Journal of Korean Neurosurgical Society最新文献

{"title":"Craniectomy Combined with Rapid Internal Decompression in Massive Cerebral Infarction : Surgical Technique and Outcomes.","authors":"Shao Xie, Jiahai Ding, Yuancheng Yao, Xiaoya Huang, Yuliang Chen, Yang Xiong, Tong Zhang, Yong Liu, Lei Wang","doi":"10.3340/jkns.2024.0210","DOIUrl":"https://doi.org/10.3340/jkns.2024.0210","url":null,"abstract":"<p><strong>Objective: </strong>Massive cerebral infarction caused by middle cerebral artery infarction leads to extensive cerebral infarction in one hemisphere, resulting in swelling of the brain and further compression of surrounding normal brain tissue, ultimately leading to a complete cerebral infarction and a mortality rate of about 50-80% for patients. Although early decompressive craniectomy and partial internal decompression can reduce mortality rates, neurosurgeons should strive to achieve lower mortality rates in the face of patients' lives. This study introduces a surgical method with lower mortality rate, which is a rapid internal decompression technique for cerebral hemisphere resection through a flat bone window after decompressive craniectomy and partial temporal lobe resection.</p><p><strong>Methods: </strong>From March 2022 to March 2024, 18 patients with extensive cerebral infarction underwent craniotomy and partial temporal lobectomy, craniectomy combined with rapid internal decompression (CCRID). Standard large bone flap craniotomy and anterior temporal lobe resection were performed. Circular electrocoagulation of the arachnoid membrane 1 cm inside the bone window, with sharp cutting, and then rapid resection of necrotic brain tissue outside the bone window (the height of the removed necrotic brain tissue is about 1-2 cm), while electrocoagulating the blood vessels from front to back along the direction of blood vessel formation. Place the drainage tube and intracranial pressure monitoring catheter for 1-2 days. Clinical outcomes were compared to 24 patients who underwent DC combined with partial temporal/frontal pole resection (DCPTR).</p><p><strong>Results: </strong>The average age of 18 patients was 63 years. The mean cerebral hemisphere resection time was 6.8 minutes with total surgery averaging 2.82 hours. Postoperative ICP averaged 4 mmHg, and the midline shifted back by 0.45 cm. At 3 months, there was one intracerebral hemorrhage, no infections, and a mortality rate of 11.1%. The mean modified Rankin scale score was 4.45. Compared to DCPTR, CCRID showed similar midline shift, shorter surgery time, and lower mortality.</p><p><strong>Conclusion: </strong>CCRID may represent a viable decompression technique for patients with massive hemispheric infarctions, warranting further consideration for future applications.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127876","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":"Neurofibromatosis Type 1 : A General Review.","authors":"Minhua Liao, Hsin-Lun Lee, Yen-Lin Liu, Tai-Tong Wong","doi":"10.3340/jkns.2025.0073","DOIUrl":"https://doi.org/10.3340/jkns.2025.0073","url":null,"abstract":"<p><p>Neurofibromatosis type 1 (NF1) is an autosomal-dominant genetic disorder caused by pathogenic variants in the NF1 gene. Its clinical phenotype is heterogeneous and evolves across the lifespan; approximately 1 in 3,000 individuals worldwide are affected. Cardinal features comprise café-au-lait macules, axillary/inguinal freckling, cutaneous neurofibromas, plexiform neurofibromas, and optic-pathway gliomas. Advanced molecular diagnostics-including next-generation sequencing (NGS) and RNA sequencing-have markedly improved mutation detection rates and facilitate definitive diagnosis. Therapeutic progress has also accelerated: the U.S. FDA has approved the MEK inhibitors selumetinib and mirdametinib for the treatment of plexiform neurofibromas, and these agents may offer benefit for additional NF1-related manifestations. The disorder further compromises skeletal integrity, neurocognitive function, and confers an increased risk of malignancy. This review highlights the necessity for multidisciplinary care of individuals with NF1, with emphasis on early diagnosis, age-stratified health-surveillance suggestion from infancy through adulthood, cancer-prevention strategies, and comprehensive genetic counseling, all aimed at mitigating complications and enhancing quality of life.