Journal of neurosurgical sciences最新文献

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Isolated spinal artery aneurysm treatment: a systematic review of the literature and an illustrative case of the neuromonitoring-assisted resection. 孤立性脊髓动脉瘤的治疗:对文献的系统回顾和神经监测辅助切除的一例说明性病例。
IF 1.2 4区 医学
Journal of neurosurgical sciences Pub Date : 2025-10-01 Epub Date: 2025-08-01 DOI: 10.23736/S0390-5616.25.06529-4
Fabio Serpico, Antonio Meola, Federico Saturno Spurio, Corrado Iaccarino, Giacomo Pavesi, Leonello Tacconi
{"title":"Isolated spinal artery aneurysm treatment: a systematic review of the literature and an illustrative case of the neuromonitoring-assisted resection.","authors":"Fabio Serpico, Antonio Meola, Federico Saturno Spurio, Corrado Iaccarino, Giacomo Pavesi, Leonello Tacconi","doi":"10.23736/S0390-5616.25.06529-4","DOIUrl":"10.23736/S0390-5616.25.06529-4","url":null,"abstract":"<p><strong>Introduction: </strong>Isolated spinal artery aneurysms (ISAAs) are rare, often presenting with sub-arachnoid hemorrhage (SAH) and severe neurological deficits. Conclusive evidence about the best management approach is lacking.</p><p><strong>Evidence acquisition: </strong>Following PRISMA guidelines, a systematic review of papers about ISAAs management was conducted from 1966 to 2024, evaluating age, sex, risk factors/comorbidities, aneurysm rupture and location, treatment modalities and clinical outcome. An illustrative case of a 65-year-old woman with a an ISAA of a radiculomedullary artery at T8 level was reported.</p><p><strong>Evidence synthesis: </strong>Overall, 106 studies obtained from the literature review showed 138 patients received an ISAA diagnosis and were managed with surgery (52.1%), observation (31.1%), or endovascular treatment (11.5%), with clinical improvement in 76.4%, 86%, 81.2% of cases, respectively. The treatment option was not reported in 5.3% of cases. Only two patients presented neurological worsening related to vasospasm, and none had rebleeding after treatment. The mean follow-up was 8.7 months (range 0.03-73 months). In the reported illustrative case, after left T7-T8 laminectomy and dural opening, a little thrombosed aneurysm was found. Under doppler and neurophysiological monitoring, temporary clips were placed on the afferent and efferent vessel and the aneurysm was resected. The patient reported complete and stable regression of symptoms. No complications were detected after 6 months. Imaging showed complete resection of the aneurysm.</p><p><strong>Conclusions: </strong>Surgical resection under neurophysiological monitoring is an excellent treatment option to both eliminate the risk of rebleeding, while preserving the neurological function. Observation and endovascular treatment may lead to comparable neurological outcomes. Larger multicentric studies with longer follow-up are needed to determine the best management option.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"422-433"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760366","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}
引用次数: 0
Comparing survival and outcomes in isolated versus polytrauma-associated TBI: a retrospective cohort study. 比较孤立性创伤性脑损伤与多发性创伤性脑损伤的存活率和预后:一项回顾性队列研究。
IF 1.2 4区 医学
Journal of neurosurgical sciences Pub Date : 2025-10-01 Epub Date: 2024-12-17 DOI: 10.23736/S0390-5616.24.06287-8
Davide Corbella, Rosalia Zangari, Francesco Biroli, Stefano Magnone, Gaia Cavalleri, Maurizio Passoni, Svetlana Martchenko, Silvia Marchesi, Lucia Zacchetti, Francesco Ferri, Laura Urbaz, Marco Aliprandi, Luca F Lorini, Paolo Gritti
