Journal of Neurological Surgery Part B: Skull Base最新文献

{"title":"Surgical Management of Trigeminal Neuralgia Emerging in the Long-Term after Cerebellopontine Angle Tumor Surgery without Tumor Regrowth.","authors":"Ken Matsushima, Kyosuke Matsunaga, Norio Ichimasu, Nobuyuki Nakajima, Michihiro Kohno","doi":"10.1055/a-2706-1672","DOIUrl":"10.1055/a-2706-1672","url":null,"abstract":"<p><strong>Objectives: </strong>Cerebellopontine angle tumors are reported causes of trigeminal neuralgia, but trigeminal neuralgia emerging long after cerebellopontine angle tumor removal, despite the absence of tumor regrowth, is extremely rare. Surgical resolution is required for intractable cases, but it is challenging due to the altered anatomy and severe adhesions from prior surgery, and unclear etiologies.</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Participants: </strong>About 2,580 patients underwent cerebellopontine angle tumor resection (including vestibular schwannomas, meningiomas, trigeminal schwannomas, epidermoid cysts, and others) during a 19-year period.</p><p><strong>Main outcome measures: </strong>Postoperative pain resolution and neurological complications after surgical intervention for trigeminal neuralgia without tumor regrowth.</p><p><strong>Results: </strong>Three patients required surgical intervention for delayed-onset trigeminal neuralgia, occurring 2 to 11 years after the vestibular schwannoma surgery. In all patients, the offending artery was transposed, and thick arachnoid adhesions were dissected. Additional procedures included the separation of the compressing vein, the separation of the adhering facial nerve, and the removal of residual tumor to isolate the trigeminal nerve. All patients experienced complete pain relief postoperatively without developing new permanent neurological deficits, except for one patient who developed mild facial hypoesthesia.</p><p><strong>Conclusion: </strong>Although rare and technically challenging, surgical intervention can be an effective and safe treatment for surgery-associated trigeminal neuralgia. Comprehensive management of all possible etiologies, including separation of the surrounding structures (arteries, veins, cranial nerves, arachnoid, and residual tumor) from the trigeminal nerve, should be considered for complete and secure pain relief under detailed neuromonitoring.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 5","pages":"604-609"},"PeriodicalIF":0.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implications of Tumor Size on Auditory Brainstem Implant Performance.","authors":"Justin Cottrell, Matthew Breen, Matthew V Leeuwen, William Shapiro, Mahan Azadpour, David Friedmann, Daniel Jethanamest, Sean McMenomey, Donato Pacione, Mari Hagiwara, Gul Moonis, John Golfinos, J Thomas Roland","doi":"10.1055/a-2706-1437","DOIUrl":"10.1055/a-2706-1437","url":null,"abstract":"<p><strong>Objectives: </strong>To better understand the implications of tumor size on auditory brainstem implant (ABI) categories of auditory performance (CAP) score to facilitate more precise patient counselling.</p><p><strong>Design: </strong>Single-center retrospective chart review.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Participants: </strong>Patients > 18 years old with neurofibromatosis type 2 who underwent ABI placement between the years 2009 and 2023 were included. Patients with prior surgical resection were excluded to reduce the potential of previous cochlear nucleus trauma confounding results.</p><p><strong>Main outcome measures: </strong>Ipsilateral tumor volume was measured from the preoperative MRI, and the primary endpoint was the 1-year CAP score.</p><p><strong>Results: </strong>Fourteen patients were included for analysis, with an average age of 35.3 years. The average preoperative ipsilateral tumor volume was 22.8 cm ³ (± 22.4). The average postoperative CAP score was 2.7 (± 2). A negative association was found between ipsilateral tumor size prior to treatment and CAP score (slope = - 0.058, <i>p</i>  = 0.010) utilizing a linear regression model. The model accounted for 43.7% of the variance in outcome ( <i>R</i> ²  = 0.437, adjusted <i>R</i> ²  = 0.390), with a significant overall model fit ( <i>F</i> [1, 12] = 9.31, <i>p</i>  = 0.010).