Journal of neurosurgery最新文献

{"title":"Letter to the Editor. Microelectrode recording and brain hemorrhage: is the evidence convincing?","authors":"Quintino Giorgio D'Alessandris, Alessandro Izzo, Manuela D'Ercole, Nicola Montano","doi":"10.3171/2024.10.JNS242474","DOIUrl":"https://doi.org/10.3171/2024.10.JNS242474","url":null,"abstract":"","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-2"},"PeriodicalIF":3.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial. Cost-effectiveness analysis as a tool for achieving equitable access to deep brain stimulation for patients with obsessive-compulsive disorder.","authors":"Somnath Das, J Nicole Bentley","doi":"10.3171/2024.9.JNS241710","DOIUrl":"https://doi.org/10.3171/2024.9.JNS241710","url":null,"abstract":"","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-2"},"PeriodicalIF":3.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors for traumatic cerebral contusion volume, expansion, and outcomes.","authors":"Parker D Smith, Ishav Shukla, Faraaz Azam, Daniel Trautmann, Evan Gee, Madison Korb, Michael Pitonak, Srivats Srinivasan, James P Caruso, Christie Caldwell, Kristen Hall, Mazin Al Tamimi, Joan Reisch, Nicole M Bedros, Salah G Aoun","doi":"10.3171/2024.8.JNS241051","DOIUrl":"https://doi.org/10.3171/2024.8.JNS241051","url":null,"abstract":"<p><strong>Objective: </strong>Traumatic hemorrhagic cerebral contusions are a well-established cause of morbidity and mortality in neurosurgery. This study aimed to determine prognostic factors for long-term functional outcomes and longitudinal contusion volume changes in traumatic brain injury (TBI) patients.</p><p><strong>Methods: </strong>Data from 285 patients with traumatic cerebral contusions were retrospectively reviewed to identify variables predictive of initial contusion volume, contusion expansion on short-term follow-up imaging, and functional outcomes according to the modified Rankin Scale (mRS). Predictors of these variables were identified using a stepwise logistic regression analysis.</p><p><strong>Results: </strong>Older age, larger initial contusion volumes, and lower presenting Glasgow Coma Scale (GCS) scores were associated with worse functional outcomes (mRS score ≥ 3). Patients with contusion volumes ≥ 15 ml at presentation had lower GCS scores and longer ICU stays (in days). Older age (OR 1.043, CI 1.024-1.063), need for a craniotomy or craniectomy (OR 2.562, CI 1.010-6.502), longer ICU stay (OR 1.092, CI 1.034-1.154), and lower total GCS score (OR 0.781, CI 0.729-0.836) were associated with worse functional outcomes. Additionally, lower admission GCS verbal score was a significant predictor of larger initial contusion volume (OR 0.779, 95% CI 0.667-0.911) and contusion expansion during hospitalization (OR 0.649, 95% CI 0.497-0.847).</p><p><strong>Conclusions: </strong>Functional outcomes in traumatic cerebral contusion patients may be associated with age and admission GCS score, and verbal GCS score may predict initial contusion volume and contusion expansion. These findings supplement an evolving understanding of factors that influence outcomes in patients with cerebral contusions, and further study into the utility of GCS to guide these decisions could help to guide the clinical management of these highly complex patients.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":3.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological and functional outcomes of 32 patients with hemorrhagic brainstem cavernous malformations: a practical guide for surgical planning.","authors":"Carmine A Donofrio, Kenan Arnautovic, Lucia Riccio, Filippo Badaloni, Federico Roncaroli, Franco Servadei, R Shane Tubbs, Antonio Fioravanti","doi":"10.3171/2024.8.JNS241171","DOIUrl":"https://doi.org/10.3171/2024.8.JNS241171","url":null,"abstract":"<p><strong>Objective: </strong>Brainstem cavernous malformations (BSCMs) were once considered inoperable. Microsurgical resection now represents a valuable option for treating patients with hemorrhagic or symptomatic lesions. The aim of this study was to provide a practical guide for surgical planning by analyzing postoperative neurological and functional outcomes.