{"title":"Comparing survival and outcomes in isolated versus polytrauma-associated TBI: a retrospective cohort study.","authors":"Davide Corbella, Rosalia Zangari, Francesco Biroli, Stefano Magnone, Gaia Cavalleri, Maurizio Passoni, Svetlana Martchenko, Silvia Marchesi, Lucia Zacchetti, Francesco Ferri, Laura Urbaz, Marco Aliprandi, Luca F Lorini, Paolo Gritti","doi":"10.23736/S0390-5616.24.06287-8","DOIUrl":"10.23736/S0390-5616.24.06287-8","url":null,"abstract":"<p><strong>Background: </strong>One in four patients with moderate to severe traumatic brain injury (TBI) also has other body district injuries (OBD). The impact of OBD on mortality and disability is debated. This study compared outcomes of TBI patients with polytrauma (p-TBI) versus isolated TBI (alone-TBI) and identified outcome determinants, focusing on survival time and prognosis.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study analyzed 193 patients with moderate to severe TBI admitted to an ICU from 2011 to 2012. Patients were divided into p-TBI and alone-TBI groups. Clinical, demographic, and outcome data were extracted from medical records. Key outcomes included survival time and Glasgow Outcome Scale-Extended (GOSE) scores at 1-year.</p><p><strong>Results: </strong>The alone-TBI group (N.=126) was older with more comorbidities and higher use of antiplatelet/anticoagulant medications. The p-TBI group (N.=67) had greater physiological dysfunction (hypotension, acidosis, anemia, coagulopathy). Trauma severity (Glasgow Coma Scale), in-hospital mortality, and GOSE were similar between groups, but p-TBI patients had a shorter median survival time (3.5 vs. 18 days, P=0.016). Key determinants of poor outcomes were age, coagulopathy, neurological impairment at admission, and intracranial hypertension.</p><p><strong>Conclusions: </strong>Polytrauma does not appear to be independently associated with the prognosis of moderate to severe TBI patients but is associated with earlier mortality. Coagulopathy and physiological instability are more critical factors in determining mortality and poor outcomes. Future research should explore whether polytrauma is a bystander in TBI or if it has a causal role in adverse outcomes.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"398-404"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837064","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}
引用次数: 0
The current role of MMAE in chronic subdural hematomas: a real advantage? A critical analysis of the EMBOLIZE study. 目前MMAE在慢性硬膜下血肿中的作用:一个真正的优势?栓塞研究的批判性分析。
IF 1.2 4区 医学
Journal of neurosurgical sciences Pub Date : 2025-10-01 Epub Date: 2025-08-01 DOI: 10.23736/S0390-5616.25.06462-8
Laura Lippa, Corrado Iaccarino, Marco M Fontanella, Franco Servadei
{"title":"The current role of MMAE in chronic subdural hematomas: a real advantage? A critical analysis of the EMBOLIZE study.","authors":"Laura Lippa, Corrado Iaccarino, Marco M Fontanella, Franco Servadei","doi":"10.23736/S0390-5616.25.06462-8","DOIUrl":"10.23736/S0390-5616.25.06462-8","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"371-372"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760367","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}
引用次数: 0
Prediction of diabetes insipidus occurrence after endoscopic endonasal removal of sellar lesions using MRI-based radiomics and machine learning. 利用基于核磁共振成像的放射组学和机器学习预测蝶窦病变内窥镜鼻内切除术后的糖尿病发生率。
IF 1.2 4区 医学
Journal of neurosurgical sciences Pub Date : 2025-10-01 Epub Date: 2024-01-29 DOI: 10.23736/S0390-5616.23.06162-3
Ciro Mastantuoni, Lorenzo Ugga, Domenico Solari, Serena D'Aniello, Gaia Spadarella, Renato Cuocolo, Filippo F Angileri, Luigi M Cavallo
{"title":"Prediction of diabetes insipidus occurrence after endoscopic endonasal removal of sellar lesions using MRI-based radiomics and machine learning.","authors":"Ciro Mastantuoni, Lorenzo Ugga, Domenico Solari, Serena D'Aniello, Gaia Spadarella, Renato Cuocolo, Filippo F Angileri, Luigi M Cavallo","doi":"10.23736/S0390-5616.23.06162-3","DOIUrl":"10.23736/S0390-5616.23.06162-3","url":null,"abstract":"<p><strong>Background: </strong>Pituitary adenomas and craniopharyngiomas are the most common lesions of the sellar region. These tumors are responsible for invasion or compression of crucial neurovascular structures. The involvement of the pituitary stalk warrants high rates of both pre- and post- operative diabetes insipidus. The aim of our study was to assess the accuracy of machine learning analysis from preoperative MRI of pituitary adenomas and craniopharyngiomas for the prediction of DI occurrence.