</p><p><strong>Conclusion: </strong>Increased tumor size has a negative correlation with ultimate ABI performance. There were patients in this study with larger tumor sizes who still benefited from ABI placement. While larger tumor size should not be a contraindication for ABI placement, understanding the role tumor size can have on performance variation can serve to improve tumor management strategies and preoperative counselling.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 5","pages":"e120-e123"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified Dandy Stair-Step Incision for Retrosigmoid Craniotomies to Reduce Postoperative Complications in Skull Base Surgery.","authors":"Jean Filo, Omar Alwakaa, John B Park, Rafael A Vega","doi":"10.1055/a-2706-1385","DOIUrl":"10.1055/a-2706-1385","url":null,"abstract":"<p><strong>Background: </strong>Retrosigmoid craniotomies are prone to postoperative complications, including wound complications, necessitating careful surgical closure. A modified Dandy stair-step technique was developed to address these concerns by ensuring a watertight seal, preserving the blood supply, sparing the muscles, and approximating the wound layers precisely under a cranial flap.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on patients undergoing retrosigmoid craniotomies at a single institution from 2019 onward. Patients with prior craniotomies or less than 1 month of follow-up were excluded.</p><p><strong>Results: </strong>Among 73 patients, 29 (39.7%) underwent the modified Dandy technique. Baseline characteristics were similar between the two groups, with 41 of them being female (56.2%), the median age being 59 (interquartile range [IQR]: 50-67), and 44 having never smoked (60.3%). The most common indications for surgery were vestibular schwannomas (53.4%), meningiomas (24.7%), and metastatic lesions (15.1%), while the rest were other lesions (6.8%). In the modified and control groups, the follow-up duration was 8.9 months (IQR: 5-10.6) and 15.9 months (IQR: 8-23.9; <i>p</i>  = 0.01). Wound complications occurred in 3.4% of the modified group (i.e., superficial wound erythema), compared to 15.9% in the control group ( <i>p</i>  = 0.02). These complications resulted in three reoperations (6.8%; <i>p</i>  = 0.32) and seven readmissions (15.9%) in the control group ( <i>p</i>  = 0.03). Three patients in the control group (6.8%) had multiple complications, one of whom required multiple reoperations for persistent pseudo-meningocele. Notably, all complications except one occurred within 30 days.</p><p><strong>Discussion: </strong>This study suggests that the modified technique may reduce wound-related complications following retrosigmoid craniotomies, though further research is required to confirm its efficacy.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 5","pages":"610-615"},"PeriodicalIF":0.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Courthouses and Craniotomies: Medical Malpractice Indemnity Payments and Litigation Verdicts in Skull Base and Open Cerebrovascular Neurosurgical Practice in the United States throughout the 21st Century.","authors":"Danner W Butler, Mehdi Khaleghi, Maxon Bassett, Nathan Ashburn, Garrett Dyess, Lake Higdon, Adnan H Shahid, Richard Menger, Anthony M Martino, Jai Deep Thakur","doi":"10.1055/a-2695-2405","DOIUrl":"10.1055/a-2695-2405","url":null,"abstract":"<p><strong>Background: </strong>This work offers analysis of lawsuits associated with skull base and open cerebrovascular pathologies in the past 24 years using Westlaw Edge legal database.</p><p><strong>Methods: </strong>Litigation outcome possibilities were either jury verdicts in favor of the plaintiff (patient) or defendant (physician), or settlement. US circuit courts were utilized for geographical analysis.</p><p><strong>Results: </strong>Overall, a defense verdict was awarded in 57.1% of cases ( <i>n</i>  = 48) while a plaintiff verdict was awarded in 33.3% of cases ( <i>n</i>  = 28). Settlement occurred in 9.5% of cases analyzed, with no significant difference in amount paid compared with plaintiff verdicts ($1.3 [IQR: 0.4-3.99] million versus $2 [IQR: 1-6.75] million, respectively; <i>p</i>  = 0.73).