World neurosurgery最新文献

{"title":"The Association Between Pulmonary Embolism and Deep Vein Thrombosis in the Upper or Lower Extremities in Neurocritical Care Patients","authors":"Yusuf Mufti ,&nbsp;Abram Qiu ,&nbsp;Jacob Chmielecki ,&nbsp;Abdallah Maach ,&nbsp;Geoffrey Peitz","doi":"10.1016/j.wneu.2025.123683","DOIUrl":"10.1016/j.wneu.2025.123683","url":null,"abstract":"<div><h3>Background</h3><div>Patients in the neurological intensive care unit (ICU) are at an increased risk of venous thromboembolism (VTE). Anticoagulation is often indicated because deep venous thrombosis (DVT) can develop into pulmonary embolism (PE). However, anticoagulation also increases the risk of intracranial bleeding. Physicians must weigh the opposing risks carefully. It is commonly believed that upper extremity DVT (UEDVT) is less likely to develop into PE as compared to lower extremity DVT (LEDVT), but this lacks evidence, and our study investigates its validity.</div></div><div><h3>Methods</h3><div>Retrospective review of patients admitted to a neurologic ICU from 2017 to 2022 who developed VTE.</div></div><div><h3>Results</h3><div>We reviewed 2891 patients and 97 patients met study criteria. VTE occurred in 3.55% of patients, DVT in 2.63%, and PE in 0.96%. Of the recorded DVTs, 52.3% were in the upper extremities, 42.3% in the lower extremities, and 6.4% in both. PE rate was not significantly different in patients with UEDVT than in those with LEDVT (<em>P</em> = 0.233). Cather-associated DVT was more common in the upper extremities (<em>P</em> = 0.002), but the PE rate was no different in catheter-associated DVT than non-catheter-associated DVT (<em>P</em> = 0.193). The proportion of patients treated with therapeutic anticoagulation was not significantly different between patients with UEDVT alone and those with LEDVT (<em>P</em> = 1.000).</div></div><div><h3>Conclusions</h3><div>In this sample of neurocritical care patients, the coexistence of DVT and PE did not differ in patients with upper versus lower extremity DVT. This should be considered in the neurocritical care unit when deciding whether to treat patients with DVT with anticoagulants.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123683"},"PeriodicalIF":1.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012594","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}

{"title":"C1 Posterior Arch Screws for the Additional Reinforcement of Upper Cervical Spine Fixation: Surgical Technique and Preliminary Case Series","authors":"Guanyi Liu ,&nbsp;Jing Wang ,&nbsp;Lihua Hu ,&nbsp;Miao Zhu ,&nbsp;Jiayu Zhang ,&nbsp;Weihu Ma ,&nbsp;Yong Hu ,&nbsp;Qing Li","doi":"10.1016/j.wneu.2025.123680","DOIUrl":"10.1016/j.wneu.2025.123680","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to evaluate the clinical outcomes of using C1 posterior arch screws (PASs) combined with C2 translaminar screws as an adjunct for reinforcing upper cervical spine fixation.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 4 male patients who underwent surgery involving C1 PASs and C2 translaminar screws between January 2022 and February 2024. Surgical technique involved the insertion of standard C1 lateral mass screws and C2 pedicle screws, followed by the placement of C1 PASs and C2 translaminar screws for additional fixation. Clinical outcomes were assessed using the Visual Analog Scale and Neck Disability Index, while radiological assessment focused on fracture union and fusion.</div></div><div><h3>Results</h3><div>The mean age of the patients was 56.2 ± 7.0 years, with a mean follow-up duration of 12.5 months. There were no intraoperative or postoperative complications. The average operative time was 100 ± 21.2 minutes, and the average intraoperative blood loss was 65 ± 17.6 mL. Postoperatively, Visual Analog Scale scores showed a significant decrease from 5.7 ± 0.7 to 1.0 ± 0.7 (<em>P</em> &lt; 0.05), and Neck Disability Index scores improved from 77.0 ± 4.2 to 7.5 ± 4.2 (<em>P</em> &lt; 0.05). The radiographic evaluation confirmed fracture union and fusion in all patients except 1 who passed away 3 months postoperatively due to complications related to COVID-19.</div></div><div><h3>Conclusions</h3><div>Unilateral or bilateral C1 PASs combined with C2 translaminar screws demonstrated successful outcomes in this small patient series. C1 PASs effectively served as additional reinforcement for C1 lateral mass screws, enhancing upper cervical spine fixation.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123680"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012930","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}

