Introduction: Three-dimensional measurements of intracranial volume (ICV) can guide clinical management of brain and skull disorders. However, widespread clinical access is limited by the scarcity of software methods for analyzing CT scans, which are more available than MRI images, and the inaccessibility of proprietary and expensive commercial software. The presented method can calculate ICV from CT scans, using an open-source software, 3D Slicer. Methods: The open-source workflow was optimized with a data-driven approach to find the optimal parameters for ICV accuracy. The accuracy of the open-source method was determined by comparing it to commercial and proprietary software with CT scans of pediatric hydrocephalic macrocephaly patients with craniosynostosis undergoing total vault reconstruction (N = 5 patients,15 scans). Results: An open-source pipeline that combines an initial semi-automatic segmentation of a coronal CT reconstruction with a fully automatic segmentation minimizes the ICV error. The open-source method shows excellent agreement with both the commercial and proprietary software methods (R² = 0.998 and 95% confidence interval of best-fit line slope: [0.986; 1.047], [0.985;1.066] respectively). The mean percent difference of ICV measurements of the open-source software from the commercial software was −0.56% [95% CI: −1.08%, −0.028%] and from the proprietary software was −0.07% [95% CI: −1.26%, 1.1%]. The mean percent difference of ICV measurements of the commercial software from the proprietary software was 0.36% [95% Confidence Interval: −0.61%, 1.32%]. Conclusions: This is the first study comparing an open-source method for measuring ICV with commercial and proprietary options. A high degree of fidelity was found, confirming this open-source method as a viable option for clinicians who are looking to incorporate ICV measurements into their practice.

Motor recovery after stroke, spinal cord injury, or traumatic brain injury reflects relearning rather than simple restitution, as surviving circuits retain plastic potential that can be re-engaged through temporally precise stimulation. This review synthesizes convergent findings demonstrating that Hebbian and spike-timing-dependent mechanisms govern reorganization across cortical, striatal, and spinal levels. Leveraging these timing rules to shape excitability during receptive network states enables durable changes in connectivity and behavior. This effect depends on temporal precision, physiological state, and reinforcement—not stimulus intensity alone—within plasticity windows regulated by metaplastic mechanisms that determine whether Hebbian processes are expressed. Together, these principles define a translational framework for neurorehabilitation, emphasizing biomarker-guided, adaptive, and scalable strategies aligned with intrinsic rules of experience-dependent reorganization.

Background: Alagille syndrome is a rare genetic syndrome, which arises due to defects in the Notch signaling pathway, resulting in liver, cardiopulmonary, renal, skeletal, and ophthalmologic problems, among others. Epidermoid cysts are rare congenital benign lesions that develop from ectopic ectodermal cell rests formed during neurulation.Case Description: A 24-year-old Alagille syndrome patient presented with hearing loss and was found to have a sizable posterior fossa mass. He underwent craniotomy for uneventful resection of the lesion, which was found to be an epidermoid cyst.Conclusion: While our case may represent a coincidental occurrence of two pathologies presenting together, given that epidermoid cysts arise from aberrant neurulation, and in light of the crucial role of the Notch signaling pathway both in normal neurogenesis and in the pathogenesis of Alagille syndrome, we hypothesize a possible association between these entities.

Synaptic connectivity between gliomas and adjacent brain was recently implicated in tumorigenesis. However, the interaction of synapse-related genes (SRGs) with patient survival and with established clinical and molecular glioma subtypes merit further study in a large patient cohort. We characterized differential expression of SRGs in gliomas and investigated SRG expression as putative clinical biomarkers in a large glioma cohort. Expression of 1189 SRGs was interrogated via RNA sequencing analysis in 603 gliomas (LGG n=451, GBM n=152) of The Cancer Genome Atlas. SRG expression patterns partitioned gliomas into two clusters that were more distinctive than priorly identified glioma subtypes. The two glioma clusters showed significantly low (14.9 months) or high median survival (105.1 months; Hazard Ratio = 7.1, 95% CI: [5.32, 9.78], p = 1.29e-46 using a log-rank test). The high survival cluster showed overrepresentation of known pro-neural and neural subtypes and IDH-mutated gliomas (p<0.00001). The mesenchymal and classic GBMs and IDH-wild type gliomas were overrepresented in the low survival cluster (p < 0.00001). In addition, an Elastic Net Cox Regression model identified 34 SRGs whose expression significantly predicted differential survival and a prognostic Synapse Gene Score (SGS) was created. Using an accelerated failure time model, SGS predicted survival in the overall gliomas after adjusting for IDH-1 mutation (HR = 2.51, 95% CI: [2.27, 2.7496], p<0.00001), and in the IDH-1 mutant cohort after adjusting for 1p/19q co-deletion (HR = 2.05, 95% CI: [1.73, 2.37], p<0.00001). Our analysis shows that gliomas can be distinctively clustered by differential SRGs expression, suggesting that synapse-related proteins may contribute to tumorigenesis via multiple mechanisms. Furthermore, the potential utility of SRGs as clinical glioma biomarkers is supported by our creation of a prognostic SGS. Future studies elucidating interactions between tumorigenesis and synaptic mechanisms may reveal additional insights for glioma biology and therapeutic targeting.

Objective: To describe early and mid-term outcomes of Viabahn stenting for extensive aorto-iliac occlusive disease involving the external iliac artery. Methods: In this single center retrospective study, all consecutive patients in whom a covered self-expanding Viabahn stent was implanted (W.L Gore & Associates, Inc., Flagstaff, AZ–USA) in the external iliac artery for symptomatic TASC II C and D lesions between 2012 and 2020 were included. Lesions limited to the iliac artery were treated percutaneously. Iliac lesions extending down to the common femoral artery were treated with a hybrid approach. Patency, major adverse limb events, target lesion revascularization (TLR) and limb salvage rates were estimated using Kaplan-Meier curves. Results: Out of 118 limbs, 48 (41%) were treated for claudication, 33 (28%) for rest pain, and 37 (31%) for tissue loss. Lesions were TASC C (n = 43 limbs, 36%) or TASC D (n = 75 limbs, 64%). Chronic total iliac occlusions were identified in 26 limbs (22%). Concomitant common femoral artery lesions were recorded in 97 limbs (82%). All lesions involved the external iliac artery. Technical success was achieved in 100% of cases. Six (5.7%) perioperative major adverse cardiovascular events occurred, including 4 (3.8%) deaths. Eleven (7.6%) early major adverse limb events were recorded. Two-years primary patency, assisted primary patency and secondary patency were 85%, 88%, and 95%, respectively. After multivariate analysis, small-diameters stents (<8 mm) was associated with lower primary patency rates (HR 3.20, 95% CI 1.26-8.13, P = .014) and lower freedom from TLR rates (HR 2.61, 95% CI 1.02-6.66, P = .045). Adjunctive common femoral artery endarterectomy was significantly associated with higher primary patency rates (HR 0.38 95% CI 0.15-0.95, P = .038). Conclusion: The use of Viabahn self-expanding covered stents for extensive aorto-iliac disease involving the external iliac artery provided acceptable post-operative morbidity and high rates of mid-term secondary patency, similar to those usually reported with aortobifemoral bypass. Adjunctive common femoral artery endarterectomy was a major determinant of patency and should be considered an essential component of the treatment strategy. Additional long-term data are necessary to evaluate the role of self-expanding covered stents for the treatment of such lesions.