Neurosurgical Review最新文献

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Dural repair after intraoperative CSF leakage in endoscopic endonasal skull base surgery without pedicled nasoseptal flap: is it a safe surgical technique? 无带蒂鼻中隔瓣鼻内窥镜颅底手术术中脑脊液漏后的硬脑膜修复:是安全的手术技术吗?
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2025-09-29 DOI: 10.1007/s10143-025-03831-4
Bernardo Reyes Medina, Stefan Linsler, Safwan Saffour, Kerim Hakan Sitoci-Ficici, Joachim Oertel
{"title":"Dural repair after intraoperative CSF leakage in endoscopic endonasal skull base surgery without pedicled nasoseptal flap: is it a safe surgical technique?","authors":"Bernardo Reyes Medina, Stefan Linsler, Safwan Saffour, Kerim Hakan Sitoci-Ficici, Joachim Oertel","doi":"10.1007/s10143-025-03831-4","DOIUrl":"10.1007/s10143-025-03831-4","url":null,"abstract":"<p><p>In this study we evaluated the outcome and efficacy of a multilayer closure technique of the sellar floor after transsphenoidal endoscopic approaches for sellar pathologies in correlation to the intraoperative grading of cerebrospinal fluid (CSF) leak. Overall 280 patients were reviewed retrospectively who underwent endonasal transsphenoidal endoscopic surgery for sellar pathologies from January 2011 to April 2020. Among them, 87 patients had an intraoperative cerebrospinal fluid leak and were included in this study. The intraoperative cerebrospinal fluid grading was based on the classification by Esposito. Clinical outcomes were evaluated based on postoperative complications and development of postoperative cerebrospinal fluid leak in correlation to the used closure technique and material of dural and skull base reconstruction. Their association with the intraoperative cerebrospinal fluid leak grade, underlying pathology and the tumor size were analyzed as well. From the 87 patients, there was 54 women (62%) and 33 men (38%). The mean age was 56.3 ± 14.8. The most frequent histological diagnosis was non-secreting adenoma in 40 cases (45%), followed by the secreting adenomas with 16 cases (18%). Eight cases of meningioma (9%), six cases of Rathke's cleft cyst (7%), six cases of craniopharyngioma (7%), four cases of colloid cysts (4%), four chordomas (4%) were observed. Of the 87 patients with intraoperative cerebrospinal fluid leaks, 20 cases were classified as grade 1, 37 cases as grade 2 and 30 cases as grade 3. The materials used for the closure of grade 1 were primarily sealant sponge Tachosil ® (70%), followed by fibrin glue (55%) and bone (55%). For grade 2, Tachosil ® (78%), bone (57%) and autologous fat graft (54%). In grade 3 dural leaks, the combination of lumbar drains (90%), autologous fat graft (87%) and fascia lata (60%) were mainly used. Only nine patients developed a new postoperative cerebrospinal fluid leak in this series, and were treated conservatively with lumbar drains, but only three of them discontinued by this method. The remaining six patients with persistent postoperative cerebrospinal fluid leak underwent revision surgery. The analyzed multilayer closure technique correlated to the intraoperative CSF leakage for endoscopic transsphenoidal surgery has been shown to be safe. This study shows a lower intraoperative cerebrospinal fluid leak rate compared to other studies and similar rate of postoperative cerebrospinal fluid leak (3.1% vs. 3.9%) compared to the pedicled vascular flap and other techniques in the literature. Based on these results, the multilayer closure represents a real alternative to nasoseptal flap application in selected cases. However, in large defects and complex reconstruction of anterior skull base defects, use of lumbar drain and pedicled nasoseptal flap should remain the gold standard of treatment.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"671"},"PeriodicalIF":2.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186594","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}
引用次数: 0
Neurosurgical journals' policies on artificial intelligence use in manuscript preparation and peer review. 神经外科期刊在稿件准备和同行评审中使用人工智能的政策。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2025-09-27 DOI: 10.1007/s10143-025-03793-7
