Journal of neurosurgical sciences最新文献

{"title":"One-year clinical and radiologic outcomes of Surpass Evolve flow diverter for large unruptured intracranial aneurysms.","authors":"Hyun J Han, Joonho Chung, Chang K Jang, Jung-Jae Kim, Keun Y Park, Yong B Kim","doi":"10.23736/S0390-5616.23.06161-1","DOIUrl":"10.23736/S0390-5616.23.06161-1","url":null,"abstract":"<p><strong>Background: </strong>Surpass Evolve Flow Diverter (SE-FD; Stryker Neurovascular, Kalamazoo, MI, USA) was launched in 2019 as a new generation FD of Surpass Streamline. The aim of this study was to report the effectiveness and safety of SE-FD insertion for unruptured intracranial aneurysm at one-year follow-up.</p><p><strong>Methods: </strong>Between November 2019 and October 2021, a total of 106 patients with 108 aneurysms were treated with FD in single institution. Of these, SE-FD insertion was performed in 40 patients with 41 aneurysms. At one-year follow-up, clinical and angiographic outcomes were retrospectively evaluated from electronic medical record and aneurysm database.</p><p><strong>Results: </strong>There were 12 male and 28 female patients (mean age 59.1 years, 95% CI: 55.3-62.9). Fusiform aneurysm dissection was 46.3% (19/41). Mean maximum aneurysm diameter was 13.2 mm (SD 5.53), and 34.1% (14/41) of aneurysms were 15 mm or bigger. Among 41 aneurysms, complex aneurysm (recurred, thrombosed, or branch artery-incorporated) was accounted for 41.5% (17/41). All procedures were successfully conducted with 7.3% (3/41) of procedure-related complications. At one-year follow-up (N.=40), neurologic morbidity was noted in 2 cases (5.0%; both with modified Rankin Scale [mRS] 1) without any mortality. At one-year follow-up (N.=41), radiologic outcomes were adequate occlusion in 33 (80.5%) and complete occlusion in 29 (70.7%). There was no retreatment in our cohort.</p><p><strong>Conclusions: </strong>Surpass Evolve Flow Diverter seemed to be safe and effective for the treatment of dissecting/fusiform or complex aneurysms at one-year follow-up. However, further study is needed to evaluate long term results.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"167-173"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830112","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":"Accuracy of predicted postoperative segmental lumbar lordosis in spinal fusion using an intraoperative robotic planning and guidance system.","authors":"Ghani Haider, Vaibhavi Shah, Thomas Johnstone, Nicolai Maldaner, Martin Stienen, Anand Veeravagu","doi":"10.23736/S0390-5616.23.06142-8","DOIUrl":"10.23736/S0390-5616.23.06142-8","url":null,"abstract":"<p><strong>Background: </strong>Restoring lumbar lordosis is one of the main goals in lumbar spinal fusion surgery. The Mazor X-Align^™ software allows for the prediction of postoperative segmental lumbar lordosis based on preoperative imaging. There is limited data on the accuracy of this preoperative prediction, especially in patients undergoing short segment lumbar fusion. The objective of our study was to determine the accuracy of predicted postoperative segmental lumbar lordosis using the Mazor X-Align^™ software in patients requiring short segmental fusion.</p><p><strong>Methods: </strong>Retrospective analysis of adult patients undergoing pedicle screw spinal instrumentation of not more than four levels using the Mazor X^™ Robot (Medtronic Inc., Minneapolis, MN, USA) between July 2017 to June 2020. The robotic guidance software, Mazor X-Align^™ (Medtronic Inc., Minneapolis, MN, USA) was used to calculate the predicted segmental lumbar lordosis based on preoperative CT-imaging and the plan was executed under intraoperative robotic guidance. Predicted segmental lumbar lordosis was compared to achieved segmental lumbar lordosis on 1-month postoperative x-rays using the Cobb angle methodology.</p><p><strong>Results: </strong>A total of 15 patients (46.6% female) with a mean age of 61.5±10.9 years were included. All patients underwent posterior lumbo-sacral spinal fusion with the Mazor X^™ robotic system with 11 patients (73.3%) undergoing anterior column reconstruction prior to posterior fixation. Instrumentation was performed across a mean of 2.6 levels per case. Preoperative, the mean segmental lumbar lordosis was 30.2±13.6 degrees. The mean planned segmental lumbar lordosis was 35.5±17.0 degrees while the mean achieved segmental lumbar lordosis was 35.8±16.7 degrees. There was no significant mean difference between the planned and achieved segmental lumbar lordosis (P=0.334).</p><p><strong>Conclusions: </strong>The Mazor X^™ intraoperative robotic planning and guidance is accurate in predicting postoperative segmental lumbar lordosis after short segmental fusion. Our findings may assure surgical decision making and planning.