Journal of neurosurgical sciences最新文献

{"title":"Longitudinal impact of intracerebral low-grade glioma disease on health-related quality of life.","authors":"Laurèl Rauschenbach, Pauline Bartsch, Alejandro N Santos, Anna Michel, Hanah H Gull, Pikria Ketelauri, Marvin Darkwah Oppong, Börge Schmidt, Celia Dobersalske, Tobias Blau, Yahya Ahmadipour, Ramazan Jabbarli, Karsten H Wrede, Ulrich Sure, Philipp Dammann","doi":"10.23736/S0390-5616.23.06107-6","DOIUrl":"10.23736/S0390-5616.23.06107-6","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to assess health-related quality of life (HRQOL) before and after treatment for intracerebral low-grade glioma.</p><p><strong>Methods: </strong>Patients with low-grade glioma who underwent surgical tumor removal between 2012 and 2018 were eligible for this study. All individuals and their closest relatives received thorough preoperative (<seven days before surgery) and posttreatment (12 months after surgery) neuropsychological testing investigating quality of life. The assessment consisted of the Aachen Life Quality Inventory (ALQI) and the Short Form 36 (SF36) questionnaire. Calculated SF36 values were compared with reference values from population-based studies. A set of clinical features were investigated for their association with longitudinal HRQOL deterioration.</p><p><strong>Results: </strong>A total of 25 patients were referred for further analysis, after adjustment to the 2021 WHO classification for central nervous system tumors. Compared to the values of a healthy reference population, the patients expressed significant limitations in several SF36 items, both before and after treatment. Under treatment, there were no significant changes in the SF36 items, but the ALQI questionnaire indicated decreasing HRQOL over time. Data derived from relatives revealed a high degree of concordance with the rating results of the patients. Univariate analysis identified neurological deterioration and ongoing epileptic seizures as predictors for unfavorable HRQOL after one year.</p><p><strong>Conclusions: </strong>Low-grade glioma disease has a significant impact on HRQOL and treatment might contribute to further deterioration. New-onset neurological deficits and ongoing epileptic seizures are predictors of limitations in quality of life. Since the results are based on a small cohort with limited follow-up time, the generalizability of these statements is limited and further studies are required.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"102-110"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119830","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":"Idiopathic normal pressure hydrocephalus: a systematic review and a streamlined six-step algorithm endorsed by the Italian Society of Neurosurgery (SINCH).","authors":"Pier P Panciani, Giorgio Palandri, Gianpaolo Petrella, Francesco Tuniz, Pasquale De Bonis, Lucio De Maria, Giovanni Nicoletti, Francesca Graziano, Edoardo Agosti, Antonino Germanò, Riccardo Draghi, Ignazio Borghesi, Anita Simonini, Claudio Pacchetti, Marco M Fontanella","doi":"10.23736/S0390-5616.25.06429-X","DOIUrl":"https://doi.org/10.23736/S0390-5616.25.06429-X","url":null,"abstract":"<p><strong>Introduction: </strong>Idiopathic normal pressure hydrocephalus (iNPH) is a treatable neurodegenerative disorder characterized by a triad of gait disturbance, cognitive impairment, and urinary incontinence. Early diagnosis and timely intervention are crucial for optimal outcomes. However, the diagnosis of iNPH remains challenging due to its variable presentation and overlap with other neurological conditions.</p><p><strong>Evidence acquisition: </strong>A comprehensive review of the literature was conducted to identify current diagnostic criteria and treatment strategies for iNPH. Based on this review, a novel, six-step algorithm was developed to streamline the diagnostic process and improve patient outcomes.</p><p><strong>Evidence synthesis: </strong>The proposed algorithm includes the following six steps: 1) suspect diagnosis of iNPH: Identification of core clinical features (gait disturbance, cognitive impairment, and urinary incontinence) and radiological evidence of ventricular enlargement; 2) investigate probable iNPH: detailed neuropsychological assessment, gait analysis, and urodynamic studies to confirm the diagnosis; 3) high-volume lumbar puncture: evaluation of the clinical response to CSF drainage, including improvements in gait, cognition, and urinary function; 4) evaluation after HVLP: assessment of the duration and magnitude of symptom improvement after lumbar puncture; 5) shunt surgery: indication for shunt surgery in patients with a positive response to CSF drainage; 6) infusion test and intracranial pressure measurement: alternative diagnostic tools for cases where the diagnosis remains uncertain.</p><p><strong>Conclusions: </strong>The proposed algorithm provides a structured approach to the diagnosis and management of iNPH. By combining clinical, radiological, and neurophysiological assessments, clinicians can improve diagnostic accuracy and optimize patient outcomes. Further research is needed to validate this algorithm in larger patient populations and to develop more sensitive and specific biomarkers for iNPH.