Neurosurgical Review最新文献

{"title":"Functional outcomes in depressed skull fractures: the role of surgical timing and perioperative clinical radiological predictors.","authors":"Hervé Monka Lekuya, Jelle Vandersteene, David Patrick Kateete, Fredrick Makumbi, Stephen Cose, Jean-Pierre Okito Kalala, Moses Galukande, Edward Baert","doi":"10.1007/s10143-025-03708-6","DOIUrl":"https://doi.org/10.1007/s10143-025-03708-6","url":null,"abstract":"<p><strong>Background: </strong>Depressed skull fractures (DSFs) are features of traumatic brain injury (TBI), frequently associated with intracranial damage and long-term functional impairments. The neurological outcomes of the perioperative management are yet to be evaluated. This study aimed to assess the effect of surgical timing and perioperative clinical radiological factors on functional outcomes in DSFs.</p><p><strong>Methods: </strong>This prospective cohort study enrolled 205 patients with DSFs at a tertiary neurosurgical center in Uganda. Patients underwent surgical management, with the primary exposure variable being surgical timing (≤ 48 h vs. >48 h). Functional outcomes at six months were assessed using the Glasgow Outcome Scale-Extended (GOSE), categorized into favorable (GOSE 5-8) and unfavorable (GOSE 1-4). Multivariate regression models were used to identify functional outcome predictors.</p><p><strong>Results: </strong>The median-age was 24 years (IQR = 15-31), 89.5% were male, and 49.73% were assault victims. Approximately 73.1% had an admission GCS > 13. The frontal bone was most commonly involved (46.2%). Early surgical intervention (≤ 48 h) significantly reduced the risk of surgical site infections (SSIs) (p = 0.01) and shortened hospital stays. However, surgical timing had no significant association with functional outcomes {adjusted risk ratio (ARR): 0.95; 95%CI: 0.35-2.61; p = 0.92}. Several perioperative factors were strongly linked to unfavorable outcomes, including ASA class 3 (ARR: 5.09, 95%CI: 2.11-12.2; p < 0.01), compound DSFs (ARR: 3.18; 95%CI: 1.70-5.96; p < 0.01), and midline shift ≥ 5 mm (ARR: 2.84; 95%CI: 1.50-5.39; p < 0.01).</p><p><strong>Conclusions: </strong>Early surgery of DSFs reduces the infection rates and hospital length of stay; however, it does not significantly impact the 6-months functional outcomes. The outcomes are instead influenced significantly by clinical radiological perioperative factors such as the ASA classification, compound type, midline shift ≥ 5 mm, and others. We advocate for an aggressive treatment for increased ICP to improve the outcomes, and an early surgical intervention for infection reduction.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"548"},"PeriodicalIF":2.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584392","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":"Increased bleeding risk with bridging and early anticoagulation in traumatic brain injury patients with intracranial hemorrhage and mechanical heart valves.","authors":"Sophie Samuel, Eman Alnosair","doi":"10.1007/s10143-025-03702-y","DOIUrl":"https://doi.org/10.1007/s10143-025-03702-y","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"546"},"PeriodicalIF":2.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584393","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":"Correction to: Focusing on the working range of two dimensions in purely endoscopic posterior interhemispheric approach: a series of 23 cases of lateral ventricular lesions.","authors":"Chongjing Sun, Pin Chen, Xiaobiao Zhang, Jinlong Huang, Shuang Liu, Tao Xie, Tengfei Liu, Chen Li, Qiang Xie, LiangLiang Yang","doi":"10.1007/s10143-025-03685-w","DOIUrl":"https://doi.org/10.1007/s10143-025-03685-w","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"544"},"PeriodicalIF":2.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575932","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":"Efficacy and safety of 5-aminolevulinic acid in meningioma resection: a systematic review and meta-analysis.","authors":"Lucca B Palavani, Gean Carlo Müller, Bernardo Vieira Nogueira, Hsien-Chung Chen, Vinicius G Pereira, Mariano Belfort Santos, Anna Luiza Pereira, Carlos Alexandre Farias, Fabiana Honorato, Dan Zimelewicz Oberman, Danilo Silva","doi":"10.1007/s10143-025-03699-4","DOIUrl":"10.1007/s10143-025-03699-4","url":null,"abstract":"<p><strong>Background: </strong>Fluorescence-guided surgery (FGS) using 5-aminolevulinic acid (5-ALA) has gained popularity in managing malignant gliomas by improving tumor boundary visualization, enabling more complete resections, and prolonging progression-free survival (PFS). Recent research has expanded its use to meningiomas, encouraged by its consistent effectiveness in highlighting these tumors. This study aims to evaluate the efficacy and safety of FGS in meningiomas.