Evaluation of non-typical diffuse axonal injury by magnetic resonance techniques

Because diffuse axonal injury（DAI）lacks specific clinical manifestations,it is difficult to evaluate DAI using computer tomography or conventional magnetic resonance imaging（MRI）.This study investigated the value of magnetic resonance techniques using fluid-attenuated inversion recovery（FLAIR）and proton magnetic resonance spectroscopy（1HMRS）for diagnosing DAI.The corpus callosum and basal nuclei were analyzed using morphological and functional imaging.Similar to the DAI group,the non-typical DAI group exhibited similar lesion characteristics on FLAIR,as well as post-injury neurochemical and molecular changes in the corpus callosum,as detected by 1HMRS.However,there were differences in degree and severity of injury.Compared to conventional MRI,FLAIR significantly increased lesion detection.1HMRS determined biochemical metabolism changes in midline structures following DAI,which resulted in increased diagnosis of non-typical DAI,which displayed similar lesion distribution,morphology,and function as DAI.Thus,the experiment proved the value of FLAIR and 1HMRS in non-typical DAI.

The potential mechanism and clinical application value of remote ischemic conditioning in stroke

Some studies have confirmed the neuroprotective effect of remote ischemic conditioning against stroke. Although numerous animal researches have shown that the neuroprotective effect of remote ischemic conditioning may be related to neuroinflammation, cellular immunity, apoptosis, and autophagy, the exact underlying molecular mechanisms are unclear. This review summarizes the current status of different types of remote ischemic conditioning methods in animal and clinical studies and analyzes their commonalities and differences in neuroprotective mechanisms and signaling pathways. Remote ischemic conditioning has emerged as a potential therapeutic approach for improving stroke-induced brain injury owing to its simplicity, non-invasiveness, safety, and patient tolerability. Different forms of remote ischemic conditioning exhibit distinct intervention patterns, timing, and application range. Mechanistically, remote ischemic conditioning can exert neuroprotective effects by activating the Notch1/phosphatidylinositol 3-kinase/Akt signaling pathway, improving cerebral perfusion, suppressing neuroinflammation, inhibiting cell apoptosis, activating autophagy, and promoting neural regeneration. While remote ischemic conditioning has shown potential in improving stroke outcomes, its full clinical translation has not yet been achieved.

Intravascular embolization versus surgical resection for patients with scalp arteriovenous fistula

Background:Scalp arteriovenous fistula(sAVF)is a rare vascular disease;so far,the standard guidelines for the treatment of sAVF are still unclear.Since its complex vascular anatomical structure,surgical management of sAVF remains an enormous challenge.Methods:Between March 2016 and October 2017,three patients with sAVF admitted to the First Affiliated Hospital of Chongqing Medical University were reviewed,and clinical characteristics,imaging features,and surgical outcomes were analyzed.Results:Three consecutive patients with sAVF were admitted to our hospital during the study period.Two patients received intravascular embolization and one patient received surgical resection.No procedure-related complications occurred after successfully treatment.During the long-term follow-up period,three patients recovered well and had no recurrence of lesion.Conclusions:Either intravascular embolization or surgical resection is an effective therapy method for sAVF.Careful identification of angioarchitecture features contributes to successful treatment for the complex sAVF;therefore,it is recommended that neurosurgeons make the best treatment plan based on the location and number of the fistulas,feeding the artery,and draining the vein.

PTEN and AKT/GSK-3β/CRMP-2 signaling pathway are involved in neuronal apoptosis and axonal injury in early brain injury after SAH in rats

In early brain injury(EBI)after subarachnoid hemorrhage(SAH),white matter(WM)axonal injury plays a key role in the prognosis of the disease.The purpose of this study was to investigate the effects of phosphatase and tensin homolog deleted on chromosome ten(PTEN)on axonal injury and neuronal apoptosis post-SAH in rats and to find its underlying mechanism.Adeno-associated virus was injected into the lateral ventricle to suppress or promote PTEN.Neural function post-SAH in animals was determined by the modified Garcia score,beam balance,and Rotarod test,and the blood–brain barrier disruption was assessed by the brain water content.Axonal injury post-SAH was observed by TEM and determined by IF,and neuron apoptosis was measured by TUNEL staining.The mechanism was analyzed by Western blot to detect p-PTEN/PTEN,p-AKT/AKT,p-GSK-3β/GSK-3β,p-CRMP-2/CRMP-2,axonal injury markerβ-APP and pro-and anti-apoptosis proteins,including Bax and Bcl-2,expression.We found 1.After knocking down PTEN,neuronal apoptosis and axonal injury were alleviated,and nerve function and blood–brain barrier were protected;accordingly,after overexpression of PTEN,neuronal apoptosis and axon damage were aggravated,and nerve function damage and blood–brain barrier damage were increased.2.PTEN and AKT/GSK-3β/CRMP-2 pathway were jointly involved in regulating neuronal apoptosis and WM axon injury after SAH.According to our research,PTEN was a negative factor of EBI,and together with the AKT/GSK-3β/CRMP-2 signaling pathway aggravates neuronal apoptosis and WM axon damage after SAH.Inhibition of PTEN expression may become a new target for SAH treatment.