Chronic traumatic encephalopathy is a disease afflicting individuals exposed to repetitive neurotrauma. Unfortunately, diagnosis is made by postmortem pathologic analysis, and treatment options are primarily symptomatic. In this clinical update, we review clinical and pathologic diagnostic criteria and recommended symptomatic treatments. We also review animal models and recent discoveries from pre-clinical studies. Furthermore, we highlight the recent advances in diagnosis using diffusor tensor imaging, functional magnetic resonance imaging, positron emission tomography, and the fluid biomarkers t-tau, sTREM2, CCL11, NFL, and GFAP. We also provide an update on emerging pharmaceutical treatments, including immunotherapies and those that target tau acetylation, tau phosphorylation, and inflammation. Lastly, we highlight the current literature gaps and guide future directions to further improve clinical diagnosis and management of patients suffering from this condition.

Chemotherapy as an adjuvant therapy that has largely failed to significantly improve outcomes for aggressive brain tumors; some reasons include a weak blood brain barrier penetration and tumor heterogeneity. Recently, there has been interest in designing effective ways to deliver chemotherapy to the tumor. In this review, we discuss the mechanisms of focused chemotherapies that are currently under investigation. Nanoparticle delivery demonstrates both a superior permeability and retention. However, thus far, it has not demonstrated a therapeutic efficacy for brain tumors. Convection-enhanced delivery is an invasive, yet versatile method, which appears to have the greatest potential. Other vehicles, such as angiopep-2 decorated gold nanoparticles, polyamidoamine dendrimers, and lipid nanostructures have demonstrated efficacy through sustained release of focused chemotherapy and have either improved cell death or survival in humans or animal models. Finally, focused ultrasound is a safe and effective way to disrupt the blood brain barrier and augment other delivery methods. Clinical trials are currently underway to study the safety and efficacy of these methods in combination with standard of care.

Delirium, a complex neurocognitive syndrome, frequently emerges following surgery, presenting diverse manifestations and considerable obstacles, especially among the elderly. This editorial delves into the intricate phenomenon of postoperative delirium (POD), shedding light on a study that explores POD in elderly individuals undergoing abdominal malignancy surgery. The study examines pathophysiology and predictive determinants, offering valuable insights into this challenging clinical scenario. Employing the synthetic minority oversampling technique, a predictive model is developed, incorporating critical risk factors such as comorbidity index, anesthesia grade, and surgical duration. There is an urgent need for accurate risk factor identification to mitigate POD incidence. While specific to elderly patients with abdominal malignancies, the findings contribute significantly to understanding delirium pathophysiology and prediction. Further research is warranted to establish standardized predictive for enhanced generalizability.

High-grade gliomas remain difficult to treat due to their infiltrative growth, therapeutic resistance, and the restrictive blood-brain barrier (BBB). Focused ultrasound (FUS) offers a noninvasive method to transiently disrupt the BBB, enhancing the delivery of therapeutics to the tumor site. Herein, the authors discuss the emerging role of FUS in glioma treatment including enhanced drug delivery, real-time monitoring techniques, and biomarker-driven patient selection. They also explore the impact of combined FUS with immunotherapy, gene therapy, exosome-based drug delivery, sonobiopsy, and radiotherapy (RT) sensitization. The authors have based their article on literature published between January 2010 and October 2024 from PubMed, Web of Science, and Google Scholar. By tailoring FUS parameters to individual tumor characteristics and patient responses, these strategies aim to overcome glioma heterogeneity and treatment resistance, further advancing personalized therapeutic approaches. The integration of FUS into neuro-oncology represents a paradigm shift, requiring interdisciplinary collaboration to maximize its potential as a cornerstone of precision medicine in glioma treatment. Future advancements in FUS will likely focus on refining treatment protocols, optimizing real-time targeting, and integrating artificial intelligence (AI)-driven predictive models to personalize therapy.

Meningitis and encephalitis are characterized by inflammation of the meninges and brain parenchyma, respectively. The blood-brain barrier normally acts as a protective barrier against inflammation in the central nervous system (CNS), but its compromise requires prompt diagnosis and treatment to prevent morbidity and mortality. Optimizing therapy for meningitis and encephalitis can expedite resolution of symptoms, mitigating the risk of neuronal injury and minimizing potential long-term neurological sequelae. This paper aims to provide a comprehensive overview of the etiology and pathophysiology of meningitis and encephalitis, discussing the diagnostic criteria, and emphasizing the clinical indications for treatments, including current treatment strategies, and emerging therapeutic approaches.