Journal of Korean Neurosurgical Society最新文献

{"title":"Exploratory Evaluation of Dual Digital Platforms for Acute Brain Conditions in Medically Underserved Rural Areas : A Chuncheon, Gangwon-do Experience.","authors":"Seung-Ho Shin, Mu Seung Park, Jaewoong Kang, Seunghun Han, Sang-Hwa Lee, Jong-Hee Sohn, Hyuk Jai Choi, Hyo Sub Jun, Jun Hyong Ahn, Seung Jin Lee, Seongheon Kim, Chulho Kim, Jin Pyeong Jeon","doi":"10.3340/jkns.2026.0091","DOIUrl":"https://doi.org/10.3340/jkns.2026.0091","url":null,"abstract":"<p><strong>Objective: </strong>To describe an exploratory initial experience with two complementary digital platforms consisting of an AI-based telemedicine system and an SNS-based transfer coordination network, for acute brain conditions in rural areas with limited or no on-site neurosurgical coverage.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with acute brain conditions who first presented to rural hospitals and were subsequently transferred to a regional hub hospital between January 2024 and March 2025. Transfers were coordinated using either an AI-integrated CT telemedicine platform or an SNS-based (KakaoTalk) collaboration network. Outcomes were assessed using the 3-month modified Rankin Scale (mRS), with favorable outcome defined as 0-2.</p><p><strong>Results: </strong>Eight patients (mean age 70.5 years) were managed via the AI platform, which supported collaboration between non-expert rural clinicians and hub-hospital neurospecialists. Referrals were initiated by general practitioners (n=5), an internist (n=1), and nurses (n=2). AI-assisted CT screening with integrated teleconsultation facilitated timely diagnostic clarification and early management. All eight patients had favorable outcomes at 3 months. Twelve patients were managed via the SNS platform for inter-hospital transfer. 11 required neurocritical care and 3 underwent neurosurgical or endovascular intervention after transfer. Overall, 9 patients achieved favorable functional outcomes (3-month mRS score, 0-2).</p><p><strong>Conclusion: </strong>This exploratory study describes the potential utility of a dual-platform strategy integrating AI-based telemedicine and SNS-based transfer coordination for supporting acute brain condition management in medically underserved rural areas. Further prospective studies are needed to determine whether this approach improves time-sensitive transfer processes and clinical outcomes.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205063","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":"Association between Early Postoperative Systemic Inflammation Response Index and Prolonged Intensive Care Unit Stay After Elective Brain Tumor Surgery.","authors":"Feyza Kargın, Ramazan Kargın, Hicran Özdemir Demir, Dicle Kocaöz, Mehmet Tiryaki, Elif Bombacı","doi":"10.3340/jkns.2026.0043","DOIUrl":"https://doi.org/10.3340/jkns.2026.0043","url":null,"abstract":"<p><strong>Objective: </strong>The systemic inflammation response index (SIRI) is a novel inflammatory marker. This study aims to evaluate the association between early postoperative SIRI and a prolonged intensive care unit (ICU) stay exceeding 24 hours after brain tumor (BT) surgery.</p><p><strong>Methods: </strong>Patients aged 18 years or older who were admitted to the ICU following elective BT surgery between January 2023 and December 2024 were analyzed. Preoperative and postoperative variables were compared between patients with a short ICU stay (<24 hours) and those with a prolonged ICU stay. Logistic regression analyses were performed to evaluate the association between perioperative variables, including early postoperative SIRI, and prolonged ICU stay. Receiver operating characteristic (ROC) curve analysis, along with area under the curve (AUC) and Youden index, was conducted to assess the discriminatory performance of early postoperative SIRI.</p><p><strong>Results: </strong>A total of 206 patients who were admitted to the intensive care unit following elective BT surgery were included in the study. 109 patients were classified as having an ICU length of stay less than 24 hours, whereas 97 patients were classified as having an ICU length of stay exceeding 24 hours. In multivariable logistic regression analyses, hypertension (odds ratio [OR] = 4.365, 95% confidence interval (CI): 1.903-10.010, p = 0.001), postoperative SIRI level (OR = 1.090, 95% CI: 1.041-1.142, p < 0.001), hemorrhage (OR = 14.348, 95% CI: 1.663-123.812, p = 0.015), cerebral edema (OR = 5.972, 95% CI: 1.076-33.148, p = 0.041) and neurological deficit (OR = 2.582, 95% CI: 1.072-12.149, p = 0.032) were independently associated with prolonged ICU stay following BT surgery. Using prolonged ICU stay as the endpoint, ROC analysis identified an optimal SIRI cutoff value of 10.94, with a sensitivity of 56.7%, specificity of 81.7%, and an AUC of 0.728.</p><p><strong>Conclusion: </strong>Given the clinical importance of optimizing ICU resource utilization, early postoperative SIRI may provide adjunctive information reflecting postoperative inflammatory response associated with prolonged ICU stay, particularly when interpreted with other clinical parameters.