Neurosurgical Review最新文献

{"title":"Effectiveness of Gamma Knife radiosurgery for recurrent glioblastoma: a 10-year retrospective analysis.","authors":"Jo Sasame, Takashi Shuto, Shigeo Matsunaga, Nagatsuki Tomura, Fukutaro Ohgaki, Kei Iwamoto, Shuto Fushimi, Hisao Aimi","doi":"10.1007/s10143-025-03725-5","DOIUrl":"https://doi.org/10.1007/s10143-025-03725-5","url":null,"abstract":"<p><p>No standard treatment for recurrent glioblastoma (rGBM) has been established. However, Gamma Knife radiosurgery (GKRS) is considered a viable option for local control. We aimed to examine the clinical characteristics of patients treated with GKRS for rGBM at our institution over 10 years. We retrospectively analyzed data of 38 patients who underwent GKRS for rGBM from April 2012 to March 2022, all of whom had received standard first-line treatment before recurrence. Forty-eight GKRS sessions were conducted on the 38 patients (stereotactic radiosurgery [SRS], 40; stereotactic radiotherapy, 8). The median marginal dose for SRS was 18 (range, 12-22) Gy. The median patient age was 62 (28-83) years. As part of postoperative chemoradiotherapy, radiation doses were 35 Gy for 1 patient, 40 Gy for 10 patients, and 60 Gy for 27 patients. The median time from surgery to GKRS was 11 (2-44) months. Adverse radiation effects included radiation necrosis in five patients (13%) and cerebral edema in two (5%). Progression at the GKRS site was observed in 24 patients (63%), with a median time to progression of 4.5 months. The median overall survival was 20 months, and that after GKRS was 12 months. A longer interval from surgery to GKRS (multivariable) and a total postoperative radiation dose of 60 Gy (univariate) were significant prognostic factors. GKRS shows promise as a treatment for rGBM, particularly for patients with a longer interval before recurrence and those receiving a 60-Gy postoperative radiation dose.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"565"},"PeriodicalIF":2.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626782","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":"Analysis of predictive factors for the efficacy of reinforced radiculoplasty in symptomatic sacral Tarlov cysts.","authors":"Jin Zhu, Ling Li, Xizhu Wang, Liang Shi, Yibing Su","doi":"10.1007/s10143-025-03712-w","DOIUrl":"https://doi.org/10.1007/s10143-025-03712-w","url":null,"abstract":"<p><p>Reinforced radiculoplasty of the sacral nerve roots has been used in the treatment of symptomatic sacral Tarlov cysts (TCs). However, there is still insufficient evidence to support the effectiveness of this procedure in relieving pain, numbness, or bowel and bladder dysfunction in TC patients. In this single-center retrospective study, we reviewed data and conducted telephone follow-ups of 41 patients who underwent surgery between 2021 and 2023. Clinical characteristics-such as age, gender, follow-up duration, cyst length, number of cysts, side of cysts, number of nerves, preoperative selective nerve root block (SNRB), and pre- and postoperative symptoms-were collected and analyzed using binary logistic regression to identify potential predictors. A total of 41 patients were included in the study. Significant improvements were observed in pain and numbness across the entire patient group, the lateral side subgroup, and the no-SNRB subgroup, as well as in pain among female patients (P < 0.05). Among the 33 patients with preoperative pain, binary logistic regression analysis revealed that of age and preoperative visual analogue scale (VAS) scores were significantly associated with pain-free status (P < 0.05). However, no variables were found to be significantly associated with numbness relief (P > 0.05). In conclusion, reinforced radiculoplasty can significantly improve pain and numbness in patients with sacral TC. Older age and lower preoperative VAS scores are associated with a greater likelihood of achieving a pain-free outcome.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"564"},"PeriodicalIF":2.