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110920","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":"A Study on Prognostic Risk Factors of Cervical Spondylotic Myelopathy.","authors":"Zihan Zhou, Yunxin Su, Yuqi Shao, Jiayun Liu, Xincan Wu, Peng Gao, Tao Qin, Kaixiao Xue, Guoyong Yin, Jian Chen","doi":"10.3340/jkns.2025.0021","DOIUrl":"https://doi.org/10.3340/jkns.2025.0021","url":null,"abstract":"<p><strong>Objective: </strong>To identify the risk factors that influence the prognosis of patients with cervical spondylotic myelopathy (CSM).</p><p><strong>Methods: </strong>Clinical data were collected from 158 CSM patients treated between January 2023 and January 2024 at a tertiary medical center. The data were retrospectively analyzed, with a one-year follow-up. Based on the Japanese Orthopaedic Association score, patients were categorized into good and poor recovery groups. Clinical characteristics, laboratory indices, and imaging findings were compared between the groups, and risk factors affecting CSM prognosis were identified.</p><p><strong>Results: </strong>In a multivariable analysis, age, symptom duration, preoperative Japanese Orthopaedic Association (JOA) score, spinal cord compression ratio, Treg cell count, the number of surgical levels and diabetes history were identified as significant predictors of postoperative outcomes. Interestingly, Treg cell counts showed a novel positive correlation with improvement rates (P < 0.001), suggesting their potential role in spinal cord recovery after surgery.</p><p><strong>Conclusion: </strong>These findings underscore the prognostic relevance of clinical and immunological factors for predicting surgical outcomes in CSM. The observed association between peripheral Treg counts and recovery rates reveals new insights into the immunological mechanisms underlying CSM prognosis, suggesting potential targets for personalized treatment strategies.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102026","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":"Clinical Nomogram Model for Predicting the Prognosis of Patients with Brainstem Glioma : A Population-based Study.","authors":"Rui Zhang, Gaoyue Jiang, Yanming Ren, Yuekang Zhang, Xiaodong Niu","doi":"10.3340/jkns.2025.0037","DOIUrl":"https://doi.org/10.3340/jkns.2025.0037","url":null,"abstract":"<p><strong>Objective: </strong>The current understanding and clinical prediction of brainstem glioma (BSG) are still limited. This study aimed to conduct a large-scale population-based study to construct a clinical predictive model.</p><p><strong>Methods: </strong>Patients with BSG diagnosed histologically from 1973 to 2016 were identified using the SEER database. According to WHO grade, the whole population was divided into the LGBSG cohort and the HGBSG cohort. Univariate and multivariate cox regression analyses were employed to determine prognostic factors of OS. All independently prognostic variables were further used to construct nomograms to predict the 1- and 2-year overall survival probability. The precision and reliability of the nomogram were evaluated by C-index and calibration plots.</p><p><strong>Results: </strong>Cox regression analysis showed that four independent prognostic factors, were identified in the LGBSG cohort and two independent prognostic factors were identified in the HGBSG cohort. These independently prognostic factors and the main demographic data were further used to construct clinical nomograms for the LGBSG and HGBSG cohorts, respectively. The C-index for the internal validation was 0.89 (95%CI, 0.83-0.95) and 0.64 (95%CI, 0.60-0.68) in the LGBSG and HGBSG cohorts, respectively. The results of the calibration plots showed that the actual observation and prediction values obtained by the nomogram had good consistency in the LGBSG and HGBSG cohorts.</p><p><strong>Conclusion: </strong>This study identified several independent prognostic variables and further constructed the clinical nomogram model. The nomogram model can provide valuable clinical reference and risk assessments for clinicians to further manage these patients with BSG.