Journal of neurosurgical sciences最新文献

{"title":"Screw bubbling with air embolism, an unusual complication of a frameless deep brain stimulation.","authors":"Massimo Marano, Francesca R Barbieri, Patrizia Sucapane, Serena Pagano, Daniele Marruzzo, Vincenzo DI Lazzaro, Riccardo Ricciuti","doi":"10.23736/S0390-5616.24.06241-6","DOIUrl":"10.23736/S0390-5616.24.06241-6","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140957892","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":"Perioperative seizure in patients undergoing brain mapping under awake craniotomy for language-related eloquent region gliomas: a prospective study.","authors":"Maysam Alimohamadi, Ahmad Pour-Rashidi, Amirhossein Larijani, Mohammad Rahmani, Kasra Hendi, Reza Shariat Moharari, Samira Raminfard, Hamideh Ajam, Venelin Gerganov","doi":"10.23736/S0390-5616.22.05675-2","DOIUrl":"10.23736/S0390-5616.22.05675-2","url":null,"abstract":"<p><strong>Background: </strong>Awake craniotomy (AC) is standard of care for lesions of eloquent brain areas. One important complication during AC is occurrence of intraoperative seizure (IOS), reported to occur among 3.4-20% of the patients. In this study, we report our experience with IOS during AC for resection of gliomas of the language eloquent regions and evaluate the predisposing factors and consequences.</p><p><strong>Methods: </strong>Patients who underwent AC for language related regions of the dominant hemisphere from August 2018 to June 2021 were enrolled. The rate of IOS during AC and relationship between predisposing factors and IOS were evaluated.</p><p><strong>Results: </strong>Sixty-five patients were enrolled (mean age: 44.4±12.5 years). Among 6 patients with IOS (9.2%), only one needed conversion to general anesthesia (GA) due to repeated seizures; while in the remaining 5, AC accomplished successfully despite one seizure attack in the awake phase. Tumor location (especially premotor cortex lesions, P=0.02, uOR:12.0, CI: 1.20-119.91), higher tumor volume (P=0.008, uOR: 1.9, CI: 1.06-1.12) and a functional tumor margin during surgery (P=0.000, uOR: 3.4, CI: 1.47-12.35) were significantly linked with IOS.</p><p><strong>Conclusions: </strong>Occurrence of IOS was associated with a longer ICU stay after surgery and worse immediate neurological outcome, but had no impact on the late neurological status. IOS can usually be managed during AC without need to converting to GA. Those with larger tumors, frontal premotor lesions and positive brain mapping are susceptible to IOS. Early neurological deterioration observed after IOS, seems to be transient with no major long-term consequence on the neurological outcome.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9425643","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":"SNHG3 deficiency restrains spinal cord injury-induced inflammation through sponging miR-139-5p and provides a novel biomarker for disease severity.","authors":"Tiecheng Wang, Likun Song, Yehuan Xu, Ye Li","doi":"10.23736/S0390-5616.22.05704-6","DOIUrl":"10.23736/S0390-5616.22.05704-6","url":null,"abstract":"<p><strong>Background: </strong>MicroRNAs and long non-coding RNAs play pivotal roles in the progression and recovery of spinal cord injury (SCI), which is a serious traumatic disease in central nervous system. The purpose of this study was to investigate the expression and clinical value of SNHG3 in SCI patients and explore the regulatory effects of SNHG3 on SCI-induced inflammatory responses in vitro.</p><p><strong>Methods: </strong>The relationship between SNHG3 and miR-139-5p was confirmed using a dual-luciferase reporter assay. A SCI cell model was constructed in SH-SY5Y cells using hypoxia treatment. SNHG3 and miR-139-5p expression was analyzed using qRT-PCR. Effects of SNHG3 and miR-139-5p on cell model viability and inflammatory cytokines were evaluated by CCK-8 assay and ELISA kits, respectively. ROC curves based on serum SNHG3 and miR-139-5p were constructed to evaluate their diagnostic performance.