Perivascular regions of the brain harbor multipotent stem cells. We previously demonstrated that brain pericytes near blood vessels also develop multipotency following experimental ischemia in mice and these ischemia-induced multipotent stem cells (iSCs) can contribute to neurogenesis. However, it is essential to understand the traits of iSCs in the poststroke human brain for possible applications in stem cell-based therapies for stroke patients. In this study, we report for the first time that iSCs can be isolated from the poststroke human brain. Putative iSCs were derived from poststroke brain tissue obtained from elderly stroke patients requiring decompressive craniectomy and partial lobectomy for diffuse cerebral infarction. Immunohistochemistry showed that these iSCs were localized near blood vessels within poststroke areas containing apoptotic/necrotic neurons and expressed both the stem cell marker nestin and several pericytic markers. Isolated iSCs expressed these same markers and demonstrated high proliferative potential without loss of stemness. Furthermore, isolated iSCs expressed other stem cell markers, such as Sox2, c-myc, and Klf4, and differentiated into multiple cells in vitro, including neurons. These results show that iSCs, which are likely brain pericyte derivatives, are present within the poststroke human brain. This study suggests that iSCs can contribute to neural repair in patients with stroke.

We analyzed clinical usefulness of the high resolution imaging system in a hybrid operation room (OR) for posterior lumbar interbody fusion. A total of 17 patients with lumbar spondylolisthesis between February 2014 and August 2016 were included. Multi-axis imaging system in a hybrid OR was used in 12 patients (hybrid OR group); the conventional C-arm fluoroscopy, in 5 patients (C-arm group). The time to confirm the first percutaneous pedicle screw (PPS) angle (hybrid OR, 80 vs C-arm, 249 s; P = 0.0026) and the second to the last PPS angle (77 vs 90 s; P = 0.040) were shorter in the hybrid OR group. Placement accuracy was higher in the hybrid OR group (88.0 vs 59.1%; P = 0.010). Irradiation dose was significantly lower in the C-arm group (462 vs 102 mGy; P = 0.0013). This study suggested that the accuracy of PPS placement and time to confirm the PPS angle are the advantages in a hybrid OR.

We report two cases of juvenile cerebral infarction caused by bow hunter’s syndrome (BHS) during sport. Case 1 was a 17-year-old male who developed a partial visual field defect after playing basketball. BHS was diagnosed because cervical ultrasonography demonstrated occlusion of the vertebral artery when the neck was rotated. After C1–2 posterior fixation was performed, his symptoms resolved. Case 2 was an 18-year-old male with recurrent visual disturbance after playing handball. Cerebral infarction occurred repeatedly despite antiplatelet therapy. After 3 years, vertebral artery dissection was diagnosed and stenting was performed, but his symptoms did not resolve. BHS was diagnosed when he was examined at our department. C1–2 posterior fixation was performed and his symptoms resolved. In these two cases, BHS was caused by sporting activity. For accurate diagnosis and treatment of BHS, neuroimaging with cervical rotation is mandatory.

No abstract

No abstract