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626781","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":"Seizure incidence after deep brain stimulation: a meta-analysis of risk factors and target-specific outcomes in non-epileptic disorders.","authors":"Amir Reza Bahadori, Parisa Javadnia, Erfan Naghavi, Ladan Heidaresfahani, Iman Sarmadi, Mohammad Rajabi, Afshan Davari, Saba Dahaghin, Sara Ranji, Sajad Shafiee, Abbas Tafakhori","doi":"10.1007/s10143-025-03727-3","DOIUrl":"https://doi.org/10.1007/s10143-025-03727-3","url":null,"abstract":"<p><strong>Introduction: </strong>The reports of seizures following Deep Brain Stimulation (DBS) are low; however, these seizures would be debilitating. Current literature has not provided a comprehensive analysis of seizure incidence post-DBS across various neuropsychiatric disorders. Additionally, there is a lack of insight into the contributing factors and the underlying mechanisms associated with this occurrence.</p><p><strong>Aim: </strong>This systematic review and meta-analysis investigated the incidence of epilepsy in patients with neurological disorders who have undergone DBS, excluding those with drug-resistant epilepsy.</p><p><strong>Method and material: </strong>The study was conducted according to PRISMA guidelines and involved thorough data extraction from several databases, specifically PubMed, Scopus, Embase, Web of Science, and the Cochrane Library, until 28-Feb-2025. We performed this Meta-analysis by using Comprehensive meta-analysis (CMA) software version 3.0 for the statistical analysis Results: This systematic review and meta-analysis encompassed 33 studies, and 5,488 patients. The most frequently neurological disorder which underwent DBS in this review, was Parkinson's Disease. Our meta-analysis revealed that the incidence of seizures following DBS was 2.9% (95% CI: 0.020 to 0.042; p-value < 0.001). A strong positive correlation was identified between the rate of intracerebral hemorrhage (ICH) and seizure occurrence, with a Pearson correlation coefficient of 0.635 (p-value: 0.007). Furthermore, there is a significant increase in the likelihood of seizure occurrences following globus pallidus internus- DBS compared to subthalamic nucleus- DBS.</p><p><strong>Conclusion: </strong>Patients with neurological disorders following DBS may experience seizures; however, the incidence of such occurrences is low and typically resolves spontaneously.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"566"},"PeriodicalIF":2.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626783","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":"Risk factors and surgical maneuvers to decrease recurrences of olfactory groove meningiomas: institutional case series and systematic literature review.","authors":"Francesco Maiuri, Giuseppe Corazzelli, Jacopo Berardinelli, Sergio Corvino","doi":"10.1007/s10143-025-03716-6","DOIUrl":"https://doi.org/10.1007/s10143-025-03716-6","url":null,"abstract":"<p><strong>Background: </strong>Recurrences of olfactory groove meningiomas (OGMs) sometimes occur even after gross total resection. The present study discusses the risk factors of recurrences and the most important surgical steps at initial surgery to reduce the recurrence rate.</p><p><strong>Methods: </strong>A monoinstitutional series of 60 patients with OGMs operated through microsurgical transcranial approaches and a comprehensive systematic literature review on recurrent OGMs operated via transcranial approaches (TCAs) (Group A) or endoscopic endonasal approach (EEA) (Group B) were retrospectively and separately analyzed. The analyzed factors included patient age, prior surgeries, tumor size, extent of resection at initial surgery, management of basal bone invasion, dural attachment, optic canals invasion, anterior cerebral arteries (ACAs) encasement, follow-up. All these data were statistically correlated with the recurrence rate. The review investigation followed a prespecified protocol registered on PROSPERO (PROSPERO 2024 CRD420250655908).