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

{"title":"International Relations of German Neurosurgeons after 1945 and the Evolution of the European Association of Neurosurgical Societies.","authors":"Hartmut Collmann, Ulrike Eisenberg, Wolf-Ingo Steudel, Jürgen Piek","doi":"10.1055/a-2558-3403","DOIUrl":"https://doi.org/10.1055/a-2558-3403","url":null,"abstract":"<p><p>International relationships of early German neurosurgeons had a long tradition. These connections had been cut off after World War II and could initially be re-established only at a personal level. In this context, Klaus Joachim Zülch, Kurt Schürmann, Hans Werner Pia, Friedrich Loew, and Arist Stender played a significant role. It took nearly two decades to establish good connections at an institutional level. During this process, major support came from France and should be considered as part of a growing cooperation of European states in various fields. The 1959 meeting of French, Swiss, and German neurosurgeons in Zürich was a crucial event, which ultimately led to the foundation of the European Association of Neurosurgical Societies.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":"86 S 01","pages":"S59-S64"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119709","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":"Artificial Intelligence Prediction Model of Occurrence of Cerebral Vasospasms Based on Machine Learning.","authors":"Konstantinos Lintas, Stefan Rohde, Anna Mpoukouvala, Boris El Hamalawi, Robert Sarge, Oliver Marcus Mueller","doi":"10.1055/a-2402-6136","DOIUrl":"10.1055/a-2402-6136","url":null,"abstract":"<p><strong>Background: </strong> Symptomatic cerebral vasospasms are deleterious complication of the rupture of a cerebral aneurysm and potentially lethal. The existing scales used to classify the initial presentation of a subarachnoid hemorrhage (SAH) offer a blink of the outcome and the possibility of occurrence of symptomatic cerebral vasospasms. Altogether, neither are they sufficient to predict outcome or occurrence of events reliably nor do they offer a united front. This study tests the common grading scales and factors that otherwise affect the outcome, in an artificial intelligence (AI) based algorithm to create a reliable prediction model for the occurrence of cerebral vasospasms.</p><p><strong>Methods: </strong> Applying the R environment, an easy-to-operate command line was programmed to prognosticate the occurrence of vasospasms. Eighty-seven patients with aneurysmal SAH during a 24-month period of time were included for study purposes. The holdout and cross-validation methods were used to evaluate the algorithm (65 patients constituted the validation set and 22 patients constituted the test set). The Support Vector Machines (ksvm) classification method provided a high accuracy. The medical dataset included demographic data, the Hunt and Hess scale (H&H), Fisher grade, Barrow Neurological Institute (BNI) scale, length of intervention for aneurysmal repair, etc. RESULTS:  Our prediction model based on the AI algorithm demonstrated an accuracy of 61 to 86% for the event of symptomatic vasospasms. For subgroup analysis, 28.8% (<i>n</i> = 13) patients in the surgical cohort developed symptomatic vasospasm. Of these, 50% (<i>n</i> = 7) were admitted with Fisher scale grade 4, 37.5% (<i>n</i> = 5) with H&H 5, and 28.5% (<i>n</i> = 4) with BNI 5. In the endovascular cohort, vasospasms occurred in 31.8% (<i>n</i> = 14) patients. Of these, 69% (<i>n</i> = 9) patients were admitted with Fisher grade 4, 23% (<i>n</i> = 3) patients with H&H 5, and 7% (<i>n</i> = 1) patients with BNI 5.</p><p><strong>Conclusion: </strong> From our data, we may believe that the algorithm presented can help in identifying patients with SAH who are at \"high\" or \"low\" risk of developing symptomatic vasospasms. This risk balancing might further allow the treating physician to go for an earlier intervention trying to prevent permanent sequelae. Certainly, accuracy will improve with a higher caseload and more statistical coefficients.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"196-204"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046763","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 Evolution of the Deutsche Gesellschaft für Neurochirurgie (German Society of Neurosurgery).","authors":"Hartmut Collmann, Jutta Krüger","doi":"10.1055/a-2558-3263","DOIUrl":"https://doi.org/10.1055/a-2558-3263","url":null,"abstract":"<p><p>In Germany, an independent society of neurosurgical specialists was devised in 1937 and from the beginning it was contemplated as a European association. National Socialist's politics and the looming next World War shelved these plans. Only in 1948, at the first postwar meeting of German neurosurgeons, appropriate preparations toward a national neurosurgical society were made under the leadership of Wilhelm Tönnis. In 1949, seven founding members, almost all of them being former trainees of Tönnis, established this new medical society and named it \"Deutsche Gesellschaft für Neurochirurgie,\" and also took care for registration after the third postwar meeting in Bonn. A total of 256 applicants signed in a list for membership, a minority of them being surgically active. Of 21 female applicants, none worked as neurosurgeons thereafter. All seven founding members were residents of the three western occupation zones, reflecting the upcoming Cold War, and de facto segregated those neurosurgeons living and working in East Germany under Soviet military control.