Supratentorial CAPNON associated with WHO grade II meningioma: A case report

Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a rare benign tumor of uncertain etiology, arising in the craniospinal axis. CAPNON typically arises in isolation, with only two prior reports of a concurrent second neoplasm. Here, we report the case of a male 17‐year‐old who presented with new‐onset seizures. MRIs revealed a 2 cm extra‐axial solid‐cystic mass, arising at the left temporo‐occipital junction and abutting the dura with marked surrounding parenchymal vasogenic edema. The solid components demonstrated dense calcification and avid enhancement. Gross total surgical resection was performed. Histopathological examination revealed central regions showing characteristic features of CAPNON. Toward the periphery, the CAPNON was intimately associated with and sharply demarcated from a meningioma, which showed up to five mitoses per 10 high‐power fields and had invasion into the adjacent brain parenchyma, warranting a WHO grade II designation. This is the first report of CAPNON arising in association with a meningioma. The coexistence of these two tumors raises the possibility of a reactive/dysplastic etiology for CAPNON.     

Triple falx cerebelli associated with two aberrant venous sinuses in the floor of posterior cranial fossa

During regular dissection classes, we came across tripled falx cerebelli in a male cadaver. The main (middle) falx cerebelli was large and was attached to the internal occipital crest. It contained the occipital sinus. There were two smaller folds (right and left), one on either side of the falx cerebelli. There were two aberrant venous sinuses; each one connecting the ipsilateral sigmoid and transverse sinuses with each other. The complex dural-venous variation reported here is seldom reported in the literature. Knowledge of such variation is important for neurosurgeons and neuroradiologists as these aberrant folds could cause haemorrhage during suboccipital approaches or may lead to erroneous interpretation during imaging of the posterior cranial fossa.     

Investigation of retinoic acid function during embryonic brain development using retinaldehyde‐rescued Rdh10 knockout mice

Background: Retinoic acid (RA) signaling controls patterning and neuronal differentiation within the hindbrain, but forebrain RA function remains controversial. RA is produced from metabolism of retinol to retinaldehyde by retinol dehydrogenase (RDH), followed by metabolism of retinaldehyde to RA by retinaldehyde dehydrogenase (RALDH). Previous studies on Raldh2?/? and Raldh3?/? mice demonstrated an RA requirement for γ‐aminobutyric acid (GABA)ergic and dopaminergic differentiation in forebrain basal ganglia, but no RA requirement was observed during early forebrain patterning or subsequent forebrain cortical expansion. However, other studies suggested that RA controls forebrain patterning, and analysis of ethylnitrosourea‐induced Rdh10 mutants suggested that RA synthesized in the meninges stimulates forebrain cortical expansion. Results: We generated Rdh10?/? mouse embryos that lack RA activity early in the head and later in the meninges. We observed defects in hindbrain patterning and eye RA signaling, but early forebrain patterning was unaffected. Retinaldehyde treatment of Rdh10?/? embryos from E7–E9 rescues a cranial skeletal defect, resulting in E14.5 embryos lacking meningeal RA activity but maintaining normal forebrain shape and cortical expansion. Conclusions: Rdh10?/? embryos demonstrate that RA controls hindbrain but not early forebrain patterning, while studies on retinaldehyde‐rescued Rdh10?/? embryos show that meningeal RA synthesis is unnecessary to stimulate forebrain cortical expansion. Developmental Dynamics 242:1056–1065, 2013. © 2013 Wiley Periodicals, Inc.     

62例成人脊髓型结核性脑膜炎临床分析

目的探讨成人脊髓型结核性脑膜炎（结脑）的临床特点和治疗方法。方法对1999—2004年收治确诊的62例成人脊髓型结脑进行回顾性分析。结果脊髓型结脑占同期住院结脑13.9%,除具有发热及脑膜刺激征外,以截瘫、尿便障碍和传导束型感觉障碍为主要表现。脑脊液循环通路存在不同程度梗阻,脑脊液常规生化并非完全符合蛋白细胞分离现象,ADA活性明显升高,虽然细胞学呈混合性细胞反应,但是嗜中性粒细胞比例较低,平均仅为17.7%,尿便障碍较截瘫恢复早,治愈率为61.3%,病死率为3.2%,后遗症发生率为35.5%,复发率为1.6%。结论脊髓型结脑治愈率低,后遗症发生率高。结脑早期发现和有效治疗可有效预防一部分脊髓型结脑的发生,以H、R、S（E）、Z为主的四联18～24个月抗结核治疗方案适用于脊髓型结脑,适宜剂量地塞米松和长疗程的放脑脊液并鞘内注药治疗可以提高脊髓型结脑的治愈率。     

复杂硬脑膜动静脉瘘的静脉途径栓塞治疗

目的探讨静脉途径栓塞治疗复杂性硬脑膜动静脉瘘的有效性和安全性。方法回顾分析6例复杂性硬脑膜动静脉瘘患者行经静脉途径栓塞治疗的临床效果。结果静脉途径栓塞治疗后,5例患者解剖性治愈(造瘘口消失),另1例患者症状好转。1例患者乙状窦栓塞后吞咽困难,1例患者海绵窦栓塞后外展不佳,经对症治疗均好转。结论静脉途径栓塞是治疗复杂性硬脑膜动静脉瘘较好的方法。     

A Binary Cre Transgenic Approach Dissects Microglia and CNS Border-Associated Macrophages

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Substance P in the mouse cornea: effects of chemical and surgical denervation

The substance P content of the cornea of the adult mouse has been determined by radioimmunoassay. Sympathectomy did not reduce corneal substance P levels. However substance P levels were reduced by 42% following surgical denervation and by 80% following neonatal capsaicin treatment, suggesting that corneal substance P is contained in the peripheral terminals of small diameter sensory neurones. In some mice capsaicin treatment reduced corneal sensitivity; it also resulted in marked corneal vascularization. These effects could not be ascribed to the reduction in corneal substance P.