In medical care for traumatic brain injury, it is important to have seamless cooperation from initial trauma care, neurosurgery, neurocritical care, and rehabilitation. Brain injury is an irreversible injury, and recovery is challenging. In the treatment of trauma, including the brain, the standardization of treatment has progressed, with input from JATEC (Japan Advanced Trauma Evaluation and Care) and guidelines for the management of head injury (the Japan Society of Neurotraumatology). Roles have been divided among emergency physicians, neurosurgeons, and intensive care physicians. While the quality of each specialty treatment has improved and better treatment outcomes are obtained, an appropriate cooperation system is required. Neurosurgeons also need to share guidelines as members of the trauma care team. Familiarization with the trauma team can be expected to improve outcomes for traumatic brain injury patients.

  Traumatic brain injuries (TBIs) are increasingly common in sports, where the majority are classified as mild. Concussion is the most common form of sport-related TBIs, but diagnosis is sometimes challenging because objective and reliable biomarkers have not been established. Early detection and management are essential to prevent prolonged or recurring symptoms. Associated symptoms usually resolve within one week ; however, about 10% of patients suffer from prolonged symptoms over months or years. Initial rest and a graduated return to play protocol have been proposed, intended to prevent relapse of the symptoms. Exploration of concussion pathophysiology using advanced neuroimaging techniques, such as magnetic resonance imaging (MRI), and physiological indices may provide clinicians with new biomarkers for treating sport-related TBIs. In this review, we present the current topics in sport-related TBI, particularly concussion, and the pitfalls of diagnosis and management in daily practice.

  It has become clear that inappropriate nurturing, abuse, and maltreatment of children by their parents or caregivers, can negatively affect the children's brains. How can we protect children's brains from the damage caused by maltreatment? Herein, we outline the importance of “Maltreatment Prevention^®” and “Tomo-nurturing^® (Alloparenting) ” in preventing damage to children's brains, from the viewpoint of brain science.

  In cases of traumatic brain or spinal cord injury, initial tissue damage cannot be prevented. However, decompression, whole body management, and fixation, are used to prevent secondary damage. The prognosis for patients with traumatic brain or spinal cord injury is not necessarily good and regenerative medicine, including cell therapy may provide potential treatment options. Rehabilitation is essential for functional recovery of patients after traumatic brain or spinal cord injury and other underlying mechanisms of rehabilitation, including neuroprotection and neurogenesis present further treatment opportunities. Rehabilitation is also a critical treatment for cell therapy. Therefore, the handling and set up of rehabilitation in clinical trials of regenerative therapy is challenging. More research is required into regenerative medicine, including cell therapy and rehabilitation, to determine its clinical application as a routine treatment option in the future.

  Calcification of metastatic brain tumors is relatively rare and long-term survival is often reported. We report a case of relatively early recurrence of a metastatic brain tumor following Gamma Knife radiosurgery. The patient is an 80-year-old woman who was diagnosed with lung adenocarcinoma. She underwent computed tomography (CT) during maintenance chemotherapy, which demonstrated a small brain tumor with areas of calcification in the right cerebellar hemisphere. Considering the patient was elderly with low cardiac function, we decided to perform Gamma Knife radiosurgery as the first intervention. After treatment, the tumor shrunk but recurred six months later. After re-treatment, the tumor shrunk once more, but again recurred six months later. There are various mechanisms of calcification within brain metastasis, but some may be associated with poor prognostic factors or may affect radiosensitivity. Therefore, further studies are needed.

  The causes of pediatric ischemic stroke are diverse and causes of cerebrovascular stenosis include reversible cerebral vasoconstriction syndrome (RCVS), arterial dissection, and focal cerebral arteriopathy (FCA). In particular, reports of RCVS in children are rare, and the course and characteristics are not clear. We herein report a case of suspected RCVS in a child who initially developed obstruction of the intracranial internal carotid artery (ICA), followed by stenoses in the right middle cerebral artery (M1 and M2). A 15-year-old male suddenly developed severe headache and left hemiparesis while running. Magnetic resonance imaging (MRI) of the head showed narrowing of the right terminal ICA and a cerebral infarction in the right basal ganglia. Subsequently, the patient developed occlusion of the right terminal ICA and a new infarction in the right cerebral peduncle. Two months after onset, the recanalization of the right ICA and new stenoses of the right MCA (M1 and M2) were observed. The M1 stenosis improved after four months and the M2 stenosis after 3.5 years. RCVS was suspected in this case because of the reversible improvement of vascular stenosis. In pediatric ischemic stroke with cerebrovascular stenosis, it is necessary to consider RCVS, arterial dissection, and FCA as differential diagnoses. RCVS may develop new spasms at different sites over time, therefore a long period of follow up is required when RCVS is suspected.