Journal of neurological surgery. Part A, Central European neurosurgery最新文献

{"title":"Endoscopic Endonasal Resection of a Pure Optic Canal Cavernous Malformation Presenting as Progressive Optic Neuropathy.","authors":"Daisuke Tanioka, Jyunichiro Kizaki, Ikuya Natori, Yusuke Kobayashi, Tsubasa Tanaka, Yoichi Morofuji, Seiya Fukuoka, Hidetoshi Onda, Mayumi Homma, Masafumi Takimoto","doi":"10.1055/a-2926-6052","DOIUrl":"https://doi.org/10.1055/a-2926-6052","url":null,"abstract":"<p><strong>Background and objective: </strong>Cavernous malformations (CMs) are relatively common in the brain parenchyma, whereas lesions strictly confined to the optic canal are exceptionally rare. Although only a few intracanalicular vascular malformations have been reported, detailed descriptions of pure optic canal CMs remain scarce. We report a pure optic canal CM successfully managed by endoscopic endonasal surgery to further highlight the surgical feasibility and clinical efficacy of this strategy.</p><p><strong>Case description: </strong>A 48-year-old woman presented with a 3-month history of progressive right visual decline that accelerated shortly before admission. Ophthalmological examinations showed decreased best-corrected visual acuity, a relative afferent pupillary defect, concentric visual field narrowing, and thinning of the ganglion cell layer on optical coherence tomography. Magnetic resonance imaging (MRI) demonstrated a well-circumscribed, homogeneously gadolinium-enhancing mass entirely within the right optic canal, whereas computed tomography showed no calcification or canal enlargement. Vision improved transiently after systemic corticosteroids but relapsed with tapering, suggesting a compressive lesion. Given the rapid progression of vision loss, endoscopic endonasal surgery was conducted.</p><p><strong>Results: </strong>Through a right nasal approach, the optic canal was unroofed and a dark-reddish, well-circumscribed lesion with minimal adhesion was removed en bloc. There was negligible blood loss and no intraoperative or postoperative cerebrospinal fluid leakage. A CM was confirmed by histopathology. Postoperatively, visual acuity and field recovered fully, and MRI confirmed gross total resection with complete decompression of the optic nerve.</p><p><strong>Conclusion: </strong>This case adds an additional well-documented example of a pure optic canal CM and supports the endoscopic endonasal approach as a safe and useful option for achieving complete resection with excellent visual recovery.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887904","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":"Surgery in the Semi-Sitting Position: A Worldwide Survey among Neurosurgeons.","authors":"Arif Abdulbaki, Osamah Almarzooq, Bipin Chaurasia, Amir Samii, Madjid Samii, Joachim K Krauss, Shadi Al-Afif","doi":"10.1055/a-2930-4165","DOIUrl":"https://doi.org/10.1055/a-2930-4165","url":null,"abstract":"<p><strong>Introduction: </strong>The semi-sitting position in neurosurgery remains a topic of debate. Despite advantages such as improved surgical accessibility and visibility, it is associated with risks such as venous air embolism. This study provides an overview of the current use, benefits, challenges, and future prospects of the semi-sitting position, based on insights from a sample of international neurosurgeons.</p><p><strong>Methods: </strong>A structured questionnaire was distributed via social media channels to neurosurgeons worldwide, collecting data on demographics, usage frequency, indications, reasons for use or nonuse, feared complications, alternative positions, and treated pathologies. Responses from 141 neurosurgeons were analyzed, comparing developed and developing countries.</p><p><strong>Results: </strong>Overall, 81.6% of neurosurgeons reported using the semi-sitting position, with a significantly higher frequency in developed countries (<i>p</i> < 0.001). A total of 97.9% of participants used this position for infratentorial pathologies. Major barriers included fear of complications (44.3%), insufficient anesthesia team training (42.9%), and lack of appropriate equipment (31.4%). Significant regional differences were observed, with training deficits (<i>p</i> = 0.007), lack of equipment (<i>p</i> = 0.001), and limited experience (<i>p</i> = 0.008) reported more frequently in developing countries. Perioperative monitoring practices showed variability; however, most modalities did not differ significantly between groups, including intraoperative transesophageal echocardiography (<i>p</i> = 0.091). Among nonusers, 44% expressed willingness to adopt the semi-sitting position with appropriate training and support.</p><p><strong>Conclusion: </strong>Despite its challenges, the semi-sitting position offers significant advantages for specific neurosurgical procedures. Successful implementation requires an experienced surgical and anesthesiology team. Efforts to enhance training, improve technology, and provide adequate infrastructure could facilitate broader adoption of the semi-sitting position.