Journal of neurosurgical sciences最新文献

{"title":"Real-life implementation of molecular criteria for diagnosing gliomas according to 2021 WHO Classification: a national survey from the Italian Association of Neuro-Oncology and Society of Neurosurgery.","authors":"Alessia Pellerino, Teresa Somma, Francesco Bruno, Quintino G D'Alessandris, Valeria Internò, Valentina Polo, Denis Aiudi, Giannantonio Spena, Tamara Ius, Vincenzo Esposito, Antonio Silvani, Roberta Rudà","doi":"10.23736/S0390-5616.25.06457-4","DOIUrl":"10.23736/S0390-5616.25.06457-4","url":null,"abstract":"<p><strong>Background: </strong>The Italian Association of Neuro-Oncology (AINO) and the Italian Society of Neurosurgery (SINch) promoted a national survey to explore how the 2021 WHO molecular diagnostic criteria for gliomas have been implemented into clinical practice.</p><p><strong>Methods: </strong>A survey containing 38-item multiple-choice questions was sent to members of the AINO and SINch from January 2022 to March 2022.</p><p><strong>Results: </strong>We collected 152 answers. Participants from non-academic vs. academic hospitals were 78 (51.3%) and 74 (48.7%). Assessment of IDH mutations and 1p/19q codeletion was reported by 140 (92.1%) and 88 (57.9%) responders, respectively. MGMTp methylation, either at diagnosis or at second surgery, was reported by 110 (72.4%) and 82 (53.9%) responders, respectively. CDKN2A/B homozygous deletion in IDH-mutant astrocytomas was investigated according to 53 (34.9%) responders. Assessment of either EGFR amplification or pTERT mutation or +7-10 chromosome changes in IDH-wild type astrocytomas was reported by 76 (50.0%), 43 (28.3%), and 16 (10.5%) responders, respectively. Academic vs. non-academic hospitals had a higher availability of molecular markers, including CDKN2A/B deletion (34/70, 48.6% vs. 19/82, 23.2%, P=0.001), MGMTp at second surgery (48/69, 69.6% vs. 34/72, 47.2%, P=0.008), EGFR/pTERT/+7-10 (46/70, 65.7% vs. 32/77, 41.6%, P=0.003), BRAF mutation (14/70, 20.0% vs. 4/82, 4.9%, P=0.002), NTRK fusion (14/70, 20.0% vs. 2/81, 2.5%, P<0.001).</p><p><strong>Conclusions: </strong>The availability of molecular markers for gliomas is widespread among Italian centers. The implementation of the molecular criteria for diagnostic and prognostic purposes in gliomas according to WHO 2021 Classification needs to be improved. Moreover, a critical issue for the future will be the search for rare actionable mutations, which is continuously evolving, in light of the use of targeted therapy.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"437-444"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475670","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":"Levetiracetam: from anticonvulsant therapy to neuroinflammatory implications in glioblastoma.","authors":"Elena Ferri, Clara Ciampi, Flavio Giordano, Laura Micheli","doi":"10.23736/S0390-5616.25.06633-0","DOIUrl":"https://doi.org/10.23736/S0390-5616.25.06633-0","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":"69 6","pages":"502-503"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029917","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":"Gastrointestinal disorders in traumatic brain injury: pathophysiology, risk factors, and interventions.","authors":"Allen Y Fu, Mahmoud M Elguindy, Geoffrey T Manley, John K Yue","doi":"10.23736/S0390-5616.25.06509-9","DOIUrl":"10.23736/S0390-5616.25.06509-9","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic brain injury (TBI) impacts over 69 million people annually worldwide and causes significant disability. Gastrointestinal (GI) dysfunction is becoming increasingly recognized as post-TBI sequelae, however best practices for their detection and management remain lacking. The current review aimed to improve the understanding of the epidemiology, pathophysiology, risk factors, and interventions of GI disorders after TBI in order to advance clinical diagnosis and treatment.</p><p><strong>Evidence acquisition: </strong>A comprehensive literature search was conducted using the PubMed database between 1996 and 25 January 2025 pertaining to post-TBI GI disorders. Special focus was given to relevant reports on the pathophysiology, epidemiology, risk factors, and management for GI disorders.</p><p><strong>Evidence synthesis: </strong>Post-TBI GI dysfunction occurs primarily due to autonomic dysfunction, increased intracranial pressure, and systemic inflammation, causing intestinal dysmotility and malabsorption, which commonly present as feeding intolerance and malnutrition. Proposed diagnostic criteria include increased gastric residual volume (with/without concurrent GI symptoms), decreased weight, body mass index, and albumin. Standardized nutritional screening methodologies, prokinetic agents, and small bowel and transpyloric feeding have shown benefits in symptomatic management and recovery of GI function, and represent targets for formal study in prospective trials.