World neurosurgery最新文献

{"title":"Optimizing Ventricular Catheterization with Real-Time Ultrasound via Burr Hole","authors":"Noritaka Sano , Sadaharu Torikoshi , Takahiro Kitahara , Yusuke Nakajima , Makoto Hayase , Masaki Nishimura","doi":"10.1016/j.wneu.2025.124084","DOIUrl":"10.1016/j.wneu.2025.124084","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"200 ","pages":"Article 124084"},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086862","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":"Elevated Admission N-Terminal Pro-Brain Natriuretic Peptide as a Predictor of Computed Tomography Perfusion Core Infarct Overestimation in Acute Ischemic Stroke in a Sample of Chinese Patients","authors":"Guosen Bu ,&nbsp;Li Yang ,&nbsp;Jianhua Ma ,&nbsp;Dengfeng Han ,&nbsp;Yuchun Yang ,&nbsp;Zhen Bao ,&nbsp;Muhuyati Wulasihan","doi":"10.1016/j.wneu.2025.124079","DOIUrl":"10.1016/j.wneu.2025.124079","url":null,"abstract":"<div><h3>Background</h3><div>Overestimation of computed tomography perfusion (CTP) core infarcts in ischemic stroke is common and may interfere with treatment decisions. We aim to assess the value of admission N-terminal pro-brain natriuretic peptide (NT-pro BNP) in predicting CTP core infarct overestimation.</div></div><div><h3>Methods</h3><div>A total of 353 patients with anterior circulation large vessel occlusion stroke who achieved satisfactory recanalization (extended thrombolysis in cerebral infarction ≥ 2c) from a single-center prospective database were enrolled in this study. Core infarct overestimation was considered when the CTP-derived infarct was larger than the final infarct measured on 24- to 48-hour noncontrast CT. Multivariable logistic regression analysis was performed to identify variables associated with overestimation.</div></div><div><h3>Results</h3><div>Fifty-two (14.8%) patients presented with CTP core infarct overestimation. Multivariate analysis, adjusted for covariates, showed that admission NT-pro BNP (adjusted odds ratio [OR] 1.34; 95% confidence interval [CI] 1.13–1.69), poor collaterals (adjusted OR 3.13; 95% CI 1.87–4.87), onset-to-imaging time (adjusted OR 0.23; 95% CI 0.17–0.46), and embolism etiology (adjusted OR 1.15; 95% CI 1.09–1.46) were independently associated with overestimation. Based on the receiver operating characteristic curve, the optimal cut-off value of NT-pro BNP for diagnosing infarct overestimation was 876 pg/ml, which yielded a sensitivity of 76.9%, a positive likelihood ratio of 2.796, a negative likelihood ratio of 0.319, and an area under the curve of 0.813 (95% CI: 0.761–0.864).</div></div><div><h3>Conclusions</h3><div>Elevated admission NT-pro BNP could serve as a predictor of CTP infarct overestimation. CTP results should be interpreted with caution in specific circumstances to ensure that patients who might benefit from thrombectomy are not inadvertently excluded.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124079"},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086861","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":"Genomic Alterations Have Prognostic Significance in Low Clinical Risk Meningiomas","authors":"Ramin A. Morshed ,&nbsp;David R. Raleigh","doi":"10.1016/j.wneu.2025.124085","DOIUrl":"10.1016/j.wneu.2025.124085","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"200 ","pages":"Article 124085"},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205054","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":"In Reply to the Letter to the Editor Regarding “Robotic Systems in Spinal Surgery: A Review of Accuracy, Radiation Exposure, Hospital Readmission Rate, Cost, and Adverse Events”","authors":"Nadia V. Haik ,&nbsp;Alison E. Burgess ,&nbsp;Norris C. Talbot ,&nbsp;James R. Bridges ,&nbsp;Michael Folse ,&nbsp;Patrick Luther ,&nbsp;Elizabeth Jee ,&nbsp;Jamie Toms","doi":"10.1016/j.wneu.2025.124064","DOIUrl":"10.1016/j.wneu.2025.124064","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124064"},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085819","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":"A New Automated Software for Enhanced Computed Tomography Perfusion Volume Assessment","authors":"Yaode He,&nbsp;Jiansheng Yang,&nbsp;Ying Zhou,&nbsp;Shenqiang Yan,&nbsp;Wansi Zhong,&nbsp;Xuting Zhang,&nbsp;Min Lou","doi":"10.1016/j.wneu.2025.124077","DOIUrl":"10.1016/j.wneu.2025.124077","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the predictive value of UKIT, a novel automated computed tomography perfusion (CTP) software, for infarct outcomes in acute ischemic stroke (AIS) and compare its perfusion volume assessments with those of MIStar.</div></div><div><h3>Methods</h3><div>Data from AIS patients were collected across 1 Chinese hospital, with all participants undergoing CTP prior to reperfusion therapy. The concordance of CTP measures between the two softwares was assessed using Spearman rank correlation, Bland-Altman plots, and kappa tests. For AIS patients who received endovascular treatment (EVT) and achieved complete recanalization, consistency between the ischemic core volume as determined by CTP and the ground truth was assessed using Spearman rank correlation.