Neurosurgical Review最新文献

{"title":"The dural tail in intracranial meningioma: Heads up or tail down? A systematic review of the literature.","authors":"Q C F Cordia, B M Dijkstra, R J M Groen","doi":"10.1007/s10143-025-03658-z","DOIUrl":"10.1007/s10143-025-03658-z","url":null,"abstract":"<p><p>Meningiomas are the most common primary intracranial tumours. Recurrence occurs in up to 20%, with even higher percentages in atypical or malignant meningiomas. The non-removal of the dural tail may be a risk factor for recurrence. In this review, we aimed to determine the prevalence of tumour tissue in the radiological dural tail sign. Our secondary outcome was to determine the clinical relevance of the dural tail, if possible. PubMed, Embase, ISI Web of Science and the Cochrane Library were systematically searched for studies. Articles evaluating dural tails with both radiological and histopathological findings were included. Two reviewers independently screened studies. Data was extracted manually. 18 articles met the inclusion criteria out of 843 identified reports. In total, 406 patients with a radiological and histopathological evaluated dural tail were found. 286 patients (70.9%) had tumour infiltrate; 110 non-neoplastic dural tails showed vascular changes, loose connective tissue proliferation or inflammation. 65 patients with seemingly normal dura mater were reported, of which 26 (40.0%) showed tumour infiltration. It appears that tumour tissue in the radiological dural tail is common. Concerningly, approximately 40% of non-enhancing dura also revealed tumour tissue in the pathological examination. This highlights the need for further systematic research into the dural tail and its clinical impact on recurrence. Clinical trial number Not applicable.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"520"},"PeriodicalIF":2.5,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336762","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":"Flow diverter with or without adjunctive coils in the treatment of large and giant intracranial aneurysms: a meta-analysis.","authors":"Matias E Sein, Alejandro Ceciliano, Fernando Navarro, Silvina Molina, Francisco Villasante, Eduardo E Tejado, Manuel Requena, David Hernandez, Marta de Dios Lascuevas, Alejandro Tomasello, Francesco Diana","doi":"10.1007/s10143-025-03675-y","DOIUrl":"10.1007/s10143-025-03675-y","url":null,"abstract":"<p><p>To evaluate the available evidence on the efficacy and safety of flow diverters (FD) with or without adjunctive coils (C) for the treatment of large and giant aneurysms. A systematic review and meta-analysis of relevant studies in PubMed and selected articles up to December 2022 were conducted. The primary objective was to evaluate the rate of favorable occlusion O'Kelly Marotta (OKM) C-D at the last follow-up, while the secondary objective was to assess complication rates. A fixed-effects model was used, and relative risks (RR) and 95% confidence intervals (CI) were calculated. A total of 146 articles were identified, but only 10 were included in the meta-analysis. This included 541 controlled aneurysms out of a total of 680 large and giant aneurysms from 1,667 patients. We found no statistical differences in favorable OKM C-D outcomes with or without the adjunctive use of coils (RR 1.06 [0.96, 1.17]; p = 0.280). However, FD + C presented fewer complications (RR 0.56 [0.33, 0.95]; I²=0%; p = 0.03). No statistical differences were found for mortality (RR 0.86 [0.34, 2.18]; I²=0%; p = 0.75). The use of adjunctive coils during treatment of large and giant aneurysms with FD seems to reduce the risk of procedural and delayed complications, while it does not increase the aneurysm occlusion rate.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"519"},"PeriodicalIF":2.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333595","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 role of neuroendoscopy in treatment of pediatric brain abscesses: case series and systematic review of the literature.","authors":"Piero Spennato, Francesco Tengattini, Stefania Picariello, Linda Gritti, Massimiliano Porzio, Claudio Ruggiero, Giulia Meccariello, Giuseppe Cinalli","doi":"10.1007/s10143-025-03669-w","DOIUrl":"10.1007/s10143-025-03669-w","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"518"},"PeriodicalIF":2.