Neurosurgical Review最新文献

{"title":"Correction to: Pre-treatment DTI markers: predicting clinical outcomes in microvascular decompression for classic trigeminal neuralgia- a systematic review.","authors":"Giuseppe Pio Cipollina, Roberta Costanzo, Benedetta Maria Campisi, Gianluca Scalia, Lara Brunasso, Lapo Bonosi, Domenico Gerardo Iacopino, Rosario Maugeri","doi":"10.1007/s10143-024-03133-1","DOIUrl":"https://doi.org/10.1007/s10143-024-03133-1","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"882"},"PeriodicalIF":2.5,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770717","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 use of cloud based machine learning to predict outcome in intracerebral haemorrhage without explicit programming expertise.","authors":"Ajay Hegde, Deepu Vijaysenan, Pitchaiah Mandava, Girish Menon","doi":"10.1007/s10143-024-03115-3","DOIUrl":"10.1007/s10143-024-03115-3","url":null,"abstract":"<p><p>Machine Learning (ML) techniques require novel computer programming skills along with clinical domain knowledge to produce a useful model. We demonstrate the use of a cloud-based ML tool that does not require any programming expertise to develop, validate and deploy a prognostic model for Intracerebral Haemorrhage (ICH). The data of patients admitted with Spontaneous Intracerebral haemorrhage from January 2015 to December 2019 was accessed from our prospectively maintained hospital stroke registry. 80% of the dataset was used for training, 10% for validation, and 10% for testing. Seventeen input variables were used to predict the dichotomized outcomes (Good outcome mRS 0-3/ Bad outcome mRS 4-6), using machine learning (ML) and logistic regression (LR) models. The two different approaches were evaluated using Area Under the Curve (AUC) for Receiver Operating Characteristic (ROC), Precision recall and accuracy. Our data set comprised of a cohort of 1000 patients. The data was split 8:1 for training & testing respectively. The AUC ROC of the ML model was 0.86 with an accuracy of 75.7%. With LR AUC ROC was 0.74 with an accuracy of 73.8%. Feature importance chart showed that Glasgow coma score (GCS) at presentation had the highest relative importance, followed by hematoma volume and age in both approaches. Machine learning models perform better when compared to logistic regression. Models can be developed by clinicians possessing domain expertise and no programming experience using cloud based tools. The models so developed lend themselves to be incorporated into clinical workflow.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"883"},"PeriodicalIF":2.5,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11614922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770725","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":"Characterizing discharge opioid prescription in postoperative neurosurgical patients: a systematic review.","authors":"Megan G Sharpe, Varun S Shah, Mina Huerta, Henry Stitzel, Ansh Desai, Collin M Labak, Kathryn Andrews, Amber Stout, Michael D Staudt","doi":"10.1007/s10143-024-03131-3","DOIUrl":"https://doi.org/10.1007/s10143-024-03131-3","url":null,"abstract":"<p><p>Over the past two decades, the United States has experienced a rise of opioid misuse, with a significant increase in drug overdose deaths- many of these deaths have been attributed to prescription opiate misuse. Given this epidemic, numerous specialties have created enhanced recovery after surgery protocols to decrease opiate usage post-operatively and some specialties have even created guidelines advising how many morphine milligram equivalents per day are recommended at discharge. The neurosurgical literature is lacking on best practices for discharge opiate prescribing. The goal of this review is to assess opiate prescribing practices at discharge for both cranial and spine neurosurgical patients, and to determine if neurosurgeons are over-prescribing opiates to their patients. A systematic literature review was performed according to PRISMA guidelines. After searching PubMed, Cochrane, and Embase, a total of 288 abstracts were identified, 71 studies underwent full text review and 23 were included in this study. Studies that quantified opiate usage (number of pills prescribed, morphine equivalents, prescription refills) were included. The range of opiate prescribing varied and there was a tendency to both over-prescribe and under-prescribe; therefore, no conclusions could be made. This review underscores the need to take individual patient pain needs into account and shows the need for higher quality literature that can help formulate guideline creation.