Neurologia medico-chirurgica最新文献

{"title":"Reply to the Editor: Real-world Experience of Embolization for Intracranial Tumors in Japan: Analysis of 2,756 Cases from the Japanese Registry of NeuroEndovascular Therapy 4.","authors":"Jun Haruma, Kenji Sugiu, Yuta Soutome, Masato Kawakami, Masafumi Hiramatsu, Shota Tanaka","doi":"10.2176/jns-nmc.2025-0387","DOIUrl":"10.2176/jns-nmc.2025-0387","url":null,"abstract":"","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"257-258"},"PeriodicalIF":2.3,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220375","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":"Giant Colloid Cysts: Evaluating Treatment Approaches and Patient Outcomes through a Case Series and Review of the Literature.","authors":"Yousef Bassi, Shahad Rafed Almarwan, Shymaa Anwar Aljefri, Thamer Hamad Alsharif, Layan Hussam Kutub, Khaled Turki Alsalhi, Ghidaa Abdullah Alghamdi, Hussam Kutub","doi":"10.2176/jns-nmc.2025-0311","DOIUrl":"10.2176/jns-nmc.2025-0311","url":null,"abstract":"<p><p>Giant colloid cysts are rare, benign lesions typically located in the third ventricle, accounting for approximately 2% of primary brain tumors and 15%-20% of intraventricular masses. Although small colloid cysts are relatively common, giant colloid cysts measuring over 3 cm are exceedingly rare and pose significant surgical challenges due to their size and critical anatomical location. This study retrospectively analyzes a series of 5 cases of giant colloid cysts from our local experience, in addition to a comprehensive literature review including 38 studies comprising 48 patients. Surgical approaches evaluated included transcallosal and transcortical craniotomy, endoscopic resection, and stereotactic aspiration. Complete cyst excision was achieved in 44 (83.0%) cases. Postoperative complications included seizures, hemiparesis, hydrocephalus, and cognitive dysfunction, though most patients demonstrated favorable recovery, particularly following complete excision. Our findings suggest that open craniotomy provides the highest rates of complete resection and remains preferable for very large, adherent, or anatomically complex giant colloid cysts, whereas endoscopic resection offers a minimally invasive alternative with acceptable outcomes in carefully selected cases with favorable ventricular anatomy. This study highlights the importance of timely diagnosis, individualized surgical approach selection, multidisciplinary care, and long-term follow-up to optimize patient outcomes and minimize complications.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"193-207"},"PeriodicalIF":2.3,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220365","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":"Impact of Onset-to-imaging Time on the Predictive Value of the Leakage Sign in Supratentorial Hemorrhage.","authors":"Takehiro Makizono, Yu Hasegawa, Jin Kikuchi, Aya Hashimoto, Keiichiro Furuta, Motohisa Koga, Hidenobu Yoshitake, Kimihiko Orito, Motohiro Morioka","doi":"10.2176/jns-nmc.2025-0337","DOIUrl":"10.2176/jns-nmc.2025-0337","url":null,"abstract":"<p><p>Intracerebral hemorrhage is frequently complicated by hematoma expansion, which is a major determinant of poor outcomes. Leakage sign, defined as progressive contrast extravasation on delayed computed tomography after angiography, has been proposed as a predictor of hematoma expansion. However, the relationship between onset-to-imaging time, hemorrhage location, and leakage sign positivity remains unclear. Data from 144 patients with primary supratentorial intracerebral hemorrhage were retrospectively collected and divided into 2 groups: leakage sign-positive (n = 58) and leakage sign-negative (n = 86) groups. Clinical characteristics, radiological findings, and outcomes were compared, and correlations between hematoma size, onset-to-imaging time, and blood pressure at admission were assessed. Leakage sign-positive patients were significantly older, more frequently underwent antithrombotic therapy, and exhibited larger hematomas, a higher incidence of spot sign(s), a greater need for surgical intervention, and worse outcomes than their leakage sign-negative counterparts. Leakage sign was detectable within 5 hours of onset. In putaminal hemorrhage, hematoma size demonstrated a significant time-dependent increase, particularly in patients who were leakage sign-positive. Moreover, in leakage sign-positive putaminal hemorrhage, admission systolic