Ali A Mohamed, Saahas Rajendran, Daniel Colome, Emma C Sargent, Clemens M Schirmer, Meena Vessell, Brandon Lucke-Wold, Akshay Sharma, Owoicho Adogwa, Stephen Pirris
{"title":"Neurosurgical journals' policies on artificial intelligence use in manuscript preparation and peer review.","authors":"Ali A Mohamed, Saahas Rajendran, Daniel Colome, Emma C Sargent, Clemens M Schirmer, Meena Vessell, Brandon Lucke-Wold, Akshay Sharma, Owoicho Adogwa, Stephen Pirris","doi":"10.1007/s10143-025-03793-7","DOIUrl":"https://doi.org/10.1007/s10143-025-03793-7","url":null,"abstract":"<p><p>As artificial intelligence (AI), particularly large language models (LLMs), continues to progress, its impact on academic publishing, both in manuscript drafting and peer review, has attracted considerable attention. In neurosurgery, where journals serve a crucial role in disseminating research, formal guidelines regarding AI remain relatively underexplored. Our study aims to investigate the current state of AI policies among prominent neurosurgical journals, focusing on their role in manuscript preparation and peer review. 38 neurosurgical journals were identified by searching the Johns Hopkins University of Medicine Welch Medical Library, combined with National Library of Medicine subject terms. Each journal's author instructions, editorial policies, and peer-review guidelines were examined for explicit AI usage policies, focusing on manuscript preparation and peer review. Tasks such as writing assistance, data analysis, figure generation, and citation management were documented if identified. Any stated requirements, prohibitions, and disclosure practices for AI were recorded, as well as instances where no policy existed. Of the 38 journals surveyed, 31 (81.6%) had AI use guidelines, 9 (23.7%) based on individual journal-level explicit policies and 22 (57.9%) based on publisher-level guidelines. Majority of journals (n=30, 78.9%) provided guidelines for using AI in manuscript preparation, with most prohibiting its inclusion as an author. Most journals allow but mandate transparent disclosure of AI involvement in readability improvements, grammar correction, and style editing. Fewer journals (n = 13, 34.2%) specified AI policies for peer review, although those that did mention AI often prohibited its use for evaluating submissions due to confidentiality concerns. Although many neurosurgical journals now acknowledge AI's role in manuscript preparation, guidelines for AI-driven peer review remain scarce. Given AI's rapid advancement, establishing clear, comprehensive, and standardized AI policies will be critical for upholding transparency, quality, and efficiency in neurosurgical publishing.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"670"},"PeriodicalIF":2.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145177026","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}
引用次数: 0
Minimally invasive evacuation for spontaneous supratentorial haemorrhage: scoping for candidates and hypothetical logistic burdens in a pragmatic scenario. 自发性幕上出血的微创疏散:在实用的情况下,候选人的范围和假设的后勤负担。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2025-09-27 DOI: 10.1007/s10143-025-03823-4
Alejandra Mosteiro, Melissa Coronel-Coronel, Leire Pedrosa, Álvaro Lambea-Gil, Ramón Torné, Pol Camps-Renom, Luis Prats-Sanchez, Joan Marti-Fabregas, Sergio Amaro, Anna Ramos-Pachón
{"title":"Minimally invasive evacuation for spontaneous supratentorial haemorrhage: scoping for candidates and hypothetical logistic burdens in a pragmatic scenario.","authors":"Alejandra Mosteiro, Melissa Coronel-Coronel, Leire Pedrosa, Álvaro Lambea-Gil, Ramón Torné, Pol Camps-Renom, Luis Prats-Sanchez, Joan Marti-Fabregas, Sergio Amaro, Anna Ramos-Pachón","doi":"10.1007/s10143-025-03823-4","DOIUrl":"10.1007/s10143-025-03823-4","url":null,"abstract":"<p><p>Minimally invasive surgery (MIS) is being evaluated as a promising treatment for spontaneous intracerebral haemorrhage (ICH). Transitioning to early clot removal requires accurate estimation of eligible candidates in practical scenarios. We conducted a prospective population-based observational study of ICH across all public stroke centres in Catalonia-Spain, between 2020 and 2022. Patient