Neurosurgical Review最新文献

{"title":"Early surgery is associated with improved postoperative visual outcomes in apoplectic pituitary neuroendocrine tumors with acute visual deterioration.","authors":"Abhijit Goyal-Honavar, Subhas Konar, Nishanth Sadashiva, Shilpa Rao, Abhinith Shashidhar, A R Prabhuraj, Dwarakanath Srinivas, A Arivazhagan, Malla Bhaskara Rao, Jitendra Saini, Dhaval Shukla","doi":"10.1007/s10143-025-03427-y","DOIUrl":"https://doi.org/10.1007/s10143-025-03427-y","url":null,"abstract":"<p><strong>Background: </strong>Pituitary apoplexy is a neurosurgical emergency that often manifests visual deterioration and cranial nerve palsies, presenting a need for urgent surgical decompression. However, the timing of surgery remains controversial, and the impact of perioperative characteristics of patients with apoplexy on visual recovery following surgery remains nebulous.</p><p><strong>Methods: </strong>We retrospectively analyzed all cases of pituitary apoplexy with acute visual deterioration operated between 2013 and 2023, recording details of clinical presentation, surgery, and the postoperative period. Visual acuity (VA) and visual field defects at presentation were recorded, as was their evolution following surgery. Perioperative characteristics of patients were compared among cases where VA improved and those that did not.</p><p><strong>Results: </strong>The cohort comprised 55 patients, 29 males and 26 females. VA was negative for perception of light (PL-) in 13 cases. Forty-four patients (80%) underwent endoscopic transsphenoidal surgery, 4 patients (7.3%) underwent transcranial surgery, and 6 patients (10.9%) underwent microscopic transsphenoidal surgery. VA improved in 39 patients (75%), while significant improvement in VA occurred in 26 of 41 patients (63.4%). Multivariate analysis revealed that PL- vision, visual deterioration > 168 h, and cranial nerve palsy predicted non-improvement of VA.</p><p><strong>Conclusions: </strong>Visual deterioration is the most frequent presentation of pituitary apoplexy. Following surgical decompression, improvement in VA occurs in most cases, with significant improvement in more than half of cases. Improvement in VA is superior in patients operated within 96 h to a week of onset of visual deterioration, but not earlier, and less frequently occurs in patients who present with blindness (46.2%).</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"275"},"PeriodicalIF":2.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524098","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 association between systemic immune-inflammation index and the short-term functional outcome of patients with aneurysmal subarachnoid hemorrhage: a meta-analysis.","authors":"Fenfang Ye, Jin Jin, Jiayong Dai","doi":"10.1007/s10143-025-03300-y","DOIUrl":"https://doi.org/10.1007/s10143-025-03300-y","url":null,"abstract":"<p><p>Systemic immune-inflammation index (SII), calculated as platelet count × neutrophil count/lymphocyte count, is a novel biomarker reflecting immune and inflammatory responses. Its prognostic value in patients with subarachnoid hemorrhage (SAH) remains unclear. This meta-analysis aimed to evaluate the association between SII at admission and the short-term functional outcomes of patients with SAH. A systematic search of PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and Wanfang databases identified cohort studies reporting the relationship between SII levels and functional outcomes in SAH. Poor functional outcomes were defined as modified Rankin Scale > 2 or Glasgow Outcome Scale < 4. Heterogeneity was assessed using I² statistic, and data synthesis was performed using a random-effects model by incorporating the influence of heterogeneity. RevMan 5.1 and Stata 17.0 were used for the analyses. Ten cohort studies involving 2,228 patients were included. Meta-analysis revealed that a high SII at admission significantly increased the risk of poor functional outcomes (OR: 3.08, 95% CI: 2.07-4.59, p < 0.001) with moderate heterogeneity (I² = 61%). Subgroup analysis showed a stronger association in studies with SII cutoffs ≥ 1400 compared to < 1400 (p for subgroup difference < 0.001). Meta-regression identified the cutoff value for SII as a significant modifier (p = 0.03) for the association between SII and poor functional outcome. Sensitivity analyses by excluding one dataset at a time showed similar results (p all < 0.05). In conclusion, elevated SII at admission is associated with an increased risk of poor short-term functional outcomes in SAH. These findings highlight SII as a potential prognostic biomarker for early risk stratification in SAH patients.