Journal of Korean Neurosurgical Society最新文献

{"title":"High-Flow Bypass with Vertebral Artery (V3) to Middle Cerebral Artery (M2) Bypass Using Radial Artery Graft for Common Carotid Artery Occlusion.","authors":"Jae Seong Hong, Jiwook Ryu, Ju In Park, Seok Keun Choi","doi":"10.3340/jkns.2025.0278","DOIUrl":"10.3340/jkns.2025.0278","url":null,"abstract":"<p><p>Common carotid artery (CCA) occlusion is a rare condition that can result in diverse neurological symptoms due to insufficient cerebral blood flow. We present a case of CCA occlusion treated with high-flow vertebral artery (VA) to middle cerebral artery (MCA) bypass using a radial artery (RA) graft. A 68-year-old man experienced recurrent ischemic events in the months preceding surgery. Preoperative diffusion-weighted imaging showed left anterior border zone infarction, and single-photon emission computed tomography revealed severe hemispheric hypoperfusion. Digital subtraction angiography confirmed complete occlusion of the left CCA with inadequate external carotid artery supply. A VA (V3 segment)-RA-MCA (M2 segment) bypass was performed, resulting in an uneventful postoperative course. Follow-up angiography demonstrated durable patency of the radial artery graft. No recurrent ischemic events were observed during the 2-year follow-up period. This technical note demonstrates key surgical considerations for VA-RA-MCA high-flow bypass as a salvage technique in a patient with symptomatic CCA occlusion.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"822-828"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-Assisted Deep Brain Stimulation for Parkinson's Disease : Accuracy, Workflow, Clinical Outcomes, and Safety.","authors":"Kyung Won Chang, Jung-Il Lee","doi":"10.3340/jkns.2025.0226","DOIUrl":"10.3340/jkns.2025.0226","url":null,"abstract":"<p><p>Robot-assisted deep brain stimulation (DBS) has emerged as a major advancement in stereotactic and functional neurosurgery, enhancing precision, reproducibility, and efficiency in targeting deep brain structures for Parkinson's disease. This comprehensive review synthesizes the current state of robotic DBS platforms, comparing their technical mechanisms, targeting accuracy, clinical outcomes, workflow efficiency, and safety profiles. Across diverse robotic systems, reported robotic targeting errors are typically around 1 mm, with values ranging from submillimeter to approximately 1.5 mm. Clinical outcomes, including 40-60% improvements in Unified Parkinson's disease rating scale (UPDRS)-III scores and significant reductions in dopaminergic medication, parallel those achieved with traditional approaches, while complication rates remain within the expected range. Robotic systems further enhance procedural efficiency through automated trajectory alignment, image-guided verification, and reduced intraoperative variability, with a clear learning-curve effect observed across centers. This review summarizes published evidence, highlights the unique strengths of robot assisted DBS, and discusses the evolving role of robotic DBS in modern neurosurgical practice.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"683-694"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Posterior Reversible Encephalopathy Syndrome with Intraventricular Hemorrhage in a Patient with Eclampsia : A Case Report.","authors":"Woo Hyeong Park, Sang Koo Lee, Young Jin Kim, Jung-Ho Yun, Jaewoo Chung, In-Ho Jung, Sung Jin Kim, Tae Woong Bae, Chun-Sung Cho","doi":"10.3340/jkns.2026.0038","DOIUrl":"10.3340/jkns.2026.0038","url":null,"abstract":"<p><p>Posterior reversible encephalopathy syndrome (PRES) typically involves parieto-occipital regions but rarely presents with extensive central involvement and intraventricular hemorrhage (IVH). We report a rare case of atypical PRES with extensive central involvement and IVH in a patient with eclampsia, emphasizing diagnostic challenges and favorable outcomes. Initial CT showed IVH in all ventricles and bilateral basal ganglia hypodensities. Following emergency cesarean section, brain magnetic resonance imaging revealed typical parieto-occipital vasogenic edema along with atypical involvement of the pons, midbrain, bilateral basal ganglia, and thalami, consistent with a central variant of PRES. Susceptibility-weighted imaging showed microhemorrhages in the basal ganglia, while magnetic resonance venography excluded cerebral venous thrombosis. Conservative management with strict blood pressure control and seizure prophylaxis resulted in complete radiological resolution on follow-up imaging, and the patient was discharged without neurological deficits. Prompt recognition of atypical PRES patterns prevents misdiagnosis and unnecessary interventions despite severe radiological findings.