World neurosurgery最新文献

{"title":"Utility of surgical simulation for tubular retractor surgery using 3D-printed intraventricular tumor models - Case series.","authors":"Ryo Omae, Ryu Kimura, Yoshihiro Otani, Jun Haruma, Tomoya Saijo, Juntaro Fujita, Shohei Nishigaki, Ryosuke Ikemachi, Shuichiro Hirano, Joji Ishida, Kentaro Fujii, Takao Yasuhara, Shota Tanaka","doi":"10.1016/j.wneu.2025.123743","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123743","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123743"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256729","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":"Risk of Post-Traumatic Spinal Cord Injury in Patients with Stenosis of the Cervical Spine: A Systematic Review and Meta-Analysis","authors":"Yasoda Satpathy,&nbsp;Pishtiwan Ahmaki,&nbsp;Jubran H. Jubran,&nbsp;Joseph D. Ciacci,&nbsp;David R. Santiago-Dieppa,&nbsp;Martin H. Pham,&nbsp;Alexander A. Khalessi,&nbsp;Brian R. Hirshman","doi":"10.1016/j.wneu.2024.123611","DOIUrl":"10.1016/j.wneu.2024.123611","url":null,"abstract":"<div><h3>Background</h3><div>Cervical stenosis (CS) is the pathologic narrowing of the central canal of the cervical spine. It is often incidentally discovered. It is unclear whether pre-existing CS can lead to worse outcomes and higher incidences of post-traumatic spinal cord injury (SCI).</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of studies collected using the keywords \"cervical stenosis\" AND (“trauma” OR “injury”). About 381 articles were collected from PubMed, Embase, and Cochrane, and 2675 patients from 7 studies were included in the final analyses. Neo-Bayesian statistics were used to estimate a number needed to treat.</div></div><div><h3>Results</h3><div>In a meta-analysis of studies with internal controls, patients with pre-existing CS are not at a higher risk of post-traumatic SCI (odds ratio 2.73, 95% confidence interval [CI] 0.78–9.50). However, CS patients have a greater incidence of SCI (0.41, 95% CI 0.26–0.56) compared to patients without CS (0.18, 95% CI 0.14–0.22). Patients with CS were also over-represented in the population of SCI patients (0.46, 95% CI 0.27; 0.65). Using neo-Bayesian statistics, we estimate that 70 patients with CS must be treated to prevent one SCI. In patients who participate in higher-risk physical activities, the number needed to treat may be lower.</div></div><div><h3>Conclusions</h3><div>Though patients with pre-existing CS do not have higher odds of SCI in studies with internal controls, we find that patients with CS do have higher incidences of SCI and are over-represented in the population of SCI patients. In select CS patients with active lifestyles, close follow-up and consideration of various treatment options may be indicated.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123611"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898431","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":"3D Quantitative MRI: A Fast and Reliable Method for Ventricular Volumetry","authors":"Rafael T. Holmgren ,&nbsp;Anders Tisell ,&nbsp;Marcel J.B. Warntjes ,&nbsp;Charalampos Georgiopoulos","doi":"10.1016/j.wneu.2025.123661","DOIUrl":"10.1016/j.wneu.2025.123661","url":null,"abstract":"<div><h3>Purpose</h3><div>Volumetry of cerebral ventricles is a far more sensitive measure for shunt-induced reduction of ventricular size than traditional 2-dimensional (2D) measures, such as Evans index. However, available ventricle segmentation methods are time-consuming, resulting in limited use in clinical practice. Quantitative MRI (qMRI) obtains objective measurements of physical tissue properties, enabling automatic segmentation of white and gray matter and intracranial cerebrospinal fluid. The aim of this study was to evaluate the reliability and processing time of both manual and manually corrected automatic ventricular volumetry through the application of 3D qMRI.</div></div><div><h3>Methods</h3><div>An independent examiner performed manual ventricular volumetry segmentations on 45 3D qMRI acquisitions (15 healthy individuals, 15 idiopathic normal pressure hydrocephalus (iNPH) patients, 15 shunted iNPH patients) twice. Another independent examiner manually segmented 15 of these acquisitions once. An automatic ventricle segmentation algorithm generated a third set of ventricular segmentations for all 45 data sets. The automatic segmentations were then corrected by both examiners to obtain a fourth set of data. All segmentations were assessed for intra- and interobserver reliability.</div></div><div><h3>Results</h3><div>Intra- and interobserver reliability for all segmentations, manual, corrected, and automatic, was excellent (intra-class correlation coefficient 1.000, 1.000 and 0.999 respectively). Ventricular volumes were on average 42 ± 18 mL (mean ± SD) in healthy individuals, 140 ± 34 mL in iNPH patients, and 113 ± 35 mL in shunted iNPH patients.