</p><p><strong>Results: </strong>48 studies met the inclusion criteria for an overall sample of 1498 patients, of which 1377 (38 studies) belonging to the group A and 121 (10 studies) belonging to group B. The overall recurrence rate was 6.6% after TCAs and 7.4% after EEA (p > 0.9); however, the median follow up was longer in group A (72.5 ± 29.6 months) compared to group B (32.3 ± 12.9 months) (p < 0.01). Studies of patients treated by TCAs showed higher median values of gross total resection (GTR) (92.5%) than studies on patients treated by EEA (67.7%) (p < 0.01). The median recurrence rate after GTR was 4.7% in group A and 5.6% in group B (p > 0.9). In group A the resection of the dural attachment (reported in 46% of the reviewed patients) resulted in further decrease of the recurrence rate (3.2%). Optic canal extension was significantly more frequent in group A (57.3%) than in group B (21.5%) (p < 0.01).</p><p><strong>Conclusion: </strong>Resection of infiltrated basal bone and dural attachment during TCAs, mainly in young anosmic patients, may reduce the recurrence rate. Residual intracranial tumor nodules and peripheral dural infiltration must be avoided during the EEA. Decompression of the optic nerves and resection of tumor extending into the optic canals is mandatory in both approaches to minimize the recurrence risk.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"562"},"PeriodicalIF":2.5,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144619440","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":"Integrated clinicopathological-radiomic-blood model for glioma survival prediction via machine learning: a multicenter cohort study.","authors":"Zhihao Wang, Tao Chang, Jing Yang, Chaodong Xiang, Xianqi Wang, Pinzhen Chen, Yunhui Zeng, Lanqin Deng, Wenhao Li, Yuhang Ou, Siliang Chen, Hao Ren, Yuan Yang, Xiaofei Hu, Qing Mao, Wei Chen, Yanhui Liu","doi":"10.1007/s10143-025-03719-3","DOIUrl":"https://doi.org/10.1007/s10143-025-03719-3","url":null,"abstract":"<p><strong>Background: </strong>Glioma is characterized by a poor prognosis and limited possibilities for treatment. Previous studies have developed prediction models for glioma using genetic, clinical, pathological, imaging and other aspects; however, few studies have combined these data. The current study is intended to fully utilize medical data from the routine practice of glioma care and develop a model with the assistance of machine learning.</p><p><strong>Methods: </strong>Multiple factors-including demographic features, radiomic features, laboratory biomarkers, and pathological features-were collected from two Class Three hospitals in China. Preoperative images and blood tests were quantified with machine learning methods. The survival time was documented during follow-up. Multivariate Cox regression and seven machine learning algorithms were used for modeling.</p><p><strong>Results: </strong>A total of 674 glioma patients from two centers were enrolled. Fifteen radiomic features (RFs) and ten laboratory biomarkers were used to create the RF score and blood score. A clinicopathological-radiomic-blood model (CRBM) was created to stratify the mortality risk of glioma patients (P < 0.0001). The AUC of the Cox-based model was 0.913 (0.886-0.940) on the training dataset and 0.802 (0.738-0.865) on the validation dataset, and the AUCs of the XGBoost model on the same datasets were 0.954 (0.935-0.973) and 0.761 (0.693-0.829), respectively. The SHapley Additive exPlanations (SHAP) method suggested the contribution of preoperative imaging and laboratory data to the model.</p><p><strong>Conclusion: </strong>The CRBM is able to predict the survival of glioma patients with acceptable accuracy. Our work suggests the considerable potential of combined clinically derived data in predicting glioma survival and the utility of machine learning in variable selection and model construction.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"560"},"PeriodicalIF":2.5,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144619438","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":"Notable differences in changes between ventral and dorsolateral spinal longitudinal extradural CSF collection after treatment in patients with spontaneous spinal CSF leaks.","authors":"Tatsuya Ohtonari, Takahiro Himeno, Kyohei Sakai, Shohei Noguchi","doi":"10.1007/s10143-025-03724-6","DOIUrl":"https://doi.org/10.1007/s10143-025-03724-6","url":null,"abstract":"<p><p>Spontaneous spinal CSF leaks can lead to significant clinical symptoms and present a diagnostic challenge. However, the