Corneliu Toader

• Professor (Associate) at Carol Davila University of Medicine and Pharmacy

The brain-derived neurotrophic factor (BDNF) has become one of the cornerstones of neuropathology, influencing synaptic plasticity, cognitive resilience, and neuronal survival. Apart from its molecular biology, BDNF is a powerful target for transformative benefit in precision medicine, leading to innovative therapeutic approaches for neurodegenerat...

Background: The Glasgow Coma Scale (GCS) is a cornerstone in neurological assessment, providing critical insights into consciousness levels in patients with traumatic brain injuries and other neurological conditions. Despite its clinical importance, traditional methods for predicting GCS scores often fail to capture the complex, multi-dimensional n...

Introduction Glioblastoma (GBM), the most aggressive primary brain tumor, poses a significant challenge in predicting patient survival due to its heterogeneity and resistance to treatment. Accurate survival prediction is essential for optimizing treatment strategies and improving clinical outcomes. Methods This study utilized metadata from 135 GBM...

Background/Objectives: Pontine cavernomas are rare and challenging vascular malformations, representing a critical subset of brainstem lesions due to their deep location and proximity to essential neural structures. When hemorrhagic, these lesions can cause rapid neurological deterioration, posing life-threatening risks. Management requires a delic...

Background: Ruptured intracranial aneurysms remain the subject of debate in their management, but the management of lesions located at high-risk locations, such as the hypophyseal artery, continue to prove to be a challenge in anatomical orientation and proximity to vascular structures. While endovascular therapies have changed the treatment paradi...

Background: Arteriovenous malformations (AVMs) are high-risk cerebrovascular anomalies that can lead to devastating complications, especially when associated with intracranial aneurysms. Their coexistence poses unique challenges in diagnosis and management due to heightened hemodynamic stress and rupture risks. This case presents a 35-year-old woma...

The spine is a complex structure critical for stability, force transmission, and neural protection, with spinal fractures and spondylolisthesis posing significant challenges to its integrity and function. Spinal fractures arise from trauma, degenerative conditions, or osteoporosis, often affecting transitional zones like the thoracolumbar junction....

Background/Objectives: Kissing aneurysms, a rare and intriguing cerebrovascular anomaly, challenge even the most advanced neurosurgical techniques. These lesions, characterized by two intimately apposed aneurysms with shared arterial walls, often masquerade as single, irregular aneurysms. This report documents a case of ruptured kissing aneurysms i...

Purpose The vertebral artery (VA) typically courses through the foramen magnum to enter the posterior cranial fossa. A transosseous course of the VA through the lateral part of the occipital bone is an unexpected finding. Such an anomaly of the VA is reported here. Methods The archived angioCT file of an 81 y.o. female was studied on planar sectio...

The convergence of Artificial Intelligence (AI) and neuroscience is redefining our understanding of the brain, unlocking new possibilities in research, diagnosis, and therapy. This review explores how AI’s cutting-edge algorithms—ranging from deep learning to neuromorphic computing—are revolutionizing neuroscience by enabling the analysis of comple...

Background: This study presents a comprehensive analysis of 135 cases of vestibular schwannoma (VS) treated between 2006 and 2022 at the National Institute of Neurology and Neurovascular Diseases in Bucharest, Romania. The investigation focuses on the clinical presentation, treatment outcomes, and demographic trends of VS patients, highlighting reg...

The management of multiple intracranial aneurysms presents significant clinical challenges, particularly when complicated by underlying conditions such as cerebral atherosclerosis. This case report highlights the successful treatment of a 66-year-old female diagnosed with three intracranial aneurysms located in the right middle cerebral artery (MCA...

Background and Objectives: The Index of Response to Stimulation (IRES) is a new index that we introduce in this study to grade the effectiveness of vagus nerve stimulation in the treatment of drug-resistant epilepsy. We assessed 76 patients at 6, 12, and 18 months after VNS evaluating improvement with the IRES in four key dimensions: seizure durati...

