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

{"title":"Collision Tumor of the Clivus: Chordoma and Chronic Lymphocytic Leukemia.","authors":"Marcos Ezequiel Yasuda, Shannon Hart, Jian-Qiang Lu, Almunder Algird","doi":"10.1055/a-2705-2937","DOIUrl":"10.1055/a-2705-2937","url":null,"abstract":"<p><p>Collision tumors, defined as the simultaneous occurrence of two distinct neoplasms within the same anatomical location, are exceptionally rare in the clivus. The coexistence of chordoma and chronic lymphocytic leukemia (CLL) within the clivus has not been previously reported, making this case particularly noteworthy.We present the case of a 69-year-old woman with a known history of stable CLL who presented with a 3-month history of progressive right-sided horizontal diplopia and hemianopsia. Imaging revealed a large sellar/suprasellar lesion with significant involvement of both cavernous sinuses, prompting surgical intervention. An endoscopic endonasal transsphenoidal and transclival approach was utilized to achieve near-total mass resection, with a small remnant left in the right cavernous sinus due to its proximity to the internal carotid artery. Histopathological examination confirmed the presence of a collision tumor composed of chordoma and CLL.This case represents the first reported instance of a collision tumor involving a chordoma and CLL within the clivus. The patient's postoperative course was uneventful, and she remains stable at 3-month follow-up after receiving adjuvant radiotherapy. The rarity of such a collision tumor underscores the need for heightened clinical suspicion and thorough pathological evaluation in cases presenting with atypical skull base lesions. The involvement of a multidisciplinary team was crucial in the management and favorable outcome of this complex case.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"235-240"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092094","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":"Predicting Postoperative Discharge Status and Readmissions in Spinal Metastatic Disease Using Machine Learning Models.","authors":"Renuka Chintapalli, Philip Heesen, Atman Desai","doi":"10.1055/a-2726-3336","DOIUrl":"10.1055/a-2726-3336","url":null,"abstract":"<p><p>Operative management of spinal metastatic disease is largely for symptom palliation rather than curative and revolves around the expectation that postoperative survival will exceed recovery time. While several scoring systems and models to predict survival exist, few studies have unified diverse predictors into integrated models to predict short-term postoperative outcomes as indicators of recovery.The Merative™ MarketScan® Commercial Database and the accompanying Medicare Supplement were queried for adult patients receiving surgery for extradural spinal metastatic disease between 2006 and 2023. Primary outcomes of interest were non-home discharge (NHD) and unplanned 90-day postdischarge readmission. Inpatient length of stay (LOS) was assessed as a secondary outcome. Five models (Extreme Gradient Boosting, Support Vector Machine, Neural Network, Random Forest, and Penalized Logistic Regression) were trained on a 70% training sample and validated on the withheld 30%.A total of 1,926 patients were included. Thoracic spine localization (vs. cervical, odds ratio [OR]: 2.83, 95% confidence interval [CI]: [1.74-4.58]) was associated with higher odds, while postresection arthrodesis (vs. no arthrodesis, OR = 1.24, [0.59-0.97]) and intraoperative neuromonitoring (vs. not, OR = 0.45, [0.31-0.66]) were associated with lower odds, of NHD. Utilizing a combined anterior and posterior approach (vs. anterior, OR = 0.50, [0.33-0.75]) and arthrodesis (OR = 0.96, [0.75-1.23]) were associated with lower odds of 90-day readmission. Similarly, using intraoperative neuromonitoring (B = - 1.84, [-2.72, -0.97]) or operating microscope (vs. not, B = - 1.71, [-2.66, -0.76]), postresection arthrodesis (B = - 0.17 [-2.66, -0.76]) were associated with shorter LOS, while thoracic localization (B = 1.67, [0.57, 2.76]) was associated with extended LOS. The random forest algorithm demonstrated the best overall predictive performance in the withheld validation cohort when assessing NHD (area under the curve [AUC] = 0.68, calibration slope = 0.82) and unplanned 90-day readmission (AUC = 0.67, calibration slope = 0.87).We developed and validated parsimonious predictive models to estimate the risk of NHD and 90-day readmission after surgery for extradural spinal metastatic disease. After integration into physician- and patient-facing interfaces, these models may serve as clinically useful decision tools to enhance prognostication and management.