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  1 / 8825 MEDLINE  
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[PMID]:29390371
[Au] Autor:Lee HD; Han SH; Park SB; Ko Y; Lee KH
[Ad] Endereço:Department of Rehabilitation Medicine.
[Ti] Título:An intradural extramedullary bronchogenic cyst in the thoracolumbar spine: A case report.
[So] Source:Medicine (Baltimore);96(50):e9263, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: We report the symptoms beginning with weakness and the clinical courses of a patient who was diagnosed with an intradural extramedullary bronchogenic cyst. PATIENT CONCERNS: The patient was a 44-year-old man visited the Department of Physical Medicine and Rehabilitation for walking difficulties characterized by limping due to muscle weakness of left lower extremity for 5 months and atrophy in left calf muscle. DIAGNOSES: Lumbar spine MRI was repeated, since radiating pain in the left hip and posterior thigh with low back pain developed 16 months later. Intraspinal mass of T12 and L1 levels that was not found in the first MRI was newly found in the follow-up MRI. INTERVENTIONS: Total tumor removal was conducted with laminectomy. It was finally diagnosed as an intradural extramedullary bronchogenic cyst on the basis of the pathological analysis results. OUTCOMES: His left calf circumference was increased compared to before surgery the radiating pain also disappeared. LESSONS: If the patient's MRI findings are not correlated with the electrophysiologic and physical examination findings, additional MRI should be accompanied with other tests for an early detection.
[Mh] Termos MeSH primário: Cisto Broncogênico/diagnóstico
Dura-Máter/patologia
Dor Lombar/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Cisto Broncogênico/diagnóstico por imagem
Cisto Broncogênico/patologia
Cisto Broncogênico/cirurgia
Dura-Máter/cirurgia
Seres Humanos
Laminectomia
Dor Lombar/patologia
Dor Lombar/cirurgia
Vértebras Lombares/patologia
Vértebras Lombares/cirurgia
Imagem por Ressonância Magnética
Masculino
Vértebras Torácicas/patologia
Vértebras Torácicas/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009263


  2 / 8825 MEDLINE  
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[PMID]:29384918
[Au] Autor:Ye Y; Wang F; Zhou T; Luo Y
[Ad] Endereço:Department of Neurosurgery, The 3rd Affiliated Hospital of Guangxi Traditional Chinese Medical University, Liuzhou, Guangxi Autonomous Region.
[Ti] Título:Low complication rate of sellar reconstruction by artificial dura mater during endoscopic endonasal transsphenoidal surgery.
[So] Source:Medicine (Baltimore);96(52):e9422, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:To evaluate effect of sellar reconstruction during pituitary adenoma resection surgery by the endoscopic endonasal transsphenoidal approach using artificial cerebral dura mater patch.This was a retrospective study of 1281 patients who underwent endoscopic transsphenoidal resection for the treatment of pituitary adenomas between December 2006 and May 2014 at the Neurosurgery Department of the People's Liberation Army General Hospital. The patients were classified into 4 grades according to intraoperative cerebrospinal fluid (CSF) leakage site. All patients were followed up for 3 months by telephone and outpatient visits.One thousand seventy three (83.7%) patients underwent sellar reconstruction using artificial dura matter patched outside the sellar region (method A), 106 (8.3%) using artificial dura matter patched inside the sellar region (method B), and 102 (8.0%) using artificial dura matter and a mucosal flap (method C). Method A was used for grade 0-1 leakage, method B for grade 1 to 2 leakage, and method C for grade 2 to 3 leakage. During the 3-month follow-up, postoperative CSF leakage was observed in 7 patients (0.6%): 2 among patients who underwent method B (1.9%) and 5 among those who underwent method C (4.9%). Meningitis was diagnosed in 13 patients (1.0%): 2 among patients who underwent method A (0.2%), 4 among those who underwent method B (3.8%), and 7 among those who underwent method C (6.7%).Compared with other reconstruction methods, sellar reconstruction surgery that only use artificial dura mater as repair material had a low rate of complications.
