Neurosurgical Review最新文献

{"title":"Effectiveness and safety of proton therapy in intracranial meningioma treatment: a systematic review and meta-analysis.","authors":"Jeremiah Hillkiah Wijaya, Abdelrahman Ramadan Elashry, Sarmad Javaid, Mohga Khaled, Bismon Jibu, Bharath Narayanan, Daniela A Perez-Chadid, Aafreen Azmi, Juan Pablo Avila-Madrigal, Elizabeth E Ginalis, Anil Nanda","doi":"10.1007/s10143-026-04319-5","DOIUrl":"https://doi.org/10.1007/s10143-026-04319-5","url":null,"abstract":"<p><p>Meningiomas are the most common primary intracranial tumors, often treated surgically. However, complete resection is frequently limited by proximity to critical structures, necessitating adjuvant or definitive radiotherapy. Proton therapy offers dosimetric advantages over photon-based radiotherapy, particularly in sparing adjacent normal tissues. This study aims to systematically evaluate the effectiveness and safety of proton therapy for intracranial meningiomas across tumor grades and clinical scenarios. A systematic review and meta-analysis was conducted according to PRISMA 2020 guidelines using PubMed, EMBASE, Scopus, Web of Science, and Cochrane from inception to November 10, 2025. Studies were eligible if they reported clinical outcomes of proton therapy in ≥ 10 adult meningioma patients. Data extraction and risk-of-bias assessment were performed independently by two reviewers. Pooled complication rates and survival outcomes were calculated using random-effects models. Nineteen studies involving 1,431 patients were included. WHO Grade I tumors comprised 70.6% of cases; Grades II/III made up 25.2% and 4.2%, respectively. The most common proton dose regimens ranged from 13 to 70.2 Gy (RBE). The pooled complication rate was 16% (95% CI 5-27; p < 0.001; I² = 98.5%). Nine studies reported a statistically significant 5-year overall-survival proportion of 91% (95% CI 88-94; p < 0.001; I² = 49.3%). Radiologic local control averaged 71% (95% CI 50-86; I² = 88.2%). Proton therapy provides effective tumor control with acceptable toxicity, especially for low-grade or anatomically complex meningiomas. It is a valuable option for select patients, though further prospective studies are needed to optimize dosing and assess long-term outcomes.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of functional, structural, and electrophysiological optic nerve changes following extradural anterior clinoidectomy in patients without preoperative optic canal compression.","authors":"Mohammed Aladdam, Mehmet Sabri Gürbüz, Gülşen İshakoğlu, Fehim Esen, Temel Tombul, Fatih Çalış","doi":"10.1007/s10143-026-04320-y","DOIUrl":"https://doi.org/10.1007/s10143-026-04320-y","url":null,"abstract":"<p><p>Extradural anterior clinoidectomy is increasingly used to improve exposure and proximal vascular control in aneurysm surgery, but its isolated effect on an otherwise uncompromised optic nerve remains unclear. To evaluate the functional, structural, and electrophysiological impact of EAC with optic canal unroofing in patients without preoperative optic nerve compression or optic canal pathology. We conducted this single-center study included 16 adults who underwent no-drill extradural anterior clinoidectomy (EAC) during microsurgical clipping of ruptured aneurysms (January 2023-December 2024). Patients with visual or optic pathway pathology were excluded. Postoperative assessment (6-12 months) included visual acuity, automated perimetry (visual field index, VFI), OCT-derived retinal nerve fiber layer (RNFL) thickness, and visual evoked potentials (P100 latency). Eyes were compared using paired tests, with repeated-measures ANOVA for quadrant-based ΔRNFL. Visual acuity was preserved in all patients. Global RNFL thickness was similar in ipsilateral and contralateral eyes (95.8 ± 12.7 vs. 99.2 ± 18.6 μm; p = 0.230). Quadrant ΔRNFL varied by quadrant, but no pairwise differences remained after correction, with a trend toward greater thinning in the superior quadrant. VFI was similar (p = 0.7); one patient had inferior nasal quadrantanopia and two had mild blind-spot enlargement. P100 latency was comparable (114.8 ± 9.7 ms vs. 113.8 ± 8.9 ms; p = 0.223). No major EAC-related neurovascular complications were observed. Extradural anterior clinoidectomy was not associated with statistically significant optic nerve impairment, although visual field changes occurred in 3/16 patients (18.75%) with a trend toward superior RNFL thinning.