Neurologia medico-chirurgica最新文献

{"title":"Dynamic Magnetic Resonance Imaging Changes in Spinal Ependymomas and Their Impact on Surgical Planning.","authors":"Yuki Sunohara, Yoshitaka Nagashima, Yusuke Nishimura, Masahito Hara, Hiroyuki Kato, Eisuke Tsukamoto, Kazuichi Terao, Naoto Kawaguchi, Takafumi Tanei, Ryuta Saito","doi":"10.2176/jns-nmc.2024-0328","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0328","url":null,"abstract":"<p><p>Spinal ependymomas are common intramedullary tumors that can show dynamic changes in magnetic resonance imaging findings over time. This study aimed to analyze these imaging changes and their implications for perioperative management. The retrospective study included patients diagnosed with World Health Organization grade 2 spinal ependymoma who underwent surgical resection and had at least 2 preoperative magnetic resonance imaging scans. Patients were divided into 2 groups based on the presence or absence of radiographic changes on magnetic resonance imaging. Magnetic resonance imaging analyses included non-contrast T1- and T2-weighted images, as well as gadolinium-enhanced T1-weighted images when available. Key features evaluated included intraparenchymal edema, hemosiderin deposition, syringomyelia, and cyst components. Changes in tumor size and contrast enhancement patterns were documented. Radiographic changes were identified in 4 out of 15 cases (26.7%). All cases with imaging changes exhibited hemosiderin deposition or hemorrhage, significantly higher than in cases without changes (100% vs. 18.2%, p < 0.05). No significant differences were observed in the presence of cystic components, syringomyelia, or edema between the groups. In the group with radiographic changes, the timeframe for these changes in the images ranged from 3 days to several years. Spinal ependymomas can demonstrate dynamic magnetic resonance imaging changes during the preoperative period, including both growth and reduction in tumor size. The presence of hemosiderin deposition or hemorrhage might be associated with these imaging changes. Proper timing of magnetic resonance imaging is crucial for informing surgical planning and optimizing treatment strategies for patients with spinal ependymomas.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nationwide Survey of Middle Meningeal Artery Embolization for Chronic Subdural Hematoma in Japan.","authors":"Satoshi Murai, Yuki Ebisudani, Jun Haruma, Masafumi Hiramatsu, Tomohito Hishikawa, Tetsu Satow, Kenji Sugiu","doi":"10.2176/jns-nmc.2025-0003","DOIUrl":"https://doi.org/10.2176/jns-nmc.2025-0003","url":null,"abstract":"<p><p>Middle meningeal artery embolization has increasingly been used to treat chronic subdural hematoma. However, the current state of its application and outcomes in Japan remains unclear. We conducted a multicenter observational study involving facilities affiliated with the Japanese Society for Neuroendovascular Therapy to assess current practices and clarify the usefulness and safety of middle meningeal artery embolization for chronic subdural hematoma. A total of 466 patients from 40 facilities were included. The mean age of the patients was 78.0 ± 10.5 years, and bleeding risks, including antithrombotic therapy or bleeding predisposition, were present in 36.1% of patients. The most common timing for middle meningeal artery embolization was after the second burr hole surgery, accounting for 34.8% of cases. N-butyl-2-cyanoacrylate was used as the embolic material in 67% of cases. The complication rate was 5.2%, with complication-related morbidity at 0.9%. Hematomas were stable in 91.5% of cases at 30 days post-middle meningeal artery embolization. The symptomatic recurrence rate was 8.9%. Cases that underwent middle meningeal artery embolization after the second or subsequent burr hole surgeries were significantly associated with symptomatic recurrence. This study is the first nationwide survey investigating the real-world clinical practice of middle meningeal artery embolization for chronic subdural hematoma in Japan. While it included many elderly patients, recurrent cases, and those with bleeding risks, the safety and usefulness of middle meningeal artery embolization were deemed acceptable. However, symptomatic recurrence was common even in cases with middle meningeal artery embolization when performed after the second or subsequent burr hole surgeries. A further prospective study will be warranted to clarify treatment indications, optimal timing, and treatment techniques of middle meningeal artery embolization.