</p><p><strong>Methods: </strong>All patients underwent MRI exams either on a 1.5- or 3-T MR scanner from two Institutions, including coronal T2-weighted (T2-w) and contrast-enhanced T1-weighted (CE T1-w) Turbo Spin Echo sequences. Feature selection was carried out as a multi-step process, with a threshold of 0.75 to identify robust features. Further feature selection steps included filtering based on feature variance (threshold >0.01) and pairwise correlation (threshold <0.80). A Bayesian Network model was trained with 10-fold cross validation employing SMOTE to balance classes exclusively within the training folds.</p><p><strong>Results: </strong>Thirty patients were included in this study. In total 2394 features were extracted and 1791 (75%) resulted stable after ICC analysis. The number of variant features was 1351 and of non-colinear features was 125. Finally, 10 features were selected by oneR ranking. The Bayesian Network model showed an accuracy of 63% with a precision of 77% for DI prediction (0.68 area under the precision-recall curve).</p><p><strong>Conclusions: </strong>We assessed the accuracy of machine learning analysis of texture-derived parameters from preoperative MRI of pituitary adenomas and craniopharyngiomas for the prediction of DI occurrence.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"378-383"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139575532","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}
引用次数: 0
Comparison of intra-operative skull fixation techniques on cervical sagittal parameters. 术中颅骨固定技术对颈椎矢状面参数的影响比较。
IF 1.2 4区 医学
Journal of neurosurgical sciences Pub Date : 2025-10-01 Epub Date: 2024-11-19 DOI: 10.23736/S0390-5616.24.06255-6
Connor C Jacob, Ryan G Eaton, Andrew J Grossbach, Asad Akhter, Nathaniel Toop, Joshua Wang, Joravar Dhaliwal, Stephanus V Viljoen
{"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":"373-377"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","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}
引用次数: 0
Suspected and surgically managed cauda equina syndrome nationwide: epidemiological trends and socioeconomic factors influencing access to care. 全国疑似马尾综合征及手术治疗情况:流行病学趋势及影响就医的社会经济因素。
IF 1.3 4区 医学
Journal of neurosurgical sciences Pub Date : 2025-08-01 Epub Date: 2024-12-17 DOI: 10.23736/S0390-5616.24.06300-8
Thomas M Johnstone, Vaibhavi Shah, Ghani Haider, Kelly H Yoo, Martin N Stienen, Anand Veeravagu
{"title":"Suspected and surgically managed cauda equina syndrome nationwide: epidemiological trends and socioeconomic factors influencing access to care.","authors":"Thomas M Johnstone, Vaibhavi Shah, Ghani Haider, Kelly H Yoo, Martin N Stienen, Anand Veeravagu","doi":"10.23736/S0390-5616.24.06300-8","DOIUrl":"10.23736/S0390-5616.24.06300-8","url":null,"abstract":"<p><strong>Background: </strong>Cauda equina syndrome (CES) is a critical condition requiring timely intervention to prevent severe morbidity. This study investigates the epidemiology and socioeconomic factors influencing access to CES care in USA Emergency Departments.</p><p><strong>Methods: </strong>Data was used from the Nationwide Emergency Department Sample (NEDS) from 2016-2020. Encounters for patients presenting with suspected CES were queried using ICD 10 codes. Incidence estimates for suspected and surgically managed CES were constructed. Encounter characteristics were tabulated to describe aspects of a typical CES presentation to a USA ED. Multivariable regression analysis ascertained the impact of hospital and socioeconomic features on in-hospital mortality, surgical management, length of stay, visit costs, and patient transfer.