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

{"title":"Vestibular Schwannomas in Pregnancy: A Case Series.","authors":"Jie Lily Huang, Hesham Khalid, Robert Chessman, Veronica Barnes, Andrew J Martin, Parag M Patel","doi":"10.1055/a-2561-7655","DOIUrl":"10.1055/a-2561-7655","url":null,"abstract":"<p><strong>Objectives: </strong>Vestibular schwannomas (VS) are benign intracranial tumors, the majority of which are indolent and managed conservatively with active surveillance. VS during pregnancy is rare and poorly understood. It is unclear whether hormonal changes during pregnancy contribute to VS growth. Currently, the largest case series describing VS during pregnancy comprises six cases from the Mayo Clinic in 1993, where they note that tumors tend to be larger and associated with higher surgical morbidity. We present five further cases of peripartum VS and their management strategies.</p><p><strong>Design: </strong>A retrospective review of 540 consecutive patients with sporadic VS at St George's Hospital from 2017 to 2023 was performed.</p><p><strong>Setting: </strong>St George's Hospital is a tertiary hospital in London providing joint neurosurgical and ENT management of VS.</p><p><strong>Participants: </strong>A total of 280 out of 540 patients were female (52%), and 5 were either pregnant at presentation or had given birth within 6 months of presentation (1%).</p><p><strong>Main outcome measures: </strong>Maternal/infant well-being, postoperative complications, and facial nerve function were our main outcome measures.</p><p><strong>Results: </strong>All patients had tumors >30 mm requiring translabyrinthine resection. One underwent VS resection with intraoperative lactation breaks 1 week following elective cesarean section. Two required cerebrospinal fluid (CSF) shunts to delay resection. One had her resection while 21 weeks pregnant. All had intact postoperative facial nerve function and healthy babies. One experienced a CSF leak requiring a lumbar drain.</p><p><strong>Conclusion: </strong>Because pregnancy tends to be associated with large tumors and surgery is complicated by obstetric considerations, appropriate counselling should be given to women of childbearing age.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"131-136"},"PeriodicalIF":0.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433669","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":"Pitfalls in Trigeminal Nerve Mapping in Neurosurgery: The Mystery of the Unexpected Motor Responses.","authors":"Jose David Siado Mosquera, Ana Mirallave Pescador, Alba Diaz Baamonde, Jonathan Shapey, Sian Ebony Murace, Emily Clare Lawson, Arjel Lejarde, Sinan Barazi","doi":"10.1055/a-2561-7866","DOIUrl":"10.1055/a-2561-7866","url":null,"abstract":"<p><strong>Objective: </strong>Intraoperative neurophysiological mapping can help identify the trigeminal nerve (TN) during surgeries where it is at risk. Low-stimulating currents may only recruit sensory branch stimulation and trigger reflex responses, potentially complicating interpretation during monitoring. This report aims to address this issue by examining cases to categorize TN responses in relation to varying stimulation intensities, identify stimulation patterns, and clarify common response characteristics in surgical contexts.</p><p><strong>Methods: </strong>Seven cerebellopontine (CP) angle surgery cases with TN exposure were studied. Concentric bipolar stimulation was applied over the TN from 0.05 to 4 mA, and responses were recorded from various muscles innervated by the cranial nerves under monitoring (V, VII, IX, X, XI, XII).</p><p><strong>Results: </strong>Low stimulation currents (particularly below 0.5 mA) may elicit reflex responses over hypoglossal and facial innervated muscles, more often than motor responses, when the TN is stimulated.</p><p><strong>Conclusion: </strong>A stimulation protocol starting at 0.05 mA and increasing to at least 1 mA or until compound muscle action potentials are observed in trigeminally innervated muscles is recommended for accurate TN mapping in CP angle surgery. These results may be helpful to avoid misinterpreting reflex responses in non-TN-innervated muscles.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"137-143"},"PeriodicalIF":0.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433594","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 Abstract of the North American Skull Base Society.","authors":"","doi":"10.1055/s-0045-1806731","DOIUrl":"10.1055/s-0045-1806731","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/s-015-61030.][This corrects the article DOI: 10.1055/s-0045-1803328.][This corrects the article DOI: 10.1055/s-0045-1803567.][This corrects the article DOI: 10.1055/s-0045-1803688.][This corrects the article DOI: 10.1055/s-0045-1803219.][This corrects the article DOI: 10.1055/s-0045-1803252.].</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"86 Suppl 1","pages":"e2"},"PeriodicalIF":0.