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reinitiating antiplatelet therapy in chronic subdural hematoma: Does adjunctive middle meningeal artery embolization improve outcomes?","authors":"Muhammed Amir Essibayi, Jay Kakadiya, Hamza Adel Salim, Huanwen Chen, Ahmed Y Azzam, Adam A Dmytriw, Vivek S Yedavalli, Mohammad A Kassar, Marco Colasurdo, Dheeraj Gandhi, Deepak Khatri, Neil Haranhalli, David J Altschul, Dhairya A Lakhani","doi":"10.1007/s10143-026-04318-6","DOIUrl":"https://doi.org/10.1007/s10143-026-04318-6","url":null,"abstract":"<p><p>The optimal timing for reinitiating antiplatelet therapy after treatment of chronic subdural hematoma (cSDH) remains uncertain, especially when middle meningeal artery embolization (MMAE) is used as an adjunct to surgery. This study evaluated the safety and outcomes of early antiplatelet reinitiation in patients undergoing combined surgical evacuation and MMAE, and compared outcomes in antiplatelet-treated patients receiving surgery with versus without MMAE. Adult cSDH patients from the TriNetX database (May 2020-May 2025) were identified using ICD-10 and RXNORM codes. Two propensity score-matched analyses were performed: (1) patients receiving surgery with adjunct MMAE, stratified by antiplatelet initiation within 30 days; and (2) antiplatelet-treated patients undergoing surgery with adjunct MMAE versus surgery alone. Outcomes included rescue surgery and 6-month mortality. After matching, early antiplatelet use in surgery + MMAE patients (n = 163 per group) was not associated with higher rescue surgery rates (OR 0.68, 95% CI 0.32-1.48) or mortality (OR 1.52, 95% CI 0.73-3.20). Among antiplatelet-treated patients, surgery + MMAE (n = 176) had similar rescue surgery rates to surgery alone (n = 176) but significantly lower mortality (10.8% vs. 21.0%; OR 0.46, 95% CI 0.25-0.83, p = 0.009). Early antiplatelet reinitiation appeared safe after cSDH evacuation with adjunct MMAE. The associated lower 6-month mortality with adjunct MMAE in antiplatelet-treated patients is observational and hypothesis-generating, and warrants prospective confirmation.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep brain stimulation for freezing of gait in Parkinson's disease: An updated systematic review, meta-analysis, and a single-center clinical experience.","authors":"Mehrdad Behboodi, Saeed Abdollahifard, Kasra Assadian, Fahimeh Golabi, Reza Moshfeghinia, Pouya Karami Dehkordi, Razieh Rezaei, Sina Sabet, Ali Razmkon, Konstantin Slavin","doi":"10.1007/s10143-026-04312-y","DOIUrl":"https://doi.org/10.1007/s10143-026-04312-y","url":null,"abstract":"<p><p>Freezing of gait is a disabling and treatment-resistant manifestation of Parkinson's disease (PD). The effectiveness of deep brain stimulation (DBS) for freezing of gait remains inconsistent across stimulation targets, frequencies, and medication states. We conducted a systematic review and meta-analysis following PRISMA guidelines to examine how DBS affects freezing of gait in patients with PD. We searched Medline, Scopus, Web of Science, and Cochrane up to September 28, 2025. For synthesis, we combined mean differences and 95% confidence intervals for the Freezing of Gait Questionnaire (FOG-Q) and the Unified Parkinson's Disease Rating Scale (UPDRS) part III across different medication and stimulation settings to calculate the final effect size. Thirty-one studies with 905 patients were included. Of these, 21 provided FOG-Q data, and all reported UPDRS-III results. DBS led to a modest decrease in FOG-Q scores (mean difference [MD] = - 2.99; 95% CI = - 5.69 to - 0.29). The biggest improvement in FOG was seen when stimulation was used while patients were off medication (Med-OFF/Stim-OFF vs. Med-OFF/Stim-ON: MD - 5.88; 95% CI - 9.28 to - 2.47). Stimulation during the medication-ON state had smaller effects (Med-ON/Stim-OFF vs. Med-ON/Stim-ON: MD - 2.65; 95% CI - 4.99 to - 0.32), and there was no significant benefit when comparing Med-ON/Stim-OFF to Med-OFF/Stim-ON (MD - 0.70; 95% CI - 3.88 to 2.48). UPDRS-III scores improved substantially in the medication-OFF state with stimulation (MD - 14.35; 95% CI - 17.39 to - 11.32). High-frequency stimulation targeting the subthalamic nucleus provided more consistent benefits, yet substantial variation persisted across studies. The results of our small cohort showed significant improvement in FOG-Q and UPDRS-III (P values = 0.034, 0.022, respectively). DBS improves freezing of gait primarily in the medication-OFF state, with greater effects observed using high-frequency stimulation and subthalamic nucleus targets. Significant heterogeneity and limited data for alternative targets warrant cautious interpretation and further controlled studies.