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":"86 S 01","pages":"S4-S8"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119847","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":"Robotic Frameless Stereotactic Aspiration with Thrombolysis for Primary Pontine Hemorrhage: A Therapeutic Evaluation of a Retrospective Cohort Study.","authors":"Chongxi Xu, Wenbo He, Tong Yi, Hongtian Zhang, Jianguo Xu, Junpeng Ma","doi":"10.1055/a-2235-5453","DOIUrl":"10.1055/a-2235-5453","url":null,"abstract":"<p><strong>Background: </strong> There is still no consensus on whether primary pontine hemorrhage (PPH) should be managed conservatively or treated promptly via surgical evacuation of the hematoma. The purpose of this study was to assess the therapeutic effect of robotic frameless stereotactic aspiration with thrombolysis in the treatment of PPH.</p><p><strong>Methods: </strong> A total of 39 patients with PPH treated between January 2012 and November 2016 were included in the study. Sixteen patients underwent frameless stereotactic surgical treatment (ST group) and 23 patients underwent conservative treatment (CT group). Clinical and radiologic parameters were assessed, and the patient outcomes were analyzed over a 6-month follow-up period.</p><p><strong>Results: </strong> Surgical treatment did not result in any intracranial infections, or complications. Baseline characteristics did not significantly differ between the two groups. At discharge, the average Glasgow Coma Scale (GCS) score and the overall Glasgow Outcome Scale (GOS) score were significantly higher in the ST group compared to the CT group (<i>p</i> < 0.05). The mortality rate (GOS score 1) was significantly lower in the ST group (18.75%, 3/16) than in the CT group (52.17%, 12/23). For patients with hematoma volumes of 5 to 10 mL or GCS scores of 6 to 8, following treatment, the ST group exhibited markedly higher GOS scores in comparison to the CT group.</p><p><strong>Conclusion: </strong> Our study suggests that robotic frameless stereotactic aspiration with thrombolysis is a safe and efficient method for the treatment of PPH. Patients with hematomas of 5 to 10 mL or GCS scores of 6 to 8 could benefit from surgery.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"111-119"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048918","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":"Neurosurgery in Germany Around 1950. On the 75th Anniversary of the German Society of Neurosurgery (DGNC).","authors":"Ulrike Eisenberg, Hartmut Collmann","doi":"10.1055/a-2558-3445","DOIUrl":"https://doi.org/10.1055/a-2558-3445","url":null,"abstract":"","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":"86 S 01","pages":"S1"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119711","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":"Establishing Safe Surgical Parameters for Placement of C2 Pedicle Screws: A Retrospective Study.","authors":"Bekir Tunç, Denizhan Divanlıoğlu, Göksal Günerhan, Egemen Işıtan, Emin Çağıl, Ali Dalgıç","doi":"10.1055/a-2235-5381","DOIUrl":"10.1055/a-2235-5381","url":null,"abstract":"<p><strong>Background: </strong> The study aimed to evaluate the safety and feasibility of transpedicular instrumentation for the C2 vertebra and to establish the precise anatomical parameters and boundaries within which this procedure can be safely and effectively performed.</p><p><strong>Methods: </strong> This retrospective study analyzed 66 patients who underwent C2 transpedicular screw fixation. Preoperative and postoperative axial, sagittal, and coronal computed tomography (CT) scans were examined. Anatomical measurements were taken to determine the horizontal and vertical distances from the C2 pedicle projection to the vertebral foramen using CT images. Based on the anatomical location of the vertebral artery within the C2 vertebral foramen, the patients were divided into four subgroups using the horizontal pedicle width (HPW) and vertical pedicle width (VPW) of the C2 spine.