blood pressure was strongly correlated with hematoma size, suggesting a synergistic effect between hypertension and ongoing bleeding. In contrast, there was no significant correlation between time and hematoma size in thalamic or subcortical hemorrhages, although trends were noted in subcortical cases. These findings indicate that leakage sign positivity reflects ongoing hyperacute bleeding, with diagnostic validity limited to within 5 hours of onset. Early detection of leakage sign, especially in cases of putaminal hemorrhage, may help identify high-risk patients who could benefit from aggressive interventions to mitigate hematoma expansion and improve outcomes.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"208-215"},"PeriodicalIF":2.3,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326611","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":"Enhancement of Intraoperative Transcranial Motor-evoked Potential Derivation with the Use of a Fibular Head Reference Electrode Placement Method in Spine Surgery.","authors":"Takashi Abe, Yusuke Nishimura, Yoshitaka Nagashima, Yuki Sunohara, Kazuichi Terao, Ryuta Saito","doi":"10.2176/jns-nmc.2025-0230","DOIUrl":"10.2176/jns-nmc.2025-0230","url":null,"abstract":"<p><p>Intraoperative transcranial motor-evoked potential recordings commonly utilize the belly tendon montage method; however, its reliability in large lower limb muscles such as the quadriceps femoris and hamstring muscles can be limited. We hypothesized that placing the reference electrode on the fibular head (fibular head reference electrode method) would improve waveform clarity and stability compared to belly tendon montage. This retrospective study analyzed 101 patients who underwent transcranial motor-evoked potential monitoring during spinal surgery at Nagoya University Hospital from October 2021 to August 2023. We compared compound muscle action potential amplitude, baseline waveform derivation success rate, noise amplitude, signal-to-noise ratio, and mean consecutive ratio between belly tendon montage and fibular head reference electrode method. Fibular head reference electrode method showed significantly higher median compound muscle action potential amplitudes in quadricep femoris (202.5 μV vs. 52.5 μV) and hamstring muscles (131.0 μV vs. 33.3 μV) with p < 0.001. Baseline waveform derivation success rates also improved with fibular head reference electrode method (quadricep femoris: 76.5% vs. 50.5%; hamstring muscles: 73.5% vs. 39.8%; p < 0.001). When noise amplitude increased, the signal-to-noise ratio improved significantly (p < 0.001), and mean consecutive ratio indicated better waveform stability in hamstring muscles. For predicting postoperative paralysis, fibular head reference electrode method yielded a sensitivity of 100% and a negative predictive value of 100% in both quadricep femoris and hamstring muscles, with specificities of 93.5% and 95.6%, respectively. These findings suggest that fibular head reference electrode method improves the reliability, clarity, and predictive value of transcranial motor-evoked potential monitoring in spinal surgery and may represent a superior alternative to conventional belly tendon montage.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"224-232"},"PeriodicalIF":2.3,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326598","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 Safety and Efficacy between Endovascular Coiling and Surgical Clipping of Posterior Communicating Artery Aneurysms: A 10-year Retrospective Analysis of 851 Aneurysms.","authors":"Hikaru Wakabayashi, Sakyo Hirai, Tatsuhiko Anzai, Yohei Sato, Keigo Shigeta, Shin Hirota, Masataka Yoshimura, Jun Karakama, Kenji Yamada, Yoshikazu Yoshino, Motoshige Yamashina, Naoki Taira, Toshihiro Yamamura, Kana Sawada, Tadahiro Ishiwada, Yosuke Ishii, Mutsuya Hara, Shogo Imae, Yoshiki Obata, Bongguk Kim, Yuki Kinoshita, Hirotaka Sagawa, Shoko Fujii, Satoru Takahashi, Kyohei Fujita, Kunihiko Takahashi, Shigeru Nemoto, Taketoshi Maehara, Kazutaka Sumita","doi":"10.2176/jns-nmc.2025-0392","DOIUrl":"https://doi.org/10.2176/jns-nmc.2025-0392","url":null,"abstract":"<p><p>Endovascular treatment is widely used for intracranial aneurysms, but evidence comparing endovascular treatment with surgical treatment for posterior communicating artery aneurysms is limited. Using a multicenter registry from January 2013 to December 2022, 841 patients with 851 posterior communicating