Background:Most reports of cadaveric specimen preparation for neurosurgical dissection describe methods using fresh cadavers. Our cultural limitations prevent us from obtaining fresh cadaveric heads.Objective:To study and report on an alternative method of preparation of head specimens for neurosurgical dissection using defrosted cadavers.Materials and Methods:Twenty-four head specimens were procured through the Department of Anatomy, received by donation three to seven days after funeral activity. The specimens were sectioned through the neck, and preserved by refrigeration at a temperature of -10°C for a period of one week to three months prior to preparation. The process began with defrosting the frozen head specimens for 48 hours in a refrigerator, in which the temperature was controlled within the range of -2° to -8°C. The great vessels were identified and cannulated. These were then irrigated with tap water until clear, following which colored silicone was injected. The specimens were preserved in 95% ethyl alcohol, and were assessed for quality one week after the preparation process. They were then re-assessed at monthly intervals for 12 months.Results:When compared with specimens prepared from fresh cadavers, our method provided similar quality specimens for dissection. The scalp and muscles of all specimens remained soft. The vasculature was good, and the colored silicone made identification easy. The brain tissues were soft and easily retracted, and still in good condition for dissection after a long preparation period (12 months).Conclusion:The head specimens prepared with this method were of good quality for dissection, and were comparable in quality to those prepared from fresh cadavers as in published methods. We were thus able to provide a suitable substitute to fresh head specimens in situations where access to fresh cadavers is unavailable.

TMZ and BEV can directly cause the dysfunction of mitochondria isolated from human brain tumors. However, BEV has a greater ability to disturb mitochondrial function in mitochondria isolated from human brain tumors than either TMZ or calcium overload conditions.

No abstract

Cranioplasty is a standard procedure used to restore skull defects after craniectomy. Many different materials are used in cranioplasty. The study aim was to compare the surgical outcomes of cranioplasty using different materials: liquid polymethylmethacrylate (PMMA), customized PMMA, and titanium. The authors retrospectively reviewed the outcomes of cranioplasty performed from 2016 to 2021. Data collection included patient characteristics and complications, including postoperative infection, hematoma, implant exposure, and subgaleal cerebrospinal fluid collection. Eighty-five patients received cranioplasty with different materials: titanium, 14; customized PMMA, 31; and liquid PMMA, 40. There were no significant differences in the basic patient characteristics among the 3 cranioplasty groups except for lower age in the customized PMMA group. There were no significant differences between superficial and deep infections, implant exposure, postoperative hematoma, or seizure. However, subgaleal cerebrospinal fluid collection was more common in the liquid PMMA group than in the customized PMMA group (P = 0.02). This study showed that good outcomes were achieved by cranioplasty performed with different materials (titanium, customized PMMA, and liquid PMMA).

Ruptured oncotic aneurysms from choriocarcioma metastasis are very rare. One rare case of metastatic cerebral choriocarcioma with an initial presentation of intracerebral hemorrhage is reported. A 25-year-old woman initially presented with sudden onset of alteration of consciousness. The computed tomography scan showed left parietal hematoma and CT angiography showed a small aneurysm of the left middle cerebral arteries territories. Her chest X-ray showed two lung masses. A craniectomy was performed to remove the hematoma and decompression following the aneurysm excision. After surgery the patient regained consciousness and had no neurological deficit. The pathology reported metastatic choriocarcioma and her beta – HCG was 73,656 units. After recovery she received chemotherapy with an etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine/oncovine (EMA-CO) regimen.

Objective Consistency of meningiomas is one of the most important factors affecting the completeness of removal and major risks of meningioma surgery. This study used preoperative magnetic resonance imaging (MRI) sequences in single and in combination to predict meningioma consistency. Methods The prospective study included 287 intracranial meningiomas operated on by five attending neurosurgeons at Chiang Mai University Hospital from July 2012 through June 2020. The intraoperative consistency was categorized in four grades according to the method of surgical removal and intensity of ultrasonic aspirator, then correlated with preoperative tumor signal intensity pattern on MRI including T1-weighted image, T2-weighted image (T2WI), fluid-attenuated inversion recovery (FLAIR), and diffusion-weighted image (DWI), which were described as hypointensity, isointensity, and hyperintensity signals which were blindly interpreted by one neuroradiologist. Results Among 287 patients, 29 were male and 258 female. The ages ranged from 22 to 83 years. A total of 189 tumors were situated in the supratentorial space and 98 were in the middle fossa and infratentorial locations. Note that 125 tumors were found to be of soft consistency (grades 1, 2) and 162 tumors of hard consistency (grades 3, 4). Hyperintensity signals on T2WI, FLAIR, and DWI were significantly associated with soft consistency of meningiomas (relative risk [RR] 2.02, 95% confidence interval [CI] 1.35–3.03, p = 0.001, RR 2.19, 95% CI 1.43–3.35, p < 0.001, and RR 1.47, 95% CI 1.02–2.11, p = 0.037, respectively). Further, chance to be soft consistency significantly increased when two and three hyperintensity signals were combined (RR 2.75, 95% CI 1.62–4.65, p ≤ 0.001, RR 2.79, 95% CI 1.58–4.93, p < 0.001, respectively). Hypointensity signals on T2WI, FLAIR, and DWI were significantly associated with hard consistency of meningiomas (RR 1.82, 95% CI 1.18–2.81, p = 0.007, RR 1.80, 95% CI 1.15–2.83, p = 0.010, RR 1.67, 95% CI 1.07–2.59, p = 0.023, respectively) and chance to be hard consistency significantly increased when three hypointensity signals were combined (RR 1.82, 95% CI 1.11–2.97, p = 0.017). Conclusion T2WI, FLAIR, and DWI hyperintensity signals of the meningiomas was solely significantly associated with soft consistency and predictive value significantly increased when two and three hyperintensity signals were combined. Each of hypointensity signals on T2WI, FLAIR, and DWI was significantly associated with hard consistency of tumors and tendency to be hard consistency significantly increased when hypointensity was found in all three sequences.

No abstract

Stroke is the third leading cause of morbidity and mortality in Thailand accounting for a significant and increasing share of hospital costs. The purpose of this project is to study the epidemiology of the prevalence and its predicting factors of working aged hemorrhagic stroke (HS) patients admitted at a tertiary teaching hospital in Chiang Mai, Thailand.We conducted a five-year retrospective descriptive study. The subjects in this study were patients diagnosed with HS, between 15-59 years of age, and admitted to a tertiary teaching hospital in Chiang Mai, Thailand from January 2009 to December 2013. A total of 404 working aged adults who had HS were admitted to the hospital during this review period; 60.9% males and 39.1% females. Nearly 70% of patients were between 46-59 years of age (M = 47.5, SD = 9.8). Of the patients admitted to the hospital, 76.7% were transferred there from other hospitals. Intracerebral hemorrhage was present in 59.7% of patients. Severe HS occurred in 35.9% of the patients with a Glasgow Coma Score from 3-8. Approximately 69% of the working aged HS patients required surgery. The top five identified risk factors for HS were hypertension (83.4%), hyperlipidemia (38.9%), alcohol consumption (21.5%), smoking (15.3 %), and drug non-adherence (14.9%).We found significantly associated risk factors in working-aged HS by multivariate analysis among male gender (p < .001), drug non-adherence (p = .047), and hypertension (p = .048). Raising awareness to reduce risk behavior and health promotion in the community are the keynotes for health care providers in working-aged HS prevention.