Journal of neurosurgical sciences最新文献

{"title":"Family-base rare variant association analysis in Saudi Arabian hydrocephalus subjects using whole exome sequencing.","authors":"Ahmed Ammar, Dalal K Bubshait, Abdulrazaq Al Ojan, Shuroq A Alshari, Cyril Cyrus, Rawan Alanazi, Mohammed A Al Ghamdi, Brendan J Keating, Abdulrahman Al-Anazi, Noorah H Al Qahtani, Amein K Al-Ali","doi":"10.23736/S0390-5616.23.06010-1","DOIUrl":"10.23736/S0390-5616.23.06010-1","url":null,"abstract":"<p><strong>Background: </strong>Hydrocephalus is a highly heterogeneous multifactorial disease that arises from genetic and environmental factors. Familial genetic studies of hydrocephalus have elucidated four robustly associated hydrocephalus associated loci. This study aims to identify potential genetic causation in cases of hydrocephalus, with or without spina bifida and Dandy Walker Syndrome (DWS), using family-based rare variant association analysis of whole exome sequencing.</p><p><strong>Methods: </strong>We performed whole exome sequencing in 143 individuals across 48 families where at least one offspring was affected with hydrocephalus (N.=27), with hydrocephalus with spina bifida (N.=21) and with DWS (N.=3), using Illumina HiSeq 2500 instrument.</p><p><strong>Results: </strong>No pathogenic or putative pathogenic single-nucleotide variants were evident in the four known hydrocephalus loci in our subjects. However, after examining 73 known hydrocephalus genes previously identified from literature, we identified three potentially impactful variants from the cohort. Using a gene panel comprising variants in known neural tube defects loci, we identified a total of 1024 potentially deleterious variants, of which 797 were missense variants and 191 were frameshift variants, 36 were stop gain/loss variants. A small portion of our family pedigree analyses yielded putative genetic signals which may be responsible for hydrocephaly elated phenotypes, however the low diagnostic yield may be due to lack of capture of genetic variants in the exonic regions i.e. structural variants may only be evident from whole genome sequencing.</p><p><strong>Conclusions: </strong>We identified three potentially impactful variants from our cohort in 73 known hydrocephalus genes previously identified in literature.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"698-703"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9432927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of intra-operative skull fixation techniques on cervical sagittal parameters.","authors":"Connor C Jacob, Ryan G Eaton, Andrew J Grossbach, Asad Akhter, Nathaniel Toop, Joshua Wang, Joravar Dhaliwal, Stephanus V Viljoen","doi":"10.23736/S0390-5616.24.06255-6","DOIUrl":"10.23736/S0390-5616.24.06255-6","url":null,"abstract":"<p><strong>Background: </strong>There is limited literature concerning the use of bi-vector traction to a Mayfield following posterior cervical fusion with respect to cervical alignment parameters. The objective of this study was to determine how variability of intra-operative fixation methods for posterior cervical fusion affects post-operative cervical sagittal alignment parameters.</p><p><strong>Methods: </strong>After institutional review board (IRB) approval, retrospective chart review of a total of 54 patients who underwent posterior cervical fusion from July 2017 to December 2019 was conducted. The patients were divided into two cohorts based on their intra-operative positioning, those who were affixed to a three-point fixation system, and those who were placed in bi-vector traction. Pre- and post-operative cervical alignment parameters were measured.</p><p><strong>Results: </strong>There was no difference in post-operative sagittal parameters between the two groups. Each group showed a statistically significant difference in T1-slope when comparing pre- and post-operative measurements.</p><p><strong>Conclusions: </strong>In our study we did not find that any of our techniques including bi-vector traction, static Mayfield positioning, or dynamic Mayfield positioning were very effective in adding lordosis during posterior cervical fusion surgeries. Interestingly, we also found a statistically significant increase in T1 slope and resulting trend towards increased cervical SVA.