</p><p><strong>Conclusions: </strong>Post-TBI GI dysfunction is prevalent and can progress to further systemic injuries, impairment, and long-term disability. Early recognition of autonomic and GI system dysfunction, early implementation of formalized nutritional support and multidisciplinary consultation, and inclusion of prokinetic medications and autonomic nervous system modulators are promising avenues for prevention and treatment of post-TBI feeding intolerance, dysmotility, and malnutrition to improve outcomes.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":"69 6","pages":"469-480"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029947","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 history of anterior cervical discectomy and fusion predicts proximal junctional kyphosis after spinal deformity surgery.","authors":"Ryan B Juncker, Nathan Ritchey, Joshua H Weinberg, Ryan G Eaton, Joshua L Wang, Stephanus Viljoen, David S Xu, Andrew J Grossbach","doi":"10.23736/S0390-5616.25.06425-2","DOIUrl":"10.23736/S0390-5616.25.06425-2","url":null,"abstract":"<p><strong>Background: </strong>Proximal junctional kyphosis (PJK) is a common complication following adult spinal deformity (ASD) surgery and puts patients at an increased risk for neurological injury. As reoperation continues to be the mainstay treatment, there is utility in identifying independent preoperative risk factors for PJK development. The aim of this study was to determine whether a history of anterior cervical discectomy and fusion (ACDF) predicts increased incidence of PJK after ASD correction.</p><p><strong>Methods: </strong>Data was retrospectively collected from the medical record of patients who underwent ASD long-segment spinal fusion between 10/2015 and 9/2020. Patients were divided into cohorts based on whether they had previously undergone ACDF. Demographic, radiographic, perioperative, complication, and patient-reported outcomes measures (PROMs) were analyzed. The primary outcome measure was the development of PJK by the 2-year postoperative timepoint.</p><p><strong>Results: </strong>Eighty-six patients met inclusion criteria, 14 of which had previously undergone ACDF. Patients with prior ACDF demonstrated a significantly higher risk of developing PJK by 2 years after ASD surgery. The prior ACDF cohort also showed significantly greater proximal junctional sagittal cobb angles (PJCA) from the upper instrumented vertebra (UIV) to UIV+2 at 2-years postoperatively, greater pre- to postoperative changes in PJCA at 1-year postoperatively, and less absolute global sagittal flexibility than the no prior ACDF cohort. No differences were seen in demographic, comorbidity, complication, or PROM data between groups.</p><p><strong>Conclusions: </strong>These retrospective data demonstrate that a history of ACDF may independently predict the development of PJK after ASD correction and should be considered in the operative decision-making for these patients.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"445-452"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275064","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":"Radiographic and clinical progression from acute to chronic subdural hematoma: a systematic review.","authors":"Adrian Liebert, Leonard Ritter, Karl-Michael Schebesch, Thomas Eibl","doi":"10.23736/S0390-5616.25.06510-5","DOIUrl":"10.23736/S0390-5616.25.06510-5","url":null,"abstract":"<p><strong>Introduction: </strong>While some patients require immediate surgery for acute subdural hematoma (ASDH), others can be managed conservatively. A subset of patients, however, may experience the progression of ASDH to a relevant chronic subdural hematoma (CSDH). This systematic review aims to synthesize studies focusing on ASDH which progress to CSDH.</p><p><strong>Evidence acquisition: </strong>We searched relevant databases for articles. Six issues were addressed: Which percentage of conservatively managed ASDH progressed to CSDH requiring treatment? What were possible risk factors for this progression? How long was the time span for chronification? How did the clinical status change during chronification? How did the radiographic parameters change during chronification? How was this entity surgically treated?