Journal of neurosurgical sciences最新文献

{"title":"Reliability of facet fluid on preoperative MRI for prediction of segmental instability after decompression surgery for degenerative lumbar spinal stenosis.","authors":"Seung-Chan Yoo, Chung-Kee Chough","doi":"10.23736/S0390-5616.22.05654-5","DOIUrl":"10.23736/S0390-5616.22.05654-5","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study is to determine whether preoperative facet fluid on MRI can help predict segmental instability (SI) after decompression surgery.</p><p><strong>Methods: </strong>We analyzed 34 patients (14 men and 20 women, a total of 37 segments) who underwent decompression for degenerative lumbar spinal stenosis from June 2011 to August 2019 at a single institution. Mean age at the time of operation was 67.8. Postoperative assessment was performed uniformly 12 months (11~15 months) after the surgery. Preoperative facet fluid on MRI, pre- and postoperative slip percentage, and segmental motion on lumbar lateral neutral and flexion-extension (LFE) radiographic images were measured. Visual Analog Scale (VAS) and necessities of interventional procedure or medication was also assessed for clinical outcomes.</p><p><strong>Results: </strong>No significant association was found between preoperative facet fluid indices and pre- or postoperative slip percentage (P=0.134) and segmental motion (P=0.936). There were no significant association also between facet fluid indices and VAS of back or leg (P=0.997 and P=0.437 respectively).</p><p><strong>Conclusions: </strong>Preoperative facet fluid is not a predictive index of postoperative segmental instability or clinical outcome. Without segmental instability on LFE radiographic images, the presence of facet fluid in MRI is not an absolute indication for fusion.</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":"9881382","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":"Endoscopic-assisted paramedian supracerebellar infratentorial approach to the posterior portion of the third ventricle: anatomical study and surgical cases.","authors":"Lucas Serrano Sponton, Mohammed Alhoobi, Eleftherios Archavlis, Ahmed T Shaaban, Elias Dumour, Amr Nimer, Jens Conrad, Sven R Kantelhardt, Ali Ayyad","doi":"10.23736/S0390-5616.22.05622-3","DOIUrl":"10.23736/S0390-5616.22.05622-3","url":null,"abstract":"<p><strong>Background: </strong>To date, morphometrical data providing a systematic quantification of accessibility and operability parameters to the boundaries of the posterior portion of the third ventricle (PTV) when applying an endoscopic-assisted paramedian supracerebellar infratentorial approach (EPSIA) are lacking. We performed an anatomical study and complemented our findings with surgical cases.</p><p><strong>Methods: </strong>Eight EPSIAs towards the PTV were performed in cadaveric specimens. Optimal approach angles (OA), surgical freedom (SF) and operability indexes (Oi) to the PTV boundaries were assessed. Additionally, a 54-year-old man and 33-year-old woman were operated on PTV tumors applying the EPSIA.</p><p><strong>Results: </strong>Sagittal OA to ventricle's roof and floor was 36±1.4° and 25.5±3.5° respectively, axial OA to the ipsilateral and contralateral ventricle's wall were 9.5±1.3° and 28.5±1.6°. SF was maximal on the contralateral wall (121.2±19.3mm²), followed by the roof (112.7±18.8mm²), floor (106.6±19.2mm²) and ipsilateral wall (94.1±15.7mm²). SF was significantly lower along the ipsilateral compared the contralateral wall (P<0.01) and roof (P<0.05). Facilitated surgical maneuvers with multiangled exposure were possible up to 8.5±1.07mm anterior to ventricle's entrance, whereas surgical maneuvers were possible but difficult up to 15.25±3.7mm. Visualization of more anterior was possible up to a distance of 27±2.9mm, but surgical maneuvers were barely feasible. EPSIA enabled successful resection of both PTV tumors and postoperative course was uneventful.</p><p><strong>Conclusions: </strong>EPSIA can be effective for approaching the PTV, enabling surgery along all boundaries, but especially on its roof and contralateral wall. In the not-enlarged ventricle, surgical maneuvers are feasible up to the level of the Monro foramen, becoming more limited anteriorly.