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"272"},"PeriodicalIF":2.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523534","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":"Diagnostic criteria utilized for selection of patients for meralgia paresthetica surgery: a systemic review.","authors":"Joshua T Finerty, Allison R Garden, Joshua S Everhart","doi":"10.1007/s10143-025-03411-6","DOIUrl":"https://doi.org/10.1007/s10143-025-03411-6","url":null,"abstract":"<p><p>Meralgia paresthetica (MP) lacks consensus on diagnostic criteria for surgical candidates. This study reviews the literature to identify the most common criteria for determining MP surgical candidates and their impact on surgical outcomes. A literature search using PubMed, MEDLINE, and Google Scholar was conducted for MP surgical outcome studies. Studies were evaluated using methodical index for non-randomized studies (MINORS) criteria, and diagnostic criteria were compared. Twenty-one studies were identified with inclusion of 616 surgical results involving decompression or neurectomy of the lateral femoral cutaneous nerve (LFCN). The most used diagnostic criteria were patient history (100%), response to LFCN injection (90%), and spinal imaging (57%). Positive outcomes were noted in 84.7% of cases. History and LFCN injection were effective for diagnosing MP, while EMG was useful to rule out other pathologies. The combination of appropriate patient history and positive response to LFCN injection is a common and sufficient diagnostic method to effectively identify MP patients who are likely to benefit from surgical decompression or neurectomy. Additionally, EMG may be useful as a supplemental test to rule out non-MP diagnoses. Level III systematic review.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"273"},"PeriodicalIF":2.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524095","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":"Cerebral salt wasting syndrome as a probable cause of postoperative polyuria in patients with supratentorial Non-midline tumors: A prospective observational study with targeted and quantitative metabolomic approach.","authors":"Lei Shi, Yu-Fang Wang, Guo-Feng Zhang, Yan Li, Ming-Li Yao, Jing-Chao Li, Chun-Fang Qiu, Shun Yao, Bin Ouyang, Ling-Yan Wang","doi":"10.1007/s10143-025-03425-0","DOIUrl":"10.1007/s10143-025-03425-0","url":null,"abstract":"<p><p>Polyuria, or excessive fluid loss through the kidneys, is a common issue in neurocritical patients, often resulting from conditions such as fluid volume overload, osmotic diuretics, central diabetes insipidus (CDI), or cerebral salt wasting syndrome (CSWS). Notably, the specific cause of postoperative polyuria within 24 h in patients with tumors located in the supratentorial non-midline region remains poorly understood. To address this gap, we conducted a prospective observational study with 30 patients and found that eight (26.7%) experienced postoperative polyuria. Binary logistic regression analysis of clinical data ruled out fluid volume and osmotic diuretics as the underlying causes of postoperative polyuria, and suggested a very subtle association between tumor size and polyuria (OR = 1.030; p = 0.041). A significant postoperative decrease in serum sodium levels in the polyuria group (p = 0.005) pointed towards CSWS as potential mechanism. Differentiating between CDI and CSWS, both involving neuroendocrine hormone dysregulation, is challenging due to the lack of efficient clinical tests. To overcome this, we developed a novel liquid chromatography-tandem mass spectrometry (LC-MS)-based targeted and quantitative method to measure seven neuroendocrine hormones, including antidiuretic hormone (ADH) related to CDI and six natriuretic peptides associated with CSWS. Elevated levels of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), C-type natriuretic peptide (CNP), and ADH were observed in the polyuria group. Univariate analysis identified ANP, BNP, and ADH as significantly associated with polyuria at a threshold of p < 0.1. Later, multivariate logistic regression further revealed elevated BNP as an independent risk factor for polyuria (OR = 9111.901; p = 0.022). These findings suggest that CSWS may be the primary cause of postoperative polyuria in patients with supratentorial non-midline tumors, as evidenced by the concomitant decrease in serum sodium and increase in natriuretic peptides, particularly BNP.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"274"},"PeriodicalIF":2.