{"title":"Tele-manipulative Neuro-registration in Robot-assisted Neurosurgery","authors":"Ravinder Kumar ,&nbsp;T.A. Dwarakanath ,&nbsp;Gaurav Bhutani ,&nbsp;S.K. Sinha","doi":"10.1016/j.wneu.2025.123658","DOIUrl":"10.1016/j.wneu.2025.123658","url":null,"abstract":"<div><h3>Background</h3><div>Accurate neuro-registration is important as the success of the surgical procedure highly depends on it. This article deals with neuro-registration using tele-manipulation (Master-Slave Manipulation) to facilitate tele-surgery and enhance the overall accuracy and reach of the robot-assisted neurosurgery.</div></div><div><h3>Methods</h3><div>A 6 degrees-of-freedom parallel kinematic mechanism (6D-PKM) master-slave robot in tele-manipulation mode is utilized for both neuro-registration and neurosurgery. Real-time kinematic control of 6D-PKM is made possible by solving its forward kinematics using the trajectory modifier algorithm with an accuracy of 1 μm and 0.001° in translation and orientation, respectively, in real time. The master operator using the 6D-PKM master mechanism moves the 6D-PKM slave robot equipped with a touch probe stylus (4 mm diameter) in tele-manipulation mode. In neuro-registration, the slave is remotely guided to touch the fiducial marker in a predetermined order. A correlation between the medical image space and the real patient space is made to establish the neuro-registration. The accuracy of neuro-registration is validated through experiments on skull phantoms. These phantoms are designed to simulate the neurosurgical process.</div></div><div><h3>Results</h3><div>The neuro-registration process successfully registers the phantoms, and maximum registration error is found to be 0.6 mm. The accuracy of neurosurgery is validated using several target points in phantom. The accuracy of registration is also verified by robot piercing a 2-mm-diameter surgical needle through a predesignated 3-mm-diameter cylindrical target hole with radial clearance of 500 μm.</div></div><div><h3>Conclusion</h3><div>Accurate neuro-registration using tele-manipulation has been demonstrated. The overall accuracy of the robot-based neurosurgery is tabulated. This approach eliminates line-of-sight issue and the requirement of an additional unit for neuro-registration. This minimizes the registration time and makes intraoperative registration feasible.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123658"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967081","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}

{"title":"Association Between Weight-Adjusted Waist Index and the Prevalence of Low Back Pain: A Cross-Sectional Observational Study from National Health and Nutrition Examination Survey","authors":"Zhiqiang Que ,&nbsp;Huirong Cai ,&nbsp;Dingqiang Chen ,&nbsp;Keyi Xiao ,&nbsp;Weibin Lan ,&nbsp;Gang Rui","doi":"10.1016/j.wneu.2025.123660","DOIUrl":"10.1016/j.wneu.2025.123660","url":null,"abstract":"<div><h3>Background</h3><div>The weight-adjusted waist index (WWI) is a novel obesity index that is calculated as the waist circumference (WC) divided by the square root of body weight (kg). Previous studies have revealed that higher body mass index (BMI) and WC increase the risk of low back pain (LBP). However, no research explores the relationship between WWI and LBP.</div></div><div><h3>Methods</h3><div>Data utilized in this cross-sectional study were drawn from the National Health and Nutrition Examination Survey. Three logistic regression models were used to evaluate the association between WWI and LBP. Stratified analysis was applied to assess the stability of the results. Receiver-operating characteristic (ROC) curves were employed to visually assess and compare the predictive effectiveness of WWI, BMI, WC, and weight on LBP.