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"884"},"PeriodicalIF":2.5,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770702","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":"Development and validation of a nomogram for predicting cerebrospinal fluid leak after endoscopic craniopharyngioma resection.","authors":"Ning Qiao, Chuzhong Li, Fangzheng Liu, Siming Ru, Lei Cao, Pengwei Lu, Yazhuo Zhang, Songbai Gui","doi":"10.1007/s10143-024-03132-2","DOIUrl":"https://doi.org/10.1007/s10143-024-03132-2","url":null,"abstract":"<p><strong>Objective: </strong>To identify risk factors for cerebrospinal fluid (CSF) leak after extended endoscopic endonasal surgery for craniopharyngiomas and develop a predictive model for predicting postoperative CSF leak.</p><p><strong>Methods: </strong>Six hundred and sixty cases of craniopharyngioma (training cohort: n = 462; validation cohort: n = 198) were retrospectively reviewed between October 2018 and May 2024, and relevant risk factors were identified. A nomogram was built using a stepwise logistic regression method based on the Akaike information criterion. The performance of the nomogram was evaluated using area under the curve (AUC), calibration curve, and decision curve analysis.</p><p><strong>Results: </strong>The overall rate of postoperative CSF leak was 4.5%. Higher prognostic nutritional index (PNI) level (OR 0.819, 95% confidence interval [CI] 0.735-0.912; p < 0.001) and larger dural defect (OR 6.789, 95% CI 3.112-14.807; p < 0.001) were identified as independent predictors for postoperative CSF leak in multivariable logistic regression analysis. The AUCs of the nomogram were 0.870 (95% CI, 0.782-0.957; p < 0.001) and 0.842 (95% CI, 0.722-0.963; p < 0.001) in the training and validation sets, respectively. Calibration curves in the training and validation cohorts showed satisfactory agreement between predictive and actual outcomes (p = 0.608 and p = 0.564, respectively). Decision curve analysis further confirmed the clinical usefulness of the nomogram.</p><p><strong>Conclusions: </strong>Higher PNI levels may help reduce the risk of postoperative CSF leak, while a larger dural defect size was demonstrated as an independent risk factor. We developed and validated a nomogram for predicting CSF leak after endoscopic craniopharyngioma resection, which showed strong predictive performance and could assist clinicians in formulating personalized treatment strategies.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"885"},"PeriodicalIF":2.5,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770719","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":"A systematic review of radiological prediction of ki 67 proliferation index of meningioma.","authors":"Amer Helal, Elie Hammam, Christopher Dillon Ovenden, Nickolas G Candy, Bipin Chaurasia, Oday Atallah, Alistair Jukes","doi":"10.1007/s10143-024-03074-9","DOIUrl":"https://doi.org/10.1007/s10143-024-03074-9","url":null,"abstract":"<p><strong>Objective: </strong>Radiological prediction of Ki-67 plays a crucial role in determining the clinical outcomes of meningioma patients. The aim of this review is to comprehensively review the literature to synthesize evidence on how accurate radiological prediction of the Ki-67 proliferation index is to determine the Ki-67 index's association with clinical outcomes of meningioma.</p><p><strong>Materials and methods: </strong>A narrative synthesis systematic review followed PRISMA guidelines. The literature was searched using database-specific, relevant keywords, text words, and MeSH terms (controlled vocabulary) such as \"Meningioma,\" \"ki-67,\" \"Ki 67 proliferation index,\" \"proliferation index,\" \"Radiomics,\" and \"clinical outcomes\" on electronic databases PubMed, Web of Science, and Google Scholar from 2014 to April 2024.</p><p><strong>Results: </strong>Out of 218 publications identified initially, only 03 moderate-quality studies were included in this paper after methodological quality assessment using the Newcastle-Ottawa scale.