</p><p><strong>Methods: </strong>The early- and long-term neurological (National Institutes of Health Stroke Scale [NIHSS] score) and functional (modified Rankin Scale [mRS] and Glasgow Outcome Scale [GOS] scores) outcomes of 32 patients who underwent surgery for hemorrhagic BSCM were reviewed. The three-step surgical planning was based on an anatomosurgical algorithm.</p><p><strong>Results: </strong>Nine lesions (28.1%) were located in the mesencephalon, 19 (59.4%) in the pons, and 4 (12.5%) in the medulla. A fronto-temporo-orbito-zygomatic approach was selected to reach anterior mesencephalic BSCMs (2, 6.3%). A retrosigmoid approach and its extended variant were selected for lateral mesencephalic (6, 18.8%), anterior (2, 6.3%) and lateral (13, 40.6%) pontine, and anterior (1, 3.1%) and lateral (1, 3.1%) medullary BSCMs. A supracerebellar infratentorial approach was selected for posterior mesencephalic BSCMs (1, 3.1%). A telovelar approach was selected for posterior pontine (4, 12.5%) and medullary (2, 6.3%) BSCMs. Total resection was achieved in 29 cases (90.6%), with a 12.5% rate of surgical complications. The NIHSS score progressively improved at both the early (5.16 ± 3.70 vs 4.63 ± 2.78, p = 0.446) and late (4.63 ± 2.78 vs 2.41 ± 2.39, p < 0.001) postoperative evaluations. Functional outcomes showed an initial deterioration followed by a long-term improvement (mRS score: 2.66 ± 1.07 vs 3.06 ± 1.11 vs 2.13 ± 1.29, GOS score: 3.78 ± 0.61 vs 3.59 ± 0.62 vs 4.19 ± 0.78). Time to surgery significantly correlated with early- and long-term NIHSS, mRS, and GOS scores, while the number of hemorrhages before surgery correlated with early- and long-term mRS and GOS scores.</p><p><strong>Conclusions: </strong>Early surgery after the first bleed following systematic surgical planning may be considered as an effective option for managing hemorrhagic BSCMs with acceptable operative morbidity and relatively favorable early- and long-term neurological and functional outcomes.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-11"},"PeriodicalIF":3.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thalamic deep brain stimulation for central poststroke pain syndrome: an international multicenter study.","authors":"Andreas Nowacki, David Y Zhang, Can Sarica, Gavin J B Elias, Sweta Bajaj, Angelo Franzini, Andrea Franzini, Assel Saryyeva, Thuy Anh Khoa Nguyen, Tipu Aziz, Joachim K Krauss, Wilhelm Eisner, Andres M Lozano, Alexander L Green, Claudio Pollo","doi":"10.3171/2024.8.JNS24742","DOIUrl":"https://doi.org/10.3171/2024.8.JNS24742","url":null,"abstract":"<p><strong>Objective: </strong>The effectiveness and optimal stimulation site of deep brain stimulation (DBS) for central poststroke pain (CPSP) remain elusive. The objective of this retrospective international multicenter study was to assess clinical as well as neuroimaging-based predictors of long-term outcomes after DBS for CPSP.</p><p><strong>Methods: </strong>The authors analyzed patient-based clinical and neuroimaging data of previously published and unpublished cohorts from 6 international DBS centers. DBS leads were reconstructed and normalized. A stimulation map was constructed on the basis of individual stimulation settings and associated outcomes. Furthermore, the authors projected the individual segmented stroke lesions and volumes of tissue activated (VTAs) of the stimulating electrode onto a normalized human connectome to obtain the connectivity profiles of the individual lesions and VTAs.</p><p><strong>Results: </strong>The authors analyzed the data of 54 patients, of whom 15 were excluded from the final analysis due to a lack of imaging data. Among the remaining 39 patients from 6 different cohorts, the authors found 14 (35.9%) responders who were defined by pain relief of at least 50% at 12-month follow-up. Stimulation mapping identified areas in the posterior limb of the internal capsule, the sensorimotor thalamus, and the medial and intralaminar thalamus as effective for pain reduction. Baseline characteristics did not differ between responders and nonresponders. The stimulation sites of the responders showed significantly reduced structural connectivity to the sensory areas of the cerebral cortex compared to nonresponders.