A spinal cord injury (SCI) is one of the most devastating lesions, as it can damage the continuity and conductivity of the central nervous system, resulting in complex pathophysiology. Encouraged by the advances in nanotechnology, stem cell biology, and materials science, researchers have proposed various interdisciplinary approaches for spinal cord regeneration. In this respect, the present review aims to explore the most recent developments in SCI treatment and spinal cord repair. Specifically, it briefly describes the characteristics of SCIs, followed by an extensive discussion on newly developed nanocarriers (e.g., metal-based, polymer-based, liposomes) for spinal cord delivery, relevant biomolecules (e.g., growth factors, exosomes) for SCI treatment, innovative cell therapies, and novel natural and synthetic biomaterial scaffolds for spinal cord regeneration.
Starting from the morphological-functional assumption of the fractal brain, a mathematical model is given by activating brain's non-differentiable dynamics through the determinism-nondeterminism inference of the responsible mechanisms. The postulation of a scale covariance principle in Schrödinger's type representation of the brain geodesics implies the spectral functionality of the brain dynamics through mechanisms of tunelling, percolation etc., while in the hydrodynamical type representation, it implies their structural functionality through mechanisms of wave schock, solitons type etc. For external constraints proportional with the states density, the fluctuations of the brain stationary dynamics activate both the spectral neuronal networks and the structural ones through a mapping principle of two distinct classes of cnoidal oscillation modes. The spectral-structural compatibility of the neuronal networks generates the communication codes of algebraic type, while the same compatibility on the solitonic component induces a strange topology (the direct product of the spectral topology and the structural one) that is responsible of the quadruple law (for instance, the nucleotide base from the human DNA structure). Implications in the elucidation of some neuropsychological mechanisms (memory's location and functioning, dementia etc.) are also presented.
Introduction: Spinal teratoma is an extremely rare entity as it represents 0.10-0.60% of all spinal tumors. It is mainly diagnosed during the first two decades of life and can be associated with spinal dysraphism. Aim: To present a case of an asymptomatic mature teratoma of filum terminale, incidentally diagnosed in an elderly patient admitted to the Neurosurgery Department for multiple traumas after falling from 3 meters height. Case description: A 76 year-old patient was admitted in the 2 nd Neurosurgery Department, "Prof. Dr.N. Oblu" Emergency Clinical Hospital, Iaşi with multiple traumas after falling from 3 meters height. The patient presented bilateral paresthesia of lower limbs and urinary incontinence. Radiography of the dorsal-lumbar spine column in emergency highlighted a dorsal -lumbar fracture (D12-L1) with medullar compression. MRI examination revealed a neoformation of filum terminale that filled almost the entire spinal canal, which had a composite, fatty and fluid structure, corresponding to L2-L4 and compressing the medullary cone. The neurosurgical decision was the excision of the entire neoformation. The histopathological examination of excised pieces revealed the presence of adipose tissue mixed together with striated and smooth muscle fibers, small and large cysts lined by various epithelia ranging from malpighian keratinized multilayered to simple ciliated columnar epithelium. No immature or malignant cells were identified and therefore the diagnosis was mature teratoma of filum terminale. The evolution of the patient was favorable with the remission of the neurological deficit. Conclusions: Our patient is one of the oldest patients diagnosed up to date with a mature teratoma of filum terminale. Moreover, the location of neoformation at the lumbar (L2-L4) level is extremely rare. This case also highlights the fact that this mature teratoma was discovered by chance, when the patient came to the Neurosurgery Department for a spinal injury due to a falling from a tree.
Many developments were made in the area of endovascular treatment of intracranial aneurysms, but this procedure also requires a good assessment of vascular anatomy prior to intervention. Seventy-six cases with brain aneurysms were selected and 1:1 scale 3D printed models were created. We asked three interventional neurosurgeons with different degrees of experience (ten years, four years, and a fourth-year resident) to review the cases using CTA (computed tomography angiogram) with MPR (multiplanar reconstructions) and VRT (volume rendering technique) and make a decision: coil embolization or stent-assisted coil embolization. After we provided them with the 3D printed models, they were asked to review their treatment plan. Statistical analysis was performed and the endovascular approach changed in 11.84% of cases for ten-year experienced neurosurgeons, 13.15% for four years experienced neurosurgeon, and 21.05% for residents. The interobserver agreement was very good between the ten years experienced interventionist and four years experienced interventionist when they analyzed the data set that included the 3D printed model. The agreement was higher between all physicians after they examined the printed model. 3D patient-specific printed models may be useful in choosing between two different endovascular techniques and also help the residents to better understand the vascular anatomy and the overall procedure.
Two different operational procedures are proposed for evaluating and predicting the onset of epileptic and eclamptic seizures. The first procedure analyzes the electrical activity of the brain (EEG signals) using nonlinear dynamic methods (the time variations of the standard deviation, the variance, the skewness and the kurtosis; the evolution in time of the spatial–temporal entropy; the variations of the Lyapunov coefficients, etc.). The second operational procedure reconstructs any type of EEG signal through harmonic mappings from the usual space to the hyperbolic one using the time homographic invariance of a multifractal-type Schrödinger equation in the framework of the scale relativity theory (i.e., in a multifractal paradigm of motions). More precisely, the explicit differential descriptions of the brain activity in the form of 2 × 2 matrices with real elements disclose, through the in-phase coherences at various scale resolutions (i.e., as scale transitions), the multitude of brain neuronal dynamics, especially sequences of epileptic and eclamptic seizures. These two operational procedures are not mutually exclusive, but rather become complementary, offering valuable information concerning epileptic and eclamptic seizures. In such context, the prediction of epileptic and eclamptic seizures becomes fundamental for patients not responding to medical treatment and also presenting an increased rate of seizure recurrence.
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