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Cerebral small vessel disease (CSVD) represents a cluster of various vascular disorders with different pathological backgrounds. The advanced vasculature net of cerebral vessels, including small arteries, capillaries, arterioles and venules, is usually affected. Processes of oxidation underlie the pathology of CSVD, promoting the degenerative status of the epithelial layer. There are several classifications of cerebral small vessel diseases; some of them include diseases such as Binswanger’s disease, leukoaraiosis, cerebral microbleeds (CMBs) and lacunar strokes. This paper presents the characteristics of CSVD and the impact of the current knowledge of this topic on the diagnosis and treatment of patients.

Spinal dural arteriovenous fistulas (sDAVF) are rare spinal cord lesions formed between a radicular artery and medullary vein leading to venous hypertension resulting in neurological impairment. Endovascular embolisation is a minimally-invasive method aiming to interrupt the shunt between the artery and vein. We report our experience with sDAVF treated endovascularly. Clinical and procedural data of 16 consecutive patients diagnosed with sDAVF was reviewed. Pre- and post-operative neurological condition was evaluated using both the Aminoff and Logue disability scale and the VAS scale. Rates of complete occlusions, technical difficulties, and procedural complications were noted. Four of the patients were female and 12 were male; mean age was 62.4 years. Mean interval between symptom onset and treatment was 13.3 months. Complete occlusion was achieved in 88% (14/16 patients). Significant or moderate clinical improvement in long-term follow-up was observed in eight patients (50%). Recurrence was observed in two cases (13%). While endovascular methods are being refined and thus achieving an increasing percentage of successful occlusions, patients should be closely monitored since this condition is recurrent and the clinical consequences of myelopathy can persist despite complete occlusion of the shunt.

Mitochondrial DNA changes can contribute to both an increased and decreased likelihood of cancer. This process is complex and not fully understood. Polymorphisms and mutations, especially those of the missense type, can affect mitochondrial functions, particularly if the conservative domain of the protein is concerned. This study aimed to identify the possible relationships between brain gliomas and the occurrence of specific mitochondrial DNA polymorphisms and mutations in respiratory complexes III, IV and V. The investigated material included blood and tumour material collected from 30 Caucasian patients diagnosed with WHO grade II, III or IV glioma. The mitochondrial genetic variants were investigated across the mitochondrial genome using next-generation sequencing (MiSeq/FGx system—Illumina). The study investigated, in silico, the effects of missense mutations on the biochemical properties, structure and functioning of the encoded protein, as well as their potential harmfulness. The A14793G (MTCYB), A15758G, (MT-CYB), A15218G (MT-CYB), G7444A (MT-CO1) polymorphisms, and the T15663C (MT-CYB) and G8959A (ATP6) mutations were assessed in silico as harmful alterations that could be involved in oncogenesis. The G8959A (E145K) ATP6 missense mutation has not been described in the literature so far. In light of these results, further research into the role of mtDNA changes in brain tumours should be conducted.

Paragangliomas are neuroendocrine tumours commonly located in the abdomen, thorax, head and neck. The definitive treatment for these tumours is surgical resection, which in some cases can be very challenging due to the involvement of critical neurovascular structures and their high vascularity. Therefore, pre-operative embolisation may be performed to reduce the risk of complications. This study aimed to present our experience with endovascular embolisation of head and neck paragangliomas (HNP). In this single-centre study, we reviewed data from consecutive patients with HNP who underwent pre-operative embolisation from 2017 to 2023. The efficacy of embolisation, the method of embolisation, as well as the rate of complications, were noted. A total of 27 patients (15 females) with an average age of 47 years underwent selective embolisation of HNP. Satisfactory embolisation, defined as occlusion of > 75% of the blood supply, was achieved in 22/27 cases (81.5%). The most commonly used embolic agents included coils and microspheres. With the exception of minor vessel dissections in two patients and embolic agent migration in two patients causing reversible occlusion of the intracranial vessels, there were no other complications associated with embolisation. No neurological deficits occurred in relation to the endovascular procedure. The results of our study indicate that endovascular embolisation of HNP prior to surgical resection is a safe and efficacious procedure, with a relatively low complication rate and associated morbidity.

Microsurgical treatment of VBSA is complex and challenging due to the deep location of the vessels and the proximity of important structures. Therefore, minimally invasive endovascular techniques have been introduced to the treatment of VBSA. The aim of this study was to present long-term results and technical aspects of VBSA embolisation. In this manuscript, we describe our experience in the treatment of VBSA with long-term results. Furthermore, we discuss the advantages and disadvantages of this treatment modality, paying special attention to the technical aspects. We believe that this is an important contribution to this topic because the number of previous reports is limited. It adds to a population that can be compared to patients treated using different methods. We analysed the medical records of patients with aneurysms of vertebral and basilar arteries referred for endovascular treatment between 2015 and 2020. A total of 44 patients were selected for the study. From this group, 10 patients (22.7%) were admitted with SAH caused by ruptured VBSA. The median age of the patients was 58 years (31-80), with 27 (61.4%) females and 17 (38.6%) males. The majority of the VBSAs (35, 79.5%) were located on the basilar artery. Complete occlusion was achieved in 39 patients (88.6%). Procedural complications occurred in three cases (6.8%). In long-term follow-up, complete embolisation was achieved in 81.8% (36 of 44 patients). In 18.2% (eight patients), recurrence of VBSA was observed. Two patients were qualified for recoiling. Clinical follow-up was uneventful in 37 (84%) patients. Four patients (9%) reported mild headaches. Three (7%) patients required assistance for daily living. Endovascular embolisation of VBSA is feasible and provides an excellent rate of complete occlusion and a high rate of favourable long-term outcomes, which support using this technique as a first-line treatment. A relatively high rate of recurrence remains the major drawback, especially in cases of wide-neck VBSA.

