Parkinson’s disease is a neurodegenerative disease whose progression and clinical characteristics have a close bidirectional and multilevel relationship with the process of neuroinflammation. In this context, it is necessary to understand the mechanisms involved in this neuroinflammation–PD link. This systematic search was, hereby, conducted with a focus on the four levels where alterations associated with neuroinflammation in PD have been described (genetic, cellular, histopathological and clinical-behavioral) by consulting the PubMed, Google Scholar, Scielo and Redalyc search engines, including clinical studies, review articles, book chapters and case studies. Initially, 585,772 articles were included, and, after applying the inclusion and exclusion criteria, 84 articles were obtained that contained information about the multilevel association of neuroinflammation with alterations in gene, molecular, cellular, tissue and neuroanatomical expression as well as clinical-behavioral manifestations in PD.

Background: The internal carotid artery (ICA) has multiple classification systems; it is essential for brain blood supply, which has bone/neurovascular relationships of wide neurosurgical interest; its anatomy must be known in detail, its angiographic-imaging aspect (endovascular), its ventral aspect (endoscopic endonasal approaches); and its lateral aspect (anterolateral skull base surgery). Our objectives were to identify coincidences/differences between the main classifications of the ICA to improve its surgical-anatomical understanding, unify the terminology of ICA segments, avoid confusion, and carry out a simple description. Methods: There are differences between classifications; however, these may overlap each other and determine the correspondence between segments, regardless of their purpose. Literature on ICA classifications was reviewed; a cadaver endonasal endoscopic and anterolateral skull base dissection was performed, obtaining representative images of the ICA, as well as angiography. The main terminology of ICA segments was collected, and artistic-anatomical illustrations were created to facilitate the study of ICA. Results: We compared the endoscopic roadmap to the ICA by Labib/Kassam, the extradural ICA at its lateral aspect by Cherian, and the classic classification by Bouthillier (as well as a small reference to the classification by Gibo/Rhoton). We found the shared characteristics and differences between classifications, with a total of 17 interrelated segments, with a variety of nomenclature and anatomical extension. Initially, we except the extradural ICA by Cherian because it uses almost the same nomenclature that Labib, varying in one segment, which coincides with the nomenclature of Bouthillier and does not change the total summary. The initial and terminal segments were nominative/anatomically equivalent, and there is anatomical nominal variation in the intermediate segments and its relation/correspondence has been easily demonstrated. Conclusion: Anatomical knowledge of all aspects of ICA using its main classifications, the relation between them, and its diversity of nomenclature is essential to improve its anatomical-surgical understanding and avoid anatomical nominal confusion. It can be achieved through our comparative tables/illustrations.

Endoscopic endonasal surgery requires specific training and essential anatomical and technical knowledge. The support of 3D technologies favors the development of this knowledge. We exemplify the use of this 3D reconstruction tool through four clinical cases of sellar tumors. Imaging analysis was performed on four patients diagnosed with sellar tumors who underwent resection surgeries using endoscopic endonasal approaches with the support of 3D reconstructions. Four sellar tumors and their related anatomical structures were reconstructed using manual planimetric segmentation to modify the pre- and trans-surgical decision. Although 3D reconstruction images are not new, the imaging studies with which we can make these reconstructions have been improving and with which to improve anatomical and surgical understanding in endoscopic transnasal surgery. This work exemplifies the usefulness of 3D technology in planning endoscopic endonasal surgeries for the different tumor pathologies of the sellar region.

Background: Pituitary adenomas (PAs) with suprasellar extension pose significant surgical challenges due to restricted access and a heightened risk of subtotal resection (STR). To test this hypothesis, we evaluated suprasellar morphometrics focusing on anteroposterior suprasellar diameter(APSS) as predictors of gross total resection (GTR) in PAs with suprasellar extension, while accounting for parasellar invasion using established cavernous sinus scales (Knosp and Zurich pituitary score [ZPS]). Methods: A retrospective cohort of 48 consecutive patients who underwent endoscopic endonasal surgery for PAs with suprasellar extension between July 2021 and June 2024 was analyzed. Demographic, radiologic, and intraoperative variables were collected. The extent of resection was determined by early postoperative magnetic resonance imaging. Logistic regression and receiver operating characteristic (ROC) curve analysis were used to identify predictors of GTR. Results: The mean patient age was 52.2 ± 11.6 years, with a male-to-female ratio of 1.1:1. Most tumors were nonfunctioning (81.3%). GTR was achieved in 70.8% of cases. Postoperative complications occurred in 27.1%, including cerebrospinal fluid leaks in 16.7%, one postoperative hematoma (2.1%), and two deaths (4.2%). Neither Knosp nor ZPS classifications showed significant correlation with GTR ( P = 0.055 and P = 0.258, respectively). Logistic regression identified APSS as an independent predictor of resectability ( P = 0.023). ROC analysis established an optimal APSS cutoff of 25.7 mm, with 78% sensitivity and 88% specificity for predicting STR. Knosp and ZPS are designed to quantify cavernous sinus invasion; in our suprasellar-extension cohort, their association with GTR did not reach statistical significance, whereas APSS capturing sagittal suprasellar depth beyond the endonasal working angle remained an independent predictor of incomplete resection. Conclusion: The APSS is an independent and reliable morphometric predictor of surgical outcome in PAs with suprasellar extension. An APSS ≥25.7 mm is associated with an increased risk of incomplete resection and may outperform conventional grading systems in preoperative planning.

Introduction and importance: Spinal arteriovenous malformations (AVMs) are a rare condition that has a high risk of bleeding and complications. The authors present the case of a spinal arteriovenous malformation in an unusual location and presentation. Case presentation: A 67-year-old man with subarachnoid hemorrhage due to a ruptured spinal arteriovenous malformation type IVa, with associated bulbomedullary aneurysm, which was managed conservatively due to the high risk of complications and mortality. Clinical discussion: Spinal AVMs have had different management and treatments over the years, so conservative management remains an option when arterial cannulation is complex and surgery carries a high risk of complications. Conclusion: Due to the high risk of complications of surgery in this location, conservative treatment is an option for the management of such cases with good outcomes.