BACKGROUND:Cerebral cavernous malformations (CCMs) are benign vascular lesions most commonly found within the brain parenchyma. Extra-axial and dural-based cavernomas are exceedingly rare, and cystic variants are even less frequently described. Their radiological appearance may mimic more common extra-axial lesions, posing a potential diagnostic challenge. We report a unique case of a dural-based cavernoma presenting as a giant extra-axial cyst with recurrent haemorrhage rhage, and we review the relevant literature. CASE DESCRIPTION:A 30-year-old woman was followed for a decade for a large left fronto-temporal extra-axial cyst, initially discovered incidentally. Serial MRI scans demonstrated a slowly enlarging cyst with high T2/FLAIR signal, low-intermediate T1 signal, and mild peripheral enhancement. Later follow-up imaging revealed an interval haemorrhage rhage within the cyst. She subsequently presented with a transient episode of dysphasia and right-hand numbness. CT confirmed acute bleeding into and around the cyst with mild mass effect. She soon underwent an elective fronto-temporal craniotomy. Intraoperatively, a thick-walled cyst with multiple septations was evacuated, and a dural-based vascular lesion near the temporal base was excised. Histopathology confirmed a cavernous malformation with haemorrhage rhage, hemosiderin deposition, and chronic inflammation. Postoperatively, she recovered rapidly without complications. CONCLUSION:This case illustrates a rare presentation of a dural-based cystic cavernoma mimicking an atypical extra-axial cyst. The absence of classic CCM imaging features, together with cystic morphology and mild wall enhancement, contributed to the diagnostic complexity. Dural-based cavernomas should be included in the differential diagnosis of giant extra-axial cysts that do not follow CSF intensity on all MRI sequences.
INTRODUCTION:Deep brain stimulation (DBS) is an established therapy for medically intractable movement disorders but poor response or habituation may prompt noninvasive salvage strategies. Stereotactic radiosurgery (SRS) offers targeted lesioning with a favourable risk profile, yet feasibility in patients with indwelling DBS systems remains underreported. We describe two patients with implanted DBS hardware who underwent Gamma Knife SRS (GKSRS) for intracranial pathologies. CASE PRESENTATIONS:Case 1: a 33-year-old female with right thalamic/midbrain arteriovenous malformation (AVM), developed Holmes rubral tremor after hemorrhage, requiring left thalamic DBS in 2018. After further AVM hemorrhage in 2022, a third GKSRS treatment was performed in 2025, (0.321 cc, 15 Gy prescription dose to 52% isodose line), with radiofrequency exposure limited to ≤2.0 μT to protect DBS components. Case 2: a 44-year-old female with multiple sclerosis and left-sided trigeminal neuralgia underwent Gamma Knife radiosurgery for facial pain in 2017 (40 Gy to 50% isodose line) and bilateral thalamic DBS implantation for tremor within the same year. Following pain recurrence despite maximum medical therapy, a second GKSRS was performed in 2019 using identical treatment parameters with bilateral DBS in place. Cone-beam computed tomography (CBCT) verification in Case 1 demonstrated <0.5mm maximal translational or rotational discrepancies, confirming acceptable registration accuracy despite metallic artifacts from DBS hardware. Ongoing follow up has not identified any stimulation-related adverse effects. CONCLUSION:This series demonstrates the safety and technical feasibility of GKSRS in patients with indwelling DBS, with CBCT confirming adequate precision despite metallic implants. GKSRS may be a viable salvage option for suboptimal DBS outcomes, avoiding surgical device removal risks. Larger cohorts are warranted to establish consensus guidelines for target planning and device management in neural implant patients undergoing radiation therapy.
BACKGROUND:Severe community-acquired central nervous system (CNS) infections may, in rare cases, cause life-threatening cerebral oedema. This study aimed to investigate the utilisation, indications, and outcomes of decompressive craniectomy (DC) as a last-tier intervention for intracranial hypertension for these conditions in a Swedish multicentre setting. METHODS:In this retrospective multicentre case series, we included all patients who underwent DC for severe CNS infection between 2008 and 2022 (only 2008-2018 at one centre) at five neurosurgical departments, covering approximately 80% of the Swedish population. Demographic, clinical, radiological, surgical, and outcome data were extracted from medical records. Functional outcome at approximately 6 months was assessed using the Glasgow Outcome Scale (GOS), with favourable outcome defined as GOS > 3. RESULTS:Ten patients underwent DC during the 15-year study period, corresponding to an annual rate of approximately 0.1 cases per million inhabitants. Seven patients had community-acquired bacterial meningitis (CABM), two viral encephalitis, and one brain abscess. Three CABM patients exhibited diffuse cerebral oedema without midline shift and underwent bifrontal DC, whereas seven patients with focal pathology and lateralised mass effect, including CABM with subdural empyema, viral encephalitis, or brain abscess, were treated with hemicraniectomy. In nearly all cases, extensive ICP-lowering therapies had been exhausted prior to DC. DC resulted in reduced midline shift and improved basal cistern patency and was associated with a low complication rate. One patient underwent reoperation for DC extension; no postoperative haemorrhages, infections, or chronic hydrocephalus occurred. Mortality was 30%, contrasted by 50% who achieved a favourable functional outcome. CONCLUSIONS:DC for severe CNS infections is exceedingly rare and reserved for highly selected patients with refractory intracranial hypertension. The observed complication burden and functional outcomes are descriptive only and should not be interpreted as evidence of treatment efficacy.