[Mh] Termos MeSH primário: Adenoma/cirurgia
Vazamento de Líquido Cefalorraquidiano/cirurgia
Cirurgia Endoscópica por Orifício Natural
Neoplasias Hipofisárias/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Sela Túrcica/cirurgia
[Mh] Termos MeSH secundário: Adenoma/diagnóstico por imagem
Adulto
Dura-Máter/cirurgia
Feminino
Seres Humanos
Masculino
Meia-Idade
Neoplasias Hipofisárias/diagnóstico por imagem
Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos
Estudos Retrospectivos
Seio Esfenoidal
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009422


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[PMID]:28468142
[Au] Autor:Kölby D; Fischer S; Arab K; Maltese G; Olsson R; Paganini A; Tarnow P; Kölby L
[Ad] Endereço:Department of Plastic Surgery, Sahlgrenska University Hospital, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
[Ti] Título:Craniotomy of the Fused Sagittal Suture Over the Superior Sagittal Sinus Is a Safe Procedure.
[So] Source:J Craniofac Surg;28(3):650-653, 2017 May.
[Is] ISSN:1536-3732
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Spring-assisted cranioplasty to correct sagittal synostosis is based on midline craniotomy through the closed sagittal suture, over the superior sagittal sinus (SSS). The aim of the present study was to evaluate the perioperative safety of this technique. MATERIALS AND METHODS: This is a retrospective study of all patients operated with median craniotomy and springs from 1998 to the end of 2015. For comparison, all Pi-plasties performed during the same time interval were also evaluated. The safety measures were evaluated based on incidence of damage to SSS, incidence of dural tears, perioperative blood loss, operative time, and hospital stay. RESULTS: In the group that had undergone midline craniotomy combined with springs (n = 225), 4 perioperative damages to SSS and 1 dural tear were seen. The perioperative blood loss was 62.8 ±â€Š65.3 mL (mean ±â€Šstandard deviation). The operative time was 67.9 ±â€Š21.5 minutes and the hospital stay was 4.8 ±â€Š1.1 days. In the group that had undergone pi-plasty (n = 105), no damages to SSS but 3 dural tears were seen. The perioperative blood loss was 352.8 ±â€Š174.4 mL. The operative time was 126.0 ±â€Š31.7 minutes and the hospital stay was 7.1 ±â€Š1.4 days. CONCLUSION: Craniotomy SSS in sagittal synostosis is a safe procedure with low morbidity in terms of damage to the SSS. Midline craniotomy combined with springs has significantly lower preoperative blood loss, operative time, and hospital stay (P < 0.001 for all) compared to pi-plasty.
[Mh] Termos MeSH primário: Craniossinostoses/cirurgia
Craniotomia/métodos
Seio Sagital Superior/cirurgia
[Mh] Termos MeSH secundário: Suturas Cranianas/cirurgia
Dura-Máter/lesões
Feminino
Seres Humanos
Lactente
Tempo de Internação
Masculino
Duração da Cirurgia
Complicações Pós-Operatórias/etiologia
Estudos Retrospectivos
Seio Sagital Superior/lesões
Suturas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180126
[Lr] Data última revisão:
180126
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1097/SCS.0000000000003440


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[PMID]:29245329
[Au] Autor:Lim YS; Mun JU; Seo MS; Sang BH; Bang YS; Kang KN; Koh JW; Kim YU
[Ad] Endereço:aDepartment of Anesthesiology and Pain Medicine, Institute for Integrative Medicine, Catholic Kwandong University of Korea College of Medicine, International St. Mary's Hospital, IncheonbDepartment of Orthopaedic Surgery, Changwon Gyeongsang National University Hospital, Republic of KoreacDepartment of Anesthesiology and Pain Medicine, National Police Hospital, Seoul, Korea.
[Ti] Título:Dural sac area is a more sensitive parameter for evaluating lumbar spinal stenosis than spinal canal area: A retrospective study.