</div></div><div><h3>Results</h3><div>In the included 278 patients, the ischemic core and hypoperfusion volumes measured by UKIT correlated strongly with MIStar's measurements (ischemic core: r = 0.982, intraclass correlation coefficient = 0.902, <em>P</em> &lt; 0.001; hypoperfusion: r = 0.979, intraclass correlation coefficient = 0.956, <em>P</em> &lt; 0.001). Excellent agreement was observed between the two softwares according to imaging criteria in EXTEND (kappa = 0.73, <em>P</em> &lt; 0.001) and DEFFUSE 3 (kappa =0.73, <em>P</em> &lt; 0.001). Among the 103 patients who underwent EVT and achieved full recanalization, 86 (83.5%) underwent diffusion-weighted imaging within 24 hours post-EVT. Ischemic core volume assessed by both UKIT and MIStar was found to be in close agreement with the ground truth (UKIT: r = 0.695, <em>P</em> &lt; 0.001; MIStar: r = 0.721, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The automated CTP software UKIT reliably assesses ischemic core and hypoperfusion volumes, aiding in the clinical selection of AIS patients for reperfusion therapy.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124077"},"PeriodicalIF":1.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080507","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":"Corrigendum to Building and Verifying a Prediction Model for Deep Vein Thrombosis Among Spinal Cord Injury Patients Undergoing Inpatient Rehabilitation [World neurosurgery, 2025, 194: 123451]","authors":"Fangfang Zhao ,&nbsp;Lixiang Zhang ,&nbsp;Xia Chen ,&nbsp;Chengqian Huang ,&nbsp;Liai Sun ,&nbsp;Lina Ma ,&nbsp;Cheng Wang","doi":"10.1016/j.wneu.2025.123997","DOIUrl":"10.1016/j.wneu.2025.123997","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"198 ","pages":"Article 123997"},"PeriodicalIF":1.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936551","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":"Antimicrobial Biomaterials for Cranioplasty: A Systematic Review","authors":"Talhah Chaudri ,&nbsp;Antonio Belli ,&nbsp;David J. Davies ,&nbsp;Andrew R. Stevens","doi":"10.1016/j.wneu.2025.124075","DOIUrl":"10.1016/j.wneu.2025.124075","url":null,"abstract":"<div><h3>Background</h3><div>Cranioplasty is a surgical procedure performed to reconstruct the calvarium, yet it carries a significant risk of infection and subsequent graft failure. Surgical asepsis, systemic antibiotic prophylaxis, and topical antiseptics may reduce this risk, but recent attention has focused on incorporating antimicrobial agents or properties directly onto or into the implant. This systematic review assesses the efficacy of antibacterial-modified cranioplasty grafts in reducing infection risk.</div></div><div><h3>Methods</h3><div>Following a registered protocol, 2 reviewers independently searched and screened for studies describing antibacterial-modified cranioplasty grafts. Inclusion criteria included in vitro, in vivo, and clinical studies evaluating altered cranioplasty implants (e.g., antibiotics or nanoparticles embedded, coated, or added to a reservoir). The primary outcome measures were suitable measures of infection, with additional outcomes including antibiotic release profile.</div></div><div><h3>Results</h3><div>Twenty studies met the inclusion criteria: 10 in vitro studies (2 also reporting results of in vivo models) and 10 clinical studies (n = 234 patients). Polymeric, ceramic, or hydrogel grafts were impregnated or coated with various antimicrobial agents, most commonly aminoglycosides. In vitro studies consistently demonstrated high local antibiotic concentrations and reduced bacterial colonization, with a biphasic release profile characterized by an early burst and sustained low-level elution. In limited in vivo studies, systemic drug levels remained low. Clinical studies reported a combined complication rate of 2.99%. While this may indicate an improvement over historical complication rates, most studies lacked appropriate comparators and sufficient power: only 1 study attempted a statistical comparison with historical data, finding a nonsignificant reduction in infection (2.6% vs. 7.8%; <em>P</em> = 0.179).</div></div><div><h3>Conclusions</h3><div>Antimicrobial modifications to cranioplasty materials show promising preclinical results, with favorable local release profiles and minimal systemic distribution. Early clinical experiences suggest a possible reduction in infection rates, but the current evidence is limited by small sample sizes and methodological biases. Well-designed comparative trials with standardized reporting are necessary to establish definitive clinical efficacy and to guide optimal material-antibiotic combinations and delivery methods.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124075"},"PeriodicalIF":1.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080618","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":"Total Uncinatectomy in Cervical Disc Replacement","authors":"Alexander J. Schupper,&nbsp;Jeremy M. Steinberger,&nbsp;Yakov Gologorsky","doi":"10.1016/j.wneu.2025.124088","DOIUrl":"10.1016/j.wneu.2025.124088","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"200 ","pages":"Article 124088"},"PeriodicalIF":1.