Rejected

Meningoencephaloceles of the skull base most commonly occur as a sequela of head trauma or they can more rarely be congenital malformations. Several types of encephalocele exist depending on anatomic features and localisation. Clinical presentation and symptoms can vary. Different methods of management and repair of the concurring skull base defects have been described and ranging vary from endoscopic to open surgical approaches. We report the case of a 56-year-old Caucasian woman with the diagnosis of right sided spontaneous transethmoidal meninoencephalocele. Clinical presentation of this rare pathology, methods of diagnostic and management and its outcome are presented. Spontaneous skull base meningoencephaloceles are rare entities, without clear underlying etiologies. Multidisciplinary management is recommended. The transnasal endoscopic approach provides a wide skull base exposure with more advantages and less morbidity in comparison with the conventional open approach.

Coronavirus disease 2019 (COVID-19) represents a novel pneumonia leading to severe acute respiratory syndrome (SARS). Recent studies documented that SARS-Coronavirus2 (SARS-CoV2), responsible for COVID-19, can affect the nervous system. The aim of the present observational study was to prospectively assess subjective neurological symptoms (sNS) in patients with SARS-CoV2 infection.

Chronic spinal pain is prevalent, expensive and long-lasting. Several provider-based nonpharmacologic therapies have now been recommended for chronic low-back pain (CLBP) and chronic neck pain (CNP). However, healthcare and coverage policies provide little guidance or evidence regarding the long-term use of this care. To provide one glimpse into the long-term use of nonpharmacologic provider-based care, this study examines the predictors of visit frequency in a large sample of patients with CLBP and CNP using ongoing chiropractic care.

Schinus terebinthifolia Raddi leaves have been used in folk medicine due to several properties, including antitumor and analgesic effects. The variable efficacy and adverse effects of analgesic drugs have motivated the search for novel antinociceptive agents. It has been reported that the S. terebinthifolia leaf lectin (SteLL) has antitumor activity against sarcoma 180 in mice.

Intrathecal injection is a rare complication of spinal anesthesia and an underreported complication of epidural blood patches. Although there are other reported cases of intrathecal blood injection, these cases lack confirmatory imaging and others report injection of mixed blood with other agents.

Spheno-orbital meningiomas require extensive bone removal around the superior and lateral orbital walls, superior orbital fissure, and anterior middle fossa floor. Incomplete resection can lead to recurrence or growth into the cavernous sinus (CS). This case involved a 46-year-old woman with history of childhood leukemia treated with chemotherapy and whole-body radiation. After presenting to an outside institution in 2004 with headache and vision changes, she underwent subtotal resection for a right spheno-orbital meningioma. As residual tumor growth caused progressive optic neuropathy, she underwent multiple orbital decompressions and fractionated radiation for the tumor. In 2017, she underwent another craniotomy for re-resection. Additional tumor growth causing neuropathic facial pain syndrome and progressive ophthalmoplegia was treated with orbital enucleation. Upon referral to our institution, MRI demonstrated right spheno-orbital and CS meningioma extending into the sella and nearly to the medial border of the contralateral CS. Given her complete ophthalmoplegia and recent orbital enucleation, the patient underwent a revision right frontotemporal craniotomy for radical resection of invasive meningioma including right internal carotid artery occlusion and CS resection. The skull-base defect was repaired with autologous fascia and free muscle flap. Postoperative transient aphasia and left hemiparesis resolved over several days. At 1-month follow-up, she was neurologically intact and had moderate improvement in her facial pain syndrome (preoperative pain score 9/10, postoperative pain score 6/10). MRI demonstrated gross-total resection. Pathological tissue analysis was consistent with a grade 1 meningioma with increased MIB-1 proliferative index, although clinically this tumor behaved more malignantly. The patient provided consent.

Pain is a common symptom, often associated with neurological and musculoskeletal conditions, and experienced especially by females and by older people. The aims of this study are to evaluate the temporal variations of pain rates among general populations for the period 1991-2015 and to project 10-year pain rates.

Hidradenitis Suppurativa is an autoinflammatory disorder of keratinization, with dysregulation of Th17 cytokines. Brodalumab is a monoclonal antibody which targets the IL-17RA receptor.