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11945205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753096","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":"June 4: International Skull Base Surgery Day.","authors":"David A Gudis, Benjamin S Bleier, Jean Anderson Eloy, James J Evans, Juan Carlos Fernandez-Miranda, Paul A Gardner, Mathew Geltzeiler, Jessica W Grayson, Richard J Harvey, Elisa A Illing, David W Kennedy, Cristine Klatt-Cromwell, Edward C Kuan, Jivianne Lee, Michael J Link, James K Liu, Patricia Loftus, Nyall R London, Erin L McKean, Kibwei A McKinney, L Madison Michael, Gurston G Nyquist, Zara M Patel, Mindy Rabinowitz, Sanjeet V Rangarajan, Kenneth D Rodriguez, Nicholas R Rowan, Rodney J Schlosser, Kafui Searyoh, Raymond F Sekula, Timothy L Smith, Carl Snyderman, Satyan B Sreenath, Dennis M Tang, Brian D Thorp, Eric W Wang, Marilene B Wang, Bradford A Woodworth, Garret Choby","doi":"10.1055/a-2538-4080","DOIUrl":"10.1055/a-2538-4080","url":null,"abstract":"","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"86 3","pages":"243-244"},"PeriodicalIF":0.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025790","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":"Immersive Neurosurgical Anatomy Using Photogrammetry: Technical Note and Scoping Review.","authors":"Jhon E Bocanegra-Becerra, Daniel Ballesteros-Herrera, Khaled Alhwaishel, Marcio Yuri Ferreira, Vanessa Emanuelle Cunha Santos, Cristian D Mendieta, Gabriel Semione, Kim Wouters, Sávio Batista, José E Chang, Raphael Bertani, Miguel Angel Lopez-Gonzalez","doi":"10.1055/a-2538-3745","DOIUrl":"10.1055/a-2538-3745","url":null,"abstract":"<p><strong>Introduction: </strong>Photogrammetry holds promise for expanding the domains of microsurgical education. The authors present a technical note and scoping review that explore the use of photogrammetry in neurosurgical anatomy, existing technical guidelines, and areas of implementation.</p><p><strong>Methods: </strong>Photogrammetry was employed to build three-dimensional models of the anatomy of the white matter tracts, brainstem, cranial nerves, and the retrosigmoid approach using human brain and skull specimens. In addition, a scoping review was performed on three databases (PubMed, Scopus, and Embase). Information was collected regarding human models, software, hardware, assessment of high-fidelity reconstruction, and anatomic depth estimation.</p><p><strong>Results: </strong>The illustrative models achieved a high-quality representation of the white matter tracts, brainstem, cranial nerves, and anatomy in the retrosigmoid approach.Our scoping review yielded 3,620 articles, of which 28 were included in the analysis. Photogrammetry was described in three technical stages: image acquisition, processing, and visualization. About 75% of studies reported high-fidelity image reconstruction, and only 42.9% of articles performed anatomic depth estimation. Concerning microsurgical anatomy education, photogrammetry has primarily rendered digital models of the cranial region (96.4%). During educational sessions, the most common surgical approaches described the orbitozygomatic (20%), endoscopic endonasal (20%), translabyrinthine (13.3%), retrosigmoid (13.3%), and Kawase (13.3%) approaches.</p><p><strong>Conclusion: </strong>Photogrammetry offers an innovative approach to creating portable and virtual anatomical models with high-fidelity and vivid representations of human specimens. The resulting three-dimensional models can provide real proportions to teach visuospatial skills in neurosurgery. However, significant challenges remain to achieve objective accuracy and anatomic depth perception, which are critical for microsurgical education.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"234-245"},"PeriodicalIF":0.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433576","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":"Multi-Institutional Modified Delphi For Genomics in Expert Consensus Survey of Genomic Testing for Anterior Skull Base Malignancies.","authors":"Anirudh Saraswathula, Shreya Sriram, Corinna Levine, Nyall R London, Shirley Y Su, Mathew Geltzeiler, Sanjeet V Rangarajan, Ian Witterick, Brian Thorp, Kathleen Kelly Gallagher, Kenneth Byrd, Ricardo Carrau, Waleed Abuzeid, Eric Wang, Carl Snyderman, Erin L McKean","doi":"10.1055/a-2531-2230","DOIUrl":"10.1055/a-2531-2230","url":null,"abstract":"<p><strong>Objectives: </strong>The use of genomic testing for patients with anterior skull base malignancies has grown dramatically. There are no clear guidelines on indications for testing. As the literature on the subject is still in early stages, there is a need for expert consensus. We conducted a modified Delphi expert consensus process with high-volume North American cranial base surgical programs.</p><p><strong>Design setting participants: </strong>A modified Delphi consensus approach was used, following the method laid out by the American Academy of Otolaryngology-Head and Neck Surgery, and included 13 high-volume care centers. An otolaryngologist was appointed at each location to serve as the institutional representative.</p><p><strong>Main outcome measures: </strong>Participant responses to Delphi surveys were tabulated to determine consensus.