Neurosurgery最新文献

{"title":"Quantifying the Importance of Upper Cervical Extension Reserve in Adult Cervical Deformity Surgery and Its Impact on Baseline Presentation and Outcomes: Erratum.","authors":"Peter G Passias, Jamshaid M Mir, Andrew J Schoenfeld, Anthony Yung, Justin S Smith, Virginie Lafage, Renaud Lafage, Bassel Diebo, Alan H Daniels, Breton G Line, Robert K Eastlack, Gregory M Mundis, Khaled M Kebaish, Jeffrey P Mullin, Richard G Fessler, Praveen V Mummaneni, Dean Chou, David Kojo Hamilton, Sang Hun Lee, Alex Soroceanu, Justin K Scheer, Themistocles Protopsaltis, Han Jo Kim, Thomas J Buell, Richard A Hostin, Munish C Gupta, Eric O Klineberg, K Daniel Riew, Douglas C Burton, Frank J Schwab, Shay Bess, Christopher I Shaffrey, Christopher P Ames","doi":"10.1227/neu.0000000000003819","DOIUrl":"https://doi.org/10.1227/neu.0000000000003819","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticosteroid Use Before Stereotactic Brain Biopsy for Suspected Lymphoma.","authors":"Maged T Ghoche, Kenji Miki, Skyler Oken, Namya Manoj, Neslihan Nisa Gecici, Ahmed Habib, Jan Drappatz, Megan Mantica, Pascal Zinn, Kalil G Abdullah","doi":"10.1227/neu.0000000000003778","DOIUrl":"https://doi.org/10.1227/neu.0000000000003778","url":null,"abstract":"<p><strong>Background and objectives: </strong>Primary central nervous system lymphoma (PCNSL) is a rare, aggressive lymphoma requiring histopathological confirmation for diagnosis. Stereotactic brain biopsy (SBB) is the gold standard for definitive diagnosis, but preoperative corticosteroid therapy (CST), commonly administered to manage symptoms, may induce cytoreduction and obscure diagnostic features. Previous studies offer conflicting evidence on whether CST compromises diagnostic yield. This study assesses the impact of preoperative CST on the diagnostic yield of SBB in PCNSL, evaluating steroid timing, dose, duration, and associated postoperative complications.</p><p><strong>Methods: </strong>We retrospectively reviewed 725 patients who underwent SBB between 2014 and 2025 to identify 104 patients with pathologically confirmed PCNSL. Patients were categorized based on CST exposure and stratified by timing, cumulative dose, and duration of therapy. Clinical, radiological, and pathological variables were analyzed. Statistical tests included χ2, Welch t-test, and Fisher exact test.</p><p><strong>Results: </strong>The overall diagnostic yield was 92.3%. Among patients who received CST (n = 43), the diagnostic yield was 95.3% (95% CI: 84.2%-99.4%), compared with 90.2% (95% CI: 79.8%-96.3%) in the non-CST group (P = .46). Yield remained high across intervals between CST administration and biopsy (<48 hours: 96.4%; 48-72 hours: 91.7%; >72 hours: 100%; P = .658), cumulative dose (≤20 mg: 95.5% [95% CI: 78.2%-99.2%], 21-40 mg: 100% [95% CI: 70.1%-100%], >40 mg: 100% [95% CI: 70.1%-100%]; P = 1.0), and duration (≤5 days: 94.6% [95% CI: 81.8%-99.3%] vs >5 days: 100% [95% CI: 91.8%-100%]; P = 1.0). Postoperative complications occurred in 4.8% of cases, with no significant difference by CST status.</p><p><strong>Conclusion: </strong>Preoperative corticosteroids do not significantly reduce diagnostic accuracy in PCNSL in our cohort. These findings support the safe use of CST for symptom control in suspected PCNSL with expeditious biopsy. Optimizing biopsy timing, technique, and coordination among disciplines remains essential to ensure diagnostic success.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait and Balance After MRI-Guided High-Intensity Focused Ultrasound Thalamotomy for Treatment of Tremor.","authors":"Rohit Prem Kumar, Ilona Cazorla-Morales, Samantha Adwani, Elma A Chowdhury, Geoffrey R O'Malley, Francis Ruzicka, Nicholas D Cassimatis, Elana Clar, Robert R Goodman, Gregory Westgate, Challiz Punla, Themba Nyirenda, Hooman Azmi","doi":"10.1227/neu.0000000000003745","DOIUrl":"10.1227/neu.0000000000003745","url":null,"abstract":"<p><strong>Background and objectives: </strong>Although magnetic resonance imaging guided focused ultrasound (MRgFUS) thalamotomy has shown a robust safety and efficacy profile for tremor treatment, gait disturbances have been reported but often lack objective measurement. The aim of this study was to evaluate gait and balance outcomes in patients with essential tremor (ET)-only and tremor-dominant Parkinson's disease with or without ET (TDPD ± ET) who have undergone MRgFUS thalamotomy for treatment of their tremors, using validated, multidimensional measures.