</div></div><div><h3>Results</h3><div>A significant positive correlation was observed between WWI and LBP, model 1 (odds ratio [OR] = 1.222, 95% confidence interval (95% CI) [1.164, 1.283], <em>P</em> &lt; 0.0001), model 2 (OR = 1.187, 95% CI [1.118, 1.261], <em>P</em> &lt; 0.0001), and model 3 (OR = 1.129, 95% CI [1.056, 1.207], <em>P</em> &lt; 0.001). Relative to the Q1, Q3 (model 1 (OR = 1.241, 95% CI [1.114, 1.382], <em>P</em> &lt; 0.001), model 2 (OR = 1.192, 95% CI [1.050, 1.353], <em>P</em> = 0.007), model 3 (OR = 1.145, 95% CI [1.002, 1.310], <em>P</em> = 0.047)) and Q4 (model 1 (OR = 1.524, 95% CI [1.341, 1.733], <em>P</em> &lt; 0.0001), model 2 (OR = 1.422, 95% CI [1.233, 1.640], <em>P</em> &lt; 0.0001), model 3 (OR = 1.333, 95% CI [1.149, 1.547], <em>P</em> &lt; 0.001)) all showed a significant positive correlation between them. The area under the receiver-operating characteristic curve (AUC) for WWI is 0.5447536, the AUC for BMI is 0.5466724, and the AUC for WC and weight is 0.5501341 and 0.5376615, respectively.</div></div><div><h3>Conclusions</h3><div>This cross-sectional study revealed a significant positive association between WWI and LBP, but WWI did not show better predictive efficacy than BMI and WC.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123660"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955916","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}

{"title":"\"Master Of Disguises: Neurosarcoidosis Presenting As Multiple Discrete Dural Based Masses\".","authors":"Ravi Ranjan, Shreyash Rai, Arun Kumar Srivastava","doi":"10.1016/j.wneu.2025.123748","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123748","url":null,"abstract":"<p><p>Neurosarcoidosis tends to occur in younger patients and shows poorer prognosis. Central nervous system involvement is found in approximately 10% of the sarcoidosis patients. Isolated neurosarcoidosis without extracranial involvement is rare. Neurosarcoidosis is known to be a master of disguises since it has variable imaging presentation and frequently mimicks meningioma. Neurosarcoidosis presenting as multiple discrete dural based mass lesions without any other systemic involvement is rarer.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123748"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256697","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":"Patient and Public Perceptions of Simulation Training in Neurosurgery: A Two-Stage Cross-Sectional Survey.","authors":"Oliver E Burton, Joachim Starup-Hansen, Jigishaa Moudgil-Joshi, Simon C Williams, Chan Hee Koh, Hani J Marcus","doi":"10.1016/j.wneu.2025.123746","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123746","url":null,"abstract":"<p><strong>Introduction: </strong>The use of simulation in neurosurgery is a widespread and popular means of training worldwide. However, little is known about patient and public acceptability of simulation in neurosurgical training, and the potential consequences of this for future simulation development.</p><p><strong>Methods: </strong>A two-stage questionnaire strategy was utilised, the first gathering insights from neurosurgical inpatients, and the second from the general public. These questionnaires assessed general understanding of the concept of simulation in neurosurgery, the relative importance of factors affecting simulation training, and acceptability of different simulation modalities and means of providing feedback to trainees.</p><p><strong>Results: </strong>17 inpatients responded to the first stage survey, and 192 members of the public responded to the second stage survey. Familiarity with the concept of simulation training in neurosurgery was generally lacking. Fidelity was established as the most important element of simulation training by the public, with cadavers and physical models the most acceptable form of simulation training. Augmented reality solutions were least popular among the public. There was enthusiasm for both artificial intelligence (AI) and telementoring as training feedback solutions.</p><p><strong>Conclusions: </strong>Patients and the public are accepting of the use of simulation training in neurosurgery. Future development should focus on improving access to high-fidelity simulation, and exploring the use of AI and telementoring in providing trainee feedback.