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Questionnaire Survey of Facilities Conducted among Members of the Japanese Society for Stroke Surgery on Surgical Intervention for Hypertensive Intracerebral Hemorrhage.","authors":"Kazutaka Uchida, Shuntaro Kuwahara, Shoichiro Tsuji, Fumihiro Sakakibara, Manabu Shirakawa, Shinichi Yoshimura","doi":"10.2176/jns-nmc.2024-0340","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0340","url":null,"abstract":"<p><p>There is limited high-level evidence guiding the surgical treatment of hypertensive intracerebral hemorrhage, leaving the decision to the clinician's discretion. To understand treatment practices, a questionnaire survey was conducted among members of the Japanese Society on Surgery for Cerebral Stroke. This survey examined stroke care systems at various institutions, stroke numbers, and treatment details of patients with hypertensive intracerebral hemorrhage from January 2021 to December 2023. We examined data from 42 facilities, compared with 10 primary stroke centers cores and 32 non-primary stroke center cores. The total number of physicians involved in stroke care (primary stroke center cores vs. non-primary stroke center cores, median interquartile range; 18 [11-26] vs. 8 [4-14], p = 0.01), stroke specialists (8 [5-12] vs. 4 [2-7], p = 0.03), and supervising stroke surgeons (2 [1-2] vs. 1 [0-2], p = 0.008) was significantly higher in the primary stroke center cores group. Overall, 36,412 patients with stroke were hospitalized: 68% had cerebral infarction, 22% cerebral hemorrhage, 8% subarachnoid hemorrhage, and 2% other strokes. The locations of hypertensive intracerebral hemorrhage varied, with the putamen (31%), thalamus (25%), and lobe (24%) being predominantly affected. Non-invasive treatment was more prevalent in non-primary stroke center cores for most hypertensive intracerebral hemorrhage types, except for putaminal and brainstem hemorrhages. Surgical interventions were more common in primary stroke center cores, with craniotomies, neuroendoscopic surgeries, and ventricular drainage being preferred for cerebellar hemorrhage (28%), caudate nucleus hemorrhage (20%), and intraventricular hemorrhage (41%). This study highlights the treatment variability of hypertensive intracerebral hemorrhage between primary stroke center and non-primary stroke center cores.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial Projection Ratio: A Novel Shape Index to Evaluate Aneurysm Rupture Risk Using Three-dimensional Geometry.","authors":"Tomoyuki Kishimoto, Fujimaro Ishida, Masanori Tsuji, Takenori Sato, Kazuhiro Furukawa, Yusuke Kuroda, Munenari Ikezawa, Yoko Yamamoto, Keiji Fukazawa, Hidenori Suzuki","doi":"10.2176/jns-nmc.2024-0303","DOIUrl":"https://doi.org/10.2176/jns-nmc.2024-0303","url":null,"abstract":"<p><p>Shape indices such as size ratio are valuable for diagnosing aneurysm rupture status and may influence rupture risk. However, as these indices are calculated based on two-dimensional measurements, bias may arise from observation directions. To address this, we developed a novel parameter, spatial projection ratio, utilizing three-dimensional geometry. A retrospective analysis of 225 aneurysms diagnosed using three-dimensional computed tomography angiography was conducted to evaluate primary variables and spatial projection ratio.Spatial projection ratio is determined by defining the gravity point as the neck orifice center and identifying the furthest point from it using commercial software. The distance between these points, known as spatial projection length, is measured and divided by the equivalent neck diameter to calculate spatial projection ratio. Significant differences in morphological variables for rupture status were observed by Brunner-Munzel tests.Receiver-operating characteristic curve analysis was employed to assess diagnostic accuracy, with Spearman's rank correlation utilized to explore the potential for predicting rupture risk by correlating spatial projection ratio and size ratio. Ruptured aneurysms exhibited significantly higher primary variables and shape indices compared to unruptured ones. The area under receiver-operating characteristic curves of all shape indices surpassed that of primary variables, with spatial projection ratio demonstrating a particularly high area under receiver-operating characteristic curves of 0.791 (95% confidence interval 0.732-0.849; sensitivity, 0.770; specificity, 0.741; cut-off value, 1.047). Moreover, spatial projection ratio exhibited a significant correlation with size ratio (r = 0.575, p < 0.01).Thus, spatial projection ratio emerges as a robust morphological parameter for evaluating rupture status and may provide insights into aneurysm rupture risks.