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887944","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":"Role of Multimodal Use of Surgery Adjuncts for Overall Survival of Patients with Supratentorial WHO Grade 4 Gliomas.","authors":"Tomasz Czernicki, Edyta Maj, Przemysław Kunert","doi":"10.1055/a-2926-6144","DOIUrl":"10.1055/a-2926-6144","url":null,"abstract":"<p><strong>Background: </strong>In recent years, numerous advanced techniques supporting surgery (TSS) have been utilized to maximize glioma resection. However, the impact of the multimodal use of TSS, such as awake surgery, intraoperative neurophysiological monitoring, neuronavigation, fluorescence-guided surgery, functional magnetic resonance imaging m(fMRI), and diffusion tensor tractography (DTT), on improving overall survival (OS) remains uncertain.</p><p><strong>Methods: </strong>In retrospective analysis of 81 patients with supratentorial WHO grade 4 gliomas, we assessed the effect of age, sex, tumor location, number of TSS used, extent of resection (EOR), postoperative Karnofsky performance scale (KPS), IDH1 status, and use of postoperative adjuvant therapy (PAT), i.e., radiotherapy and chemotherapy, on overall survival. Kaplan-Meyer plots with F-Cox test and Cox proportional hazards model were used for univariate and multivariate survival analyses.</p><p><strong>Results: </strong>We used none, one, two, three, or four TSS in 30, 20, 15, 9, and 7 patients, respectively. The number of TSS used (none vs. 1-2 vs. 3-4) correlated with OS in eloquent areas (<i>p</i> = 0.029, univariate; <i>p</i> = 0.006, multivariate) with median survival of 194, 364, and 674 days, respectively, whereas no correlation was observed in non-eloquent areas. In univariate analysis but not in multivariate analysis, significant factors for OS in gliomas in eloquent areas were younger age (<i>p</i> = 0.026), EOR (gross total vs. subtotal vs. partial resection) (<i>p</i> = 0.015), and PAT use (<i>p</i> = 0.00066), and in gliomas in non-eloquent areas were EOR (<i>p</i> = 0.01), postoperative KPS (≥70 vs. <70) (<i>p</i> = 0.023), and PAT use (<i>p</i> = 0.015).</p><p><strong>Conclusion: </strong>The simultaneous use of multiple TSS appears to be associated with improved overall survival in patients with supratentorial WHO grade 4 gliomas in eloquent areas, in contrast to non-eloquent areas.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648637","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":"Study of the Spread of Scarring along the Damaged Area of the Limb Nerve after Gunshot and Explosive Injuries.","authors":"Serhii Strafun, Serhii Savosko, Andrii Lysak, Olexandr Grabovyi, Anna Kyrpychova","doi":"10.1055/a-2797-9932","DOIUrl":"10.1055/a-2797-9932","url":null,"abstract":"<p><strong>Background: </strong>Determining the true size or extent of the nerve defect after damage and excision of the posttraumatic neuroma is fundamental in the microsurgical treatment of the patient. It is assumed that the length of the scar in the nerve may depend on the nature of the combat wound of the limb, gunshot, or mine-explosive. Determining the extent of scarring in the nerve in cases of these two types of injury may provide an opportunity to establish a relationship with the type of injury or to disprove such a relationship. This should help in the surgical treatment tactics.</p><p><strong>Methods: </strong>Fifty samples of damaged peripheral nerves were studied, including 36 nerves of the upper limb and 14 nerves of the lower limb. Microsurgical operations were performed after the injury in an average of 5.4 ± 0.4 months (min = 2 months, max = 17 months). The specifics of scarring in the nerve were investigated by histochemical method, and the specific density of collagen at different distances was calculated. A map of scarring was created for each nerve sample to determine the length of the scar.</p><p><strong>Results: </strong>Based on the mapping of nerve samples, the average length of the scar was determined, which reached 40 to 50 mm in the nerves (Me = 35.5 mm, Q1 = 30.0, Q3 = 55.2, min = 19 mm, max = 120 mm). That length was 37.5 ± 5.5 mm (mean = 30.0) after a gunshot wound and 43.5 ± 8.0 mm (mean = 36.0) after mine-explosive wound. Morphological features of nerve scarring after these two types of damage did not differ (<i>p</i> = 0.29), neither in length nor in scar density.</p><p><strong>Conclusion: </strong>When calculating the true defect of the nerve, one should take into account the spread of the scarring process in the nerve, which in a combat wound is approximately 30 to 50 mm. The length of the scar in the nerve does not depend on the nature of the striking projectile, which proves the critical importance of the energy of the injury.