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"176-183"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Bibliometric Analysis of Neurosurgical Research in Africa: Trends, Challenges, and Future Directions.","authors":"Inibehe Ime Okon, Marianna E Kapsetaki, Olutayo Toriola, Bipin Chaurasia, Muhammad Kabir Musa, Arwa Salam Alabide, Don Eliseo Lucero-Prisno","doi":"10.1055/a-2679-5657","DOIUrl":"10.1055/a-2679-5657","url":null,"abstract":"<p><p>Neurosurgery in Africa has quite different realities compared to the developed countries, with emphasis on clinical procedures rather than research. The aim of this study was to conduct a bibliometric analysis of neurosurgical research to understand the trends across Africa. We examined the scientific production, collaboration, and publication impact of African institutions from 2010 to 2024. This bibliometric analysis provides information on the statistical tendencies, challenges, and recommendations to improve engagement in neurosurgical research in Africa.Following the Preferred Reporting Items for Bibliometric Analysis (PRIBA) guidelines, a PubMed search was conducted starting on October 9, 2024, where 1,431 publications affiliated with neurosurgical institutions were found. The bibliometric analysis was done using the <i>bibliometrix</i> package from <i>RStudio</i> 4.4.1 version, which involved analyzing the annual scientific production (evaluated in 5-year increments), the countries' scientific production and collaborations, and the most productive affiliations and journals in the context of neurosurgical research in Africa.Egypt, Nigeria, and South Africa are the major contributors to neurosurgical research in Africa, with an upward trend in publications predominantly seen in 2023. These countries' most prevalent collaborators are the United States, India, and Burundi, respectively. Regarding the journals, <i>World Neurosurgery</i>, <i>Child's Nervous System</i>, and <i>Neurosurgical Review</i> were the ones that mostly published Africa-affiliated neurosurgical papers.Amid the challenges, research endeavors in the field of neurosurgery in Africa have yielded some progress, as seen by the upward trend in publication output and the international collaborations among researchers. Recommendations include the need to further strengthen collaborations internationally, infrastructural improvements, and quality enhancement of local research outputs to meet global standards.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"184-191"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513136","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":"The New Surface-Modified Flow Diverter p48 MW HPC Device Implanted in Arteries under 2.0 mm Diameter for Treatment of Distal Intracranial Aneurysms.","authors":"Pedro Lucas Moreira Fernandes, Luis H de Castro-Afonso, Guilherme Seizem Nakiri, Ricardo Santos de Oliveira, Benedicto Oscar Colli, Daniel Giansante Abud","doi":"10.1055/a-2697-4429","DOIUrl":"10.1055/a-2697-4429","url":null,"abstract":"<p><p>Preliminary studies on the new modified surface flow diverters (FD) have shown promising results in the treatment of distal aneurysms. However, there is a lack of data in the literature regarding the use of these devices in very small-caliber arteries. The aim of this study was to analyze the safety and efficacy of the p48 MW HPC device (Wallaby-phenox, Bochum, Germany) device in the treatment of intracranial aneurysms associated with parent arteries with a diameter of <2.0 mm.Sixteen patients were prospectively evaluated from November 2019 to July 2023. All patients underwent follow-ups at 1, 6, and 12 months. Safety was assessed using the modified Rankin Scale and the National Institutes of Health Stroke Scale. Efficacy was defined as complete (grade D) or partial (grade C) aneurysm occlusion, as assessed by the O'Kelly-Marotta scale (OKM).The mean proximal and distal artery diameters were 1.61 mm (1.3-1.9) and 1.5 mm (1.0-1.8), respectively. All procedures were performed with technical success, and no severe adverse events occurred. At the 12-month follow-up, no patients experienced serious adverse events, new neurological symptoms, or deficits. At this stage, seven aneurysms were completely occluded (OKM grade D: 43.7%), and four aneurysms showed entry remnant contrast (OKM grade C: 25%).The treatment of distal unruptured aneurysms with the p48 MW HPC device device appears to be safe in vessels with a diameter of <2 mm. Larger studies with long-term follow-ups are necessary to better clarify the outcomes reported.