characteristics, need for conventional surgery and clinical outcomes were recorded. Inclusion and exclusion criteria from major trials assessing MIS for ICH were retrospectively applied to obtain the number of potential candidates. Sensitivity analyses examined the impact of withdrawal of care (WoC) decisions and variations in selection criteria on eligibility estimates. Among 2,197 reported ICH cases, 1,571 met the selection criteria and had complete follow-up to be analysed. Annually, 113 (14.4%) patients met the criteria for catheter plus thrombolysis evacuation (MISTIE-III criteria), and 45 (5.7%) for parafascicular evacuation (ENRICH criteria). Eligibility rates varied considerably depending on age and haematoma volume thresholds, and with changes in WoC, which affected 20-29% of potential candidates. Conventional evacuation was performed as a life-saving measure in 40 (5%) patients annually according to local protocols. If implemented, MIS protocols could increase the number of clot evacuation procedures in a range of 1.1-1.8 times. In a hypothetical scenario of MIS implementation for early ICH evacuation protocol in Catalonia, 5.7-14.4% of patients could potentially qualify for surgery. Consequently, the annual number of emergent clot evacuation procedures might increase 1.1-fold to 1.8-fold, highlighting substantial impact on healthcare infrastructure and resource planning.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"669"},"PeriodicalIF":2.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145177001","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}
引用次数: 0
Intra-hospital MRI transport in neurocritical patients with aneurysmal subarachnoid hemorrhage: complications and clinical impact with predominant continuation of care. 神经危重症动脉瘤性蛛网膜下腔出血患者的院内MRI转运:并发症和主要延续治疗的临床影响
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2025-09-26 DOI: 10.1007/s10143-025-03824-3
Alexandra Grob, Jonas Georg Buff, Lilian Kriemler, Federica Stretti, Giovanna Brandi
{"title":"Intra-hospital MRI transport in neurocritical patients with aneurysmal subarachnoid hemorrhage: complications and clinical impact with predominant continuation of care.","authors":"Alexandra Grob, Jonas Georg Buff, Lilian Kriemler, Federica Stretti, Giovanna Brandi","doi":"10.1007/s10143-025-03824-3","DOIUrl":"10.1007/s10143-025-03824-3","url":null,"abstract":"<p><p>Introduction Magnet Resonance Imaging (MRI) is essential for neurocritical care but requires intrahospital transport (IHT) in patients treated in an intensive care unit, which carries significant risks. This study assesses the risk profile and whether the benefits of MRI in aneurysmal subarachnoid hemorrhage (aSAH) outweigh the associated complications of IHT. Method In this retrospective study, all aSAH patients treated in our neurocritical care unit (NCCU) between 2016 and 2023 were screened. Data collection included baseline demographics, hemorrhage severity scores, aneurysm treatment strategies, additional neurosurgical procedures, and need for spasmolysis. IHT- and MRI-related variables were recorded, including timing, indication, duration, and associated physiological parameters such as blood gas values, vital signs, intracranial pressure (ICP), and cerebral perfusion pressure (CPP). The incidence of complications and the clinical impact of MRI findings were evaluated. Statistical comparisons were conducted using the Wilcoxon signed-rank test. Results Of 337 screened patients, 115 (34.1%) patients with aSAH underwent a MRI during the NCCU stay and were included in the analysis, with a total of 156 MRI scans performed. The most common reason for a MRI was ischemia exclusion (61%). Complications occurred in 16% of patients (n = 25), classified as systemic (56%), cerebral (37%), and technical (7%). Blood gas analysis showed no significant changes before and after IHT. In the subgroup of patients with an external ventricular drain (EVD) in situ (n = 93), ICP remained stable, while CPP increased from 85.4 (± 20.5) to 92.1 (± 19.9) mmHg (p = 0.009). Accordingly, systolic BP and MAP increased (p = 0.019 and < 0.001, respectively) and HR decreased by 4/min (p < 0.001). Conclusion We found lower frequency of IHT-related complication in brain MRI after aSAH compared to existing literature reflecting a well-established and safe clinical process. Moreover, MRI findings had a notable impact on key therapeutic decisions, supporting the use of MRI-based IHT in selected cases, provided that a thorough risk-benefit assessment is conducted.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"667"},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149920","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}
