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

{"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":0.9,"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}

{"title":"Patient-Specific Computed Tomography-Based Three-Dimensional Spine Trauma Models for Preoperative Planning in Virtual Reality and 3D Printing: An EANS Young Neurosurgeons' Network Study.","authors":"Martin Trandzhiev, Erik Schulz, Martin N Stienen, Oliver Bozinov, Cateno Petralia, Carmelo Vitaliti, Martina Rossitto, Daniel Alvarado Flores, Giuseppe M V Barbagallo, Vincenzo Fanelli, Mary Solou, Efstathios J Boviatsis, Dimitrios Dimopoulos, Vivek Sanker, Antonia Vogt, Vladimir Nakov, Diogo Belo, Evangelos Drosos, Maria L Gandía-González, Toma Spiriev, Giovanni Raffa","doi":"10.1055/a-2726-3537","DOIUrl":"10.1055/a-2726-3537","url":null,"abstract":"<p><p>Lately, the wide availability of open-source modelling and rendering software in neurosurgery has led to the development of a methodological pipeline for creating patient-specific three-dimensional (3D) models based on preoperative imaging data. With recent innovations in virtual reality (VR) technology and 3D printing, these models can be applied to enhance preoperative planning and medical training. The main question this paper aims to answer is whether the proposed algorithm of intensity-based CT segmentation and basic 3D modelling is adequate to create a reference library of patient-specific models, categorized according to the AO Spine Injury Classification System, and suitable for VR and 3D printing-based preoperative planning.We used the open-source medical image viewer Horos to create volumetric renderings of CT scans of trauma patients from several European centers. The models were postprocessed using 3D modelling software and exported in appropriate formats for VR or 3D printing.We created 37 models of trauma patients, spanning from the upper cervical to the thoracolumbar segment, categorized according to the AO Spine Injury Classification System. Additionally, a remote case discussion conducted by uploading these models into a collaborative VR environment was demonstrated as a proof of concept.In the present study, we demonstrated that open-source software can create a database of patient-specific 3D models. Additionally, the communication between remote departments can be facilitated by uploading these models into a collaborative VR environment, and the comprehensive evaluation of spine fractures fostered through 3D printing. Further studies are needed to assess the database's educational value.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"197-206"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856876","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":"Magnetic Resonance Perfusion Dynamics in Arachnoid Cysts: Insights from Pre- and Postendoscopic Intervention.","authors":"Gopal Krishna, Mohammad Sajid, Ishwar Singh, Seema Rohilla, Manjeet Singh, Meghna Chauhan","doi":"10.1055/a-2749-5829","DOIUrl":"10.1055/a-2749-5829","url":null,"abstract":"<p><p>Arachnoid cysts by virtue of their volume and intracystic tension, produce local mass effect, and impair the perfusion of surrounding brain parenchyma.The magnetic resonance (MR) perfusion parameters cerebral blood flow (CBF), relative cerebral blood volume (rCBV), and mean transit time (MTT) of brain parenchyma contiguous with the arachnoid cyst were compared with corresponding contralateral hemisphere. Twenty cases of arachnoid cyst were treated using endoscopic techniques. The perfusion changes in parenchyma were assessed 3 months postoperatively. Clinical outcomes were assessed at 6 months' postsurgery.Headache was the predominant symptom (85%), with Sylvian fissure representing the most frequent anatomical location (65%). Endoscopic procedure was successful in 80% of the cases, whereas 20% of the cases required conversion to minicraniotomy and microsurgical cyst excision. Preoperatively, mean CBF (mL/100 g/min), rCBV (mL/100 g), MTT (seconds) in perilesional brain area were 42.58 ± 7.17, 4.48 ± 1.25, 5.56 ± 1.72, respectively, and 3 months postoperatively were 45.83 ± 8.87, 4.48 ± 1.62, 4.37 ± 1.68, respectively. The mean CBF (mL/100 g/min), rCBV (mL/100 g), MTT (seconds) in corresponding contralateral hemisphere was 46.77 ± 10.85, 4.29 ± 1.35, 5.24 ± 1.104, respectively, whereas postoperatively they were 46.29 ± 8.49, 5.03 ± 1.16, 5.49 ± 1.97, respectively. The <i>p</i>-value, however, was not significant. Headache improved in 87.5%, whereas seizure in 60% of the cases.Endoscopic treatment of arachnoid cyst is an optimally invasive procedure. The perfusion study is a valuable tool in evaluation of arachnoid cysts. MR perfusion highlights regions of impaired blood flow and focal brain dysfunction. Additionally, changes in perfusion can help assess the therapeutic impact of surgery on the compressed brain tissue.