</p><p><strong>Results: </strong> The average age of the patients included in the study was 46.48 years. The patient population comprised 32 (48.5%) males and 34 (51.5%) females. Based on the anatomical measurements, the distribution of C2 vertebra types was as follows: type 1 accounted for 68.9%, type 2 for 3.8%, type 3 for 16.7%, and type 4 for 10.6%. Significantly narrower pedicle widths were observed in types 2 and 4 compared to other vertebra types. Type 2 had the largest medial angle (MA), while type 4 had the narrowest MA. In terms of the sagittal plane, type 4 exhibited the widest MA and type 3 had the narrowest MA, but these differences were not statistically significant. Among the cases, 12 (18.1%) involved the vertebral foramen, with 1 case (8.3%) showing screw-related vertebral artery injury (0.75% of all screws). No vertebral artery injuries were observed with the other transpedicular screws.</p><p><strong>Conclusion: </strong> Preoperative anatomical measurements for patients undergoing transpedicular instrumentation on the C2 vertebra should include planning CT images on three planes: axial, sagittal, and coronal.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"162-168"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048915","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 Extension of Traumatic Subdural Hematoma into the Interhemispheric Fissure Is Associated with Coagulation Disorders: A Retrospective Study.","authors":"Lennart W Sannwald, Dag Moskopp, Mats L Moskopp","doi":"10.1055/s-0043-1777859","DOIUrl":"10.1055/s-0043-1777859","url":null,"abstract":"<p><strong>Background: </strong> This study investigates the correlation of the radiologic sign of interhemispheric subdural hematoma (iSDH) in different injury patterns with clinical coagulation disorders. It is hypothesized that the presence of iSDHs is correlated with clinical coagulation disorders in patients with traumatic brain injuries and subdural hematoma (SDH).</p><p><strong>Methods: </strong> Between January 1, 2020 and June 30, 2022, 154 patients with SDH were identified. Coagulation disorders were assessed using chart review and patients were divided into four groups: SDH without iSDH without further injuries (SDH), SDH with iSDH without further injuries (SDH + iSDH), SDH without iSDH with further brain injuries (Combi), SDH with iSDH with further injuries (Combi + iSDH). These four groups were formed under the assumption that isolated SDHs result from a highly specific trauma mechanism (rupture of bridging veins) in predisposed elderly patients, while combined brain injuries with SDH result from a severe global traumatic brain injury combining different pathophysiologic mechanisms often in younger patients. The groups were analyzed for patient demographics, clinical presentation, and association with coagulation disorders. The significance level was set at <i>p</i> < 0.005.</p><p><strong>Results: </strong> The presence of an iSDH was associated with a higher likelihood of concomitant coagulation disorder or anticoagulants in cases of isolated subdural hemorrhage (56.8% of the population in SDH vs. 94.7% in SDH + iSDH, <i>p</i> < 0.005). This effect was not significant in the cases with combined traumatic brain injuries (33.3% in Combi vs. 53.6% in Combi + iSDH, <i>p</i> > 0.005).</p><p><strong>Conclusion: </strong> Our data indicate a high positive predictive value (PPV = 94.7%) for coagulation disorders in traumatic SDH patients with iSDH without any further focal and diffuse brain injuries. We consider this a relevant finding since it hints at the presence of coagulation disorders and might be used in early hemostaseologic assessment and emergency management.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"148-155"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140326702","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":"Intraoperative Germinoma Staining: A Technical Note.","authors":"Emanuil Naydenov, Petar Karazapryanov, Velislav Pavlov, Dimitar Metodiev, Krasimir Minkin","doi":"10.1055/a-2389-5353","DOIUrl":"10.1055/a-2389-5353","url":null,"abstract":"<p><p>As the main treatment modality of central neural system germinomas is radiotherapy and/or chemotherapy, the exact initial diagnosis of the disease is crucial. Depending on the different national protocols, histologic verification can be obligatory in some instances. This is a serious challenge, taking into account the usual location and nonspecific macroscopic appearance of these lesions. Here, we propose a safe and effective method of intraoperative tumor enhancement that can increase the confidence of the surgeon during the intervention.