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

{"title":"Surgical Treatment of Developmental Dysplastic Lumbosacral Spondylolisthesis: Additional Help from an Intervertebral Distraction, Correction, and Reduction Device.","authors":"Thomas Lübbers, Gerd Sandvoss, Rainer Baalmann, Peter Wigt","doi":"10.1055/a-2091-6921","DOIUrl":"10.1055/a-2091-6921","url":null,"abstract":"<p><strong>Background: </strong> In mid- to high-grade adult dysplastic spondylolisthesis, surgeons are faced with three underlying components: angular, translational, and collapse of the disk. In extremely narrow intervertebral spaces, it is difficult to distract and lift the vertebral bodies by the pedicle screw system alone. In this prospective case control study, we analyzed the efficacy of the latest prototypes (distraction, correction, and reduction [DCR] instrument) with intervertebral application in terms of distraction, correction of segmental kyphosis, and slip reduction.</p><p><strong>Methods: </strong> Twelve adult patients (5 male and 7 female patients) were enrolled in this study. The average age was 42 years (range: 17-67 years) and in all cases the maneuver was documented during the surgery. The amount of slip reduction, the lumbosacral angle according to the Spinal Deformity Study Group dysplastic angle (dys-SDGG), and the disk height were measured preoperatively, intraoperatively, 3 months after surgery, and during the latest follow-up (range: 3-44 months). The relative height of the lumbosacral disk was determined in relation to the disk height in L3/L4.</p><p><strong>Results: </strong> Slippage ranged from 17 to 67%. Overall, the average slippage was 45% preoperatively and 4.8% after the reduction maneuver. The average ratio of the disk height was 0.3 preoperatively, 1.0 intraoperatively, and 0.9 at the latest follow-up. Two patients showed significant kyphotic changes, and these patients had an 18- and 21-degree lordotic improvement. From those who had a lumbosacral kyphosis >20 degrees, only one patient did not show any lordotic improvement. All other patients had a significant lordotic improvement. In total, the lumbosacral angle changed from 15 to 23 degrees.</p><p><strong>Conclusion: </strong> The application of an intervertebral distractor with a mobile thigh has a good clinical and radiologic outcome for mid- to high-grade adult dysplastic spondylolisthesis in terms of distraction, kyphosis correction, and reduction of underlying slippage. The described hardware failures and the complications were not related to the DCR device.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9799379","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":"Early Identification of Correlated Risk Factors can Improve the Prognosis of Patients with Postoperative Intracranial Infection.","authors":"Rongfang Zhang, Jiangtao Niu","doi":"10.1055/a-1938-0202","DOIUrl":"10.1055/a-1938-0202","url":null,"abstract":"<p><strong>Background: </strong> In this retrospective study, we explore the clinical risk factors correlated to the prognosis of patients who suffered from central nervous system infection after a neurosurgical procedure.</p><p><strong>Methods: </strong> The study included 113 patients diagnosed with a postoperative intracranial infection. Several factors with clinical relevance were identified and analyzed by univariate analyses. The risk factors that showed any significant difference between the cases were analyzed by multivariate logistic regression analyses.</p><p><strong>Results: </strong> Here we show that the duration of the drainage before infection (measured in days; Beta [B]: -0.113; odds ratio [OR]: 0.893; 95% confidence interval [CI]: 0.805-0.991; <i>p</i> = 0.033), the number of antibiotics used for the treatment (B: -1.470; OR: 0.230; 95% CI: 0.072-0.738; <i>p</i> = 0.013), and the number of leucocytes in the cerebrospinal fluid (CSF; B: -0.016; OR: 0.984; 95% CI: 0.970-0.998; <i>p</i> = 0.027) are risk factors for the prognosis of patients with an intracranial infection. In contrast, the duration of antibiotic treatment (measured in days; B: 0.176; OR: 1.193; 95% CI: 1.063-1.339; <i>p</i> = 0.003) turned out to be a positive factor for recovery from infection.</p><p><strong>Conclusions: </strong> Our results suggest that early identification of the correlated risk factors can improve the prognosis of patients with intracranial infection after neurosurgery.