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097218","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":"Mini-Invasive Neurosurgical Treatment of Subdural Empyema: A Two-Patient Case Series.","authors":"Ejona Rifat Isakaj Lilamani, Aurora Arben Muça, Arben Jonuz Rroji, Artid Agron Lame, Arba Firdus Cecia, Mithat Ismail Demneri, Arsen Haki Seferi, Ridvan Hamid Alimehmeti","doi":"10.1055/a-2931-1083","DOIUrl":"https://doi.org/10.1055/a-2931-1083","url":null,"abstract":"<p><strong>Background: </strong>Subdural empyema is a neurosurgical emergency traditionally managed with craniotomy and prolonged intravenous antibiotic therapy. Minimally invasive approaches may represent an alternative in selected cases, particularly when combined with timely diagnosis and targeted antimicrobial treatment.</p><p><strong>Patients: </strong>We report two cases of subdural empyema treated with minimally invasive burr-hole evacuation.</p><p><strong>Case 1: </strong>A 22-year-old man with developmental anomalies and postischemic stroke history presented with intermittent high fever for 2 weeks. Rapid neurological deterioration over 24 hours led to coma (Glasgow Coma Scale 5). Cranial computed tomography (CT) revealed a right-sided subdural empyema with significant mass effect. Emergency burr-hole evacuation was performed, followed by broad-spectrum antibiotics later tailored to <i>Staphylococcus aureus</i>.</p><p><strong>Case 2: </strong>A 40-year-old man presented with hypertensive intracranial syndrome and febrile episodes for 1 week. CT and magnetic resonance imaging revealed a left hemispheric subdural collection suggestive of empyema, likely secondary to otitis media from suspected <i>Streptococcus anginosus</i>. Burr-hole evacuation and empiric triple antibiotic therapy were initiated.</p><p><strong>Results: </strong>In both cases, postoperative imaging confirmed complete evacuation without residual collection. The first patient required prolonged intensive care with gradual neurological improvement over several weeks, whereas the second patient achieved immediate postoperative recovery. At 2-year radiological follow-up, no recurrence was observed in either patient.</p><p><strong>Conclusion: </strong>Minimally invasive burr-hole evacuation, combined with culture-guided antibiotic therapy, can be effective in selected cases of subdural empyema, yielding favorable clinical and radiological outcomes.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850860","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":"Closed Manual Reduction of Bilaterally Jumped and Locked Cervical Facets under General Anesthesia: Technical Note.","authors":"Vincy Mathew, Sahar Sorek, Aaron Miller, Christina Moawad, Bruno Lazaro, Stephanie Moawad, Ralph Rahme","doi":"10.1055/a-2795-8415","DOIUrl":"10.1055/a-2795-8415","url":null,"abstract":"<p><strong>Background and importance: </strong>Closed reduction is an important adjunct in the surgical management of traumatic cervical facet dislocations, particularly jumped and locked facets. By restoring normal spinal alignment, successful closed reduction allows the surgeon to proceed with surgical stabilization via an anterior-first approach, obviating the need to rotate a dislocated, biomechanically unstable cervical spine, thereby minimizing the risk of iatrogenic spinal cord injury. While closed reduction has traditionally been achieved with Gardner-Wells tongs and weights, this reduction method requires the patient to remain bedbound for prolonged periods of time, is not MRI-compatible, and is associated with inconsistent results.</p><p><strong>Clinical presentation: </strong>We present two patients with bilaterally jumped and locked cervical facets, in whom a closed manual reduction technique was used, allowing rapid spinal realignment prior to surgical stabilization. We provide a detailed video illustration of this technique, emphasizing the steps involved and relevant technical nuances. While this technique might have been previously used and rarely reported, it has not, to the best of our knowledge, been described in a detailed, step-by-step fashion.</p><p><strong>Conclusion: </strong>Closed manual reduction of traumatic cervical facet dislocations can be performed safely and effectively in the operating room prior to definitive surgical stabilization of the spine. This technique should not be attempted in patients with severe spinal cord compression or neurologic compromise. The importance of adequate muscle relaxation provided by general anesthesia and continuous intraoperative feedback provided by live fluoroscopy and neurophysiologic monitoring cannot be overemphasized.