Heat shock proteins (HSPs) are conservative and ubiquitous proteins that are expressed both in prokaryotic and eukaryotic organisms and play an important role in cellular homeostasis, including the regulation of proteostasis, apoptosis, autophagy, maintenance of signal pathways, protection from various stresses (e.g., hypoxia, ionizing radiation, etc.). Therefore, HSPs are highly expressed in tumor cells, including malignant brain tumors, where they also associate with cancer cell invasion, metastasis, and resistance to radiochemotherapy. In the current review, we aimed to assess the diagnostic and prognostic values of HSPs expression in CNS malignancies as well as the novel treatment approaches to modulate the chaperone levels through the application of inhibitors (as monotherapy or in combination with other treatment modalities). Indeed, for several proteins (i.e., HSP10, HSPB1, DNAJC10, HSPA7, HSP90), a direct correlation between the protein level expression and poor overall survival prognosis for patients was demonstrated that provides a possibility to employ them as prognostic markers in neuro-oncology. Although small molecular inhibitors for HSPs, particularly for HSP27, HSP70, and HSP90 families, were studied in various solid and hematological malignancies demonstrating therapeutic potential, still their potential was not yet fully explored in CNS tumors. Some newly synthesized agents (e.g., HSP40/DNAJ inhibitors) have not yet been evaluated in GBM. Nevertheless, reported preclinical studies provide evidence and rationale for the application of HSPs inhibitors for targeting brain tumors.

Background: Deep brain stimulation (DBS) is an effective treatment for movement disorders, but its long-term efficacy may be undermined by hardware complications such as lead fractures. These complications increase healthcare costs and necessitate surgical revisions. The frequency, timing, and clinical factors associated with lead fractures remain poorly understood. Objective: This study aimed to determine the incidence, timing, and clinical factors associated with lead fractures in a large cohort of DBS patients over a 10-year period. Methods: This retrospective study analyzed data from 325 patients who underwent bilateral DBS implantation at the National Centre for Neurosurgery from 2013 to 2023. The analysis specifically focused on 17 patients who experienced lead fractures during the long-term follow-up period. Results: Among the 325 patients, lead fractures were identified in 17 patients (5.23%), affecting 18 electrodes. The majority of cases involved patients with Parkinson’s disease (76.5%) or dystonia (23.5%), with an average age of 59.17 ± 8.77 years. Nearly all patients with lead fractures had a history of trauma. Additionally, two cases were associated with active engagement in sports, particularly activities involving movements like pulling up on a horizontal bar, while Twiddler’s Syndrome was identified in two other cases. All electrode fractures required surgical revision. Conclusions: Lead fractures, while rare, remain a significant complication in DBS systems. Precise surgical techniques, early detection, and advancements in DBS hardware design may help to mitigate this risk. Future innovations, such as durable leads or wireless systems, may improve long-term outcomes in DBS therapy for movement disorders.

Background: Seizures are one of the most debilitating manifestations of brain arteriovenous malformations (AVMs). This study aimed to evaluate the effect of curative embolization on brain AVM patients presenting with seizures. Methods: The records of patients who underwent embolization for brain AVM from January 2012 to December 2020 were evaluated and patients presenting with seizures were interviewed. Patient responses were evaluated according to the International League Against Epilepsy (ILAE) and Engel classifications. Statistical analyses of factors associated with seizure outcomes and complications were performed using ANOVA and Fischer’s exact tests. Results: The mean age of the participants was 35.2 ± 10.7 years. More than 80% of the patients received no or suboptimal dosages of antiepileptic drugs (AEDs) prior to embolization. Positive seizure dynamics were observed in 50% of the patients post-procedure. A correlation was found between length of seizures in anamnesis and outcomes of both Engel and ILAE score, where shorter length was associated with better outcomes. Post-embolization hemorrhage was associated with initial presentation with hemorrhage. Conclusions: The embolization of brain AVMs had a positive effect on seizure presentation and a relatively low prevalence of complications. However, the results of the study are obscured by inadequate AED treatment received by the patients, which prompts prospective studies on the topic with careful patient selection.