</p><p><strong>Results: </strong>Thirteen teams responded comprising 23 otolaryngologists and 10 neurosurgeons. Overall, 11 of 12 institutions reported genomic testing to be fairly or easily available at their location, and 22 of 38 initial statements achieved consensus. Statements achieving consensus focused on primary and recurrent rare tumors without possibility of margin-negative resection, those with family history of anterior skull base malignancies, or rare tumors with distant metastasis. Statements regarding routine genomic sequencing or for primary tumors and cost of care did not achieve consensus.</p><p><strong>Conclusion: </strong>Expert multidisciplinary teams agreed on several appropriate settings for genomic sequencing in patients with anterior skull base malignancies, including recurrence, distant metastasis, and the inability to achieve a margin-negative resection. Further research is needed to explicitly clarify the role of genomic sequencing in this rare disease group.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 1","pages":"14-22"},"PeriodicalIF":0.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917813","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":"Multi-Center, Multi-National Outcomes Following Endoscopic Endonasal Resection of Nonfunctional Pituitary Adenomas.","authors":"Robert G Briggs, Dhiraj J Pangal, Shane Shahrestani, David J Cote, Stephanie K Cheok, Jacob Ruzevick, Ben A Strickland, Martin J Rutkowski, Ilaria Bove, Jeffrey J Feng, Ishan Shah, David Gomez, Kyle M Hurth, Mark Shiroishi, Bozena Wrobel, John D Carmichael, Alexander Micko, Stefan Wolfsberger, Engelbert Knosp, Luigi Cavallo, Paolo Cappabianca, Edward R Laws, Gabriel Zada","doi":"10.1055/a-2538-3928","DOIUrl":"10.1055/a-2538-3928","url":null,"abstract":"<p><strong>Objective: </strong>Nonfunctioning pituitary adenomas (NFPA) are common, benign lesions of the pituitary gland. The endoscopic endonasal approach (EEA) has improved their treatment. Large multi-center data across different healthcare systems on outcomes following EEA resection of NFPA are limited. We aimed to provide highly generalizable benchmark outcomes from an international, multi-center review of EEA for NFPA resection.</p><p><strong>Methods: </strong>Institution-level data on symptoms, tumor and intraoperative characteristics, complications, and long-term outcomes were obtained from four tertiary pituitary centers located in the United States (2), Italy (1), and Austria (1). Means and weighted averages were used to generate descriptive statistics of patient characteristics and outcomes.</p><p><strong>Results: </strong>A total of 1,097 patients who underwent EEA for NFPA were included (mean age: 55.3 years). Presenting symptoms included vision loss (55.2%) and headache (42.1%). The most common preoperative endocrinopathies were hyperprolactinemia (26%) and hypothyroidism (18%). The gross total resection rate was 66%. Patients presenting with headache and visual symptoms experienced improvement (81 and 89%, respectively). Common complications included delayed hyponatremia (7.5%), transient arginine vasopressin deficiency (AVP-D; 6.6%), cerebrospinal fluid leak (3.5%), new endocrinopathy (3.5%), and new cranial nerve palsy (0.8%). There were no instances of carotid artery injury. Stroke (0.4%) and death (0.1%) were exceedingly rare. During the mean follow-up of 30 months, <5% of patients underwent reoperation or radiation-based treatments.</p><p><strong>Conclusion: </strong>In this large, international series, EEA proved a safe and effective intervention that was generalizable across centers in the United States and Europe. Severe complications were rare, and significant improvements in headache and vision loss were noted in most patients.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"151-156"},"PeriodicalIF":0.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433599","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":"Intraosseous Pseudoprogression vs. Progression and Recurrence of Clival Chordoma after Proton Radiation Therapy: Case Series.","authors":"Sukwoo Hong, Yuki Shinya, Anita Mahajan, Nadia N Laack, Aditya Raghunathan, Ian T Mark, Jamie J Van Gompel","doi":"10.1055/a-2538-3865","DOIUrl":"10.1055/a-2538-3865","url":null,"abstract":"<p><strong>Objective: </strong>To propose a novel entity of possible intraosseous pseudoprogression in clival chordoma following proton radiation therapy (PRT).</p><p><strong>Methods: </strong>A total of 38 consecutive patients who underwent surgical resection followed by PRT for clival chordoma between January 2015 and December 2023 were analyzed retrospectively. Follow-up magnetic resonance imaging (MRI) suggesting recurrence or progression was evaluated for validity. Apparent diffusion coefficient (ADC) and tumor-to-brainstem signal intensity ratio on contrast-enhanced T1-weighted imaging (Rce) were assessed. Pseudoprogression was defined as (1) MRI signs of recurrence or progression with no pathological confirmation despite obtaining a specimen, or (2) MRI signs of recurrence or regression with spontaneous resolution/regression.