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":"https://doi.org/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":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-03-14","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":"Frailty predicts non-home discharge in anterior lumbar interbody fusion patients.","authors":"Derek B Asserson, Danielle A Alaouieh, Joanna M Roy, Meic H Schmidt, Christian A Bowers","doi":"10.23736/S0390-5616.24.06179-4","DOIUrl":"https://doi.org/10.23736/S0390-5616.24.06179-4","url":null,"abstract":"<p><strong>Background: </strong>Anterior lumbar interbody fusion (ALIF) is a well-established surgical approach in the treatment of degenerative pathology, trauma, infection, and neoplasia of the spine. This study sought to assess the usefulness of frailty as a predictor of non-home discharge (NHD) for patients who undergo the procedure.</p><p><strong>Methods: </strong>Patient cases were extracted from the American College of Surgeons's National Surgical Quality Improvement Program database from 2012 to 2020. Univariable and receiver operating characteristic curve analyses were used to compare the 5-item Modified Frailty Index (mFI-5) to the Revised Risk Analysis Index (RAI-rev) in relation to NHD.</p><p><strong>Results: </strong>Simple linear regression demonstrated that increasing frailty was associated with an increased likelihood of NHD among 25,317 patients (mFI-5 odds ratio: 2.13, 3.23, 8.4; RAI-rev odds ratio: 3.22, 9.6, 23.6 [P<0.001 for all]). In each instance, a Cochran-Armitage trend test was significant (P<0.001), indicating a linear association of increasing odds. The RAI-rev resulted in a C-statistic of 0.722, compared to 0.628 for the mFI-5, and was shown to have superior discriminative ability with a DeLong Test (P<0.001).</p><p><strong>Conclusions: </strong>Frailty, as measured by mFI-5 and RAI-rev, was associated with an increased likelihood of NHD in patients who underwent ALIF. This finding supports recent literature on the promising utility of these indices, especially the RAI-rev, in preoperative decision-making across multiple facets of neurosurgery.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140049690","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":"Is contact sport participation associated with chronic traumatic encephalopathy or neurodegenerative decline? A systematic review and meta-analysis.","authors":"Meredith A Monsour, Daniel I Wolfson, Jacob Jo, Douglas P Terry, Scott L Zuckerman","doi":"10.23736/S0390-5616.22.05895-7","DOIUrl":"10.23736/S0390-5616.22.05895-7","url":null,"abstract":"<p><strong>Introduction: </strong>We sought to evaluate a potential association between contact vs. non-contact sport participation and long-term neurologic outcomes and chronic traumatic encephalopathy (CTE).</p><p><strong>Evidence acquisition: </strong>PubMed/Embase/PsycINFO/CINAHL databases were queried for studies between 1950-2020 with contact and non-contact sports, longitudinal assessment >10 years, and long-term neurologic outcomes in four-domains: I) clinical diagnosis; II) CTE neuropathology; III) neurocognition; and IV) neuroimaging.</p><p><strong>Evidence synthesis: </strong>Of 2561 studies, 37 met inclusion criteria, and 19 contained homogenous outcomes usable in the meta-analysis. Domain I: Across six studies, no significant relationship was seen between contact sport participation and antemortem diagnosis of neurodegenerative disease or death related to such a diagnosis (RR1.88, P=0.054, 95%CI0.99, 3.49); however, marginal significance (P<0.10) was obtained. Domain II: Across three autopsy studies, no significant relationship was seen between contact sport participation and CTE neuropathology (RR42.39, P=0.086, 95%CI0.59, 3057.46); however, marginal significance (P<0.10) was obtained. Domain III: Across five cognitive studies, no significant relationship was seen between contact sport participation and cognitive function on the Trail Making Test (TMT) scores A/B (A:d=0.17, P=0.275,95% CI-0.13, 0.47; B:d=0.13, P=0.310, 95%CI-0.12, 0.38). Domain IV: In 10 brain imaging-based studies, 32% comparisons showed significant differences between those with a history of contact sport vs. those without.