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Tigertriever and Self-expanding Stent Retrievers for Mechanical Thrombectomy of Acute Ischemic Stroke: A Single-center Experience.","authors":"Koichiro Shindo, Kazutaka Uchida, Manabu Shirakawa, Shoichiro Tsuji, Shuntaro Kuwahara, Yoji Kuramoto, Shinichi Yoshimura","doi":"10.2176/jns-nmc.2024-0297","DOIUrl":"10.2176/jns-nmc.2024-0297","url":null,"abstract":"<p><p>Stent retrievers, including the novel Tigertriever, are important in mechanical thrombectomy for acute ischemic stroke due to a proximal large-vessel occlusion within the anterior circulation. We aimed to assess the efficacy and safety of the Tigertriever compared to self-expanding stent retrievers like EmboTrap, Solitaire, Trevo, or Tron. Patients treated at a stroke center for intracranial vessel occlusion in the anterior circulation between August 2022 and August 2024 were evaluated. The primary outcome was a modified first-pass effect, defined as a modified thrombolysis in cerebral infarction grade of 2b-3 after the first pass. Secondary outcomes included the first-pass effect, device-related serious adverse events, embolization in new territory, and hemorrhagic complications within 24 hours post-procedure. Data from 104 hemispheres in 103 patients were analyzed (24 in the Tigertriever group and 80 in the stent-retriever group). The Tigertriever group demonstrated a higher modified first-pass effect (70.8% vs. 52.5%; adjusted odds ratio 3.17; 95% confidence interval 1.06-9.47; p = 0.02). Although not statistically significant, vessel dissection (0% vs. 3.8%), subarachnoid hemorrhage (20.8% vs. 32.5%), and symptomatic intracranial hemorrhage (4.2% vs. 12.5%) within 24 hours post-procedure were lower in the Tigertriever group. No significant differences were observed in the first-pass effect or embolization in the new territory between the 2 groups. The Tigertriever might be effective for anterior circulation intracranial vessel occlusion, achieving a higher rate of modified first-pass effect. It might also be associated with minimal serious procedural complications, indicating its safety profile.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"247-254"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Surgical Outcomes in Microscopic and Fully Endoscopic Microvascular Decompression for Hemifacial Spasm.","authors":"Kyosuke Matsunaga, Norio Ichimasu, Nobuyuki Nakajima, Michihiro Kohno","doi":"10.2176/jns-nmc.2024-0245","DOIUrl":"10.2176/jns-nmc.2024-0245","url":null,"abstract":"<p><p>Fully endoscopic microvascular decompression is increasingly being used to treat hemifacial spasm; however, its efficacy must be validated by comparing it with conventional microscopic microvascular decompression. In this study, we aimed to compare the surgical outcomes of microsurgical and endoscopic microvascular decompression for hemifacial spasm and discuss the usefulness and risks of endoscopic treatment. A total of 40 patients with hemifacial spasm were retrospectively evaluated at a single institution between 2016 and 2022, including 33 patients who underwent microscopic microvascular decompression (microvascular decompression group) and 7 patients who underwent fully endoscopic microvascular decompression group, which was chosen for patients with sufficient space in the cerebellopontine cistern for endoscopic manipulation. Statistical analyses of the microvascular decompression group and the endoscopic microvascular decompression group were performed to compare patient background and surgical outcomes. No significant differences in age, sex, or affected side were observed between the 2 groups. At the 6-month follow-up, substantial improvement was observed in more than 85% of the patients in each group. Delayed facial palsy and mild lower cranial nerve palsy, such as hoarseness, were more common in the endoscopic microvascular decompression group than in the microvascular decompression group, although there were no significant differences in the rate of complications between the 2 groups. All complications were alleviated within 3 months after surgery. During endoscopic microvascular decompression, interference between the endoscope and instruments can cause neural damage owing to the limited space along the petrosal surface of the cerebellum. Our results suggest that endoscopic procedures cannot always be used as a substitute for conventional microscopic microvascular decompression.