World neurosurgery最新文献

{"title":"Individualized Prediction of Overall Survival Time for Patients with Primary Intramedullary Spinal Cord Astrocytoma: A Population-Based Study.","authors":"Yihao Li, Zezheng Zheng, Qiuju He","doi":"10.1016/j.wneu.2024.10.092","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.092","url":null,"abstract":"<p><strong>Background: </strong>The incidence rate of primary intramedullary spinal cord astrocytoma is approximately 0.047 per 100,000 individuals per year, making it the second most common type of intramedullary spinal cord tumor. Due to its rarity, there is a scarcity of related research, and prognostic factors remain unclear. The aim of this study is to identify risk factors affecting the prognosis of patients with primary intramedullary spinal cord astrocytoma. Based on these factors, we aim to develop and visualize a prognostic model for predicting the overall survival time of patients with this condition, thereby facilitating individualized predictions of overall survival time for patients with primary intramedullary spinal cord astrocytoma.</p><p><strong>Methods: </strong>This study selected patients diagnosed with primary intramedullary spinal cord astrocytoma between 1975 and 2016 from the United States SEER database, incorporating a total of 582 eligible patients. We employed the Kaplan-Meier method for survival analysis of various factors to preliminarily screen for potential prognostic influences. Univariate and multivariate Cox regression analyses were utilized to identify independent risk factors. A multivariate Cox regression model was constructed, and the model was visualized using a nomogram. Finally, various methods were applied to validate and evaluate the model.</p><p><strong>Results: </strong>Multivariate Cox analysis revealed that tumor grade, age, and surgical approach are independent prognostic factors for overall survival (OS). A multivariate Cox regression model and a nomogram were developed based on these factors. The overall C-index of the model was 0.764, indicating good discriminative ability. Time-dependent ROC curve analysis showed the model had a good distinction with a 1-year survival rate AUC of 0.801 [95% CI: 0.763-0.839], a 3-year survival rate AUC of 0.842 [95% CI: 0.809-0.874], and a 10-year survival rate AUC of 0.855 [95% CI: 0.821-0.888]. Calibration plots also demonstrated good model calibration. Decision curve analysis (DCA) indicated that the nomogram had good clinical utility in predicting 1-year, 3-year, and 10-year OS. Internal validation based on enhanced bootstrap resampling showed good consistency between nomogram predictions and actual observations.</p><p><strong>Conclusion: </strong>Lower WHO tumor grade, younger age groups, and undergoing gross total resection (GTR) surgery are significant protective factors affecting the prognosis of patients with primary intramedullary spinal cord astrocytoma. Among patients with Grade II astrocytoma, being female appears to be a protective factor, whereas being male seems to be a protective factor in Grade III astrocytoma. Radiation therapy and chemotherapy do not appear to improve long-term survival; specifically, radiation therapy may lead to worse outcomes for low-grade spinal cord astrocytomas. The study found no impact of tumor size, year of diagnosis,","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605834","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 carotid-cavernous fistula with complete shunt.","authors":"Jincai Fang, Genghuan Wang, Yunnong Song","doi":"10.1016/j.wneu.2024.10.085","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.085","url":null,"abstract":"<p><p>Patient is a 37-year-old male with a history of head trauma surgery 8 years ago, admitted for persistent pulsatile exophthalmos and intracranial murmur. Angiography results showed: blood from the right internal carotid artery(RICA) flowed directly into the cavernous sinus(CS), with the arterial system above the CS not visualized; early visualization of the right venous sinus system; dilation of the right superior ophthalmic vein(SOV) and the medial canthal vein. Bilateral anterior and middle cerebral arteries were perfused through the left internal carotid artery(LICA). We diagnosed a right-sided carotid cavernous fistula(CCF). After a comprehensive preoperative assessment, we chose spring coil embolization treatment, which resulted in the disappearance of symptoms post-treatment. Three month later, upon follow-up, the patient reported no longer hearing intracranial murmur, and auscultation of the right temporal region revealed no abnormal sounds.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605929","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":"Occipital lobectomy utilizing parietooccipital fissure: 2-dimensional operative video.","authors":"Ichiyo Shibahara, Hajime Handa, Takashi Kiga, Toshihiro Kumabe","doi":"10.1016/j.wneu.2024.10.102","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.102","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605837","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":"Obliteration of the Superior Petrosal Vein During Cerebellopontine Angle-Surgery: More Cons than Pros?","authors":"H Joswig, U Träger, G Hildebrandt","doi":"10.1016/j.wneu.2024.10.015","DOIUrl":"10.1016/j.wneu.2024.10.015","url":null,"abstract":"<p><p>A profound knowledge of the anatomy and surgical management of the superior petrosal vein (SPV) is vital during neurosurgical procedures in the posterior fossa. The debate on preserving the SPV or whether it can be duly obliterated is still ongoing. This review provides an update on all historical articles pertaining to the risk profile of superior petrosal sacrifice since Walter Dandy. Not only were the heterogenous methods but also the respective authors' conclusions analyzed. In light of the collected evidence, we come to the conclusion that occluding the SPV poses an ineligible risk to patient safety and should be considered obsolete.