artery aneurysms were analyzed. Logistic regression with multivariable adjustment and inverse probability of treatment weighting was applied to adjust for confounders. Of the aneurysms, 499 (58.6%) were treated by endovascular treatment. Patients undergoing endovascular treatment were generally older, had more comorbidities, and had larger aneurysms than those receiving surgical treatment. Functional outcomes assessed by the modified Rankin Scale showed no significant difference between endovascular treatment and surgical treatment in ruptured aneurysms (poor outcome at discharge: odds ratio, 1.09 [0.74-1.69]; p = 0.698; at final follow-up: odds ratio, 0.74 [0.48-1.15]; p = 0.183), whereas endovascular treatment was associated with significantly better outcomes in unruptured aneurysms (poor outcome at discharge: odds ratio, 0.11 [0.03-0.32]; p < 0.001; at final follow-up: odds ratio, 0.33 [0.11-0.96]; p = 0.045). Intraoperative and postoperative complications were similar overall (interoperative: odds ratio, 0.92 [0.55-1.54]; p = 0.752; postoperative: odds ratio, 0.76 [0.54-1.07]; p = 0.121). Subgroup analyses demonstrated that endovascular treatment reduced intraoperative complications in elderly patients, with a significant interaction between endovascular treatment and elderly age (p = 0.008). Endovascular treatment was associated with markedly higher recurrence (odds ratio, 37.41 [16.63-107.15]; p < 0.001) and retreatment rates (odds ratio, 13.73 [6.32-36.06]; p < 0.001). These findings suggest surgical treatment remains a viable option for ruptured aneurysms, providing similar functional outcomes with lower recurrence and retreatment rates, whereas endovascular treatment is suitable for unruptured aneurysms, offering comparable safety and potential advantages in elderly patients.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623514","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":"Local Recurrence after Microsurgical Clipping of Unruptured Intracranial Aneurysms: Incidence, Timing, and Risk Factors over 20 Years.","authors":"Shunsuke Kawamoto, Go Ikeda, Shunsuke Fukaya, Kanae Okunuki, Hiroyoshi Akutsu","doi":"10.2176/jns-nmc.2025-0342","DOIUrl":"https://doi.org/10.2176/jns-nmc.2025-0342","url":null,"abstract":"<p><p>This retrospective cohort study evaluated long-term local recurrence rates following microsurgical clipping of anterior circulation unruptured intracranial aneurysms. Between April 2003 and August 2025, 657 patients underwent 700 procedures for 786 aneurysms. Local recurrence was assessed by computed tomography angiography at 5-year intervals. During a mean follow-up of 10.5 ± 3.5 years (6,927.8 patient-years), 9 local recurrences were identified, yielding annual recurrence rates of 0.156% per patient-year and 0.111% per aneurysm-year. Cumulative recurrence-free rates were 100% at 5 years, 99.1% at 10 years, and 98.6% at 15 years. Location-specific analysis revealed significantly higher recurrence rates for internal carotid-anterior choroidal artery aneurysms (0.630% annually) and internal carotid-posterior communicating artery aneurysms (0.262% annually) compared with other locations (p = 0.011). Review of recurrent cases identified 3 mechanistic patterns: closure-line regrowth after parallel clipping (Pattern A, n = 2), residual thin-walled basal footprint in broad-based aneurysms (Pattern B, n = 2), and sub-angiographic remnants preserved for perforator safety (Pattern C, n = 5). The predominance of Pattern C at anterior choroidal artery and posterior communicating artery locations explains the location-specific recurrence risk. All recurrences occurred in aneurysms with complete obliteration (Sindou Grade 0) on early postoperative imaging, whereas no recurrences were observed among 26 cases (3.3%) with small neck remnants (Sindou Grades I-II). Microsurgical clipping of unruptured intracranial aneurysms demonstrated excellent long-term durability with very low local recurrence rates, though the gradual increase beyond 10 years highlights the need for continued surveillance, particularly at locations requiring perforator-preserving techniques.