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668283","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":"Follow-up neuroimaging after non-perimesencephalic, angiogram-negative subarachnoid hemorrhage.","authors":"Jean-Philippe Dufour, Menno R Germans, Emanuela Keller, Zsolt Kulcsàr, Luca Regli, Giuseppe Esposito","doi":"10.23736/S0390-5616.22.05686-7","DOIUrl":"10.23736/S0390-5616.22.05686-7","url":null,"abstract":"<p><strong>Background: </strong>In approximately 15% of spontaneous subarachnoid hemorrhage (SAH) patients, no bleeding source is found in the initial imaging. These patients can be categorized as either perimesencephalic (PM-SAH) or non-perimesencephalic (NP-SAH) subarachnoid hemorrhage patients. Follow-up imaging is routinely performed after NP-SAH to detect treatable etiologies; however, the optimal follow-up imaging protocol remains unclear. This study examines the optimal time interval to re-imaging and the performance of magnetic resonance imaging and angiography (MRI/A) in this setting.</p><p><strong>Methods: </strong>In this retrospective study, the records of NP-SAH patients treated at the University Hospital of Zurich (Switzerland) from 2005 to 2018 were analyzed. Clinical and radiological data were collected. Re-imaging data was grouped according to imaging modality and divided into three time-categories after bleeding: short-term (<2 weeks), medium-term (2-8 weeks) and long-term (>8 weeks) re-imaging.</p><p><strong>Results: </strong>Eighty-one NP-SAH patients were included. In 8 patients an aneurysm was diagnosed during re-imaging via digital subtraction angiography (9.9% diagnostic yield). Five aneurysms were detected at short-term in 81 patients (6.2% short-term yield) and three at medium-term re-imaging in 27 patients (11.1% medium-term yield). No aneurysms were found after 8 weeks in 56 patients. Five of these 8 patients also received MRI/A re-imaging, which was able to show the aneurysm in all 5 cases.</p><p><strong>Conclusions: </strong>Our study emphasizes the importance of re-imaging in NP-SAH patients, which should be done both at short-term and at medium-term follow-up after the hemorrhage. Long-term re-imaging after 8 weeks might not be of diagnostic benefit. MRI/A might be considered as a possible noninvasive re-imaging modality in this setting.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"541-550"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9152205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of neutrophil-to-lymphocyte ratio and neutrophil-to-monocyte ratio in severe traumatic brain injury: a retrospective cohort.","authors":"Luiz F Matias, Murilo D Pimentel, Mateus F Medeiros, Franciani R Rocha, Marcelo V Gambetta, Samantha C Lopes","doi":"10.23736/S0390-5616.23.05877-0","DOIUrl":"10.23736/S0390-5616.23.05877-0","url":null,"abstract":"<p><strong>Background: </strong>The neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), the lymphocyte-monocyte ratio (LMR), the neutrophil-monocyte ratio (NMR) and the systemic immune inflammation index (SII) are associated with clinical outcomes in oncological diseases, cardiovascular diseases, infectious / inflammatory diseases, endocrinological, pulmonary and brain injuries. Here, we investigate its association with hospital mortality in patients with severe traumatic brain injury.</p><p><strong>Methods: </strong>We retrospectively reviewed clinical data from patients with severe traumatic brain injury (sTBI) who were treated in our department between January 2015 and December 2020. NLR, PLR, NMR, LMR and SII data were collected between admission and day 3, as well as other indicators related. The relationship between hematological ratios and in-hospital mortality were analyzed.</p><p><strong>Results: </strong>A total of 96 patients were included in study, hospital mortality was 40.6% (N.=39). The levels of NLR on admission (D0), NLR day 1 (D1), NLR day 2 (D2), NLR day 3 (D3), NMR day 1 (D1) and NMR day (2) remained significantly higher in patients with death intra-hospital (P=0.030; P=0.038; P=0.016; P=0.048; P=0.046 and P=0.001, respectively). Multivariate logistic analysis showed that higher NLR values at admission and day 2 NMR were associated with in-hospital mortality (OR=1.120, P=0.037; and OR=1.307, P=0.004, respectively). Analysis of the recipient operating characteristic (ROC) curve showed that the NLR on admission had a sensitivity of 59.0% and a specificity of 66.7% (area under the curve 0.630, P=0.031, Youden's Index 0.26) and the NMR of day 2 had a sensitivity of 67.7% and a specificity of 70.4% (area under the curve 0.719, P=0.001, Youden's index 0.38) to predict mortality intra-hospital based on the best threshold.