Multinodular and Vacuolating Neuronal Tumor of the Cerebrum: A New "Leave Me Alone" Lesion with a Characteristic Imaging Pattern.

Multinodular and vacuolating neuronal tumor of the cerebrum is a recently reported benign, mixed glial neuronal lesion that is included in the 2016 updated World Health Organization classification of brain neoplasms as a unique cytoarchitectural pattern of gangliocytoma. We report 33 cases of presumed multinodular and vacuolating neuronal tumor of the cerebrum that exhibit a remarkably similar pattern of imaging findings consisting of a subcortical cluster of nodular lesions located on the inner surface of an otherwise normal-appearing cortex, principally within the deep cortical ribbon and superficial subcortical white matter, which is hyperintense on FLAIR. Only 4 of our cases are biopsy-proven because most were asymptomatic and incidentally discovered. The remaining were followed for a minimum of 24 months (mean, 3 years) without interval change. We demonstrate that these are benign, nonaggressive lesions that do not require biopsy in asymptomatic patients and behave more like a malformative process than a true neoplasm.

Intraperitoneal anaesthesia with propofol, medetomidine and fentanyl in mice.

Fast recoveries are essential when looking for a safe anaesthetic protocol to use on mice. Propofol is a short-acting anaesthetic agent, which provides a smooth, fast recovery. A recent study carried out in our laboratory showed that the intraperitoneal (i.p.) administration of propofol combined with a fast-acting opioid does not provide a sufficiently stable anaesthesia. In this experiment, we hypothesized that the additional application of medetomidine would increase muscle relaxation and analgesia. Fifty-four male CD1 mice, divided into six groups of five and three groups of eight, were used to test nine different combinations of propofol, medetomidine and fentanyl administered i.p. and reversed with atipamezole 30 min after induction. These combinations were composed in the following manner: propofol 75 mg/kg, medetomidine 1 and 2 mg/kg and fentanyl 0.1, 0.15 and 0.2 mg/kg. The depth of anaesthesia, loss of righting reflex, loss of pedal withdrawal reflex, pulse rate and respiratory rate were recorded along with the duration and quality of the recovery. The combination of propofol and medetomidine provided a predictable induction, hypnosis and muscle relaxation, but surgical anaesthesia (loss of pedal withdrawal reflex) was not achieved. The addition of fentanyl increased analgesia leading to surgical anaesthesia. We concluded that a combination of 75/1/0.2 mg/kg of propofol, medetomidine and fentanyl, respectively, is a safe, easy and reversible technique for i.p. anaesthesia in mice, providing a surgical window of 15 min and restraint for 30 min with a fast recovery.

Intraperitoneal propofol and propofol fentanyl, sufentanil and remifentanil combinations for mouse anaesthesia.

The combination of propofol and a rapid-acting opioid, such as fentanyl, sufentanil or remifentanil, is a relatively safe, total intravenous anaesthesia technique, commonly used in humans and which has been investigated in laboratory animals. The objective of this study was to evaluate these combinations for anaesthesia of mice by the intraperitoneal (i.p.) route. Sixty-seven mice, divided into groups of four, were used to test 28 combinations of propofol alone and propofol with fentanyl, sufentanil or remifentanil administered i.p. The dose ranges of drugs studied were propofol 50-200 mg/kg, fentanyl 0.2-0.4 mg/kg, sufentanil 0.05-0.1 mg/kg and remifentanil 0.2-1.0 mg/kg. The loss of righting reflex (RR) and the loss of pedal withdrawal reflex (PWR) were recorded along with the duration and quality of recovery. The results obtained in these studies were unpredictable. The same dose combinations of propofol and opioids were associated with different responses in different individuals. Higher doses did not induce loss of RR and PWR in all animals and were associated with high mortality rates. An adequate hypnotic level was only observed with higher doses of propofol. The synergistic effect of propofol and the opioids was not sufficient to allow surgical procedures. Animals that reached PWR loss showed tail rigidity, shaking limbs and scratched their heads with their forefeet. Higher opioid doses induced respiratory depression and higher death rates. The inconsistency between and within groups may be associated with the i.p. route. The results reported here show that the i.p. route is not appropriate for mouse anaesthesia using propofol alone or in combination with fentanyl, sufentanil or remifentanil.