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524093","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":"Spetzler-Martin grade I and II cerebral arteriovenous malformations: a propensity-score matched analysis of resection and stereotactic radiosurgery in adult patients.","authors":"Salem M Tos, Mahmoud Osama, Georgios Mantziaris, Bardia Hajikarimloo, Nimer Adeeb, Sandeep Kandregula, Adam A Dmytriw, Hamza Adel Salim, Basel Musmar, Kareem El Naamani, Christopher Ogilvy, Douglas Kondziolka, Ahmed Abdelsalam, Deepak Kumbhare, Sanjeev Gummadi, Cagdas Ataoglu, Ufuk Erginoglu, Muhammed Amir Essibayi, Abdullah Keles, Sandeep Muram, Daniel Sconzo, Howard Riina, Arwin Rezai, Johannes Pöppe, Rajeev D Sen, Omar Alwakaa, Christoph J Griessenauer, Pascal Jabbour, Stavropoula I Tjoumakaris, Jan-Karl Burkhardt, Robert M Starke, Mustafa Baskaya, Laligam N Sekhar, Michael R Levitt, David J Altschul, Neil Haranhalli, Malia McAvoy, Assala Aslan, Abdallah Abushehab, Christian Swaid, Adib Abla, Christopher Stapleton, Matthew Koch, Visish M Srinivasan, Peng R Chen, Spiros Blackburn, Mark J Dannenbaum, Omar Choudhri, Bryan Pukenas, Darren Orbach, Edward Smith, Markus Möhlenbruch, Ali Alaraj, Ali Aziz-Sultan, Aman B Patel, Hugo H Cuellar, Michael Lawton, Jacques Morcos, Bharat Guthikonda, Jason Sheehan","doi":"10.1007/s10143-025-03431-2","DOIUrl":"10.1007/s10143-025-03431-2","url":null,"abstract":"<p><p>Cerebral arteriovenous malformations (AVMs) are congenital vascular anomalies that can lead to severe complications, including hemorrhage and neurological deficits. This study compares the outcomes of microsurgical resection and stereotactic radiosurgery (SRS) for SM grade I and II AVMs. Out of a large multicenter registry, we identified 180 matched patients with SM grade I and II AVMs treated with either microsurgical resection or SRS between 2010 and 2023. The primary outcomes were AVM obliteration rates and complications; secondary outcomes included neurological status and functional outcomes measured by the modified Rankin Scale (mRS). Propensity score matching (PSM) was utilized to ensure comparability between treatment groups. After PSM, 90 patients were allocated to each treatment group. Significant differences were observed in complete obliteration rates, with resection achieving higher rates compared to SRS in overall cases (97.8% vs. 60.0%, p < 0.001), unruptured AVMs (100% vs. 58.3%, p < 0.001), and ruptured AVMs (95.2% vs. 61.9%, p < 0.001). Functional improvement rates were similar between the groups for overall cases (67.2% in resection vs. 66.7% in SRS, p = 0.95), unruptured AVMs (55.2% in resection vs. 55.6% in SRS, p > 0.9), and ruptured AVMs (78.1% in resection vs. 74.1% in SRS, p = 0.7). Symptomatic complication rates were identical between the groups (11.1% each, p > 0.9), while permanent complication rates were comparable (6.7% in resection vs. 5.6% in SRS, p = 0.8). Resection demonstrated significantly higher complete obliteration rates compared to SRS across all cases, including unruptured and ruptured AVMs. Functional improvement rates were similar between the two treatment groups, with no significant differences in symptomatic or permanent complication rates.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"276"},"PeriodicalIF":2.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524100","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":"Hemilaminectomy vs. laminectomy for spinal tumors: a systematic review and meta-analysis.","authors":"Gabriel Teles de Oliveira Piñeiro, Marcos Paulo Rodrigues de Oliveira, Pedro Henrique Ferreira Sandes, Davi Chaves Rocha de Souza, Caio Passos de Azevedo Figueiredo Trocoli, Gabriel Souza Medrado-Nunes, Vinícius Monteiro de Paula Guirado, Roger Schmidt Brock, Danilo Gomes Quadros","doi":"10.1007/s10143-025-03435-y","DOIUrl":"10.1007/s10143-025-03435-y","url":null,"abstract":"<p><p>Hemilaminectomy is a less invasive surgical option than laminectomy for spinal tumors, but which method provides better results remains to be determined. Thus, we aimed to perform a meta-analysis comparing outcomes between the two approaches. We searched PubMed, EMBASE, and Web of Science for studies comparing hemilaminectomy to laminectomy in patients who underwent spinal tumor resection until August 2024. The outcomes were total resection rate, neurological deterioration, postoperative complications, length of stay, operative time, and estimated blood loss. Statistical analysis was performed via R software (version 4.4.1). Heterogeneity was assessed with I² statistics. We included 12 studies with 1047 patients, of whom 405 (38.7%) underwent hemilaminectomy. The mean age was 56.6 ± 7.5 years. The mean follow-up ranged from 1 to 60 months. Among the tumors, 44.8% were meningiomas, and 57.4% were located in the thoracic spine. With no significant difference between hemilaminectomy