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205129","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":"Predictive Value of Pan-Immune-Inflammation Value for Recurrence of Chronic Subdural Hematoma after Burr Hole Drainage.","authors":"Yongho Kwon, Ho Jun Yi, Dong-Seong Shin, Bum-Tae Kim","doi":"10.3340/jkns.2026.0114","DOIUrl":"https://doi.org/10.3340/jkns.2026.0114","url":null,"abstract":"<p><strong>Objective: </strong>The Pan-Immune-Inflammation Value (PIV) is a novel composite biomarker that reflects systemic inflammatory status. This study aimed to assess the prognostic value of preoperative PIV in predicting recurrence after burr hole drainage (BHD) in patients with chronic subdural hematoma (CSDH).</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 521 patients who underwent BHD for CSDH between January 2015 and October 2025. Preoperative inflammatory markers, including PIV, the systemic Immune-Inflammation Index (SII), and the systemic Inflammation Response Index (SIRI), were calculated. We performed receiver operating characteristic (ROC) curve analysis and multivariate logistic regression to identify predictive factors for recurrence after BHD.</p><p><strong>Results: </strong>Recurrence was observed in 123 patients (23.6%). The recurrence group had a significantly higher mean PIV value compared to the non-recurrence group (481.8 ± 211.2 vs. 259.4 ± 164.7, p = 0.020). ROC analysis showed that PIV had the highest predictive accuracy for recurrence, with an area under the curve of 0.801 (95% confidence interval [CI] 0.753-0.850; p < 0.001). The optimal cutoff value for PIV to predict recurrence after BHD was determined to be 311.4. In multivariate analysis, elevated SII (≥ 551.2) (odds ratio [OR] 1.12, 95% CI 1.06-1.38; p = 0.048) and elevated PIV (≥ 311.4) (OR 1.28, 95% CI 1.08-1.86; p = 0.022) were identified as independent predictors of recurrence after BHD.</p><p><strong>Conclusion: </strong>Preoperative PIV is a strong, independent predictor of CSDH recurrence following BHD. Further research is needed to validate the prognostic role of PIV in patients with CSDH.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205113","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":"Delayed Internal Carotid Artery Pseudoaneurysm Following Endoscopic Endonasal Approach for Anterior Clinoid Process Mucocele Treated with Flow Diversion and Adjunctive Coil Embolization : A Case Report.","authors":"Yeong Jin Kim, You-Sub Kim, Dong Hoon Lee, Kyung-Hwa Lee, Woong Yoon","doi":"10.3340/jkns.2026.0124","DOIUrl":"https://doi.org/10.3340/jkns.2026.0124","url":null,"abstract":"<p><p>Anterior clinoid process (ACP) mucoceles are extremely rare lesions that may pose significant surgical challenges due to their proximity to the internal carotid artery (ICA). We report a case of a 54-year-old male with an ACP mucocele who presented with rapidly progressive visual loss in the left eye. Endoscopic endonasal approach (EEA) was performed, during which inadvertent ICA injury occurred following bone removal, resulting in massive bleeding that required immediate gauze packing and termination of the procedure. Despite unremarkable early postoperative imaging, a pseudoaneurysm detected one week later at cavernous ICA and rapidly enlarged with findings of a carotid-cavernous fistula. Urgent endovascular treatment with a flow-diverting stent and adjunctive coil embolization was performed and the gauze packing was removed one week after endovascular treatment. Follow-up MRA and DSA at 1 year confirmed successful vessel remodeling and sustained exclusion of the pseudoaneurysm. This case highlights the risk of ICA injury during EEA for ACP lesions, the importance of careful postoperative imaging surveillance for delayed pseudoaneurysm formation, and the effectiveness of a combined endovascular reconstructive strategy in managing unstable pseudoaneurysms.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143616","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":"Comparison of Femoral Neck and Lumbar Spine BMD as Correlates of Atlantoaxial Subluxation in Rheumatoid Arthritis.","authors":"Shin-Woong Ko, Byeong Jin Ha, Yu Deok Won, Jin Hwan Cheong, Myung-Hoon Han, Je Il Ryu","doi":"10.3340/jkns.2026.0092","DOIUrl":"https://doi.org/10.3340/jkns.2026.0092","url":null,"abstract":"<p><strong>Objective: </strong>Lumbar spine and femoral neck dual-energy X-ray absorptiometry (DXA) measurements are known to be influenced by degenerative changes to different extents. This study evaluated which site shows a stronger association with atlantoaxial subluxation (AAS) in rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>We retrospectively identified 952 RA patients who had both cervical radiographs and dual-site DXA. AAS was defined as an anterior atlantodental interval exceeding 3 mm. We constructed a logistic regression model for each DXA site and compared their discriminative accuracy using the DeLong test, the Akaike information criterion (AIC), and subgroup analyses stratified by body mass index (BMI) tertile.