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Cochrane, and Web of Science databases following Cochrane and PRISMA guidelines. Eligible studies included those with ≥ 4 patients reporting patients with meningioma who underwent FGS using 5-ALA. Key endpoints included positive fluorescence, fluorescence intensity, Simpson grade, and surgical complications.</p><p><strong>Results: </strong>Data from nine studies, encompassing 361 patients (108 males and 253 females) with a mean age of 59.1 years, were analyzed. A high positive fluorescence rate of 95% (95% CI: 92-98%) was found. Strong fluorescence rate occurred in 81% (95% CI: 65-97%), while weak fluorescence was found in 18% (95% CI: 3-34%). According to the Simpson grading system, 80% (95% CI: 65-95%) achieved grades I and II, while 20% (95% CI: 5-35%) reached grades III and IV. Surgical complications occurred in 10% (95% CI: 2-18%). No complications were directly related to 5-ALA.</p><p><strong>Conclusion: </strong>The study indicates that 5-ALA-guided FGS is safe for meningiomas and improves their Simpson grade, with higher rates of Simpson grades I and II. This underscores the utility of 5-ALA as a valuable tool in the surgical management of meningiomas.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"545"},"PeriodicalIF":2.5,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575933","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":"Primary intracranial alveolar soft part sarcomas: a report of seven cases and a pooled analysis of individual patient data.","authors":"Pengcheng Zuo, Wanjing Zou, Yang Wang, Huan Li, Xiong Li","doi":"10.1007/s10143-025-03704-w","DOIUrl":"https://doi.org/10.1007/s10143-025-03704-w","url":null,"abstract":"<p><strong>Objective: </strong>Primary intracranial alveolar soft part sarcoma (PIASPS) represents an exceptionally rare entity. This study aims to characterize its clinical manifestations and evaluate prognostic factors affecting overall survival (OS) and progression-free survival (PFS).</p><p><strong>Methods: </strong>From 2012 to 2023, Beijing Tiantan Hospital diagnosed and treated 7 cases of PIASPS. Through a systematic PubMed literature review spanning 1988-2023 using the search terms 'primary intracranial alveolar soft part sarcoma,' we identified 17 additional published cases. Pooled analysis of these 24 cases was performed to evaluate prognostic factors affecting OS and PFS.</p><p><strong>Results: </strong>Our cohort comprised 24 patients (10 males, 14 females) with a mean age of 26.0 ± 16.9 years (range: 3-72 years). With a mean follow-up of 38.2 ± 43.5 months, we observed tumor recurrence in 9 (45%) patients and mortality in 5 (22.7%) patients within 45.3 ± 39.0 months. Survival analysis revealed 1-, 2-, and 5-year OS rates of 100%, 88.5%, and 71.9%, respectively, with corresponding PFS rates of 77.4%, 58.0%, and 41.5%. Both univariate and multivariate Cox regression analyses identified non-gross total resection (Non-GTR) as a significant independent prognostic factor for worse OS (p = 0.031) and PFS (p = 0.009).</p><p><strong>Conclusion: </strong>Our study demonstrates that PIASPS predominantly affects pediatric and young adult populations without significant gender predilection. Surgical intervention with gross total resection (GTR) was identified as the primary determinant of favorable outcomes, whereas adjuvant radiotherapy and chemotherapy demonstrated limited therapeutic efficacy. These preliminary findings warrant validation through larger, multicenter prospective studies to establish evidence-based management guidelines for this rare entity.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"543"},"PeriodicalIF":2.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564946","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":"Comparison of discectomy with and without fusion in the surgical treatment of recurrent lumbar disc herniation.","authors":"Ali Osman Mucuoglu, Huseyin Dogu, Hidayet Akdemir","doi":"10.1007/s10143-025-03687-8","DOIUrl":"10.1007/s10143-025-03687-8","url":null,"abstract":"<p><strong>Objective: </strong>Recurrent intervertebral disc herniation is one of the most common problems encountered in spine surgery. This study aimed to compare the clinical outcomes of revision microdiscectomy and fusion surgeries in patients with recurrent lumbar disc herniation.