Centella asiatica effect on traumatic brain injury: A systematic review.

Background: Mortality and morbidity in traumatic brain injury (TBI) cases remain a global problem. Various therapeutic modalities have been researched, including using herbal medicine. Centella asiatica has a lot of potential in neuropharmacology for various diseases. This systematic review aims to comprehensively review the currently available data about the impact of C. asiatica on TBI in a rat model. Methods: Systematic searches were conducted on PubMed, Scopus, and Google Scholar up to July 2023. This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Researchers screened the titles and abstracts of all identified studies and then selected relevant studies through full-text reviews. Studies reported the effect of C. asiatica on animal model of TBI were included in the study. Data were extracted, and the result was reported using descriptive analysis. The risk of bias was evaluated using SYRCLE. Results: Four studies met the inclusion criteria. One study highlighted the potential neuroprotective effects of Asiatic acid, one study explored spade leaf extract phytosome, while the rest used C. asiatica extracts. The primary findings of the included research revealed that C. asiatica might reduce oxidative stress, decrease neuronal apoptosis, have anti-inflammatory properties, alleviate neurological dysfunction, reduce cerebral edema, and boost cognitive performance in the TBI-induced rat's model. Conclusion: This review suggests that C. asiatica had the potential to benefit the TBI-induced rat model in terms of decreasing morbidity. Nevertheless, more studies are needed to perform a meta-analysis and ascertain the effects of C. asiatica on TBI in animal models.

Gross total resection of benign retroperitonealy/intra/paraspinal giant schwannoma.

Background: Schwannoma is a typically benign nerve sheath tumor. Here, a 30-year-old female underwent resection of a benign retroperitoneal/intra/paraspinal schwannoma. Case Description: A 30-year-old female originally had urological surgery to remove an ill-defined retroperitoneal tumor. When she newly presented with right-side low back pain, and the magnetic resonance documented a recurrent/residual L1-L3 intra/paraspinal lesion, she required an additional tumor excision for the removal of the benign schwannoma. Conclusion: Spinal surgeons, dealing with benign schwannomas located in the retroperitoneal/intra/paraspinal compartments, need to work collaboratively with other surgeons (i.e., in this case, urologists) to achieve gross total tumor excision, and the best long-term results.

The role of preoperative hematological inflammatory markers as a predictor of meningioma grade: A systematic review and meta-analysis.

Background: Inflammatory processes play an important role in the aggressiveness of a tumor. However, the relationship between inflammatory markers in meningioma grade is not well known. Knowledge of preoperative meningioma grade plays an important role in the prognosis and treatment of this tumor. This study aims to assess preoperative hematological inflammatory markers as a predictor of the pathological grade of meningioma. Methods: To ensure comprehensive retrieval of relevant studies, we searched the following key databases, PubMed, Science Direct, and Biomed Central, with evidence related to preoperative hematological inflammatory markers among meningioma up to September 2023. The studies involved were selected based on established eligibility criteria. The analysis in this study uses Review Manager 5.4. Results: Six studies were obtained from the search results. The total number of patients 2789 (469 high-grade meningioma and 2320 low-grade meningioma) analysis shows elevated neutrophil-to-lymphocyte ratio (NLR) (mean difference [MD]: 0.29; 95% confidence interval [CI] 0.13-0.45; P = 0.0004), monocyte-to-lymphocyte ratio (MLR) (MD: 0.02; 95% CI 0.00-0.04; P = 0.003), and low lymphocyte-to-monocyte ratio (LMR) (MD: -0.82; 95% CI -1.46--0.18; P = 0.005) significantly associated with high-grade meningioma compared to low-grade meningioma. No significant correlation between high-grade and low-grade meningioma based on platelet-lymphocyte ratio value is observed. Conclusion: The parameters of NLR, MLR, and LMR have been found to be cost-effective preoperative methods that demonstrate potential value in the prediction of meningioma grade. To enhance the reliability of the findings, it is imperative to do further prospective study.

Case of compressive myelopathy due to juvenile xanthogranuloma of cervicothoracic junction in a 28-year-old male.

Background: Juvenile xanthogranuloma (JXG) is a proliferative disorder of non-Langerhans histiocytes. The lesions typically occur in children as solitary cutaneous lesions, but are only rarely found in adults in their late twenties to thirties. Approximately 5-10% of JXG are extracutaneous in location, with spinal JXG being only rarely encountered. Here, we described a 28-year-old male with an extradural spinal JXG resulting in severe C6- T1 spinal cord compression and a progressive quadriparesis that warranted a decompressive laminectomy/C6-T2 fusion. Case Description: A 28-year-old male presented with a progressive quadriparesis of 12 months' duration that rapidly worsened over the last 3 months. When the MRI revealed severe cord epidural C6-T1 cord compression, the patient successfully underwent a C6-T1 laminectomy for gross total tumor excision followed by a C6-T2 instrumented fusion. The histopathology confirmed the diagnosis of a spinal JXG. Conclusion: Spinal JXGs in adults are only rarely encountered and should be treated with gross total tumor excision with/without fusion to achieve the best long-term outcomes.

Extradural malignant peripheral nerve sheath tumor of the thoracic spine: A rare case report.

BACKGROUND: Malignant peripheral nerve sheath tumors (MPNSTs) typically found in the trunk, limbs, head, and neck represent 3-10% of all soft-tissue sarcomas. Although they typically originating from peripheral nerve Schwann cells, 2-3% arise from the spinal nerves and may be found within the spinal canal. Here, we present a 43-year-old male with an extradural thoracic MPNST contributing to marked cord compression and a progressive paraparesis. CASE DESCRIPTION: A 43-year-old male presented with a progressive paraparesis of 16 months' duration. The MRI showed a posterior T2-T4 extradural tumor in the thoracic spine resulting in significant cord compression. Following a T2-T4 laminectomy and gross total excision of the epidural mass, the patient regained modest neurological function. Immunohistochemistry staining supported the diagnosis of thoracic spinal MPNST. CONCLUSION: Rarely, spinal MPNST can be considered amongst the differential diagnoses of an extradural spinal tumor. In this case, gross total excision of a posterior T2-T4 epidural MPNST resulted in improvement in the patient's original paraparesis. Notably, immunohistochemistry staining helped confirm the diagnosis of a MPNST.