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40355090","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":"Placement of a Catheter into the Transverse Sinus in Monitoring Intracranial Lesions: A Technical Note.","authors":"Xingping Dai, Yanyi Chen, Mingyue Xia, Min Yi, Xia Xu, Dongsheng Wang, Edwin M Nemoto","doi":"10.1055/s-0042-1759826","DOIUrl":"10.1055/s-0042-1759826","url":null,"abstract":"<p><p>High intracranial pressure (ICP) can be induced by stroke, brain trauma, and brain tumor, and lead to cerebral injury. Monitoring the blood flow of a damaged brain is important for detecting intracranial lesions. Blood sampling is a better way to monitor changes in brain oxygen and blood flow than computed tomography perfusion and magnetic resonance imaging. This article describes how to take blood samples from the transverse sinus in a high ICP rat model. Also, it compares the blood samples from the transverse sinus and femoral artery/vein through blood gas analysis and neuronal cell staining. The findings may be of significance to the monitoring of the oxygen and blood flow of intracranial lesions.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9288856","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":"Intracranial Aneurysm \"Clip Anchoring\": Technical Note.","authors":"David Bervini, David Zhang, Johannes Goldberg, Andreas Raabe","doi":"10.1055/a-2070-4346","DOIUrl":"10.1055/a-2070-4346","url":null,"abstract":"<p><p>Clip slippage and displacement during or after intracranial aneurysm surgery is associated with morbidity and can be detrimental. We report the usage of concomitant aneurysm clips and artery clips aiming to avoid this complication in a patient undergoing elective aneurysm surgical clipping.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9765840","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":"Survey on Training Satisfaction among German Neurosurgical Trainees.","authors":"Anna Cecilia Lawson McLean, Stefanie Maurer, Dorothea Nistor-Gallo, Ina Moritz, Meriem Tourbier","doi":"10.1055/a-2053-3108","DOIUrl":"10.1055/a-2053-3108","url":null,"abstract":"<p><strong>Background: </strong> There has been a fivefold increase of neurosurgeons over the last three decades in Germany, despite a lesser increase in operations. Currently, there are approximately 1,000 neurosurgical residents employed at training hospitals. Little is known about the overall training experience and career opportunities for these trainees.</p><p><strong>Methods: </strong> In our role as resident representatives, we implemented a mailing list for interested German neurosurgical trainees. Thereafter, we created a survey including 25 items to assess the trainees' satisfaction with their training and their perceived career prospects, which we then distributed through the mailing list. The survey was open from April 1 until May 31 2021.</p><p><strong>Results: </strong> Ninety trainees were enrolled in the mailing list and we received 81 completed responses to our survey. Overall, 47% of the trainees were very dissatisfied or dissatisfied with their training. Sixty-two percent of the trainees reported a lack of surgical training. Fifty-eight percent of trainees found it difficult to attend courses or classes and only 16% had consistent mentoring. There was an expressed desire for a more structured training program and mentoring projects. In addition, 88% of trainees were willing to relocate for fellowships outside their current hospitals.</p><p><strong>Conclusions: </strong> Half of the responders were dissatisfied with their neurosurgical training. There are various aspects that require improvement, such as the training curriculum, structured mentoring, and reduction of the amount of administrative work. We propose the implementation of a modernized structured curriculum, which addresses the mentioned aspects, in order to improve neurosurgical training and, consecutively, patient care.