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102089","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":"Full-Endoscopic Spine Surgery : Its Roles and Limitations.","authors":"Yong Ahn","doi":"10.3340/jkns.2024.0227","DOIUrl":"https://doi.org/10.3340/jkns.2024.0227","url":null,"abstract":"<p><p>Endoscopic spine surgery is the perfect culmination of the concept of minimally invasive spine surgery. Among the various endoscopic spine procedures, full-endoscopic spine surgery (FESS) is an endoscopic technique characterized by the performance of the entire spinal procedure via the percutaneous approach using a uniportal working-channel endoscope with continuous saline perfusion. FESS effectively decompresses the tissues and allows for instrumentation while preserving the normal musculoskeletal structures. It also has fewer complications and enables quicker return to work. However, potential disadvantages include its steep learning curves and limited indications. Previously, the indications for endoscopic procedures had been limited to soft disc herniations or focal neural impingement, with most degenerative spinal diseases other than disc herniation being considered contraindications. However, owing to the remarkable advancements in endoscopic technology, nearly all degenerative spinal diseases, including spinal stenosis and instability, can currently be treated using FESS. Furthermore, the application of spinal endoscopes has expanded to other spinal disorders, including infections, traumas, and tumors. Unfortunately, the steep learning curve and technical limitations of FESS cannot be overlooked by most standard spine surgeons. To ensure the clinical success of endoscopic procedures in actual clinical practice, a comprehensive understanding of the core properties of working channel endoscopes is necessary to facilitate the learning process. With the ongoing development of endoscopic technology, endoscopic surgery can be expected to become the standard treatment approach for all degenerative spinal diseases in the near future.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021453","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":"Rituximab in the Treatment of Subarachnoid Hemorrhage and Widespread Bleeding in Microscopic Polyangiitis : A Case Report.","authors":"Tian Tao, Lizeyu Lv, Jun Chen, Ling Wu, Meijun Liu, Anqi Tang, Hong Yan, Shuqin Liu, Liangbin Zhao","doi":"10.3340/jkns.2023.0232","DOIUrl":"https://doi.org/10.3340/jkns.2023.0232","url":null,"abstract":"<p><p>Microscopic polyangiitis (MPA) is a rare autoimmune disorder characterized by small-vessel vasculitis and the presence of anti-neutrophil cytoplasmic antibody (ANCA). Typically, MPA primarily affects the respiratory system, kidneys, and skin, with infrequent involvement of the nervous system, resulting in neuropathy. However, the occurrence of subarachnoid hemorrhage (SAH) in MPA is exceedingly rare, especially when it is accompanied by hemorrhagic events in multiple organs. This case report details the clinical presentation of a 61-year-old male patient diagnosed with MPA who experienced an exceptionally uncommon occurrence of SAH, coupled with extensive bleeding manifestations including epistaxis, skin purpura, and gastrointestinal bleeding. Notably, the patient's symptoms exhibited potential improvement following a treatment regimen consisting of rituximab and glucocorticoids. This case emphasizes the critical importance of promptly recognizing and comprehensively managing rare complications in MPA patients to optimize clinical outcomes.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024646","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":"Constitutional Mismatch Repair Deficiency, the Most Aggressive Cancer Predisposition Syndrome : Clinical Presentation, Surveillance, and Management.","authors":"Eungu Kang, Jin Kyung Suh, Sang-Dae Kim","doi":"10.3340/jkns.2025.0024","DOIUrl":"https://doi.org/10.3340/jkns.2025.0024","url":null,"abstract":"<p><p>Constitutional mismatch repair deficiency (CMMRD) is a rare and highly aggressive cancer predisposition syndrome caused by biallelic germline mutations in mismatch repair genes. This condition is characterized by early-onset malignancies across multiple organ systems, including central nervous system tumors, hematological cancers, and gastrointestinal malignancies. CMMRD-associated tumors exhibit hypermutation and microsatellite instability, resulting in a high tumor mutation burden and rendering these malignancies responsive to immune checkpoint inhibitors (ICIs). ICIs targeting programmed cell death protein-1 and programmed cell death ligand 1 have demonstrated remarkable efficacy, particularly in hypermutated tumors, providing durable responses and improving survival outcomes. Advances in genetic and molecular diagnostics have enhanced the ability to identify CMMRD early, allowing for the implementation of comprehensive surveillance programs and improved management strategies. A multidisciplinary and individualized approach is essential for managing CMMRD patients. This review underscores the importance of early diagnosis, surveillance, and emerging therapeutic approaches to improve outcomes and quality of life for individuals and families affected by this devastating syndrome.