Holothurians are increasingly recognized as bioindicators and bioremediators in marine ecosystems. This study assessed the relationship between total mercury (THg) levels in Holothuria polii and Holothuria tubulosa from two Southern Italian coastal sites differing for ecological and anthropogenic characteristics, and those in corresponding marine sediments. THg levels in holothurians were consistently low across species and sites (0.0022–0.0146 mg kg− 1 wet mass) and showed no direct correspondence with sediment levels, which were high (1.5080 ± 1.1687 mg kg− 1 dry mass) at the Ionian site (IS), and low (0.0055 ± 0.0028 mg kg− 1 dry mass) at the Adriatic site (AS). Despite lower sediment mercury contamination, the bioconcentration factor, indicator of the efficiency of metal bioaccumulation was higher at the AS site (3.54–4.76) than at the IS site (0.021–0.022), suggesting different mercury bioavailability in the sites. Size-related analyses of THg in holothurians indicated that THg levels in individual holothurians correlated positively with body size (p < 0.05), except for H. tubulosa from AS. Results demonstrate that site-specific factors, more than species-specific ones, play a key function in controlling mercury bioavailability and uptake in the studied holothurians, supporting their potential role in environmental monitoring and their safe consumption in the studied areas.
Neonicotinoids have become widely used pesticides due to their specificity for insects. We explored how these contaminants are distributed on protected lands within Illinois. We hypothesized that there would be lower insect biomass at sites with higher neonicotinoid concentrations which we expected to occur at sites with a higher surrounding proportion of agriculture. We predicted that neonicotinoid levels would be highest at the start of the season, coincident with planting, then taper off throughout the growing season. Our results revealed that 25 of 50 sites surveyed had concentrations of at least one neonicotinoid (imidacloprid or clothianidin) over United States Environmental Protection Agency (EPA) benchmarks for chronic exposure. Imidacloprid had high detection above EPA benchmarks in Cook County while clothianidin was more often above benchmarks in central Illinois. There was a negative relationship between clothianidin levels and ratio of agriculture on measured insect biomass at sites with a higher proportion of agriculture. We did not identify a clear peak of imidacloprid or clothianidin concentrations. This study suggests the high level of contamination found at protected sites is concerning for ecosystem health as insects are the target prey for many wildlife species.
Microplastics (> 300 µm) ingestion by marine organisms drives trophic transfer and chemical bioaccumulation, posing risk to sea food safety and coastal fisheries. In this study, the gastrointestinal tracts of commercially important finfish species along with a crustacean species, were analyzed to assess microplastic contamination and its potential entry into the food chain. A total of 540 samples (30 individuals from six species per season) were collected from the fishing harbour Kalamukku along the Keralam coast, India, across the pre-monsoon, monsoon and post monsoon season of 2021. Overall, microplastic ingestion was confirmed in 44.25
Mercury exposure remains a public health concern in Amazonian populations. This study assessed hair total mercury levels and associated determinants in 205 women of reproductive age from riverine communities in the Lower Tocantins and Xingu regions, Pará,Brazil. Hair Hg concentrations were measured using cold vapor atomic absorption spectrometry. Multivariable linear regression was used to identify predictors of log-transformed mercury total levels. Median concentration was 0.332 µg/g, with 85.4
Microplastic (MP) pollution in river systems is increasingly recognized as a critical environmental challenge, yet the extent to which basin-scale geomorphology controls MP distribution remains poorly constrained, particularly in rapidly urbanizing tropical catchments. This study integrates catchment morphometric analysis with water-column MP sampling across eight first-order streams in the Ona River Basin, southwestern Nigeria. MP concentrations exhibited pronounced spatial heterogeneity (13.58–63.58 items L⁻¹), with consistently higher values in streams draining densely populated and commercially active areas. Simple and multiple regression analyses revealed weak and statistically non-significant relationships between MP concentrations and classical morphometric indices, including stream length, form factor, circularity ratio, and elongation ratio, although the latter showed a marginal inverse trend. Diagnostic evaluation confirmed limited predictive capacity of morphometric parameters. These exploratory results (120 data points across 8 streams) suggest localized anthropogenic inputs are more closely associated with MP distribution than basin-scale geomorphic form, though anthropogenic and connectivity variables were assessed qualitatively rather than measured directly. The findings highlight the limits of applying traditional morphometric frameworks to synthetic pollutants in urban tropical rivers and the need for integrated approaches combining geomorphological context with socio-environmental indicators.