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroworsening in traumatic brain injury: A consensus of the Latin American Brain Injury Consortium (LABIC) and the Latin American Federation of Neurosurgical Societies (FLANC) expert group.","authors":"Daniel A Godoy, Robson Luís Oliveira de Amorim, Jorge Luís Paranhos, Kelia Santiago, Wellingson Paiva, Jorge Carrizosa, Franly Vázquez, Piedad Acurio, Jorge Flecha, Pedro Grille, Gustavo Domeniconi, Carlos Romero Patiño, Miguel Ángel Vences, Maximiliano Rovegno, Denise Efren Hermosa Altez, Manuel Jibaja, Rodrigo Faleiro, Marcelo Zenteno, Laura Bottani, Alejandro Rabinstein, Andrés M Rubiano","doi":"10.1007/s10143-026-04284-z","DOIUrl":"https://doi.org/10.1007/s10143-026-04284-z","url":null,"abstract":"<p><p>Neuroworsening (NW) after traumatic brain injury (TBI) is a life-threatening complication affecting at least one in five patients. The current definition remains heterogeneous and does not integrate contemporary neuromonitoring tools that could help reduce this variability. Current diagnostic approaches are predominantly reactive, identifying deterioration only after brain herniation has occurred. To establish an expert consensus to update the definition of NW in TBI by proposing a stratified diagnostic framework aligned with precision and personalized medicine principles, aiming to shift a paradigm that has been in use for the past 50 years. A formal Delphi consensus process was conducted involving 25 experts from the Latin American Brain Injury Consortium (LABIC) and the Latin American Federation of Neurosurgical Societies (FLANC). A pre-consensus systematic literature review was performed, followed by structured electronic surveys with Likert-scale and multiple-choice items. Consensus was predefined as ≥80% agreement for establishing a statement. A 95.2% response rate was achieved in the first Delphi round, with 100% of statements reaching the consensus threshold. The panel agreed on a stratified three phenotype NW framework: Established NW, Subclinical NW and High-Risk Phenotype, including patients with pre-existing anatomical or systemic conditions that affect cerebral compliance or oxygenation reserve. This consensus proposes integrating clinical, imaging, and multimodal neuromonitoring parameters to update the definition of NW, thereby reducing heterogeneity in the current concept. Seven statements were established with >80% agreement. The new definition promotes a preventive approach to this critical condition, in contrast to the traditional reactive model.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detailed evaluation of the long-term outcomes of repeat stereotactic radiosurgery for brain arteriovenous malformations: A single-center retrospective study.","authors":"Takeru Hirata, Motoyuki Umekawa, Hirotaka Hasegawa, Yuki Shinya, Atsuto Katano, Satoshi Koizumi, Nobuhito Saito","doi":"10.1007/s10143-026-04303-z","DOIUrl":"https://doi.org/10.1007/s10143-026-04303-z","url":null,"abstract":"<p><p>Repeat stereotactic radiosurgery (SRS) is a treatment option for residual brain arteriovenous malformations (AVMs) following incomplete response to an initial SRS, and this study aimed to clarify the long-term outcomes. Patients who underwent repeat SRS between 1990 and 2022 were retrospectively analyzed. Primary outcome was a favorable patient outcome, defined as AVM obliteration without post-SRS hemorrhage or symptomatic T2 signal change/late radiation-induced complications (LRICs). Fifty-eight patients with a median follow-up of 97 months were analyzed. Six patients (10.3%) experienced recurrent hemorrhage between the initial and repeat SRS, indicating high risk of hemorrhage in this cohort. Favorable patient outcome was achieved in 41 patients (70.7%), with 3- and 5-year cumulative rates of 68.1% and 79.2%. Maximum dose was associated with a