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"207-212"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513195","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":"Additional Lateral Intermuscular Access to Standard Costotransversectomy Increases Surgical Operability and Exposure in the Resection of Large Median Thoracic Disc Herniations.","authors":"Filippo Gagliardi, Pierfrancesco De Domenico, Enrico Garbin, Martina Piloni, Silvia Snider, Francesca Roncelli, Pietro Mortini","doi":"10.1055/a-2726-3463","DOIUrl":"10.1055/a-2726-3463","url":null,"abstract":"<p><p>Thoracic disc herniations still represent a challenge for spinal surgeons. Their intimate relationship with the spinal cord and the difficult access to the target area are limiting factors even in expert hands.We describe a novel technical variant of the standard costotransversectomy (CTT) approach that utilizes an additional intermuscular corridor between the longissimus and iliocostalis muscles to access the central portion of the spinal canal.An anthropometric study was conducted on neuroimaging in the general population to quantify the working distance, the maneuverability arc, and the surgical angle of incidence recorded on the central canal compartment, as provided by the proposed additional lateral intermuscular access (ALIA) in the CTT approach. The described technique has been applied in the clinical setting. We here report an illustrative case.ALIA allows additional access to the central canal compartment with comparable exposure and surgical operability as those provided by the minimally invasive extracavitary approach (ECA). By respecting the regional muscular and vascular anatomy, it potentially reduces the risk of devascularization damage associated with the standard ECA. The combination of a median and a lateral exposure maintains the advantage of ECA multiangularity, allowing, where necessary, canal decompression and the possibility of easily instrumenting the spine segment.Combining ALIA with a standard CTT optimizes exposure and surgical operability on the central canal compartment, as after performing a standard ECA, but avoiding extensive dissection of the paravertebral tissues and muscles. Median complex thoracic disc herniations represent the main indication for this technical variant.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"229-234"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276483","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":"Operative Technique in a Resection of Solitary Fibrous Tumor within the Sigmoid Sinus: Technical Note and Case Presentation.","authors":"Akinari Yamano, Masahide Matsuda, Keiji Tabuchi, Eiichi Ishikawa","doi":"10.1055/a-2697-4122","DOIUrl":"10.1055/a-2697-4122","url":null,"abstract":"<p><p>Intracranial solitary fibrous tumors (SFTs) are rare mesenchymal tumors often presenting with dural-based lesions. These tumors can exhibit aggressive characteristics with high recurrence rates and extracranial metastasis. While SFTs occasionally invade venous sinuses, cases where the tumor arises within the venous sinus are rare. This case explores the surgical strategy for removing SFTs occupying the sigmoid sinus and the jugular bulb while preserving the flow of the vein of Labbé.A 59-year-old woman with progressive left hearing loss and facial nerve palsy was diagnosed with a left temporal bone tumor mainly located in the sigmoid sinus and the jugular bulb. Imaging revealed a vascularized tumor with occlusion of the left sigmoid sinus, and the vein of Labbé was preserved via retrograde perfusion of the transverse sinus. After preoperative embolization, surgery was performed using a trans-sigmoid approach. The tumor was carefully extracted, and the sigmoid sinus was ligated distant from the transverse-sigmoid junction to avoid the occlusion of the vein of Labbé outlet. Subtotal resection was achieved, and the patient experienced full recovery from facial paralysis within 3 weeks. Postoperative radiotherapy was administered, and no recurrence was observed 1 year later.SFTs arising within venous sinuses are rare but require thorough surgical planning, especially near critical venous structures like the vein of Labbé. This case highlights the feasibility of the operative technique of extracting the tumor from venous sinuses and the importance of individualized strategies for maximizing resection while preserving neurological function and venous patency.