Deformation of a Titanium Calvarial Implant following Trauma: A Case Report

Alloplastic material is widely used for the reconstruction of calvarial defects. The objective of this article is to describe the effect of mechanical impact on a titanium calvarial implant and to discuss mechanical properties of alternative implant materials. The patient is a 19-year-old man who was involved in a traffic accident and underwent decompressive craniectomy for an extensive subdural hematoma. Reimplantation of the skull flap was complicated by infection and the flap had to be removed. The remaining cranial defect was closed with a titanium plate. The recovery was without complications. One year later, the patient was hit on the titanium plate, during a soccer match, by the elbow of a fellow player. The implant deflected inward, leaving a visible indentation of the cranial vault. Fortunately, there were no significant neurological symptoms and radiography did not show any signs of damage or pressure on the brain parenchyma. The patient had no aesthetic complaints regarding the shape. Thus, there was no indication to remove the plate. This case illustrates the limits of the protection offered by titanium cranioplasty.

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Recurrent Malignant Fibrous Histiocytoma in the Left Parietal Region of Cranium: A Case Report

TAJ Journal of Teachers Association ◽

10.3329/taj.v17i1.3492 ◽

1970 ◽

Vol 17 (1) ◽

pp. 55-56

Author(s):

ML Rahman ◽

ASM Shawkat Ali

Keyword(s):

Malignant Fibrous Histiocytoma ◽

Fibrous Histiocytoma ◽

Brain Parenchyma ◽

Parietal Region ◽

Skull Bone ◽

Previous Surgery ◽

History Of ◽

One Year ◽

The Brain ◽

Space Occupying Lesion

A male of 20 years of age presented with features of intracranial space occupying lesion of cranium involving the brain. He came with the history of previous surgery in the head one-year back. On operation, an osteolytic growth from the skull bone invading the meninges and brain parenchyma. Who found Histopathological report revealed malignant fibrous histiocytoma. doi: 10.3329/taj.v17i1.3492 TAJ 2004; 17(1) : 55-56

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Intraparenchymal Supratentorial Neurenteric Cyst

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100003553 ◽

2004 ◽

Vol 31 (3) ◽

pp. 412-416 ◽

Cited By ~ 23

Author(s):

Edward Kachur ◽

Lee-Cyn Ang ◽

Joseph F. Megyesi

Keyword(s):

Cystic Lesion ◽

Brain Parenchyma ◽

Neurenteric Cyst ◽

Complete Excision ◽

First Case ◽

History Of ◽

The Central Nervous System ◽

One Year ◽

The Right ◽

The Brain

Background:Neurenteric cysts are congenital cysts of the central nervous system that are believed to be of endodermal origin. In this report we present the unique case of a supratentorial neurenteric cyst that is contained entirely within the brain parenchyma.Methods:Apatient presented with an intraparenchymal cystic lesion that was subsequently identified as a neurenteric cyst. This lesion is reviewed in light of the available literature.Case report:A 35-year-old female presented with a one year history of progressive headaches and seizure-like episodes. Her examination revealed no deficits. Magnetic resonance imaging showed a 4 cm x 4 cm x 4 cm cystic lesion within the parenchyma of the right frontal lobe. A right frontal craniotomy and complete excision of the cystic lesion was performed. Pathologic examination confirmed that it was a neurenteric cyst. Postoperatively the patient's symptoms improved.Conclusion:Review of the literature revealed this to be the first case of a surgically excised, pathologically confirmed supratentorial neurenteric cyst, contained entirely within the brain parenchyma.