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080895","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":"Cephalgia Following Flow Diversion of Unruptured Intracranial Aneurysms","authors":"Zeev Itsekson-Hayosh ,&nbsp;Andrew Falzon ,&nbsp;Hugo Andrade Barazarte ,&nbsp;Ronit Agid ,&nbsp;Eef Hendriks ,&nbsp;Pascal J. Mosimann ,&nbsp;Timo Krings","doi":"10.1016/j.wneu.2025.124080","DOIUrl":"10.1016/j.wneu.2025.124080","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Headaches following treatment of unruptured intracranial aneurysms with flow diverting stents is a known, however under-reported, entity. Prevalence of this phenomenon, its clinical and procedural correlates, as well as its clinical course and correlation to aneurysm location and size have not been reported in the past. This manuscript aims to quantify the prevalence of the phenomenon, describe its natural course, and identify risk factors for its emergence.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Within our prospectively collected institutional database, we identified 141 consecutive patients treated electively for unruptured intracranial aneurysms by flow diversion between 2015 and 2021 who had a minimum of 2 years of clinical follow-up. The mean patient age was 55.7 (±13) y/o and 120/141 patients (85%) were females. Based on chart review and clinical notes we evaluated the presence of postprocedural headache complaints and correlated these with anatomical and periprocedural data. Additionally we have assessed charts of 88 patient who underwent aneurysm coiling without flow diversion during the same time period.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Twenty-four (17%) patients complained of new headaches postflow diversion which were hemicranial or holocranial (n = 17) or retro-orbital (n = 7) in nature. Headaches were most common in paraclinoid, paraophthalmic, and cavernous aneurysms, while retro-orbital pain was correlated to larger aneurysms of same locations mean dimensions and older age (Pearson's correlation, 13 mm ± 5.4, &lt;em&gt;P&lt;/em&gt; = 0.04; 65 ± 14, &lt;em&gt;P&lt;/em&gt; = 0.048). Two stent constructs were also correlated to retro-orbital headaches (hazard ratio [HR] 3.8, &lt;em&gt;P&lt;/em&gt; = 0.03, confidence interval [CI] 1.0–16.4). In addition, in 15 of 24 cases (62.5%) of headache presentations, the stent construct was crossing the dura. In 6 of 7 (87.5%) of patients presenting with retro-orbital headaches the stent construct was crossing the dural ring. The clinical course of the pain syndrome was invariably benign and short-lived (&lt;1 year long). During the same time period only 3 patients (3.4%) in the elective coiling without flow diverter group presented with various duration of holocranial eventually resolving headaches.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;In our cohort, new postprocedural headaches following flow-diversion were present in 17% of patients thus constituting a common adverse event that was exclusively related to anterior circulation aneurysms, in contrast to only 3.4% prevalence of new postprocedural headaches following elective aneurysm coiling. The phenomenon was short-lived and benign, related to larger aneurysm size, proximity to the dural ring in the treated segment, double stent construct, and older age. We hypothesize that these headaches may be related to meningeal irritation. We recommend that patients are educated during the consent process of this phenomenon and its clinical course prior to ","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124080"},"PeriodicalIF":1.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080689","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 Severe Rigid Early-Onset Scoliosis with Co-Cr-Mo Guided Multidirectional Sliding Growth Rod Combined with Apical Control Techniques","authors":"Feng Zhu MD ,&nbsp;Wei Mei ,&nbsp;Xiangjian Song ,&nbsp;Yu Yue","doi":"10.1016/j.wneu.2025.124063","DOIUrl":"10.1016/j.wneu.2025.124063","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the efficacy and complications of the Co-Cr-Mo guided multidirectional sliding growth rod technique (CMSG) combined with apical control techniques (ACTs) in the treatment of severe rigid early-onset scoliosis (EOS).</div></div><div><h3>Methods</h3><div>Twenty-two patients with severe rigid EOS were treated with the CMSG combined with ACTs. The surgical details and complications were recorded, and the Cobb angle, apical vertebra offset, and T1-S1 vertical height were measured.</div></div><div><h3>Results</h3><div>All patients were followed up for 24–144 (66.8<!--> <!-->±<!--> <!-->29.6) months. The coronal Cobb angle after the first surgery, the coronal apical vertebra offset after the first surgery, and the T1–S1 vertical height at the last follow-up were all improved compared with those before surgery (<em>P</em> &lt; 0.05). The postoperative orthopedic effect was relatively satisfactory, and there was no aggravation of scoliosis. Complications occurred in 6 cases, including 1 case of rod fracture, 1 case of screw loosening, 2 cases of proximal junctional kyphosis, 1 case of trunk balance decompensation, and 1 case of local infection.</div></div><div><h3>Conclusions</h3><div>The CMSG combined with ACTs can effectively correct scoliosis and control its progression in patients with severe rigid EOS, preserve the growth potential of the spine, and has a lower complication rate than traditional growth rod surgery.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124063"},"PeriodicalIF":1.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080897","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}