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

{"title":"Vertebral endplate cavities (VECs) after microscopic assisted anterior cervical discectomy and fusion (ACDF) with polyetheretherketone (PEEK) cages.","authors":"Tarek Elfiky, Mahmoud Nafady, Martin N Stienen, Walter Liberatus Lyimo, Yaser El Mansy","doi":"10.1055/a-2848-8509","DOIUrl":"https://doi.org/10.1055/a-2848-8509","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective CT- based study Objectives: The aim is to assess the prevalence of vertebral endplate cavities VEC after ACDF using PEEK cages by CT, and to estimate their impact on fusion.</p><p><strong>Methods: </strong>The term \"cavity\" was used to describe the endplate changes. CT analysis of the VECs and fusion status following ACDF with PEEK cages was conducted by two observers. VECs were assessed according to the size, multiplicity, location, and presence of sclerosis.</p><p><strong>Results: </strong>A total of 46 consecutive (20 males and 26 females) were enrolled in the study. The mean age at surgery was 50.43±11.37 years. A total of 96 levels were fixed. The mean follow-up was 30.87± 25.371 months (range, 6-96 months). VECs were found at 30 levels (31.3%) by both observers. The level of agreement was regarded as almost perfect. All the VECs were small (<5 mm) Definite fusion was seen in 50 levels (52.1%) by observer 1 versus 52 levels (54.2%) by observer 2. The level of agreement was regarded as almost perfect. With both observers, the presence of VECs was significantly related to the fusion status (p ≤ 0.05). However, the follow-up period, the levels, age, sex and cigarette smoking had no statistical significance with fusion status.</p><p><strong>Conclusion: </strong>Our study confirmed the existence of VECs following ACDF using PEEK cages in about one third of our patients (31.3%). These VECs tend to be small (<5 mm) in size and might be associated with non-union.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147296","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":"Percutaneous Endoscopic Interlaminar Lumbar Discectomy for Treating Acute Cauda Equina Syndrome: A Case Series of 25 Patients.","authors":"Islam Abdelsamad, Ihap Bedier","doi":"10.1055/a-2959-1769","DOIUrl":"https://doi.org/10.1055/a-2959-1769","url":null,"abstract":"<p><strong>Background: </strong>Cauda equina syndrome (CES) is caused by compression of nerves in the lumbar spine below the conus medullaris. Symptoms include progressive weakness in the lower extremities, back pain with sciatica, saddle anesthesia, and urinary or bowel dysfunction. These symptoms vary in intensity and onset, and can sometimes be an emergency. The standard surgical procedure for CES typically involves a microscope-assisted interlaminar decompression with laminotomy and sequestrectomy, with or without partial, rather than complete, discectomy. However, endoscopic spine surgery was introduced as an alternative method in the treatment of CES. We aimed to evaluate the feasibility and clinical efficacy of percutaneous endoscopic interlaminar lumbar discectomy (PEILD) for the treatment of CES.</p><p><strong>Methods: </strong>A retrospective study of 25 patients with CES who underwent PEILD surgery from May 2017 to April 2022 at our institution, and the data were collected and retrospectively analyzed. All patients complained of incomplete or complete cauda equina manifestations. These patients may have one or more lumbar disc herniations and unilateral or bilateral nerve root compression. We used clinical examination, Macnab criteria, Oswestry Disability Index (ODI) score, and Visual Analog Scale (VAS) score to evaluate the outcome.</p><p><strong>Results: </strong>A total of 25 patients with a mean age of 38.32 years (range 18-60 years) were included in our study. Of these 25 patients, 16 were males (64%), and 9 were females (36%), with an average follow-up of 1 year. The main complaint was sciatica, hypoesthesia (including saddle hypoesthesia and anesthesia), weakness, impotence, and sphincteric disturbance (including urinary hesitancy, urgency, frequency, or retention). We performed PEILD in all patients. About 20 patients had no postoperative complications (80%). The most common complications were superficial wound infection, cerebrospinal fluid (CSF) leak, pseudomeningocele, and discitis. The preoperative mean ODI score for low back pain for our patients was 61.76%. One year postoperatively, the mean ODI score improved to 13.36%. The preoperative mean VAS score for leg pain was 6.47. One year after surgery, the mean VAS score significantly decreased to 1.81.</p><p><strong>Conclusion: </strong>PEILD as a minimally invasive surgery could be considered a valid surgical option for treatment of different stages of CES; however, it has a steep learning curve and needs high surgical experience to ensure adequate decompression, especially in complete CES.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074409","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":"On the Reported Impact of the Sitting Position on Postoperative Functional Outcome in Posterior Fossa Brain Metastasis Surgery.","authors":"Laurèl Rauschenbach, Philipp Dammann, Ulrich Sure","doi":"10.1055/a-2948-9836","DOIUrl":"https://doi.org/10.1055/a-2948-9836","url":null,"abstract":"","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906472","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":"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":"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}