</p><p><strong>Conclusion: </strong>Most malpractice cases (53.6%) involved aneurysmal pathology, followed by skull base tumors (23.8%). Claims were most commonly against neurological surgery specialty (41.7%) and radiology (15.5%). US circuit 9 had the highest number of cases (22/84, 26.2%), with a majority occurring in California ( <i>n</i>  = 16). The total amount owed from cases resulting in plaintiff verdict or settlement totaled to $171,387,558 with a median of $2,000,000 (IQR: 1,000,000-6,650,000). The highest per single case paid to the plaintiff was $49,000,000 (New York). There was no significant association between the geographical circuit and the median amount paid ( <i>p</i>  = 0.42).</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 4","pages":"414-420"},"PeriodicalIF":0.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioengineered Materials for Skull Base Reconstruction-Current Clinical Applications: Systematic Review and Meta-analysis.","authors":"Guilherme Gago, Marc-Olivier Comeau, Rodrigo Ness, Fernando Gomes, Frederico de Lima Gibbon, Pierre-Olivier Champagne","doi":"10.1055/a-2693-1905","DOIUrl":"10.1055/a-2693-1905","url":null,"abstract":"<p><strong>Introduction: </strong>Skull base reconstruction (SBR) is a crucial aspect of open and endoscopic skull base surgery. Currently, multilayer reconstruction with vascularized tissues is the standard technique. Despite advancements, complications such as postoperative cerebrospinal fluid leaks (PO-CSF-L) and infections persist. Bioengineered materials (BEM) have emerged for SBR, showing promising results.</p><p><strong>Methods: </strong>A systematic review was conducted using Embase, PubMed, Scopus, and Cochrane databases. We performed a proportional meta-analysis of studies utilizing BEM for SBR and a comparative analysis with control groups that underwent SBR without biomaterials. The odds ratio assessed treatment effects for binary outcomes.</p><p><strong>Results: </strong>From 1,075 potential articles, 14 met the inclusion criteria. Five BEM were identified: hydroxyapatite (HXA), leukocyte-platelet-rich fibrin (L-PFR), collagen matrix (CM), polyglycolic acid (PGA), and porous polyethylene (PP). The analysis included 1,960 patients, with 1,570 in experimental groups using BEM. Pooled data indicated a PO-CSF-L proportion of 0.02% (95% CI: 0.01-0.03%), postoperative CSF diversion (PO-CSF-d) at 0.01% (95% CI: 0.00-0.04), and PO infection at 0.02% (95% CI: 0.00-0.05%). Common effect models showed that CM had a lower total PO infection rate (0.01; 95% CI: 0.00-0.01, <i>p</i>  = 0.0006) compared with HXA (0.08; 95% CI: 0.05-0.11, <i>p</i>  = 0.0007). Comparative analysis demonstrated lower odds of PO-CSF-L (OR 0.37; 95% CI: 0.15-0.89, <i>p</i>  = 0.026) and infections (OR 0.47; 95% CI: 0.13-1.47, <i>p</i>  = 0.264) in patients with BEM.</p><p><strong>Conclusion: </strong>Our results indicate that bioengineered materials are viable for skull base reconstruction, associated with low rates of postoperative CSF leaks, diversions, and infections.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 4","pages":"391-405"},"PeriodicalIF":0.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Localization and Performance of Auditory Brainstem Implants Based on MRI Measures of Paddle Placement.","authors":"Justin Cottrell, Matthew Breen, Matthew Van Leeuwen, William Shapiro, Mahan Azadpour, David Friedmann, Daniel Jethanamest, Sean McMenomey, Donato Pacione, John Golfinos, Mari Hagiwara, Gul Moonis, J Thomas Roland","doi":"10.1055/a-2692-6720","DOIUrl":"10.1055/a-2692-6720","url":null,"abstract":"<p><strong>Objectives: </strong>To develop and study a novel means of imaging auditory brainstem implant (ABI) paddle placement utilizing postoperative MRI images to determine correlation between ABI performance and ideal paddle placement properties.</p><p><strong>Design: </strong>Single-center retrospective review and image analysis.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Participants: </strong>Patients >18 years old who received an ABI from 2009 to 2023 and had subsequent MRI and auditory performance testing completed.