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123746"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256717","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":"Treatment of Unruptured Large and Giant Carotid Cavernous Aneurysms in Japan at the Time of Flow Diverter Introduction: A Nationwide, Multicenter Survey by the Japanese Society on Surgery for Cerebral Stroke","authors":"Hideyuki Yoshioka ,&nbsp;Kazuya Kanemaru ,&nbsp;Koji Hashimoto ,&nbsp;Nobuo Senbokuya ,&nbsp;Hajime Arai ,&nbsp;Nobuyuki Sakai ,&nbsp;Toshihiko Wakabayashi ,&nbsp;Miki Fujimura ,&nbsp;Susumu Miyamoto ,&nbsp;Isao Date ,&nbsp;Kensuke Suzuki ,&nbsp;Tooru Inoue ,&nbsp;Toshihiko Kuroiwa ,&nbsp;Satoshi Kuroda ,&nbsp;Teiji Tominaga ,&nbsp;Hiroyuki Kinouchi","doi":"10.1016/j.wneu.2024.123629","DOIUrl":"10.1016/j.wneu.2024.123629","url":null,"abstract":"<div><h3>Background</h3><div>Flow diverters (FDs) were introduced for management of large or giant cavernous carotid aneurysms (CCAs) in addition to conventional modalities, dramatically changing treatment strategies. This study examined the management of unruptured large/giant CCAs in Japan when FDs were being introduced using a nationwide survey.</div></div><div><h3>Methods</h3><div>A total of 540 unruptured large/giant CCAs treated at neurosurgical teaching departments in Japan between 2012 and 2016 were retrospectively studied.</div></div><div><h3>Results</h3><div>Large CCAs were treated equally by parent artery occlusion (PAO), FD, and coiling, but giant aneurysms were occluded mainly by PAO. PAO was combined with revascularization in most cases. The nearly complete obliteration rate at final follow-up was higher after PAO (92.4%) than after FD (60.1%) and coiling (70.3%), and PAO was the most effective for ophthalmoparesis. Coiling had higher risks of recurrence and retreatment. Procedure-related major complications were observed in 9.6%. Cranial nerve symptoms were the most common complications, with coiling having significantly higher risks. All treatment modalities achieved good clinical outcomes (92.1%–96.1%); however, 5 delayed rupture cases were observed (1 PAO, 4 FD), resulting in 5 deaths (1 PAO, 1 FD).</div></div><div><h3>Conclusions</h3><div>The nationwide survey reported here determined the status of treatment for unruptured large/giant CCAs in Japan when FDs were being introduced. Because PAO has disadvantages including the long-term hemodynamic effects of ICA occlusion, reconstructive treatment using FDs is optimal for this type of aneurysm; however, PAO can be an option in selected cases given the higher rates of complete occlusion and symptom improvement.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123629"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907694","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}

{"title":"Unilateral and Bilateral Percutaneous Vertebroplasty for Thoracolumbar Osteoporotic Vertebral Compression Fracture with Distant Lumbosacral Pain: A Single-Center Retrospective Analysis","authors":"Chen Dai,&nbsp;Shuang Wang,&nbsp;Liang Zheng,&nbsp;Kaiqiang Wang,&nbsp;Hailong Yu,&nbsp;Yu Chen","doi":"10.1016/j.wneu.2025.123687","DOIUrl":"10.1016/j.wneu.2025.123687","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have found that percutaneous vertebroplasty (PVP) can effectively improve the local pain (LP) of the affected vertebra caused by thoracolumbar osteoporotic vertebral compression fracture (OVCF) regardless of unilateral or bilateral puncture, but there are few reports on whether it is equally effective for the accompanying distant lumbosacral pain. The objective of this study was to analyze the clinical efficacy of unilateral or bilateral PVP in the treatment of thoracolumbar OVCF with distant lumbosacral pain.</div></div><div><h3>Methods</h3><div>The clinical data of patients with single-stage OVCF treated with PVP in our hospital from March 2019 to March 2023 were retrospectively analyzed. According to different intraoperative puncture methods, the whole cohort of patients was divided into unilateral puncture group (52 cases) and bilateral puncture group (40 cases). Preoperative, postoperative, and final follow-up were evaluated using a visual analogue scale (VAS) to assess the degree of LP in the fractured vertebrae and distant lumbosacral pain, respectively. The Oswestry Disability Index (ODI) was used to evaluate functional impairment. At the last follow-up, the proportion of patients who achieved the minimum clinical importance difference and acceptable symptom status on these measures was evaluated.