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476195","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 and Safety of Low-Density Pedicle Screw versus High-Density Screw in Lenke I Scoliosis: A Systematic Review and Meta-Analysis.","authors":"Zhe Qiang, Qiang Zhou, Xuanwen Liu, Bin Zheng","doi":"10.1016/j.wneu.2024.10.029","DOIUrl":"10.1016/j.wneu.2024.10.029","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of low-density versus high-density pedicle screw in patients with Lenke I adolescent idiopathic scoliosis through systematic review and meta-analysis.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed, Web of Science, and Embase databases. Studies comparing low-density and high-density pedicle screw in Lenke I adolescent idiopathic scoliosis were included. Two authors independently selected studies, assessed risk of bias, and extracted data. Meta-analysis was performed using systematic review software.</p><p><strong>Results: </strong>The meta-analysis included 11 studies comprising 697 patients (397 in low-density group and 300 in high-density group). No significant differences were found between low-density and high-density groups in terms of blood loss, operative time, complication rates, or revision rates. Radiographic outcomes, including major Cobb angle, curve correction, thoracic kyphosis, and coronal and sagittal balance, were also similar between the groups. However, low-density pedicle screw was associated with significantly lower costs.</p><p><strong>Conclusions: </strong>This meta-analysis suggests that low-density pedicle screw can achieve similar clinical and radiographic outcomes compared with high-density constructs in patients with Lenke I adolescent idiopathic scoliosis, while potentially reducing costs, making it a more cost-effective option without compromising patient outcomes.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476184","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":"Unilateral carotid rete mirabile presenting with limb-shaking transient ischemic attack.","authors":"Jian Wang, Hongbo Zheng, Fayun Hu","doi":"10.1016/j.wneu.2024.10.114","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.114","url":null,"abstract":"<p><p>A rare presentation of unilateral carotid rete mirabile (RM) in a 70-year-old male manifesting as limb-shaking transient ischemic attacks (LS-TIAs), a disorder typically associated with carotid artery stenosis. The patient experienced recurrent left-sided limb shaking and numbness, with angiography revealing an anomalous microarterial collateral network replacing the right internal carotid artery's (ICA) cavernous segment, indicative of RM. Differential diagnoses included recanalization following occlusion, arteriovenous malformation, with carotid canal dysplasia on CT supporting the RM diagnosis. The patient's management involved antiplatelet therapy and lifestyle changes, following which he reported no further cerebrovascular events. This case underscores the importance of considering RM in differential diagnoses of LS-TIA and suggests conservative management as a favorable approach.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591849","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":"Evaluating the Feasibility of Cervical Vertebral Maturation Stages as an Alternative to Risser Sign in Assessing Skeletal Maturity in Adolescent Idiopathic Scoliosis Patients.","authors":"Hao Qi, Xiaonan Tian, Feiyu Zu, Zenghui Zhao, Chenchen Wang, Chenxi Wang, Zuzhuo Zhang, Peng Zhang, Rui Xue, Wei Chen, Di Zhang","doi":"10.1016/j.wneu.2024.10.014","DOIUrl":"10.1016/j.wneu.2024.10.014","url":null,"abstract":"<p><strong>Background: </strong>Radiographic methods for evaluating skeletal maturity traditionally include the Risser sign and the hand-wrist maturation method. While the cervical vertebral maturation (CVM) stage is widely recognized in orthodontics, its application in assessing spinal growth, particularly in adolescent idiopathic scoliosis (AIS), has been less explored. This study explores the correlation between CVM, chronological age, and the Risser sign to evaluate the feasibility of CVM in assessing skeletal development in adolescents.</p><p><strong>Methods: </strong>This prospective study included AIS patients and asymptomatic adolescents, aged 7-15 years, who underwent full-spine imaging with clear visibility of the cervical and pelvic regions. The correlation between CVM and the Risser sign was analyzed. The height of the cervical C3-7 vertebral body was measured, and its growth trend with age was examined. Differences between AIS patients and asymptomatic adolescents were compared.</p><p><strong>Results: </strong>A total of 85 AIS patients (mean age 11.44 ± 2.36 years) and 47 asymptomatic adolescents (mean age 11.48 ± 3.14 years) were included. No statistically significant differences were observed in age, Risser sign grading, CVM staging, or C3-7 vertebral body height between the 2 groups. Chronological age showed a stronger correlation with CVM stages than with the Risser sign in both the AIS group (r = 0.93 vs. r = 0.82, P < 0.01) and the asymptomatic group (r = 0.81 vs. r = 0.72, P < 0.01).</p><p><strong>Conclusions: </strong>The CVM stage, which shows a strong correlation with Risser sign grading, could serve as a reliable alternative for assessing skeletal maturity in adolescent subjects, particularly in clinical scenarios where minimizing radiation exposure is a priority.