and laminectomy in terms of the total resection rate achieved (RR 1.04, 95% CI: 0.98-1.11, I² = 38%), hemilaminectomy showed lower neurological deterioration (RR 0.53, 95% CI: 0.35-0.81, I² = 0%) and postoperative complications (RR 0.58, 95% CI: 0.39-0.86, I² = 12%). Furthermore, the length of stay (MD -2.91 days, 95% CI: -4.98 to -0.85; I² = 90%), operative time (MD -26.44 min, 95% CI: -46.22 to -6.67; I² = 61%), and estimated blood loss (MD -115.64 mL, 95% CI: -175.68 to -55.60; I² = 78%) were significantly lower in hemilaminectomy. Hemilaminectomy is associated with lower neurological deterioration, postoperative complications, operation time, length of stay, and estimated blood loss. Therefore, our results might suggest that hemilaminectomy may be a more promising and preferable alternative to laminectomy.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"270"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516294","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":"Spinal dural arteriovenous fistula: review of clinical presentation, prognosis and imaging findings.","authors":"Jon Bjarnason, Vilhjalmur Vilmarsson, Ingvar Hakon Olafsson, Enrico Bernardo Arkink","doi":"10.1007/s10143-025-03432-1","DOIUrl":"10.1007/s10143-025-03432-1","url":null,"abstract":"<p><p>Spinal dural arteriovenous fistulas (SDAVF) are rare vascular lesions in the spine. Misdiagnosis is frequent due to non-specific symptoms, which leads to delayed treatment and poorer prognosis. This study reviews the clinical presentation, diagnosis and outcomes of SDAVF cases in Iceland to raise awareness of this rare, but potentially debilitating condition. A retrospective review was conducted of all patients diagnosed with and/or treated for SDAVF at our institution from 2003 to 2024. Medical records were examined for disease duration, severity and prognosis. Imaging was evaluated for features of SDAVF, and outcomes were assessed using the modified Rankin Scale (mRS) and modified Aminoff-Logue Scale (mALS). Seven patients (four males) were identified, with a mean age of 64 and a disease duration of 21 months. Motor, sensory and gait disturbances were present in all patients, as well as bladder dysfunction. Bowel dysfunction (83%) was also common. All patients were wrongfully diagnosed either clinically and/or at imaging, despite showing typical magnetic resonance imaging (MRI) features of SDAVF. All patients underwent successful surgical ligation, with an average of one-point improvement on the mRS and the greatest improvement in gait on the mALS, with an average of one and a half-point improvement. SDAVF should be considered with middle-aged and elderly patients with progressive myelopathy. MRI of at least the thoracic and lumbar spine is essential to include the level of the fistula. Multisegmental T2 hyperintensity and prominent perimedullary flow void should prompt further evaluation with DSA. Post-contrast images and MR angiography may also aid in the diagnosis of SDAVF and guide the DSA.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"269"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516298","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":"Health-related quality-of-life outcomes in CNS WHO grade 2 and 3 meningioma: a systematic review.","authors":"William H Cook, Fareha Khalil, Conor S Gillespie, Adel E Helmy","doi":"10.1007/s10143-025-03420-5","DOIUrl":"10.1007/s10143-025-03420-5","url":null,"abstract":"<p><p>WHO grade 2 and 3 meningioma constitute approximately 20% of all meningioma. The lower incidence of these more aggressive meningiomas has led to under-representation of clinical outcomes in the literature. It is hypothesised that patients with grade 2 or 3 meningiomas are disabled by tumour and treatment morbidity, contributing to lower health-related quality-of-life (HRQoL). A PRISMA-compliant systematic review was conducted (PROSPERO CRD42023441009). MEDLINE, EMBASE, and Cochrane Library databases were searched between inception and September 2023. Studies of adults (> 16 y.o.) with histologically-proven WHO grade 2 and 3 cranial meningioma who underwent a combination of surgery, radiotherapy, and stereotactic radiosurgery and had HRQoL outcome data were included. Primary outcome was HRQoL. Fifteen studies were included. HRQoL was measured with 10 different tools, three of which have been validated in meningioma patients. Only two studies exclusively reported on WHO grade 2 and 3 meningioma and four further studies considered WHO grade in statistical analysis. WHO grade 2 and 3 meningioma were associated with reduced HRQoL in two studies that reported direct comparison and no difference in another two. Psychological domains were reduced in most studies compared to normative data or controls including in one of the two studies reporting on WHO grade 2 and 3 tumours exclusively. This systematic review highlights the need for prospective studies of more patients with grade 2 and 3 meningioma with validated meningioma-specific HRQoL tools. The current literature is limited by the small proportion of patients within reported studies, and heterogenous and poorly reported management paradigms.