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Thalia Estefania Sanchez Correa, David Gallardo Ceja and Diego Mendez-Rosito

Brainstem cavernous malformation management is complex due to its critical location and deleterious effect when bleeding. Therefore, every case should be thoroughly analyzed preoperatively. We present the case of a female patient with a midbrain cavernous malformation. A comprehensive anatomical and clinical analysis of the surgical corridors is done to decide the safest route. A subtemporal approach was done and the lateral mesencephalic sulcus and vein were important anatomical landmarks to guide the safe entry zone. Nuances of technique and surgical pearls related to the safe entry zones of the midbrain are discussed and illustrated in this operative video.

The video can be found here: https://youtu.be/vYA-IgiT2lU.

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Juan Barges-Coll, Iván Pérez-Neri, Javier Avendaño, Diego Mendez-Rosito, Juan Luis Gomez-Amador and Camilo Ríos

Object

The object of this study was to determine the relationship between plasma taurine and subarachnoid hemorrhage (SAH) outcome.

Methods

Forty patients with SAH and mild neurological deficits were included in this prospective, blinded cohort study. Plasma taurine levels were measured using high-performance liquid chromatography on admission and were correlated with patient outcomes at discharge.

Results

Twenty-five percent of the patients ultimately had a poor outcome. Plasma taurine concentrations at admission were increased (2-fold) in SAH patients with a favorable outcome and were further increased (6-fold) in those who had a poor outcome. Increased taurine levels identified patients who would be discharged with a poor outcome, with sensitivity and specificity values of approximately 80% and 100%, respectively, and positive and negative predictive values of approximately 90%. Delayed cerebral vasospasm showed an OR of 27.9 (95% CI 1.090–714.9) for a poor outcome, whereas an increased taurine concentration had an OR of 105 for a poor outcome (95% CI 8.3–1328.0, p < 0.001).

Conclusions

Increased plasma taurine concentrations on admission predict a poor outcome in SAH.

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Samuel Romero-Vargas, José Luis Ruiz-Sandoval, Arturo Sotomayor-González, Rogelio Revuelta-Gutiérrez, Miguel Angel Celis-López, Juan Luis Gómez-Amador, Ulises García-González, Raul López-Serna, Victor García-Navarro, Diego Mendez-Rosito, Victor Correa-Correa and Sergio Gómez-Llata

Induced deformation of the cranial vault is one form of permanent alteration of the body that has been performed by human beings from the beginning of history as a way of differentiating from others. These procedures have been observed in different cultures, but were particularly widespread in Mesoamerica. The authors examined and reviewed the historical and anthropological literature of intentional deformation practices in Mayan culture. The Mayans performed different types of cranial deformations and used different techniques and instruments to deform children's heads. The most remarkable morphological alteration is seen in the flattening of the frontal bone. Some archeological investigations link deformation types with specific periods. This article provides a glance at the cultural environment of the Mayans and demonstrates the heterogeneity of this interesting cultural phenomenon, which has changed over time.