[So] Source:Medicine (Baltimore);96(49):e9087, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Narrowing of the dural sac cross-sectional area (DSCSA) and spinal canal cross-sectional area (SCCSA) have been considered major causes of lumbar central canal spinal stenosis (LCCSS). DSCSA and SCCSA were previously correlated with subjective walking distance before claudication occurs, aging, and disc degeneration. DSCSA and SCCSA have been ideal morphological parameters for evaluating LCCSS. However, the comparative value of these parameters is unknown and no studies have evaluated the clinical optimal cut-off values of DSCSA and SCCSA. This study assessed which parameter is more sensitive.Both DSCSA and SCCSA samples were collected from 135 patients with LCCSS, and from 130 control subjects who underwent lumbar magnetic resonance imaging (MRI) as part of a medical examination. Axial T2-weighted MRI scans were acquired at the level of facet joint from each subject. DSCSA and SCCSA were measured at the L4-L5 intervertebral level on MRI using a picture archiving and communications system.The average DSCSA value was 151.67 ±â€Š53.59 mm in the control group and 80.04 ±â€Š35.36 mm in the LCCSS group. The corresponding average SCCSA values were 199.95 ±â€Š60.96 and 119.17 ±â€Š49.41 mm. LCCSS patients had significantly lower DSCSA and SCCSA (both P < .001). Regarding the validity of both DSCSA and SCCSA as predictors of LCCSS, Receiver operating characteristic curve analysis revealed an optimal cut-off value for DSCSA of 111.09 mm, with 80.0% sensitivity, 80.8% specificity, and an area under the curve (AUC) of 0.87 (95% confidence interval, 0.83-0.92). The best cut off-point of SCCSA was 147.12 mm, with 74.8% sensitivity, 78.5% specificity, and AUC of 0.85 (95% confidence interval, 0.81-0.89).DSCSA and SCCSA were both significantly associated with LCCSS, with DSCSA being a more sensitive measurement parameter. Thus, to evaluate LCCSS patients, pain specialists should more carefully investigate the DSCSA than SCCSA.
[Mh] Termos MeSH primário: Dura-Máter/diagnóstico por imagem
Dura-Máter/patologia
Vértebras Lombares/diagnóstico por imagem
Vértebras Lombares/patologia
Estenose Espinal/diagnóstico por imagem
Estenose Espinal/patologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos de Casos e Controles
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Manejo da Dor
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009087


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[PMID]:29190646
[Au] Autor:Ishikura H; Ogihara S; Oka H; Maruyama T; Inanami H; Miyoshi K; Matsudaira K; Chikuda H; Azuma S; Kawamura N; Yamakawa K; Hara N; Oshima Y; Morii J; Saita K; Tanaka S; Yamazaki T
[Ad] Endereço:Department of Orthopaedic Surgery, Sagamihara National Hospital, Kanagawa, Japan.
[Ti] Título:Risk factors for incidental durotomy during posterior open spine surgery for degenerative diseases in adults: A multicenter observational study.
[So] Source:PLoS One;12(11):e0188038, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Incidental durotomy (ID) is a common intraoperative complication of spine surgery. It can lead to persistent cerebrospinal fluid leakage, which may cause serious complications, including severe headache, pseudomeningocele formation, nerve root entrapment, and intracranial hemorrhage. As a result, it contributes to higher healthcare costs and poor patient outcomes. The purpose of this study was to clarify the independent risk factors that can cause ID during posterior open spine surgery for degenerative diseases in adults. We conducted a prospective multicenter study of adult patients who underwent posterior open spine surgery for degenerative diseases at 10 participating hospitals from July 2010 to June 2013. A total of 4,652 consecutive patients were enrolled. We evaluated potential risk factors, including age, sex, body mass index, American Society of Anesthesiologists physical status classification, the presence of diabetes mellitus, the use of hemodialysis, smoking status, steroid intake, location of the surgery, type of operative procedure, and past surgical history in the operated area. A multivariate logistic regression analysis was performed to identify the risk factors associated with ID. The incidence of ID was 8.2% (380/4,652). Corrective vertebral osteotomy and revision surgery were identified as independent risk factors for ID, while cervical surgery and discectomy were identified as factors that independently protected against ID during posterior open spine surgery for degenerative diseases in adults. Therefore, we identified 2 independent risk factors for and 2 protective factors against ID. These results may contribute to making surgeons aware of the risk factors for ID and can be used to counsel patients on the risks and complications associated with open spine surgery.
[Mh] Termos MeSH primário: Dura-Máter/cirurgia
Complicações Intraoperatórias
Vértebras Lombares/cirurgia
Doenças Neurodegenerativas/cirurgia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188038


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[PMID]:28457176
[Au] Autor:Lenck S; Bresson D; Bernat AL; Saint-Maurice JP; Labeyrie MA; Froelich S; Houdart E
[Ad] Endereço:1 Department of Neuroradiology, Hôpital Lariboisière, Paris, France.
[Ti] Título:3D digital subtracted CT angiography to evaluate the venous anatomy in extra-axial tumors invading the major dural venous sinuses.
[So] Source:Interv Neuroradiol;23(4):346-349, 2017 Aug.