relationship between post-treatment headache relief and changes in epidural CSF collections, commonly observed laterally and dorsally around the dural sac, or in ventral spinal longitudinal extradural CSF collections (vSLEC), is not yet well understood. Forty-five consecutive patients with spontaneous CSF leaks (female, 28; median age, 44 years) treated at our hospital between April 2006 and December 2023 were retrospectively investigated. Clinical outcomes were assessed in all 45 patients following treatment, which included conservative management with intravenous fluids and rest (7 cases [15.6%]), and large-volume epidural blood patch (38 cases [84.4%]), including an analysis of changes in dorsolateral epidural CSF collection and vSLEC at baseline and final follow-up in 35 patients who underwent postoperative MRI. The findings of dorsolateral epidural CSF collection disappeared or reduced after treatments in all 35 patients (disappearance, 20 of 35 cases [57.1%]; marked reduction, 13 [37.1%]; and mild reduction, 2 [5.7%]). Conversely, post-treatment MRI was available in 32 (77.3%) of 41 patients with vSLEC findings at baseline (median follow-up period, 129 days). The changes in vSLEC were as follows: disappearance, 4 of 32 cases (12.5%); marked reduction, 10 (31.3%); mild reduction, 12 (37.5%); no change, 4 (12.5%); and enlargement, 2 (6.2%). In conclusion, despite the low rate of vSLEC reduction after treatment, patients experienced significant headache relief in 44 (97.8%) of the 45 cases, along with a high rate of reduction in dorsolateral epidural CSF collections following treatment. Clinical trial number: not applicable.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"561"},"PeriodicalIF":2.5,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144619439","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":"Comparative analysis of the efficacy of neuro-endoscopy versus conventional surgery in the treatment of hypertensive intracerebral hemorrhage.","authors":"Yijie You, Peiyuan Ding, Yunlian Niu, Fengbing Sun, Xuhui Wang","doi":"10.1007/s10143-025-03720-w","DOIUrl":"https://doi.org/10.1007/s10143-025-03720-w","url":null,"abstract":"<p><strong>Background: </strong>There are multiple therapeutic approaches for hypertensive intracerebral hemorrhage, including neuro-endoscopy and traditional craniotomy. This study aims to compare the efficacy and prognosis of these two modalities in managing hypertensive intracerebral hemorrhage.</p><p><strong>Method: </strong>By retrospectively analyzing data from two medical centers, we comprehensively investigated patients who underwent surgical intervention for spontaneous cerebral hemorrhage within 48 h of admission between June 2021 and May 2024. A total of 285 patients diagnosed with HICH were included in this study, divided into two groups (endoscopic surgery group and traditional surgery group). Comparative analyses were conducted to assess differences in baseline characteristics, clinical outcomes, prognosis, and neurological function between the two groups.</p><p><strong>Results: </strong>Among the 285 eligible patients, we conducted endoscopic surgery and traditional open craniotomy. The baseline table indicates no statistically significant difference between the two groups regarding bleeding volume and admission GCS score (p > 0.05). Compared to the traditional surgery group, the neuro-endoscopic surgery group demonstrates advantages in operation time (105.25 ± 10.6 vs. 154.33 ± 22.64, p < 0.01), surgical bleeding volume (89.65 ± 34.96 vs. 175.35 ± 67.6, p < 0.01), hospital stay time (16.73 ± 2.38 vs. 20.4 ± 4.6, p < 0.01), hematoma clearance rate (92.7 ± 3.15 vs. 87.6 ± 6.4, p < 0.01), and hospital expenses (9 ± 2.02 vs. 13.8 ± 2.6, p = 0.001). The neuro-endoscopy group can bring better long-term benefits compared to the traditional surgical group. (p<0.05).</p><p><strong>Conclusions: </strong>Our findings suggest that neuroendoscopy may improve long-term prognosis compared to conventional surgical approaches. The utilization of neuro-endoscopy in patients with hypertensive intracerebral hemorrhage significantly enhances the rate of hematoma clearance, reduces intraoperative bleeding and surgical time, shortens hospital stay, and lowers hospitalization expenses.