Mitochondria are organelles necessary for oxidative phosphorylation. The interest in the role of mitochondria in the process of carcinogenesis results from the fact that a respiratory deficit is found in dividing cells, especially in cells with accelerated proliferation. The study included tumor and blood material from 30 patients diagnosed with glioma grade II, III and IV according to WHO (World Health Organization). DNA was isolated from the collected material and next-generation sequencing was performed on the MiSeqFGx apparatus (Illumina). The study searched for a possible relationship between the occurrence of specific mitochondrial DNA polymorphisms in the respiratory complex I genes and brain gliomas of grade II, III and IV. The impact of missense changes on the biochemical properties, structure and functioning of the encoded protein, as well as their potential harmfulness, were assessed in silico along with their belonging to a given mitochondrial subgroup. The A3505G, C3992T, A4024G, T4216C, G5046A, G7444A, T11253C, G12406A and G13604C polymorphisms were assessed as deleterious changes in silico, indicating their association with carcinogenesis.

Introduction: Lumbar disc herniation (LDH) is a common cause of back pain and leg pain. For more than 60 years, standard discectomy by fenestration has been used to treat LDH. In his study, three commonly used scales were used to assess the outcome after microdiscectomy, such as the Low Back Pain Rating Scale (LBPRS), Oswestry Disability Index (ODI) and the Visual Analogue Scale (VAS). To the best of the authors’ knowledge, this is the first study analyzing treatment results at 3 months after microdiscectomy. Material and methods: During almost 5 years, a total of 327 patients underwent microdiscectomy operations for single level disc disease. Of these, 286 patients were available for 3-mounth follow-up. All patients were operated on at the Neurosurgery Department in the Specialist Hospital in Sandomierz, Poland. Before surgery and 3 months after burgery, all patients were asked to complete LBPRS, ODI and VAS scales. The statistical analysis used was p2, the effect size indicator for ANOVA. Results: Significant improvement was observed in all scales used 3 months after surgery. Conclusions: There are new, minimally invasive percutaneous techniques available, such as percutaneous laser disc decompression and intradiscal injection of radiopaque gelified ethanol. There are also trials with platelet-rich plasma or mesenchymal stem cells injected into the disc, aimed at the restoration of healthy disc properties. The hypothesis that metabolic products of bacteria propionibacterium acnes can contribute to disc degeneration inspired attempts at antibiotic therapy This study was conducted on a large group of patients and confirmed that discectomy is the recommended method of surgery which produces good treatment results in 3-mounths follow-up.

Eagle syndrome is a rare condition where an abnormally elongated (over 3cm) calcified stylohyoid ligament irritates the adjacent soft tissues, causing a number of symptoms related to neck movements, such as local pain, odynophagia, dyphagia, otalgia and limited neck mobility. The symptoms depend from the structures involved: cranial nerves VII, IX, X and XII, as well as internal jugular vein and carotid artery. The conservative treatment of the condition includes: non-steroidal anti-inflammatory, antyepileptic drugs, physiotherapy and neck exercises, steroids, and local anesthetic injections. The possible surgical approaches are internal (transoral) or external – transcervical and parapharyngeal. The case is presented of a female patient who suffered neck and shoulder pain from the combined occurrence of left-sided elongated styloid and cervical disc herniation. She was successfully treated with resection of the styloid via parapharyngeal approach.

Ectopic and heterotopic both refer to cells displaced from their normal site – ectopic cells occur outside their organ of origin whereas heterotopic cells are in an aberrant location within their organ of origin. The most common localization of heterotopic neuroglial tissue (HNT) is the nasal region. We report a case of 69-years-old man who presented with long history of lumbosacral pain with paresis of the inferior limb. MRI examination detected a cystic tumour located at the L1-L2 level. Histologic examination revealed the presence of heterotopic neuroglial tissue, containing synaptophysin, glial cells and encircled meninges.

Giant cell tumour (GCT) is a benign aggressive tumour, which affects the axial and peripheral skeleton. Pathological fractures often occur in cases where epiphyses are affected. GCT located in the cervical spine is rare and poses a serious surgical challenge and as far as approach and range of operation is concerned, is subject of debate. We report a case of GCT involving two vertebral bodies, C2 and C3, treated with posterior occipito-cervical junction stabilization, denosumab chemotherapy and transoral corpectomy.