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

{"title":"Bilateral Rod Loosening and Sequential Distal Migration after Thoracolumbar Junction Fracture Stabilization.","authors":"Andreas K Demetriades, Himanshu Shekhar","doi":"10.1055/a-2088-3039","DOIUrl":"10.1055/a-2088-3039","url":null,"abstract":"<p><p>Distal rod migration remains uncommon and has been reported in a variety of anatomical locations, including the retroperitoneal region, knee, and pelvis. It is postulated that spinal fixation without fusion might allow the mechanical system some vulnerability to motion effects of the spine. Bilateral distal rod migration is rarer still. We report the interesting scenario of sequential and delayed bilateral rod migration 17 months after thoracolumbar fracture stabilization.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9793729","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":"Otogenic Brain Abscess and Concomitant Acute COVID-19 Infection: Case Report and Review of the Literature.","authors":"Artem Rafaelian, Sae-Yeon Won, Svorad Trnovec, Bedjan Behmanesh, Susanne Barz, Christoph Busjahn, Daniel A Reuter, Lichun Zhang, Robert Mlynski, Thomas Freiman, Florian Gessler, Daniel Dubinski","doi":"10.1055/a-2479-5462","DOIUrl":"10.1055/a-2479-5462","url":null,"abstract":"<p><strong>Background: </strong> 2019 coronavirus disease (COVID-19) has attracted global attention primarily because of the severe acute respiratory symptoms associated with it. However, nearly one third of the patients also present with neurological symptoms. This report describes a case of a previously healthy woman with acute COVID-19 infection, who developed acute facial nerve palsy and rapid progression to coma due to otogenic brain abscess.</p><p><strong>Case description: </strong> A 63-year-old woman with acute COVID-19 infection exhibited acute facial nerve paresis, high fever, and purulent secretion from her left ear within 48 hours after COVID-19 onset. Cranial computed tomography scan confirmed acute mastoiditis, precipitating an urgent mastoidectomy. A postoperative contrast-enhanced magnetic resonance imaging on the same day revealed a subdural empyema, which prompted an urgent craniotomy and decompression. Intraoperative microbiological swabs confirmed a <i>Streptococcus pyogenes</i> infection; however, reverse transcription polymerase chain reaction was negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). After immediate intravenous antibiotic treatment, extubation was achieved 4 days after operation, and the patient was discharged without neurological deficits 19 days after postoperatively.</p><p><strong>Conclusion: </strong> This finding adds a layer of insight into the specific nature of the infection, suggesting a potential absence of SARS-CoV-2 involvement in otogenic subdural empyema. However, the impact of SARS-CoV-2 in otogenic brain abscess cannot be excluded to date and should be further prospectively investigated. The complete recovery of neurological status emphasizes the importance of prompt and interdisciplinary interventions in managing rare and severe complications associated with COVID-19.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682028","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":"Impact of Suturing Techniques on Microvascular Anastomosis Maturation.","authors":"Jiri Dostal, Pavel Klein, Tereza Blassova, Vladimir Priban","doi":"10.1055/a-2389-7761","DOIUrl":"10.1055/a-2389-7761","url":null,"abstract":"<p><strong>Background: </strong> Microvascular anastomosis using interrupted suture is a widely accepted standard technique. Continuous suture is less common due to the presumption that its firmness can negatively affect anastomosis maturation. The purpose of this study was to determine whether the use of continuous suture allows maturation of the microanastomosis site.</p><p><strong>Methods: </strong> A rat common carotid artery (CCA) end-to-end microanastomosis model was utilized, with 19 Long-Evans rats in the interrupted suture group and 13 in the continuous suture group. Immediate blood flow of the operated and contralateral intact CCAs was compared before clamping, at the completion of the anastomosis and after 14 days. Quantitative transit time flowmetry measurement and histologic examination were employed.</p><p><strong>Results: </strong> Initial blood flow in both intact CCAs was similar across all animals (<i>p</i> = 0.004). In the interrupted suture group, the median anastomosis blood flow was 88.9% of the contralateral CCA blood flow, with a median suture time of 46 minutes. After 2 weeks, blood flow increased to 96.1%. In the continuous suture group, the median anastomosis blood flow was 88.3% of the contralateral CCA blood flow, with a median suture time of 30 minutes. After 2 weeks, blood flow increased to 100.0%. The reduction in suture time achieved with continuous suture was 34.8% (<i>p</i> < 0.001). Histologic examination confirmed scar maturity.</p><p><strong>Conclusions: </strong> The maturation rates of continuous and interrupted suture microanastomosis were comparable in our study, implying that concerns about the suture restricting maturation may be unwarranted. Additional finding is the potential for a reduction in microanastomosis time when using the continuous suture technique.