Pupil symmetry was impressive in the entire cohort.

Object Petroclival meningiomas remain a formidable challenge for neurosurgeons because of their location deep within the skull base and proximity to eloquent neurovascular structures. Various skull base approaches have been used in their treatment, and deciding which is the optimal one remains controversial. Attempts at achieving gross- or near-total resections are associated with an increased rate of morbidity and mortality. As adjunctive treatment options such as stereotactic radiosurgery have been developed and become widely available, there has been a trend toward accepting subtotal resections in an effort to minimize neurological morbidity. This paper reviews a recent series of patients with petroclival meningiomas and highlights current management trends and important considerations useful in surgical decision making. Methods The records of patients with large (> 3 cm) petroclival meningiomas surgically treated by the senior author over the past 5 years were reviewed. The clinical results are presented as examples of the surgical approaches available for approaching these tumors, and treatment options are reviewed. Results Of 196 meningiomas surgically treated during the study period, 8 lesions in 8 patients met the study criteria. Overall clinical results were excellent, with no death or major morbidity. Intracranial gross- or near-total resection (Simpson Grade 1, 2, or 3) was achieved in 5 patients (67%). New cranial nerve deficits occurred in 3 patients (37%) and were more common in patients in whom a subtotal resection was performed (2 of 3 cases). A variety of surgical approaches were used. Important considerations determining the best approach include the location of the tumor relative to the internal auditory canal, the presence of preoperative hearing loss, and the location of the tumor relative to the tentorium. Conclusions Achieving gross- or near-total resections of large petroclival meningiomas remains achievable and should be the primary goal of surgical treatment. A retrosigmoid craniotomy remains a workhorse surgical approach for most petroclival tumors of any size. Tumors that are medial to the internal auditory canal and span both middle and posterior cranial fossae are often best treated with a combined transpetrosal approach, which is especially true if there is a preoperative hearing deficit.

A study is presented of photothermal effects associated with nanosecond-pulsed laser-illuminated subwavelength metallic nanoparticles in aqueous solutions. Computational electromagnetic and fluid analysis are used to model fundamental aspects of the photothermal process taking into account energy conversion within the nanoparticle at plasmon resonance, heat transfer to the fluid, homogeneous bubble nucleation, and the dynamic behaviour of the bubble and surrounding fluid. Various nanoparticle geometries are modelled including spheres, nanorods and tori. The analysis demonstrates that the laser intensity and pulse duration can be tuned to achieve controllable bubble generation without exceeding the melting temperature of the particle. The analysis also shows that the particle geometry can be tuned to optimize photothermal energy conversion for bubble generation at wavelengths that span the UV to NIR spectrum. Multiparticle systems are studied and a cooperative heating effect is demonstrated for particles that are within a few radii of each other. This provides more robust bubble generation using substantially reduced laser energy as compared to single-particle systems. The modelling approach is discussed in detail and should be of considerable use in the development of new photothermal applications.

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In our series, anterior odontoid screw fixation comprised a safe therapeutic modality with high stability and low mechanical failure rates during short-term and long-term follow-up.

Spinal oligodendrogliomas are a distinctly rare type of nervous system tumor, especially in the pediatric population. An international registry addressing all of their clinical and pathobiological characteristics would be of great benefit to patients harboring these rare tumors.

We propose the use of plasmonic nanorings and nanotori for enhanced colloidal photothermal energy conversion in the visible (vis) to near-infrared (NIR) spectrum. We use full-wave field analysis to demonstrate for the first time that the plasmon resonant absorption of these structures remains high over a broad range of orientations relative to the polarization of the incident field. The finding of strong orientation-independent plasmon absorption is a key result as it indicates that the structures can provide enhanced photothermal heating for colloidal applications. We use computational fluid dynamic analysis to investigate pulsed-laser plasmon-enhanced heating of the nanostructures in a fluid. We quantify the laser intensity and pulse duration needed to superheat the nanostructures to initiate bubble nucleation, and we simulate the dynamics of generated nanobubbles. The modeling provides insight into the plasmonic and thermofluidic behavior of colloidal nanostructures, thereby enabling rational design of novel plasmon-enhanced photothermal processes.

Precise control of self-renewal and differentiation of progenitor cells into the cranial neural crest (CNC) pool ensures proper head development, guided by signaling pathways such as BMPs, FGFs, Shh and Notch. Here, we show that murine Sox2 plays an essential role in controlling progenitor cell behavior during craniofacial development. A “Conditional by Inversion” Sox2 allele (Sox2COIN) has been employed to generate an epiblast ablation of Sox2 function (Sox2EpINV). Sox2EpINV/+(H) haploinsufficient and conditional (Sox2EpINV/mosaic) mutant embryos proceed beyond gastrulation and die around E11. These mutant embryos exhibit severe anterior malformations, with hydrocephaly and frontonasal truncations, which could be attributed to the deregulation of CNC progenitor cells during their epithelial to mesenchymal transition. This irregularity results in an exacerbated and aberrant migration of Sox10+ NCC in the branchial arches and frontonasal process of the Sox2 mutant embryos. These results suggest a novel role for Sox2 as a regulator of the epithelial to mesenchymal transitions (EMT) that are important for the cell flow in the developing head.