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"268"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516268","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":"Astrocytomas IDH-mutant of posterior cranial fossa, clinical presentation, imaging features and onco-functional balance in surgical management.","authors":"Matteo De Simone, Anis Choucha, Carlotta Ranalli, Giuseppina Pecoraro, Romain Appay, Oliver L Chinot, Henry Dufour, Giorgio Iaconetta","doi":"10.1007/s10143-025-03436-x","DOIUrl":"10.1007/s10143-025-03436-x","url":null,"abstract":"<p><p>IDH-mutant astrocytomas (AIDHmut) in the posterior cranial fossa (PCF) are rare and present substantial diagnostic and therapeutic challenges due to their location. We analyzed patients with PCF AIDHmut from our institutions, treated between December 2021 and September 2024. Additionally, we conducted a systematic literature review (from January 2021 to September 2024) using PubMed, Ovid MEDLINE, and Ovid EMBASE to identify cases of PCF AIDHmut. We identified a total of 19 cases, including one institutional case. Most patients were young adults, with a male predominance (15 males, 4 females). Tumors primarily originated from the brainstem (94.7%), with only one case involving the cerebellum. Clinical presentations frequently included cranial nerve deficits, with diplopia being the most common symptom (47.4%). Adjuvant radiotherapy (IMRT, DT 54 Gy/27 fractions, 78.9%) and chemotherapy (temozolomide, 68.4%) formed the mainstays of treatment. Tumor grading revealed 63.2% (12/19) were WHO grade 2, 21% (4/19) were WHO grade 3, and 15.8% (3/19) were grade 4. The mean follow-up period was 45 months. PCF AIDHmut are rare but pose significant treatment challenges due to their location and infiltrative nature. Multimodal treatment-comprising surgery, radiotherapy, and chemotherapy-is essential for achieving long-term disease control. Subtotal resection followed by adjuvant therapies provides a favorable balance between tumor control and functional preservation.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"271"},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516266","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":"Medial temporal lobotomy in the treatment of medial temporal lobe epilepsy: a case series of 12 patients.","authors":"Jingyi Yang, Yixuan Zhou, Yuankun Cai, Lei Shen, Yuanyuan Ruan, Songshan Chai, Dongyuan Xu, Jianzhang Pu, Hao Du, Nanxiang Xiong","doi":"10.1007/s10143-025-03414-3","DOIUrl":"https://doi.org/10.1007/s10143-025-03414-3","url":null,"abstract":"<p><strong>Purpose: </strong>This case series aimed to investigate the safety and efficacy of medial temporal lobotomy (MTL) in the treatment of medial temporal lobe epilepsy (MTLE).</p><p><strong>Methods: </strong>We presented our experience with 12 MTLE patients who underwent MTL in our center from January 2018 to July 2021. The MTL technique involves suction-based removal of the amygdala, effectively severing the fibrous connections between the medial temporal lobe structures and the surrounding cortex while maintaining the integrity of the medial temporal lobe structures without removing the hippocampus as in selective amygdalohippocampectomy.</p><p><strong>Results: </strong>Among the 12 MTLE patients, five were men and seven were women. Mean age was 18.7 years-old, ranging from 6 to 41 years-old. All surgeries were completed successfully. Although one patient developed a transient mild disturbance of consciousness that fully resolved, no patient experienced intracranial hemorrhage, cerebral infarction, hemiplegia, aphasia, or visual field defect. Mean follow-up was 3.25 years, ranging from 6 to 41 years. The Engel classification for seizure outcomes at the last follow-up was as follows: class I, 9 patients (75.0%); class II, 1 patient (8.3%); and class III, 2 patients (16.7%).</p><p><strong>Conclusion: </strong>Our preliminary results show that MTL is safe and effective. Future studies are warranted to validate our outcomes.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"267"},"PeriodicalIF":2.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502356","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}