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995914","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":"First Experience Using a New Minimally Invasive Screw-Rod System for Completely Percutaneous Pedicle Screw Fixation of the Cervical Spine.","authors":"Christoph Scholz, Marc Hohenhaus, Ulrich Hubbe, Florian Volz, Ralf Watzlawick, Jürgen Beck, Jan-Helge Klingler","doi":"10.1055/a-2479-5742","DOIUrl":"10.1055/a-2479-5742","url":null,"abstract":"<p><p>In contrast to the thoracolumbar spine, where pedicle screws can be inserted via a minimally invasive, percutaneous technique through small skin incisions, all previously available cervical instrumentation systems required a larger midline incision, especially for rod insertion. Screw placement via small incisions reduces the risk of wound healing disorders and blood loss, and patients can be mobilized more quickly and with less pain. In 2022, a cervical, minimally invasive stabilization system became available for the complete percutaneous insertion of both cervical pedicle screws and rods. We report on the first results and experiences with this new technology.In this retrospective case series, we included patients with cervical instability treated by minimally invasive percutaneous cervical and upper thoracic spine pedicle screw and rod insertion between August 2022 and August 2023. Intra- and postoperative complications as well as revision surgeries were recorded. The screw position was evaluated by three examiners in the postoperative computed tomography (CT) using the Bredow classification.Our series includes six male patients (age = 56.9 ± 12.9 years; body mass index [BMI] = 29.8 ± 9.6 kg/m²). The indication for surgery was trauma, tumor, and degenerative stenosis in two patients each. An excellent/good screw position (Bredow 1 and 2) was found in 84.4% of the screws (n = 27/32). None of the screws rated as Bredow 3 (<i>n</i> = 2/32) or Bredow 4 (<i>n</i> = 3/32) resulted in a neurological deficit or radicular pain and none had to be repositioned. No neurologic complication or revision surgery occurred. As a complication not directly related to the surgery technique, one patient died of a pulmonary lung embolism on the seventh postoperative day.The results of this study indicate that minimally invasive percutaneous implantation of a pedicle screw-rod system is also possible in the cervical spine with sufficient accuracy using intraoperative navigation. However, technical details, possible pitfalls and finally careful patient selection must be taken into account.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687155","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":"Risk Factors for and Molecular Pathology Characteristics of Systemic Metastasis of Adult Cerebral Glioblastoma: A Pooled Individual Patient Data Analysis and Systematic Review.","authors":"Lingcheng Zeng, Hongkuan Yang, Hua Li, Rudong Chen, Jian Chen, Jiasheng Yu","doi":"10.1055/a-2479-9978","DOIUrl":"10.1055/a-2479-9978","url":null,"abstract":"<p><strong>Objective: </strong> The risk factors for and molecular mechanisms of systemic metastasis of cerebral glioblastoma (GBM) remain to be evaluated.</p><p><strong>Patients and methods: </strong> Literature about adult GBM patients with systemic metastasis published before December 31, 2022, was searched in \"PubMed\" and \"Web of Science,\" and the patient's clinical data were collected and compared with those of patients without metastasis to evaluate the risk factors. The molecular pathology results were summarized to evaluate the mechanism.</p><p><strong>Results: </strong> One hundred and forty-seven patients with metastasis in 113 papers published from 1928 to 2022 were included. Two hundred and forty-nine patients without metastasis who underwent surgery in our department in 2017 were included. Comparison of the two groups showed that age ≤40 years was significantly correlated with metastasis (hazard ratio [HR]: 2.086, 95% CI: 1.124-3.871, <i>p</i> = 0.020) and better overall survival (HR: 1.493, 95% CI: 1.067-2.083, <i>p</i> = 0.019). Molecular pathology results were reported in 39 cases (39/147, 26.5%). The genetic results showed obvious heterogeneity. According to the frequency and positive ratio, IDH-wild type (positive rate 27/30), TERT promoter mutation (11/13), PTEN mutation (10/11), TP53 mutation (10/13), and RB1 mutation (8/9) were common gene changes.</p><p><strong>Conclusion: </strong> In young adult GBM patients, especially those ≤40 years of age with long survival, attention should be given to the development of systemic metastases. Metastasis can be the result of multiclonal gene mutations, in which proliferation- and invasion-related gene changes, such as oncogene or tumor suppressor gene mutations and epithelial-mesenchymal transition-related genes, may play an important role in metastasis.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687256","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":"Frontal Sulcotomy through 3D-Printed Illuminated Endoport for Minimally Invasive Evacuation of a Deep-Seated Intracerebral Hematoma: A Case Report.","authors":"Eduardo Trejo-Olguín, Jesús A Morales-Gómez, Everardo García-Estrada, Marco A Villegas-Aguilera, César A Ramos-Delgado, Jorge A Cantú-Hernández, Ángel R Martínez-Ponce de León","doi":"10.1055/a-2344-8695","DOIUrl":"10.1055/a-2344-8695","url":null,"abstract":"<p><p>Spontaneous intracerebral hemorrhage carries high mortality and disability rates and usually affects deep brain structures. We have implemented a self-designed low-cost 3D-printed illuminated endoport for the surgical drainage of a deep spontaneous intracerebral hemorrhage in a patient who arrived with right hemiparesis and a Glasgow coma scale (GCS) score of 10. A minimally invasive approach was made and our patient had a favorable functional outcome after surgery. Carrying out this approach with a low-cost 3D-printed endoport makes it possible to offer a safe and efficient treatment option to a low-income country population.