</p><p><strong>Results: </strong>Of 952 patients, 381 (40.0%) had AAS. Each one-standard deviation (SD) increase in femoral neck T-score reduced AAS odds by 32% (adjusted odds ratio [OR] 0.68; 95% confidence interval [CI] 0.58-0.80; p < 0.001); the lumbar spine yielded 15% (adjusted OR 0.85; 95% CI 0.73-0.99; p = 0.035). The femoral neck model had a higher area under the curve (AUC) (0.77 vs. 0.71; DeLong p = 0.008) and lower AIC (1125 vs. 1152). Disparity was widest in the lowest BMI tertile (adjusted OR 0.55 vs. 0.91). Isolated femoral neck osteoporosis raised AAS risk 3.1-fold; lumbar spine osteoporosis alone did not.</p><p><strong>Conclusion: </strong>Femoral neck bone mineral density (BMD) was more strongly associated with AAS than lumbar spine BMD in RA patients. When screening for cervical instability, the femoral neck T-score may be more informative than the lumbar spine value, particularly in patients with low BMI.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143563","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":"Comment on \"Pain and Functional Outcome of Supraclavicular Decompression of the Brachial Plexus for Neurogenic Thoracic Outlet Syndrome\".","authors":"Hawkar A Nasralla, Fahmi H Kakamad, Shakew S Mohammed","doi":"10.3340/jkns.2026.0132","DOIUrl":"https://doi.org/10.3340/jkns.2026.0132","url":null,"abstract":"","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981960","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 High Preoperative Neutrophil Percentage-to-Albumin Ratio Is Associated with Contrast-Associated Acute Kidney Injury Following Endovascular Treatment for Intracranial Aneurysm.","authors":"Seoyoung Ma, Kyung Won Shin, Woo-Young Jo, Hyung-Chul Lee, Hee-Pyoung Park, Kangmin Kim, Hyun-Seung Kang, Dong Hyun Yoo, Young Dae Cho, Hyongmin Oh","doi":"10.3340/jkns.2026.0024","DOIUrl":"https://doi.org/10.3340/jkns.2026.0024","url":null,"abstract":"<p><strong>Objective: </strong>Inflammation is a major pathophysiologic mechanism of contrast-associated acute kidney injury (CA-AKI). This study investigated the association between preoperative neutrophil percentage-to-albumin ratio (NPAR), a novel systemic inflammatory index, and CA-AKI, and compared its discriminative ability for CA-AKI with that of other preoperative systemic inflammatory indices in patients who underwent endovascular treatment for intracranial aneurysms.</p><p><strong>Methods: </strong>Perioperative data were retrospectively collected and analyzed from 2,759 adult patients who underwent endovascular treatment for intracranial aneurysms. Based on the optimal cutoff value of preoperative NPAR, patients were categorized into high (NPAR ≥ 14.55; n = 836) and low (NPAR < 14.55; n = 1,923) NPAR groups. After propensity score matching (PSM), 697 patients were selected from each group. CA-AKI was defined as an increase in serum creatinine concentrations of ≥ 25% or ≥ 0.5 mg/dL from preoperative baseline within 72 hours after contrast administration.</p><p><strong>Results: </strong>CA-AKI occurred more frequently in the high NPAR group before (46 [5.5%] vs. 42 [2.2%], p < 0.001) and after (39 [5.6%] vs. 19 [2.7%], p = 0.007) PSM. A high preoperative NPAR was independently associated with an increased risk of CA-AKI before (odds ratio [95% confidence interval] 1.85 [1.16-2.96], p = 0.010) and after (2.12 [1.21-3.70], p = 0.009) PSM. Among the eight preoperative systemic inflammatory indices evaluated, NPAR demonstrated the highest area under the receiver operating characteristics curve (0.622) for predicting CA-AKI.</p><p><strong>Conclusion: </strong>A high preoperative NPAR was an independent predictor of CA-AKI following endovascular treatment for intracranial aneurysms.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941675","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":"The Feasibility, Accuracy and Safety of Robot-Assisted Ventriculoperitoneal Shunt.","authors":"Zhao Gao, Yuanyuan Dang, Jiayu Liu, Yuxin Wang, Xudong Shi, Xiangyang Bao, Lijuan Wang, Jianning Zhang, Hulin Zhao","doi":"10.3340/jkns.2025.0165","DOIUrl":"10.3340/jkns.2025.0165","url":null,"abstract":"<p><strong>Objective: </strong>Ventriculoperitoneal shunt (VPS) treats hydrocephalus effectively, but manual ventricular catheter placement has a high misplacement rate. This study assesses the feasibility, accuracy, and safety of robot-assisted VPS.</p><p><strong>Methods: </strong>A retrospective analysis was performed on the clinical data of 87 patients from 2022 to 2024, with 42 receiving robot-assisted VPS and 45 receiving conventional manual VPS. Logistic regression analysis was performed to identify risk factors affecting placement accuracy.