</p><p><strong>Conclusions: </strong>No statistically significant increased risk of neurodegenerative diagnosis, CTE neuropathology, or neurocognitive changes was found to be associated with contact sport participation, yet marginal significance was obtained in two domains. A minority of imaging comparisons showed differences of uncertain clinical significance. These results highlight the need for longitudinal investigations using standardized contact sport participation and neurodegenerative criteria.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10701059","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":"Q-ball high-resolution fiber tractography of language associated tracts: quantitative evaluation of applicability for glioma resections.","authors":"Daniela Becker, Moritz Scherer, Peter Neher, Christine Jungk, Jessica Jesser, Irada Pflüger, Martin Bendszus, Klaus Maier-Hein, Andreas Unterberg","doi":"10.23736/S0390-5616.19.04782-9","DOIUrl":"10.23736/S0390-5616.19.04782-9","url":null,"abstract":"<p><strong>Background: </strong>To date, fiber tractography (FT) is predominantly based on diffusion tensor imaging (DTI). High angular resolution diffusion imaging (HARDI)-based reconstructions have become a focus of interest, enabling the resolution of intravoxel fiber crossing. However, experience with high resolution tractography (HRFT) for neurosurgical applications is still limited to a few reports. This prospectively designed feasibility study shares our initial experience using an analytical q-ball approach (QBI) for FT of language-associated pathways in comparison with DTI-FT, focussing on a quantitative analysis and evaluation of its applicability in clinical routine.</p><p><strong>Methods: </strong>Probabilistic QBI-, and DTI-FT were performed for the major components of the language-associated fiber bundles (superior longitudinal fasciculus, inferior fronto-occipital fasciculus, medial/inferior longitudinal faciculus) in 11 patients with eloquent gliomas. The data was derived from a routine DWI sequence (b=1000s/mm², 64 gradient directions). Quantitative analysis evaluated tract volume (TV), tract length (TL) and tract density (TD). Results were correlated to tumor and edema size.</p><p><strong>Results: </strong>Quantitative analysis showed larger TV and TL of the overall fiber object using QBI-FT compared with DTI-FT (TV: 16.45±1.85 vs. 10.07±1.15cm³; P<0.0001; TL: 81.95±6.14 vs. 72.06±6.92 mm; P=0.0011). Regarding overall TD, DTI delivered significantly higher values (40.57±6.59 vs. 60.98±15.94 points/voxel; P=0.0118). Bland-Altman analysis illustrated a systematic advantage to yield lager TV and TL via QBI compared with DTI for all reconstructed pathways. The results were independent of tumor or edema volume.</p><p><strong>Conclusions: </strong>QBI proved to be suitable for an application in the neurosurgical setting without additional expense for the patient. Quantitative analysis of FT reveals larger overall TV, longer TL with lower TD using QBI compared with DTI, suggesting the better depiction of marginal and terminal fibers according to neuroanatomical knowledge. This emphasizes the known limitation of DTI to underestimate the dimensions of a pathway. Rather than relying on DTI, sophisticated HRFT techniques should be considered for preoperative planning and intraoperative guidance in selected cases of eloquent glioma surgery.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42076850","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":"Technical aspects of total spondylectomy of C2.","authors":"Jan Stulik, Zdenek Klezl, Michal Varga, Tomas Vyskocil","doi":"10.23736/S0390-5616.21.05443-6","DOIUrl":"10.23736/S0390-5616.21.05443-6","url":null,"abstract":"<p><strong>Background: </strong>Tumorous involvement of the second cervical vertebra is an infrequent, but severe disease. Primary tumors and solitary metastases can be addressed by a radical procedure, a complete removal of the whole compartment. The second cervical vertebra has a highly complex anatomy, and its operation requires considerable surgical skills. The aim of this retrospective study is to present technical aspects of complete resection of C2 for tumor indications, clinical and radiological evaluation of our group of patients and comparison of results of recent reports on surgery in this region in the literature.