</p><p><strong>Results: </strong>The incidences of suspected and surgically managed CES rose year-by-year (P=0.006; P=0.005). Uninsured patients (P<0.001) and African American (P=0.002) were less likely to be admitted for care. Patients residing in the wealthiest quartile of zip codes were more likely to be admitted for care (P<0.001). In addition, uninsured (P=0.017) and African American patients (P=0.009) were less likely to receive surgical management of suspected CES. Lastly, uninsured (P<0.001), Hispanic (P=0.038), and rurally located patients (P=0.007) were more likely to be transferred, while patients residing in the wealthiest zip codes (P=0.007) were less likely to be transferred.</p><p><strong>Conclusions: </strong>Socioeconomic factors like race, income, insurance, and residence potentially alter CES management, which may inform health policy and future patient care.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"297-304"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837072","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}
引用次数: 0
Monocentric experience of transforaminal endoscopic lumbar discectomy and foraminotomy outcomes: pushing the indications and avoiding failure. Report of 200 cases. 经椎间孔内窥镜腰椎间盘切除术和椎板切除术的单中心经验:突破适应症,避免失败。200 例病例报告。
IF 1.3 4区 医学
Journal of neurosurgical sciences Pub Date : 2025-08-01 Epub Date: 2024-01-23 DOI: 10.23736/S0390-5616.23.06105-2
Alessandro Grieco, Letizia Dell'aglio, Jacopo Del Verme, Domenico Billeci, Roberto Zanata, Giuseppe Canova, Enrico Giordan
{"title":"Monocentric experience of transforaminal endoscopic lumbar discectomy and foraminotomy outcomes: pushing the indications and avoiding failure. Report of 200 cases.","authors":"Alessandro Grieco, Letizia Dell'aglio, Jacopo Del Verme, Domenico Billeci, Roberto Zanata, Giuseppe Canova, Enrico Giordan","doi":"10.23736/S0390-5616.23.06105-2","DOIUrl":"10.23736/S0390-5616.23.06105-2","url":null,"abstract":"<p><strong>Background: </strong>This paper reports the results of the treatment of our first 200 cases of lumbar disc herniation and foraminal stenosis using full-endoscopic transforaminal lumbar discectomy (FETLD). We analyzed outcomes and radiological parameters to overcome failure and inappropriate indications and also highlighted the red flags for surgeons coming to this field as well as the pathways to success.</p><p><strong>Methods: </strong>Data on endoscopic procedures were retrospectively analyzed between October 2018 and March 2023. We abstracted sex, age, leg pain by NPRS, postoperative satisfaction according to the MacNaab score, postoperative surgical complications/adverse events (≤30 days), and history of any previous surgery. Furthermore, we measured different radiological parameters to determine the grade of stenosis or discopathy.</p><p><strong>Results: </strong>Once the learning curve was completed, patients' satisfaction increased to 94%, with only a small percentage (6%) of patients unsatisfied 30 days after the operation. Perioperatively, 33.5% of the patients experienced mild to moderate transitory paresthesia. Univariate analysis showed a tendency toward a higher risk of failure in those patients with degenerative listhesis (odds ratio [OR] 4.8, 95% CI 0.97-23.9, P=0.055) as well as those with severely degenerated discs (OR 8.7, 95% CI 0.96-79.4, P=0.054). Conversely, the chances of failure seemed to be lower in patients with severe foraminal stenosis.</p><p><strong>Conclusions: </strong>FETLD proved its efficacy in treating several degenerative spine conditions or was useful for avoiding previous scarring in patients already operated on to the same extent. Therefore, FETLD can be safely used in patients with comorbidities, the elderly, and when the invasiveness of an open technique is not suitable.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"324-330"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139521128","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}
引用次数: 0
Intraoperative seizures during neuro-oncological supratentorial surgery: the role of prophylaxis with levetiracetam and intraoperative monitoring in a consecutive series of 353 patients. 脑室上神经肿瘤手术中的术中癫痫发作:在连续 353 例患者中使用左乙拉西坦预防和术中监测的作用。