</p><p><strong>Results: </strong>In SCI patients, serum SNHG3 was upregulated, but miR-139-5p was downregulated (P<0.05), and a negative correlation between the two ncRNAs was found. Both SNHG3 and miR-139-5p showed relatively high discrimination abilities for the screening of SCI and complete SCI (CSCI) patients. SNHG3 was positively correlated with inflammatory cytokines, and miR-139-5p showed opposite results in SCI patients. By in-vitro analysis, SNHG3 knockdown enhanced cell viability but inhibited inflammation by increasing miR-139-5p.</p><p><strong>Conclusions: </strong>All the data found that serum upregulated SNHG3 and downregulated miR-139-5p served as biomarkers to diagnose SCI and indicate injury severity. The deficiency of SNHG3 alleviated neuronal injury by restraining inflammatory responses through targeting miR-139-5p. Thus, the SNHG3/miR-139-5p axis may provide novel biomarkers and therapeutic targets for SCI.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33455178","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":"Ulipristal-temozolomide-hydroxyurea combination for glioblastoma: in-vitro studies.","authors":"Meric A Altinoz, Aysegul Yilmaz, Ali Taghizadehghalehjoughi, Sidika Genc, Yesim Yeni, Ibrahim Gecili, Ahmet Hacimuftuoglu","doi":"10.23736/S0390-5616.22.05718-6","DOIUrl":"10.23736/S0390-5616.22.05718-6","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma multiforme (GBM) is a brain malignancy with worst survival. Low dose progesterone stimulates GBM growth, while progesterone receptor (PR)-antagonist mifepristone was shown to reduce growth and to enhance temozolomide sensitivity in GBM cells. Mifepristone is not available in all countries due to ethical reasons and may cause adrenal insufficiency and pelvic infections. Ulipristal is also a PR-antagonist used in treatment of uterine leiomyomas with higher biosafety. Ulipristal is demonstrated to suppress growth of breast cancer, yet it is not tested as yet whether it can also block growth and sensitize to temozolomide in glioblastoma as it was previously shown with mifepristone. Our first aim was to detect whether ulipristal exerts antiproliferative and chemotherapy-sensitizing effects in glioblastoma. Hydroxyurea inhibits DNA replication via blocking ribonucleotide reductase (RR) and it was demonstrated to increase temozolomide antineoplasticity in GBM. Progesterone receptor-activation in the uterus enhances RR transcription. Hence, we have hypothesized that PR-inactivation with ulipristal would further enhance hydroxyurea antineoplasticity by shutting down DNA synthesis mechanisms through further suppression of RR. Lastly, there exists no study as yet whether ulipristal, hydroxyurea and temozolomide could exert ternary antineoplastic efficacy, which was our last aim to define.</p><p><strong>Methods: </strong>To reveal interactions between ulipristal, hydroxyurea and temozolomide, we treated human U251 GBM cell line with these agents alone and in combination and measured cell proliferation, total antioxidant capacity (TAC) and total oxidant status (TOS) in conditioned medium and cellular cytokine gene expressions.</p><p><strong>Results: </strong>All agents significantly reduced cell proliferation significantly, yet the most significant decrease of GBM cells occurred with the triple drug combination at the 96^th hour. All agents significantly decreased TAC and increased TOS in culture media, which was mostly relevant for the triple combination at the 96^th hour. All these three agents tend to reduce the expression of immunosuppressive and/or GBM-growth stimulating cytokines TGF-β, IL-10 and IL-17 while increasing the expression of GBM-growth suppressing cytokine IL-23.</p><p><strong>Conclusions: </strong>Reproposal of these agents in treatment of GBM would be a plausible approach if future studies prove their efficacy.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40409122","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":"Successful staged separation of total angular craniopagus.","authors":"Carlo E Marras, Andrea Carai, Alessandro DE Benedictis, Alessandra Savioli, Camilla M Rossi Espagnet, Mario Zama, Franco Randi, Aurelio Secinaro, Luca Borro, Antonio Napolitano, Giuseppe Ricci, Alessandra Marasi, Enrico Castelli, Tommaso Calloni, Sergio G Picardo","doi":"10.23736/S0390-5616.21.05633-2","DOIUrl":"10.23736/S0390-5616.21.05633-2","url":null,"abstract":"<p><strong>Background: </strong>Total craniopagus is an exceedingly rare condition in which surgical treatment is complex and potentially fatal. Over the last decades, a multistep surgical approach, which allows development of venous collateral circulation, has fostered a dramatic improvement of successful separation rates and neurological outcomes. Most of the experience derives from management of vertical craniopagus, as the angular form is even less common and less amenable to successful surgical separation.