引用次数: 0
Single vs. multiple lesions in sporadic cerebral cavernous malformations: the role of developmental venous anomalies. 散发性脑海绵状畸形的单发vs多发病变:发育性静脉异常的作用。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2025-09-26 DOI: 10.1007/s10143-025-03845-y
Delal Bektas, Giuseppe Lanzino, Kelly D Flemming
{"title":"Single vs. multiple lesions in sporadic cerebral cavernous malformations: the role of developmental venous anomalies.","authors":"Delal Bektas, Giuseppe Lanzino, Kelly D Flemming","doi":"10.1007/s10143-025-03845-y","DOIUrl":"https://doi.org/10.1007/s10143-025-03845-y","url":null,"abstract":"<p><p>This study evaluated clinical and radiological factors associated with lesion multiplicity in sporadic cerebral cavernous malformations (CCMs), focusing on developmental venous anomalies (DVAs) as potential drivers of lesion multiplicity. Data from 269 patients with sporadic CCMs in a prospective registry were analyzed. Demographic, clinical, and radiological variables were collected, and patients were categorized into single or multiple CCM groups. CCM-DVAs were classified into Type I, II, or III based on angioarchitecture. Comparative analyses and multivariate logistic regression identified predictors of lesion multiplicity. The mean age at diagnosis was 45.5 years (SD 15.9); 41.3% of patients were male. Most patients had a single lesion (92.2%, n = 248), while 7.8% (n = 21) had multiple lesions. Lesions were most commonly supratentorial cortical (40.5%, n = 109), followed by the brainstem (26.8%, n = 72) and supratentorial subcortical (24.2%, n = 65). The mean lesion size was 13.2 mm (SD 7.5). DVAs were present in 51.1% of patients (n = 135), with Type I CCM-DVAs accounting for 51.1%, Type II for 32.6%, and Type III for 16.3%. The mean DVA size was 2.3 mm (SD 1.3), with Type III being the largest (mean: 3.82 mm, SD 1.18). CCM-DVA type was significantly associated with lesion multiplicity, and Type II and III were the strongest independent predictors (p = 0.011 and p < 0.001, respectively). Brainstem CCM lesions were also significant in both univariate and multivariate models (p = 0.044). No significant associations were found with modifiable risk factors. This study is the first to systematically evaluate clinical and radiological factors associated with lesion multiplicity in sporadic CCMs. The findings identify CCM-DVA type and brainstem CCM location as key predictors, underscoring the need for further investigation into the genetic and vascular mechanisms driving lesion formation and progression.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"668"},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149836","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}
引用次数: 0
Effect of fludrocortisone in the management of hyponatremia after aneurysmal subarachnoid hemorrhage. 氢化可的松治疗动脉瘤性蛛网膜下腔出血后低钠血症的疗效观察。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2025-09-26 DOI: 10.1007/s10143-025-03825-2
Matthieu Sadoul, Baptiste Balança, Frédéric Dailler, Thomas Ritzenthaler
{"title":"Effect of fludrocortisone in the management of hyponatremia after aneurysmal subarachnoid hemorrhage.","authors":"Matthieu Sadoul, Baptiste Balança, Frédéric Dailler, Thomas Ritzenthaler","doi":"10.1007/s10143-025-03825-2","DOIUrl":"https://doi.org/10.1007/s10143-025-03825-2","url":null,"abstract":"<p><p>Aneurysmal subarachnoid hemorrhage (aSAH) is associated with significant morbidity, particularly related to delayed cerebral ischemia (DCI). Hyponatremia, defined as a serum sodium level < 135 mmol/l, is a common complication of aSAH and is associated with the development of DCI. Fludrocortisone is used to decrease natriuresis and improve hyponatremia, but