{"title":"Intraoperative Differentiation of Pilocytic Astrocytoma and Hemangioblastoma with Indocyanine Green Video Angiography.","authors":"Berkay Paker, Deniz Kılıç, Kerem Kenan Özçınar, Akın Akakın, Türker Kılıç","doi":"10.1055/a-2849-8919","DOIUrl":"10.1055/a-2849-8919","url":null,"abstract":"<p><strong>Purpose: </strong>Differentiating between pilocytic astrocytomas (PA) and hemangioblastomas (HB) during surgery is challenging due to their radiological similarities but distinct vascular characteristics and surgical considerations. This study explores the application of indocyanine green (ICG) fluorescence angiography for intraoperative differentiation of these tumors.</p><p><strong>Methods: </strong>Four patients with cerebellar cystic masses underwent surgical resection using ICG video angiography. ICG fluorescence patterns were observed intraoperatively to distinguish vascular characteristics. Homogeneous enhancement in HB was hypothesized to contrast with the nonenhancing nodules of PA. The findings were correlated with preoperative imaging and histopathology.</p><p><strong>Results: </strong>In cases of HB, ICG angiography demonstrated early-phase homogeneous fluorescence, highlighting the tumor's high vascularity and aiding complete resection while preserving vascular integrity. In contrast, PA showed no fluorescence in the tumor nodule, enabling piecemeal resection with minimal blood loss. Histopathological diagnoses confirmed the intraoperative findings. The technique was safe, with no complications reported.</p><p><strong>Conclusion: </strong>This study demonstrates the utility of ICG video angiography as an intraoperative adjunct for differentiating PA from HB. Compared with digital subtraction angiography, ICG offers a cost-effective, safe, and efficient alternative, without the need for specialized equipment or radiation exposure. ICG fluorescence enhances intraoperative decision-making and optimizes surgical outcomes for challenging posterior fossa lesions. Further studies are warranted to validate these findings and expand the role of ICG in neurosurgical practice.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"375-381"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645624","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":"Temporal Stem Anatomy: A Photorealistic Surface Scanning, Anatomical and 3D Tractography Study.","authors":"Francesco Carbone, Milko Milev, Martin Trandzhiev, Lili Laleva, Ivan Maslarski, Daniele Armocida, Michael Wolf-Vollenbröker, Jan Frederick Cornelius, Matteo de Notaris, Vladimir Nakov, Toma Spiriev","doi":"10.1055/a-2848-8345","DOIUrl":"10.1055/a-2848-8345","url":null,"abstract":"<p><strong>Background: </strong>The temporal stem is a critical structure within the brain, connecting the frontal, temporal, and occipital lobes via various fiber tracts. This study aims to evaluate the use of photogrammetry surface scanning and magnetic resonance imaging (MRI)-based tractography in presenting the layered anatomy of the fibers comprising the temporal stem.</p><p><strong>Objective: </strong>This study aimed to clearly present the layered anatomy of the fibers comprising the temporal stem through photogrammetry surface scanning methods and MRI-based tractography studies.</p><p><strong>Materials and methods: </strong>Three body donor-based brain dissections were documented with photogrammetry surface scanning and compared with MRI-based diffusion tensor imaging tractography. High-resolution three-dimensional (3D) models were created using both techniques to visualize the layered fiber architecture of the temporal stem. Tractography data were processed using DSI Studio software based on population-averaged white matter templates from open-access databases.</p><p><strong>Results: </strong>Seven photorealistic 3D models were generated through photogrammetry, complemented by detailed coronal sections of an MRI-based 3D tractography model. These models revealed the anatomical organization of critical fiber tracts, including the inferior fronto-occipital fasciculus, uncinate fasciculus, anterior commissure, and Meyer's loop of the optic radiation.</p><p><strong>Conclusion: </strong>The temporal stem is a crucial anatomical region comprising important white matter tracts. Their layered anatomical course can be clearly demonstrated by stratigraphical dissections and surface scanning methods, as well as augmented with 3D segmentation of MRI data. White matter dissection perfectly fits photogrammetry, permitting stratification and creating a truly interactive experience, allowing a more precise 3D representation of individual fibers, their orientation, and position, surpassing the limitations of 2D representations of anatomy.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"329-337"},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633636","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}