</p><p><strong>Methods: </strong>We present a case of total angular craniopagus twins observed at our Institution. Specific features included a large occipital fusion area with a bone defect, complete separation of brain and arterial vessels and a complex configuration of dural venous sinuses. The superior sagittal sinus of each twin preferentially drained to a single transverse sinus through a shared torcular.</p><p><strong>Results: </strong>After an extensive diagnostic phase, including neuroimaging, tridimensional and virtual reality modelling, neurological, neurophysiological and rehabilitation assessment, a detailed multistep surgical plan, was designed by a wide multidisciplinary team. The venous system was managed by taking advantage of the fact each twin's superior sagittal sinus was drained preferentially by the transverse sinus on the twin's left. The transverse sinuses were thus separated accordingly.</p><p><strong>Conclusions: </strong>Successful separation was achieved in three surgical steps over one year, with an excellent outcome for both twins.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44968326","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":"Frailty is a risk factor for intracranial abscess and is associated with longer length of stay: a retrospective single institution case-control study.","authors":"Jose F Dominguez, Tolga Sursal, Syed F Kazim, Christina Ng, Sima Vazquez, Ankita DAS, Alexandria Naftchi, Eris Spirollari, Yuval Elkun, Stergios Gatzoflias, Leonel Ampie, Eric Feldstein, Anaz Uddin, Nitesh Damodara, Simon J Hanft, Chirag D Gandhi, Christian A Bowers","doi":"10.23736/S0390-5616.22.05720-4","DOIUrl":"10.23736/S0390-5616.22.05720-4","url":null,"abstract":"<p><strong>Background: </strong>Intracranial abscess (IA) causes significant morbidity and mortality. The impact of baseline frailty status on post-operative outcomes of IA patients remains largely unknown. The present study evaluated if frailty status can be used to prognosticate outcomes in IA patients.</p><p><strong>Methods: </strong>We retrospectively reviewed all IA patients undergoing craniotomy at our institution from 2011 to 2018 (N.=18). These IA patients were age and gender matched with patients undergoing craniotomy for intracranial tumor (IT), an internal control for comparison. Demographic and clinical data were collected to measure frailty, using the modified frailty index-11 (mFI-11) and pre-operative American Society of Anesthesiologists Physical Status Classification System (ASA). Post-operative complications were measured by the Clavien-Dindo Grade (CDG).</p><p><strong>Results: </strong>No significant difference in mFI-11 or ASA score was observed between the IA and IT groups (P=0.058 and P=0.131, respectively). IA patients had significantly higher CDG as compared with the control IT patients (P<0.001). There was a trend towards increasing LOS in the IA group as compared to the IT group (P=0.053). Increasing mFI and ASA were significant predictors of LOS by multiple linear regression in the IA group (P=0.006 and P=0.001, respectively), but not in the control IT group. Neither mFI-11 nor ASA were found to be predictors for CDG in either group. Within this case-control group of patients, we found an increase for odds of having IA with increasing mFI (OR=1.838, 95% CI: 1.016-3.362, P=0.044).</p><p><strong>Conclusions: </strong>Frail IA patients tend to have more severe postoperative complications. The mFI-11 seems to predict increased resource utilization in the form of LOS. This study provides the initial retrospective data of another neurosurgical pathology where frailty leads to significantly worse outcomes. We also found that mFI may serve as a potential risk factor for severe disease.