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"213-219"},"PeriodicalIF":0.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146064376","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":"Supraorbital and Endonasal Approaches: Tailoring Surgical Techniques for Tuberculum Sellae Meningiomas Based on Preoperative Grading Systems-Minimally Invasive Approaches for Tuberculum Sellae Meningiomas.","authors":"Riccardo Antonio Ricciuti, Fabrizio Mancini, Riccardo Paracino, Matteo Maria Ottaviani, Pierfrancesco De Domenico, Serena Pagano, Francesca Romana Barbieri, Daniele Marruzzo, Stefano Vecchioni, Carlo Conti","doi":"10.1055/a-2479-4598","DOIUrl":"10.1055/a-2479-4598","url":null,"abstract":"<p><p>Tuberculum sellae meningiomas (TSMs) tend to compress the optic apparatus and an ideal surgical route, whether transcranial or endonasal, is still debated. Another issue is if the minimally invasive supraorbital (SO) approach offers the same results compared with the more invasive craniotomies. Aiming to guide approach selection, preoperative grading systems have been described.All cases of TSMs treated from 2013 to 2018 by extended endoscopic endonasal approach (EEA) or SO approach have been reviewed and classified according to three preoperative grading systems: McDermott scale, Optic Nerve Laterality Score, and Yaşargil criteria.A total of 15 patients with TSMs were treated with the EEA (<i>n</i> = 6) or the SO (<i>n</i> = 9) approach. Globally, gross total resection was obtained in 87% (<i>n</i> = 13) of cases and was higher with the SO (100%, <i>n</i> = 9) compared with the EEA (67%, <i>n</i> = 4). Visual function improved in all but one patient (<i>n</i> = 14). Compared with the EEA group, patients treated by the SO approach had larger tumors (32.3 mm vs. 24.5 mm), a higher rate of optic canal invasion (4/9 vs. 0/6), and arterial encasement (6/9 vs. 1/5). Patients with McDermott total points of 1 to 2 (7/15) were treated mainly by the EEA; all patients with McDermott total score of ≥3 (8/15) were treated by the SO approach. All patients with optic canal invasion (4/15) and lateral extension of the tumor (ONL score = 1-3) were treated by the SO approach.The SO and EEA are two minimally invasive approaches safe and effective for treating TSMs. For tumors with lateral extension (optic nerve laterality [ONL] score = 1-3), larger diameter (>30-35 mm), vascular encasement, or optic canal involvement (McDermott total point = 2-3), the SO craniotomy is preferred. For small and median tumors with no optic canal invasion or vascular encasement (McDermott total point = 1-2), the EEA represents a valid option.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"69-76"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682066","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":"Management and Outcomes of Ganglion Cysts of the Posterior Longitudinal Ligament: A Systematic Review of Diagnostic and Surgical Approaches.","authors":"Gianluca Scalia, Francesca Graziano, Salvatore Marrone, Gianluca Ferini, Eliana Giurato, Giovanni Federico Nicoletti, Gianluca Galvano, Giuseppe Emmanuele Umana","doi":"10.1055/a-2642-7869","DOIUrl":"10.1055/a-2642-7869","url":null,"abstract":"<p><p>Ganglion cysts of the posterior longitudinal ligament (PLL) are a rare cause of lumbar radicular pain and claudication, primarily affecting young athletic males. These cysts are often linked to repetitive trauma and degenerative changes in the PLL, potentially aggravated by disc degeneration. Diagnosis is typically achieved through magnetic resonance imaging (MRI), with surgical excision being the preferred treatment in symptomatic cases. This systematic review consolidates the current knowledge on PLL ganglion cysts, examining clinical characteristics, diagnostic findings, and surgical outcomes to provide a basis for future research and clinical management.A systematic literature search was conducted in PubMed, Embase, Cochrane Library, and Web of Science, including studies from inception to June 2024. Search terms included \"ganglion