Votive Offerings from Floresti Orthodox Monastery in Romania: An Ophthalmological Lesson from the Eighteenth and Nineteenth Centuries CE

Since Antiquity, votive offerings were deposited in temples dedicated to deities in order to fulfil a special request of a supplicant. Later, in Orthodox churches, votive offerings entered in the form of anatomical ex-voto or tamata, metallic effigies that realistically represented the disease-affected portion of the body. In this paper, we show four tamata from eighteenth-nineteenth century identified in the museum of the Orthodox monastery of Floresti (Romania); votive offerings that represent ocular pathologies. Even if the supplicants did not have a medical background and often did not fully understand their diseases, the votive offerings demonstrate their ability to observe pathological changes, at the same time emphasising the importance of their faith in the healing process.

The tumour volume influence on tumour recurrence and progression-free survival in the case of atypical meningiomas

Objective: The objective of our study was to evaluate a possible relation between the volume of atypical meningiomas (AMs) and the risk of tumour recurrence, as well as progression-free survival (PFS). Material and methods: We evaluated 81 patients diagnosed with AMs (WHO grade II meningioma) who have undergone surgery at the "Prof. Dr. N. Oblu" Emergency Clinical Hospital Iasi between January 1, 2010, and December 31, 2019. The recorded data were demographic and imagistic (MRI, contrast-enhanced T1WI). We calculated the tumour volume prior to the surgery and evaluated the tumour recurrence using MRI at 12, 24, 36, 48 and 60 months after the surgery. Results: 50.6% of patients had meningioma volume < 26.4 cm3. Women had larger tumour volumes than men (52.6%). Patients of age ? 60 years old, had tumour volumes ? 26.4 cm3 in 58.5% of cases and meningiomas with volumes ? 26.4 cm3 recurred earlier (p=0.010). Also, patients who had tumour volumes ? 26.4 cm3, had a shorter PFS (40.976 months), compared to patients with tumour volumes < 26.4 cm3, who had better PFS (53.4 months). Conclusions: the tumour volume of AMs ? 26.4 cm3 represents a negative prognostic factor for both early tumour recurrence and reduced PFS.

Extradural autologous temporal muscle graft mimicking a meningioma

Meningiomas are the most common dural tumour, but there are also many other dural masses which mimic their appearances, such as neoplastic and non-neoplastic lesions. In this paper we report another mass which may mimic a dural lesion, namely a muscle graft harvested from the temporal site and left in situ, used to achieve haemostasis in a posttraumatic temporal extradural hematoma in a young male patient. Solid knowledge of differentiating neuroimaging characteristics of dural masses, as well as its corroboration with the patient’s medical history are extremely helpful in establishing an accurate diagnostic.

“The Silk Road” via subarachnoid cisterns

Meningiomas are generally slow-growing extra-axial benign tumours and in rare cases they can metastasize both neural and extra-neural. Intracranial meningiomas with leptomeningeal dissemination are extremely rare and the exact pathogenesis still remains unknown. The aim of this review is to analyse the pathways of intracranial and spinal metastatic spread of intracranial meningiomas and to discuss their particular clinical and pathological features. We highlight the fact that there is a possibility of leptomeningeal dissemination, even if cerebrospinal fluid cytology is negative, in patients with a medical history of a resected meningioma. We identified three possible ways of dissemination: haematogenous, through the CSF, or during surgery. From a histopathological point of view, the more malignant the meningioma, the more likely its leptomeningeal dissemination.

Anatomical localization of intracranial grade II meningiomas in North-Eastern Romania

Objective. Our research aims to assess a possible connection between tumour localization and histological subtypes of grade II meningiomas. Material and methods. 143 patients with grade II WHO meningiomas underwent surgical resection in "Prof. Dr. N. Oblu" Emergency Clinical Hospital Ia?i between 1990 and 2015. The collected data included: patient age, gender, tumour localization and histopathological diagnosis (atypical, clear cells and chordoid meningioma). Results. 135 (94.4%) of all 143 patients with grade II meningiomas were atypical meningiomas, 6 (4.2%) were cell clear meningiomas and only 2 (1.4%) were chordoid meningiomas. As concerns their distribution by gender, 79 (55.2%) were female and 64 (44.8%) were male. Grade II meningiomas were most commonly located at convexity 49.7% (n=71), followed by skull base in 30.8% (n=44) of the cases and parasagittal/falcine in 14.7% (n=21) of the patients. Conclusions. The most common localization of grade II meningiomas was convexity, followed by skull base, parasagittal/falcine and intraventricular areas. We have also noticed that convexity meningiomas are more frequent in women, unlike the other anatomical localizations in which the male-female ratio is almost equal. Therefore, further research is necessary to determine the role of embryological, anatomopathological and genetic factors in underlying the connection between meningioma grade and anatomical localization.