[Is] ISSN:2385-2011
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background Investigation of the venous system surrounding a tumor that is invading a dural sinus is of great use for guiding the surgical excision. Non-invasive imaging is often inadequate since enhancement of the tumor causes it to blend with the contrast of the venous vascular structures. Conventional two-dimensional angiography is also often insufficient. Objective The objective of this study was to report regarding the potential of three-dimensional digital subtracted computed tomography angiography (3D DS-CTA) as a technique to preoperatively explore these tumors. Methods We retrospectively studied the radiological and surgical features of patients explored with 3D DS-CTA for a tumor invading a major dural sinus. Results Three patients were included in this study, one hemangiopericytoma and two meningiomas. 3D DS-CTA allows for accurate assessment of the patency of the sinus, the location of the secondary intra- and trans-osseous venous outlets, and surgical guidance by neuronavigation. Conclusion 3D DS-CTA could be a promising guiding and diagnostic tool for the pre- and intraoperative treatment of vascular tumors invading the dural sinuses, for which the venous morbidity and mortality is substantial.
[Mh] Termos MeSH primário: Neoplasias Encefálicas/irrigação sanguínea
Neoplasias Encefálicas/diagnóstico por imagem
Angiografia Cerebral/métodos
Angiografia por Tomografia Computadorizada/métodos
Cavidades Cranianas/diagnóstico por imagem
Dura-Máter/irrigação sanguínea
Dura-Máter/diagnóstico por imagem
Dura-Máter/crescimento & desenvolvimento
Hemangiopericitoma/irrigação sanguínea
Hemangiopericitoma/diagnóstico por imagem
Neoplasias Meníngeas/irrigação sanguínea
Neoplasias Meníngeas/diagnóstico por imagem
Meningioma/irrigação sanguínea
Meningioma/diagnóstico por imagem
[Mh] Termos MeSH secundário: Angiografia Digital/métodos
Neoplasias Encefálicas/patologia
Meios de Contraste
Cavidades Cranianas/patologia
Dura-Máter/patologia
Feminino
Hemangiopericitoma/patologia
Seres Humanos
Imagem Tridimensional/métodos
Imagem por Ressonância Magnética
Masculino
Neoplasias Meníngeas/patologia
Meningioma/patologia
Invasividade Neoplásica/diagnóstico por imagem
Invasividade Neoplásica/patologia
Flebografia/métodos
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contrast Media)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171204
[Lr] Data última revisão:
171204
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1177/1591019917702522


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[PMID]:28885133
[Au] Autor:Lu VM; Phan K; Crowley SP; Daniels DJ
[Ad] Endereço:Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota; and.
[Ti] Título:The addition of duraplasty to posterior fossa decompression in the surgical treatment of pediatric Chiari malformation Type I: a systematic review and meta-analysis of surgical and performance outcomes.
[So] Source:J Neurosurg Pediatr;20(5):439-449, 2017 Nov.
[Is] ISSN:1933-0715
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE Surgery is the definitive treatment of Chiari malformation Type I (CM-I). It involves posterior fossa decompression, which can be performed along with C-1 laminectomy, reconstructive duraplasty, or tonsil shrinkage. The aim of this study was to provide an updated systematic review and meta-analysis of the latest available evidence regarding posterior fossa decompression only (PFDO) versus posterior fossa decompression with duraplasty (PFDD) in the treatment of CM-I in children. METHODS A literature search was performed in compliance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for article identification, screening, eligibility, and inclusion. Relevant articles were identified from 6 electronic databases from their inception to April 2016. These articles were screened against established criteria for inclusion into this study. RESULTS From 12 relevant studies identified, 1492 pediatric patients treated via PFDD were compared with 1963 pediatric patients treated by PFDO for CM-I. PFDD was associated with greater overall clinical improvement (p = 0.0009), along with longer length of stay (p < 0.0001) and more postoperative complications (p = 0.0001) compared with PFDO. No difference was observed between PFDD and PFDO in terms of revision surgery incidence (p = 0.13), estimated blood loss (p = 0.14), syrinx improvement (p = 0.09), or scoliosis improvement (p = 0.95). CONCLUSIONS It appears that the addition of duraplasty to posterior decompression in the definitive treatment of CM-I in children may alter surgical and performance outcomes. In particular, parameters of overall clinical improvement, length of stay, and postoperative complication may differ between children undergoing PFDD and those undergoing PFDO. Current evidence in the literature is of low to very low quality that, as of yet, has not been able to completely control for inherent selection bias both in study design and surgeon preference. Future, large prospective registries and randomized controlled trials are warranted to validate the findings of this study.