favorable patient outcome (hazard ratio [HR] 1.07, 95% confidence interval [CI] 1.01-1.14; p = 0.016). AVM obliteration was achieved in 47 patients (81.0%), with 3- and 5-year rates of 69.2% and 85.0%. Three patients (5.2%) experienced post-repeat SRS hemorrhage, with an annual hemorrhage rate of 1.66%/person-year. Five patients (8.6%) experienced LRICs requiring resection with 5- and 10-year rates of 4.0% and 6.9%. T2 signal change after initial SRS (HR 17.11, 95% CI 1.06-276.55; p = 0.046) and initial maximum diameter > 25 mm (HR 21.12, 95% CI 1.01-442.76; p = 0.049) were associated with LRICs. Repeat SRS demonstrated long-term favorable outcomes in patients at a high risk of hemorrhage. A longer follow-up duration is important, as in the case of LRICs, which could be predicted by T2 signal change and nidus size before repeat SRS.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stand-alone porous titanium cages for anterior cervical discectomy and fusion: clinical outcomes in a multicenter experience.","authors":"Flavio Panico, Stefano Colonna, Marco Bozzaro, Andrea Gatto, Luca Ceroni, Ludovico Maria Comite, Salvatore Petrone, Marco Ajello, Nicola Marengo, Emanuele Bavaresco, Nicola Zullo, Diego Garbossa, Fabio Cofano","doi":"10.1007/s10143-026-04316-8","DOIUrl":"10.1007/s10143-026-04316-8","url":null,"abstract":"<p><strong>Background: </strong>Porous titanium cages have emerged as a promising alternative to traditional interbody materials in anterior cervical discectomy and fusion (ACDF), potentially enhancing osteointegration while maintaining mechanical stability. This multicenter study evaluates clinical and radiological outcomes following stand-alone ACDF using 3D-printed porous titanium cages.</p><p><strong>Methods: </strong>This retrospective observational study included 120 patients (mean age 54.8 years) who underwent stand-alone ACDF across three tertiary spine centers. Clinical outcomes were assessed using the Numerical Rating Scale (NRS) and Short Form-12 (SF-12). Radiological outcomes at 12 months included fusion, subsidence, migration, and sagittal alignment parameters. Fusion assessment at 12 months was performed using CT or dynamic flexion/extension radiographs.</p><p><strong>Results: </strong>At 12 months, interbody fusion was achieved in 106 patients (88.3%; 95% CI: 81.4%-92.9%). NRS scores significantly improved (mean reduction 4.2 points; p < 0.001), while SF-12 showed no significant change. Cage subsidence occurred in 7 patients (5.8%), with no cases of migration. Cervical sagittal alignment parameters remained stable over time, with no significant differences after correction for multiple comparisons. No significant associations were identified between preoperative variables and adverse radiological outcomes.</p><p><strong>Conclusions: </strong>Stand-alone ACDF with porous titanium cages is associated with high fusion rates, significant pain reduction, and low complication rates at 1 year. These findings support the use of porous titanium cages as a viable option in non-plating cervical fusion strategies, although further comparative studies are warranted to better define their relative performance.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Surgical screening protocol for craniocervical instability secondary to ehlers-danlos syndrome and other connective tissue disorders: analysis of a 347 patient case series.","authors":"Allison R Bloom, John B Biggins, Andrew Brodbelt, Misao Nishikawa, Mansoor Foroughi, Ilene S Ruhoy, Randall Dass, Kamil Rohana, Jeffrey D Wood, David Putrino, Veit Rohde, Christoph Bettag, Shawn Belverud, Travis Caton, Paolo A Bolognese, Tanvir Choudhri","doi":"10.1007/s10143-026-04280-3","DOIUrl":"10.1007/s10143-026-04280-3","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of ventriculosubgaleal shunt in managing neonatal hydrocephalus due to intraventricular hemorrhage: a systematic review and meta-analysis.","authors":"Stefeson Gomes Cabral Junior, Marcelo Porto Sousa, Filipe Virgilio Ribeiro, Maria Antonia Oliveira Machado Pereira, Raphael Camerotte, Christian Ken Fukunaga, Caio Vinicius Figueredo Almeida, Leonardo O Brenner, Márcio Yuri Ferreira, Sávio Batista, Felippe Figueiredo Torres Ribeiro, Raphael Bertani, Herika Negri Brito","doi":"10.1007/s10143-026-04239-4","DOIUrl":"https://doi.org/10.1007/s10143-026-04239-4","url":null,"abstract":"<p><p>Intraventricular