</div></div><div><h3>Conclusions</h3><div>3D qMRI is a reliable and time-efficient method to obtain relevant volumetric measures of intracranial cerebrospinal fluid spaces for both clinical and research purposes. The corrected automatic segmentations provide a feasible time expenditure for clinicians caring for patients with iNPH.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"195 ","pages":"Article 123661"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955913","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":"Safety Profile of Preoperative Meningioma Embolization: A Meta-Analysis Comparing Embolic Agents and Carotid Systems Embolized.","authors":"Hussain Alkhars, Nanami L Miyazaki, Malik Obeidallah, Arhum Naeem, Brij Kathuria, Peter Harris, Dimitri Sigounas","doi":"10.1016/j.wneu.2025.123733","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123733","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123733"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256720","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 Global Bibliometric Study of Spinal Arachnoiditis: Research Trends and Future Directions","authors":"Tong Li ,&nbsp;Yiran Wang","doi":"10.1016/j.wneu.2024.123587","DOIUrl":"10.1016/j.wneu.2024.123587","url":null,"abstract":"<div><h3>Background</h3><div>Spinal arachnoiditis (SA) involves chronic inflammation of the spinal arachnoid membrane, often due to surgery, trauma, infections, or autoimmune issues. It leads to ongoing pain and sensory disturbances in the back and lower limbs, along with possible bladder and bowel issues. Treatments focus on symptom relief and improving life quality. Despite growing research interest, a comprehensive analysis of SA’s research trends is missing. This study uses bibliometric analysis to explore SA research trends, offering guidance for future research directions.</div></div><div><h3>Methods</h3><div>The study analyzed SA-related literature from the Web of Science Core Collection database between 2011 and 2024. It used bibliometric tools like VOSviewer and CiteSpace to assess publication trends, key contributors, influential journals, and keyword relationships, as well as citation patterns.</div></div><div><h3>Results</h3><div>The study found an increasing trend in SA-related publications. The United States leads in contributions, and the University of Toronto in Canada and King George's Medical University in India are among the top contributing institutions. The research involves 1152 authors, notably Marcus A. Stoodley. It covers fields like neurosurgery, neurology, psychiatry, and anesthesiology. Keywords highlight focal points in SA’s etiology, pathogenesis, diagnosis, and treatment. Citations identify influential papers and cutting-edge research.</div></div><div><h3>Conclusions</h3><div>This study provides the first extensive bibliometric overview of SA research, examining trends, hotspots, and future paths. It covers 7 key areas: from fundamental and pathogenesis research to personalized medicine and public education, reflecting a shift toward clinical applications and social strategies. The goal is to enhance understanding and treatment of SA.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123587"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877713","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":"Stereotactic Radiosurgery for Choriocarcinoma Brain Metastases: Illustrative Case Presentation and Systematic Review","authors":"Amirhossein Akhavan-Sigari,&nbsp;Yusuke S. Hori,&nbsp;Paul M. Harary,&nbsp;Amit RL. Persad,&nbsp;Rodas Kassu,&nbsp;Armine Tayag,&nbsp;Louisa Ustrzynski,&nbsp;Sara C. Emrich,&nbsp;David J. Park,&nbsp;Steven D. Chang","doi":"10.1016/j.wneu.2024.10.116","DOIUrl":"10.1016/j.wneu.2024.10.116","url":null,"abstract":"<div><h3>Background</h3><div>Choriocarcinoma (CC) is a rare and aggressive form of germ cell tumor. There is limited evidence describing clinical outcomes in patients with primary CC and brain metastases (BM). Only a few single case reports have documented the use of stereotactic radiosurgery (SRS) for CC BM.</div></div><div><h3>Methods</h3><div>We retrospectively assessed patients who were treated with SRS for pure CC BM from 1998 to 2024. Lesion follow-up sizes and local tumor control status were evaluated after SRS treatment using response evaluation criteria in solid tumors criteria. A comprehensive literature search was performed for CC BM in accordance with PRISMA guidelines.</div></div><div><h3>Results</h3><div>In our series, 3 patients with 7 CC BM underwent SRS. Two were male with testicular CC and one was female with gestational CC. The median diameter of the lesions was 8 mm, with a median volume of 0.14 cm³ at treatment. Magnetic resonance imaging at 3 and 6 months showed reductions in median diameters to 6 mm and 4 mm, respectively. At the last follow-up visits, one lesion had local progression at 15 months after SRS and 1 lesion had sustained complete response. The systematic review yielded 249 articles. After screening, 18 reports were identified for CC BM. Among these reports, only 3 single case reports document outcomes of SRS for CC BM.