risk recurrent stroke or mortality., Results: The follow-up rate was 98.2% in 220 stroke patients. Of 216 patients, 18.5% (95%CI: 13.3%-23.7%) patients had a stroke recurrence, and 30.1% (95% CI: 24.0%-36.2%) died. After adjustment for traditional risk factors, serum 25(OH) D levels were negatively associated with the risk of stroke recurrence (odds ratio [OR], 0.77; 95% confidence interval [CI], 0.70-0.85; P < 0.001) and negatively associated with mortality during 24 months of follow-up (OR, 0.72; 95% CI, 0.64-0.80; P< 0.001). Compared with the first quartile of serum 25(OH) D levels, the ORs for stroke recurrence and mortality were as follows: second quartile, 0.80 (95% CI, 0.63-0.93) and 0.77 (95% CI, 0.65-0.89); third quartile, 0.42 (95% CI, 0.31-0.55) and 0.39 (95% CI, 0.30-0.52); fourth quartile, 0.12 (95% CI, 0.07-0.19) and 0.10 (95% CI, 0.06-0.15), respectively., Conclusions: Lower serum levels of 25(OH) D are independently associated with the stroke recurrence and mortality at 24 months in ischemic stroke patients., Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.