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9926829","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":"Low-/Negative-Pressure Hydrocephalus: To Understand the Formation Mechanism from the Perspective of Clinicians","authors":"Guangzhao Li, Bin Lin, Fei Yang","doi":"10.1055/s-0044-1785671","DOIUrl":"https://doi.org/10.1055/s-0044-1785671","url":null,"abstract":"<p>Low-/negative-pressure hydrocephalus (LPH/NePH) is uncommon in clinical practice, and doctors are unfamiliar with it. LPH/NePH is frequently caused by other central nervous system diseases, and patients are frequently misdiagnosed with other types of hydrocephalus, resulting in delayed treatment. LPH/NePH therapy evolved to therapeutic measures based on “external ventricular drainage below atmospheric pressure” as the number of patients with LPH/NePH described in the literature has increased. However, the mechanism of LPH/NePH formation is unknown. Thus, understanding the process of LPH/NePH development is the most important step in improving diagnosis and treatment capability. Based on case reports of LPH/NePH, we reviewed theories of transcortical pressure difference, excessive cerebral venous drainage, brain viscoelastic changes, and porous elastic sponges.</p> ","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833744","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 blood markers predicting long term neurological outcome following decompressive craniectomy for malignant ischemic stroke: a preliminary single center study.","authors":"R. Paracino, Pierfrancesco De Domenico, A. Di Rienzo, M. Dobran","doi":"10.1055/a-2312-9448","DOIUrl":"https://doi.org/10.1055/a-2312-9448","url":null,"abstract":"OBJECTIVE\u0000Malignant ischemic stroke (MIS) is defined by progressive cerebral edema leading to intracranial pressure, compression of neural structurs and, eventually, death. Decompressive craniectomy (DC) has been advocated as a lifesaving procedure in the management of patients with MIS. This study aims to identify pre- and postoperative predictive variables of neurological outcomes in patients undergoing DC for MIS.\u0000\u0000\u0000METHODS\u0000We conducted a retrospective study of patients undergoing decompressive hemi-craniectomy in a single center from April 2016 to April 2020. Preoperative work-up included baseline clinical status, laboratory data, and brain CT. The primary outcome was the 6-months modified ranking score (mRS). The secondary outcome was the 30-day mortality.\u0000\u0000\u0000RESULTS\u0000During data capture a total of 58 patients fulfilled the criteria for MIS, of which 22 underwent DC for medically refractory increased ICP and were included in the present analysis. The overall median age was 58.5 years old. An immediate (24hr) postoperative GOSE score >= 5 was associated with good 6-month mRS (1-3)(p=0.004). Similarly, low postoperative neutrophils (p=0.002), low lymphocytes (p=0.004), decreased neutrophil to lymphocyte ratio (NLR)(p=0.02) and decreased platelet to lymphocytes ratio (PLR)(p=0.03) were associated with good neurological outcomes. Per-operative variables independently associated with worsened 6-month mRS were: increased age (OR 1.10, 95% CI 1.01-1.20, p=0.02), increased NIHSS score (OR 7.8, 95% CI 2.5-12.5, p=0.035), GCS < 8 at the time of neurosurgical referral (OR 21.63, 95% CI 1.42-328, p=0.02), and increased PTT time before surgery (OR 2.11, 95% CI 1.11-4, p=0.02). Decreased postoperative lymphocytes confirmed a protective role against worsened functional outcomes (OR 0.01, 95% CI 0.01-0.4, p=0.02). Decreased post-operative lymphocyte count was associated with showed a protective role against increased mRS (OR: 0.01, 95% CI: 0.01-0.4; p=0.02). The occurrence of hydrocephalus at postoperative CT scan was associated with 30-day mortality (p=0.005), while the persistence of postoperative compression of the ambient and crural cistern showed a trend towards significance (p=0.07). Conclusions This study reports that patients undergoing DC for MIS showing decreased postoperative blood inflammatory markers achieved better 6-month neurological outcomes than patients with increased inflammatory markers. Similarly, poor NIHSS, poor GCS, increased age, and larger PTT values at the time of surgery were independent predictors of poor outcomes. Moreover, the persistence of postoperative compression of basal cisterns and the occurrence of hydrocephalus is associated with 30-day mortality.","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140659967","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":"Analysis of KLRB1-mediated immunosuppressive regulation in adamantinomatous craniopharyngioma.","authors":"Wei Wei","doi":"10.1055/a-2312-9813","DOIUrl":"https://doi.org/10.1055/a-2312-9813","url":null,"abstract":"BACKGROUND\u0000Adamantinomatous craniopharyngioma (ACP) is the most common type of craniopharyngioma (CP). Under the current surgery and/or radiotherapy strategies, the survival rate is high but