</p><p><strong>Conclusions: </strong>This comprehensive, multicenter analysis corroborates the efficacy of DBS in treating CPSP for a relevant number of patients. The posterior limb of the internal capsule and the sensorimotor thalamus emerged as potential stimulation sweet spots. The difference in structural connectivity between responders and nonresponders may constitute a biomarker of effective stimulation that can help guide surgical planning in future well-designed prospective trials.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-12"},"PeriodicalIF":3.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and complications of external ventricular drainage in primary and secondary intraventricular hemorrhage: a descriptive observational study.","authors":"Chenghao Gu, Allice N R Lind, Mette Haldrup, Jens T Eschen, Mads H Eskildsen, Asbjørn Kjær, Mads Rasmussen, Stig Dyrskog, Kaare Meier, Claus Z Simonsen, Birgit Debrabant, Anders R Korshøj","doi":"10.3171/2024.8.JNS24915","DOIUrl":"https://doi.org/10.3171/2024.8.JNS24915","url":null,"abstract":"<p><strong>Objective: </strong>Intraventricular hemorrhage (IVH) is a serious condition with high mortality rates and poor functional outcome in survivors. Treatment includes external ventricular drains (EVDs), which are associated with several complications. This study reports the clinical outcome and complication rate in patients with primary IVH (pIVH) and secondary IVH treated with EVDs.</p><p><strong>Methods: </strong>The authors conducted a retrospective observational study using the Danish National Patient Registry. Patients treated with EVDs for pIVH or secondary IVH between September 2012 and August 2022 at Aarhus University Hospital were included. Demographic data, clinical treatment, and outcomes were extracted and analyzed.</p><p><strong>Results: </strong>A total of 436 patients with 615 EVDs were included. Of these, 4.1% had pIVH, 60.6% had IVH secondary to subarachnoid hemorrhage, and 35.3% had IVH secondary to intracerebral hemorrhage. During EVD treatment, 38.8% of patients experienced complications, including complete occlusion (17.2%), partial occlusion (16.1%), ventriculitis (7.1%), and other complications (9.6%). Of patients surviving the initial 30 days, 34.2% received a ventriculoperitoneal shunt, and 29.9% remained shunt dependent 6 months after inclusion. Mortality rates were 28.9% at 30 days and 33.7% at 90 days. A total of 31.0% of patients had good functional outcomes at 90 days.</p><p><strong>Conclusions: </strong>This study provides a comprehensive historical reference of complications, mortality rate, and functional outcome of EVD-treated patients with pIVH and secondary IVH. These findings provide a baseline for evaluating novel catheter-based interventions in IVH management.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-7"},"PeriodicalIF":3.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early radiological reduction of periventricular anastomosis after direct bypass surgery for adult moyamoya disease.","authors":"Hiroki Yamada, Takeshi Funaki, Yasutaka Fushimi, Yukihiro Yamao, Yu Hidaka, Takayuki Kikuchi, Yohei Mineharu, Masakazu Okawa, Kazumichi Yoshida, Hideo Chihara, Susumu Miyamoto, Yoshiki Arakawa","doi":"10.3171/2024.7.JNS24237","DOIUrl":"https://doi.org/10.3171/2024.7.JNS24237","url":null,"abstract":"<p><strong>Objective: </strong>Periventricular anastomosis (PA), a recently recognized cause of hemorrhage in moyamoya disease, is reducible after bypass surgery. The timing of the reduction, however, remains poorly understood. The objectives of the present study were to demonstrate radiological reduction of PA occurring within 48 hours after surgery and to identify factors associated with reduction.