Fine particulate matter (PM2.5) is a major urban air contaminant associated with adverse human health effects. Urban green spaces have been proposed as nature-based solution for mitigating particulate pollution, but evidence of their effectiveness at micro-scale in arid cities remains limited. We evaluated whether small urban green spaces are associated with local reductions in PM2.5 concentrations in an arid South American city. PM2.5 was measured during six mobile monitoring campaigns in winter 2026 along a 4.3 km urban transect comprising 75 georeferenced sampling locations. Sampling sites were classified as urban green spaces or non-green urban areas based on surrounding vegetation cover. The effects of site type were evaluated using Generalized Linear Mixed Models, accounting for traffic intensity, distance to the nearest road, and repeated measurements across sampling days and locations. PM2.5 concentrations were significantly lower in urban green spaces than in non-green areas, with adjusted concentrations approximately 31
Sewage sludge generated from wastewater treatment plants possesses significant resource potential but also raises environmental concerns due to its organic-rich composition and associated contaminants. This study collected raw sewage sludge from various urban sources in the state of Kerala, India, to evaluate its resource potential and assess ecological risks, with a focus on preliminary chemical characterization and risk screening. The average nutrient composition of the sludge samples revealed Total Organic Carbon (TOC) of 43.7
OBJECTIVES:Goreisan is a traditional herbal medicine composed of five active ingredients, and our previous meta-analysis demonstrated a significant reduction in recurrence after surgery for chronic subdural hematoma (CSDH). However, its effect in nonsurgical cases remains unclear. This systematic review and meta-analysis aimed to evaluate its effectiveness in the management of minimally symptomatic, nonoperative CSDH. METHODS:Following PRISMA guidelines, we included studies assessing Goreisan for nonoperative CSDH management. PubMed, Cochrane Library, Embase, Google Scholar, and ICHUSHI were searched from inception to August 2025. The primary outcome was the rate of surgical intervention. Heterogeneity was assessed using the I2 statistic. RESULTS:Seven studies (two comparative studies and five single-arm studies) involving 356 patients (241 received Goreisan; 115 did not) met the inclusion criteria. All patients received 7.5 g/day of Goreisan for 1-12 months. In comparative studies, the surgical intervention rate was not significantly lower in the Goreisan group than in the control group (12/43 [28%] vs. 42/115 [37%]; odds ratio, 0.55 [95% confidence interval [CI]: 0.13-2.38]; I2 = 63%). In single-arm studies, the pooled surgical intervention rate was 0.15 (95% CI: 0.10-0.21; I2 = 0%). CONCLUSIONS:This meta-analysis did not demonstrate a significant benefit of Goreisan in reducing surgical intervention for minimally symptomatic CSDH. Additional high-quality studies are warranted to clarify its potential efficacy and to address heterogeneity (PROSPERO CRD420251118315).
Although fisher (Pekania pennanti) populations have stabilized due to reintroduction efforts and habitat reconstruction, they face ongoing threats from environmental stressors such as deforestation, climate change, vehicle collisions, and toxicants. This study examines the presence of heavy metals in fishers harvested in Wisconsin from 2005 to 2006, providing a foundational understanding of baseline heavy metal concentrations for future reference. Liver samples were analyzed for levels of Aluminum, Copper, Nickel, Zinc, Arsenic, Cadmium, Iron, Manganese, Cobalt, Mercury, Molybdenum, Lead, Thallium, Chromium, and Vanadium. Mass spectrometry was used to quantify the metal concentrations in parts per million and the data were analyzed using robust multiple linear regression analyses and classical linear models to assess the effects of age and sex, and a Kruskal–Wallis test to determine the effect of county of harvest on the metal concentrations. The findings suggest that fishers in Wisconsin do not have measurable levels of Ni, As, Hg, and Tl. Sex and age significantly influenced Cd levels in fishers, while county location influenced Fe and Mo concentrations.