</p><p><strong>Main outcome measures: </strong>ABI paddle angulation and insertion depth measure, in addition to categories of auditory performance (CAP) score.</p><p><strong>Results: </strong>Inclusion criteria were met by 21 patients with neurofibromatosis type 2 (NF2) who underwent ABI placement. The average insertional depth into the foramen of Luschka was 1.0 cm (Stdev 0.4), with average axial paddle angulation of 62.7 degrees (Stdev 29.7 degrees), average sagittal paddle angulation of 108.7 degrees (Stdev 44.4 degrees), and average coronal paddle angulation of -14.5 degrees (Stdev 62.4 degrees). Single variable linear regression showed a statistically significant negative relationship between insertion depth and CAP score ( <i>p</i>  = 0.049) once patients with large tumor burden were excluded. Insertion depth and axial angulation showed a negative correlation, in which higher insertion depth was associated with a decrease in axial angulation value, although not statistically significant.</p><p><strong>Conclusion: </strong>We present a novel means of measuring ABI paddle placement utilizing MRI to improve the objectivity of paddle placements assessments. Multicenter collaboration to increase the number of patients studied with this new measurement scheme will be required before stronger measurement associations can be determined.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 4","pages":"439-447"},"PeriodicalIF":0.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LINAC-based Stereotactic Radiotherapy for Acromegaly: A Single-center Retrospective Cohort.","authors":"Geovanne P Mauro, Leila M Da Róz, Vinicius de Carvalho Gico, Silvio Thiago Pereira Vasconcelos, Eduardo Weltman, Evandro C de Souza, Raquel S Jallad, Malebranche Berardo Carneiro da Cunha Neto, Rosangela C Villar","doi":"10.1055/a-2693-1815","DOIUrl":"10.1055/a-2693-1815","url":null,"abstract":"<p><strong>Background: </strong>Most results for stereotactic radiotherapy (SRT) for acromegaly patients come from Gamma-Knife series. We aim to describe outcomes for LINAC-based SRT, as well as compare results for single-dose (SRS) and fractionated (SFRT) treatments.</p><p><strong>Methods: </strong>Single-center retrospective cohort in a tertiary, academic hospital assessed between 2008 and 2024.</p><p><strong>Results: </strong>A total of 48 patients were assessed for outcomes of acromegaly after SRT. Most of them female (62.5%). Mean age was 42.5 years (range 12-73). Median lesion size was 2.1 cm (range 0.2 to 7.2 cm). Among previous deficits, previous hormonal deficits (31.3%) and visual deficits (45.8%) were common. Most patients were diagnosed with pure somatotrophic lesions (87.5%). SRS was done in 16 (33.3%) patients and 32 (66.7%) underwent SFRT. Concurrent octreotide long-acting release (Oct-LAR) (29/60.4%) and cabergoline (20/41.7%) were also common. Median follow-up was 85.3 months (8.2-187.9 months). Tumor control was achieved in 47 (97.9%). Mean progression-free survival (PFS) was 85.3 months (92.4 months for SRS and 81.7 months for SFRT, <i>p</i>  = 0.42). Univariate analysis showed no variable impacted overall survival (OS), PFS, new visual, or new hormonal disorders. Hormonal remission was achieved in 22 (45.8%) patients. Median time to hormonal disease control (THC) was 73.1 months for the entire cohort, and 45.8 months for SRS patients and 74.7 months for SFRT patients, with no difference between groups ([HR], 0.30; 95% CI, -1.14 to 0.53; <i>p</i>  = 0.47).</p><p><strong>Conclusion: </strong>We described acromegaly patients treated with LINAC SRS and with the current criteria for hormonal cure. THC was longer for SFRT patients, with no statistical differences. Concurrent treatment did not impact outcomes.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 4","pages":"421-427"},"PeriodicalIF":0.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum: Presentation Abstracts of the North American Skull Base Society.","authors":"","doi":"10.1055/s-0045-1811603","DOIUrl":"10.1055/s-0045-1811603","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/s-015-61030.][This corrects the article DOI: 10.1055/s-0045-1803264.].