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Single-Stage Craniectomy and Cranioplasty for Multilobular Osteochondrosarcoma Managed with a Custom Additive Manufactured Titanium Plate in a Dog

Case Reports in Veterinary Medicine ◽

10.1155/2019/6383591 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Galina M. Hayes ◽

Elena A. Demeter ◽

Eunju Choi ◽

Michelle Oblak

Keyword(s):

Brain Parenchyma ◽

Anatomic Reconstruction ◽

Patient Specific ◽

Intracranial Extension ◽

Post Mortem ◽

Titanium Plate ◽

Large Area ◽

Intractable Seizures ◽

Deep Margin ◽

The Brain

A 9-year-old spayed female dachshund presented with a large multilobular osteochondrosarcoma of the crania, with obliteration of approximately 70% of the surface area of the dorsal calvaria and intracranial extension. The mass was excised with histologically clean lateral bone margins (2–4 mm) and invasion at the deep margin. The resulting defect was reconstructed with a custom titanium plate. The patient recovered routinely and was asymptomatic until 7 months postoperatively. The patient developed intractable seizures 7 months postoperatively and was euthanized. Post-mortem examination showed tumor regrowth within the brain parenchyma. No abnormalities were seen associated with the plate. The patient-specific, custom additive manufactured titanium plate provided an excellent option for anatomic reconstruction and protection of the brain over a relatively large area with no complications noted.

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Macrophages and microglia: the cerberus of glioblastoma

Acta Neuropathologica Communications ◽

10.1186/s40478-021-01156-z ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Alice Buonfiglioli ◽

Dolores Hambardzumyan

Keyword(s):

Tumor Cells ◽

Innate Immune System ◽

Tumor Heterogeneity ◽

Expression Profiles ◽

Brain Parenchyma ◽

Innate Immune ◽

Malignant Growth ◽

Neoplastic Cells ◽

Functional Roles ◽

The Brain

AbstractGlioblastoma (GBM) is the most aggressive and deadliest of the primary brain tumors, characterized by malignant growth, invasion into the brain parenchyma, and resistance to therapy. GBM is a heterogeneous disease characterized by high degrees of both inter- and intra-tumor heterogeneity. Another layer of complexity arises from the unique brain microenvironment in which GBM develops and grows. The GBM microenvironment consists of neoplastic and non-neoplastic cells. The most abundant non-neoplastic cells are those of the innate immune system, called tumor-associated macrophages (TAMs). TAMs constitute up to 40% of the tumor mass and consist of both brain-resident microglia and bone marrow-derived myeloid cells from the periphery. Although genetically stable, TAMs can change their expression profiles based upon the signals that they receive from tumor cells; therefore, heterogeneity in GBM creates heterogeneity in TAMs. By interacting with tumor cells and with the other non-neoplastic cells in the tumor microenvironment, TAMs promote tumor progression. Here, we review the origin, heterogeneity, and functional roles of TAMs. In addition, we discuss the prospects of therapeutically targeting TAMs alone or in combination with standard or newly-emerging GBM targeting therapies.

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Practical application of synthetic head models in real ballistic cases

International Journal of Legal Medicine ◽

10.1007/s00414-021-02671-3 ◽

2021 ◽

Author(s):

F. Riva ◽

T. Fracasso ◽

A. Guerra ◽

P. Genet

Keyword(s):

