World neurosurgery最新文献

{"title":"\"The Hidden Challenge: Building Datasets for AI-Based Intracranial Pressure Prediction\".","authors":"Dimitrios Theodoropoulos, Kostas Marias, Antonios Vakis, Efrosini Papadaki, Dimitrios A Karabetsos","doi":"10.1016/j.wneu.2025.124483","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124483","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124483"},"PeriodicalIF":2.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058463","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":"Efficacy Observation of Cranioplasty in the Treatment of Ruptured Middle Cranial Fossa Arachnoid Cyst with Cranial Deformity in Children.","authors":"Wei Yin, Yong Han","doi":"10.1016/j.wneu.2025.124460","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124460","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical efficacy of cranial reduction surgery in treating children with rupture of middle cranial fossa arachnoid cysts complicated by cranial deformity, and to provide reference for clinical treatment.</p><p><strong>Methods: </strong>This study retrospectively analyzed the clinical and imaging data of 5 children with rupture and hemorrhage of middle cranial fossa arachnoid cysts who underwent surgical treatment in the Department of Neurosurgery, Children's Hospital of Soochow University, from July 2016 to June 2024. All children had cranial deformities caused by arachnoid cysts, and they were all male with a median age of 6 years (range, 4-8 years). Among them, 3 children had arachnoid cysts located in the right temporal region, 1 in the left temporal region, and 1 involved both temporal regions. All children received a comprehensive treatment plan including craniotomy for hematoma evacuation, cystocephalostomy, subdural drainage, and cranial reduction surgery.</p><p><strong>Results: </strong>The median follow-up time for the 5 children was 19 months (range, 6-97 months). Compared with preoperatively, all children and their families reported varying degrees of improvement in cranial appearance after the surgery. The volume of arachnoid cysts was reduced to varying degrees, and no recurrence of cyst rupture or hemorrhage occurred.</p><p><strong>Conclusion: </strong>When selecting a treatment plan for arachnoid cysts, it is essential to take into account the clinical symptoms and imaging findings of the children. For cases where the rupture of arachnoid cysts leads to refractory chronic bleeding or acute bleeding that cannot be effectively managed by burr hole drainage to evacuate the hematoma and relieve intracranial hypertension, and when the children also present with cranial deformity, the combined treatment plan of craniotomy for hematoma evacuation and cranial reduction surgery may be a viable option. This surgical approach not only effectively removes intracranial hematomas and alleviates intracranial hypertension but also improves cranial deformity. However, further research is needed to determine whether this surgical approach can reduce the recurrence rate of arachnoid cyst rupture and bleeding.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124460"},"PeriodicalIF":2.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056147","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":"Biocompatible and Low-Cost Dura Mater Scaffold: Evaluation of Tilapia Skin Acellular Dermal Matrix in an Animal Model.","authors":"Rodrigo Becco de Souza, Renata Pereira da Silva, Edmar Maciel Lima Júnior, Helvécio Neves Feitosa Filho, Ana Paula Negreiros Nunes Alves, Sofphia Martins da Silva, Felipe Augusto Rocha Rodrigues, Liova Chabot Díaz, Manoel Odorico de Moraes Filho, Maria Gilnara Lima Bandeira, Mônica Beatriz Mathor, Carlos Roberto Koscky Paier","doi":"10.1016/j.wneu.2025.124461","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124461","url":null,"abstract":"<p><strong>Background: </strong>Scaffolds for dura mater repair have been widely used in neurosurgery. Over the past decades, various materials have been employed for the synthesis of these scaffolds, with collagen-based materials showing particularly promising results.</p><p><strong>Methods: </strong>An experimental study was conducted on 29 Wistar rats to evaluate the biocompatibility of a collagen scaffold derived from tilapia skin. The animals were divided into three groups: an experimental group (Tilapia Skin Acellular Dermal Matrix, TS-ADM), a positive control group (Duragen™ scaffold), and a negative control group (no scaffold). Scanning Electron Microscopy (SEM) was used to analyze the structure of each scaffold. Histological and immunohistochemical analyses were performed to assess inflammation, scaffold integrity, and connective tissue formation.