</p><p><strong>Methods: </strong>This retrospective review included all consecutive patients who underwent MRgFUS thalamotomy between June 14, 2021, and February 1, 2023. Patients who did not have a preprocedure or postprocedure gait and balance evaluation, and those lost to follow-up, were excluded. Primary outcomes were changes in the preprocedural and postprocedural Tinetti gait and balance scores and timed up and go time at the 3-month visit. Additional outcomes included changes in ambulation time, steps taken to walk 30 feet, and clinical improvement.</p><p><strong>Results: </strong>Of 92 total patients (72 ET-only, 20 TDPD ± ET), the ET-only cohort had a median follow-up of 94 days (IQR 91-113), and the TDPD ± ET cohort had a follow-up of 99.5 days (IQR 92.25-119.00). In ET-only patients, significant improvements were observed in median Tinetti balance (pre 15 [IQR 12-16] vs post 15 [IQR 13-16], P = .031) and median 30-ft ambulation time (8.11 seconds [IQR 6.74-10.77] vs 8.06 seconds [IQR 6.21-10.23], P = .009), with no change in median Tinetti gait, Tinetti total scores, timed up and go time, or steps to ambulate 30-ft. In patients with TDPD ± ET, only the median Tinetti gait improved (9.00 [IQR 6.00-11.00] vs 9.50 [IQR 7.75-12.00], P = .004).</p><p><strong>Conclusion: </strong>MRgFUS thalamotomy is associated with a low risk of gait/balance disturbances and may also improve these functions in patients with ET and TDPD ± ET. This supports MRgFUS as a viable treatment option.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract Awards for the 2025 Congress of Neurological Surgeons Annual Meeting.","authors":"","doi":"10.1227/neu.0000000000003723","DOIUrl":"https://doi.org/10.1227/neu.0000000000003723","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":"97 4","pages":"988-990"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurosurgery Practice: A Journal Comes of Age.","authors":"Douglas Kondziolka","doi":"10.1227/neu.0000000000003712","DOIUrl":"https://doi.org/10.1227/neu.0000000000003712","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":"97 4","pages":"765"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Connections.","authors":"Douglas Kondziolka","doi":"10.1227/neu.0000000000003560","DOIUrl":"https://doi.org/10.1227/neu.0000000000003560","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":"97 4","pages":"763-764"},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Stereotactic Radiosurgery Dose Reduction for Melanoma Brain Metastases Patients on Immunotherapy or Target Therapy: A Single-Center Experience.","authors":"Shamsudheen Cholayil, Vangipuram Harshil Sai, Vangipuram Shankar","doi":"10.1227/neu.0000000000003795","DOIUrl":"https://doi.org/10.1227/neu.0000000000003795","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Reply: Blood Pressure Targets After Aneurysmal Subarachnoid Hemorrhage: Is Lower Better?","authors":"Catherine Veilleux, Matthew E Eagles, Jay Riva-Cambrin, R Loch Macdonald","doi":"10.1227/neu.0000000000003794","DOIUrl":"https://doi.org/10.1227/neu.0000000000003794","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Reply: Stereotactic Radiosurgery Dose Reduction for Melanoma Brain Metastases Patients on Immunotherapy or Targeted Therapy: A Single-Center Experience.","authors":"Salem M Tos, Georgios Mantziaris, Jason P Sheehan","doi":"10.1227/neu.0000000000003796","DOIUrl":"https://doi.org/10.1227/neu.0000000000003796","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Blood Pressure Targets After Aneurysmal Subarachnoid Hemorrhage: Is Lower Better?","authors":"Maximiliano A Hawkes, Giuseppe Lanzino, Alejandro A Rabinstein","doi":"10.1227/neu.0000000000003793","DOIUrl":"https://doi.org/10.1227/neu.0000000000003793","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}