</p><p><strong>Methods: </strong>Between 2006 and 2019 we performed 10 total resections of C2 for primary bone tumor or solitary metastasis at our department. Operation was indicated for chordoma in 4 cases and for other diagnoses (plasmacytoma, EWSA, metastases of papillary thyroid carcinoma, medullary thyroid carcinoma, lung carcinoma and sinonasal carcinoma) in one case each. The operative procedure was in all cases performed in two steps. It always started with the posterior approach. The anterior procedure was scheduled according to the patient's condition after an average interval of 16.9 days (range 7-21).</p><p><strong>Results: </strong>A stable upper cervical spine was achieved in all patients. A solid bone fusion over the whole instrumentation was present in all living patients and they returned to their preoperative activity level. By the final follow-up 6 patients died: one patient died on the 5^th postop day because of diffuse uncontrollable bleeding from surgical wound, three patients died of generalization of the underlying disease and two patients due to complications associated with local recurrence of the disease. In addition to regular follow-ups, the surviving patients (N.=4) were also examined upon completion of the study, i.e., on average 91 months (range 17-179 months) postoperatively. With exclusion of an early deceased patient, the average follow-up period of deceased patients was 34.6 months (range 9-55) (N.=5). The average follow-up of the whole group of patients was 59,7 months (N.=9).</p><p><strong>Conclusions: </strong>Total spondylectomy of C2 is an exceptional surgical procedure associated with risk of serious complications but offers chance for a complete recovery of the patient. Defining indications accurately, especially in solitary metastases, is very difficult even with current level of imaging and other testing. The quality of life of long-term surviving patients in our study was not significantly impacted.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10678123","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":"Enhancement of miR-16-5p on spinal cord injury-induced neuron apoptosis and inflammatory response through inactivating ERK1/2 pathway.","authors":"Qian-Cheng Zhao, Zhe-Wei Xu, Qing-Ming Peng, Jia-Hui Zhou, Zhi-Yue Li","doi":"10.23736/S0390-5616.20.04880-8","DOIUrl":"10.23736/S0390-5616.20.04880-8","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to explore the effect and mechanism of miR-16-5p on neuron apoptosis and inflammatory response induced by spinal cord injury (SCI).</p><p><strong>Methods: </strong>Allen's weight-drop method and Basso Bcattie Bresnahan (BBB) rating scale were used to establish SCI rat model and assess locomotor function, respectively. Histopathology of SCI rats and Sham-operated rats was validated by hematoxylin and eosin (H&E) staining. After intravenous injection of miR-16-5p agomir, miR-16-5p antagomir, pcDNA3.1-Apelin-13 or negative controls into SCI rat tails, neuron apoptosis and the expression of miR-16-5p, Apelin-13, apoptotic proteins, inflammatory response-related proteins, and ERK1/2 pathway-related protein were detected. Dual luciferase reporter gene assay was applied for identifying the binding between miR-16-5p and Apelin-13.</p><p><strong>Results: </strong>SCI rats had locomotor impairment with markedly edema and hemorrhage. Upregulated miR-16-5p expression and downregulated Apelin-13 expression were presented in SCI rats. Intravenous injection of miR-16-5p antagomir or/and pcDNA3.1-Apelin-13 could increase the expression of antiapoptotic proteins (Bcl-2 and Mcl-1) and p-ERK1/2 expression while decrease the expression of proapoptotic proteins (cleaved caspase-3 and Bax) and inflammatory response-related proteins (TNF-α, IL-1β and IL-6). The reverse pattern was shown in rats injected with miR-16-5p agomir. MiR-16-5p targeted Apelin-13. Promotion of miR-16-5p agomir on SCI was attenuated by injection of agomir + pcDNA3.1-Apelin-13.</p><p><strong>Conclusions: </strong>Downregulation of miR-16-5p could upregulate Apelin-13 expression to activate ERK1/2 pathway, thus alleviating SCI-induced neuron apoptosis and inflammatory response.