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623470","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":"First-year Experience with Brivaracetam in Japan: Real-world Data from Juntendo Epilepsy Center.","authors":"Yasushi Iimura, Kazuki Nomura, Takumi Mitsuhashi, Hiroharu Suzuki, Tetsuya Ueda, Kazuki Nishioka, Taiji Tsunemi, Shinichi Ueno, Hidenori Sugano, Akihide Kondo","doi":"10.2176/jns-nmc.2025-0293","DOIUrl":"https://doi.org/10.2176/jns-nmc.2025-0293","url":null,"abstract":"<p><p>Approximately 30% of patients still develop drug-resistant epilepsy despite the introduction of newer antiseizure medications. Brivaracetam, a high-affinity synaptic vesicle protein 2A ligand with a mechanism of action similar to that of levetiracetam, was only recently approved in Japan in June 2024 and became available at our institution in September 2024. Clinical data in real-world settings remain limited. To date, no real-world clinical data have been systematically reported in patients in Japan, and the present study aimed to characterize the initial real-world experience with Brivaracetam use shortly after its approval. We retrospectively analyzed 73 patients with focal epilepsy who initiated Brivaracetam at our center between September 2024 and August 2025, evaluating patient characteristics, seizure outcomes, treatment retention, and adverse events. Among 41 patients with at least 3 months of follow-up, seizure freedom was achieved in 5%, whereas 44% of patients were responders with ≥50% seizure reduction. Overall, 59 patients continued Brivaracetam, with a treatment retention rate of 76.5% and a mean treatment duration of 7.4 months. Adverse events were observed in 18 patients (24%), most frequently somnolence, followed by dizziness and irritability. Brivaracetam discontinuation occurred in 14 patients (19%), with psychiatric symptoms leading to discontinuation in only 3 patients (4%), a lower rate compared with prior reports of levetiracetam. These findings suggest that Brivaracetam is effective and generally well tolerated in patients in Japan with focal epilepsy. Future multicenter prospective studies with longer follow-up are warranted to further evaluate the role of Brivaracetam, including as monotherapy and in patients with multilobar epilepsy.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623467","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":"Association between the A1 Segment Asymmetry and Severe Clinical Presentation in Ruptured Anterior Communicating Artery Aneurysms.","authors":"Hiroki Karita, Shunichiro Miki, Yoshiro Ito, Takuma Hara, Satoshi Miyamoto, Kazuya Uemura, Eiichi Ishikawa, Yuji Matsumaru","doi":"10.2176/jns-nmc.2025-0320","DOIUrl":"https://doi.org/10.2176/jns-nmc.2025-0320","url":null,"abstract":"<p><p>The asymmetry of the A1 segment of the anterior cerebral artery has been implicated in the development and rupture of anterior communicating artery aneurysms; however, its relationship with the severity of subarachnoid hemorrhage remains unclear. We retrospectively analyzed 114 patients with subarachnoid hemorrhage due to ruptured anterior communicating artery aneurysms (mean age, 64.2 ± 13.9 years; 56 males, 58 females) treated at 2 institutions between January 2014 and March 2024. Patients were categorized into Symmetric and Asymmetric A1 groups, with asymmetry defined as a diameter ratio of ≥2 between sides. Among the 114 patients, 72 (63.2%) and 42 (36.8%) had symmetric and asymmetric A1 segments, respectively. The Asymmetric A1 group demonstrated significantly larger aneurysm size, a higher incidence of World Federation of Neurosurgical Surgeons grade IV-V, and more frequent intracerebral hemorrhage. Surgical clipping was more frequently performed in the Asymmetric A1 group (p = 0.04), likely due to associated intracerebral hemorrhage. The A1 diameter ratio was negatively correlated with aneurysm angle (r = -0.27, p < 0.01) and positively correlated with aneurysm length (r = 0.28, p < 0.01). Multivariate analysis showed an association of A1 asymmetry with severe clinical presentation but not with functional outcome. The effect of A1 asymmetry on severity was attenuated after adjustment for intracerebral hemorrhage, the strongest predictor of both severity and outcome. These findings suggest that in ruptured anterior communicating artery aneurysms, A1 asymmetry is associated with larger aneurysms, more severe subarachnoid hemorrhage, and higher rates of intracerebral hemorrhage.