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"213-216"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995915","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":"Alternative Bypass Technique Using Radial Artery Graft between V3 Segment of Vertebral Artery and Middle Cerebral Artery: Technical Note.","authors":"Yasuhiro Ito, Katsuhiko Maruichi, Naoki Nakayama, Hiroyuki Kobayashi, Ryota Tatezawa, Shinitirou Shinada, Shunsuke Terasaka","doi":"10.1055/s-0043-1775989","DOIUrl":"10.1055/s-0043-1775989","url":null,"abstract":"<p><strong>Background: </strong> There are some cases where a radial artery (RA) graft is needed for a high-flow extracranial to intracranial (EC-IC) bypass as the external carotid artery (ECA) cannot be utilized as a donor artery. In this report, we describe two cases of extracranial vertebral artery (VA) to middle cerebral artery (MCA) high-flow bypass using an RA graft with an artificial vessel as an alternative bypass technique.</p><p><strong>Methods: </strong> The patient was placed supine with a head rotation of 80 degrees. After frontotemporal craniotomy, another C: -shaped skin incision was made at the retroauricular region and the V3 portion of the VA was exposed at the suboccipital triangle. Prior to attempting the high-flow bypass, the superficial temporal artery (STA) was anastomosed to the M4 portion of the MCA as an insurance bypass. The RA graft was anastomosed to the V3 portion of the VA that traveled under the periosteum at the supra-auricular region through an artificial vessel. After RA-M2 anastomosis, an alternative EC-IC bypass, the V3-RA-M2 bypass, was achieved.</p><p><strong>Results: </strong> Postoperative angiography demonstrated successful graft patency and no perioperative complications were observed in both cases.</p><p><strong>Conclusions: </strong> In the cases where a high-flow bypass is required, the V3 portion of the VA is a suitable alternative proximal anastomosis site when the ECA is not a candidate donor. Furthermore, an artificial vessel shows satisfactory protection against graft complications.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"99-104"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41203561","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":"Subdural Hematoma due to Dural Metastasis: A Systematic Review on Frequency, Clinical Characteristics, and Neurosurgical Management.","authors":"Bhavya Pahwa, Anish Tayal, Atulya Chandra, Joe M Das","doi":"10.1055/s-0044-1782141","DOIUrl":"10.1055/s-0044-1782141","url":null,"abstract":"<p><strong>Background: </strong> Subdural hematoma (SDH) occasionally accompanies dural metastasis and is associated with high recurrence rate, significantly impacting patient morbidity and mortality. This systematic review aims to evaluate the characteristics, management options, and outcomes of patients with SDH associated with dural metastasis.</p><p><strong>Methods: </strong> A comprehensive search of the PubMed and Cochrane databases was conducted for English-language studies published from inception to March 20, 2023, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The authors reviewed cases of histopathologically confirmed SDH with non-central nervous system (non-CNS) tumor metastasis, focusing on therapeutic management of SDH. Statistical analysis was performed using SPSS software, with a significance level set at 0.05.</p><p><strong>Results: </strong> This review included 32 studies comprising 37 patients with 43 SDH cases associated with dural metastasis. Chronic SDH was the most frequently observed presentation (<i>n</i> = 28, 65.12%). The systemic malignancies most commonly associated with SDH due to dural metastasis were prostate carcinoma (<i>n</i> = 9, 24.32%) and gastric carcinoma (<i>n</i> = 5, 13.51%). A statistically significant association was found between metastatic melanoma and subacute SDH (<i>p</i> = 0.010). The majority of patients were treated with burr holes (<i>n</i> = 15, 40.54%) or craniotomies (<i>n</i> = 14, 37.84%), with no statistically significant difference in mortality rates between the two techniques (<i>p</i> = 0.390). Adjuvant therapy was administered to a limited number of patients (<i>n</i> = 5, 13.51%), including chemotherapy (<i>n</i> = 2, 5.41%), whole brain radiotherapy (<i>n</i> = 1, 2.70%), a combination of chemotherapy and whole brain radiotherapy (<i>n</i> = 1, 2.70%), and transcatheter arterial chemoembolization (<i>n</i> = 1, 2.70%). The overall recurrence rate was 45.95% (<i>n</i> = 17), with burr holes being the most common management approach (<i>n</i> = 4, 10.81%). Within a median of 8 days, 67.57% (<i>n</i> = 25) of patients succumbed, primarily due to rebleeding (<i>n</i> = 3, 8.11%), disseminated intravascular coagulation (<i>n</i> = 3, 8.11%), and pneumonia (<i>n</i> = 3, 8.11%).</p><p><strong>Conclusion: </strong> This review highlights the need for improving existing neurosurgical options and exploring novel treatment methods. It also emphasizes the importance of dural biopsy in patients with suspected metastasis to rule out a neoplastic etiology.</p>","PeriodicalId":16544,"journal":{"name":"Journal of neurological surgery. Part A, Central European neurosurgery","volume":" ","pages":"73-84"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140028254","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}