[Mh] Termos MeSH primário: Malformação de Arnold-Chiari/cirurgia
Craniotomia
Descompressão Cirúrgica
Dura-Máter/cirurgia
Crânio/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Criança
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.3171/2017.6.PEDS16367


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[PMID]:28862640
[Au] Autor:Louveau A; Plog BA; Antila S; Alitalo K; Nedergaard M; Kipnis J
[Ad] Endereço:Center for Brain Immunology and Glia, Department of Neuroscience, School of Medicine, University of Virginia, Charlottesville, Virginia, USA.
[Ti] Título:Understanding the functions and relationships of the glymphatic system and meningeal lymphatics.
[So] Source:J Clin Invest;127(9):3210-3219, 2017 Sep 01.
[Is] ISSN:1558-8238
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Recent discoveries of the glymphatic system and of meningeal lymphatic vessels have generated a lot of excitement, along with some degree of skepticism. Here, we summarize the state of the field and point out the gaps of knowledge that should be filled through further research. We discuss the glymphatic system as a system that allows CNS perfusion by the cerebrospinal fluid (CSF) and interstitial fluid (ISF). We also describe the recently characterized meningeal lymphatic vessels and their role in drainage of the brain ISF, CSF, CNS-derived molecules, and immune cells from the CNS and meninges to the peripheral (CNS-draining) lymph nodes. We speculate on the relationship between the two systems and their malfunction that may underlie some neurological diseases. Although much remains to be investigated, these new discoveries have changed our understanding of mechanisms underlying CNS immune privilege and CNS drainage. Future studies should explore the communications between the glymphatic system and meningeal lymphatics in CNS disorders and develop new therapeutic modalities targeting these systems.
[Mh] Termos MeSH primário: Sistema Linfático/fisiologia
Vasos Linfáticos/fisiologia
Meninges/fisiologia
Neuroglia/fisiologia
[Mh] Termos MeSH secundário: Doença de Alzheimer/patologia
Peptídeos beta-Amiloides/metabolismo
Animais
Encéfalo/fisiologia
Sistema Nervoso Central/imunologia
Doenças do Sistema Nervoso Central/patologia
Dura-Máter/metabolismo
Líquido Extracelular
Seres Humanos
Sistema Imunitário
Linfonodos
Sistema Linfático/fisiopatologia
Meninges/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Amyloid beta-Peptides)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170902
[St] Status:MEDLINE


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[PMID]:28844842
[Au] Autor:Tischfield MA; Robson CD; Gilette NM; Chim SM; Sofela FA; DeLisle MM; Gelber A; Barry BJ; MacKinnon S; Dagi LR; Nathans J; Engle EC
[Ad] Endereço:Department of Neurology, Boston Children's Hospital, Boston, MA 02115, USA; FM Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA 02115, USA; Department of Neurology, Harvard Medical School, Boston, MA 02115, USA. Electronic address: max.tischfield@gmail.com.
[Ti] Título:Cerebral Vein Malformations Result from Loss of Twist1 Expression and BMP Signaling from Skull Progenitor Cells and Dura.
[So] Source:Dev Cell;42(5):445-461.e5, 2017 Sep 11.
[Is] ISSN:1878-1551
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Dural cerebral veins (CV) are required for cerebrospinal fluid reabsorption and brain homeostasis, but mechanisms that regulate their growth and remodeling are unknown. We report molecular and cellular processes that regulate dural CV development in mammals and describe venous malformations in humans with craniosynostosis and TWIST1 mutations that are recapitulated in mouse models. Surprisingly, Twist1 is dispensable in endothelial cells but required for specification of osteoprogenitor cells that differentiate into preosteoblasts that produce bone morphogenetic proteins (BMPs). Inactivation of Bmp2 and Bmp4 in preosteoblasts and periosteal dura causes skull and CV malformations, similar to humans harboring TWIST1 mutations. Notably, arterial development appears normal, suggesting that morphogens from the skull and dura establish optimal venous networks independent from arterial influences. Collectively, our work establishes a paradigm whereby CV malformations result from primary or secondary loss of paracrine BMP signaling from preosteoblasts and dura, highlighting unique cellular interactions that influence tissue-specific angiogenesis in mammals.