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"144-149"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138299274","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":"Microsurgery of Koos I-II vestibular schwannomas: a case series of 100 consecutive patients.","authors":"Luciano Mastronardi, Alberto Campione, Fabio Boccacci, Guglielmo Cacciotti, Ettore Carpineta, Carlo Giacobbo Scavo, Raffaelino Roperto, Giovanni Stati, Cristiana F Altamura, Amer A Alomari","doi":"10.23736/S0390-5616.23.06014-9","DOIUrl":"10.23736/S0390-5616.23.06014-9","url":null,"abstract":"<p><strong>Background: </strong>Treatment of small vestibular schwannomas (VS) depends on size, growth pattern, age, symptoms, co-morbidities. Watchful waiting, stereotactic radiosurgery and microsurgery are three valid options of treatment.</p><p><strong>Methods: </strong>We reviewed clinical sheets, surgical data and results of 100 consecutive patients with Koos Grade I-II VS, operated at our department via a retrosigmoid microsurgical approach between September 2010 and July 2021. Extent of resection was assessed as total, near-total or subtotal. The course of facial nerve (FN) around the tumor was classified as anterior (A), anterior-inferior (AI), anterior-superior (AS) and dorsal (D). FN function was assessed according to House-Brackmann (HB) Scale and hearing level according to AAO-HNS Classification.</p><p><strong>Results: </strong>Mean tumor size was 1.52 cm. FN course was mainly AS (46.0%) in the overall cohort; in Koos I VS, FN was AS in 83.3%. Postoperative FN function was HB I in 97% and HB II in 3% of cases. Hearing preservation (AAO-HNS class A-B) was possible in 63.2% of procedures. Total/near-total removal was achieved in 98%. Postoperative mortality was zero. Transient complications were observed in 8% of patients; permanent complications never occurred. Tumor remnant progression was observed in one case, 5 years after subtotal removal.</p><p><strong>Conclusions: </strong>Microsurgery represents a valid option for management of VS, including Koos I-II grades, with an acceptable complication rate. In particular, in small VS long-term FN facial outcome, HP and total/near-total removal rate are favorable.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"174-181"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9615157","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 landmark study on spine and spinal cord injuries treated surgically in Italy.","authors":"Rossella Rispoli, Barbara Cappelletto","doi":"10.23736/S0390-5616.25.06471-9","DOIUrl":"10.23736/S0390-5616.25.06471-9","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"141-143"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567413","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":"Statins and middle meningeal artery embolization: a literature review in the treatment of chronic subdural hematoma.","authors":"Basel Musmar, Joanna M Roy, Samantha Spellicy, Stavropoula I Tjoumakaris, Michael R Gooch, Robert H Rosenwasser, David Hasan, Pascal Jabbour","doi":"10.23736/S0390-5616.25.06426-4","DOIUrl":"https://doi.org/10.23736/S0390-5616.25.06426-4","url":null,"abstract":"<p><p>Chronic subdural hematoma (cSDH) presents a multifaceted challenge in contemporary neurological practice, necessitating innovative therapeutic strategies. This comprehensive review explores the convergence of two promising interventions: statins and middle meningeal artery (MMA) Embolization. With cSDH incidence on the rise, particularly among the aging population and those with long-term anticoagulant usage, the traditional surgical avenues face limitations in recurrence rates and associated risk factors. Statins, heralded for their anti-inflammatory, vasculogenic, and angiogenic properties, are emerging as potential allies in cSDH management. Concurrently, MMA embolization offers a nuanced approach to target the neomembrane's blood supply, with evidence supporting its efficacy and safety. However, the synthesis of MMA embolization with statins remains relatively unexplored, presenting a complex interplay between inflammation modulation and blood supply interruption.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":"69 2","pages":"218-224"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976044","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":"Effectiveness of invasive interventions for chronic subdural hematoma: a systematic review.","authors":"Victor B Amaral, Rivaldo F Filho, João V Fernandes, Olavo B Neto, André S Oliveira","doi":"10.23736/S0390-5616.25.06356-8","DOIUrl":"10.23736/S0390-5616.25.06356-8","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic subdural hematoma (CSDH) is a frequent neurological problem, especially in older adults. It often presents headache as a primary symptom. The optimal approach to managing CSDH through invasive treatments is still debated, with various procedures available. We conducted a systematic review of randomized clinical trials, based on the most recent available literature, to assess the efficacy and safety of invasive interventions for the treatment of CSDH.</p><p><strong>Evidence acquisition: </strong>A comprehensive search of major databases was performed according to PRISMA guidelines with an extensive consultation with experts that independently conducted study selection, data extraction, and bias assessment. The GRADE approach and RoB 2 tool were used to assess evidence quality and risk of bias.