</p><p><strong>Results: </strong>The negative control group showed less inflammation compared to the Duragen™ and tilapia groups at 15 and 30 days (p=0.011 and p=0.035, respectively). By 45 days, the inflammatory process was similar across all groups (p=0.183). Connective tissue formation was observed in both the tilapia and Duragen™ groups, with complete biodegradation of the scaffolds by 45 days.</p><p><strong>Conclusion: </strong>TS-ADM exhibited a self-limiting inflammatory response, biodegradability, and replacement by functional connective tissue. Human studies are necessary to validate this new biomaterial for clinical use.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124461"},"PeriodicalIF":2.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056068","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":"ANALYSIS OF SURGICAL APPROACHES FOR BURST-TYPE THORACOLUMBAR FRACTURES IN A REFERENCE HOSPITAL IN NORTHEASTERN BRAZIL.","authors":"Abraão Wagner Pessoa Ximenes, Ana Cristina Veiga Silva, Otávio da Cunha Ferreira Neto, Pedro Silvino José De Vasconcelos, Lucas Bezerra de Melo Botelho, Deoclides Lima Bezerra Júnior, Geraldo de Sá Carneiro Filho, Hildo Rocha Cirne de Azevedo Filho","doi":"10.1016/j.wneu.2025.124463","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124463","url":null,"abstract":"<p><p>Thoracolumbar burst fractures are among the most common spinal injuries, frequently resulting from high-energy trauma such as traffic accidents or falls from height. These injuries can lead to severe pain, neurological deficits, and long-term disability, representing a major public health concern. Effective surgical management is critical to restoring spinal stability, minimizing neurological impairment, and improving patient outcomes. This retrospective, descriptive cohort study analyzed medical records of patients treated for burst-type thoracolumbar fractures at a reference hospital in Northeastern Brazil between 2014 and 2020. Variables assessed included sex, age, trauma mechanism, ASIA (American Spinal Injury Association) neurological grading, Visual Analog Scale (VAS) scores for pain, fracture classification, and surgical approach. Neurological and pain outcomes were evaluated at admission and at 3 and 6 months post-treatment. Our analysis showed a significant improvement in outcomes when short-segment arthrodesis was used, particularly in the comparison between preoperative status and three months postoperatively. No significant preference was identified for either long or short arthrodesis in relation to fracture types A3 or A4. Similarly, the decision to place a pedicle screw at the fracture site did not vary significantly between these fracture types. Patients with A3 fractures demonstrated greater Cobb angle variation compared to A4 fractures, with statistical significance. These findings suggest that short-segment arthrodesis, particularly when combined with pedicle screw fixation at the fractured vertebra, may be a viable and cost-effective option in selected cases despite potential kyphotic progression.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124463"},"PeriodicalIF":2.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056150","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":"How to Simplify In-Hospital Aneurysmal Subarachnoid Hemorrhage Outcome: The Hospital Assessment Scale.","authors":"Yuliia Solodovnikova, Anatoliy Son","doi":"10.1016/j.wneu.2025.124457","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124457","url":null,"abstract":"<p><strong>Background: </strong>Aneurysmal subarachnoid hemorrhage (aSAH) remains a life-threatening condition with high mortality and disability rates, despite advances in treatment. Accurate clinical outcome assessment is essential for patient care and research; yet, a standardized approach is currently lacking.</p><p><strong>Methods: </strong>A structured PubMed search was conducted using the keywords \"aneurysmal subarachnoid hemorrhage\", \"assessment scale\", and \"outcome\". Titles, abstracts, and full texts of eligible studies were screened. Extracted data were analyzed to summarize the use, strengths, and limitations of outcome assessment instruments applied in aSAH research.</p><p><strong>Results: </strong>Simplistic dichotomization into \"favorable\" or \"unfavorable\" outcomes fails to reflect the full clinical spectrum. More detailed instruments such as the extended GOS and structured mRS interviews exist, but are often impractical in routine neurosurgical settings. Recent international efforts, including a 2025 Delphi survey, highlight the need to incorporate cognitive, emotional, and functional domains into outcome evaluation-areas still underrepresented. To address these gaps, we propose the Hospital Assessment Scale (HAS), a simplified four-point ordinal scale for in-hospital use. Score 0 indicates no neurological deficit; 1, a deficit not requiring caregiver support; 2, a deficit requiring support; and 3, death. The HAS provides a standardized, non-dichotomized approach, supports discharge planning, and enhances consistency across clinical studies.