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"230-238"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospects of BRAF/MEK Inhibitor Therapy in Papillary Craniopharyngiomas with the BRAF V600E Mutation: A Scoping Review.","authors":"Shingo Fujio, Rafi Ilmansyah, Ryutaro Makino, Tareq A Juratli, Jun Sugata, Yuriz Bakhtiar, Ryosuke Hanaya","doi":"10.2176/jns-nmc.2024-0246","DOIUrl":"10.2176/jns-nmc.2024-0246","url":null,"abstract":"<p><p>Craniopharyngiomas are locally aggressive, rare tumors that pose significant treatment challenges and often result in permanent neurological deficits. Since the discovery of the BRAF V600E driver mutation in papillary craniopharyngioma, several case reports have reported on the efficacy of BRAF inhibitors or the combination of BRAF and MEK inhibitors in treating papillary craniopharyngiomas with this mutation. However, the efficacy, safety, and optimal utilization of this emerging therapy for craniopharyngiomas remain unclear. We conducted a systematic review of published articles in PubMed, Scopus, and the Cochrane Library-CENTRAL, focusing on the efficacy and safety of BRAF/MEK inhibitor therapy in papillary craniopharyngiomas with the BRAF V600E mutation, covering publications from inception through June 2024. A total of 20 case reports and series involving 22 patients were included in the analysis. Combination therapy with BRAF/MEK inhibitors was employed in 81.8% of cases. Significant tumor reduction (≥80%) was observed in 18 of 21 cases, regardless of radiation therapy history, pretargeted therapy tumor volume, and tumor composition. The duration of tumor minimization ranged from 1 to 24 months (median: 5 months). Fever was the most commonly reported adverse event (28.6%), followed by dermatological symptoms (19%). Tumor recurrence was noted in 4 of 6 patients who did not receive additional treatment following the completion of targeted therapy; however, targeted therapy was effective in the cases in which it was resumed. This study provides critical insights into optimizing treatment strategies for papillary craniopharyngiomas and underscores the potential role of targeted therapies in enhancing patient outcomes.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"217-229"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of ELAPSS Score and Computational Fluid Dynamics for Predicting Growth of Small Unruptured Cerebral Aneurysms.","authors":"Masanori Tsuji, Fujimaro Ishida, Ryuta Yasuda, Yoichi Miura, Takenori Sato, Kazuhiro Furukawa, Takeshi Okada, Keiji Fukazawa, Yasuyuki Umeda, Naoki Toma, Hidenori Suzuki","doi":"10.2176/jns-nmc.2024-0289","DOIUrl":"10.2176/jns-nmc.2024-0289","url":null,"abstract":"<p><p>ELAPSS score is commonly utilized for predicting the growth of unruptured cerebral aneurysms. However, its application is unsuitable for small aneurysms with high demand for growth prediction. Consequently, we investigated the diagnostic accuracy of semi-quantitative assessment using the ELAPSS score and hemodynamic parameters using computational fluid dynamics in small aneurysms. A prospective observational study from January 2013 to February 2022 included 185 patients with 215 unruptured aneurysms with a maximum diameter of 3-5 mm. Aneurysms were classified into stable (186 aneurysms) and growth (29 aneurysms) groups based on repeated images. We calculated high shear area ratios, high shear concentration ratios, and flow concentration ratios as hemodynamic parameters that we have already reported to be associated with small aneurysm growth in our previous study. The characteristics associated with the growth of small aneurysms were statistically investigated with morphological variables and hemodynamic parameters. The ELAPSS score was also calculated for the same aneurysm group to determine whether the growth risk was sufficiently assessed. In morphological variables, no significant differences were observed between the 2 groups. As for the hemodynamic parameters, the growth group had a significantly lower flow concentration ratio (0.61 vs 0.66, p = 0.016), lower high shear area ratio (0.28 vs 0.33, p < 0.001), and a higher high shear concentration ratio (6.39 vs 5.01, p < 0.001). However, there were no significant differences in the ELAPSS scores between the 2 groups. When limited to small aneurysms, computational fluid dynamics may offer more enhanced predictive capabilities compared to the ELAPSS score for identifying growth tendencies.