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"369-374"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271981","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":"Evaluating Three-Dimensional Navigation versus Conventional Fluoroscopy for Posterior Cervical Foraminotomy: An Exploratory Cohort Comparison.","authors":"Christian Blume, Andrej Bitter, Guido Wapenhans, Patrick Weidle, Kerstin Jütten, Miguel Pishnamaz, Alexander Romagna, Ulf Bertram, Christian Andreas Mueller, Hans Clusmann, Tobias Philip Schmidt","doi":"10.1055/a-2790-3799","DOIUrl":"10.1055/a-2790-3799","url":null,"abstract":"<p><strong>Background: </strong>Unilateral monosegmental radiculopathy, caused by foraminal soft disc nerve root compression, can be treated with posterior cervical foraminotomy (PCF). Conventional fluoroscopy is widely used for level localization and verifying decompression extent intraoperatively. However, the failure rate increases, especially in obese patients and the lower cervical spine. Can intraoperative three-dimensional (3D) navigation improve outcomes in PCF compared with conventional fluoroscopy?</p><p><strong>Materials and methods: </strong>In this retrospective study, we analyzed two groups: 42 patients (mean age: 54 ± 10 years) who underwent PCF using intraoperative 3D navigation (study group) and 63 patients (mean age: 51 ± 11 years) who underwent PCF with conventional fluoroscopy (control group). Each cohort was divided into upper (C3-C6) and lower cervical spine (C6-T1) subgroups. Differences were explored by Mann-Whitney U and Friedman tests.</p><p><strong>Results: </strong>Both groups experienced significant postoperative symptom improvement, with no significant neurological differences. Subgroup analyses revealed no significant differences between surgeries in the upper (C3-C6) and lower (C6-T1) cervical spine. Only blood loss in the C3-C6 group differed significantly between control and study groups.</p><p><strong>Conclusion: </strong>Intraoperative 3D navigation was successfully used for PCF, resulting in significant symptom relief. Outcomes after PCF with 3D navigation appeared comparable to those achieved with conventional fluoroscopy, without statistical evidence of a clear advantage. Thus, technical complexity should be considered when selecting the surgical method.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"346-352"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368816","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":"Clinical Criteria for the Assessment of Permanent Cerebrospinal fluid Shunting after Endovascularly Treated Aneurysmal Subarachnoid Hemorrhage: The \"Endovascular Treatment and Risk of Shunt\" Score.","authors":"Bastian Stemmer, Stefan Schiele, Gernot Müller, Björn Sommer, Ehab Shiban, Dorothee Mielke, Volkmar Heidecke","doi":"10.1055/a-2848-6936","DOIUrl":"10.1055/a-2848-6936","url":null,"abstract":"<p><strong>Objective: </strong>An exact classification for estimating the risk of shunt-dependent hydrocephalus (SDHC) after endovascularly treated aneurysmal subarachnoid hemorrhage (aSAH) is still missing, although studies underline that the type of aneurysm care (clipping/coiling) has a decisive influence on the development of an SDHC.</p><p><strong>Methods: </strong>A total of 91 patients who underwent an endovascularly treated aSAH at the Department of Neurosurgery of the University Hospital Augsburg from January 2010 to July 2015 were selected. Clinical variables, radiographic features, and amount of cerebrospinal fluid (CSF) drainage via external ventricular drainage (EVD) were included in the scoring process. We determined the optimal cutoff values by an univariate logistic regression for each dichotomized variable and the Akaike Information Criterion (AIC). Finally, the \"Endovascular Treatment and Risk of Shunt\" (EROS) score was established.</p><p><strong>Results: </strong>A ventricular score >0.6 (<i>p</i> < 0.001), poor Glasgow Coma Scale (GCS) score (<10; <i>p</i> = 0.001), age over 46 years (<i>p</i> < 0.001), cerebral vasospasm (<i>p</i> < 0.001), and a CSF drainage volume over 180 mL per day (<i>p</i> = 0.001) in the first week of treatment, were identified to be risk factors of shunt dependency. Out of these independent risk factors, the EROS score was developed. The area under the receiver operating curve (AUROC score = 0.90) shows a good performance of this score. Patients with >3 points showed a significantly high risk of shunt dependency.</p><p><strong>Conclusion: </strong>The EROS score is easy to determine and showed a good predictive value in the investigated patient population. Prospective validation is still needed.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"319-328"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633607","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 May Not Reduce Reoperation Rates in Chronic Subdural Hematoma, Regardless of the Use of Antithrombotic Medication.","authors":"Johann Klein, Barbara Carl, Gabriele Schackert","doi":"10.1055/a-2841-9614","DOIUrl":"10.1055/a-2841-9614","url":null,"abstract":"<p><strong>Objective: </strong>Various studies have shown a beneficial effect of statins in patients with chronic subdural hematoma (cSDH) who do not require surgery. In surgical cohorts, however, the results of statin treatment in cSDH have been inconsistent, and meta-analyses showed no significant effect. It has been hypothesized that this lack of effect may be due to a higher proportion of patients in the statin group taking antithrombotic medication. Therefore, we designed a study to analyze the impact of statins on surgical cSDH patients who did not receive antithrombotic drugs.