has failed to demonstrate a reduction in the frequency of cerebral vasospasm or DCI. Using the ProReSHA database, we retrospectively analyzed the impact of fludrocortisone on the development of DCI in patients hospitalized in neurocritical care unit after aSAH and presenting hyponatremia. Two hundred sixteen patients were included, 88 in the fludrocortisone group and 128 in the control group. DCI occurred in 35 (39.8%) patients in the fludrocortisone group and 34 (26.6%) in the control group (p = 0.058). Hyponatremia was significantly deeper in the fludrocortisone group than in the control group (median [interquartile range]: 130 [128-131] vs. 132 [131-133] mmol/l; p < 0.001), and lasted longer (6.0 [4.0-8.3] vs. 3.0 [2.0-5.0] days; p < 0.001). An ancillary analysis stratified according to the etiology of hyponatremia (cerebral salt wasting syndrome or syndrome of inappropriate secretion of antidiuretic hormone) also found no significant difference regarding DCI occurrence (33.3% vs. 44.6%; p = 0.238) but a significantly lower natriuresis in the cerebral salt wasting syndrome group (225 [187-308] vs. 293 [253-359] mmol/d; p = 0.01). Fludrocortisone did not prevent the development of DCI in patients admitted to a neurocritical care unit for an aneurysmal subarachnoid hemorrhage and presenting with hyponatremia. Effect of fludrocortisone in the management of hyponatremia after aneurysmal subarachnoid hemorrhage.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"666"},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150291","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}
引用次数: 0
Wartime blast induced mild traumatic brain injury in the military, damage to white matter tracts, and neuropsychological symptoms: a systematic review. 战时爆炸在军队中引起轻度创伤性脑损伤,白质束损伤和神经心理症状:系统回顾。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2025-09-25 DOI: 10.1007/s10143-025-03827-0
Nathan Beucler, Aurore Sellier, Fabien Almairac, Antoine Do Tran, Benjamin Guyot, Michel Mouramba, Philémon Robert, Rayan Fawaz, Mathilde Fouet, François-Léopold Maison, Julien Tinois, Christophe Joubert, Cédric Bernard, Romain Manet, Arnaud Dagain
{"title":"Wartime blast induced mild traumatic brain injury in the military, damage to white matter tracts, and neuropsychological symptoms: a systematic review.","authors":"Nathan Beucler, Aurore Sellier, Fabien Almairac, Antoine Do Tran, Benjamin Guyot, Michel Mouramba, Philémon Robert, Rayan Fawaz, Mathilde Fouet, François-Léopold Maison, Julien Tinois, Christophe Joubert, Cédric Bernard, Romain Manet, Arnaud Dagain","doi":"10.1007/s10143-025-03827-0","DOIUrl":"10.1007/s10143-025-03827-0","url":null,"abstract":"<p><p>Chronic traumatic encephalopathy has originally been described in the 1950s in concussion-providing sports such as boxing. Since the early 2010s, the concept is used for Iraq and Afghanistan veterans suffering from long-lasting neuropsychological symptoms following blast-related mild traumatic brain injury. The aim of the work is to synthesize evidence regarding any correlation between wartime blast exposure in military veterans and damage to white matter tracts on neuroimaging. Systematic review conducted on Medline database from inception to 2024 using the MeSH terms \"blast\" and \"white matter\" in the title, looking for military patient series with extractable data correlating neuropsychological symptoms and damage to white matter tracts on diffusion tensor brain MRI. The research yielded 11 articles for a total of 544 patients, with a mean age of 32.9 (± 7.5) years-old, and male / female sex ratio of 21.6/1. Most frequently damage white matter tracts were the corticospinal tract (88.2%), anterior thalamic radiations (81.2%), cingulum (60.0%), SLF (55.9%), ILF (27.4%), the uncinate (27.1%), the fornices (27.1%). 5 articles (n = 293 patients) reported correlation between white matter tracts damage and physical symptoms, with direct correlation for the forceps major, the IFOF, the ILF. 7 articles (n = 455 blast patients) reported correlation between white matter tracts damage and PTSD, with direct correlation for the ILF and SLF. There is a growing body of evidence suggesting a correlation between blast-induced mTBI, microstructural damage to specific white matter tracts on diffusion tensor brain MRI, and neuropsychological symptoms (level of evidence 3a).</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"665"},"PeriodicalIF":2.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137928","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}