the long-term quality of life is poor because of the relationship between the hypothalamic-pituitary and the tumor. Many studies had shown that endocrine deficiencies caused by craniopharyngiomas of the hypothalamic-pituitary axis persist throughout almost the entire life of the patients after surgery, requiring them to receive hormone replacement therapy. Thus, we need to explore new treatments to improve the prognosis of patients. In recent years, there are more and more studies on immunotherapy of various tumors. However, due to the rarity of the disease, immunotherapy for ACP is rarely researched. The discovery of the tumor immunosuppressive checkpoint KLRB1 (Killer Cell Lectin Like Receptor B1), which encodes CD161, may provide a novel target for the treatment of ACP.\u0000\u0000\u0000METHODS\u0000Data analysis of retrospective RNA-sequencing was conducted in a cohort of 51 pediatric samples in the GSE94349 dataset, and the results were well validated in the GSE68015 dataset including 31 pediatric samples. We used R language as the main tool for statistical analysis and graphical work.\u0000\u0000\u0000RESULTS\u0000Our research showed that KLRB1 was enriched in ACP. Additionally, the expression of KLRB1 was positively related to immune functions and most inflammatory responses of ACP. We found that most of the T lineage-related immune responses were positively correlated with KLRB1 expression, and KLRB1 played an important role in the activation of inflammatory processes.\u0000\u0000\u0000CONCLUSIONS\u0000KLRB1 is a promising target for immunotherapeutic strategies.","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140663641","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, microbiological profile and treatment response to intraventricular antibiotics in the Management of Post-Neurosurgical Meningitis: A single center experience.","authors":"Debajyoti Datta, Arunkumar Sekar, Amir Pasha, A. Patnaik, R. Sahu, S. Bansal","doi":"10.1055/a-2312-9276","DOIUrl":"https://doi.org/10.1055/a-2312-9276","url":null,"abstract":"Introduction Post-Neurosurgical Meningitis (PNM) is a serious medical condition with high mortality and morbidity caused by organisms like Staphylococcus aureus and Gram-negative organisms like Acinetobacter baumannii. Optimum concentration of antibiotics in the cerebrospinal fluid (CSF) to treat these infections are difficult to achieve. Intraventricular antibiotic administration bypasses the blood-brain barrier and can achieve high CSF concentration without causing systemic toxicity. Methods Retrospective review of all patient records were done to identify patients who developed post-neurosurgical meningitis and received intraventricular antibiotic therapy during the period of July 2017 to December 2022. Demographic and clinical data along with type of antibiotic, route, dose and duration of administration was collected. CSF parameters before and after intraventricular antibiotic administration were collected and analyzed. Results 26 patients with post-neurosurgical meningitis received intraventricular antibiotic therapy. Intracranial tumors were the most common underlying pathology followed by aneurysms. 17/26 patients had received vancomycin and 9/26 patients had received colistin. External ventricular drain was used in 17/26 cases and Ommaya reservoir was used in 9/26 cases. 6 cases showed growth of organism in CSF before starting intraventricular antibiotics, 1 case remained culture positive despite treatment. 3/26 patients died despite treatment. There were significant changes in the CSF parameters after intraventricular antibiotic therapy. Conclusion Intraventricular administration of antibiotic provides an alternative therapeutic option in the management of patients who are not responding or poorly responding to systemic antibiotics.","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140664979","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":"Erratum: Neuroendoscopic Lavage and Third Ventriculostomy for the Treatment of Intraventricular Hemorrhage and Hydrocephalus in Neonates. A Prospective Study with 18 Months of Follow-Up.","authors":"M. A. Islas-Aguilar, J. Torrez-Corzo, J. Chalita-Williams, D. Cervantes, J. Viñas-Rios","doi":"10.1055/s-0044-1786193","DOIUrl":"https://doi.org/10.1055/s-0044-1786193","url":null,"abstract":"","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140695968","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}