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"563"},"PeriodicalIF":2.5,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144619437","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":"Enhancing decision-making strategies in treatment for unruptured intracranial aneurysms: a novel analytical approach using PHASES, ELAPSS and UIATS scores for microsurgical clipping outcome prediction.","authors":"Philipp A Geiger, Christian Preuss-Hernandez, Nikolaus Kögl, Jeannine Rey, Claudius Thomé, Ondra Petr","doi":"10.1007/s10143-025-03683-y","DOIUrl":"10.1007/s10143-025-03683-y","url":null,"abstract":"<p><strong>Objective: </strong>The management of unruptured intracranial aneurysms (UIA) is complex, balancing the risks of surgical intervention against aneurysm rupture. The PHASES, ELAPSS, and UIATS scoring systems have been developed to assist in clinical decision-making, but their efficacy in predicting surgical outcome remains unclear.</p><p><strong>Methods: </strong>In this monocentric, retrospective, observational study, we included 380 patients with UIA from January 2010 to January 2021. We assessed the predictive value of the PHASES, ELAPSS, and UIATS scores in determining clinical outcome post-surgery, including different variables. Statistical analyses, including Principal Component Analysis and Multiple logistic and linear regression, were employed to analyze the data.</p><p><strong>Results: </strong>Our cohort of 380 predominantly female patients (71.3%) had a mean age of 54.7 years. The PHASES and UIATS pro-conservative scores were significant predictors of poor clinical outcome (p = 0.03 and p = 0.04, respectively), while the ELAPSS score was predictive of new neurological deficits post-surgery (p = 0.01). Aneurysm size was significantly associated with new neurological deficits but not with long-term clinical performance/outcome.</p><p><strong>Conclusions: </strong>The study underscores the utility of PHASES, ELAPSS, and UIATS scores in preoperative risk stratifications. Conservative PHASES and UIATS scores were associated with poor outcome, therefore supporting their predictive value of non-operative management. Our findings suggest the routine implementation of these scores into clinical practice could improve the management of UIAs.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"559"},"PeriodicalIF":2.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608923","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":"Predictive factors of external ventricular drain placement in ruptured brain arteriovenous malformations with intraventricular hemorrhage.","authors":"Idriss Haffaf, Jonathan Cortese, Lorenzo Garzelli, Bertrand Mathon, Gonzague Guillaumet, Alexandru Dimancea, Tom Boeken, Stéphanie Lenck, Alice Jacquens, Caroline Amouyal, Atika Talbi, Kevin Premat, Nader-Antoine Sourour, Vincent Degos, Frédéric Clarençon, Eimad Shotar","doi":"10.1007/s10143-025-03700-0","DOIUrl":"https://doi.org/10.1007/s10143-025-03700-0","url":null,"abstract":"<p><strong>Background ad purpose: </strong>Intraventricular (IV) hemorrhage is a common finding after brain arterio-venous malformation (BAVM) rupture and has been associated with poor prognosis. This report investigates previously published IV hemorrhage quantification scores as predictors of external ventricular drain (EVD) placement following BAVM rupture, along with other clinical and radiological parameters.</p><p><strong>Methods: </strong>One hundred and twenty-nine patients with BAVM rupture and IV hemorrhage were included (133 ruptures), all admitted in our institution between January 1, 2003 and May 15, 2020. IV hemorrhage score, LeRoux, Graeb and modified Graeb score were compared as predictors of EVD placement using receiver operating (ROC) curves. Multivariate models were constructed for prediction of EVD placement and to define radiological hydrocephalus. Multivariate logistic regression was also used to test whether the different IV hemorrhage quantification scores were predictors of death or in-hospital mortality.