Pathways of metastatic spread in meningiomas

Meningioma is a common intracranial neoplasm derived from meningothelial cells, and it is generally associated with a benign clinical course. In spite of this, the malignant behaviour of these tumours as the occurrence of extracranial meningioma metastases in different organs is described in the literature: lung and pleura, spine and other bones, abdominal organs, lymph nodes or even skin. The aim of this review is to analyse the pathways of metastatic spread of the intracranial meningioma tumour cells towards different organs.

Prognostic factors in atypical meningioma

Atypical meningioma represent an intermediary group between the benign meningioma (grade I) and anaplastic meningioma (grade III), and are known for high recurrence rate and short life expectancy. After modification of the classification World Health Organization in 2007, subsequent studies have tried to find prognostic factors for recurrence and survival, which are inconstant from author to author. This paper aims to present a short review of the most important prognostic factors in atypical meningioma.

To be or not to be a neurovascular conflict: importance of the preoperative identification of the neurovascular conflict in the trigeminal neuralgia

The trigeminal neuralgia caused by neurovascular compression is a neurosurgical pathology requiring the preoperative identification as exact as possible of the neurovascular conflict. In this case, neuroimaging is very useful, as it allows not only the determination of the neurovascular conflict of the trigeminal nerve, but also the correct indication of an adequate surgical approach.

NEUROPSYCHOLOGICAL GROUNDS IN THE AWAKE BRAIN SURGERY

Traditionally, the awake cerebral neurosurgical interventions are carried out when the primary motor areas and the areas involved in language are concerned. This procedure is also known as mapping (Intraoperative Brain Mapping). The intraoperative neuropsychological protocol supposes the setting of a list of steps and tasks that the patient must perform during the surgery, taking into account the lesion localization (both the cortical and the subcortical structures), the cognitive functions involved and the individual particularities of each patient. As a result of the high validity of certain tests, we propose a common minimal set of tests, which can allow a minimal standardization and replicability.

Intraorbital foreign body

Penetrating orbitocranial injuries caused by intraorbital foreign body are a rare cause of morbidity being most common among young people. The term intraorbital foreign body refers to a foreign body that occurs within the orbit but outside the ocular globe. We report the case of a 12-year-old male child who sustained a right cranial facial trauma due to accidental fall on a piece of wood, which penetrated intraorbitally. Native cranial magnetic resonance imaging (MRI -1.5 T) revealed the presence of an intraorbital foreign body, 6 cm long and 1.5 cm wide, near the orbital apex. In our patient, early surgical extraction of the foreign body had a decisive role on his full recovery. In this case, although a large foreign body penetrated the entire length of the orbit, it did not cause damage to any intraorbital structure. Vision and right ocular globe function had an excellent prognosis.

[Family income--nutrition correlation in a group of Negreşti Vaslui preschool children]

Growth and development are influenced by genetic and environmental factors. From the environmental factors, nutrition plays a key role and is income dependent.

OBJECTIVES

Assessing food intake according to family financial status.

MATERIAL AND METHOD

A study was conducted on 134 preschool children (ages from 3 to 7 years of age) from a Negreşti kindergarten. Questionnaires were filled by parents for weekly food intake and family financial situation. Statistical analysis used Pearson test.

RESULTS

According to income the group is structured in: very low income (32.8%), low income (28.3%), average income (26.8%) and above average income (12.1%). The majority of the families provides milk to their children (58.9%), varying from 54.5% (very low income) to 63.1% (low income). Poultry is present in the diet mainly for 2-3 times per week (45.5%) going from 36.8% in low income families to 55.5% in average income families. Daily fruit intake is present in 59.7% of families, varying from 45.4% (very low income) to 68.7% (above average income). Recorded differences have no statistic significance.

CONCLUSION

Families income is different but the nutrition provided to children is similar, being strongly influenced by traditional nutritional habits.