引用次数: 0
Efficacy of microvascular decompression versus percutaneous balloon compression in trigeminal neuralgia: a propensity-matched retrospective analysis. 微血管减压与经皮球囊加压治疗三叉神经痛的疗效:倾向匹配的回顾性分析。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2025-09-24 DOI: 10.1007/s10143-025-03804-7
Ziyi Zhang, Jiancong Weng, Xiaoli Xu, Jiqiang Duan, Hanlin Liu, Jianke Wang, Yu Duan, Ke Yang, Yanbing Yu, Jiang Liu
{"title":"Efficacy of microvascular decompression versus percutaneous balloon compression in trigeminal neuralgia: a propensity-matched retrospective analysis.","authors":"Ziyi Zhang, Jiancong Weng, Xiaoli Xu, Jiqiang Duan, Hanlin Liu, Jianke Wang, Yu Duan, Ke Yang, Yanbing Yu, Jiang Liu","doi":"10.1007/s10143-025-03804-7","DOIUrl":"https://doi.org/10.1007/s10143-025-03804-7","url":null,"abstract":"<p><p>To compare the efficacy and safety of microvascular decompression (MVD) and percutaneous balloon compression (PBC) in trigeminal neuralgia (TN) management, focusing on pain relief, recurrence, complications, and patient satisfaction.A retrospective cohort of 226 MVD and 127 PBC patients was analyzed after propensity score matching (PSM). Clinical baseline characteristics, surgical details, and postoperative follow-up information were collected. The primary outcome of this study was recurrent pain of TN, and the secondary outcome was facial numbness dissatisfaction. Univariate and multivariate Cox proportional hazards regression models were employed to assess potential predictors associated with pain recurrence.From May 2019 to May 2023, this study retrospectively collected 405 patients with TN: 265 underwent MVD and 140 received PBC. The overall cohort included 234 females (57.8%) with a median age of 68.0 years (range: 29.0-85.0 years), and baseline demographics, including symptom Duration, involved nerve branches, and comorbidities, showed no significant differences between groups. After a median follow-up of 34.0 months, pain recurrence occurred in 7.5% of the MVD group and 9.4% of the PBC group. Univariate Cox regression analysis revealed no significant difference in recurrence risk between PBC and MVD (Hazard Ratio [HR] 1.160, 95% Confidence Interval [CI] 0.553-2.434, P = 0.693). Procedure-related complications included facial numbness in 28.3% of MVD patients and 88.2% of PBC patients (P < 0.001), with bothersome numbness (BNI ≥ III) reported in 9.3% and 26.0%, respectively (P < 0.001). New or worsening masticatory dysfunction was observed in 2.2% of the MVD group compared to 7.9% of the PBC group (P = 0.011). No permanent neurological deficits or mortality occurred in either cohort.MVD offers durable pain relief with minimal sensory morbidity, while PBC achieves comparable pain relief at the cost of a significantly higher incidence of facial numbness. Treatment selection requires balancing efficacy, complications (particularly sensory side effects), and invasiveness.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"662"},"PeriodicalIF":2.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131289","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}
引用次数: 0
Clinical characteristics and management for intracranial serpentine aneurysms: a 12-year single-center retrospective analysis of 51 patients. 颅内蛇形动脉瘤的临床特点及治疗:51例12年单中心回顾性分析。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2025-09-24 DOI: 10.1007/s10143-025-03811-8
Xingyu Qiu, Zhenghaonan Qiu, Jun Zheng, Lu Ma, Chuanyuan Tao, Dingke Wen