</p><p><strong>Conclusion: </strong>Implementing the HAS may enhance the quality and comparability of outcome assessment in aSAH, thereby improving clinical decision-making and the design of future studies.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124457"},"PeriodicalIF":2.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041471","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":"Cerebrospinal fluid refill test.","authors":"Eiichi Nakai, Hitoshi Fukuda, Tetsuya Ueba","doi":"10.1016/j.wneu.2025.124456","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124456","url":null,"abstract":"<p><p>Cerebrospinal fluid (CSF) hypovolemia is characterized by symptoms, such as orthostatic headaches, due to a deficit of CSF caused by intermittent CSF leakage. Traditionally, the diagnosis of CSF hypovolemia relied on measuring CSF pressure, magnetic resonance imaging, and computed tomography myelography, though several cases showed no positive findings with these methods. We addressed this diagnostic challenge by developing the CSF refill test and announced its effectiveness in January 2024. The CSF refill test diagnoses CSF hypovolemia by replenishing CSF and observing symptom improvement. This report also includes results from experimental tests conducted prior to the published clinical study. In 27 cases diagnosed with CSF hypovolemia, symptom improvement was observed in 25 cases following CSF replenishment. These results indicate that the CSF refill test, which involves CSF replenishment, effectively alleviates symptoms, such as orthostatic headaches, and is useful for diagnosing and predicting treatment outcomes for CSF hypovolemia.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124456"},"PeriodicalIF":2.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034300","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":"Tailored Reconstruction of Low- and High-Flow cerebrospinal fluid Leaks: A Single-Center, 1-Year Analysis Following 656 Endoscopic Endonasal Surgeries.","authors":"Atakan Emengen, Aykut Gokbel, Eren Yilmaz, Ayse Uzuner, Sibel Balci, Leonie Witters, Salih Aktas, Orkhan Mammadov, Savas Ceylan","doi":"10.1016/j.wneu.2025.124459","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124459","url":null,"abstract":"<p><strong>Background and objectives: </strong>The endoscopic endonasal approach (EEA) has become a key surgical method for managing midline skull base lesions, offering minimally invasive access with reduced morbidity. One of the most significant complications following EEA is cerebrospinal fluid (CSF) leakage, especially in high-flow cases. Based on over two decades of institutional experience with 6,221 EEA procedures, this study aims to categorize and evaluate standardized reconstruction strategies based on intraoperative CSF flow rates in order to optimize outcomes and reduce postoperative complications.</p><p><strong>Methods: </strong>This retrospective study included 179 patients with intraoperative CSF leaks among 656 EEA surgeries performed in 2024 at tertiary center. Intraoperative CSF leaks were classified as low- or high-flow, and patients were grouped by reconstruction strategy. Techniques included free mucosal grafts(FMG), autologous fat and fascia lata, vascularized nasoseptal flaps (NSF), and lumbar drainage (LD) where necessary. Preoperative imaging, surgical details, and postoperative complications were analyzed. Statistical comparisons were performed using appropriate parametric and non-parametric tests.</p><p><strong>Results: </strong>Intraoperative CSF leakage occurred in 27.2% of cases (n = 179), of which 60.9% were high-flow leaks. Postoperative rhinorrhea developed in 2.1% of all patients and was significantly associated with extended approaches, third ventricular exposure, and high Evans ratio. FMG-based reconstructions were effective in low-flow leaks, while complex multilayer closure using NSF and LD reduced complications in high-risk cases. Meningitis occurred in 1.1% of the cohort, rising to 14.3% in patients with postoperative rhinorrhea and 13% in those with LD.</p><p><strong>Conclusions: </strong>Tailored reconstruction based on intraoperative CSF flow rate and anatomical risk factors is critical to minimizing postoperative complications following EEA. A structured, risk-based approach can enhance the safety and efficacy of skull base surgery and may serve as a model for standardized reconstruction protocols in endoscopic neurosurgery.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124459"},"PeriodicalIF":2.