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":"69 1","pages":"92-101"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567430","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":"What is idiopathic in normal pressure hydrocephalus?","authors":"Alfonso Fasano, Chifumi Iseki, Shigeki Yamada, Masakazu Miyajima","doi":"10.23736/S0390-5616.24.06363-X","DOIUrl":"https://doi.org/10.23736/S0390-5616.24.06363-X","url":null,"abstract":"<p><strong>Introduction: </strong>Normal pressure hydrocephalus (NPH) can be caused by acquired events - e.g. subarachnoid hemorrhage, meningitis, or trauma - or can be \"idiopathic\" (iNPH) when no clear cause is identifiable. The entity and nosology of iNPH has received renewed attention and has recently gone through scrutiny and academic debate.</p><p><strong>Evidence acquisition: </strong>Authors searched PubMed using the following keywords: \"adult hydrocephalus,\" \"alfa synuclein,\" \"Alzheimer's disease,\" \"beta-amyloid,\" \"cerebrospinal fluid,\" \"cilia,\" \"CSF,\" \"genes,\" \"hydrocephalus,\" \"idiopathic,\" \"Lewy Body Dementia,\" \"phosphorylated tau,\" \"shunt responsiveness\".</p><p><strong>Evidence synthesis: </strong>During the past decades several studies have reshaped our view of iNPH, examples are the identification of monogenic forms of iNPH caused by genes involved in the structure and function of cilia or the discovery of the glymphatic system. This review will discuss the causes of iNPH and particularly the relationship with neurodegeneration in terms of: 1) coincidental association; 2) iNPH predisposing to neurodegeneration, 3. neurodegeneration predisposing to iNPH, and 4. independent processes (genetic and environmental) predisposing to both. Based on the gathered evidence, a unified model is then presented, characterized by three sequential events: impairment of CSF dynamic, occurrence of reversible signs, occurrence of irreversible signs.</p><p><strong>Conclusions: </strong>Almost 70 years after its description, a growing literature on its basic mechanisms is clarifying that iNPH is a syndrome with pathogenetic mechanisms arising from different causes. The paradigm shift has been recognizing that iNPH is not just a CSF disorder but rather a brain disorder expressing with ventriculomegaly. Finally, the better understanding of what causes iNPH support the proposal of changing its name into \"Hakim's disease.\"</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":"69 1","pages":"20-36"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567437","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":"Differences between real-world and score-based decision-making in the microsurgical management of patients with unruptured intracranial aneurysms.","authors":"Sandro Hügli, Victor E Staartjes, Martina Sebök, Patricia G Blum, Luca Regli, Giuseppe Esposito","doi":"10.23736/S0390-5616.23.06038-1","DOIUrl":"10.23736/S0390-5616.23.06038-1","url":null,"abstract":"<p><strong>Background: </strong>Management of unruptured intracranial aneurysms (UIAs) is complex, balancing the risk of rupture and risk of treatment. Therefore, prediction scores have been developed to support clinicians in the management of UIAs. We analyzed the discrepancies between interdisciplinary cerebrovascular board decision-making factors and the results of the prediction scores in our cohort of patients who received microsurgical treatment of UIAs.</p><p><strong>Methods: </strong>Clinical, radiological, and demographical data of 221 patients presenting with 276 microsurgically treated aneurysms were collected, from January 2013 to June 2020. UIATS, PHASES, and ELAPSS were calculated for each treated aneurysm, resulting in subgroups favoring treatment or conservative management for each score. Cerebrovascular board decision-factors were collected and analyzed.</p><p><strong>Results: </strong>UIATS, PHASES, and ELAPSS recommended conservative management in 87 (31.5%) respectively in 110 (39.9%) and in 81 (29.3%) aneurysms. The cerebrovascular board decision-factors leading to treatment in these aneurysms (recommended to manage conservatively in the three scores) were: high life expectancy/young age (50.0%), angioanatomical factors (25.0%), multiplicity of aneurysms (16.7%). Analysis of cerebrovascular board decision-making factors in the \"conservative management\" subgroup of the UIATS showed that angioanatomical factors (P=0.001) led more frequently to surgery. PHASES and ELAPSS subgroups \"conservative management\" were more frequently treated due to clinical risk factors (P=0.002).</p><p><strong>Conclusions: </strong>Our analysis showed more aneurysms were treated based on \"real-world\" decision-making than recommended by the scores. This is because these scores are models trying to reproduce reality, which is yet not fully understood. Aneurysms, which were recommended to manage conservatively, were treated mainly because of angioanatomy, high life expectancy, clinical risk factors, and patient's treatment wish. The UIATS is suboptimal regarding assessment of angioanatomy, the PHASES regarding clinical risk factors, complexity, and high life expectancy, and the ELAPSS regarding clinical risk factors and multiplicity of aneurysms. These findings support the need to optimize prediction models of UIAs.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"123-130"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9668009","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":"Idiopathic normal pressure hydrocephalus revisited: welcome interdisciplinarity!","authors":"Alfonso Fasano","doi":"10.23736/S0390-5616.25.06478-1","DOIUrl":"https://doi.org/10.23736/S0390-5616.25.06478-1","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":"69 1","pages":"1-3"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567416","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":"Hakim's disease: an update on idiopathic normal pressure hydrocephalus.","authors":"Sevil Yasar, Mats Tullberg","doi":"10.23736/S0390-5616.25.06365-9","DOIUrl":"https://doi.org/10.23736/S0390-5616.25.06365-9","url":null,"abstract":"<p><strong>Introduction: </strong>Idiopathic normal pressure hydrocephalus (iNPH) increases with age but is still underdiagnosed and undertreated. In the last decade, iNPH research has expanded into understanding broader contributions to iNPH, the role of cerebrospinal fluid (CSF), and imaging biomarkers to aid early detection, help diagnosis and differentiation from iNPH mimics, and aid with outcome prediction.