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333598","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":"Lipid peroxidation metabolites as biomarkers in patients with aneurysmal subarachnoid hemorrhage and cerebral vasospasm or delayed cerebral ischemia: a systematic review.","authors":"Natalia Anna Koc, Maurycy Rakowski, Samuel D Pettersson, Adriana Mika, Piotr Zieliński, Tomasz Szmuda","doi":"10.1007/s10143-025-03662-3","DOIUrl":"10.1007/s10143-025-03662-3","url":null,"abstract":"<p><p>Intracranial aneurysms often remain asymptomatic until rupture, causing aneurysmal subarachnoid hemorrhage (aSAH). aSAH frequently leads to cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI), significantly increasing the risk of severe neurological deficits and mortality. Identifying reliable biomarkers, such as lipid peroxidation metabolites (LPMs), is crucial for early prediction and timely intervention. This study summarizes current knowledge on LPMs as potential biomarkers for CVS and DCI after aSAH. A systematic review was conducted following PRISMA guidelines. Two independent authors searched PubMed, Web of Science, and Scopus for articles studying the association between non-enzymatic and enzymatic lipid metabolites and CVS or DCI after aSAH. Quality and risk of bias were evaluated using the Newcastle-Ottawa Scale. Extracted data included metabolite concentrations, biological sample types, timing of collection, patient demographics, clinical severity of aSAH, Fisher's grade, DCI definition, and relationship to DCI. Of 519 records screened, 17 studies were included. Lipid metabolites were measured in blood (5 studies), cerebrospinal fluid (11 studies), and urine (2 studies). F2-isoprostanes (F2-IsoPs), studied in 7 articles, were linked to increased DCI risk, with elevated levels observed within three days post-aSAH. Isofurans (IsoFs) predicted DCI risk between days 5 and 8 post-aSAH, while elevated cholesteryl ester hydroperoxide (CEOOH) levels on day 2 linked to symptomatic vasospasm. Enzymatic arachidonic acid (AA) metabolites, including 6-keto-prostaglandin F1-α, prostaglandin D2, and leukotriene C4, were also associated with early DCI risk. To the best of our knowledge, this review is the first to comprehensively assess all LPMs in relation to CVS and DCI. Elevated concentrations of F2-IsoPs and enzymatic AA derivatives may serve as biomarkers for DCI prediction in aSAH. These findings highlight the need to explore the potential of LPMs, paving the way for risk stratification and timely interventions to improve patient outcomes and aid researchers in developing predictive scoring systems for DCI. Clinical trial number Not applicable.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"516"},"PeriodicalIF":2.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333596","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":"Reshaping neurosurgical training: a novel simulation-based concept for structured skill acquisition and curriculum integration.","authors":"Belal Neyazi, Amir Amini, Vanessa M Swiatek, Klaus-Peter Stein, Ali Rashidi, I Erol Sandalcioglu","doi":"10.1007/s10143-025-03666-z","DOIUrl":"10.1007/s10143-025-03666-z","url":null,"abstract":"<p><p>As neurosurgical caseloads decline, alternative training methods are essential for practical, hands-on training and technical skill acquisition. Physical simulators have the potential to enhance surgical training, but current models lack realism and fail to replicate the full surgical workflow. This study aims to develop and evaluate a novel, affordable microneurosurgical simulator designed for structured, effective and transferable skill acquisition. Based on previously established methodologies, we developed a novel high-fidelity yet cost-effective simulator that replicates the key steps of the neurosurgical workflow, including patient positioning, craniotomy, microsurgical dissection, clipping of aneurysms, tumor resection, and closure techniques. The simulator's fidelity was validated through intense rheological testing and tactile evaluations by experienced neurosurgeons. It was subsequently implemented in a two-day microneurosurgical simulation course involving 12 neurosurgical residents from leading German institutions. Participants completed pre- and post-course evaluations. Objective evaluations of technical proficiency and surgical learning curves were conducted using a newly developed tool-the Objective Structured Assessment of Neurosurgical Skills (OSANS). Participants rated the simulator highly for anatomical accuracy and tactile realism, with 95% considering it \"highly realistic.\" Objective assessments revealed significant improvements in technical skills, including craniotomy precision and dural closure. Confidence in performing complex neuro-oncological and vascular procedures increased by 40%. Incorporating simulation-based training into neurosurgical curricula can enhance resident education, improve skill acquisition, and promote patient safety. This presented cost-effective, reusable simulator bridges gaps in neurosurgical training by enabling realistic and repetitive practice.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"517"},"PeriodicalIF":2.