The fetal-type posterior communicating artery (PCoA) variant, present in approximately 17.5% of adults, has significant clinical and surgical implications, particularly in the management of cerebrovascular disorders such as aneurysms. This variant alters cerebral hemodynamics, increasing the risk of ischemic events and complicating neurosurgical in...

Purpose The sigmoid sinus (SS) is a major surgical landmark. The paramastoid process (PMP) occurs rarely. Inferior diverticula of the SS were not found or reported previously. We aimed to determine the incidence and detailed anatomy of such morphology of the SS. Methods Archived angioCT files of 25 males and 25 females were used. The morphology of...

Neuroimmunology is reshaping the understanding of the central nervous system (CNS), revealing it as an active immune organ rather than an isolated structure. This review delves into the unprecedented discoveries transforming the field, including the emerging roles of microglia, astrocytes, and the blood–brain barrier (BBB) in orchestrating neuroimm...

Background: Cerebral cavernous malformations (CCMs), particularly when located in the cerebellum, pose unique clinical challenges due to the risk of hemorrhage and proximity to critical neurovascular structures. Surgical resection is often necessary to prevent further neurological deterioration. This case report describes the management of a sympto...

This review aims to address the significant challenges of treating central nervous system (CNS) disorders such as neurodegenerative diseases, strokes, spinal cord injuries, and brain tumors. These disorders are difficult to manage due to the complexity of disease mechanisms and the protective blood–brain barrier (BBB), which restricts drug delivery...

Background/Objectives: Cerebral arteriovenous malformations (AVMs) are rare but complex vascular anomalies, particularly challenging when located in eloquent regions such as the corpus callosum and post-central gyrus. This report aims to highlight the management and outcomes of a 41-year-old female patient with a hemorrhagic AVM in these critical a...

Background/Objectives: Superior cerebellar artery (SCA) aneurysms are exceedingly rare, posing unique diagnostic and management challenges due to their complex anatomical location within the posterior circulation. The proximity of the SCA to vital structures, such as the brainstem and cerebellum, along with the significant role of poorly controlled...

Anomalies of the vertebral artery (VA) and its branches are rare but critical in neurovascular procedures. In a 38-year-old female, digital subtraction angiography revealed an anomalous origin of the occipital artery (OA) from the V3 segment of the left VA, with a tortuous course supplying the neck and scalp. Below the OA's origin, the suboccipital...

Neurodegenerative diseases, such as Alzheimer’s, Parkinson’s, ALS, and Huntington’s, remain formidable challenges in medicine, with their relentless progression and limited therapeutic options. These diseases arise from a web of molecular disturbances—misfolded proteins, chronic neuroinflammation, mitochondrial dysfunction, and genetic mutations—th...

Background/Objectives: Arteriovenous malformations (AVMs) are complex vascular anomalies that can present with significant complications, including intracranial hemorrhage. This report presents the case of a 36-year-old female with Prothrombin G20210A mutation-associated thrombophilia, highlighting its potential impact on AVM pathophysiology and ma...

The lateral pterygoid muscle (LPM), a critical component of the masticatory muscles, typically comprises upper (SLPM) and lower (ILPM) heads. However, it is essential to note that the LPM’s structure is not a constant feature, as the number of bundles and their topography can vary. Moreover, additional heads, such as medial and middle heads, and un...

Background: This case report highlights a rare presentation of a giant convexity en plaque anaplastic meningioma, located in the left frontoparietal parasagittal region, infiltrating the superior sagittal sinus, and associated with Gerstmann syndrome. This study aims to explore the clinical challenges, surgical management, and potential reversibili...

Background Glioblastoma (GBM) is one of the most aggressive brain cancers, with a median overall survival (OS) of about 15 months. This retrospective study focuses on 144 GBM cases treated over 12 years in our clinic in Romania, analyzing factors affecting progression-free survival (PFS) and OS, including genetic markers and treatment modalities. M...

Background Migraine is a prevalent neurological disorder characterized by chronic headaches, significantly impacting the global population. This comprehensive review aims to advance the understanding of migraine pathogenesis and treatment, focusing on molecular markers and novel therapeutic strategies. Material Molecular markers such as calcitonin...