</p><p><strong>Evidence acquisition: </strong>We performed a literature search on the PubMed database. English language articles published between 2015-2024 were included. The strategies focused on iNPH and specific terms related to the topics of this review.</p><p><strong>Evidence synthesis: </strong>We first addressed the ambiguity of current classification terminology and reviewed the newly proposed classification system. This review has shown that prevalence is higher than previously reported. We have reviewed imaging and found numerous highly sensitive and specific imaging markers to aid diagnosis and differentiate from common mimics. CSF biomarkers have revealed that amyloid β and tau levels were lower in iNPH patients, which helped with differentiation from iNPH mimics, and that other emerging inflammatory markers need to be studied further. We also found numerous promising genetic markers in familial iNPH involved in cilial dysfunction, neuroinflammation, and neurodegeneration. Literature also reported the frequent presence of spinal stenosis, and studies reported better iNPH outcomes when these were addressed.</p><p><strong>Conclusions: </strong>This has shown that there is a need for the development of a structured and standardized classification system, iNPH assessment protocol with standardized testing, and standardized biomarkers to aid diagnosis and treatment, and that this needs an interdisciplinary team approach.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":"69 1","pages":"4-19"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567415","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 treatment: is it time to rethink?","authors":"Loay Shoubash","doi":"10.23736/S0390-5616.24.06361-6","DOIUrl":"10.23736/S0390-5616.24.06361-6","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"136-137"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668285","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":"Targeting the fasciola cinereum: a breakthrough in treating drug-resistant temporal lobe epilepsy.","authors":"Hiba Abid, Eisha Abid, Areeba Abid, Abid Ali","doi":"10.23736/S0390-5616.24.06415-4","DOIUrl":"10.23736/S0390-5616.24.06415-4","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"138-139"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813355","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: a European perspective.","authors":"Graziano Taddei, Giuseppe Demichele, Marco Failla Mulone, Mariasole Gagliano, Laura Carocci, Alessandro Pesce, Silvia Ciarlo, Edvige Iaboni, Angelo Pompucci, Gianpaolo Petrella","doi":"10.23736/S0390-5616.24.06383-5","DOIUrl":"10.23736/S0390-5616.24.06383-5","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"137-138"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837068","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":"Instrumental assessment of INPH: structural and functional neuroimaging.","authors":"Chifumi Iseki, Kazunari Ishii, Nicolò G Pozzi, Massimiliano Todisco, Claudio Pacchetti","doi":"10.23736/S0390-5616.25.06411-2","DOIUrl":"https://doi.org/10.23736/S0390-5616.25.06411-2","url":null,"abstract":"<p><strong>Introduction: </strong>For the accurate diagnosis of idiopathic normal pressure hydrocephalus (iNPH) an accurate neuroimaging is essential. Disproportionately enlarged subarachnoid-space hydrocephalus (DESH) is a key neuroradiological feature and novel imaging techniques, including voxel-based morphometry and AI-assisted analyses are emerging as powerful tools to investigate iNPH pathophysiology. Converging evidence also suggests a role for dopaminergic dysfunction in iNPH. Molecular imaging of the dopamine transporter (DaT) enables the investigation of dopaminergic function and holds potential for advancing differential diagnosis and guiding treatment decisions in iNPH.</p><p><strong>Evidence acquisition: </strong>A comprehensive literature search was conducted using MeSH key words. Studies assessing the role of structural and functional neuroimaging in iNPH. The evidence was summarized, and key results were provided.</p><p><strong>Evidence synthesis: </strong>DESH is crucial for accurate diagnosis and treatment planning. Advanced structural and functional imaging techniques are expanding our understanding of iNPH pathophysiology. Only few functional imaging studies have directly examined the dopaminergic dysfunction in iNPH and severe methodological limitations exist in both clinical classification and imaging processing. Nonetheless, evidence supports the presence of dopaminergic dysfunction in iNPH, which may be linked to specific clinical symptoms, aid in differential diagnosis, and be reversed with shunt surgery treatment.</p><p><strong>Conclusions: </strong>This review covers the structural and functional imaging data in iNPH, providing a comprehensive outlook of the current knowledge, highlighting the limitations and possible future perspectives.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":"69 1","pages":"64-78"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567431","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}