Gomes-da Silva de Rosenzweig P, et al. J Dent Anesth Pain Med. 2024 Aug;24(4):227-243. https://doi.org/10.17245/jdapm.2024.24.4.227

Meningiomas, the most common tumors of the central nervous system (CNS), present significant challenges in treatment, particularly for atypical and anaplastic subtypes where standard therapies often fall short of therapeutic expectations. Chimeric antigen receptor (CAR) T-cell therapy, a groundbreaking immunotherapy approach, has demonstrated great success in hematological malignancies but faces obstacles in solid tumors, including CNS tumors like glioblastomas. This article provides a comprehensive review of the efficacy of CAR-T therapy in meningiomas, highlighting the tumor’s immunogenic potential and the challenges associated with applying this therapy in clinical practice. Through an extensive literature review, the study explores potential antigens for CAR-T targeting in meningiomas, shedding light on the tumor-immune microenvironment interactions. Challenges such as tumor heterogeneity, blood-brain barrier penetration, off-target effects, and tumor recurrence are discussed, alongside potential strategies to overcome these obstacles. The study also investigates recent advancements in CAR-T therapy, including the identification of novel target antigens and the development of engineering approaches to enhance therapeutic efficacy. Furthermore, the article highlights the importance of ongoing research efforts in exploring the tumor-immune dynamics in meningiomas and underscores the urgent need for clinical trials to validate the safety and efficacy of CAR-T therapy in this context. By addressing these challenges, CAR-T therapy holds the promise of revolutionizing meningioma treatment, offering new hope for patients suffering from this disease.

Introduction: Foix–Alajouanine syndrome (FAS) is an uncommon neurological disorder marked by the gradual development of spinal cord congestion. First documented by Foix and Alajouanine in 1926. Although it is infrequent, delayed or misdiagnosis is nonetheless prevalent, resulting in inadequate therapy and unfavorable results. Methods: Using the PubMed database, MEDLINE, and EMBASE, we collected data on FAS patients and conducted a pooled analysis. The term ‘FAS’ was used to search for related articles. Our search was restricted to previous clinical case reports or series that were published in English. Non-English articles were excluded. We included the articles in the period from 1974 to 2024. Articles were eligible if the radiographic and clinical findings were indicative of FAS. A thorough research analysis was performed, examining case reports that specifically addressed this issue. This study examines the clinical symptoms, difficulties in diagnosis, methods of treatment, and outcomes related to FAS. Results: FAS predominantly impacts the elderly population. A total of 26 patients were diagnosed with FAS. The median age of affected individuals was 53 (SD ±15.96). The ratio of males to females is roughly 5:1. The clinical manifestations encompass gradual muscle weakness and sensory impairments. The diagnosis is dependent on radiological evaluations, specifically MRI and digital subtraction angiography. Possible treatments include endovascular therapy, surgical closure of arteriovenous fistula, or a combination of the two. Significant improvements in neurological impairments can be achieved by early intervention. Conclusion: The diagnosis of FAS continues to be difficult due to its infrequency and varied clinical manifestations. Prompt and precise diagnosis is essential for proper intervention, typically utilizing endovascular or surgical methods. Additional research is required to determine prognostic markers and enhance long-term care techniques for this rare neurological condition.

Introduction The Callosomarginal artery (CMA) is a terminal branch of the anterior cerebral artery (ACA). It is the main branch and the largest artery branching off from the pericallosal artery and coursing in parallel to it. Its course is posterior to or within the cingulate sulcus of the brain. The Callosomarginal artery (CMA) has several anatomical variations and established neurosurgical applications. The Callosomarginal artery (CMA) is poorly described in the standard anatomical textbooks. Therefore, we conducted this study as an overview to illustrate a complete picture of the anatomical variations and their implications in the neurosurgical field. Method We conducted a literature review in Google Scholar and PubMed medical databases to review the literature discussing the CMA, its anatomical variations, and neurosurgical applications. Results We identified 40 articles that discuss the CMA’s anatomical variations and neurosurgical applications. We noticed the CMA’s anatomical variations in origin, course, diameter, branches, depth, and distance from the associated structures. While reviewing the available articles and original works regarding CMA, we also discussed certain applications of CMA and its importance in neurosurgical bypass, embolization, and aneurysms. Conclusion Comprehending the anatomy of the CMA is crucial for neurosurgeons to safely and effectively perform procedures such as bypass and embolization. In addition, knowledge of the anatomical variations of the CMA and its clinical significance can help surgeons anticipate potential challenges and tailor their approach accordingly.