cyst,\" \"posterior longitudinal ligament,\" \"PLL,\" and \"lumbar spine,\" among others. Studies published in English and French were reviewed if they reported on ganglion cysts of the PLL with clinical or radiological data. Data on demographics, symptoms, imaging findings, treatment approaches, outcomes, and follow-up were extracted. Due to the heterogeneity of the included studies, a narrative synthesis was performed, focusing on clinical presentation, diagnostic criteria, surgical techniques, and recurrence rates.A total of 14 studies comprising 20 patients were analyzed. The majority (90%) were male, with a mean age of 30.2 years (standard deviation [SD] = 11.47). The most common presenting symptom was radicular pain, primarily left-sided (70%). Disc degeneration was reported in 85% of cases, supporting a link between degenerative disc disease and PLL cyst formation. MRI revealed hypointense cysts on T1-weighted images and hyperintense on T2, aiding in differentiation from other intraspinal pathologies. Surgical excision was performed in all cases, with hemilaminectomy (50%) and interlaminar approaches (40%) being the most common techniques. Minimally invasive endoscopic methods were used in one case. Complete recovery was reported in 65% of patients, with a mean follow-up of 13.8 months (SD = 12.1). Recurrence data were limited due to inconsistent follow-up.This systematic review highlights the clinical and imaging characteristics of PLL ganglion cysts, with MRI as a critical tool for diagnosis. Surgical management, particularly hemilaminectomy and interlaminar approaches, is effective in providing symptom relief and preventing recurrence. Although minimally invasive techniques show promise, further research is needed to confirm their efficacy. Given the rarity of PLL cysts, tailored treatment and larger studies with standardized follow-up are essential to improve understanding and management of this condition.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"142-153"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086347","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 Screening Protocol for Idiopathic Normal Pressure Hydrocephalus: Reducing Underdiagnosis, Relieving the Economic Burden for the Health Systems, while Improving the Quality of Life of our Patients.","authors":"Gianpaolo Petrella, Silvia Ciarlo, Giuseppe Demichele, Edvige Iaboni, Daniele Armocida, Maurizio Salvati, Angelo Pompucci, Alessandro Pesce","doi":"10.1055/a-2649-7805","DOIUrl":"10.1055/a-2649-7805","url":null,"abstract":"<p><p>Idiopathic normal pressure hydrocephalus (iNPH) is a common condition affecting the elderly. Numerous investigations highlight that its period-prevalence could be underestimated, as well as the economic burden of the missed treatments. The objective of the present investigation is to determine if a cohort of radiologically suspected iNPH patients presents the clinical landmarks of this condition, and to estimate the economic burden of these potentially missed diagnoses.We recorded age, sex, reason to access emergency rooms of our community hospitals, values of Evans' Index, callosal Angle, presence of disproportionately enlarged subarachnoid space hydrocephalus and obvious ventricular enlargement. We telephoned the patients who presented at least two radiological signs of iNPH and administered the idiopathic normal-pressure hydrocephalus grading scale (iNPHGS), to assess the severity of signs and symptoms linked to iNPH, to understand if a strong radiological suspect had a clinical correlation.Among the 308 brain computed tomography scans of a week, a total of 21 agreed to be enrolled in the present investigation. When administering iNPHGS questionnaire to radiologically suspected iNPH, 17/21 patients (80.1%) scored ≥1 in at least two of the three iNPHGS subscales. The scores of the three subscales were strongly associated to each other. The estimated monthly and yearly health-related costs may be EUR 4'799'440 and 57.59 million of Euros, respectively.There is an association between the radiological features of iNPH and the scores of iNPHGS. The period-prevalence could be 5.51%, implying high health care costs, with significant societal impact, and reduced quality of life in patients suffering from undiagnosed iNPH.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"115-124"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584197","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}