Traumatic brain injury (TBI) is a leading cause of death and disability for which there is currently no effective drug therapy available. Because drugs targeting a single TBI pathological pathway have failed to show clinical efficacy to date, pleiotropic agents with effects on multiple mechanisms of secondary brain damage could represent an effective option to improve brain recovery and clinical outcome in TBI patients. In this multicenter retrospective study, we investigated severity-related efficacy and safety of the add-on therapy with two concentrations (20 ml/day or 30 ml/day) of Cerebrolysin (EVER Neuro Pharma, Austria) in TBI patients. Adjunctive treatment with Cerrebrolysin started within 48 hours after TBI and clinical outcomes were ranked according to the Glasgow Outcome Scale and the Modified Rankin Disability Score at 10 and 30 days post-TBI. Analyses of efficacy were performed separately for subgroups of patients with mild, moderate or severe TBI according to Glasgow Coma Scale scores at admission. Compared to standard medical care alone (control group), both doses of Cerebrolysin were associated with improved clinical outcome scores at 10 days post-TBI in mild patients and at 10 and 30 days in moderate and severe cases. A dose-dependent effect of Cerebrolysin on TBI recovery was supported by the dose-related differences and the significant correlations with treatment duration observed for outcome measures. The safety and tolerability of Cerebrolysin in TBI patients was very good. In conclusion, the results of this large retrospective study revealed that early Cerebrolysin treatment is safe and is associated to improved TBI outcome.

Meningioma is a common intracranial neoplasm derived from meningothelial cells, and it is generally associated with a benign clinical course. In spite of this, the malignant behaviour of these tumours as the occurrence of extracranial meningioma metastases in different organs is described in the literature: lung and pleura, spine and other bones, abdominal organs, lymph nodes or even skin. The aim of this review is to analyse the pathways of metastatic spread of the intracranial meningioma tumour cells towards different organs.

Even if meningiomas are the most common radio-induced tumors that occur in the adult population, the epidemiology of these types of tumors after Chernobyl nuclear accident, is still unclear. This paper aims to determine the tumoral behavior of intracranial meningiomas in North-Eastern Romania, affected by the radioactive cloud from Chernobyl nuclear accident , over a period of 25 years, namely between 1990 and 2015. Our research consists of an analytical, observational, cohort-based and retrospective study, conducted in Prof. Dr. N. Oblu Clinical Emergency Hospital of Iasi, Romania, on a group of 1287 patients diagnosed with intracranial meningiomas and operated between 1990 and 2015. In these period there was an increased number of intracranial meningiomas, with first peak between 1993-1996 and the second peak between 2007-2015, corresponding to 7-10 years and 21-30 years, after the Chernobyl accident. Regarding the annual frequency of histopathologic grading, for grade I meningiomas there were no trend or cyclicity of the cases diagnosed each year, but for grade II and III meningiomas there were an ascending trend in the period 1996-2000, that corresponds to the 10-14 years from the Chernobyl accident.

For a long time, because of its location at the skull base level, the sphenoid bone was rather mysterious as it was too difficult for anatomists to reach and to elucidate its true configuration. The configuration of the sphenoid bone led to confusion regarding its sutures with the other skull bones, its shape, its detailed anatomy, and the vascular and nervous structures that cross it. This article takes the reader on a journey through time and space, charting the evolution of anatomists’ comprehension of sphenoid bone morphology from antiquity to its conception as a bone structure in the eighteenth century, and ranging from ancient Greece to modern Italy and France. The journey illustrates that many anatomists have attempted to name and to best describe the structural elements of this polymorphous bone.

Atypical meningioma represent an intermediary group between the benign meningioma (grade I) and anaplastic meningioma (grade III), and are known for high recurrence rate and short life expectancy. After modification of the classification World Health Organization in 2007, subsequent studies have tried to find prognostic factors for recurrence and survival, which are inconstant from author to author. This paper aims to present a short review of the most important prognostic factors in atypical meningioma.