</p><p><strong>Methods: </strong>276 patients who underwent surgery with same surgeon for recurrent lumbar disc herniation between January 2012 and December 2023 were retrospectively analyzed. The patients were divided into three groups: Group 1 (revision microdiscectomy, n = 129), Group 2 (discectomy with posterolateral fusion, n = 123), and Group 3 (discectomy with posterolateral fusion and posterior lumbar interbody fusion, n = 24). Clinical outcomes were evaluated using pre- and postoperative VAS and JOA scores.</p><p><strong>Results: </strong>Postoperative radicular and lumbar VAS scores were significantly higher in Group 1 compared with Groups 2 and 3. The recovery rates were highest in Group 3 (77%) and Group 2 (75.5%), while Group 1 showed a lower recovery rate (71.8%). Postoperative JOA scores improved significantly in all groups, with Group 3 showing the greatest improvement in total JOA scores and SLR test results.</p><p><strong>Discussion: </strong>Fusion procedures were associated with better pain control and functional improvement but higher risks of complications, including screw malposition and cage displacement. Both revision microdiscectomy and fusion surgeries are effective for recurrent lumbar disc herniation. Revision microdiscectomy is effective in young patients with limited back pain but carries risks of recurrence and instability. Fusion surgeries provide superior pain relief and functional outcomes but carry higher risks of complications and longer recovery times.</p><p><strong>Conclusion: </strong>Both revision microdiscectomy and discectomy with fusion appear to be effective surgical options for the management of recurrent lumbar disc herniation. The selection of the surgical technique should be guided by patient-specific factors such as age and the predominance of low back versus radicular pain.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"542"},"PeriodicalIF":2.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564945","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":"Influence of scalp nerve block on analgesia and hemodynamic stability in pediatric patients: a systematic literature review and meta-analysis.","authors":"João Gabriel Santana Trindade, Airton Lima Batalha Filho, Pedro Salgueiro Pereira de Castro, Diogo Costa Garção","doi":"10.1007/s10143-025-03690-z","DOIUrl":"10.1007/s10143-025-03690-z","url":null,"abstract":"<p><p>Among current procedures for analgesia and control of hemodynamic changes, scalp nerve block (SNB) stands out as a simple technique that contributes to the quality of patient recovery. This study aims to evaluate the influence of SNB on postoperative pain and hemodynamic stability in pediatric patients. A review protocol was registered on PROSPERO under the registry code CRD42023491890. The search string \"nerve block AND scalp AND analgesia\" was used to search MEDLINE-PubMed, Embase, Cochrane, LILACS, SciELO, and Scopus. R software was used for meta-analysis, and I²was used to assess heterogeneity. A total of 314 trials were identified. Out of these, 310 articles were excluded after title, abstract, and full-text reading. Four randomized trials (n = 186 pediatric patients undergoing head surgery) were included in the review. All studies performed SNB to five scalp nerves with ropivacaine or bupivacaine. The SNB was performed plus ropivacaine concentrations of 0.20% and 0.30%. Analgesic effects were observed as ropivacaine significantly reduced the Face, Legs, Activity, Cry and Consolability (FLACC) scale compared to the control group at both time points (p < 0.01). The effect on hemodynamic stability was observed only at the 0.30% concentration, immediately after incision (p < 0.01). The results demonstrate that SNB plus ropivacaine reduces postoperative pain in children and decreases mean arterial pressure after incision in pediatric head surgery.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"541"},"PeriodicalIF":2.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560608","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 for cerebral vasospasm following arteriovenous malformation-related hemorrhage: a systematic review and meta-analysis.","authors":"Maurycy Rakowski, Natalia Anna Koc, Samuel D Pettersson, Piotr Zieliński","doi":"10.1007/s10143-025-03684-x","DOIUrl":"10.1007/s10143-025-03684-x","url":null,"abstract":"<p><p>Cerebral vasospasm (CVS) is a severe complication associated with significant morbidity and in-hospital mortality. While well characterized in aSAH, its occurrence following AVM-related hemorrhage remains less understood. To address this gap, a meta-analysis adhering to PRISMA guidelines was conducted, with two independent authors searching PubMed, Scopus, and Web of Science from inception to July 2024, seeking studies on CVS risk factors following AVM-related hemorrhage. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Dichotomous variables were pooled into an overriding odds ratio (OR) with a 95% confidence interval (CI), while continuous variables were analyzed using the mean difference (MD) with a 95% CI, both using a random-effects model. Out of 2360 screened articles, 4 studies met the inclusion criteria, totaling 7483 AVM-related hemorrhage patients, 958 of whom developed CVS. All studies were rated high quality, according to NOS. A total of 10 extractable demographic, behavioral, clinical, and radiographic variables reported in the literature were assessed. The following CVS risk factors were statistically significant: younger age (MD = -4.99; 95% CI [-9.40 to -0.57]; p = 0.03), female sex (OR = 1.72; 95% CI [1.50-1.98]; p < 0.00001), and intraventricular hemorrhage (OR = 1.24; 95% CI [1.04-1.48]; p = 0.02). Subarachnoid hemorrhage was close to significance (OR = 1.17; 95% CI [1.00-1.36]; p = 0.05). This is the first systematic review and meta-analysis to identify risk factors for CVS in the context of AVM-related hemorrhage. The presented findings may aid clinicians in recognizing high-risk individuals. Further research is warranted to develop a reliable risk scoring system that can predict AVM-associated CVS in clinical settings and to further explore the differences between CVS following aSAH and AVM-related hemorrhage.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"540"},"PeriodicalIF":2.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541554","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":"Evaluating artificial intelligence models for rupture risk prediction in unruptured intracranial aneurysms: a focus on vessel geometry and hemodynamic insights.","authors":"Muhammad Mohsin Khan, Noman Shah, Javed Iqbal, Nasser M F El-Ghandour, Miroslav Vukic, Michael Lawton, Jacques J Morcos, Bostjan Matos, Najia El-Abbadi, Amir Samii, Eberval Gadelha Figueiredo, Franco Servadei, Ahmed AlAzri, Kodeeswaran M, Aruni Velalakan, Bipin Chaurasia","doi":"10.1007/s10143-025-03689-6","DOIUrl":"https://doi.org/10.1007/s10143-025-03689-6","url":null,"abstract":"<p><p>The estimation of rupture risk in Unruptured Intracranial Aneurysm (UIA) constitutes a major area of clinical interest due to the significant morbidity and mortality rates associated with aneurysm rupture. Classic clinical models based on factors such as size and location have demonstrated limited predictive accuracy, with small aneurysms being capable of rupture and larger ones remaining stable. Recent advances in Artificial Intelligence (AI) now allow the development of more sophisticated models that integrate both geometric and hemodynamic variables, including wall shear stress (WSS) and blood flow dynamics. While previous studies have examined these factors separately, our review specifically focuses on how they are combined within AI-based predictive models for unruptured intracranial aneurysms (UIAs). This integrated approach offers a more comprehensive and patient-specific risk assessment, going beyond traditional size-based methods. A wide array of machine learning (ML) and deep learning (DL) using SVMs (Support Vector Machine) and CNNs (Convolutional Neural Network) has demonstrated much better predictive accuracy than those attained by classical methods. Minimum necessary hemodynamic parameters including WSS and oscillatory shear index (OSI) were identified as critical indicators of rupture. Moreover, the review emphasized how CFD (Computational Fluid Dynamics) merged with AI in simulating patient-specific hemodynamics, outstanding progress having been achieved in the realm of risk assessment. Currently, there are promising developments in AI models for clinical practice, but large and good-quality datasets, along with interpretation of model predictions, remain challenges. More research would further refine these models toward improvement, with increased utility in a clinical setup to better aim at patient-specific risk assessment and optimization of treatment strategies for UIAs.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"539"},"PeriodicalIF":2.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541550","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":"Consciousness-only simple prognostic scale for subarachnoid hemorrhage: large database validation of the modified world federation of neurosurgical societies scale.","authors":"Shinya Tabata, Fusao Ikawa, Kazunori Toyoda, Ryohei Yamamoto, Shotai Kobayashi, Hiroki Kurita","doi":"10.1007/s10143-025-03676-x","DOIUrl":"https://doi.org/10.1007/s10143-025-03676-x","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"537"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541549","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}