</p><p><strong>Discussion: </strong>The evidence synthesis by systematic review emphasizes the importance of radiographic approaches in predicting the Ki-67 proliferation index and their consequences for prognosis and treatment results in meningioma patients. Various radiological techniques, such as pre-operative MRI with clinical and radiomic analysis and machine learning algorithms, show promise for accurately predicting Ki-67 status, with significant associations between radiological features and clinical outcomes such as recurrence, survival, and progression-free survival. The radiomics models were compared and found that Lasso with LDA radiomic models outperformed other radiomics models in terms of accuracy, sensitivity, specificity, and predictive power. Lasso with LDA model also showed significant improvements in performance when the clinical datasets of meningiomas patients were combined to predict ki-67 levels. However, the comparison to histological evaluation emphasizes the necessity for additional validation and standardization. While these approaches provide non-invasive and possibly time-saving alternatives, drawbacks such as inherent biases, methodological limits, and practical challenges with automated selection procedures highlight future research and development topics.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"881"},"PeriodicalIF":2.5,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770700","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":"Clinical features and outcomes of basilar invagination.","authors":"Maoyang Qi, Yueqi Du, Boyan Zhang, Hongfeng Meng, Tianyu Jin, Zong Xin, Can Zhang, Jialu Wang, Jiaxing Yu, Xuesong Bai, Wanru Duan, Zan Chen","doi":"10.1007/s10143-024-03103-7","DOIUrl":"https://doi.org/10.1007/s10143-024-03103-7","url":null,"abstract":"<p><p>Basilar invagination has been classified into two types by Goel: Type A is defined mechanical instability of the atlantoaxial joint with upward displacement of the odontoid process while Type B is characterized by stable atlantoaxial joints. This study reviews the association between radiological features and symptomatology and prognosis of two types of basilar invagination for better clinical management. A retrospective analysis was conducted including 141 patients diagnosed with basilar invagination who underwent surgical treatment from January 2016 to December 2020. The neurological function was assessed by the JOA scores, and Short-Form 12 scores. Logistic univariate and multivariate analyses were performed to predict prognostic risk factors. Type A patients (21/101, 20.8%) with more cases of dizziness, lower preoperative JOA scores and SF-12 PCS scores (JOA, 13.0 vs. 13.9, P = 0.042; SF-12 PCS, 37.48 vs. 38.42, P = 0.034) compared to type B (2/40, 5%) (P = 0.022). Type B (22/40, 55%) with more cases of ataxia than type A (35/101, 34.7%) (P = 0.026). Patients with type B demonstrated a significantly higher improvement rate in SF-12 PCS than type A (P = 0.018). Further logistic regression revealed that onset age ≥ 45 years (OR 4.654, 95% CI 1.645-13.165; p = 0.004) and basal angle ≥ 125° (OR 28.139, 95% CI 1.090-726.239; p = 0.044) were independent risk factors for type A and type B, respectively. Type A patients with more cases of dizziness, and type B patients with more cases of ataxia, can achieve better long-term prognosis following clinical intervention.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"879"},"PeriodicalIF":2.5,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770704","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":"Robot-assisted versus manually guided stereotactic biopsy for intracranial lesions - a systematic review and meta-analysis.","authors":"Fernando Cotrim Gomes, Felipe Takamori Oliveira, Diego Dias Freire Carvalho, Flávia Baldotto Zampirolo, Antônio Gaudi Pinheiro Vorcaro Garcia, Anna Laura Lima Larcipretti, Alice Campos Meneses, Isabella Cristina Santos de Castro, Marcio Yuri Ferreira, Dan Zimelewicz Oberman, Allan Dias Polverini, João Paulo Almeida","doi":"10.1007/s10143-024-03121-5","DOIUrl":"10.1007/s10143-024-03121-5","url":null,"abstract":"<p><p>Stereotactic biopsies are essential for obtaining accurate histopathological analysis to guide treatment decisions for deep-seated brain lesions. Manually guided methods, while commonly used and highly precise, can be limited by potential inaccuracies and insufficient tissue sampling. The emerging robot-assisted (RA) techniques offer