</p><p><strong>Methods: </strong>This retrospective cohort study included patients aged 16 years or older who were diagnosed with moyamoya disease and underwent direct bypass surgery. PAs were assessed using sliding thin-slab maximum intensity projection MR angiography images acquired before surgery and on postoperative day 1. The signal ratio of PA, the ratio of the signal value of the medullary artery to that of the brain parenchyma, was measured at the same point on automatically aligned baseline and postoperative images. The location of bypass was defined as either targeted or nontargeted to the PA.</p><p><strong>Results: </strong>A total of 68 PAs were analyzed. The signal ratio of PA significantly decreased (mean change [95% CI] -0.16 [-0.21 to -0.11]), while that of cerebellar arteries increased (mean change [95% CI] 0.20 [0.09-0.31]). The interrater reliability measurement of the signal ratio change was excellent (intraclass correlation coefficient 0.94). Multivariate linear regression analysis revealed that targeted bypass (regression coefficient [95% CI] -0.1063 [-0.1558 to -0.0569]) and cross-sectional area of the donor artery (regression coefficient [95% CI] -0.1317 [-0.2101 to -0.0534]) were significant factors contributing to signal reduction of the PA. Analysis of the receiver operating characteristic curve revealed that early signal reduction well predicted late-phase reduction (area under the curve 0.78).</p><p><strong>Conclusions: </strong>PA could be reduced within 48 hours after direct bypass surgery, suggesting an early preventive effect against hemorrhage. Early reduction, a potential predictor for late-phase reduction, might be promoted by targeted bypass surgery.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":3.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of intraoperative MRI and early postoperative MRI findings in glioma surgery patients.","authors":"Yoshihiro Otani, Fumiyo Higaki, Kentaro Fujii, Joji Ishida, Yosuke Shimazu, Shuichiro Hirano, Naoya Kemmotsu, Yasuki Suruga, Ryoji Imoto, Ryo Mizuta, Yasuhito Kegoya, Yohei Inoue, Tsuyoshi Umeda, Madoka Hokama, Takao Yasuhara, Takao Hiraki, Kazuhiko Kurozumi, Tomotsugu Ichikawa, Shota Tanaka, Isao Date","doi":"10.3171/2024.7.JNS24784","DOIUrl":"https://doi.org/10.3171/2024.7.JNS24784","url":null,"abstract":"<p><strong>Objective: </strong>The extent of resection (EOR) is an important prognostic factor for both low- and high-grade gliomas. Intraoperative MRI (iMRI) has been used to increase the EOR in glioma surgery. While a recent study reported differences between iMRI and early postoperative MRI (epMRI), their specific relationship to postoperative clinical symptoms remains unclear. This study aims to compare the differences between iMRI and epMRI in glioma surgery.</p><p><strong>Methods: </strong>A retrospective assessment was conducted on 43 patients with glioma who underwent surgery with iMRI and for whom no additional resection was performed after iMRI. The study evaluated the discrepancies in EOR, surgically induced contrast enhancement (SICE), and diffusion-weighted imaging (DWI) abnormality between iMRI and epMRI. EOR was defined as gross-total resection (GTR), near-total resection, subtotal resection (STR), or partial resection (PR) for enhancing lesions, and GTR, STR, or PR for nonenhancing lesions. In addition, the relationship between postoperative neurological findings and iMRI findings was evaluated.</p><p><strong>Results: </strong>Discrepancies in EOR were observed in 2 (11.1%) of 18 cases with nonenhanced lesions and 1 (4.0%) of 25 cases with enhanced lesions. The positive rate of SICE was 25.0% on iMRI and 67.9% on epMRI. Enhancement at the resection cavity was the most frequent pattern in both iMRI and epMRI. The positive rate of enhancement of the resection cavity was strongly increased on epMRI compared with iMRI, potentially mimicking residual tumor. The positive rate of DWI abnormality was 73% on iMRI and 89.2% on epMRI. Among the 10 patients who showed no DWI abnormality on iMRI, 6 exhibited DWI abnormality on epMRI (the late-developing group). Two patients developed new neurological deficits postoperatively, and both showed DWI abnormality on both iMRI and epMRI. No patient in the late-developing group developed postoperative neurological deficits.