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"220-223"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029975","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":"Duraplasty with Autologous Blood: A Cost-Effective and Efficient Alternative to Medical Products.","authors":"Ersin Haciyakupoglu, Evren Yüvrük, Dervis Mansuri Yilmaz, Sait Polat, Sebahattin Haciyakupoğlu","doi":"10.1055/a-2705-2876","DOIUrl":"10.1055/a-2705-2876","url":null,"abstract":"<p><p>The aim of this experimental study was to investigate the effects of autologous plasma used as an alternative to duraplasty.We operated 21 patients and 8 New Zealand Rabbits and performed duraplasty with autologous blood. First, heparin was added to autologous blood withdrawn from the patient/rabbit. The sample was then centrifuged to obtain plasma. Protamine sulfate was added to the plasma. This mixture was then applied to the dural space and tumor cavity, resulting in fibrin formation within 2 to 3 minutes. All 21 patients had magnetic resonance imaging (MRI) scans 1 month after surgery to show neodura formation. Three of our patients and all rabbits were operated at least a month later, and the biopsy was taken to show the neodura formation microsopically.In MRI scans, as well as in biopsies, we have detected the neodura formation. In rabbits that underwent experimental craniotomy and duratomy, neodura had formed as a weak, thin membrane that did not show continuity into the defect area after one month. In the control group, the distribution of collagen fibers appeared relatively normal in areas close to the intact dura. However, further from this area, the regular structure was disrupted, edematous areas had formed in the fibrous layers, and bone fragments were separated from the endosteal layerThe hypothesis of this study was that plasma obtained from the patient's own arterial blood could serve as an alternative to traditional duraplasty materials. Plasma possesses many of the properties required for duraplasty material and can be a cost-effective, readily available option. Results demonstrate that autologous plasma does not induce significant histological changes and shows excellent biocompatibility with brain parenchyma. Therefore, autologous plasma can be considered a reliable and safe tissue sealant. It is easy to prepare and apply, remains stable in the operating room for 1 to 2 hours, and can be adjusted in size and thickness according to the dural defect and tumor cavity dimensions.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"169-175"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Technique for Stereotactically Guided Burr Hole Trephination Simplifies the Workflow of Stereotactic Surgery.","authors":"Laura Mühlhausen, Veerle Visser-Vandewalle, Maximilian I Ruge, Daniel F Ruess","doi":"10.1055/a-2697-3953","DOIUrl":"10.1055/a-2697-3953","url":null,"abstract":"<p><p>Stereotactic procedures usually require burr hole trephination. To date, there is no Conformité Européenne-certified drilling system that can be integrated into a stereotactic apparatus, thus enabling stereotactically guided trephinations (SGTs). Therefore, free-hand burr hole trephination is the standard of care, often requiring time-consuming burr hole widening.We developed a novel drill, which can be picked up through a standard cordless drill and a novel guide sleeve (Instrument guide inner diameter: 10 mm for Riechert-Mundinger [RM] rail holder for microprobe insertion), which can be easily integrated into a stereotactic RM-system. This device enables stereotactic guidance of the drill. Over a period of 8 months, we recorded the trephination in all patients who underwent stereotactic-guided biopsy or catheter insertion in our department. In the first 4 months, a freehand trephination (FHT) using a standard trepan was performed; in the second half of the period, the novel SGT was performed. An unpaired <i>t</i>-test and chi-square test were used to compare SGT with FHT in terms of time for trephination, time from trephination to dura incision, and whether additional surgical measurements (osteoclastic enlargement, hemostasis) were necessary.Overall, 84 trephinations (SGT: <i>n</i> = 27, FHT = 57) for stereotactic biopsies were included. The mean time for completing the burr hole showed no difference between the groups (SGT: 64 s, FHT: 55 s, <i>p</i> = 0.485). The mean time until dura incision was significantly (<i>p</i> = 0.018) reduced when using SGT (FHT: 304 ± 170 s vs. SGT: 136 ± 89 s). Additional osteoclastic expansion was frequently necessary in the FHT group (81% [<i>n</i> = 46] vs. 3.7% [<i>n</i> = 1], <i>p</i> < 0.001). Similar results were observed for hemostasis, which was significantly less necessary in the SGT group (71% [<i>n</i> = 41] vs. 40% [<i>n</i> = 11], <i>p</i> = 0.006). We did not observe any difference between board-certified neurosurgeons and trainees for all these parameters.SGT significantly shortens the time until dura opening compared to FHT. Additionally, time-consuming hemostasis and osteoclastic entlargements are no longer necessary when using SGT. Furthermore, SGT seems to be successfully applied regardless of the surgeon's level of training.