Background: The study aimed to analyze the 5-year survival of adult patients with glial tumors and to define characteristics that are associated with the disease outcomes in Kazakhstan. Methods: Medical records of patients that were surgically treated at the National Center for Neurosurgery during the 5-year period from 2016 to 2020 were collected retrospectively. Patients with a histologically confirmed diagnosis of diffuse astrocytic or oligodendroglial tumor type were included and their survival was assessed with life tables, Kaplan–Meier plot, and Cox regression using STATA 16 statistical software. Results: Almost half of the patients had glioblastoma. The 5-year survival rate of the whole sample was 45.93%. Among Grade 4 patients, 15.6% survived the 5-year mark. Differences in survival between grades 1–3 were not significant. Grade 1 patients demonstrated worse survival rates compared to Grade 2 patients (69% vs. 74%). Worse survival rates were observed among patients of Russian ethnicity and in rural residents. Conclusions: The study described the unusual patterns in survival rates of glial tumor patients in Kazakhstan, pointing to the need for reassessment of diagnostic accuracy and resulting treatment of glial patients in Kazakhstan, and the need to introduce molecular and genetic parameters in tumor type classification. Moreover, the observed difference in survival of different ethnic groups and residents of rural and urban areas should be further investigated and addressed by healthcare professionals.

Background: Meningiomas are the most common type of primary brain tumor, originating from the meninges – the protective membranes that surround the brain and spinal cord. Several well‐studied risk factors for meningiomas include gender, age, radiation exposure, genetic factors, and hormonal factors. Moreover, the influence of a person's psycho‐emotional stateon their overall health and mental well‐being, specifically stress, iscurrently a significant and relevant topic of discussion.Aims: This case–control study aimed to study the association between perceived stress, chronic stress, and meningioma in adult patients.Methods and results: The study included cases, which comprised adult patients with histologically confirmed meningioma, and controls, consisting of adult patients with no history of brain cancer. Data collection involved the use of three types of questionnaires. The first questionnaire focused on patients' personal information, geographic factors, and lifestyle habits. Two additional questionnaires “The Perceived Stress Scale” and “The Chronic Stress Scale” were employed to assess perceived stress and chronic stress. The questioning was conducted by a neurologist. Microsoft Excel and Stata 14 were used for the data analysis. Overall, 148 questionnaires were completed and included in the analyses. The average age of participants was 45.60 ± 13.90 years. Females outnumbered males in both groups. Patients with meningioma diagnosis had a higher level of perceived high stress compared to those without meningioma (p = .045). Respondents without a diagnosis of meningioma have reported having more chronic stress in general and ambient problems (p = .004), financial issues (p = .006), work (p < .001), non‐employment (p = .008), love and marriage (p < .001), isolation (p < .001), and residence (p < .001). Patients with meningioma, however, had less chronic stress compared to meningioma‐free patients.Conclusion: This study revealed no discernible connection between stress and meningioma within our study sample. Further research with matched case–control methodology with a larger sample size is warranted to thoroughly evaluate the potential role of stress in patients with meningioma.

Purpose This technical note introduces the novel faucet technique, which enables neurosurgeons to evaluate the patency of a bypass during superficial temporal artery–middle cerebral artery bypass surgery. The technique is particularly useful when there is a lack of equipment such as micro-Doppler or indocyanine green in the operating rooms. This is often the case in Central Asian countries. Methods The faucet technique involves carefully examining the graft by gently opening a valve, comparable to a faucet, to observe the blood flow through the bypassed vessel. Overall, 36 procedures underwent the faucet technique for assessing the superficial temporal artery–middle cerebral artery bypass patency. Results The results indicate that the bypass remained patent in all cases, as confirmed through the intraoperative faucet technique, postoperative magnetic resonance angiography, or cerebral angiography. Conclusion By visually inspecting the blood flow through the faucet technique, surgeons can confirm the effectiveness of the graft and ensure that the bypass remains unobstructed during the surgery.