The MIB-1 index is an essential predictor of progression-free-survival (PFS) in meningioma. To date, the MIB-1 index is not available in preoperative treatment planning. A preoperative score estimating the MIB-1 index in patients with intracranial meningiomas has not been investigated so far. Between 2013 and 2019, 208 patients with tumor morphology data, MIB-1 index data, and plasma fibrinogen and serum C-reactive protein (CRP) data underwent surgery for intracranial WHO grade I and II meningioma. An optimal MIB-1 index cut-off value (≥6/<6) in the prediction of recurrence was determined by ROC curve analysis (AUC: 0.71; 95% CI: 0.55–0.87). A high MIB-1 index (≥6%) was present in 50 cases (24.0%) and was significantly associated with male sex, peritumoral edema, low baseline CRP, and low fibrinogen level in the multivariate analysis. A scoring system (“FORGE”) based on sex, peritumoral edema, preoperative CRP value, and plasma fibrinogen level supports prediction of the MIB-1 index (sensitivity 62%, specificity 79%). The MIB-1 labeling index and the FORGE score are significantly associated with an increased risk of poor PFS time. We suggest a novel score (“FORGE”) to preoperatively estimate the risk of an increased MIB-1 index (≥6%), which might help in surgical decision making and follow-up interval determination and inform future trials investigating inflammatory burden and proliferative activity.

Background Facial nerve palsy is a severe morbid condition that occurs after vestibular schwannoma (VS) surgery. The objective of this study was to evaluate facial nerve outcomes based on surgical techniques, tumour size, and immunohistochemical factors. Methods One hundred eighteen patients with VS were retrospectively analysed. Gross total resection (GTR) was achieved in 83 patients, and subtotal resection (STR) was achieved in 35 patients. Follow-up was 60 months (median). Facial nerve outcomes were assessed for 24 months after surgery. Analysis of the MIB-1 index was performed in 114 patients (97%) to evaluate recurrence and facial nerve outcomes. Results Immediately after surgery, 16 of 35 patients (45.7%) with STR and 21 of 83 patients (25.3%) with GTR had a good (House-Brackmann (HB) score ≤ 2) facial nerve outcome (p = 0.029). Semi-sitting positioning (p = 0.002) and tumour size class of 3 (> 4 cm) were also associated with worse HB outcomes after 2 years (p = 0.004) in univariate analyses. The MIB-1 index was significantly correlated with diffuse infiltration of tumour-associated CD45 + lymphocytes (r = 0.63, p = 0.015) and CD68 + macrophages (r = 0.43, p = 0.021). ROC analysis found an AUC of 0.73 (95% CI = 0.60-0.86, p = 0.003) for the MIB-1 index in predicting poor facial nerve outcomes. Binary logistic regression analysis revealed an MIB-1 index ≥ 5% (16/28 (57.1%) vs. 5/ 40 (12.5%); p < 0.001, OR = 14.0, 95% CI = 3.2-61.1) and a tumour size class of 3 (6/8 (75.0%) vs. 2/8 (25.0%); p = 0.01, OR = 14.56, 95% CI = 1.9-113.4) were predictors of poor HB scores (≥ 3) after 1 year. Conclusions An MIB-1 index ≥ 5% seems to predict worse long-term facial nerve outcomes in VS surgery.

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The brain arteries derived from 50 adult degu individuals of both sexes were injected with synthetic latex introduced with a syringe into the left ventricle of the heart under constant pressure. After fixation in 5% formalin and brain preparation, it was found that the sources of the brain's supply of blood are vertebral arteries and the basilar artery formed as a result of their anastomosis. The basilar artery gave rise to caudal cerebellar arteries and then divided into two branches which formed the arterial circle of the brain. The internal carotid arteries in degus, except for one case, were heavily reduced and did not play an important role in the blood supply to the brain. The arterial circle of the brain in 48% of the cases was open from the rostral side. Variation was identified in the anatomy and the pattern of the arteries of the base of the brain in the degu which involved an asymmetry of the descent of caudal cerebellar arteries (6.0%), rostral cerebellar arteries (8%) as well as middle cerebral arteries (12%). In 6% of the individuals double middle cerebral arteries were found. In one out of 50 cases there was observed a reduction in the left vertebral artery and the appearance of the internal carotid artery on the same side. In that case the left part of the arterial circle of the brain was supplied with blood by an internal carotid artery, which was present only in that animal.

ABSTRACT:The cortical branches of the middle cerebral artery in the otter were described using 60 hemispheres. It was demonstrated that the artery is divided into ten permanent branches. Two rhinal arteries supply the region of the brain located on the border between the old and the archicortex and the neocortex. The other eight branches are divided into three branches running towards the frontal lobe, two branches -to the region of the parietal lobe and three temporal branches which supply blood to the neocortex only. The frontal, parietal and temporal branches descended independently from the main trunk of the middle cerebral artery or first formed a common trunk. Common trunks for specific groups of bifurcations were described as the middle cerebral artery (anterior, superior and posterior).