Introduction Vestibular schwannomas (VS) are benign tumors affecting the vestibulocochlear nerve. This study analyzed the clinical presentations and treatment outcomes of 68 VS cases managed between 2014 and 2023 at the National Institute of Neurology and Neurovascular Diseases in Bucharest, Romania. Methods A retrospective analysis was conducted o...

Background By distal arterial territories we mean the arteries located after the main bifurcations of the cerebral arteries. They can occur at multiple sites throughout the course of distal arteries, but most often are found after the bifurcation of the M1 segment of the middle cerebral artery. Methods A retrospective review of 18 consecutive patie...

Background This study investigates the application of Machine Learning (ML) techniques to predict clinical outcomes in microsurgical clipping treatments of cerebral aneurysms. The goal is to enhance healthcare processes through informed clinical decision-making by utilizing a dataset of 344 patients' preoperative characteristics.Methods Various ML...

Background Intracranial aneurysms (IAs) represent life-threatening neurosurgical emergencies. This study aims to provide a comprehensive analysis of 346 patients with 416 IAs treated using microsurgical clipping between 2016/2022, focusing on demographic characteristics, aneurysm features, and surgical outcomes. Methods This retrospective study inv...

Background: Intracranial AVMs are a highly heterogeneous group of lesions that, while not very common, can pose significant risks. The therapeutic management of AVMs is complicated by ambiguous guidelines, particularly regarding which Spetzler–Martin grades should dictate specific treatment options. This study analyzed the clinical presentations an...

Traumatic brain injury (TBI) is associated with various endocrine abnormalities, including pituitary axis dysfunction. Understanding the prevalence and temporal patterns of these dysfunctions is crucial for effective clinical management. This study aimed to systematically review the literature and conduct a meta-analysis to determine the prevalence...

Pericallosal artery aneurysms are rare, accounting for 2–9% of all intracranial aneurysms, and mirror aneurysms in this location are exceptionally uncommon, presenting unique surgical challenges due to their deep location and proximity to critical neurovascular structures. The aim of this case report is to describe the surgical management and succe...

There are reported here multiple rare anatomical variants of the sphenoidal sinus found in a 53-year-old male. The sinus exhibited uncommon features, including a prominent occipital recess extending bilaterally into the basilar part of the occipital bone. A narrow posterior isthmus connected the main chamber to 2 recesses: a superior postsellar rec...

Intracranial aneurysms, characterized by abnormal dilations of cerebral arteries, pose significant health risks due to their potential to rupture, leading to subarachnoid hemorrhage with high mortality and morbidity rates. This paper aim is to explore the innovative application of nanoparticles in treating intracranial aneurysms, offering a promisi...

Dehiscences of the intrapetrous canal of the facial nerve (FN) and those of a high jugular bulb (HJB) have various incidences. However, the HJB-FN common dehiscent osseous wall is a scarce finding and rarely reported. Thus, this work aimed to study this peculiar intrapetrous morphology on computed tomograms (CTs). A batch of 60 archived CTs was use...

Background: Hypopituitarism is a potentially serious but often underdiagnosed condition that can occur following non-traumatic subarachnoid hemorrhage (SAH). The condition is characterized by the partial or complete deficiency of one or more pituitary hormones, leading to a range of clinical manifestations that may complicate the recovery process....

This case report delves into the case of a 56-year-old female patient presenting with progressive cephalalgia syndrome, nausea, vomiting, and gait disorders, diagnosed with a high-grade thalamic glioma. Glioma is the most common form of central nervous system (CNS) neoplasm that originates from glial cells. Gliomas are diffusely infiltrative tumors...

Gerstmann syndrome, alternatively recognized as angular gyrus syndrome, epitomizes a complex cognitive impairment that has ignited substantial scholarly discourse within the realms of neurology and neuropsychology. The syndrome’s original portrayal was, however, changed. It was demonstrated that the manifestation of its symptomatic tetrad, consisti...