</div></div><div><h3>Conclusions</h3><div>SRS is a feasible and viable approach for CC BM, particularly in cases where immediate surgical management is not necessary. This is the largest report to date evaluating the outcome of CC BM treated with SRS.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123387"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569738","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":"Preoperative Multifidus and Psoas Major Muscle Quality and Patient-Reported Outcomes After Anterolateral Lumbar Interbody Fusion: Predictors for Preoperative Disability and Back Pain Improvement","authors":"Juan P. Giraldo ,&nbsp;Anna G.U. Sawa ,&nbsp;Gerardo Gomez-Castro ,&nbsp;James J. Zhou ,&nbsp;Nima Alan ,&nbsp;S. Harrison Farber ,&nbsp;Lea M. Alhilali ,&nbsp;Pablo Sanchez-Quinones ,&nbsp;Luke K. O'Neill ,&nbsp;Brian P. Kelly ,&nbsp;Jay D. Turner ,&nbsp;Juan S. Uribe","doi":"10.1016/j.wneu.2024.10.143","DOIUrl":"10.1016/j.wneu.2024.10.143","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate associations between preoperative lumbar multifidus muscle (LMM) and psoas major muscle qualities and preoperative and postoperative patient-reported outcomes (PROs) after anterolateral lumbar interbody fusion (A-LLIF).</div></div><div><h3>Methods</h3><div>A retrospective review was conducted of patients with A-LLIF between L1 and S1 during 2017–2022 at a single institution who had at least approximately 1 year of follow-up and preoperative magnetic resonance imaging available. Preoperative magnetic resonance imaging was analyzed using 2 image analysis platforms (AMBRA and ImageJ). Parameters studied included cross-sectional area (CSA) and fat infiltration indices. Pearson correlation and multiple linear regression analyses were used to study relationships between muscle quality and preoperative and postoperative PROs. Subanalyses were performed for LMM CSA percentiles and stratification of previous surgery.</div></div><div><h3>Results</h3><div>One hundred patients met the inclusion criteria (mean [standard deviation] age, 65.3 [11.0] years; 57% women, 43% men) during a mean (standard deviation) follow-up period of 1.29 (0.20) years. In total, 207 surgical levels were analyzed. Smaller LMM CSA was significantly associated with greater preoperative disability and preoperative back pain (<em>P</em> &lt; 0.04 [ImageJ]). There were no statistically significant confounding factors. Patients with greater LMM CSA and previous lumbar procedures (n = 42) had more improvement in visual analog scale for lower back pain delta scores (<em>P</em> = 0.02 [ImageJ]; <em>P</em> = 0.04 [AMBRA]). Neither LMM fat infiltration indices nor psoas major muscle morphology influenced PROs.</div></div><div><h3>Conclusions</h3><div>Significant associations were found between LMM CSA and preoperative disability and back pain. Compared to A-LLIF patients with larger LMM (CSA &gt;12 cm²), those with LMM CSA &lt;5 cm² had significantly greater preoperative disability and back pain.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123414"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629116","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":"Surgical Management of Symptomatic Recurrent/Progressive Craniopharyngioma: Is There a Gold-Standard Approach?","authors":"Onur Ozgural ,&nbsp;Eyup Bayatli ,&nbsp;Halit Anil Eray ,&nbsp;Omer Mert Ozpiskin ,&nbsp;Suha Beton ,&nbsp;Gokmen Kahilogullari ,&nbsp;Mustafa Agahan Unlu","doi":"10.1016/j.wneu.2024.10.134","DOIUrl":"10.1016/j.wneu.2024.10.134","url":null,"abstract":"<div><h3>Background</h3><div>The standard treatment for craniopharyngiomas (CPs) involves either initial gross total resection or subtotal resection with adjuvant radiotherapy. However, there is no consensus regarding the management of recurrent cases. We reviewed a series of patients with CP to evaluate the characteristics of patients with recurrent/progressing CP.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 31 patients with biopsy-proven recurrent/progressed CP who were initially operated on at our clinic from 2015 to 2023. Demographic and clinical data, including age, sex, tumor localization, lesion size and features, radiologic findings, and endocrine, neurologic, and ophthalmologic issues, were compared between those with and without recurrence.</div></div><div><h3>Results</h3><div>Fifteen out of 31 patients (48.4%) underwent transnasal/transsphenoidal endoscopic surgery; the remaining 16 underwent microscopic transcranial or neuroendoscopic surgery. After treatment, recurrence, and events (any medical condition related to the patient's current condition other than recurrence) were observed in 48.4% and 32.3% of the cases, respectively. There were no statistically significant disparities between patients with and without recurrence in terms of age, tumor dimensions, tumor localization, gender distribution, surgical modality, or the presence of calcifications or hydrocephalus (<em>P</em> &gt; 0.05). The highest and lowest overall survival was 25 years and 6 months, respectively.