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476189","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":"The Correlation of Vessel Wall Macrophage Infiltration with Hemosiderin in Arteriovenous Malformations.","authors":"Jessica Hossa, Laura Stone McGuire, Tibor Valyi-Nagy, Tatiana Abou-Mrad, Peter Theiss, Mpuekela Tshibangu, Adrusht Madapoosi, Fady T Charbel, Ali Alaraj","doi":"10.1016/j.wneu.2024.10.097","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.097","url":null,"abstract":"<p><strong>Introduction: </strong>Endothelial dysfunction, induced by high shear stress from increased nidal blood flow, may promote a cycle of inflammation, possibly leading to instability and cerebral arteriovenous malformations (AVMs) rupture. Macrophages, identified with CD68, are key inflammatory components in AVM pathology. We aim to evaluate the relationship of inflammation with AVM flow and hemosiderin.</p><p><strong>Methods: </strong>This is a retrospective study of archived tissue. Adult patients (2002-2022) with baseline quantitative magnetic resonance angiography (QMRA) imaging, no embolization, and history of microsurgical resection (n=17), with both ruptured (n=9) and unruptured cases (n=8). Brain AVM sections were stained with CD68 to quantify vessel wall macrophage infiltration and hematoxylin and eosin stain as a control and to quantify hemosiderin. QMRA with noninvasive optimal vessel analysis (NOVA) was reviewed, and AVM flow was calculated. Statistical analyses were performed.</p><p><strong>Results: </strong>There were no significant differences between macrophage infiltration and patient demographics, Spetzler-Martin grade, eloquence, venous stenosis, nidus compactness, volume, and AVM flow. Vessel wall macrophage infiltration positively correlated with patients who presented with confirmed AVM rupture (163.8 +/- 46.7 vs. 101.3 +/- 49.4, p=0.017). Increases in vessel wall macrophage infiltration were found to positively correlate with higher grades of hemosiderin (p=0.023), except for grade 4 hemosiderin. Venous anomaly showed a negative association with macrophage infiltration (p=0.035).</p><p><strong>Conclusion: </strong>These findings suggest a relationship between AVM vessel wall inflammation, hemosiderin, and hemorrhage presentation. Further investigations with larger sample sizes are warranted to understand the role of altered hemodynamics, hemosiderin deposition and inflammation in AVM vessel walls.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591843","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":"Duckbill release technique for the outside-in method in full-endoscopic spine surgery via transforaminal approach: A technical note.","authors":"Daisuke Ukeba, Ken Nagahama, Katsuhisa Yamada, Yuichiro Abe, Yoshinori Hyugaji, Yuto Horita, Tsutomu Endo, Takashi Ohnishi, Hiroyuki Tachi, Yuichi Hasegawa, Hideki Sudo, Norimasa Iwasaki","doi":"10.1016/j.wneu.2024.10.120","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.10.120","url":null,"abstract":"<p><strong>Introduction: </strong>In full-endoscopic spine surgery via trans-foraminal approach (FESS-TF), the outside-in method facilitates treatment for various cases; however, the technique is difficult to perform. To facilitate this procedure, we developed a duckbill release technique. In this paper, we aimed to introduce the details of this technique and investigate its effectiveness.</p><p><strong>Materials and methods: </strong>Fifty patients who underwent FESS-TF for intervertebral disc herniation were divided into two groups: the conventional technique and the duckbill release technique groups. The time from the initiation of surgery to exposure of the bone outside the superior articular process was measured in both groups. The visual analog scale (VAS) score for leg pain and the Japanese Orthopaedic Association (JOA) score before and after surgery were compared in terms of clinical outcomes.</p><p><strong>Results: </strong>No significant differences were observed between the two groups in terms of patient background. The approach time was 252 ± 86 s in the conventional group, while it was 105 ± 26 s in the duckbill release group, which was significantly shorter (p < 0.001). In terms of clinical outcomes, the two groups did not significantly differ in all endpoints of the VAS score for leg pain or the JOA score.</p><p><strong>Conclusions: </strong>The duckbill release technique for the outside-in method in FESS-TF could be efficient because it is a simple and time-saving approach.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591836","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":"Magnetic Resonance Imaging Diagnosis of Spinal Longitudinal Epidural Collections in a Spontaneous Spinal Dural Breach and Successful Surgical Treatment.","authors":"Mehdi Bensemain, Pierre-Adrien Lampson, Bruno Law-Ye","doi":"10.1016/j.wneu.2024.10.027","DOIUrl":"10.1016/j.wneu.2024.10.027","url":null,"abstract":"<p><p>Spontaneous intracranial hypotension is generally secondary to cerebrospinal fluid leaks. Spinal magnetic resonance imaging is an important part of the diagnostic workup, especially to display spinal longitudinal epidural collections. Other causes of leaks include nerve root sleeve tear and cerebrospinal fluid-venous fistula. We propose a standard magnetic resonance imaging protocol including sagittal T1, T2-weighted, and T2 fat-saturated sequences, with addition of high-resolution three-dimensional T2 images to improve detection of spinal longitudinal epidural collections and help locate the dural breach level. Spine computed tomography may prove useful in detecting a bony spur that may cause the dural breach. Treatment of identified dural breaches includes targeted epidural blood patch or neurosurgery in case of blood patch inefficacy. Few cases of successful surgical treatments of dural breaches have been reported with complete regression of spinal longitudinal epidural collections; thus more studies will be valuable to help establish guidelines in this pathology.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476192","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}