</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":"43252274","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":"Effect of mannitol on platelet function during elective craniotomy in adult patients with brain tumor.","authors":"Kilian Arlt, Paul Frank, Markus Flentje, Hendrik Eismann, Elvis J Hermann, Joachim K Krauss, Shadi Al-Afif, Thomas Palmaers","doi":"10.23736/S0390-5616.22.05678-8","DOIUrl":"10.23736/S0390-5616.22.05678-8","url":null,"abstract":"<p><strong>Background: </strong>Mannitol is used in the treatment of raised intracranial pressure (ICP). The aim of this study was to investigate whether mannitol (MAN) leads to a relevant deterioration in platelet function in routine neurosurgical procedures.</p><p><strong>Methods: </strong>Thirty-eight patients undergoing elective craniotomy due to a brain tumor with elevated ICP were included. After induction of anesthesia a blood sample was taken (T1). The patients then received 1 g∙kg^-1 MAN within 30 minutes. The second blood sample (T2) was obtained 60 minutes after T1. Blood samples were examined by means of aggregometry (Multiplate^®; Roche, Basel, Switzertland) and PFA-100^® tests (Siemens Healthineers, Erlangen, Germany).</p><p><strong>Results: </strong>No patient had clinical signs of increased bleeding. We could not find any deterioration in the aggregometry using Multiplate^® (Roche), neither in the adenosine diphosphate (ADP), the arachidonic acid (ASPI), or the thrombin receptor activating protein (TRAP) test. PFA-100^® (Siemens Healthineers) closing times (cT) showed a significant prolongation between T1 and T2: collagen/adenosine diphosphate (COL/ADP) test 79 s [70/99] and 91 s [81/109]; P=0.002); collagen/epinephrine (COL/EPI) test 109 s [92/129] and 122 s [94/159]; P=0.0004). A subgroup analysis showed that the patients who received isotonic balanced infusions only, had no prolongation of cT, whereas the patients who received additionally gelatin solution had a significant prolongation. COL/ADP: 78 s [70/98] and 91 s [82/133]; P=0.0004). COL/EPI: test 111 s [92/128] and 127 s [103/146]; P=0.0026). Except for individual outliers, the measured values were in the normal range.</p><p><strong>Conclusions: </strong>In this study, we found no clinically relevant deterioration of platelet function in neurosurgical patients with increased ICP after administration of MAN. Changes that occurred were all within normal ranges.</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":"42673518","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":"Current state of global neurosurgery activity amongst European neurosurgeons.","authors":"Saniya Mediratta, Laura Lippa, Sara Venturini, Andreas K Demetriades, Abdessamad El-Ouahabi, Maria L Gandía-González, William Harkness, Peter Hutchinson, Kee B Park, Katrin Rabiei, Gail Rosseau, Karl Schaller, Franco Servadei, Jesus Lafuente, Angelos G Kolias","doi":"10.23736/S0390-5616.21.05447-3","DOIUrl":"10.23736/S0390-5616.21.05447-3","url":null,"abstract":"<p><strong>Background: </strong>The expanding field of global neurosurgery calls for a committed neurosurgical community to advocate for universal access to timely, safe, and affordable neurosurgical care for everyone, everywhere. The aim of this study was to assess the current state of global neurosurgery activity amongst European neurosurgeons and to identify barriers to involvement in global neurosurgery initiatives.</p><p><strong>Methods: </strong>Cross-sectional study through dissemination of a web-based survey, from September 2019 to January 2020, to collect data from European neurosurgeons at various career stages. Descriptive analysis was conducted on respondent data.</p><p><strong>Results: </strong>Three hundred and ten neurosurgeons from 40 European countries responded: 53.5% regularly follow global neurosurgery developments, and 29.4% had travelled abroad with a global neurosurgery collaborative, with 23.2% planning a future trip. Respondents from high income European countries predominantly travelled to Africa (41.6%) or Asia (34.4%), whereas respondents from middle income European countries frequently traversed Europe (63.2%) and North America (47.4%). Cost implications (66.5%) were the most common barrier to global neurosurgery activity, followed by interference with current practice (45.8%), family duties (35.2%), difficulties obtaining humanitarian leave (27.7%) and lack of international partners (27.4%). 86.8% would incorporate a global neurosurgery period within training programmes.