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141321011","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":"Obituary for Prof. Dr. med. habil. Winfried Burkert.","authors":"Volkmar Heidecke, Nikolai G Rainov","doi":"10.1055/a-2563-3606","DOIUrl":"https://doi.org/10.1055/a-2563-3606","url":null,"abstract":"","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127907","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":"Meningioma and cerebral spindle cell sarcoma as two different metachronous tumor entities secondary to medulloblastoma treatment in childhood - case report and review of the literature.","authors":"Anna Jung, Michael Brodhun, Andreas Lemmer, Rüdiger Gerlach","doi":"10.1055/a-2618-6807","DOIUrl":"https://doi.org/10.1055/a-2618-6807","url":null,"abstract":"<p><p>The authors report on a 21-year-old clinically asymptomatic female patient, who was admitted with two supratentorial intradural lesions in her follow up magnetic resonance imaging (MRI) 17 years after treatment of a posterior fossa medulloblastoma. Sequential surgical removal was performed. The left parietal tumor with dural involvement was diagnosed as a transitional meningioma WHO grade 1. The right temporal lesion, which had also close relationship to the dura, was diagnosed as a spindle cell sarcoma. We therefore report a metachronous tumor development of a benign and a malignant intradural sarcomatous tumor as secondary neoplasms following childhood medulloblastoma treatment.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127904","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":"Differences in Complications and Patency Rates in Young and Elderly Patients Undergoing Extra-Intracranial Bypass Surgery.","authors":"Davide M Croci, Jeffrey Farooq, Molly Monsour, Kunal Vakharia, Tsz Lau, Rahul Mhaskar, Harry van Loveren, Siviero Agazzi","doi":"10.1055/a-2521-3005","DOIUrl":"https://doi.org/10.1055/a-2521-3005","url":null,"abstract":"<p><p>Extra-Intracranial (EC-IC) bypass surgery is an effective procedure to restore hemodynamic insufficiency and mitigating cerebral ischemia. With increasing life expectancy, the incidence of patients with hemodynamic insufficiency is expected to rise further. Here we aimed to analyze the complications and patency rate of patients ≥70 years that underwent EC-IC bypass and compare it with a younger cohort (<70 years).Patient charts were retrospectively reviewed for diagnosis, patient presentation, type of bypass, postoperative course, and follow-up. A total of 175 patients underwent arterial bypass during the study period. A total of 158 patients were <70 years old compared with 17 patients ≥70 years old.EC-IC bypass was performed with a scalp artery in 88.2% cases in the older group and 88.0% cases in the younger group. The younger group was more likely to undergo bilateral bypass (28.1%) than the older group (0%; <i>p</i> = 0.01). There were no significant differences in overall medical and surgical complication rates between older and younger patients undergoing arterial bypass (<i>p</i> = 0.61). Direct postoperative graft patency was similar between groups. Follow-up patency data were available in 97.7% of patients (average 18.0 ± 25.1 months). Graft patency rate at follow-up was 88.3%, with rates 88.2% in the older group and 88.3% in the younger group.Our data confirm previous data in the literature on the safety and efficacy of EC-IC Bypass in the elderly population. These results suggest that variables other than age may be more important in determining potential benefit from EC-IC bypass treatment.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078494","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 McConnell Capsular Artery: Anatomical Insights and Neurosurgical Considerations.","authors":"Yasser F Almelwy, Amr Badary, Alan Hernández-Hernández, Assma Dwebi, Bipin Chaurasia, Oday Atallah","doi":"10.1055/a-2479-9867","DOIUrl":"https://doi.org/10.1055/a-2479-9867","url":null,"abstract":"<p><strong>Introduction: </strong> The McConnell capsular artery (MCCA) is a vascular component with notable significance in neurosurgery. Discovered by McConnell in 1953, these arteries, categorized as inferior and anterior capsular, contribute significantly to the vascularization of the sellar region. This article explores the anatomical variations of MCCA, aiming to provide a comprehensive overview of its structure and neurosurgical implications.</p><p><strong>Methods: </strong> This study was conducted following a literature review of articles related to the MCCA. Electronic databases, including PubMed, ScienceDirect, and Web of Science, were searched up until January 2024. Specific keywords used in the search included \"McConnell capsular artery,\" \"intracapsular branches,\" and \"MCCA.\" An in-depth investigation was undertaken to explore the existence, anatomy, pathology, and clinical implications of the MCCA.</p><p><strong>Results: </strong> We found a mere 13 articles pertaining to this artery. It highlights the MCCA's close proximity to important neuroanatomical components and describes how it has been consistently identified in multiple studies. The review explores anatomical variations and anomalies and provides insights into neurosurgical cases that emphasize the artery's involvement in oncological diseases.</p><p><strong>Conclusion: </strong> The variability in the occurrence of this artery has significant therapeutic ramifications, especially in procedures involving pituitary and suprasellar lesions. The study emphasizes the importance of meticulous identification and management of MCCA during surgical interventions, underscoring their crucial role in neurosurgical procedures.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078515","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}