</p><p><strong>Evidence synthesis: </strong>It was identified 4 studies (N.=579) meeting the inclusion criteria. Invasive interventions included burr hole craniostomy, twist drill craniostomy, and subdural drainage systems. Findings varied across studies. A Chinese study suggested shorter hospital stays with twist drill craniostomy compared to simple burr hole craniostomy. A Denmark study showed that the 48-hour drainage has a significantly higher volume of postoperative drain production compared to the 24-hour group. An Iranian study suggested fewer hematomas with burr hole irrigation without drainage compared to with drainage.</p><p><strong>Conclusions: </strong>Evidence on invasive interventions for CSDH is limited. Treatment decisions should be individualized based on patient factors and potential risks/benefits. Large-scale randomized controlled trials are needed to provide clearer guidelines for CSDH treatment.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"200-209"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657524","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":"Can clinicians correctly predict intracranial pressure state based on clinical symptoms alone in shunted patients?","authors":"Sogha Khawari, Anand Pandit, Laurence Watkins, Ahmed Toma, Lewis Thorne","doi":"10.23736/S0390-5616.23.06065-4","DOIUrl":"10.23736/S0390-5616.23.06065-4","url":null,"abstract":"<p><strong>Background: </strong>Clinicians are well-versed in the classical symptoms of low vs. high intracranial pressure (ICP). However, symptoms may not be as predictable of ICP state in shunted patients with chronic symptoms. In this study, we assess whether clinicians can predict high vs. low ICP state in chronically symptomatic shunted patients without any diagnostic clues.</p><p><strong>Methods: </strong>A detailed retrospective analysis was performed on 259 patients undergoing ICP monitoring. A total of 17 patients who had a ventriculoperitoneal shunt were identified, with a suspected chronic abnormal ICP state based only on clinical symptoms. Patients with investigations guiding towards a likely pressure state were excluded, e.g., imaging or ophthalmological findings suggestive of ICP state.</p><p><strong>Results: </strong>Clinical suspicion of ICP state was incorrect in 16 out of 17 cases (P<0.05). The symptoms described by patients were suggestive of abnormal ICP states; however, 13 out of 17 cases demonstrated ICP within the normal range (-1.3 to 5.3 mmHg). Three patients with occipital headaches worse on standing, typical of low-pressure symptoms, were in fact shown to have ICP above 10.0 mmHg.</p><p><strong>Conclusions: </strong>This study casts doubt on the utility of classic symptoms in diagnosing abnormal ICP state in chronically symptomatic shunted patients with equivocal adjuncts. Additionally, it highlights the importance of ICP monitoring for this patient group.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"131-135"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138299275","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":"Enhancing physician-patient communication in neurology: is the patient's comprehension adequately assessed?","authors":"Roberto Tedeschi","doi":"10.23736/S0390-5616.24.06299-4","DOIUrl":"10.23736/S0390-5616.24.06299-4","url":null,"abstract":"","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":" ","pages":"139-140"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558909","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":"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":"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":" ","pages":"102-110"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","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":"Is normal pressure hydrocephalus a movement disorder?","authors":"Giovanni Mostile, Giulia Donzuso, Katarina Laurell, Mario Zappia","doi":"10.23736/S0390-5616.25.06390-8","DOIUrl":"10.23736/S0390-5616.25.06390-8","url":null,"abstract":"<p><p>Idiopathic normal pressure hydrocephalus (iNPH) represents a nosographic entity characterized by phenotypic variability. In this context, the need arises to differentiate iNPH from neurological conditions characterized by impairment in mobility and cognition, including atypical and secondary parkinsonism, with which it shares several common aspects. In this review we will discuss clinical evidence supporting different iNPH clinical phenotypes mimicking Parkinson's disease and secondary/atypical parkinsonism, indicating iNPH as a neurological condition that should be considered by movement disorders specialists. We will also propose a preliminary diagnostic algorithm combining clinical, imaging and biological markers leading to a multidimensional diagnosis of iNPH associated with parkinsonism.</p>","PeriodicalId":16504,"journal":{"name":"Journal of neurosurgical sciences","volume":"69 1","pages":"37-45"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567432","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}