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of patients who received cSDH evacuation via burr-hole trepanation with the implantation of a subdural drain at our institution from 2012 through 2021. The data were pooled with a previously analyzed cohort to result in a two-center analysis. Patients who received antithrombotic medication were excluded. We separated the patients into a statin group and a control group based on whether they received a statin as part of their home medication and evaluated the rate of reoperations for any reason as the primary outcome parameter, and reoperations for residual hematoma and hematoma recurrence, respectively, as secondary outcome parameters.</p><p><strong>Results: </strong>We identified 614 patients in the total cohort, of whom 297 did not take antithrombotic medication. The mean age of these patients was 71.75 ± 13.27 years, and 195 were male (65.66%). A total of 42 patients took statins (14.14%). A reoperation was necessary in 5 patients in the statin group (11.90%) and 35 patients in the control group (13.73%), <i>p</i> = 0.749. Residual hematoma after the initial surgery was ascertained in 2 patients in the statin group (4.76%) and 17 in the control group (6.67%), <i>p</i> = 0.640, whereas 3 patients in the statin group (7.14%) and 18 patients in the control group (7.06%) experienced hematoma recurrence, <i>p</i> = 0.984. Logistic regression analysis revealed no significant associations with reoperation.</p><p><strong>Conclusion: </strong>We found no evidence of a beneficial effect of statins in patients undergoing surgery for cSDH, regardless of the use of antithrombotic medication.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"313-318"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264863","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":"Radiological and Surgical Findings of Patients with Intradiploic Mass Lesion: Case Series and Systematic Review.","authors":"Abdulkerim Gökoğlu, Hüseyin Yiğit, Merdan Orunoğlu, Turgut Tursem Tokmak, Ayça Erşen Danyeli, Erdoğan Unur, Ahmet Selçuklu","doi":"10.1055/a-2731-4781","DOIUrl":"10.1055/a-2731-4781","url":null,"abstract":"<p><strong>Background and objectives: </strong>In this study, our goal is to examine the radiological findings and clinical outcomes of nine patients with intradiploic masses, who were treated at our clinic, along with a comprehensive review of the existing literature.</p><p><strong>Methods: </strong>The study includes a total of nine adult patients, who were under follow-up and treatment for intradiploic masses from 2015 to 2022. Exclusions from the study criteria comprised patients in the pediatric age group, those with a documented history of cancer, prior cranial surgery, active central nervous system infection, and acute head trauma resulting in cranial damage.</p><p><strong>Results: </strong>Our study comprised a total of nine patients, with six females and three males, with a median age of 36 years (range: 18-76). Epidermoid cysts were identified in two patients, whereas others presented with cavernous hemangioma, arachnoid/leptomeningeal cyst, intradiploic lipoma, dermoid cyst, arachnoid cyst, fibrous dysplasia, and eosinophilic granuloma. Among the cohort, eight patients presented with headaches. The patient with cavernous hemangioma underwent total resection and mini-plate reconstruction. Similarly, total resection was performed in cases of leptomeningeal cyst (<i>n</i> = 1) and intradiploic lipoma (<i>n</i> = 1). In a single patient, fibrous dysplasia was diagnosed through open biopsy. For the patient with eosinophilic granuloma, total mass excision and chemotherapy were undertaken. Notably, four patients (44.4%), including those with epidermoid cysts (<i>n</i> = 2), dermoid cyst (<i>n</i> = 1), and arachnoid cyst (<i>n</i> = 1), were managed conservatively without surgical intervention.</p><p><strong>Conclusions: </strong>The use of computed tomography and magnetic resonance imaging in intradiploic lesions seems sufficient to differentiate the mass. However, it may be difficult to reach a definitive diagnosis in some patients without surgery. Therefore, based on the experience of clinical management, it is important to evaluate in detail the various radiological and clinical findings for further therapeutic decision making.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"353-368"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145377409","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}