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Background: Evaluating the differential impact of vagus nerve stimulation (VNS) therapy across various seizure types, our study explores its efficacy specifically in patients with categorized minor and major seizures. Methods: We conducted a retrospective cohort study involving 76 patients with pharmacoresistant epilepsy treated at the University Emergency Hospital of Bucharest between 2021 and 2024. Seizures were classified as 'minor' (including focal-aware and non-motor/absence seizures) and 'major' (including focal to bilateral tonic-clonic and generalized motor seizures), based on modified International League Against Epilepsy (ILAE) criteria. This classification allowed us to assess the response to VNS therapy, defined by a 50% or greater reduction in seizure frequency at the 12-month follow-up. Results: Our findings reveal that major seizures respond more favorably to VNS therapy, significantly reducing both frequency and intensity. In contrast, minor seizures showed a less pronounced response in frequency reduction but noted improvements in neurocognitive functions, suggesting a nuanced benefit of VNS in these cases. Conclusion: The study underscores the importance of seizure type in determining the efficacy of VNS therapy, advocating for personalized treatment approaches based on seizure classification. This approach could potentially enhance clinical outcomes by tailoring VNS settings to specific seizure types, improving overall management strategies in pharmacoresistant epilepsy. [ABSTRACT FROM AUTHOR]

Introduction: Hereditary multiple exostosis or hereditary multiple osteochondromas is a very rare clinical condition. Usually, these lesions tend to occur in the pediatric population, remaining silent until adulthood. Moreover, current studies show a small prevalence in the male population. The osteochondromas usually occur at sites with great bone activity and turnover, such as the diaphysis or metaphyseal plates (especially in children) of long bones. Their appearance in short bones (such as vertebrae) is very rare. Case presentation: We present a case of familial HME in a 53-year-old female patient with a very uncommon clinical description of the disease. The patient presented at our hospital with Frankel D-type paraparesis, with multiple osteochondromas (located at the right humerus, bilateral femurs, right tibia, and hip joints, besides the numerous ones over the spinal column) and urinary incontinence. She was suffering from bilateral coxarthrosis and gonarthrosis, which limited severely the range of her movements. An early menopause status was brought into consideration by the patient, being installed circa 15 years before, at 38 years old. She was currently in treatment with bisphosphonates for her concomitant osteoporosis. Conclusions: Despite the relatively rare nature of the disease, it may be an important concern for the patient's quality of life. Intraspinal processes may trigger paraparesis or other neurological statuses, which may require a surgical treatment. The nature of the lesions is usually benign and do not require further radio- or chemotherapy. [ABSTRACT FROM AUTHOR]

Lumbar disc hernia represents one of the most frequent neurosurgical pathologies, consisting of a posterior migration of the nucleus pulposus which protrudes through the surrounding protective connective tissue. The patient usually exhibits leg pain, paraesthesia or a variable degree of discomfort at the lower extremities, those clinical characteristics are correlated to the extent of nucleos pulposus protrusion. Regarding neuroimaging diagnosis, the gold standard of evaluation is Magnetic resonance imaging in different sequences which highlights a precise topography of the herniated disc. Currently, in a well-digitalized era, machine learning and deep learning algorithms are used to assess the sensibility of detecting a lumbar disc hernia, with promising results. In those cases requiring surgical intervention, besides the open lumbar microdiscectomy, a less invasive surgical approach regularly used in the medical practice is endoscopic lumbar discectomy, being limited to cases where a wide intraoperative perspective is not necessary. In the actual neurosurgical management, postoperative complications following lumbar disc hernia surgery are rare and accessible to manage. [ABSTRACT FROM AUTHOR]

This article explores the history and significance of the discovery of DNA's molecular structure by James D. Watson and Francis H. C. Crick in 1953. It emphasizes the importance of DNA replication, its specificity as genetic material, its informative capability, and its adaptability for mutation. The contributions of other scientists, such as Rosalind E. Franklin, Maurice H. F. Wilkins, and Edward Zacharias, are also acknowledged. The article concludes by discussing the impact of DNA discovery on various fields, including medicine and the fight against the COVID-19 pandemic. Additionally, it mentions earlier research by Hermann J. Muller, Theophilus S. Painter, and Theodosius G. Dobzhansky that provided evidence for the chromosome theory of inheritance and the discovery that DNA, rather than proteins, contains genetic material composed of nucleic acid. The discovery of DNA has revolutionized our understanding of genetics and has the potential to improve diagnosis, treatment strategies, and personalized approaches to diseases such as Alzheimer's and Parkinson's. [Extracted from the article]

