BACKGROUND Vaccines against coronavirus disease 2019 have a high level of efficacy and safety across all populations. However, numerous case series have been published on neurological disorders, including Bell’s palsy, Guillain-Barre syndrome, transverse myelitis, and multiple sclerosis. The authors presented a case of trigeminal neuropathy after coronavirus vaccination in a patient who had undergone microvascular decompression (MVD) for trigeminal neuralgia (TN). OBSERVATIONS A 77-year-old woman presented with acute trigeminal neuropathy after receiving a Pfizer-BioNtech vaccination (tozinameran) against severe acute respiratory syndrome coronavirus 2. The patient had undergone MVD for TN and the facial pain completely disappeared. One month later, she received the first injection of the tozinameran vaccine. Twelve hours after vaccination, she presented with numbness and pain induced by touching any place on the entire right face. No eruption was observed on her face. The serum herpes zoster virus antibodies were confirmed within the normal range. Magnetic resonance imaging revealed no abnormalities. The authors suspected a right trigeminal neuropathy after vaccination. Administration of carbamazepine and pregabalin improved TN but facial numbness persisted, especially in the mandibular division. LESSONS The coronavirus is a possible etiology of secondary trigeminal neuropathy in the case of MVD for TN.

Background: Novice neurosurgeons require neurosurgical technique training, but the current method is demanding and time consuming. Therefore, it is crucial to perform training using an appropriate and informative method. In this report, we describe our attempts to provide training in neurosurgical techniques using goat in vivo brain model and to demonstrate the effectiveness of this model. Methods: Under general anesthesia, the surgery was performed on a male goat in the prone position. A midline liner skin incision was made in the scalp, six burr holes were drilled, a craniectomy was performed, and the dura was incised in an arcuate fashion. We attempted the interhemispheric approach and a retrosigmoid approach. Results: It was confirmed that common neurosurgical approaches are achievable in this model. Furthermore, anatomical structures such as nerves and blood vessels were similar to those of humans. Moreover, the goat brain was similar in color and texture to that of humans. Conclusion: Unlike a cadaver brain, in vivo brain requires hemostasis and careful dissection, which provides the surgeons a realistic experience of actual neurosurgery.

Background: Despite the proven benefit of stent retriever thrombectomy for acute ischemic stroke caused by large-vessel embolic occlusion, acute revascularization in the setting of underlying intracranial, atherosclerosis-related, and emergent large-vessel occlusion remains to be a challenge. In this case report, we present a novel revascularization technique that can be used to treat acute ischemic stroke caused by suspected intracranial, atherosclerosis-related, and emergent large-vessel occlusion of the internal carotid artery (ICA). Case Description: This case report presents two patients with intracranial, atherosclerosis-related, and emergent large-vessel occlusion of the ICA: a 73-year-old man with a right-sided hemiparesis and aphasia and a 60-year-old man with altered level of consciousness. These patients were treated using the prolonged deployment and partial resheath method with a stent retriever, using the following devices: Solitaire Platinum, Trevo Trak 21, and AXS catalyst 6 for suction. On prolonged deployment of the Solitaire Platinum device, underlying focal atherosclerotic disease was noted. The device remained in place for more than 10 min, until the blood vessel was occluded. Next, the device was partially resheathed into the Trevo Trak 21 to reduce the radial force and minimize vessel injury during the pull. The partially constrained device was then retrieved under continuous aspiration at the lesion site and blood flow was successfully restored. Both patients recovered without any new deficits. Conclusion: The prolonged deployment and partial resheath method using a stent retriever may be safe and effective in the treatment of intracranial, atherosclerosis-related, and emergent large-vessel occlusion of the ICA.

No abstract

Prolactin and growth hormone can acquire anti-angiogenic properties after undergoing proteolytic cleavage by Cathepsin D and bone morphogenetic protein 1 (BMP-1) into fragments known as vasoinhibins. Little is known about the effect of vasoinhibins on angiogenesis through the involvement of key cleavage enzymes Cathepsin D and BMP-1 in pituitary neuroendocrine tumors (PitNETs, formerly pituitary adenomas). The purpose of this study was to investigate the mechanism of action of Cathepsin D and BMP-1 on angiogenesis in PitNETs compared with that of pro-angiogenic factors, including vascular endothelial growth factor (VEGF) and basic fibroblast growth factor-2 (FGF2). A total of 43 patients were enrolled in a retrospective analysis and 22 samples were suitable for RNA extraction, including 16 nonfunctional PitNETs and six somatotroph tumors. The mRNA and protein levels of Cathepsin D, BMP-1, VEGF, and FGF2 were compared with those of von Willebrand factor, which was assessed to determine the vascularization of PitNETs. Cathepsin D and FGF2 were significantly correlated with vascularization in PitNETs. Both Cathepsin D and FGF2 are highly involved in angiogenesis in PitNETs, although the effect of Cathepsin D as an antiangiogenic factor is dominant over that of FGF2 as a pro-angiogenic factor.