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623479","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":"Impact of Metabolic Syndrome Components on Early Outcomes after Aneurysmal Subarachnoid Hemorrhage.","authors":"Emre Ozkara, Turan Kandemir, Gizem Kiper, Pinar Yildiz, Atilla Ozcan Ozdemir, Ali Arslantas","doi":"10.2176/jns-nmc.2025-0334","DOIUrl":"https://doi.org/10.2176/jns-nmc.2025-0334","url":null,"abstract":"<p><p>Aneurysmal subarachnoid hemorrhage remains a devastating condition with persistently high rates of early mortality and disability. While numerous prognostic models exist, the prognostic relevance of metabolic dysfunction in aneurysmal subarachnoid hemorrhage remains uncertain. We retrospectively analyzed 60 consecutive patients with subarachnoid hemorrhage admitted between 2022 and 2024. Metabolic syndrome and its components-including impaired glucose tolerance, insulin resistance, hypertension, dyslipidemia, and obesity-were evaluated within 24 hours of admission. The primary endpoint was poor functional outcome at discharge (modified Rankin Scale 3-6). Secondary endpoints included in-hospital complications and mortality. In adjusted ridge-penalized logistic regression analyses, impaired glucose tolerance (adjusted odds ratio 4.93, 95% confidence interval 1.39-17.4, p = 0.014) and World Federation of Neurological Surgeons grade ≥3 (adjusted odds ratio 5.12, 95% confidence interval 1.62-16.18, p = 0.006) independently predicted poor outcome. Insulin resistance was independently associated with in-hospital complications (adjusted odds ratio 4.05, 95% confidence interval 1.15-14.3, p = 0.030). Mortality was independently predicted by age (adjusted odds ratio 1.06, 95% confidence interval 1.01-1.12, p = 0.032), World Federation of Neurological Surgeons grade ≥3, and impaired glucose tolerance. The composite metabolic syndrome variable was not an independent predictor of any outcome. In conclusion, specific metabolic abnormalities- impaired glucose tolerance, insulin resistance, and hypertension-rather than metabolic syndrome appear to drive early prognosis after subarachnoid hemorrhage. Early metabolic profiling and individualized glucose control may help identify patients at risk and guide future interventional studies.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623502","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":"Experimental Study of a Newly Developed Prosthesis and Its Initial Clinical Use in Microvascular Decompression Surgery.","authors":"Mitsuhiro Hasegawa, Yuya Nishiyama, Takuro Hayashi, Yuichi Hirose","doi":"10.2176/jns-nmc.2025-0116","DOIUrl":"10.2176/jns-nmc.2025-0116","url":null,"abstract":"<p><p>This study aimed to develop a new, refined, and easy-to-use microvascular decompression surgical prosthesis and report its processability, uniformity, stability, and clinical safety.In an experimental study, the processing time required to create five slings and five balls from a prototype clump (0.010 ± 0.001 grams) was measured. Similarly, the processing time to form a clump (0.01 ± 0.001 grams) by plucking an equivalent amount of fibers from commercial polytetrafluoroethylene felt was measured. After approval from the Pharmaceuticals and Medical Devices Agency, the new prosthesis was used in 39 consecutive microvascular decompression surgeries.The handling time to make slings and balls from the refined polytetrafluoroethylene material was shorter than that from polytetrafluoroethylene felt (60.5 ± 4.81 versus 155 ± 6.59 seconds, p-value < 0.001 and 84.0 ± 8.51 versus 141.1 ± 7.02 seconds, p-value < 0.001). The tensile study showed that the prototype was significantly stronger than the slings conventionally made from polytetrafluoroethylene felt (6.2 ± 2.12 Newtons versus 1.56 ± 0.647 Newtons, p-value = 0.012). The adhesion study showed an equivalent adhesive strength to the conventional one (0.137 ± 0.05 Newtons versus 0.108 ± 0.05 Newtons, p-value = 0.40). The 39 microvascular decompression surgeries (trigeminal neuralgia, 13 cases; hemifacial spasm, 26 cases) showed no adverse events related to the materials (follow-up period: 9 months-3 years 9 months, mean: 2 years 9 months).The new Pharmaceuticals and Medical Devices Agency-approved, refined polytetrafluoroethylene material, which is easier to handle and less time-consuming, exhibited uniform characteristics, excellent manipulability, sufficient strength, and clinical reliability for prostheses. It may serve as a valuable additional option for prostheses in microvascular decompression surgery.</p>","PeriodicalId":19225,"journal":{"name":"Neurologia medico-chirurgica","volume":" ","pages":"135-144"},"PeriodicalIF":2.3,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}