hemorrhage (IVH) is a severe complication in premature neonates, occurring in 25%-30% of cases and often leading to posthemorrhagic hydrocephalus (PHH). When blood clots in the cerebrospinal fluid (CSF), preventing permanent shunt placement, temporary interventions are considered. Ventriculosubgaleal shunt (VSGS) utilizes the subgaleal space to absorb and drain excess CSF, reducing infection risk and allowing hydrocephalus control until the neonate reaches an appropriate weight and CSF clarity. This systematic review and meta-analysis evaluate the safety and efficacy of VSGS in treating neonatal PHH. A systematic review was conducted using Medline, Embase, and Web of Science following Cochrane and PRISMA guidelines. Eligible studies included those with ≥ 4 neonates. The primary outcomes analyzed were VSGS-related infection, VSGS revision, VSGS catheter migration, catheter obstruction, VSGS-related CSF leakage, permanent ventriculoperitoneal shunt (VPS) placement, overall mortality, and procedure-related mortality. A total of nineteen studies, encompassing 562 neonates, were included in our analysis. The pooled VSGS-related infection rate was 9% (95%CI: 5% to 12%). The need for VSGS revision was observed in 4% of cases (95%CI: 0% to 8%). The catheter obstruction rate was 2% (95% CI: 0% to 5%), while VSGS catheter migration occurred in 1% of cases (95%CI: 0% to 5%). VSGS-related CSF leakage was reported in 6% of neonates (95%CI: 3% to 9%). Permanent VPS placement was required in 75% of patients (95%CI: 67% to 82%). The overall mortality rate was 10% (95%CI: 4% to 16%), and the procedure-related mortality rate was 1% (95%CI: 0% to 2%). This systematic review and meta-analysis identified VSGS as a safe and effective option for treating hydrocephalus caused by IVH in premature neonates.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The research of subdural effusion collection complicating cerebral revascularization following ventriculoperitoneal shunting in adults with hemorrhagic moyamoya disease: A retrospective case series.","authors":"Wang Lu, Zhang Chaoran, Chen Xinhua, Wu Lingyun, Sun Yuanyuan, Wang Yi, Li Wei, Hang Chunhua, Wang Juan, Zhou Lei, Liu Yi, Wang Rong, Zhao Bo, Shi Zhiyong, Yang Yongbo","doi":"10.1007/s10143-026-04294-x","DOIUrl":"https://doi.org/10.1007/s10143-026-04294-x","url":null,"abstract":"<p><p>Ventriculoperitoneal shunting (VPS) helps reduce intracranial pressure and alleviate clinical symptoms caused by hydrocephalus in hemorrhagic Moyamoya disease (MMD). To date, no literature describes the occurrence of subdural fluid collection (SDFC) in hemorrhagic MMD patients undergoing VPS prior to cerebral revascularization. This report aims to explore the potential pathological mechanisms underlying SDFC following cerebral revascularization after prior VPS, and to provide effective strategies for future prevention. Clinical data of hemorrhagic MMD patients undergoing VPS prior to bypass admitted to our hospital from 2021 January and 2024 December were selected. Medical records were reviewed to analyze patient characteristics and the entire disease course. Among the 7 patients (9 cases), postoperative SDFC occurred in 7 cases (7/9, 77.8%), located contralateral to the shunt in 6 cases (6/7, 85.7%) and ipsilateral to the surgical side in 1 case (1/7, 14.3%), with onset mostly within 1 day after surgery. Among these 7 patients, 2 underwent subdural drilling and drainage due to significant mass effect caused by the effusion. One of these patients developed herniation with decreased consciousness and notable midline shift, and symptoms gradually improved after subdural drainage. Durin-g short-term clinical follow-up (postoperative period < 12 months), recurrent hemorrhage occurred in 1 out of 9 cases, while no cases of cerebral infarction or seizures were observed. CT angiography (CTA) revealed occlusion of the bypass graft in 2 out of 6 direct bypass cases. Through the findings of this study and literature review, we observe that cerebral revascularization performed during the late phase of VPS may induce SDFC complications through multiple mechanisms. Future implementation of early intervention may effectively reduce the risk of adverse events and improve surgical outcomes.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}