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"808-814"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Early Supplemental Parenteral Nutrition with Clinical Outcomes in Patients with Traumatic Brain Injury.","authors":"Heejin Kim, Jingyeong Kim, Jihyeon Ahn, Mihwa Jang, Eunyoung Kim, Dae-Sang Lee, Min Ho Lee, Hyung Sun Choi, Maru Kim","doi":"10.3340/jkns.2026.0042","DOIUrl":"10.3340/jkns.2026.0042","url":null,"abstract":"<p><strong>Objective: </strong>Early oral or enteral nutrition (EN) is recommended for critically ill patients; however, individuals with traumatic brain injury (TBI) often fail to meet their nutritional goals. Supplementary parenteral nutrition (SPN) in this instance may be of benefit, but evidence is lacking. This study examined the association between early SPN and nutritional adequacy and clinical outcomes in patients with TBI.</p><p><strong>Methods: </strong>This retrospective, non-randomized, single-center cohort study analyzed adult patients with TBI admitted to a trauma intensive care unit (ICU) from January 2023 to December 2024. Patients who received oral nutrition or EN on hospital day 4 (HD4) were included and classified based on their use of SPN. We assessed total caloric and protein intake on HD4, as well as survival rates, lengths of ICU and hospital stays, the occurrence of infectious complications, and unplanned ICU readmissions.</p><p><strong>Results: </strong>Among 260 screened patients, 122 were included in the study. The SPN group achieved higher caloric intake (1508 vs. 852 kcal; p<0.05) and total protein intake (79 vs. 41 g; p<0.05). Additionally, SPN was associated with lower rates of urinary tract infections (19.7% vs. 44.3%; p=0.004) and unplanned ICU readmissions (9.8% vs. 31.1%; p=0.004). Logistic regression analysis revealed a reduced risk for urinary tract infections (odds ratio [OR], 0.38; p=0.026) and unplanned ICU readmissions (OR, 0.25; p=0.007).</p><p><strong>Conclusion: </strong>Early SPN was associated with improved caloric and protein delivery and fewer infectious complications and unplanned ICU readmissions in TBI patients. Despite several limitations, these results suggest that SPN may be a beneficial strategy when oral or EN alone is inadequate.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"770-778"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Where Does JKNS Stand in JCR 2025, and How Should We Proceed for Sustainable Growth?","authors":"Hee-Jin Yang","doi":"10.3340/jkns.2026.0223","DOIUrl":"10.3340/jkns.2026.0223","url":null,"abstract":"<p><p>The 2025 Journal Citation Reports (JCR) reveal that the Impact Factor (IF) for the Journal of Korean Neurosurgical Society (JKNS) has risen to 1.9, an increase from 1.7 in 2024. The upward trend in the IF compared to previous years is a highly encouraging development. Although the IF of JKNS has increased, a substantial gap still remains compared to top-ranked neurosurgical journals. The time has come to set clear goals for where JKNS should head next and to explore how to reach them. While maintaining our existing strategies, we aim to consider actionable approaches to advance to the next level.