This case report presents an exceedingly rare instance of skull base chondromyxoid fibroma (CMF) managed surgically. Chondromyxoid fibromas are very rare tumors (<1% of benign bone tumors), the occurrence in the skull area being even more rare. The location of tumors at the skull base makes their surgical resection extremely challenging, usually re...

Purpose The vertebral artery (VA) pierces the dura mater and continues with the intradural V4 segment. Once entered into the dura mater, the VA ascends from the infero-lateral to the antero-superior side of the medulla. Scarce reports of VAs compressing the medullospinal junction (MSJ) are available. We therefore aimed to determine the incidence of...

Background: This study investigates the application of Machine Learning techniques to predict clinical outcomes in microsurgical clipping treatments of cerebral aneurysms, aiming to enhance healthcare processes through informed clinical decision making. Methods: Relying on a dataset of 344 patients’ preoperative characteristics, various ML classifi...

Background and Objectives: The jugular bulb (JB) is the uppermost part of the internal jugular vein receiving the sigmoid sinus. The aim of the present research is to aid the comprehension of the JB, its abnormalities, and surrounding structures for improving both academic and surgical awareness. Materials and Methods: Various studies on this topic...

Background and Objectives: Typically, the vertebral arteries (VAs) enter the posterior fossa through dural rings and further unite, forming the basilar artery. The posterior inferior cerebellar artery (PICA) is usually a branch of the V4 segment of the VA (intradural origin). It may also leave the V3 suboccipital segment of the VA (extradural origi...

Introduction: Hereditary multiple exostosis or hereditary multiple osteochondromas is a very rare clinical condition. Usually, these lesions tend to occur in the pediatric population, remaining silent until adulthood. Moreover, current studies show a small prevalence in the male population. The osteochondromas usually occur at sites with great bone...

Background: Evaluating the differential impact of vagus nerve stimulation (VNS) therapy across various seizure types, our study explores its efficacy specifically in patients with categorized minor and major seizures. Methods: We conducted a retrospective cohort study involving 76 patients with pharmacoresistant epilepsy treated at the University E...

This retrospective mono-center study focuses on 144 cases of glioblastoma treated over a time span of 12 years in our clinic in Romania. We offer critical insight into the dreadful aspect of this tumor by highlighting the principal characteristics such as localization, the genetic information of each case, progression-free survival (PFS), and overa...

Intracranial "kissing" aneurysms are rare vascular conditions described as two anatomically adjacent aneurysms originating from either the same or different arteries, with their walls pressed together. Two-dimensional angiography was formerly considered the gold standard for diagnosis, with the three-dimensional rotational type now offering more in...

Solitary fibrous tumor (SFT) is a rare type of tumor characterized by spindle-shaped cells originating from mesenchymal tissue. This case series presents a collection of 14 intracranial solitary fibrous tumors treated between 2014 and 2022 in our institute in Bucharest, Romania. Through a systematic investigation, key aspects spanning the preoperat...

In the field of cerebrovascular neurosurgery, intracranial aneurysms (IAs) have been occasionally associated with brain arteriovenous malformations (BAVMs), indicating a more aggressive clinical course, and increased rates of hemorrhage and rehemorrhage. Treatment of flow-related IAs in BAVMs remains debatable, with considerations for preventive in...

Gliomas constitute a diverse and complex array of tumors within the central nervous system (CNS), characterized by a wide range of prognostic outcomes and responses to therapeutic interventions. This literature review endeavors to conduct a thorough investigation of gliomas, with a particular emphasis on glioblastoma (GBM), beginning with their cla...

In the original publication [...]

In our study, we document the case of a 48-year-old patient who presented at our clinic with various neurological disturbances. Magnetic Resonance Imaging revealed the presence of an intraventricular meningioma located in the body of the left lateral ventricle measuring 60 mm in diameter. This tumor was classified as a giant meningioma, accompanied...

