Purpose The management of cervical facet dislocation injuries remains controversial. The main purpose of this investigation was to identify whether a surgeon's geographic location or years in practice influences their preferred management of traumatic cervical facet dislocation injuries. Methods A survey was sent to 272 AO Spine members across all geographic regions and with a variety of practice experience. The survey included clinical case scenarios of cervical facet dislocation injuries and asked responders to select preferences among various diagnostic and management options. Results A total of 189 complete responses were received. Over 50% of responding surgeons in each region elected to initiate management of cervical facet dislocation injuries with an MRI, with 6 case exceptions. Overall, there was considerable agreement between American and European responders regarding management of these injuries, with only 3 cases exhibiting a significant difference. Additionally, results also exhibited considerable management agreement between those with ≤ 10 and > 10 years of practice experience, with only 2 case exceptions noted. Conclusion More than half of responders, regardless of geographical location or practice experience, identified MRI as a screening imaging modality when managing cervical facet dislocation injuries, regardless of the status of the spinal cord and prior to any additional intervention. Additionally, a majority of surgeons would elect an anterior approach for the surgical management of these injuries. The study found overall agreement in management preferences of cervical facet dislocation injuries around the globe.

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Programmed cell death is crucial for the correct development of the organism and the clearance of harmful cells like tumor cells or autoreactive immune cells. Apoptosis is initiated by the activation of cell death receptors and in most cases it is associated with the activation of the cysteine proteases, which lead to apoptotic cell death. Cells shrink, chromatin clumps and forms a large, sharply demarcated, crescent-shaped or round mass; the nucleus condenses, apoptotic bodies are formed and eventually dead cells are engulfed by a neighboring cell or cleared by phagocytosis. The authors have summarized the most important data concerning apoptosis in subarachnoid hemorrhage that have been issued in the medical literature in the last 20 years.

Introduction. Intracranial cavernomas are rare neurovascular lesions, met frequently in patients with anomalies of the vasculature of the encephalon and medulla. Cavernomas account for 0.02-0.53% of all intracranial lesions and approximately 8-15% of all intracranial vascular malformations. A procentage of about 10-30% of all cases show an association between cavernomas and arteriovenous malformations. Clinically, the lesions become symptomatic when their size becomes larger than 1cm. The symptoms include headache, seizures, focal neurologic deficit and last but not least hemorrhage. Materials and methods. The authors present a study of 99 patients diagnosed and treated for intracranial cavernomas between January 2004 and January 2015 (11 years). The study encompasses 45 male patients and 44 female patients with ages ranging between 11 and 56, all treated at the Bagdasar-Arseni Emergency University Hospital in Bucharest, Romania. A large percentage of the cavernomas were supratentorial 72 cases (72.72%), while only 27 tumors were positioned in the infratentorial compartment of the skull. Regarding the position of the cavernomas, 29 of them (40.27%) were in the frontal lobe, 13 (18.05%) were in the parietal lobe, 20 (27.7%) were in the temporal lobe, while 3 were in the occipital lobe (4.16%). Infratentorial tumors affected the brainstem in 17 cases (62.9%) while 10 cases showed cerebellar implication (37.03%). There were 7 patients in which the authors described multiple cavernomas. The clinical onset was represented by seizures in 59 cases (59.59%), hemorrhage in 20 cases (20.20%) and focal neurologic deficit in 13 cases (13.13%). The symptoms consisted of seizures in 63 cases (63.63%), focal neurologic deficit in 16 cases (16.16%) and hemorrhage in 23 cases (23.23%) while 9 cases (9.9%) were completely asymptomatic. The authors chose to practice a conservative management for the 7 cases with multiple lesions, the 9 asymptomatic cases and 5 cases with deep positioning. In the 5 cases with deep cavernomas the patients were subjected to gamma knife stereotactic radiosurgery but only 2 patients showed response to treatment. Results. In the 99 patients presented by the authors, out of the 76 cases operated, a number of 57 interventions (75%) managed to completely remove the lesion and perilesional gliosis. A number of 19 interventions only managed to remove the tumor as perilesional gliosis was impossible to remove without lesions to eloquent areas. Conclusions. Intracranial cavernomas are rare lesions, usually incriminated when seizures appear. When they are asymptomatic the best option for the surgeon is to wait and see how the tumor behaves. When seizures appear in the array of symptoms of a given tumor the best prognosis is offered by lesionectomy with the removal of perilesional gliosis. Neuronavigation guided surgery has managed in most cases to facilitate complete removal of such tumors and to avoid postoperative defficit with the improvement of clinical results. Furthermore, neuronavigation removes the necessity of an unpleasant stereotactic frame. When intracerebral hemorrhage occurs, surgery is mandatory and represents a neurosurgical emergency. In multiple tumors, the bleeding cavernoma must be removed. The effectiveness of Gamma Knife Surgery (GKS) is debatable.

This article presents a multi-centre study cohort study on 50 patients with cranial defects of multiple etiologies (trauma, decompression, tumour surgery, etc.) operated in 10 hospitals. In all patients the neurosurgeon repaired the cranial defect using 3D printed and CNC milling and drilling grafts or Patient Specific Implants, from two world known manufacturers, custom made in accordance with the data obtained from the patient’s 3D CT reconstruction.