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"670-673"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Adaptive, Time-Informed, Phenotype-Guided Pharmacological Framework for Severe Traumatic Brain Injury : A Hypothesis-Driven Narrative Review.","authors":"Jae Min Choi, Kwang Wook Jo","doi":"10.3340/jkns.2026.0187","DOIUrl":"https://doi.org/10.3340/jkns.2026.0187","url":null,"abstract":"<p><p>Severe traumatic brain injury (TBI) remains difficult to treat because successful control of mass lesions, intracranial pressure, cerebral perfusion, oxygenation, and systemic instability does not ensure that secondary cellular injury has stopped. PubMed/MEDLINE and ClinicalTrials.gov were searched through July 28, 2026, and representative candidates were organized across five overlapping pathophysiological nodes. Evidence was described by study source, purpose, and result direction rather than assigned a formal quality grade. Human evidence was heterogeneous. Glibenclamide/glyburide and hypertonic sodium lactate produced preliminary imaging or physiological signals without demonstrated functional benefit. Riluzole was neutral in an adult randomized trial, whereas a small study in chronic TBI found that minocycline reduced a neuroinflammatory imaging signal but increased plasma neurofilament light. Metformin and N-acetylcysteine plus probenecid provided exploratory pharmacokinetic, biomarker, or safety data. Amantadine provided phenotype-specific clinical proof of principle in traumatic disorders of consciousness. Cerebrolysin showed mixed human evidence, including a favorable day-90 multidimensional ensemble signal that requires independent replication. Deferoxamine and clemastine remain preclinical. We therefore propose a modular pharmacological framework composed of separable investigational modules rather than simultaneous multidrug treatment. Module activation should require optimized foundational care, a matching phenotype, measurable target activation or engagement, and acceptable systemic safety. This framework prioritizes phenotype-enriched, single-module development before any sequential or combination design and does not support routine off-label polypharmacy.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurocognitive Changes and Cerebral Blood Flow in Patients with Symptomatic Carotid Artery Stenosis before and after Carotid Endarterectomy.","authors":"Yu Xiao, Shifang Li, Yongli Bo, Yingbin Jiao, Changqing Ding, Hongye Yang","doi":"10.3340/jkns.2025.0248","DOIUrl":"10.3340/jkns.2025.0248","url":null,"abstract":"<p><strong>Objective: </strong>Carotid endarterectomy (CEA) reduces stroke risk in carotid stenosis patients, with potential but unclear benefits on cognitive function and cerebral blood flow (CBF). This study aimed to assess cognitive and CBF changes after CEA in patients with transient ischemic attack (TIA) and severe symptomatic carotid artery stenosis, exploring the relationship between these changes.</p><p><strong>Methods: </strong>In this prospective, observational study was conducted at Affiliated Hospital of Qingdao University between June 2021 and September 2022, and included patients with recent TIA and confirmed severe symptomatic carotid artery stenosis underwent CEA. Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA), and CBF was assessed through arterial spin labeling magnetic resonance imaging (MRI). Measurements were taken preoperatively and at 1 and 6 months postoperatively. Statistical analysis involved paired and independent t-tests, with p<0.05 considered significant.</p><p><strong>Results: </strong>Forty-one patients (average age, 66.8 years; 75.6% male) were assessed. Initially, patients with left internal carotid artery (ICA) stenosis demonstrated naming ability scores significantly lower (2.8±0.4) than controls (3.0±0.2; p<0.05). Right ICA stenosis patients exhibited reduced MoCA scores (21.5±4.3) compared to controls (24.8±3.6, p<0.05). Significant improvements in cognitive performance and CBF were observed 1 month post-surgery, with sustained gains by 6 months. A positive association (R=0.437, p<0.01) was identified between increased CBF and cognitive improvement.</p><p><strong>Conclusion: </strong>CEA may enhance cognitive function and CBF in patients with severe symptomatic carotid artery stenosis. The association between cognitive gains and increased CBF suggests cerebral hemodynamics may play a role as a potentially reversible factor influencing cognitive dysfunction in this population.