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"224-228"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549651","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":"Clinical and Radiological Analyses of Anterior Cervical Discectomy and Fusion Involving One to Three Levels without Additional Plate Fixation: A Single-Center Experience.","authors":"Alexander Romagna, Christoph Schwartz, Reuben Christopher, Martin Geroldinger, Dana Dinzenhofer-Kessler, David Schul, Andre Tomasino","doi":"10.1055/a-2697-4029","DOIUrl":"10.1055/a-2697-4029","url":null,"abstract":"<p><p>This study aimed to evaluate clinical and radiological outcomes of patients who underwent anterior cervical discectomy and fusion (ACDF) without additional anterior plate fixation.A retrospective, single-center analysis was conducted. Clinical outcomes were assessed by the Visual Analog Scale (VAS) scores, Neck Disability Index (NDI), and Odom's criteria. Radiological outcomes were evaluated based on changes in segmental disc height (subsidence), and Cobb angle by X-rays. Fusion was defined as a consistent distance between spinous processes.The study population consisted of 98 patients (mean age of 55.8 years) with a follow-up of 22.1 months. Procedures included 55 one-level, 33 two-level, and 10 three-level surgeries. The study results demonstrated good clinical outcomes, with statistically significant reductions in NDI scores with notable improvements in VAS (<i>p</i> < 0.001). Radiologically, we recorded a subsidence and reduction in Cobb angle of 1.6 mm/2.2 degrees in one-level, 3.8 mm/3.0 degrees in two-level, and 2.5 mm/2.4 degrees in three-level surgeries, respectively. Complete postoperative fusion was recorded for 86.7% patients, comprising rates of 87.3% for one-level, 90.9% for two-level, and 70.0% for three-level procedures. No revision surgery had to be performed.ACDF without additional plating appears to be an effective procedure for the surgical treatment of single- and multilevel degenerative cervical disease with good clinical outcome.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"161-168"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029938","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":"The Three-Dimensional Growth of Traumatic Intracerebral Hemorrhage in Patients with Abnormal Coagulation.","authors":"Jakob Rossmann, Johannes Falter, Julius Höhne, Christoph Hohenberger, Lisa Bründl, Nils Ole Schmidt, Karl Michael Schebesch, Sylvia Bele","doi":"10.1055/a-2737-7527","DOIUrl":"10.1055/a-2737-7527","url":null,"abstract":"<p><p>The goal of the present study was to compare the volumetric three-dimensional growth of traumatic intracerebral hemorrhage (tICH) in patients with and without abnormal coagulation and to question the necessity to perform repeated CT scans in all those patients.We retrospectively analyzed CT scans from 50 patients with tICH. Abnormal coagulation was defined by the results of standard coagulation tests at admission, including Factor XIII. The three-dimensional size of the hemorrhage was measured at admission, within 48 hours, and 2 weeks.Growth of the tICH was detected in 56% of the patients. In the group with normal coagulation (n = 30 patients), growth could only be detected in 10 (33.34%) patients, whereas in the abnormal coagulation group, volume increase occurred in 18 of 20 patients (90%). The mean growth was 3.46 mL (95% CI:±2.99 mL) and varied from 0.1 mL (95% CI: ±1.57) in the normal coagulation group to 8.52 mL (95% CI: ±6.67 mL) in the coagulation disorder group.This study demonstrates the need to perform repeated CT scans in patients with coagulation disorders since patients with tICH and coagulation abnormalities are likely to experience substantial growth of the hemorrhage.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"192-196"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458821","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}