</p><p><strong>Conclusions: </strong>European neurosurgeons are interested in engaging in global neurosurgery partnerships, and several sustainable programs focused on local capacity building, education and research have been established over the last decade. However, individual and system barriers to engagement persist. We provided insight into these to allow development of tailored mechanisms to overcome such barriers, enabling European neurosurgeons to advocate for the Global Surgery 2030 goals.</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":"39909758","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":"Lessons learned during COVID-19 pandemic, a worldwide survey: evolution of global neurosurgical practice.","authors":"Harsh Deora, Amol Raheja, Shashwat Mishra, Vivek Tandon, Edoardo Agosti, Pierlorenzo Veiceschi, Kanwaljeet Garg, Vikas Naik, Shweta Kedia, Rajesh Meena, Satya S Munjal, Bipin Chaurasia, Jack Wellington, Davide Locatelli, Marco M Fontanella, Manmohan Singh, P S Chandra, Shashank S Kale, Kenan Arnautovic","doi":"10.23736/S0390-5616.22.05733-2","DOIUrl":"10.23736/S0390-5616.22.05733-2","url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic, a multitude of surveys have analyzed the impact virus spreading on the everyday medical practice, including neurosurgery. However, none have examined the perceptions of neurosurgeons towards the pandemic, their life changes, and the strategies they implemented to be able to deal with their patients in such a difficult time.</p><p><strong>Methods: </strong>From April 2021 to May 2021 a modified Delphi method was used to construct, pilot, and refine the questionnaire focused on the evolution of global neurosurgical practice during the pandemic. This survey was distributed among 1000 neurosurgeons; the responses were then collected and critically analyzed.</p><p><strong>Results: </strong>Outpatient department practices changed with a rapid rise in teleservices. 63.9% of respondents reported that they have changed their OT practices to emergency cases with occasional elective cases. 40.0% of respondents and 47.9% of their family members reported to have suffered from COVID-19. 56.2% of the respondents reported having felt depressed in the last 1 year. 40.9% of respondents reported having faced financial difficulties. 80.6% of the respondents found online webinars to be a good source of learning. 47.8% of respondents tried to improve their neurosurgical knowledge while 31.6% spent the extra time in research activities.</p><p><strong>Conclusions: </strong>Progressive increase in operative waiting lists, preferential use of telemedicine, reduction in tendency to complete stoppage of physical clinic services and drop in the use of PPE kits were evident. Respondents' age had an impact on how the clinical services and operative practices have evolved. Financial concerns overshadow mental health.</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":"41956434","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":"Intraoperative navigation in surgical management of traumatic spine injury: a propensity score matching analysis.","authors":"Merritt D Kinon, Sima Vazquez, Eris Spirollari, Christina Ng, Ankita DAS, Alexandria F Naftchi, Aiden K Lui, Cameron Beaudreault, Tiffany Ming, Jose F Dominguez, Syed F Kazim, Chad D Cole, Meic H Schmidt, Chirag D Gandhi, Rachana Tyagi, Vishad V Sukul, John K Houten, Christian A Bowers","doi":"10.23736/S0390-5616.22.05722-8","DOIUrl":"10.23736/S0390-5616.22.05722-8","url":null,"abstract":"<p><strong>Background: </strong>Traumatic spinal injury (TSI) can lead to severe morbidity and significant health care resource utilization. Intraoperative navigation (ION) systems have been shown to improve outcomes in some populations. However, controversy about the benefit of ION remains. To our knowledge, there is no large database analysis studying the outcomes of ION on TSI patients. Here we hope to compare complications and outcomes in patients with TSI undergoing spinal fusion of 3 or more levels with or without the use of ION.</p><p><strong>Methods: </strong>The 2015-2019 National Surgical Quality Improvement Program (NSQIP) database was queried for cases of posterior spinal instrumentation of 3 or more levels. This population was then selected for postoperative diagnosis consistent with TSI. The effect of prolonged operative time was analyzed for all patients. Propensity score matching analysis was performed to create ION case and non-ION control groups. Baseline demographic characteristics, complications, and outcome data were collected and compared between ION and non-ION groups.