IF 1.3 4区 医学
Journal of neurosurgical sciences Pub Date : 2025-08-01 Epub Date: 2024-04-02 DOI: 10.23736/S0390-5616.24.06154-X
Francesca Battista, Giovanni Muscas, Alberto Parenti, Maddalena Spalletti, Cristiana Martinelli, Riccardo Carrai, Andrea Amadori, Alessandro Della Puppa
{"title":"Intraoperative seizures during neuro-oncological supratentorial surgery: the role of prophylaxis with levetiracetam and intraoperative monitoring in a consecutive series of 353 patients.","authors":"Francesca Battista, Giovanni Muscas, Alberto Parenti, Maddalena Spalletti, Cristiana Martinelli, Riccardo Carrai, Andrea Amadori, Alessandro Della Puppa","doi":"10.23736/S0390-5616.24.06154-X","DOIUrl":"10.23736/S0390-5616.24.06154-X","url":null,"abstract":"<p><strong>Background: </strong>The aim of this paper was to understand the role of prophylaxis with levetiracetam at skin incision in preventing convulsive intraoperative seizures (IOS) during neurosurgical procedures with and without intraoperative neuromonitoring (IONM).</p><p><strong>Methods: </strong>Authors retrospectively reviewed the Institutional database for cases of supratentorial brain tumors undergoing surgical resection performed from January 2021 to October 2022. Patients were operated on both under general anesthesia and awake, using motor-evoked potentials (MEP) and direct cortical stimulation for cortical mapping. 1000 mg ev of Levetiracetam before skin incision in case of a history of seizures was administrated. We excluded all infratentorial cases.</p><p><strong>Results: </strong>Three hundred fisty three consecutive cases were retrieved. IOS occurred in 22 patients (6.2%). Prophylaxis with Levetiracetam was administered in 149 patients, and IOS occurred in 16 cases (10.7%) in this group of patients. The IOS rate in the case of no Levetiracetam prophylaxis administration (3.5%) was significantly lower (P<0.001, OR=3.38 [1.35-8.45], RR=3.12 [1.32-7.41]). The Penfield technique stimulation evoked seven of all 22 IOS reported (31.8%) (P=0.006, RR 5.4 [1.44 -20.58], OR 21 [2.3-183.9]), and the train-of-five technique stimulation caused two of all registered IOS (8.7%) (P=0.2, RR 2.3 [0.99-5.67], OR 6.5 [0.55-76.17]). Transcranial MEPs evoked no IOS.</p><p><strong>Conclusions: </strong>Under levetiracetam prophylaxis, the IOS rate was not significantly lower than in the group of patients without Levetiracetam prophylaxis, regardless of the histology of the tumor and IONM. Neither the transcranial stimulation (MEP) nor train-of-five technique stimulation increases the risk of convulsive IOS, as Penfield technique stimulation does.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"315-323"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335968","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}
引用次数: 0
What have we learned in fluorescein-guided resection of brain metastases? An update after 79 consecutive cases. 在荧光素引导的脑转移瘤切除术中我们学到了什么?连续79例病例后的最新情况。
IF 1.3 4区 医学
Journal of neurosurgical sciences Pub Date : 2025-08-01 Epub Date: 2023-11-16 DOI: 10.23736/S0390-5616.23.06134-9
Jacopo Falco, Morgan Broggi, Emanuele Rubiu, Francesco Restelli, Bianca Pollo, Marco Schiariti, Paola Lanteri, Mario Stanziano, Emanuele LA Corte, Elio Mazzapicchi, Ignazio G Vetrano, Paolo Ferroli, Francesco Acerbi