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"239-246"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Which Cases Is Additional Direct Surgery Useful for Mechanical Thrombectomy Failure?","authors":"Takao Koiso, Nakao Ota, Kenichi Haraguchi, Hiroyuki Mizuno, Kosumo Noda, Sadahisa Tokuda, Rokuya Tanikawa","doi":"10.2176/jns-nmc.2024-0295","DOIUrl":"10.2176/jns-nmc.2024-0295","url":null,"abstract":"<p><p>Clinical evidence for adding direct surgery to the management of patients with large vessel occlusion after mechanical thrombectomy failure is limited. We investigated which patients would benefit from the additional surgery. We retrospectively examined factors influencing mechanical thrombectomy success and the outcomes of patients receiving additional direct surgery. Direct surgery was performed in patients younger than 75 years with modified Rankin Scale 0-2 and with Diffusion-Weighted Imaging-Clinical mismatch in the middle cerebral artery area on post-mechanical thrombectomy magnetic resonance imaging. To convert the hyperdense artery sign into an objective index, the ratio of the occluded to the normal vessel in Hounsfield Units was calculated (defined as the hyperdense artery sign ratio). A total of 152 patients were included in this study; the median patient age was 77.0 years; 13 patients (8.5%) had posterior circulation occlusion, and effective recanalization was confirmed in 124 patients (82.8%). Multivariable analysis showed the factors significantly associated with successful recanalization to be male gender (p = 0.0020) and a higher hyperdense artery sign ratio (p = 0.0012). The cut-off value of the hyperdense artery sign ratio was 1.05. Additional direct surgery was performed in 6 of 28 patients with mechanical thrombectomy failure. In 5 of these patients, recanalization was not successful even with direct embolectomy, and bypass was added. Patients who underwent direct surgery had better modified Rankin Scale scores at discharge than those who did not (p = 0.0405). The hyperdense artery sign ratio was a predictor of mechanical thrombectomy success; if the hyperdense artery sign ratio was less than 1.05, mechanical thrombectomy was often unsuccessful, and an early conversion to direct surgery was deemed beneficial.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"255-261"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Table-top Microscope Mounted on Flexible Monitor Arm Using a Customized Multipurpose Metal Plate for Microsurgical Training: Technical Note.","authors":"Satoshi Yamaguchi, Jangbo Lee, Prabin Shrestha, Satoka Shidoh, Kyongsong Kim","doi":"10.2176/jns-nmc.2025-0001","DOIUrl":"https://doi.org/10.2176/jns-nmc.2025-0001","url":null,"abstract":"<p><p>Despite the recognized usefulness of a portable table-top microscope in microsurgical training, its effectiveness is limited when training involves anatomical models and long surgical instruments. This limitation arises from the microscope's exclusive mobility to an up-and-down direction and the restricted working space beneath it. To address these challenges, we customized the table-top microscope by attaching its scope body and focusing rack to a Visual Electronics Standards Association (San Jose, CA, USA) monitor arm, originally designed for mounting computer monitors. A multipurpose metal plate, known as a \"cheese plate\" and designed for use with photography cameras, was customized to function as an adapter between the microscope and the monitor arm. The plate has Visual Electronics Standards Association-standard screw holes, which allowed the connection between the microscope focusing rack and the Visual Electronics Standards Association monitor arm. This assembly, referred to as a focusing rack-adapter plate complex, was then mounted on the Visual Electronics Standards Association monitor arm. To evaluate the modified microscope, its view was compared with that of a traditional microscope using concentric circles and gauze on the slope models. The modified microscope, mounted on the Visual Electronics Standards Association monitor arm, exhibited remarkable flexibility in its working area, height, and angles. The total cost of the modification was approximately $140. The advantages of the modified microscope over the traditional one, shown by a comparative study, were primarily attributed to the enhanced mobility of the modified microscope. With its simple modification process and affordable cost, this upgraded microscope has the potential to greatly benefit neurosurgeons who undergo microsurgical training.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}