</p><p><strong>Conclusions: </strong>Overall, iMRI demonstrated more accurate EOR and less SICE compared with epMRI. Although the positive rate of DWI abnormality was lower on iMRI than on epMRI, the late-developing group showed no postoperative neurological deficits. Therefore, iMRI is more useful in assessing accurate EOR and detecting postoperative neurological deficits than epMRI.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":3.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A spinal perimedullary arteriovenous fistula treated by Walter Dandy and illustrated by Dorcas Hager Padget in 1934.","authors":"Lydia J Gregg, Rafael J Tamargo, Philippe Gailloud","doi":"10.3171/2024.8.JNS241550","DOIUrl":"https://doi.org/10.3171/2024.8.JNS241550","url":null,"abstract":"<p><p>Dorcas Hager Padget was a renowned neurosurgical illustrator and neuroembryologist. She collaborated closely with Walter E. Dandy, founder of the field of vascular neurosurgery, from 1928 until his death in 1946. In 1934, Hager Padget created an unpublished illustration accurately depicting a spinal perimedullary arteriovenous fistula (pmAVF) despite the fact that the exact nature of the lesion would only be described 43 years later. The illustration portrays the patient's myelopathic symptoms and pmAVF treatment by ligation and resection of a venous pouch located at the fistula site, indicating Dandy's early understanding of the lesion's architecture. Whether the illustration was created for a publication that fell to the wayside or exclusively for Dandy's patient history records remains unknown.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-6"},"PeriodicalIF":3.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive impacts of unilateral MR-guided focused ultrasound thalamotomy: a meta-analysis and a call for systematic neuropsychological assessment.","authors":"Mickael Aubignat, Martine Roussel, Ardalan Aarabi, Melissa Tir, Michel Lefranc, Olivier Godefroy","doi":"10.3171/2024.7.JNS24906","DOIUrl":"https://doi.org/10.3171/2024.7.JNS24906","url":null,"abstract":"<p><strong>Objective: </strong>Pharmacoresistant tremors, often seen in Parkinson disease and essential tremor, significantly impair patient quality of life. Although deep brain stimulation has been effective, its invasive nature limits its applicability. MR-guided focused ultrasound (MRgFUS) thalamotomy offers a noninvasive alternative, but its cognitive impacts are not fully understood. This meta-analysis aimed to evaluate the cognitive and emotional effects of unilateral MRgFUS thalamotomy in patients with pharmacoresistant tremors.</p><p><strong>Methods: </strong>Adhering to PRISMA guidelines, a comprehensive literature search was conducted across PubMed, Web of Science, and the Cochrane Library. Studies were included if they involved unilateral MRgFUS thalamotomy and assessed cognitive functions pre- and postprocedure. The primary outcomes were changes in cognitive functions and emotional states postthalamotomy.</p><p><strong>Results: </strong>Of 90 identified articles, 5 met the inclusion criteria, encompassing 112 patients (74 essential tremor, 38 Parkinson disease). The analysis revealed no significant deterioration in cognitive domains or emotional states postprocedure. Statistical heterogeneity among studies was small for cognitive outcomes but moderate for emotional states.</p><p><strong>Conclusions: </strong>Unilateral MRgFUS thalamotomy appears to be a safe procedure with respect to cognitive and emotional outcomes in patients with pharmacoresistant tremors. However, the small number of studies and the short-term nature of assessments necessitate caution. Further research, especially on long-term cognitive effects and in the context of bilateral procedures, is essential for a comprehensive understanding of MRgFUS thalamotomy's neuropsychological impact. Systematic review registration no.: CRD42023491757 (www.crd.york.ac.uk/prospero).</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":3.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}