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37632125","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":"Transvenous Onyx embolization for dural arteriovenous fistula with concomitant transvenous balloon protection of the venous sinus.","authors":"Xianzeng Tong, Ming Ye, Jingwei Li, Peng Hu, Tao Hong, Peng Zhang, Hongqi Zhang","doi":"10.23736/S0390-5616.20.04937-1","DOIUrl":"10.23736/S0390-5616.20.04937-1","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to evaluate the technical efficacy and safety of transvenous Onyx embolization for dural arteriovenous fistulas (DAVFs) with concomitant transvenous balloon protection of the venous sinus when transarterial route failed or was not feasible.</p><p><strong>Methods: </strong>Between September 2010 and December 2016, thirty-six patients presenting with intracranial DAVFs underwent transvenous balloon-assisted Onyx embolization. The technical efficacy, treatment-related complications, and angiographic and clinical outcomes were reviewed from our prospectively maintained DAVF database.</p><p><strong>Results: </strong>According to the Cognard Classification, 11 patients presented with clinically symptomatic Cognard type I; 11 cases with Cognard type IIa; 10 cases with Cognard type IIb; and 4 cases with Cognard type IIa+b. Complete angiographic occlusion of the DAVFs at the latest follow-up (mean 18 months after transvenous embolization) was achieved in 28 patients (77.8%), near-complete angiographic occlusion with minimal residual fistula in 5 patients (13.9%) and significant flow reduction of the DAVF in 2 patients (5.6%) and residual fistula for further treatment in 1 (2.8%) patient. Total clinical cure or remission of the pretreatment symptoms was achieved in 31 patients (31/36, 86.1%; 26 and 5 cases respectively). Affected venous sinus was preserved in 28 patients, intentionally occluded in 7 patients and gradually occluded in 1 patient. There were no immediate or long-term persistent complications after treatment.</p><p><strong>Conclusions: </strong>Transvenous Onyx embolization of dural arteriovenous fistulas with combined transvenous balloon protection of the venous sinus is safe and effective in achieving high occlusion rate, low embolization-related complications and satisfactory clinical outcomes.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37883372","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 rehabilitation nursing based on target management theory on swallowing function and Quality of Life in patients with stroke dysphagia.","authors":"Chenya Yu, Jiong Wu, Susu Yu","doi":"10.23736/S0390-5616.23.06087-3","DOIUrl":"10.23736/S0390-5616.23.06087-3","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10152023","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 computed tomography, navigated ultrasound, 5-amino-levulinic acid fluorescence and neuromonitoring in brain tumor surgery: overtreatment or useful tool combination?","authors":"Giuseppe M Barbagallo, Massimiliano Maione, Simone Peschillo, Francesco Signorelli, Massimiliano Visocchi, Giuseppe Sortino, Giuseppa Fiumanò, Francesco Certo","doi":"10.23736/S0390-5616.19.04735-0","DOIUrl":"10.23736/S0390-5616.19.04735-0","url":null,"abstract":"<p><strong>Background: </strong>Brain tumor surgery is routinely supported by several intraoperative techniques, such as fluorescence, brain mapping and neuronavigation, which are often used independently. Efficacy of navigation is limited by the brain-shift phenomenon, particularly in cases of large or deep-sited lesions. Intraoperative imaging was introduced also to update neuronavigation data, to try and solve the brain-shift phenomenon-related pitfalls and increase overall safety. Nevertheless, each intraoperative imaging modality has some intrinsic limitations and technical shortcomings, making its clinical use challenging. We used a multimodal intraoperative imaging protocol to update neuronavigation, based on the combination of intraoperative Ultrasound (i-US) and intraoperative Computed Tomography (i-CT) integrated with 5-ALA fluorescence and neuromonitoring-guided resection.</p><p><strong>Methods: </strong>This is a pilot study on 52 patients (29 men), including four children, with a mean age of 57.67 years, suffering from brain low- (N.