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":"68 3","pages":"294-304"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996486","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":"Rhabdoid Tumor Predisposition Syndrome : A Comprehensive Review of Genetics, Clinical Manifestations, and Management.","authors":"Taehoon Kim, Ji Hoon Phi","doi":"10.3340/jkns.2025.0014","DOIUrl":"10.3340/jkns.2025.0014","url":null,"abstract":"<p><p>Rhabdoid tumor predisposition syndrome (RTPS) is a rare autosomal dominant disorder characterized by an increased risk of developing malignant rhabdoid tumors in early childhood. This syndrome is primarily caused by germline heterozygous loss-of-function pathogenic variants in the SMARCB1 gene (RTPS1) and rarely in the SMARCA4 gene (RTPS2). RTPS is characterized by the development of atypical teratoid rhabdoid tumors of the central nervous system, malignant rhabdoid tumors of the kidney, and/or extrarenal extracranial rhabdoid tumors. The syndrome demonstrates high penetrance, with most tumors developing before age 3 years, and carries a poor prognosis despite intensive multimodal therapy. Early diagnosis through genetic testing, implementation of surveillance protocols, and aggressive treatment approaches are crucial for improving outcomes. This review comprehensively examines the genetic basis, clinical manifestations, surveillance strategies, and current management approaches for RTPS, with particular emphasis on emerging therapeutic options and the importance of multidisciplinary care.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"311-320"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719773","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":"Li-Fraumeni Syndrome : Current Strategies and Future Perspectives.","authors":"Ji Won Lee","doi":"10.3340/jkns.2025.0050","DOIUrl":"https://doi.org/10.3340/jkns.2025.0050","url":null,"abstract":"<p><p>Li-Fraumeni syndrome (LFS) is a rare inherited cancer predisposition syndrome caused by germline mutations in the TP53 tumor suppressor gene. It predisposes affected individuals to a wide spectrum of early-onset malignancies, including sarcomas, breast cancer, brain tumors, and adrenocortical carcinoma. Advances in genetic testing and risk management strategies have enhanced the identification and clinical management of LFS patients. Comprehensive surveillance has demonstrated increased survival rates through proactive screening. Beyond surveillance, research is exploring novel approaches such as liquid biopsy for early cancer detection and chemoprevention strategies, including metformin trials, to mitigate cancer risk. This review discusses the molecular basis, clinical spectrum, surveillance strategies, and emerging research in LFS.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":"68 3","pages":"305-310"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015433","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":"Treatment of Plexiform Neurofibromas : Current Perspectives on Surgery and Medical Treatment.","authors":"Jun Kyu Hwang, Se Hoon Kim, Dong-Seok Kim","doi":"10.3340/jkns.2025.0041","DOIUrl":"https://doi.org/10.3340/jkns.2025.0041","url":null,"abstract":"<p><p>Plexiform neurofibromas (PNFs), a critical clinical feature of neurofibromatosis type 1, mainly involve several peripheral nerve branches and extend widely, including the skin and bones and the internal organs. Determining the appropriate treatment is difficult. Additionally, they possess the potential to develop into malignant peripheral nerve sheath tumors (MPNSTs), which are linked to an extremely poor prognosis. Active treatment is critical in patients with symptoms or progressive tumor growth, especially in pediatric cases. Surgery remains the standard treatment for managing PNFs and MPNSTs; however, it has often demonstrated insufficient results because of its wide distribution and the frequent involvement of major organs. Selumetinib, a recently approved mitogen-activated protein kinase kinase inhibitor, is gaining traction in treating inoperable PNFs in children.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":"68 3","pages":"252-260"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007014","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}