enhanced precision and could address these limitations for improved accuracy. We aimed to compare safety and effectiveness of RA stereotactic biopsies to traditional techniques. We conducted a systematic search of PubMed, Embase, and Web of Science using terms related to robotic biopsies and intracranial lesions. Eligible studies compared robot-assisted procedures to traditional techniques. Data extracted included diagnostic yield, complication rates, and accuracy. Quality assessment of studies was performed with the ROBINS-I tool, and a random-effects model meta-analysis was performed. Five studies were included, encompassing 913 patients (robot-assisted n = 434, traditional n = 479). Robot-assisted biopsies demonstrated higher diagnostic yield (OR 2.06, 95% CI [1.01,4.21], p = 0.04), and improved trajectory accuracy, with entry point error (EPE) reduced by 0.42 mm (95% CI [-0.59,-0.26], p < 0.001) and target point error (TPE) reduced by 0.93 mm (95% CI [-1.80,-0.06], p < 0.01). There were no significant differences in the incidence of complications or operative time. RA stereotactic biopsies may improve diagnostic yield and accuracy in targeting intracranial lesions without increasing complication rates or operative time. The limited number of studies and potential biases suggest a need for further high-quality, prospective research to ascertain these findings.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"880"},"PeriodicalIF":2.5,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770723","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":"Traumatic posterior fossa extradural hematoma in children: a meta-analysis and institutional experience of its clinical course, treatment and outcomes.","authors":"Keng Siang Lee, Shi Hui Ong, Conor S Gillespie, Lee Ping Ng, Wan Tew Seow, Sharon Yy Low","doi":"10.1007/s10143-024-03089-2","DOIUrl":"10.1007/s10143-024-03089-2","url":null,"abstract":"<p><p>Posterior fossa extradural hematoma (PFEDH) is rare but has a greater incidence amongst children. It is also associated with a rapid deterioration. The aim of this study was to present the management of PFEDH through our institutional experience and a meta-analysis. A retrospective single institution review of all children from 2004 to 2024 who underwent craniotomy for PFEDH was undertaken. The collected variables included: demographics, type of trauma, clinical findings, computed tomography findings, and clinical course. A systematic review using Ovid Medline, Ovid Embase, and Cochrane Central Register of Controlled Trials (CENTRAL), and meta-analysis were performed. Nineteen children with PFEDH who underwent surgery were identified. All 19 (100%) patients benefited from good Glasgow Outcome Scale (GOS) score 4-5, and there were no incidences of in-hospital mortality. From the systematic review, 391 patients, across twenty-four studies and our series, were included. A total of 308 were treated with surgery, whereas 83 patients were treated conservatively. A comparative meta-analysis was not performed as the two groups were deemed too heterogeneous in clinical characteristics. Instead, single-arm meta-analyses were performed. The pooled incidence of patients initially under conservative management requiring surgery was 9.90% (95%CI 1.61;22.21%, I² = 35.2). The incidence of good functional outcomes in patients managed surgically and conservatively were 93.68% (95%CI: 88.69;97.57%, I² = 0.0%), and 99.99% (95%CI: 96.53;100%, I² = 0.0%), respectively. Overall pooled of mortality in patients managed surgically and conservatively were 0.57% (95%CI: 0.00;2.87%, I² = 0.0%) and 0.00% (95%CI: 0.00;1.18%, I² = 0.0%). Overall, our study reiterates that pediatric PFEDH is uncommon, and patients often present atypically. Based on our institutional experience and extrapolating data from our meta-analysis of the wider literature, neurosurgical intervention is a reliable therapeutic option with good clinical outcomes.