</p><p><strong>Evidence synthesis: </strong>Fourteen studies met the inclusion criteria. The proportion of conservatively managed ASDH patients who eventually required surgery due to CSDH ranged from 6.5% to 45.3%. Several risk factors for progression were identified, with initial hematoma size and midline shift being the most significant. The majority required surgery within two to three weeks following trauma. As ASDH progressed to CSDH, a notable deterioration in clinical status occurred for many patients, including a decline in consciousness. While the hematoma density decreased, its size and midline shift increased. Most patients underwent burr hole trephination.</p><p><strong>Conclusions: </strong>The progression of ASDH to CSDH often led to an increase in hematoma size and midline shift, resulting in the worsening of clinical symptoms. Surgery was typically required within the second or third week after trauma for these patients.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"415-421"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742283","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":"Artificial intelligence and machine learning in the management of patients with degenerative cervical myelopathy: a systematic review.","authors":"Vikas N Vattipally, Ritvik R Jillala, Carlos A Aude, Arjun K Menta, Jacob Jo, Liam P Hughes, Jawad M Khalifeh, Tej D Azad","doi":"10.23736/S0390-5616.25.06504-X","DOIUrl":"10.23736/S0390-5616.25.06504-X","url":null,"abstract":"<p><strong>Introduction: </strong>Degenerative cervical myelopathy (DCM) is a debilitating condition caused by compression of the spinal cord. Despite established surgical treatments, accurate diagnosis and prognostication remain challenging in part due to the variability in clinical presentation and lack of screening tools. Machine learning (ML) has emerged as a promising approach to address these challenges through its predictive capabilities for diagnosis, decision-making, and prognostication. Given the recent advent of ML, there is a need to systematically synthesize its applications to the treatment of patients with DCM.</p><p><strong>Evidence acquisition: </strong>A systematic review was performed in accordance with PRISMA guidelines. We searched five databases (PubMed, Embase, Cochrane, Scopus, Web of Science) in November 2024 and included studies employing predictive ML techniques among a population of patients with DCM. Studies primarily focused on ML applications to neuroimaging were excluded. Variables such as study focus, number of patients with DCM, and ML approaches used were extracted.</p><p><strong>Evidence synthesis: </strong>Thirty full-text studies were included in this review. These studies encompassed 11,407 patients, with 84% (N.=9615) holding a diagnosis of DCM. Most studies (N.=16, 53%) used ML to predict outcomes for patients with DCM, including functional recovery, quality-of-life, and postoperative complications. Thirteen studies (43%) focused on the diagnosis of DCM using ML-augmented screening tools, and the remaining study focused on surgical decision-making. Support vector machine was the most used ML approach (N.=14 studies, 47%) followed by random forest (N.=8 studies, 27%). Throughout the studies included, ML algorithm predictions were demonstrated to outperform traditional statistical methods.</p><p><strong>Conclusions: </strong>ML models are a promising step forward for diagnosis, clinical decision-making, and prognostication for patients with DCM. Further validation in large, multi-institutional cohorts is needed to help improve translatability to clinical practice.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"405-414"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742282","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":"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":" ","pages":"384-391"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","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}

{"title":"Hakim disease: a new eponym for idiopathic normal pressure hydrocephalus.","authors":"Steven H Yale, Halil Tekiner, Advitiya Aggarwal, Eileen S Yale","doi":"10.23736/S0390-5616.25.06520-8","DOIUrl":"10.23736/S0390-5616.25.06520-8","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"434-435"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540563","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":"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":" ","pages":"392-397"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","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":"Neuropsychological assessment in idiopathic normal pressure hydrocephalus.","authors":"Domenico LA Torre, Attilio Della Torre, Fabio Pirrotta, Angelo Lavano","doi":"10.23736/S0390-5616.25.06554-3","DOIUrl":"10.23736/S0390-5616.25.06554-3","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"435-436"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225738","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}