</div></div><div><h3>Results</h3><div>The average follow-up time of the 92 patients was 20.1 ± 7.6 months, and the LP, lumbosacral pain VAS score and ODI index at 3 days after surgery, and the last follow-up were significantly improved compared with those before surgery, with statistical differences (<em>P</em> &lt; 0.05), but there was no statistical difference between the above indexes at 3 days after surgery and the last follow-up (<em>P</em> &gt; 0.05). There were no significant differences in LP, lumbosacral pain VAS scores and ODI scores between unilateral puncture group and bilateral puncture group at different time points after surgery (<em>P</em> &gt; 0.05). At the last follow-up, there were no statistically significant differences in the minimum clinical significance of LP, lumbosacral pain VAS score and ODI index and the rate of patients achieving acceptable symptom status between the two groups (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>PVP can not only improve the LP and ODI index of the responsible vertebra of OVCF in the thoracolumbar region, but also improve the accompanying distant lumbosacral pain symptoms, and the puncture approach does not affect the improvement of postoperative pain and function.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123687"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012804","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}

{"title":"Predictive Modeling of Nonfunctioning Giant Pituitary Neuroendocrine Tumor Resection: A Multi-Planar Perspective","authors":"Biren Khimji Patel ,&nbsp;Youssef M. Zohdy ,&nbsp;Samir Lohana ,&nbsp;Leonardo Tariciotti ,&nbsp;Alejandra Rodas ,&nbsp;Ali Alawieh ,&nbsp;Arman Jahangiri ,&nbsp;Razan R. Faraj ,&nbsp;Justin Maldonado ,&nbsp;Rodrigo Uribe-Pacheco ,&nbsp;Silvia M. Vergara ,&nbsp;Erion De Andrade Jr. ,&nbsp;Juan M. Revuelta Barbero ,&nbsp;Emily Barrow ,&nbsp;C. Arturo Solares ,&nbsp;Tomas Garzon-Muvdi ,&nbsp;Gustavo Pradilla","doi":"10.1016/j.wneu.2024.123653","DOIUrl":"10.1016/j.wneu.2024.123653","url":null,"abstract":"<div><h3>Background</h3><div>Giant pituitary neuroendocrine tumors (GPitNETs) are challenging tumors with low rates of gross total resection (GTR) and high morbidity. Previously reported machine learning (ML) models for prediction of pituitary neuroendocrine tumor extent of resection (EOR) using preoperative imaging included a heterogenous dataset of functional and nonfunctional pituitary neuroendocrine tumors of various sizes leading to variability in results.</div></div><div><h3>Methods</h3><div>A retrospective study of 100 large nonfunctioning GPitNETs (≥3 cm diameter, &gt;10 cm³ volume) was conducted to develop predictive models for GTR or EOR based on 5 variables: tumor diameter, shape, revised Knosp grade, and modified Hardy classifications for sellar and extrasellar invasion. Model performance was assessed using receiver operating characteristic-area under the curve (AUC) and confusion matrix metrics.</div></div><div><h3>Results</h3><div>The median preoperative tumor volume was 17.35 cm³ (interquartile range: 12.4–27.0). The median EOR was 97.6% (interquartile range: 84.9–100), and GTR was achieved in 49% of patients. The most predictive variables were the modified Hardy classification for extrasellar extension and Knosp grade (AUC of 0.771 and 0.713, respectively). Among the constructed ML models, the extreme gradient boost algorithm had the highest predictive capability, with an internal validation AUC of 0.86, while the external validation sensitivity, specificity, positive, and negative predictive values were 84%, 77%, 78%, and 82%, respectively.</div></div><div><h3>Conclusions</h3><div>Utilizing preoperative imaging parameters in a 3-dimensional manner proves highly valuable in predicting the EOR for nonfunctioning GPitNETs. These predictions can be easily calculated using an online open-access application: <span><span>http://emoryskullbase.shinyapps.io/giant_pituitary_adenoma_resection/</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123653"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967078","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}

{"title":"Utility and Efficacy of a Virtual Normal Pressure Hydrocephalus Support Group.","authors":"Judy Pham, Christopher Nguyen, Gianna Fote, Ishan Shah, Sara Khoshniyati, Jefferson W Chen","doi":"10.1016/j.wneu.2025.123724","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123724","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123724"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256723","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}