</p><p><strong>Results: </strong>A total of 1,034 patients were included in the propensity matched analysis. Among comorbidities, only obesity was significantly more likely in the non-ION group. There was no difference in case complexity between the two groups. ION was associated with higher incidence of prolonged operative time but was a negative independent predictor for sepsis. Prolonged operative time was a significant independent predictor for pulmonary embolism and requirement of transfusion in all patients. Discharge to home, readmission, and reoperation rates did not differ between TSI patients with or without ION.</p><p><strong>Conclusions: </strong>Use of ION during posterior spinal fusion of 3 or more levels in TSI patients is not associated with worse outcomes. Prolonged operative time, rather than ION, appears to have a higher influence on the rate of complications in this population. Evaluation of ION in the context of specific populations and pathology is warranted to optimize its use.</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":"46829982","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":"The role of the craniotomy size in the surgical evacuation of acute subdural hematomas in elderly patients: a retrospective multicentric study.","authors":"Gianluca Trevisi, Alba Scerrati, Oriela Rustemi, Luca Ricciardi, Fabio Raneri, Alberto Tomatis, Amedeo Piazza, Anna M Auricchio, Vito Stifano, Michele Dughiero, Pasquale DE Bonis, Annunziato Mangiola, Carmelo L Sturiale","doi":"10.23736/S0390-5616.22.05648-X","DOIUrl":"10.23736/S0390-5616.22.05648-X","url":null,"abstract":"<p><strong>Background: </strong>Elderly patients operated for an acute subdural hematoma (ASDH) frequently have a poor outcome, with a high frequency of death, vegetative status, or severe disability (Glasgow Outcome Score [GOS] 1-3). Minicraniotomy has been proposed as a minimally invasive surgical treatment to reduce the impact of surgery in the elderly population. The present study aimed to compare the influence of the size of the craniotomy on the functional outcome in patients undergoing surgical treatment for ASDH.</p><p><strong>Methods: </strong>We selected patients ≥70 years old admitted to 5 Italian tertiary referral neurosurgical for the treatment of a post-traumatic ASDH between January 1, 2016, and December 31, 2019. We collected demographic data, clinical data (GCS, GOS, Charlson Comorbidity Index [CCI], antiplatelet/anticoagulant therapy, neurological deficits, seizure, pupillary size, length of stay), surgical data (craniotomy size, dividing the patients into 3 groups based on the corresponding tertile, and surgery duration), radiological data (ASDH side and thickness, midline shift, other post-traumatic lesions, extent of ASDH evacuation) and we assessed the functional outcome at hospital discharge and 6-month follow-up considering GOS=1-3 as a poor outcome. ANOVA and χ² Tests and logistic regression models were used to assess differences in and associations between clinical-radiological characteristics and functional outcomes.</p><p><strong>Results: </strong>We included 136 patients (76 males) with a mean age of 78±6 years. Forty-five patients underwent a small craniotomy, 47 a medium size, and 44 a large craniotomy. Among the different craniotomy size groups, there were no differences in gender, anticoagulant/antithrombotic therapy, CCI, side of ASDH, ASDH thickness, preoperative GCS, focal deficits, seizures, and presence of other post-traumatic lesions. Patients undergoing small craniotomies were older than patients undergoing medium-large craniotomies; ASDH treated with medium size craniotomy were thinner than the others; patients undergoing large craniotomies showed greater midline shift and a higher rate of anisocoria. The three groups did not differ for functional outcome and postoperative midline shift, but the length of surgery and the rate of >50% of ASDH evacuation were lower in the small craniotomy group.</p><p><strong>Conclusions: </strong>A small craniotomy was not inferior to larger craniotomies in determining functional outcomes in the treatment of ASDH in the elderly.</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":"47083884","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":"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}