</p><p><strong>Conclusions: </strong>Our analysis indicates that higher NLR levels on admission and day 2 NMR are independent predictors of in-hospital mortality in patients with sTBI.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"604-611"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10867134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of baseline frailty and age with postoperative outcomes in metastatic brain tumor patients.","authors":"Christine J Colasacco, Joanna Abouezzi, Sophia Arbuiso, Derek B Asserson, Syed F Kazim, Kyril L Cole, Alis J Dicpinigaitis, Jose Dominguez, Rohini G McKEE, Meic H Schmidt, William T Couldwell, Christian A Bowers","doi":"10.23736/S0390-5616.22.05865-9","DOIUrl":"10.23736/S0390-5616.22.05865-9","url":null,"abstract":"<p><strong>Background: </strong>The impact of baseline frailty status versus that of chronological age on surgical outcomes of metastatic brain tumor patients remains largely unknown. The present study aimed to evaluate this relationship for preoperative risk stratification using a large national database.</p><p><strong>Methods: </strong>The National Surgical Quality Improvement Program database was queried to extract data of metastatic brain tumor patients who underwent surgery between 2015 and 2019 (N.=5943). Univariate and multivariate analyses were performed to assess the effect of age and modified Frailty Index-5 on mortality, major complications, unplanned readmission and reoperation, extended length of stay (eLOS), and non-home discharge.</p><p><strong>Results: </strong>Both univariate and multivariate analyses demonstrated that frailty status was significantly predictive of 30-day mortality, major complications, eLOS, and non-home discharge. Although increasing age was also a significant predictor of eLOS and discharge to non-home destination, effect sizes were smaller compared with frailty.</p><p><strong>Conclusions: </strong>The present study, based on analysis of data from a large national registry, shows that frailty, when compared with age, is a superior predictor of postoperative outcomes in metastatic brain tumor patients. A future prospective study, namely a randomized controlled trial, would be beneficial in helping to corroborate the findings of this retrospective study.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"526-532"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10444368","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":"Tuberculum sellae meningiomas: surgical outcomes in 65 patients, review of the literature and proposal for an anatomical and radiological classification.","authors":"Giulio Maira, Biagia LA Pira, Alessandra Serraino, Maria P Tropeano, Delia Cannizzaro","doi":"10.23736/S0390-5616.23.06061-7","DOIUrl":"10.23736/S0390-5616.23.06061-7","url":null,"abstract":"<p><p>Tuberculum sellae meningiomas (TSM) are challenging tumors due to their proximity to vital neurovascular structures. We propose a new classification system based on anatomical and radiological parameters. All patients treated for TSM, between January 2003 and December 2016, have been retrospectively reviewed. A systematic research was performed in PubMed database to review all studies comparing the performance of transcranial (TCA) and transphenoidal (ETSA) approaches. Overall, 65 patients were included in the surgical series. Gross total removal (GTR) was achieved in 55 patients (85%) and near total resection in 10 (15%). 54 patients (83%) showed a stability or an improvement of visual functions and 11 (17%) worsened. Postoperative complications were observed in seven patients (11%): CSF leak in one patient (1.5%); diabetes insipidus in two (3%); hypopituitarism in two (3%) third cranial nerve paresis and subdural empyema in one (1.5%). For the literature review, data about 10,833 patients (TCA N.=9159; ETSA N.=1674) were recorded; GTR was achieved in 84.1% (range 68-92%) of TCA and in 79.1% (range 60-92%) of ETSA; visual improvement (VI) occurred in 59.3% of TCA (range 25-84%) and in 79.3% of ETSA (range 46-100%); visual deterioration (VD) was registered in 12.7% of TCA (0-24%) and in 4.1% of ETSA (range 0-17%); a CSF-leak was observed in 3.8% of TCA (range 0-8%) while in ETSA in 18.6% of patients (range 0-62%); vascular injuries was reported in 4% (range 0-15%) of TCA and in 1.5% (range 0-5%) of ETSA. In conclusion, TSMs represent a unique category of midline tumors. The proposed classification system provides an intuitive and reproducible method in the choice of the most suitable approach.