Urban stormwater runoff introduces tire‑related contaminants such as 6PPD‑quinone (6PPD‑Q), which has been shown to exhibit acute toxicity in some salmonid species, although the underlying toxic mechanisms remain incompletely understood. To expand in vitro toxicological assessments, we evaluated the cytotoxicity of 3,4‑dichloroaniline and 6PPD‑quinone using six fish‑derived cell lines from salmonids and phylogenetically distant species, based on nominal concentrations at the time of addition. Among these cell lines, CSE‑119 cells, which are derived from coho salmon, exhibited the highest sensitivity to 6PPD‑quinone (EC50 = 8.54 µg/L), demonstrating pronounced species‑specific differences in sensitivity to quinone‑type toxicants and underscoring the value of comparative in vitro models. Using multiple fish cell lines enables the efficient, animal‑welfare–conscious screening of tire‑associated chemicals. However, further investigation is needed into evaluation methods that take into account factors such as the stability of chemicals in the culture medium.
Urban environments are increasingly affected by heavy metal pollution originating from traffic, industrial activities, and other anthropogenic sources, which can have adverse consequences for urban ecosystems and human health. This study investigated the concentrations of heavy metals, including cadmium (Cd), iron (Fe), manganese (Mn), nickel (Ni), lead (Pb), and zinc (Zn), in the leaves of three commonly occurring urban tree species-pine (Pinus sp.), mulberry (Morus sp.), and Chinaberry (Melia azedarach)-as well as in the corresponding surface soils in Sabzevar, Iran. To assess species-specific accumulation patterns, the bioaccumulation factor (BCF) and metal accumulation index (MAI) were calculated, and non-carcinogenic health risks from soil exposure were estimated using the hazard quotient (HQ) and hazard index (HI). The results indicated significant differences in metal concentrations among tree species, with Morus sp. exhibiting the highest accumulation of Fe, Mn, and Ni, whereas Pinus sp. displayed the highest MAI values. Soil analysis revealed considerable spatial heterogeneity, with the highest Pb and Zn concentrations observed in high-traffic urban areas. HQ and HI values for all metals and age groups were below critical thresholds, although children exhibited higher values than adults. These findings underscore the importance of selecting appropriate tree species for biomonitoring and managing heavy metal pollution in semi-arid urban environments.
INTRODUCTION:Preoperative neutrophil-lymphocyte ratio (NLR) has been found in various fields to be a predictor of post-operative pain and functional outcomes. To date no studies have looked at NLR in relation to patient outcomes after anterior cervical discectomy and fusion (ACDF). The primary aim is to determine the relationship between pre-operative NLR, pain and functional outcomes at 12-months post elective ACDF. MATERIALS AND METHODS:This single-centre retrospective cohort study included 60 patients undergoing 1 or 2 level ACDF. Pre-operative NLR and demographic data were collected. Visual analogue scale (VAS) for neck and arm pain, and Neck Disability Index (NDI) were collected at baseline and 12 months postoperatively. Binary logistic regression was used to estimate the associations of demographic factors and NLR with improvement in VAS and NDI scores. RESULTS:A unit increase in NLR was associated with a 56% decrease in the odds of improvement in neck pain (OR: 0.44; CI: 0.21-0.89, p = 0.02). NLR was not found to be a statistically significant predictor of improvement in VAS Arm or NDI. Higher baseline VAS arm and neck scores were associated with greater odds of improvement in pain postoperatively. Compared to patients with cervical disc herniation, those with cervical stenosis had a 72% decrease in the odds of substantial clinical benefit in NDI score (OR: 0.28 CI: 0.09-0.91, p = 0.03). CONCLUSION:Elevated preoperative NLR was associated with lower odds of neck pain improvement after ACDF but did not predict disability or arm pain improvement.