This study conducts an in-depth analysis of the management of a complex arteriovenous malformation (AVM) in a 44-year-old individual, who initially manifested with acute left hemiparesis and progressively declined into a comatose state. Diagnostic neuroimaging identified a substantial right fronto-temporal intraparenchymal hematoma via a CT scan. Cerebral angiography further elucidated a choroidal AVM originating from the anterior choroidal artery, accompanied by intranidal aneurysms. The elected treatment strategy was the surgical excision of the AVM. The procedure achieved complete removal of the intracranial AVM, situated in a neurologically sensitive region, leading to notable neurological recovery. This study thoroughly explores and critically evaluates a wide spectrum of treatment approaches for intracranial arteriovenous malformations, including novel endovascular therapies. Despite extensive discourse on AVM in contemporary literature, this report is among the few documenting the treatment of a choroidal AVM via a microsurgical technique, and highlights various therapeutic options. [ABSTRACT FROM AUTHOR]

This review presents a comprehensive analysis of pituitary adenomas, a type of brain tumor with diverse behaviors and complexities. We cover various treatment approaches, including surgery, radiotherapy, chemotherapy, and their integration with newer treatments. Key to the discussion is the role of biomarkers in oncology for risk assessment, diagnosis, prognosis, and the monitoring of pituitary adenomas. We highlight advances in genomic, epigenomic, and transcriptomic analyses and their contributions to understanding the pathogenesis and molecular pathology of these tumors. Special attention is given to the molecular mechanisms, including the impact of epigenetic factors like histone modifications, DNA methylation, and transcriptomic changes on different subtypes of pituitary adenomas. The importance of the tumor immune microenvironment in tumor behavior and treatment response is thoroughly analyzed. We highlight potential breakthroughs and innovations for a more effective management and treatment of pituitary adenomas, while shedding light on the ongoing need for research and development in this field to translate scientific knowledge into clinical advancements, aiming to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Chiari Malformation and Syringomyelia are neurosurgical entities that have been the subject of extensive research and clinical interest. Globally prevalent, these disorders vary demographically and have witnessed evolving temporal trends. Chiari Malformation impacts the normal cerebrospinal fluid flow, consequently affecting overall health. Key observations from canine studies offer pivotal insights into the pathogenesis of Syringomyelia and its extrapolation to human manifestations. Genetics plays a pivotal role; contemporary knowledge identifies specific genes, illuminating avenues for future exploration. Clinically, these disorders present distinct phenotypes. Diagnostically, while traditional methods have stood the test of time, innovative neurophysiological techniques are revolutionizing early detection and management. Neuroradiology, a cornerstone in diagnosis, follows defined criteria. Advanced imaging techniques are amplifying diagnostic precision. In therapeutic realms, surgery remains primary. For Chiari 1 Malformation, surgical outcomes vary based on the presence of Syringomyelia. Isolated Syringomyelia demands a unique surgical approach, the effectiveness of which is continually being optimized. Post-operative long-term prognosis and quality of life measures are crucial in assessing intervention success. In conclusion, this review amalgamates existing knowledge, paving the way for future research and enhanced clinical strategies in the management of Chiari Malformation and Syringomyelia. [ABSTRACT FROM AUTHOR]

This review delves into neuroimmunology, focusing on its relevance to multiple sclerosis (MS) and potential treatment advancements. Neuroimmunology explores the intricate relationship between the immune system and the central nervous system (CNS). Understanding these mechanisms is vital for grasping the pathophysiology of diseases like MS and for devising innovative treatments. This review introduces foundational neuroimmunology concepts, emphasizing the role of immune cells, cytokines, and blood–brain barrier in CNS stability. It highlights how their dysregulation can contribute to MS and discusses genetic and environmental factors influencing MS susceptibility. Cutting-edge research methods, from omics techniques to advanced imaging, have revolutionized our understanding of MS, offering valuable diagnostic and prognostic tools. This review also touches on the intriguing gut–brain axis, examining how gut microbiota impacts neuroimmunological processes and its potential therapeutic implications. Current MS treatments, from immunomodulatory drugs to disease-modifying therapies, are discussed alongside promising experimental approaches. The potential of personalized medicine, cell-based treatments, and gene therapy in MS management is also explored. In conclusion, this review underscores neuroimmunology's significance in MS research, suggesting that a deeper understanding could pave the way for more tailored and effective treatments for MS and similar conditions. Continued research and collaboration in neuroimmunology are essential for enhancing patient outcomes. [ABSTRACT FROM AUTHOR]