</p><p><strong>Results: </strong>The four IV hemorrhage quantification scores performed similarly (area under ROC curves comprised between 0.65 and 0.67) for EVD placement. In multivariate analysis, only elevated S-100B protein serum level (p = 0.01) and radiological hydrocephalus (p < 0.001) were associated with EVD placement. None of the four IV hemorrhage quantification scores were predictive of EVD placement. Among all radiological features, only the occipital horn index > 0.12 (p < 0.001), the frontal horn index > 0.13 (p = 0.04) and V3 index > 0.05 (p = 0.006) were independently associated with hydrocephalus. None of the four IV hemorrhage quantification scores were predictive of death or in-hospital mortality.</p><p><strong>Conclusions: </strong>IV hemorrhage scores are reproducible with high inter-observer agreement but were not predictive of EVD placement. Only hydrocephalus and elevated S-100B protein serum level, a surrogate for clinical severity, were independently associated with EVD placement in our study.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"552"},"PeriodicalIF":2.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601075","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":"Infraorbital nerve as effective intraoperative guidance during the endoscopic transorbital approach to the anterolateral skull base.","authors":"Peng-Wei Wang, Da-Tong Ju, Wei-Hsiu Liu, Dueng-Yuan Hueng, Yuan-Hao Chen, Hsin-I Ma, Ming-Ying Liu, Bon-Jour Lin","doi":"10.1007/s10143-025-03710-y","DOIUrl":"10.1007/s10143-025-03710-y","url":null,"abstract":"<p><strong>Objective: </strong>The endoscopic transorbital approach (ETOA) has been recognized as a pivotal technique within the realm of endoscopic skull base surgery for the management of lesions situated in the skull base with paramedian and lateral positioning. In the execution of the ETOA targeting the anterolateral skull base, the surgical intervention is performed in the coronal plane from superficial to deep with the anatomy becoming progressively more complex. Given that the trajectory of the infraorbital nerve (ION) algins favorably with the surgical corridor of the ETOA to the anterolateral skull base, this investigation evaluates the feasibility of employing the ION as an intraoperative navigational aid during the ETOA, utilizing both cadaveric dissection and relevant clinical applications.</p><p><strong>Methods: </strong>Anatomical dissections were conducted on five adult cadaveric heads bilaterally utilizing two distinct endoscopic transmaxillary techniques aimed at the anterolateral skull base, namely the ETOA and the endoscopic endonasal approach (EEA). For each technique, the anatomical interrelationship between the ION and the adjacent compartments of the anterolateral skull base was meticulously documented. Additionally, the extent of ION exposure was systemically compared between the ETOA and EEA methodologies. The clinical practicality of cadaveric findings was evaluated in two patients presenting with deeply seated neoplasm located in the anterolateral skull base.</p><p><strong>Results: </strong>In contrast to the EEA, the ETOA demonstrated a markedly greater exposure of the orbitomaxillary segment (ETOA = 32.10 ± 3.32 mm; EEA = 9.98 ± 2.23 mm; P <.001) and the cavernous segment (ETOA = 14.61 ± 1.24 mm; EEA = 8.7 ± 3.72 mm; P <.001) of the ION. Both approaches exhibited a comparable extent of exposure concerning the pterygopalatine segment of the ION (ETOA: 10.66 ± 1.39 mm; EEA: 9.98 ± 2.23 mm). In both cases where patients underwent treatment via the ETOA with the ION utilized as intraoperative navigation, complete tumor resection was achieved without any occurrence of neurological or ophthalmic complications.</p><p><strong>Conclusions: </strong>According to the findings derived from cadaveric studies and the preliminary clinical implementations, the ION serves as a dependable intraoperative navigational tool throughout the ETOA toward the anterolateral skull base. Each distinct segment of the ION is capable of guiding the operator safely towards the deeper segment and more profound complex anatomy.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"557"},"PeriodicalIF":2.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601073","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}