[Mh] Termos MeSH primário: Proteínas Morfogenéticas Ósseas/metabolismo
Veias Cerebrais/anormalidades
Veias Cerebrais/metabolismo
Proteínas Nucleares/metabolismo
Transdução de Sinais
Crânio/patologia
Células-Tronco/metabolismo
Proteína 1 Relacionada a Twist/metabolismo
[Mh] Termos MeSH secundário: Animais
Diferenciação Celular
Artérias Cerebrais/crescimento & desenvolvimento
Artérias Cerebrais/patologia
Veias Cerebrais/patologia
Suturas Cranianas/patologia
Craniossinostoses/genética
Craniossinostoses/patologia
Dura-Máter/patologia
Feminino
Seres Humanos
Mesoderma/metabolismo
Camundongos
Camundongos Mutantes
Mutação/genética
Crista Neural/patologia
Osteoblastos
Comunicação Parácrina
Seios Transversos/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Morphogenetic Proteins); 0 (Nuclear Proteins); 0 (TWIST1 protein, human); 0 (Twist-Related Protein 1); 136253-27-5 (Twist1 protein, mouse)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170829
[St] Status:MEDLINE


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[PMID]:28723776
[Au] Autor:Huang Y; Chen J; Gui L
[Ad] Endereço:aDepartment of Neurology bDepartment of General Surgery and Center of Minimal Invasive Gastrointestinal Surgery, Southwest Hospital, The Third Military Medical University, Chongqing, China.
[Ti] Título:A case of idiopathic hypertrophic pachymeningitis presenting with chronic headache and multiple cranial nerve palsies: A case report.
[So] Source:Medicine (Baltimore);96(29):e7549, 2017 Jul.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Idiopathic hypertrophic pachymeningitis (IHP) is a rare condition, characterized by a chronic fibrosing inflammatory process usually involving either the intracranial or spinal dura mater, but rarely both. Here, we report a rare case of IHP affecting both the intracranial and spinal dura mater. We also discussed the diagnosis, management, and outcome of IHP. PATIENT CONCERNS: We reviewed the case of a 60-year-old woman presenting with chronic headache, multiple cranial nerve palsies and gait disturbance. Magnetic resonance imaging (MRI) of her head revealed thickened and contrast-enhanced dura in the craniocervical region as well as obstructive hydrocephalus and cerebellar tonsillar herniation. The patient had a suboccipital craniectomy and posterior decompression through C1 plus a total laminectomy. The dura was partially resected to the extent of the bony decompression, and a duroplasty was performed. DIAGNOSES: Microscopic examination of the surgically resected sample showed chronic inflammatory changes, lymphoplasmacytic cell infiltration, fibrous tissue hyperplasia, and hyaline degeneration. Blood tests to evaluate the secondary causes of hypertrophic pachymeningitis (HP) were unremarkable. INTERVENTIONS: Steroid was used to treat suspected IHP. OUTCOMES: Postoperatively, the patient showed gradual improvement in her headache, glossolalia, and bucking. Prior to discharge, a follow-up MRI showed improvement of the dura mater thickening. LESSONS: IHP is a chronic inflammatory disorder of the dura mater that usually causes neurological deficits. Clinical manifestations of IHP, MRI findings, and laboratory abnormalities are the essential components for making an accurate diagnosis. When the radiological or laboratory evaluation is uncertain, but neurological deficits are present, a prompt surgical approach should be considered. Postoperative steroid therapy and close observation for recurrence are necessary to ensure a good long-term outcome.
[Mh] Termos MeSH primário: Doenças dos Nervos Cranianos/complicações
Doenças dos Nervos Cranianos/diagnóstico
Transtornos da Cefaleia/complicações
Transtornos da Cefaleia/diagnóstico
Meningite/complicações
Meningite/diagnóstico
[Mh] Termos MeSH secundário: Encéfalo/diagnóstico por imagem
Doenças dos Nervos Cranianos/patologia
Doenças dos Nervos Cranianos/terapia
Diagnóstico Diferencial
Dura-Máter/diagnóstico por imagem
Dura-Máter/patologia
Dura-Máter/cirurgia
Feminino
Transtornos da Cefaleia/patologia
Transtornos da Cefaleia/terapia
Seres Humanos
Meningite/patologia
Meningite/terapia
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170808
[Lr] Data última revisão:
170808
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007549



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