Electrical Status Epilepticus during Sleep (ESES) is an uncommon epileptic encephalopathy typically seen in children. It features pronounced epileptiform activity during non-REM sleep stages and is linked with behavioral and cognitive impairments. This article introduces a novel method for managing patients with ESES. [ABSTRACT FROM AUTHOR]

Introduction. The important development of the Private Healthcare System in Romania is on a significantly ascending pathway, with more specialties being included in the private sector, highly trained professionals and the most adequate technology being used. Neurosurgery is still an unavailable specialty in many private medical centers in Romania, due to sophisticated logistics management and expensive costs. At this moment, there are 6 private hospitals which provides neurosurgical treatments for inpatients and outpatients, with special management for pediatric patients in the case where neuroanesthesia and others connected specialties had to adopt to the age specificities. Materials and Methods. We conducted a retrospective, observational study on the patients operated in the Neurosurgical Department of Sanador Medical Center in a period of 10 years. The database was analyzed using Microsoft Office Excel, version 2019. Results. The pediatric patients operated between 2012-2021 were included in the study. From 570 children admitted in our department, only 173 were operated. The male to female ratio was 1.4:1 and the sex distribution included all ages, between 0-18 years old, with a median age of 11 years old. Our study cohort included multiple neurosurgical pathologies, 149 children (86.2%) were operated for cranial pathologies including tumor processes, vascular pathologies and even traumatic brain injuries, while 24 children (13.8%) were operated for spinal pathologies such as cervical and lumbar hernia, vertebral tumors, disrafic anomalies and spinal traumatology. Conclusions. Postoperative results in a Neurosurgical Department depend on an organic cohesion of investigation departments and surgical teams, the aim of any Healthcare Center should be reaching the level of an Excellence Center. Especially in the private medical sector, there are no limitations of what is possible operatory with nowadays investigations and technology. [ABSTRACT FROM AUTHOR]

This article provides a comprehensive review of the role of functional magnetic resonance imaging (fMRI) in characterizing neural plasticity in glioblastoma patients. Glioblastoma, the most common primary brain tumor, has a rapid growth rate and infiltrative nature that leads to the disorganization of the normal brain network. Neuroplasticity, still not fully understood, is the foundation for the development of brain functions during the growth and recovery of certain brain functions after a brain lesion such as a tumor, trauma, or vascular event. Functional MRI has the capacity to identify the regions that activate at rest or when performing a task. It can determine the extent to which these regions, responsible for a specific function, are impacted by a tumor and eventually after surgical excision. Likewise, it can help evaluate to which extent activation changes when recovery of function occurs. In this article, we aimed to understand the significance of fMRI in the management of glioblastoma by analyzing representative articles from the literature. [ABSTRACT FROM AUTHOR]

Introduction: Intracranial aneurysms consist in abnormal dilatation of the cerebral arteries, most frequently asymptomatic, with symptoms appearing in the case of aneurysm rupture. From an imaging point of view, a cranial CT scan shows the subarachnoid haemorrhage caused by aneurysm rupture and the "gold standard" for aneurysm diagnosis is cerebral angiography. Case presentation: A 49 years-old female, Ukrainian refugee, presented with a unique comitial crisis and chronic headache. Following an MRI performed in Kiev, it was decided to perform a bilateral carotid and vertebral angiography in our clinic. Clinical and imagistic results showed a giant left middle cerebral artery aneurysm. Postoperative, the patient had a favourable neurological recovery, with no neurological deficits. Additionally, control angiography and CT scan highlight complete occlusion of the aneurysm and no complications. Conclusions: Cerebral aneurysms represent a high-risk vascular condition that needs a CT scan and angiography to be precisely diagnosed, surgical clipping should be performed as soon as possible. [ABSTRACT FROM AUTHOR]