This comprehensive study analyzes 346 surgically treated intracranial aneurysms, emphasizing the importance of understanding risk factors and prevalent characteristics in patients. Intracranial aneurysms, primarily of the saccular or berry type, significantly contribute to nontraumatic subarachnoid hemorrhages and demonstrate a rising incidence due...

Psychiatric disorders represent a primary source of disability worldwide, manifesting as disturbances in individuals’ cognitive processes, emotional regulation, and behavioral patterns. In the quest to discover novel therapies and expand the boundaries of neuropharmacology, studies from the field have highlighted the gut microbiota’s role in modula...

COVID-19-associated rhino-orbital mucormycosis has become a new clinical entity. This study’s aim was to evaluate the histopathological and ultramicroscopic morphological aspects of this fungal infection. This was an observational retrospective study on eight patients from three tertiary centers in Romania. The tissue samples collected during funct...

This study conducts an in-depth analysis of the management of a complex arteriovenous malformation (AVM) in a 44-year-old individual, who initially manifested with acute left hemiparesis and progressively declined into a comatose state. Diagnostic neuroimaging identified a substantial right fronto-temporal intraparenchymal hematoma via a CT scan. C...

Subependymomas are benign tumors of the ventricles that grow from the ventricular wall into the cerebrospinal fluid spaces within the brain, obstructing the flow of the cerebrospinal fluid and causing obstructive hydrocephalus. It is estimated that ependymomas represent between 0.2% and 0.7% of all intracranial tumors. They arise most frequently in...

This case report elucidates the clinical and surgical journey of a 62-year-old patient with a history of multiple comorbidities including a severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection, presenting with temporospatial disorientation, bradypsychia, and bradyphasia, without motor deficits, diagnosed with sarcomatous meningiom...

Meningiomas represent a prevalent class of primary brain tumors, with malignancies such as World Health Organization grade III meningiomas posing significant clinical challenges due to their aggressive nature and potential for recurrence. This case report showcases the clinical journey of a 67-year-old female patient presenting with a giant maligna...

This review presents a comprehensive analysis of pituitary adenomas, a type of brain tumor with diverse behaviors and complexities. We cover various treatment approaches, including surgery, radiotherapy, chemotherapy, and their integration with newer treatments. Key to the discussion is the role of biomarkers in oncology for risk assessment, diagno...

This case report presents a comprehensive analysis of a 67-year-old patient diagnosed in 2017 with meningothelial meningioma, focusing on the challenges of managing such tumors and their neurological implications. Meningiomas, being the most common benign intracranial neoplasms, have a notable research gap regarding their association with seizures...

The study reflects on a 69-year-old female patient with a history of cardio-respiratory disorders who was diagnosed with meningioma en plaque. Her clinical management entailed surgical resection of the tumor, which was followed by a complex postoperative course, including cardiorespiratory arrest and respiratory failure. Histologically, extracrania...

Background and Objectives: The microanatomy of the superior cerebellar artery (SCA) is clinically significant. We, thus, aimed at patterning unilateral and bilateral possibilities of SCA origin. Materials and Methods: In total, 205 archived records of computed tomography and magnetic resonance angiograms were used. There were defined types of SCA o...

Low-Grade Gliomas (LGGs) represent a diverse group of brain tumors originating from glial cells, characterized by their unique histopathological and molecular features. This article offers a comprehensive exploration of LGGs, shedding light on their subtypes, histological and molecular aspects. By delving into the World Health Organization’s gradin...

Chiari Malformation and Syringomyelia are neurosurgical entities that have been the subject of extensive research and clinical interest. Globally prevalent, these disorders vary demographically and have witnessed evolving temporal trends. Chiari Malformation impacts the normal cerebrospinal fluid flow, consequently affecting overall health. Key obs...

With the inexorable aging of the global populace, neurodegenerative diseases (NDs) like Alzheimer’s disease (AD), Parkinson’s disease (PD), and amyotrophic lateral sclerosis (ALS) pose escalating challenges, which are underscored by their socioeconomic repercussions. A pivotal aspect in addressing these challenges lies in the elucidation and applic...