Soft Tissues ◽

Spherical Model ◽

Brain Parenchyma ◽

Human Bone ◽

Shape Model ◽

The Difference ◽

Open Shape ◽

The Brain ◽

Synthetic Models ◽

Representative Material

AbstractIn shooting crimes, ballistics tests are often recommended in order to reproduce the wound characteristics of the involved persons. For this purpose, several “simulants” can be used. However, despite the efforts in the research of “surrogates” in the field of forensic ballistic, the development of synthetic models needs still to be improved through a validation process based on specific real caseworks. This study has been triggered by the findings observed during the autopsy performed on two victims killed in the same shooting incident, with similar wounding characteristics; namely two retained head shots with ricochet against the interior wall of the skull; both projectiles have been recovered during the autopsies after migration in the brain parenchyma. The thickness of the different tissues and structures along the bullets trajectories as well as the incident angles between the bullets paths and the skull walls have been measured and reproduced during the assemblage of the synthetic head models. Two different types of models (“open shape” and “spherical”) have been assembled using leather, polyurethane and gelatine to simulate respectively skin, bone and soft tissues. Six shots have been performed in total. The results of the models have been compared to the findings of post-mortem computed tomography (PMCT) and the autopsy findings.Out of the six shots, two perforated the models and four were retained. When the projectile was retained, the use of both models allowed reproducing the wounds characteristics observed on both victims in terms of penetration and ricochet behaviour. However, the projectiles recovered from the models showed less deformation than the bullets collected during the autopsies. The “open shape” model allowed a better controlling on the shooting parameters than the “spherical” model. Finally, the difference in bullet deformation could be caused by the choice of the bone simulant, which might under-represent either the strength or the density of the human bone. In our opinion, it would be worth to develop a new, more representative material for ballistic which simulates the human bone.

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Primary Cranial Vault Lymphoma Extending between Subcutaneous Tissue and Brain Parenchyma without Skull Destruction after Mild Head Trauma: A Case Report and Literature Review

Case Reports in Oncology ◽

10.1159/000516272 ◽

2021 ◽

pp. 1118-1123

Author(s):

Kengo Setta ◽

Takaaki Beppu ◽

Yuichi Sato ◽

Hiroaki Saura ◽

Junichi Nomura ◽

...

Keyword(s):

Tumor Cells ◽

Head Trauma ◽

Dura Mater ◽

Subcutaneous Tissue ◽

Bone Destruction ◽

B Cell Lymphoma ◽

Brain Parenchyma ◽

Skin Tumor ◽

Cranial Vault ◽

The Brain

Malignant lymphoma of the head rarely arises outside of the brain parenchyma as primary cranial vault lymphoma (PCVL). A case of PCVL that invaded from subcutaneous tissue into the brain, passing through the skull, and occurred after mild head trauma is reported along with a review of the literature. The patient was a 75-year-old man with decreased activity. One month before his visit to our hospital, he bruised the left frontal area of his head. Magnetic resonance imaging showed homogeneously enhanced tumors with contrast media in the subcutaneous tissue corresponding to the head impact area and the cerebral parenchyma, but no obvious abnormal findings in the skull. A biopsy with craniotomy was performed under general anesthesia. The pathological diagnosis was diffuse large B-cell lymphoma. On histological examination, tumor cells grew aggressively under the skin. Tumor cells invaded along the emissary vein into the external table without remarkable bone destruction and extended across the skull through the Haversian canals in the diploe. Tumor cells were found only at the perivascular areas in the dura mater and extended into the brain parenchyma. Considering the history of head trauma and the neuroimaging and histological findings, the PCVL in the present case arose primarily under the skin, passed though the skull and dura mater, and invaded along vessels and reached the brain.

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Microglial Function and Regulation during Development, Homeostasis and Alzheimer’s Disease

Cells ◽

10.3390/cells10040957 ◽

2021 ◽

Vol 10 (4) ◽

pp. 957

Author(s):

Brad T. Casali ◽

Erin G. Reed-Geaghan

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Immune Cells ◽

Expression Patterns ◽

Brain Parenchyma ◽

Primary Role ◽

And Function ◽

Inflammatory Milieu ◽

The Brain ◽

Homeostatic State

Microglia are the resident immune cells of the brain, deriving from yolk sac progenitors that populate the brain parenchyma during development. During development and homeostasis, microglia play critical roles in synaptogenesis and synaptic plasticity, in addition to their primary role as immune sentinels. In aging and neurodegenerative diseases generally, and Alzheimer’s disease (AD) specifically, microglial function is altered in ways that significantly diverge from their homeostatic state, inducing a more detrimental inflammatory environment. In this review, we discuss the receptors, signaling, regulation and gene expression patterns of microglia that mediate their phenotype and function contributing to the inflammatory milieu of the AD brain, as well as strategies that target microglia to ameliorate the onset, progression and symptoms of AD.