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48390541","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":"Enhancing physician-patient communication in neurology: is the patient's comprehension adequately assessed?","authors":"Roberto Tedeschi","doi":"10.23736/S0390-5616.24.06299-4","DOIUrl":"https://doi.org/10.23736/S0390-5616.24.06299-4","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558909","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":"Normal pressure hydrocephalus does not matter: an Italian perspective.","authors":"Graziano Taddei, Giuseppe Demichele, Marco Failla Mulone, Mariasole Gagliano, Alessandro Pesce, Silvia Ciarlo, Edvige Iaboni, Angelo Pompucci, Gianpaolo Petrella","doi":"10.23736/S0390-5616.24.06257-X","DOIUrl":"https://doi.org/10.23736/S0390-5616.24.06257-X","url":null,"abstract":"<p><strong>Background: </strong>Normal pressure hydrocephalus (NPH) is a reversible condition characterized by gait disturbance, dementia, and urinary incontinence. Despite being underdiagnosed, surgical treatment can significantly improve symptoms. Previous studies have shown a lack of awareness of NPH among physicians, prompting further investigation into its recognition.</p><p><strong>Methods: </strong>A survey was conducted among Italian physicians to assess their awareness of NPH. A 9-point questionnaire was anonymously distributed online to physicians registered with Medical Boards in Italy. Data analysis focused on responses related to NPH knowledge and exposure.</p><p><strong>Results: </strong>Out of 103 Medical Boards invited, 42 participated, potentially reaching 145,788 physicians. Analysis of 547 valid responses revealed varying levels of awareness across specialties. Neurologists showed higher awareness, but overall exposure to NPH cases in clinical practice was limited.</p><p><strong>Conclusions: </strong>The survey highlighted a lack of interest and awareness of NPH among Italian physicians. Recommendations were made to enhance recognition, especially among Family Practitioners and Neurologists. Continuous education efforts are crucial to improve early diagnosis and management of NPH. Efforts by medical boards and specialty societies are needed to increase awareness and ensure timely intervention for NPH patients.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558966","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":"Cracking the glass ceiling: women's evolution in neurosurgical leadership.","authors":"Teresa Somma, Ilaria Bove, Francesca Vitulli, Felice Esposito, Tamara Ius, Paolo Cappabianca","doi":"10.23736/S0390-5616.24.06289-1","DOIUrl":"https://doi.org/10.23736/S0390-5616.24.06289-1","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498281","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 prognostic value of emergency microsurgical clipping of ruptured anterior circulation aneurysms.","authors":"Biagia LA Pira, Giancarlo D'Andrea, Paolo Ferroli, Melina Castiglione, Giovanni Pennisi, Giulio Maira, Placido Bruzzaniti","doi":"10.23736/S0390-5616.24.06236-2","DOIUrl":"https://doi.org/10.23736/S0390-5616.24.06236-2","url":null,"abstract":"<p><strong>Background: </strong>The treatment of aneurysmal subarachnoid hemorrhage poses a formidable challenge, given the high mortality rate and associated mortality. Current recommendations are for treatment to be initiated within 24 hours of diagnosis.</p><p><strong>Methods: </strong>In our study, we compared a cohort of 66 patients who received prompt microsurgical treatment within 6 hours of diagnosis with a cohort of 51 patients who received prompt microsurgical treatment within 12 hours of diagnosis.</p><p><strong>Results: </strong>The modified Rankin Scale was utilized to evaluate the follow-up of patients at 30 days, 12 months, and 18 months following surgery. We performed a parametric comparison of the distributions of the means of groups, and our results indicate that treatment within 6 hours of diagnosis results in a lower incidence of obstructive hydrocephalus and a more favorable outcome.</p><p><strong>Conclusions: </strong>A favorable outcome was observed in patients who were treated within 6 hours. The availability of a specialized vascular team ensures the highest levels of care.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468619","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}