The landscape of cranial base surgery has undergone monumental transformations over the past several decades. This article serves as a comprehensive survey, detailing both the historical and current techniques and technologies that have propelled this field into an era of unprecedented capabilities and sophistication. In the prologue, we traverse t...

This review initiates by outlining the clinical relevance of IA, underlining the pressing need to comprehend its foundational elements. We delve into the assorted risk factors tied to IA, spotlighting both environmental and genetic influences. Additionally, we illuminate distinct genetic syndromes linked to a pronounced prevalence of intracranial a...

The pituitary gland, a puzzling medical subject up until the 20th century, had its early pathologies first documented in the 19th century by Pierre Marie and Hutchinson, where the gland’s meaningful study was hindered by its hard-to-reach location. This paper revisits the pioneering work of Romanian doctors such as Gheorghe Marinescu, Nicolae Paule...

Music is a complex phenomenon with multiple brain areas and neural connections being implicated. Centuries ago, music was discovered as an efficient modality for psychological status enrichment and even for the treatment of multiple pathologies. Modern research investigations give a new avenue for music perception and the understanding of the under...

This article critically evaluates the multifunctional role of the Golgi apparatus within neurological paradigms. We succinctly highlight its influence on neuronal plasticity, development, and the vital trafficking and sorting mechanisms for proteins and lipids. The discourse further navigates to its regulatory prominence in neurogenesis and its imp...

Among the high prevalence of cerebrovascular diseases nowadays, acute ischemic stroke stands out, representing a significant worldwide health issue with important socio-economic implications. Prompt diagnosis and intervention are important milestones for the management of this multifaceted pathology, making understanding the various stroke-onset sy...

Aquaporins (AQPs), integral membrane proteins facilitating selective water and solute transport across cell membranes, have been the focus of extensive research over the past few decades. Particularly noteworthy is their role in maintaining cellular homeostasis and fluid balance in neural compartments, as dysregulated AQP expression is implicated i...

In this review article, we embark on a thorough exploration of cannabinoids, compounds that have garnered considerable attention for their potential therapeutic applications. Initially, this article delves into the fundamental background of cannabinoids, emphasizing the role of endogenous cannabinoids in the human body and outlining their significa...

Neurodegenerative disorders often acquire due to genetic predispositions and genomic alterations after exposure to multiple risk factors. The most commonly found pathologies are variations of dementia, such as frontotemporal dementia and Lewy body dementia, as well as rare subtypes of cerebral and cerebellar atrophy-based syndromes. In an emerging...

Aneurysmal subarachnoid hemorrhage is a neurosurgical emergency, representing a major factor in the morbidity and mortality of mother and fetus, and requires prompt intervention and multidisciplinary care. There are no standardized guidelines to date on management and treatment of this clinically rare scenario and the main issues are debated in rec...

Context. Pituitary adenomas are benign tumors, usually found in men in their 3 rd and 5 th decades of life, representing 10-15% of all intracranial tumors. The clinical manifestations include important endocrinological disturbances and visual impairment. Objective. This study aimed to determine the most suitable neurosurgical approach regarding the...

The anterior communicating artery (AComA) normally joins the anterior cerebral arteries (ACAs) when they change their directions from horizontal to vertical. Each postcommunicating segment of the ACAs commonly sends off the callosomarginal artery (CMA) and continues as the pericallosal artery. While documenting the archived computed tomography angi...

(1) Background: The external jugular vein (EJV) descends on the sternocleidomastoid muscle to drain deep into the subclavian vein. Anatomical variations of the EJV are relevant for identification of the greater auricular nerve, flap design and preparation, or EJV cannulation. (2) Methods: Different publications were comprehensively reviewed. Dissec...

Background and Objectives: Anatomical variations of the arterial circle of Willis (cW) are common. A posterior cerebral artery (PCA) fed mostly or exclusively from the internal carotid artery is a fetal PCA (FPCA), partial (p-FPCA), or full/complete (f-FPCA), respectively. Because FPCA occurs in different anatomical configurations of the cW sides,...