</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"86 Suppl 1","pages":"e3"},"PeriodicalIF":0.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microsurgical Treatment of Spheno-Orbital Meningiomas: The Clinical Significance of the Tumor Invasion into the Greater Sphenoid Wing.","authors":"Baris Kucukyuruk, Alperen Kaya, Revna Cetiner, Necmettin Tanriover, Ali M Kafadar, Galip Z Sanus","doi":"10.1055/a-2678-8385","DOIUrl":"10.1055/a-2678-8385","url":null,"abstract":"<p><strong>Objectives: </strong>The management of spheno-orbital meningiomas (SOM) is challenging due to complex characteristics of these tumors, such as extension into the orbit, hyperostosis of the greater sphenoid wing (GSW), and invasion of the superior orbital fissure (SOF), cavernous sinus (CS), and optic canal. To address this challenge, this study reports the results of microsurgically treated SOM patients and the nuances that affect the surgical technique.</p><p><strong>Methods: </strong>The clinical data of 14 consecutive patients who underwent surgery through a microsurgical transcranial approach were collected retrospectively.</p><p><strong>Results: </strong>Among 14 patients, exophthalmos was present in all patients, and facial numbness and visual acuity decline were both present in 50% of patients. Preoperative radiological imaging showed SOF narrowing in seven cases, optic canal compression in six cases, and CS invasion in five cases. Our surgical technique relies on direct removal of the affected GSW, promoting the removal of the temporal intradural tumor and decompression of the lateral wall of the orbit, optic canal, and SOF. Total removal of GSW is found to be beneficial in the treatment of SOMs since tumor invasion to the affected bone was observed in all cases. Simpson grade 1 resection was achieved in 64% of cases. CS invasion is present in five cases left intentionally unremoved. In two cases, a second surgery was required, while in four cases, radiotherapy was necessary.</p><p><strong>Conclusion: </strong>Microsurgical treatment aiming for maximal safe resection with preservation of contents within the CS is the best option in the first-line treatment of SOMs. Aggressive removal of the bone tumor is beneficial in oncological control of the disease.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 4","pages":"456-461"},"PeriodicalIF":0.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatNSG: An Overview of Contemporary and Emerging Artificial Intelligence Models for the Neurosurgeon.","authors":"Kishore Balasubramanian, Christopher Janssen, Ali S Haider, Visish M Srinivasan, Daniel A Donoho, Nicholas Sader, Christopher S Graffeo","doi":"10.1055/a-2678-8460","DOIUrl":"10.1055/a-2678-8460","url":null,"abstract":"<p><p>Artificial intelligence (AI) is rapidly transforming health care, with significant implications for neurosurgery. This essay provides a focused overview of contemporary and emerging AI models relevant to neurosurgery, with particular emphasis on natural language processing (NLP) tools such as large language models (LLMs) and retrieval augmented generation systems. We present a framework for conceptualizing the AI-user relationship, emphasizing a collaborative model that promotes iterative refinement of queries and responses. The paper offers guidance on AI model selection for various neurosurgical tasks, highlighting the strengths of different AI types such as NLP models and machine learning algorithms. We introduce prompt engineering as a critical skill for neurosurgeons, providing practical tips and examples to optimize AI interactions. The review also discusses current limitations of AI in neurosurgery, including dataset biases and ethical considerations. By addressing these key areas, this article serves as a practical guide for neurosurgeons at all career stages to effectively integrate AI tools into their work, ultimately enhancing patient care, research capabilities, and educational practices in the field of neurosurgery.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 4","pages":"383-390"},"PeriodicalIF":0.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}