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333597","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":"Efficacy of transcranial direct current stimulation on seizure control in patients with refractory epilepsy: a systematic review and meta-analysis of randomized controlled trials.","authors":"Nada Ibrahim Hendi, Yaser AbuSammour, Mohamed Khaled, Ahmed S Mohamed, Ahmed Mostafa Amin, Mohamed Saleh Fallaha, Basma Kamel, Yehia Nabil Abdalla Helmy, Mohamed Ali Saeed Hassan, Mostafa Meshref","doi":"10.1007/s10143-025-03657-0","DOIUrl":"10.1007/s10143-025-03657-0","url":null,"abstract":"<p><p>Drug-resistant epilepsy is a challenging condition that affects around 30% of all patients with epilepsy. Evidence regarding treatment options is limited, especially for surgery and invasive techniques. However, non-invasive techniques constitute a promising alternative for these patients. This meta-analysis aims to evaluate the effectiveness of transcranial direct current stimulation on seizure frequency management in patients with drug-resistant epilepsy. We searched the literature in PubMed, Scopus, and Web of Science up to December 2023. We included randomized controlled trials that compared transcranial direct current stimulation with sham stimulation. Our main outcomes of interest were a percentage reduction in seizure frequency and epileptiform discharge frequency. A total of 10 studies with 269 patients were included. Monthly seizure frequency was significantly reduced by an average of -45.39%and -39.34% at week 4 and week 8, respectively. There was a significant reduction in IED in favor of tDCS at week 2 (SMD = -0.87, 95% CI = [- 1.49, - 0.25], P = 0.006), 4 weeks (SMD = -1.17, 95% CI = [- 1.67, - 0.66], P < 0.00001, Moderate quality of evidence) and 8 weeks (SMD = -1.11, 95% CI = [- 1.69, - 0.53], P = 0.0002) of follow-up. There were no serious adverse events associated with the stimulation. Transcranial direct current stimulation was associated with a reduction in both seizure frequency and epileptiform discharges with minimal side effects. Further studies with larger sample sizes and consensus protocol guidelines are needed to verify its long-term safety and effectiveness.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"515"},"PeriodicalIF":2.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326332","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":"Pre- and post-cranioplasty hydrocephalus in patients following decompressive craniectomy for ischemic stroke: a systematic review and meta-analysis.","authors":"I Khalil, R Sayad, S K Kamal, Z Hussein, S Allam, A L F Caprara, J P Rissardo","doi":"10.1007/s10143-025-03650-7","DOIUrl":"10.1007/s10143-025-03650-7","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"514"},"PeriodicalIF":2.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326333","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":"Efficacy and safety of multiple-target deep brain stimulation in non-parkinsonian movement disorders: a systematic review.","authors":"Evangelos Kalogirou, Spyridon Voulgaris, George A Alexiou","doi":"10.1007/s10143-025-03661-4","DOIUrl":"https://doi.org/10.1007/s10143-025-03661-4","url":null,"abstract":"<p><strong>Introduction: </strong>To analyze studies employing multiple-target deep brain stimulation (DBS) for non-parkinsonian movement disorders and identify potential indications, therapeutic outcomes, and associated side effects.</p><p><strong>Methods: </strong>We systematically screened PubMed and included studies involving patients treated with DBS targeting at least two brain regions, synchronous stimulation of ≥2 regions, patient data regarding symptoms/disease, and reported outcomes. Exclusion criteria included animal studies and reports lacking original data.</p><p><strong>Results: </strong>Twenty-seven studies were identified, included and analyzed; general trends were noted for each disorder. For essential tremor multi-target DBS (VIM+VOA/VOP) demonstrated promising outcomes regarding symptom improvement and reduction of side-effects. For multiple Sclerosis Tremor limited evidence suggested positive outcomes, comparable to standard DBS. The VIM/VOP border has been highlighted as a promising target. Regarding holmes Tremor although limited to case reports, multi-target DBS yielded favorable outcomes with minimal adverse effects. Finaly for dystonia multi-target DBS (GPi+VIM, GPi+VO) effectively addressed tremor and dystonic features. Statistically significant advantages were demonstrated over single-target stimulation in myoclonus-dystonia and hemidystonia.</p><p><strong>Conclusion: </strong>While variability in target selection, methodologies, and outcomes precludes a meta-analysis, evidence supports the potential role of multi-target DBS in cases where single-target stimulation is inadequate. Promising target combinations, such as GPi+VIM (myoclonus-dystonia) and VIM+VOA (essential tremor), warrant further clinical exploration. The heterogeneity and predominance of case reports highlight the need for high-quality, controlled studies to refine indications and optimize strategies for multi-target DBS.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"512"},"PeriodicalIF":2.