</p><p><strong>Results: </strong>Of the 11 patients with MRI findings suggestive of recurrence or progression, 3 were diagnosed with recurrence, 5 with progression, and 3 with pseudoprogression. Patients with pseudoprogression were significantly younger than those with progression ( <i>p</i>  = 0.04), and all were female. The median time to recurrence, progression, and pseudoprogression was 31, 29, and 21 months, respectively. The three pseudoprogression cases were managed with gross-total resection followed by stereotactic radiosurgery, extensive biopsy, and observation, respectively. Although statistical significance was not reached, ADC ( <i>p</i>  = 0.33) and Rce ( <i>p</i>  = 0.13) tended to be higher in pseudoprogression cases.</p><p><strong>Conclusion: </strong>After PRT for clival chordoma, intraosseous pseudoprogression should be considered in the differential diagnosis, particularly in relatively young female patients, although the role of ADC and Rce on MRI remains inconclusive. Multidisciplinary teams managing chordomas should take this into account when determining the aggressiveness of treatment in such cases.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"173-181"},"PeriodicalIF":0.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433581","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":"Incidence and Risk Factors for Postoperative Pulmonary Complications in Endoscopic Skull Base Surgery.","authors":"Nana-Hawwa Abdul-Rahman, Carl H Snyderman","doi":"10.1055/a-2531-2417","DOIUrl":"10.1055/a-2531-2417","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the incidence and risk factors for postoperative pulmonary complications (PPCs) following endoscopic endonasal surgery (ESS).</p><p><strong>Design: </strong>Retrospective review from January 2023 to May 2023.</p><p><strong>Setting: </strong>Tertiary academic center.</p><p><strong>Participants: </strong>One hundred EES cases, of which 97 met the inclusion criteria.</p><p><strong>Main outcome measures: </strong>The primary outcome was the incidence of PPC. Univariable and multivariable analyses were used to assess preoperative variables, demographics, and respiratory comorbidities; intraoperative variables of surgery and duration of intubation, endotracheal tube (ETT) size, estimated blood loss (EBL), gastric tube use during surgery; postoperative cerebrospinal fluid (CSF) leak, and length of hospital stay as predictors of PPC.</p><p><strong>Results: </strong>Ninety-seven patients met the inclusion criteria. Twenty-nine developed PPC including increased oxygen requirement (14.4%), pneumonia (9.3%), atelectasis (3.1%), respiratory failure (2.1%), and pulmonary embolism (2.1%). Sixty-four percent were clinically significant PPC. PPC was associated with age ( <i>p</i>  < 0.007), longer duration of surgery ( <i>p</i>  < 0.001), longer duration of intubation ( <i>p</i>  < 0.001), postoperative intubation ( <i>p</i>  < 0.001), higher EBL ( <i>p</i>  = 0.022), and longer length of hospital stay ( <i>p</i>  < 0.001). There was no significant association between PPC and sex ( <i>p</i>  = 0.705), body mass index (BMI; <i>p</i>  = 0.403), gastric tube presence ( <i>p</i>  = 0.778), ETT size ( <i>p</i>  = 0.636), and preoperative history of pulmonary disease ( <i>p</i>  = 0.403).</p><p><strong>Conclusion: </strong>The incidence of PPC in patients undergoing EES is significant. Targeting perioperative risk factors including age ≥65, duration of intubation, postsurgical intubation status, and intraoperative blood loss should have a meaningful impact on decreasing PPC. The contribution of silent intraoperative aspiration during surgery needs to be investigated further in high-risk patient populations.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 1","pages":"50-56"},"PeriodicalIF":0.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917793","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":"A Guide to Intracranial Bypass Suture.","authors":"Sonia Ajmera, Svetlana Kvint, Christopher S Graffeo, Ronald R Barbosa, Visish M Srinivasan","doi":"10.1055/a-2531-2506","DOIUrl":"10.1055/a-2531-2506","url":null,"abstract":"<p><strong>Introduction: </strong>Cerebrovascular bypass surgery is technically demanding, with dozens of modifiable parameters influencing operative decision-making. Thoughtful selection of needle and suture materials is critical to success in these operations.</p><p><strong>Methods: </strong>Based on the authors' experiences and existing literature, a brief guide to needle and suture selection is provided.</p><p><strong>Results: </strong>Recommendations for needle and suture have taken into consideration key features of bypass constructs, such as bypass type, vessel caliber, and working space. Specific suture and needle are highlighted from two of the most common industry suppliers.</p><p><strong>Conclusion: </strong>This guide synthesizes clinical insights and practical guidelines to support neurosurgical trainees and practitioners in mastering cerebrovascular bypass techniques.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 1","pages":"84-87"},"PeriodicalIF":0.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917838","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}