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CTNI-03. IMAGING FEATURES OF LEPTOMENINGEAL METASTASES OF NON-SMALL CELL LUNG CANCER: A SINGLE-CENTER REAL-WORLD STUDY

Neuro-Oncology ◽

10.1093/neuonc/noaa215.170 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii41-ii41

Author(s):

Junjie Zhen ◽

Lei Wen ◽

Shaoqun Li ◽

Mingyao Lai ◽

Changguo Shan ◽

...

Keyword(s):

Spinal Cord ◽

Type A ◽

Brain Parenchyma ◽

Imaging Features ◽

Type B ◽

Type D ◽

Mri Examination ◽

Mri Features ◽

Brain And Spinal Cord ◽

The Brain

Abstract BACKGROUND According to EANO-ESMO clinical practice guidelines, the MRI findings of LM are divided into 4 types, namely linear enhancement (type A), nodular enhancement (type B), linear combined with nodular enhancement (type C), and sign of hydrocephalus (type D). METHODS The MRI features of brain and spinal cord in patients diagnosed with NSCLC-LM in Guangdong Sanjiu Brain Hospital from 2010 until 2019 were investigated, and then were classified into 4 types. The imaging features were analyzed. RESULTS A total of 80 patients were enrolled in the study. The median age of the patients was 53.5 years old, and the median time from the initial diagnosis to the confirmed diagnosis of LM was 11.6 months. The results of enhanced MRI examination of the brain in 79 cases showed that the number of cases with enhancements of type A, B, C and D were 50 (63.3%), 0, 26 (32.9%) and 3 (3.8%), respectively, and that LM with metastases to the brain parenchyma was found in 42 cases (53.2%). The results of enhanced MRI examination of spinal cord in 59 cases showed that there were only enhancements of type A and C in 40 cases (67.8%) and 3 cases (5.0%), and no enhancement sign in the other 16 cases (27.2%). CONCLUSION MRI examination of brain and spinal cord will improve the detection rate of LM. The MRI features of NSCLC-LM in real world are mainly characterized by the linear enhancements of brain and spinal cord, followed by linear combined with nodular enhancement. The enhancements of type B and type D are rare in clinic. Almost half of the patients have LM and metastases to the brain parenchyma. Therefore, the differentiation of tumor metastases is needed to be paid attention to for the early diagnosis and the formulation of reasonable treatment plans.

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The topography, structure and incidence of mineralized bodies in the basal ganglia of the brain of cynomolgus monkeys (Macaca fascicularis)

Laboratory Animals ◽

10.1258/002367795781088360 ◽

1995 ◽

Vol 29 (3) ◽

pp. 276-281 ◽

Cited By ~ 8

Author(s):

P. F. Wadsworth ◽

H. B. Jones ◽

J. B. Cavanagh

Keyword(s):

Basal Ganglia ◽

Natural Occurrence ◽

Optic Chiasma ◽

Cynomolgus Monkeys ◽

Small Vessels ◽

Mammillary Bodies ◽

Naturally Occurring ◽

Toxicological Studies ◽

One Year ◽

The Brain

Whole coronal slices from 6 levels of the brain of 16 cynomolgus monkeys (8 control and 8 treated by daily gavage with a novel pharmaceutical agent for one year) were examined histologically. Mineralized bodies were identified only in coronal sections passing through the optic chiasma and mammillary bodies. Identical mineralized structures were present in the basal ganglia of both control and treated animals. The majority were seen in the globus pallidus, occasionally in the putamen and once in the nearby caudate nucleus. These structures were partially ferruginated and also partially calcified. They appeared to arise in relation to small vessels. They are part of the naturally occurring background pathology of several species of non-human primates and the incidence in this study (3/8 control and 5/8 treated) was approximately what might be expected from reports in the literature. Mineralized bodies of the basal ganglia of primates represent a spontaneous lesion with a characteristic distribution. They may cause confusion in interpretation of toxicological studies if their natural occurrence is not appreciated.

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