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":"69 5","pages":"725-733"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Inter-relationship between Sarcopenia and Osteoporosis : Molecular Mechanisms and Therapeutic Interventions.","authors":"Jeonghyeon Seo, Sang Hoon Hwang, Ji Yeon Yoon, Jinyoung Hong, Suk Hyung Kang, Myeong Jin Ko, Subum Lee, Woo-Keun Kwon, Hae-Won Koo, Je Hoon Jeong, Byung-Jou Lee","doi":"10.3340/jkns.2026.0170","DOIUrl":"https://doi.org/10.3340/jkns.2026.0170","url":null,"abstract":"<p><p>Sarcopenia and osteoporosis are prevalent age-related musculoskeletal disorders that frequently coexist and interact, giving rise to the clinical entity known as osteosarcopenia. Although traditionally considered distinct entities, growing evidence indicates that muscle and bone are functionally integrated through biomechanical and biochemical crosstalk. Sarcopenia is characterized by progressive loss of skeletal muscle mass, strength, and function, whereas osteoporosis is defined by reduced bone mineral density (BMD) and microarchitectural deterioration, resulting in increased fracture risk. Both conditions share common risk factors, including aging, chronic inflammation, hormonal changes, physical inactivity, and nutritional deficiencies. Emerging evidence highlights the important role of muscle-derived myokines, bone-derived osteokines, and adipokines in mediating inter-organ communication within the musculoskeletal unit. This narrative review synthesizes current evidence supporting osteosarcopenia as an integrated musculoskeletal syndrome, with a particular focus on biomechanical loading, biochemical crosstalk, and inflammatory signaling. In addition, we discuss diagnostic challenges and therapeutic strategies, emphasizing integrated assessment and management approaches that target skeletal fragility, muscle dysfunction, and musculoskeletal interfaces to reduce frailty, falls, and fractures in aging populations.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Brain Abscess in Patient with Eisenmenger Syndrome.","authors":"Su Jeong Sung, Dae Lim Koo, Songyi Park, Dong Hoon Shin, Haechan Cho, You Jung Ok, Jin-Young Hwang, Hack-Lyoung Kim, Yoon Hwan Byun","doi":"10.3340/jkns.2025.0243","DOIUrl":"10.3340/jkns.2025.0243","url":null,"abstract":"<p><p>Eisenmenger syndrome (ES) is a complex multisystem disorder caused by untreated congenital heart disease. Management of brain abscess in ES is challenging, as treatment decisions must balance infection control with altered cardiopulmonary physiology, necessitating a multidisciplinary approach. We present a case of a 45-year-old male with ES and symptomatic brain abscess treated successfully with abscess aspiration under monitored anesthesia care and appropriate antibiotic therapy. We share our experience, outline key perioperative considerations, and discuss relevant literature.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"798-807"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synchronous Multicentric WHO grade 3 Oligodendroglioma and WHO grade 3 Astrocytoma : A Case Report and Literature Review.","authors":"Byung-Rae Cho, Young Suk Lee, Dong-Sup Chung, Wan-Soo Yoon","doi":"10.3340/jkns.2026.0026","DOIUrl":"10.3340/jkns.2026.0026","url":null,"abstract":"<p><p>Multicentric gliomas are rare clinical entities, and cases exhibiting distinct histological lineages despite sharing a common molecular origin are exceptionally scarce. We report a unique case of synchronous multicentric gliomas in the bilateral frontal lobes of a 59-yearold female that shared an ancestral IDH1-R132H mutation but diverged into distinct molecular trajectories. According to the 2021 World Health Organization (WHO) classification, the left frontal tumor was diagnosed as a central nervous system (CNS) WHO grade 3 oligodendroglioma characterized by 1p/19q co-deletion and CDKN2A mutation, while the right frontal tumor was identified as a CNS WHO grade 3 astrocytoma harboring ATRX and TP53 mutations. This case provides compelling evidence for the stem cell origin theory, suggesting that a common progenitor undergoes independent clonal evolution in different anatomical locations through disparate secondary genetic alterations. Our findings underscore that multicentric lesions cannot be assumed to be molecularly identical, necessitating comprehensive and individual molecular evaluation of each discrete lesion to ensure accurate prognostic stratification and the formulation of personalized therapeutic strategies in the era of integrated diagnostics.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":"69 5","pages":"789-797"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}