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034258","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 Risk Factors and a New Transfer Pathway on Endovascular Thrombectomy Outcomes in Acute Ischemic Stroke.","authors":"Chi-Ping Ting, Dong-Yi Hsieh, Hung-Sheng Lin, Wen-Chan Chiu, Yun-Ru Lai, Fei-Shu Chang, Shih-Wei Hsu, Shih-Hsuan Chen, Cheng-Hsien Lu","doi":"10.1016/j.wneu.2025.124458","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124458","url":null,"abstract":"<p><strong>Objective: </strong>Endovascular thrombectomy (EVT) is a time-critical therapy for acute ischemic stroke (AIS) caused by large vessel occlusion. To improve transfer efficiency, a web-based EVT transfer system was implemented in the Taiwan Stroke Network. This study evaluated its impact on workflow metrics and patient outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included AIS patients transferred for EVT between January 2021 and May 2024. Patients were categorized into Traditional Transfer Pathway (TTP) or New Transfer Pathway (NTP) groups. Given the older age, longer onset-to-door time (ODT), and smaller sample size in the NTP group, propensity score matching (1:1, caliper = 0.1) was conducted using age and ODT.</p><p><strong>Results: </strong>Among 356 patients (TTP: n = 293; NTP: n = 63), 63 matched pairs were analyzed. The NTP group had significantly shorter door-to-CT angiography (12.2 ± 10.7 vs. 39.8 ± 33.8 minutes; p < 0.0001) and door-to-groin puncture times (83.0 ± 24.4 vs. 109.2 ± 44.6 minutes; p < 0.0001). These improvements were associated with better outcomes, including higher one-month EQ-5D-5L visual analogue scale scores (61.6 ± 31.9 vs. 32.0 ± 30.9; p = 0.004), lower in-hospital mortality (11.1% vs. 31.7%; p = 0.009), and lower three-month modified Rankin Scale scores (3.8 ± 1.7 vs. 4.6 ± 1.4; p = 0.004). Hypertension and National Institutes of Health Stroke Scale scores at 24-36 hours independently predicted poor functional outcomes.</p><p><strong>Conclusion: </strong>The web-based EVT transfer system improved workflow and functional outcomes, highlighting its value even in a small referral cohort.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124458"},"PeriodicalIF":2.1,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024267","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 Pyogenic Ventriculitis with Retroauricular External Ventricular Drainage.","authors":"Arylic Singh, Katrina Shute","doi":"10.1016/j.wneu.2025.124455","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124455","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124455"},"PeriodicalIF":2.1,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024235","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":"Incidence of Spinal Epidural Hematoma after Anterior Cervical Decompression and Fusion - Systematic Review, Meta-Analysis, and Case Report.","authors":"Jerzy Gregorczyk, Negin Fani, Mikołaj Biegański, Jakub Mocarski, Piotr Dąbrowski, Rafał Górski, Mateusz Bielecki","doi":"10.1016/j.wneu.2025.124442","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124442","url":null,"abstract":"<p><strong>Introduction: </strong>Anterior cervical discectomy and fusion (ACDF) is a common surgical procedure used to treat herniated discs, degenerative disc disease, and nerve root compression in the cervical spine. This systematic literature review aims to analyze the available literature on the incidence, risk factors, clinical considerations, and available therapies for spinal epidural hematoma (SEH) following ACDF.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Google Scholar, and Embase from database inception to June 18, 2025, following the PRISMA guidelines. The search yielded 71 studies without duplicates. After applying the inclusion and exclusion criteria, 5 studies were selected for the final analysis.</p><p><strong>Results: </strong>The overall incidence of SEH following ACDF was 0.835%. Most patients presented with dyspnea, paraplegia, or quadriplegia. A meta-analysis of the 5 studies (n = 3246; 28 events) confirmed this incidence, with moderate heterogeneity. Management varied on the basis of symptom severity, hematoma size, and neurological impairment. Surgical decompression was the most common treatment, although some cases were managed conservatively with success. SEH onset ranged from within 24 hours postoperatively to several days after surgery.</p><p><strong>Conclusion: </strong>Although uncommon, SEH after ACDF carries significant clinical risks. Preventive measures may help mitigate its occurrence. However, the limited literature prevents a precise determination of the incidence and associated risk factors, including coagulation disorders. There is a clear need for large-scale prospective and retrospective studies with standardized reporting to more accurately define the incidence, identify risk factors, and determine the optimal management of SEH following ACDF.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124442"},"PeriodicalIF":2.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016280","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}