{"title":"What have we learned in fluorescein-guided resection of brain metastases? An update after 79 consecutive cases.","authors":"Jacopo Falco, Morgan Broggi, Emanuele Rubiu, Francesco Restelli, Bianca Pollo, Marco Schiariti, Paola Lanteri, Mario Stanziano, Emanuele LA Corte, Elio Mazzapicchi, Ignazio G Vetrano, Paolo Ferroli, Francesco Acerbi","doi":"10.23736/S0390-5616.23.06134-9","DOIUrl":"10.23736/S0390-5616.23.06134-9","url":null,"abstract":"<p><strong>Background: </strong>Cerebral metastasis (CM) is the most common malignancy affecting the brain. Individualized treatment of CM still represents a challenge for neuro-oncological teams: in patient eligible for surgery, complete tumor removal is the most relevant predictor of overall survival (OS) and neurological outcome. The development of surgical microscopes harboring specific filter able to elicit the fluorescent response from sodium fluorescein (SF) has facilitated fluorescein-guided microsurgery and the identification of pathological tumor tissue, especially at the tumor margins. In this study, we analyzed the effect of SF on the visualization and resection of a large monoinstitutional cohort of CM.</p><p><strong>Methods: </strong>Surgical database of FLUOCERTUM study (Besta Institute, Milan, Italy) was retrospectively reviewed to find CM surgically removed with a fluorescein-guided technique from March 2016 to December 2022. SF was intravenously injected (5 mg/kg) immediately after induction of general anesthesia. Tumors were removed using a microsurgical technique with the YELLOW560 filter (Carl Zeiss Meditec, Oberkochen, Germany). In the most recent cases, biopsies at the tumor margins were performed to evaluate the ability of fluorescein to discriminate between fluorescent and nonfluorescent tissue at the lesion borders.</p><p><strong>Results: </strong>Seventy-nine patients were included; most of them showed a bright, diffuse fluorescent staining that markedly enhanced tumor visibility; 11 melanomas presented a specific faint enhancement of the black pigmented central nodule with high fluorescence at tumor boundaries. Only in a minimal percentage of cases (N.=4-5.1%), fluorescein enhancement was tenuous, thus not providing a significant help during tumor resection. Altogether, in more than 90% of cases, SF was considered useful in the identification of tumoral tissue and in achieving a high rate of CM resection; thus, gross total resection was achieved in 96.2% (N.=76) of patients and in no case the detection of tumor remnants was an unexpected event. The resulted sensitivity and specificity of fluorescein in identifying tumor tissue at the tumor margin was 88.9% with a predictive positive value of 88.9%. No adverse event was registered during the postoperative course.</p><p><strong>Conclusions: </strong>The use of SF is a valuable method for safe fluorescence-guided tumor resection. Our data showed a positive effect of fluorescein-guided surgery on intraoperative visualization during resection of CM, suggesting a role in improving the extent of resection of these lesions.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"305-314"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136397767","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}
引用次数: 0
Retraction of: Transforming neurosurgical practice with large language models: comparative performance of ChatGPT-omni and Gemini in complex case management. 用大型语言模型转化神经外科实践:ChatGPT-omni和Gemini在复杂病例管理中的比较表现。
IF 1.2 4区 医学
Journal of neurosurgical sciences Pub Date : 2025-06-05 DOI: 10.23736/S0390-5616.25.06447-1
Barış Çöllüoğlu, Şamil Dikici
{"title":"Retraction of: Transforming neurosurgical practice with large language models: comparative performance of ChatGPT-omni and Gemini in complex case management.","authors":"Barış Çöllüoğlu, Şamil Dikici","doi":"10.23736/S0390-5616.25.06447-1","DOIUrl":"10.23736/S0390-5616.25.06447-1","url":null,"abstract":"<p><p>The paper entitled \" Transforming neurosurgical practice with large language models: comparative performance of ChatGPT-omni and Gemini in complex case management\" by Bariş Çöllüoğlu et al., which was published online on June 5, 2025, is being retracted. The publisher retracts this article because, after online publication, it was discovered that the authors had submitted the manuscript to another journal simultaneously, resulting in duplicate publication</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225739","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}
引用次数: 0
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