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"878"},"PeriodicalIF":2.5,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770727","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":"Retreatment predictors after percutaneous balloon gangliolysis for trigeminal neuralgia.","authors":"Daniel Sconzo, Alejandro Enriquez-Marulanda, Ekin Simwatachela, Thai Vu, Bindu Setty, Sakai Osamu, Ahmed El-Araby, James Holsapple","doi":"10.1007/s10143-024-03099-0","DOIUrl":"10.1007/s10143-024-03099-0","url":null,"abstract":"<p><p>Percutaneous balloon ganglyolysis (PBG) for trigeminal neuralgia (TN) is an inexpensive and minimally invasive treatment modality that is effective and safe. While there are reports of its efficacy, there is still a lack of evidence of which patients are at a higher risk of treatment failures and needing retreatment. We performed a retrospective study at a major academic institution from 2012 to 2023, including TN patients who underwent PBG procedures to evaluate predictors of retreatment. Patients without imaging available from the PBG were excluded. Fifty-two patients who underwent 83 procedures in total were included in the analysis. All patients had typical TN and were primarily female (59.6%), with a median age of 61.5 years. Immediately after PBG, 42.3% had pain resolution, and 57.7% had improved but persistent pain. 30.8% underwent retreatment with PBG in a median of 32 months. From multiple factors assessed, TN disease duration ≤ 6 months and trigeminal nerve enhancement on pre-operative MRI were identified as significant retreatment predictors on univariate analysis. However, after performing logistic regression, only TN disease duration ≤ 6 months remained significant OR 3.99 (95% CI 1.59-10.0; p = 0.003). This was further confirmed in a Kaplan-Meier survival analysis, which showed that patients with TN duration ≤ 6 months require retreatment earlier (22 vs. 41 months; p = 0.01). Retreatment after PBG occurs roughly in a third of patients, and TN disease duration of ≤ 6 months is an important predictor in this study. Further studies should be performed to confirm these findings, which may impact treatment considerations in the future.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"877"},"PeriodicalIF":2.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751398","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":"Bilateral deep brain stimulation (DBS) of globus pallidus internus (GPi) for the treatment of benign hereditary chorea and other childhood onset choreas: a single-center experience.","authors":"Arthur R Kurzbuch, Ben Cooper, Gina Lumsdon, Nicola Idowu, Helen Gedrim, Philipa Mulholland, Volker Tronnier, Ram Kumar, Jonathan R Ellenbogen","doi":"10.1007/s10143-024-03124-2","DOIUrl":"https://doi.org/10.1007/s10143-024-03124-2","url":null,"abstract":"<p><strong>Purpose: </strong>Chorea is a clinical sign characterized by involuntary, rapid, unpredictable, and irregular muscle movements that can affect various parts of the body. It can be seen in various medical conditions, both neurological and systemic, of genetic and acquired etiology. Deep brain stimulation (DBS) of the globus pallidus internus (GPi) has been used to treat various types of chorea. The aim of this study was to evaluate the efficacy of GPi DBS for chorea in pediatric patients.</p><p><strong>Methods: </strong>The authors undertook a single-center retrospective study of all pediatric patients who underwent DBS in the period from July 2017 to April 2024 to identify those presenting with chorea.</p><p><strong>Results: </strong>Three patients with chorea underwent bilateral posteroventral GPi DBS without surgical complications. The mean age at operation was 14.2 years (range: 1.5 years), and the mean follow-up was 49 months (range: 15 months). Two of the 3 patients experienced a positive effect on chorea with an improvement in functional status. In one patient, the pre- and postop Gross Motor Function Classification System (GMFCS) score was 4, while his Burke-Fahn-Marsden Dystonia Scale (BFMDS) score improved from 102/20 pre- to 53.5/20 postop. In the other patient the GMFCS score improved from 4 preop to 3 postop. His preop BFMDS score was not available, postop it was 83/120. In the patient who did not experience a positive effect on chorea the pre- and postop GMFCS score was 4, her BFMDS score was 84.5/120 pre- and 100/120 postop.</p><p><strong>Conclusion: </strong>Bilateral GPi DBS can be safely administered to pediatric patients with choreiform movement disorders, and it could be an effective treatment option for managing chorea in certain patients.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"875"},"PeriodicalIF":2.5,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739869","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}