{"title":"Clinical characteristics and management for intracranial serpentine aneurysms: a 12-year single-center retrospective analysis of 51 patients.","authors":"Xingyu Qiu, Zhenghaonan Qiu, Jun Zheng, Lu Ma, Chuanyuan Tao, Dingke Wen","doi":"10.1007/s10143-025-03811-8","DOIUrl":"https://doi.org/10.1007/s10143-025-03811-8","url":null,"abstract":"<p><strong>Background: </strong>Serpentine aneurysms, a rare and complex type of intracranial aneurysm, pose significant treatment challenges. The natural course of these aneurysms and the definitive interventional treatment effect remains elusive. This study aims to delineate the characteristics of serpentine aneurysms, explore the risk factors influencing their progression, and compare the postoperative outcomes among different treatment.</p><p><strong>Results: </strong>This study enrolled 51 patients with an average age of 44.31 years (range 11-75), of whom 29 (59%) were men. Comorbidities included heart disease in 2 patients (3.9%), high cholesterol in 7 (14%), and neoplasm in 1 (2%). Various symptoms were reported: dizziness in 9 patients (17.6%), with headache being the most common symptom, observed in 18 (35.3%). Among the cohort, 58.8% (30/51) opted for conservative observation, while 41.2% (21/51) underwent interventional treatment, including 7 cases of endovascular therapy and 14 cases of microsurgical revascularization. Most aneurysms exhibited a slow progression pattern, with a median symptom duration of 1 month. Interventional treatment, regardless of the approach, significantly reduced the risk of aneurysm progression over 8 years (p = 0.02). In the observation cohort, both univariate and multivariate analyses identified aneurysm length as a potential independent risk factor for aneurysm progression (aOR = 1.169, 95% CI: 1.043-1.383, p = 0.024). Postoperative analysis revealed that surgical treatment reduced modified Rankin Scale (mRS) scores within the first year. Patients undergoing endovascular therapy appeared to have better mRS outcomes compared to those treated with microsurgery. Male gender was also identified as an independent predictor of aneurysm progression.</p><p><strong>Conclusions: </strong>Intracranial serpentine aneurysms are slowly progressing lesions, and aneurysm length exceeding 20.5 mm is a critical risk factor for progression. Interventional treatment significantly reduces the risk of aneurysm progression over the long term. Tailored treatment strategies are necessary, with surgical or interventional approaches carefully considered for patients with high-risk factors.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"664"},"PeriodicalIF":2.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131344","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}
引用次数: 0
Outcomes and costs in the management of poor grade subarachnoid haemorrhage. 不良级别蛛网膜下腔出血治疗的结果和费用。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2025-09-24 DOI: 10.1007/s10143-025-03838-x
Lena Dablouk, Mohamed O Dablouk, Michael G J O'Sullivan
{"title":"Outcomes and costs in the management of poor grade subarachnoid haemorrhage.","authors":"Lena Dablouk, Mohamed O Dablouk, Michael G J O'Sullivan","doi":"10.1007/s10143-025-03838-x","DOIUrl":"https://doi.org/10.1007/s10143-025-03838-x","url":null,"abstract":"<p><p>Poor-grade subarachnoid haemorrhage is associated with high morbidity and mortality, with good neurological outcomes in only 20-40% of patients. We retrospectively analysed the management, outcomes, and associated healthcare costs for patients presenting in poor neurological grade (WFNS grades 4-5) at a tertiary neurosurgical centre in Ireland between 2018 and 2022. Patients improving to WFNS grade 3 or better after initial resuscitation and/or CSF drainage were excluded. Seventy-two patients met the inclusion criteria, with a median age of 61.5 years. 75% were female. 59% of patients underwent aneurysm treatment, most using endovascular techniques. The median hospital length of stay was 25.72 days. The mean treatment cost was €39.895.15 per patient. 33.3% of patients achieved a favourable neurological outcome at 6 months (GOS 4 or 5). Our findings demonstrate the substantial cost burden and poor outcomes associated with poor-grade SAH, underscoring the need for better prognostic tools and optimised resource allocation.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"663"},"PeriodicalIF":2.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131347","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}
引用次数: 0
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