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317528","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 Orbital Grading system yields higher precision than the Matsushima grading system in assessing angiographic outcomes after EDAS for Moyamoya disease: an interrater reliability analysis.","authors":"Omar Alwakaa, Emmanuel Mensah, Felipe Ramirez-Velandia, Alejandro Enriquez-Marulanda, Sandeep Muram, Syed Sarmad Bukhari, Jasmeet Singh, Alfred P See, Justin H Granstein, Philipp Taussky, Christopher S Ogilvy","doi":"10.1007/s10143-025-03660-5","DOIUrl":"https://doi.org/10.1007/s10143-025-03660-5","url":null,"abstract":"<p><p>Matsushima Grading System has been widely used to evaluate vessel ingrowth after bypass procedures for patients with Moyamoya disease (MMD). However, Matsushima is notably subjective and prone to measurement variability among clinicians. To address these limitations, the Orbital Grading System was developed as an objective approach to assess collateralization after EDAS, utilizing orbital craniometric landmarks to segment the ipsilateral skull into three distinct regions. The current study compares the interrater reliability of both scales. Six physicians, including two attending hybrid-neurovascular surgeons, one interventional neurologist, one neurointerventional radiologist and two vascular neurosurgery fellows, independently graded digital subtraction angiography (DSA) images from 37 hemispheres of MMD-patients using both the Matsushima and Orbital Grading scales. Fleiss'-kappa was used to assess inter-rater agreement for each scale, with results interpreted according to Landis-and-Koch-agreement-scale. All six raters graded 37 DSA-images using both Matsushima and the Orbital grading systems. Both scales demonstrated statistically significant inter-rater agreement (p < 0.0001). However, the Orbital Grading System produced significantly higher agreement (Kappa:0.83 [95%CI:0.74-0.93], indicating almost-perfect-agreement) compared to Matsushima grading system (Kappa:0.52 [95%CI:0.38-0.65], indicating moderate-agreement). Simple percentage agreement among all raters was 81.1% in the Orbital Grading System and 48.6% in Matsushima Grading. The Orbital Grading System demonstrates superior interrater reliability compared to the Matsushima grading, with significantly higher agreement among raters. This suggests that the Orbital Grading System is a more consistently objective tool for evaluating collateralization following EDAS. By reducing grading discrepancies between observers and enhancing generalizability, this system has the potential to optimize the management of MMD. Although our study demonstrates excellent reproducibility of the Orbital Grading System, future studies are needed to validate its accuracy in reflecting the true extent and functional significance of postoperative collateral formation.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"513"},"PeriodicalIF":2.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317529","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 effectiveness of clinical frailty assessment in older patients with Traumatic brain injury in predicting outcome and quality of life: a systematic review.","authors":"Elizabeth Cray, Nida Javed Hayat, Chi Ho Song, Max Western, Ellie Edlmann","doi":"10.1007/s10143-025-03659-y","DOIUrl":"10.1007/s10143-025-03659-y","url":null,"abstract":"<p><p>Ground-level falls are the most common cause of Traumatic brain injury (TBI) leading to emergency hospital admissions, in adults aged 65 years and older. The world's population is ageing and frailty is becoming more relevant in healthcare provision, therefore assessment of frailty on admission is integral to care planning. Identifying whether frailty is a risk factor for poor outcomes may facilitate clinical decision making and direct care appropriately. This review aimed to evaluate the effectiveness of a clinical frailty assessment or scale in predicting outcomes in older patients following a TBI, including mortality, functional recovery, hospital length of stay, and discharge disposition. A systematic review of OVID, EBSCO, Elsevier and Wiley from 2005 to 2025. Included a majority of patients aged 65 years and over, diagnosed with a TBI with a validated frailty assessment tool and at least one outcome measure reported. A total of 12 observational studies (464,606 patients) were included, with a mean age ranging between 70 and 83 years. These studies utilised seven distinct frailty assessment tools. Falls from standing were the most common mechanism of injury identified. Frailty was associated with 30-day and 1-year mortality and unfavourable outcome in combination with a reduced Glasgow Coma Score (GCS) on admission. Frailty was an independent predictor of length of hospital stay, discharge disposition and functional recovery but no study used a validated quality of life tool. Various frailty assessment tools demonstrate effectiveness in predicting clinical outcomes when used in combination with patients age, co-morbidity and neurological evaluation. The predictive value of these tools supports their clinical utility in clinical decision making. Further prospective research is needed to understand how frailty relates to longer term outcomes, particularly quality of life, which was not measured in the included studies. Clinical trial number Not applicable.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"511"},"PeriodicalIF":2.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302585","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}