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"631-641"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9615160","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":"VEGF gene polymorphisms in Iranian patients with intracranial glioblastoma.","authors":"Sara Hanaei, Hanieh Mojtahedi, Mohamad Namvar, Arad Iranmehr, Reyhaneh Safaei, Azadehsadat Razavi, Marzie Esmaeili, Maryam Sadr, Arezou Rezaei, Maryam Edalatfar, Hamidreza Khayat Kashani, Mohsen Sadeghi-Naini, Farzaneh Darbeheshti, Jaber Gharehdaghi, Mehdi Forouzesh, Abdolali Ebrahimi, Nima Rezaei","doi":"10.23736/S0390-5616.22.05832-5","DOIUrl":"10.23736/S0390-5616.22.05832-5","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma is one of the most common malignant brain tumors in adults with poor prognosis. Neovascularization is one of the characteristics of these tumors, which is associated with overexpression of vascular endothelial growth factor (VEGF). Accordingly, single nucleotide polymorphisms of this gene could play an important role in structural and functional alterations leading to overexpression of this gene in GBM.</p><p><strong>Methods: </strong>A total number of 49 patients with GBM and 50 healthy controls were included in the current study. The Genomic DNA was extracted from brain tumor/tissue samples, and after purification assessment, the alleles, and genotypes of rs3025039 and rs2010963 polymorphisms of the VEGF gene were investigated using T-ARMS-PCR.</p><p><strong>Results: </strong>The \"T\" allele of rs3025039 was 2.79 times more frequent in GBM patients compared to controls (P=0.01). Moreover, the \"CT\" genotype was 2.83 times more common among patients (P=0.015), while the \"CC\" was more frequent in controls (P=0.009). The mean overall survival was significantly different between three genotypes of rs3025039, with the longest survival time in \"CT\" genotype (15.10±5.21, P=0.041). Besides, rs2010963, was significantly associated with GBM occurrence, with the \"G\" allele being 1.96 times more frequent in patients (P=0.01), as well as the \"GG\" genotype, which was 7.87 times more common in patients (P<0.001).</p><p><strong>Conclusions: </strong>Polymorphisms of VEGF could potentially play a role in pathogenesis of GBM, as the allele and genotype distributions of rs3025039 and rs2010963 SNPs were significantly associated with GBM occurrence.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"583-589"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10541870","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":"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":" ","pages":"453-458"},"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":"The western giants of neuroanatomical past: an ode to yesterday - Part I.","authors":"Sanjeev Sreenivasan, Kaustav Chattopadhyay, Michael Rallo, Arevik Abramyan, Srihari Sundararajan, Sudipta Roychowdhury, Anil Nanda, Gaurav Gupta","doi":"10.23736/S0390-5616.24.06223-4","DOIUrl":"10.23736/S0390-5616.24.06223-4","url":null,"abstract":"<p><p>\"The only history is a mere question of one's struggle inside oneself. But that is the joy of it. One need neither discover Americas nor conquer nations, and yet one has as great a work as Columbus or Alexander to do,\" said David H. Lawrence. In this historical vignette, we look at the lives of certain western giants of neuroanatomy from the past. To understand the origin of today's advancements and successes in neurosurgery, a strong foothold on the path taken by anatomical greats is necessary. What curiosity inspired them to search the meaning of the human nervous system? Learning this from the paths of Herophilus, Galen, Franciscus Sylvius, Thomas Willis, Alexander Monro secundus, Luigi Rolando, François Magendie, and Martin Rathke, will propel us to create a better future for our successors.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"492-499"},"PeriodicalIF":1.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140101800","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":" ","pages":"439-446"},"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}