=10) or high-grade (N.=34) glioma or metastasis (N.=8), prospectively and consecutively enrolled. They underwent 5-ALA fluorescence-guided microsurgical tumor resection and neuromonitoring was used in cases of lesions located in eloquent areas, according to preoperative clinical and neuroradiological features. Navigated B-mode ultrasound acquisition was carried out after dural opening to identify the lesion. After tumor resection, i-US was used to identify residual tumor. Following further tumor resection or in cases of unclear US images, post-contrast i-CT was performed to detect and localize small tumor remnants and to allow further correction for brain shift. A final i-US check was performed to verify the completeness of resection. Clinical evaluation was based on comparison of pre- and postoperative Karnofsky Performance Score (KPS) and assessment of overall survival (OS) and progression-free survival (PFS). Extent of tumor resection (EOTR) was evaluated by volumetric postoperative Magnetic Resonance performed within 48 h after surgery.</p><p><strong>Results: </strong>Forty-one of the 52 (78.8%) patients were alive and still under follow-up in December 2017. 5-ALA was strongly or vaguely positive in 45 cases (86.5%). Seven lesions (four low-grade glioma, one high-grade glioma, and two metastases) were not fluorescent. i-US visualized residual tumor after resection of all fluorescent or pathological tissue in 22 cases (42.3%). After i-US guided resection, i-CT documented the presence of further residual tumor in 11 cases (21.1%). Mean EOTR was 98.79% in the low-grade gliomas group, 99.84% in the high-grade gliomas group and 100% in the metastases group. KPS changed from 77.88, preoperatively, to 72.5, postoperatively. At the last follow-up, mean KPS was 84.23.</p><p><strong>Conclusions: </strong>The combination of different intraoperative imaging modalities may increase brain tumor safety and extent of","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37153376","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":"Intracranial pressure monitor insertion in traumatic brain injury: a single center, retrospective decision process analysis.","authors":"Francesca Fossi, Chiara Robba, Matteo Rota, Alessia Vargiolu, Doriana Lagravinese, Paola Volpi, Giuseppe Citerio","doi":"10.23736/S0390-5616.18.04568-X","DOIUrl":"10.23736/S0390-5616.18.04568-X","url":null,"abstract":"<p><strong>Background: </strong>Evidence-based indications for intracranial pressure (ICP) monitoring in patients with traumatic brain injury (TBI) are lacking. The aim of this study was to analyze the main factors that guided the decision-making of invasive ICP monitoring in a large cohort of TBI patients from our institution.</p><p><strong>Methods: </strong>This is a retrospective, single centre, observational study including adult TBI patients consecutively admitted to our Neurointensive Care Unit over 20 years. Logistic regression analyses were performed to identify potential factors associated with the decision for ICP monitor insertion. A decision tree was developed to identify the combination of factors with the highest statistical power to predict the decision for ICP monitor insertion.</p><p><strong>Results: </strong>A total of 857 adult patients were included in the analysis. The decision to monitor ICP was strongly related to different factors, including Glasgow Coma Scale (GCS), computed tomography (CT) scan classification, pupils' reactivity, and patients' prognosis at the admission calculated by the International Mission on Prognosis in Traumatic Brain Injury (IMPACT) score (P<0.01). Results from the decision tree showed an overall ability of the 72% in the prediction of ICP monitoring and that, among the factors analyzed, CT findings had the primarily and strongest discrimination power.</p><p><strong>Conclusions: </strong>The decision to insert an invasive ICP monitoring in patients with TBI is multifactorial. Among the different factors analysed in our cohort of TBI patients, prognostication factors as for IMPACT score and in particular CT findings could potentially explain the decision making for ICP monitoring.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36659429","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}