This report describes a case of delayed glossopharyngeal and vagus nerve paralysis following a closed head injury. A depressed fracture of the occipital condyle was diagnosed using high-resolution computerized tomography (CT) scanning and three-dimensional CT images. Magnetic resonance imaging complemented the study. The anatomical features, mechanisms, diagnosis, and treatment of this unusual lesion are discussed.
Isolated trochlear nerve palsy is a rare and reversible complication after percutaneous balloon compression for trigeminal neuralgia. This case illustrates that the mechanism of injury to the fourth nerve is the result of an erroneous technique: excessive penetration of the Fogarty catheter in Meckel's cave beyond the porus trigemini and compression of the cisternal segment of the trochlear nerve when the inflated balloon is pushed against the tentorium.
Glioblastoma is the most common, aggressive and lethal brain tumor in adults. However, current therapeutic protocols have low success rates and average overall survival is less than 15 months. The resistance to therapy is largely a result of the remarkable cellular and phenotypical heterogeneity that characterizes this type of tumor. The discovery of a subpopulation of cells exhibiting stem cell properties within the tumor bulk has profound implications for therapy as increasing evidence indicates that these cells, glioblastoma stem cells (GSCs), are responsible for the origin, maintenance and recurrence of the glioblastomas. These findings highlight the need to characterize GSCs in order to find novel treatments directly targeted specifically against them. In this review, we summarize the current knowledge regarding this issue, including some recent and relevant patents.
After the use of Mullan's technique, macroscopic changes take place on the gasserian ganglion and the surrounding structures. These changes were studied on 20 trigeminal nerves of 10 fresh adult cadavers. Changes took place on the dura as well as in the neural elements. There was compression on the ganglion and on the trigeminal nerve, and there were changes in the position of the trigeminal root, with shortening of its cisternal segment. When the balloon was inflated to capacity (0.75-1.0 ml), dural stretching in an area of 15 x 10 mm took place. This stretching of the dura extended from the lateral wall of the cavernous sinus to the level of the porus trigemini. Despite these important mechanical effects, we never found a rupture or tear on the dura or the trigeminal nerve fibers. We discuss the relationship between mechanical effects and clinical results.
Long non-coding RNAs (LncRNAs) have emerged as a relevant class of genome regulators involved in a broad range of biological processes and with important roles in tumor initiation and malignant progression. We have previously identified a p53-regulated tumor suppressor signature of LncRNAs (PR-LncRNAs) in colorectal cancer. Our aim was to identify the expression and function of this signature in gliomas. We found that the expression of the four PR-LncRNAs tested was high in human low-grade glioma samples and diminished with increasing grade of disease, being the lowest in glioblastoma samples. Functional assays demonstrated that PR-LncRNA silencing increased glioma cell proliferation and oncosphere formation. Mechanistically, we found an inverse correlation between PR-LncRNA expression and SOX1, SOX2 and SOX9 stem cell factors in human glioma biopsies and in glioma cells in vitro. Moreover, knock-down of SOX activity abolished the effect of PR-LncRNA silencing in glioma cell activity. In conclusion, our results demonstrate that the expression and function of PR-LncRNAs are significantly altered in gliomagenesis and that their activity is mediated by SOX factors. These results may provide important insights into the mechanisms responsible for glioblastoma pathogenesis.
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