</p><p><strong>Results: </strong>The robot-assisted cohort showed smaller bilateral frontal horn diameters and a lower Evans index (p<0.05). It achieved higher placement accuracy, required fewer puncture attempts, and had a lower postoperative complication rate (p<0.05). No significant difference was found in operation time (p>0.05). Logistic regression analysis confirmed robot-assistance as a key factor for accurate catheter placement (odds ratio, 6.52; p<0.001).</p><p><strong>Conclusion: </strong>Robot-assisted VPS achieves precise placement, reduces puncture attempts and complications, and does not increase time costs, confirming its clinical feasibility, accuracy, and safety.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"459-471"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146180697","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":"Early Clinical Experience with the Stealth Autoguide Cranial Robotic Guidance Platform for Stereotactic Brain Biopsy.","authors":"Hye Seok Park, Jong Ha Hwang, Sun Mo Nam, So Young Ji, Kihwan Hwang, Min-Sung Kim, Jung Ho Han, Yong Hwy Kim, Chul-Kee Park, Chae-Yong Kim, Yoon Hwan Byun, Ho Kang","doi":"10.3340/jkns.2025.0183","DOIUrl":"10.3340/jkns.2025.0183","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to report the early clinical experience with stereotactic biopsy using the Medtronic Stealth Autoguide Cranial Robotic Guidance Platform, representing the first relevant clinical study in the Republic of Korea (ROK). We evaluated potential advantages and limitations related to workflow integration, instrument setup, procedural efficiency, accuracy, and safety.</p><p><strong>Methods: </strong>A retrospective case series was conducted across three centers in the ROK. From April to July 2025, 17 consecutive patients underwent frameless stereotactic biopsy using the Stealth Autoguide system. Data on demographics, operative time, and complications were collected, and descriptive analyses were performed.</p><p><strong>Results: </strong>Biopsy using the Stealth Autoguide System was successfully completed in 16 of 17 patients. The median operative time was 48 minutes (interquartile range, 33-64), and the median target alignment error was 0.4 mm (interquartile range, 0.3-0.6). One case required conversion to the conventional manual method due to targeting inaccuracy. Three cases of asymptomatic intracerebral hemorrhage occurred, including one at the tissue-harvest site and two with cortical hemorrhage, all of which were managed conservatively.</p><p><strong>Conclusion: </strong>The Stealth Autoguide system facilitates a more efficient frameless stereotactic biopsy than conventional methods by reducing operative time, enhancing accuracy, and allowing for a smaller, muscle-sparing incision. However, some concerns remain, and further clinical validation is needed to define its optimal indications and safety profile.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"472-481"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010199","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":"From Static Diagnosis to Dynamic Guidance : Evolution of Artificial Intelligence in Pediatric Neuroimaging.","authors":"Boa Jang, Youmin Shin, Geonhee Lee, Young-Gon Kim","doi":"10.3340/jkns.2026.0030","DOIUrl":"10.3340/jkns.2026.0030","url":null,"abstract":"<p><p>The pediatric brain represents a dynamic biological target characterized by rapid myelination and functional reorganization, which presents unique challenges for conventional, adult-centric artificial intelligence (AI) models. This review provides a structured overview of the evolution of AI applications in pediatric neuroimaging and neurosurgery, tracing the transition from early standardized pipelines and handcrafted imaging biomarkers to contemporary deep learning-based approaches for segmentation, prediction, and anomaly detection. Recent advances indicate a paradigm shift from static image interpretation toward dynamic and interactive intelligence, in which AI systems actively support clinical decision-making during surgery rather than functioning solely as diagnostic tools. This new paradigm is supported by four technological domains : brain foundation models designed to capture age-aware neurodevelopmental representations; spatial computing technologies for three-dimensional, context-aware-visualization; physical AI systems integrating robotic safety constraints; and multimodal AI agents that act as cognitive surgical copilots by synthesizing imaging, physiological, and intraoperative data in real time. By shifting the role of AI from preoperative assessment to intraoperative guidance, this paradigm offers new opportunities to enhance surgical precision, safety, and workflow efficiency in pediatric neurosurgery. This review aims to provide neurosurgeons with a conceptual framework for understanding and adopting next-generation AI technologies that align with the dynamic nature of the developing brain and the clinical demands of pediatric neurosurgical care.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":" ","pages":"329-337"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773945","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}