Baiyangdian Lake, the largest freshwater lake in the North China Plain, plays a crucial role in regional ecology and hydrology. Benthic macroinvertebrates are widely recognized as important bioindicators for assessing the ecological health of lake ecosystems. Following the establishment of the Xiong'an New Area, comprehensive ecological restoration was implemented from 2019 to 2023, yet the recovery status of benthic communities remains inadequately understood. In this study, we conducted a comprehensive analysis of the temporal and spatial dynamics of benthic macroinvertebrates using Generalized Additive Models (GAMs). A total of 449 individuals of benthic macroinvertebrates were identified, belonging to 3 phyla (Mollusca, Annelida, and Arthropoda), 6 classes, 7 orders, 7 families, and 20 genera. Five dominant species were identified: Propsilocerus akamusi, Bellamya aeruginosa, Cipangopaludina cathayensis, Chironomus flaviplumus, and Bellamya purificata. The Shannon–Wiener diversity (H') and Margalef richness (D) indices showed non-significant upward trends (p > 0.05), increasing from 0.708 to 1.854 and from 0.638 to 2.875, respectively. Biomass showed a significant increasing trend, peaking at 427.02 g/m2 in 2023 (357.9
Fish have the capacity to bioaccumulate metals such as mercury through the food web, posing potential health risks to aquatic ecosystems and humans. This study aimed to assess total mercury (THg) concentrations in different tissues of freshwater fish and evaluate the potential risk for consumers. Perch (Perca fluviatilis) and rudd (Scardinius erythrophthalmus), representing different trophic levels, were collected from Koronowo Reservoir and Lake Wierzchucińskie Duże in summer and autumn. THg accumulation followed the order: muscle > liver > gills, with significant differences observed between tissues. In perch, THg concentrations were 0.061 μg/g (muscle), 0.037 μg/g (liver), and 0.028 μg/g (gills). In rudd, THg levels were 0.050 μg/g (muscles), 0.034 μg/g (liver), and 0.022 μg/g (gills). The target hazard quotient (THQ) values were below 1, indicating that their consumption does not pose a significant health risk to humans. Estimated safe weekly intake was 1,839 g for perch and 2,249 g for rudd for dorsal muscle.
INTRODUCTION:Trigeminal Neuralgia, characterised by paroxysmal facial pain, is often managed surgically via microvascular decompression (MVD). While microscopic MVD (M-MVD) is the traditional gold standard, it has many limitations, such as a restricted field of view. Endoscopic MVD (E-MVD) offers panoramic visualisation, potentially improving outcomes. This systematic review compares the safety and efficacy of E-MVD versus M-MVD. METHODS:A systematic review was conducted, adhering to PRISMA 2020 guidelines, searching PubMed, Embase, and Scopus. Nine studies involving 1,205 patients (556 E-MVD, 649 M-MVD) were included. Primary outcomes included pain relief and recurrence; secondary outcomes included operative time, hospitalisation time, and adverse effects. Risk of bias was assessed using the Newcastle-Ottawa Scale. RESULTS:Pooled meta-analysis showed no significant difference in postoperative pain relief (OR: 1.16, 95% CI: 0.88-1.54). However, E-MVD demonstrated a significantly lower recurrence rate (OR: 0.58, 95% CI: 0.37-0.93) and reduced hospital stay (SMD: -0.45, 95% CI: (-0.70) - (-0.20)), despite longer operative times (SMD: 0.40, 95% CI: 0.20-0.60). E-MVD significantly reduced facial numbness (OR: 0.63) and total complications (OR: 0.67), with no difference in facial paralysis or hearing loss. CONCLUSION:E-MVD offers comparable efficacy to M-MVD for initial pain relief but potentially offers superior long-term durability (lower recurrence) and a better safety profile. Further validation through randomised trials is necessary to determine if a shift in the surgical standard is warranted. Endoscope-assisted microscopic MVD may be a therapy that represents the best of both surgical techniques, especially in the intermediate term, where more literature is needed to establish the potential benefits of E-MVD and to determine the optimal technique.
The Chodha Lake sediment core of Korba district, Chhattisgarh was investigated for 10 potentially toxic elements to asses metal pollution, their sources, past apportionment and eco-environmental risks. Geochemical analysis was performed with the help of X-ray Fluorescence spectrometer. The discrete sources of the potentially toxic elements were distinguished mainly using principal component analysis and factor analysis. The core sediments show elevated concentrations of Potentially toxic elements, with notable enrichment in Fe, Cr, Mn and Co, while Cu, V, Zn and Ni also exhibit relatively high levels. Cu, V, Pb, and Cr pollution was mainly related to the adjoining coal productions, particularly burning of coal and associated fly ash. The contamination of Mn and Fe may be attributable to coal mine tailings and allied rock fragments. On the contrary, Al, Ni and Zn indicate their geogenic origin derived largely from the weathering and erosion of soils of the study region. The various levels of contamination are interpreted based on the pollution indices. Most of the elements indicated their moderate enrichment in the sediment core, whereas moderate to substantial levels of contamination was exhibited by Fe and excessive contamination by Cobalt. The moderate to substantial degree of pollution based on the Index of geo-accumulation was revealed by Fe, Zn and Mn. However, all the core sediments confirm the consistent low potential ecological risk to aquatic life.