</div></div><div><h3>Conclusions</h3><div>The management of recurrent CP is too complicated to fit into a standard treatment algorithm. Therefore, surgical treatment for these patients should be individualized and planned according to patient symptoms and radiologic findings, which is presumably a more versatile, efficient, and safe approach for recurrent CPs.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123405"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629118","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":"Does Bone Preservation at the Anterior Edge of the Vertebral Body Affect the Subsidence of Zero-Profile Cages After Anterior Cervical Discectomy and Fusion?","authors":"Bin Zhang ,&nbsp;Qingquan Kong ,&nbsp;Pin Feng ,&nbsp;Junlin Liu ,&nbsp;Junsong Ma","doi":"10.1016/j.wneu.2024.11.057","DOIUrl":"10.1016/j.wneu.2024.11.057","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to investigate whether the preservation of the anterior edge of the vertebral body affects the cage subsidence and clinical outcomes after anterior cervical discectomy and fusion (ACDF) using zero-profile cages.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 86 patients who underwent 1–3 levels of ACDF using zero-profile cages between December 2017 and June 2023. According to whether the anterior edge was protected, the patients were divided into an intact group and a defect group. Cage subsidence was defined as a ≥2 mm decrease in vertebral height at follow-up compared with measurement on postoperative day 2. The patients' radiological parameters and clinical outcomes were also analyzed.</div></div><div><h3>Results</h3><div>The subsidence rate was 17.02% (8/47) in the intact group and 41.03% (16/39) in the defect group (<em>P</em> = 0.014). At the last follow-up, all patients in both groups achieved complete intervertebral fusion. The cervical lordosis of the 2 groups was effectively restored after surgery, and the visual analog scale and Neck Disability Indexscores of the 2 groups were significantly improved. Multivariate logistic regression analysis showed that the protective factor for zero-profile cage subsidence was bone protection at the anterior edge of the vertebral body (odds ratio = 0.270; 95% confidence interval = 0.091–0.804), and the risk factor was related to the height of the preoperative surgical segment (odds ratio = 2.285; 95% confidence interval = 1.395–3.743).</div></div><div><h3>Conclusions</h3><div>For patients who undergo ACDF with zero-profile cages, especially those with a higher surgical segment, bone protection at the anterior edge of the vertebral body can effectively reduce the risk of zero-profile cage subsidence, but there is no difference in the final clinical effect.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123474"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693605","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":"Prognostic Value of Apparent Diffusion Coefficient for Mechanical Thrombectomy in Patients with Acute Posterior Ischemic Stroke","authors":"Xinze Guo ,&nbsp;Xiaopan Cao ,&nbsp;Qian Sun ,&nbsp;Honghao Li ,&nbsp;Yang Zhang ,&nbsp;Yi Sui","doi":"10.1016/j.wneu.2024.11.041","DOIUrl":"10.1016/j.wneu.2024.11.041","url":null,"abstract":"<div><h3>Background</h3><div>This study investigates the prognostic value of the apparent diffusion coefficient (ADC) in magnetic resonance imaging for patients with acute posterior circulation stroke (PCS) undergoing endovascular therapy (EVT).</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted of patients with acute PCS from January 2017 to December 2021, confirmed by diffusion-weighted imaging (DWI)-ADC within 24 hours of onset. Patients were categorized based on their 3-month modified Rankin Scale score after EVT. Data on the National Institutes of Health Stroke Scale at admission, ADC value, and 3-month modified Rankin Scale score were collected. Multivariable logistic regression analyzed the impact of various factors on ADC values. The receiver operating characteristic curve assessed predictive indices.</div></div><div><h3>Results</h3><div>Among 94 patients, 47 had a good prognosis and 47 had a poor prognosis. Univariate analysis showed that factors significantly associated with a good prognosis included lower National Institutes of Health Stroke Scale at admission, higher ADC values, smaller infarct areas, unilateral infarction, basilar artery occlusion, lower pons-midbrain-thalamus scores, intravenous thrombolysis, intra-arterial thrombolysis, and fewer perioperative complications (<em>P</em> &lt; 0.05). Multivariable logistic regression identified high ADC values (<em>P</em> = 0.002) and unilateral infarction (<em>P</em> = 0.017) as independent predictive factors for prognosis. An ADC value &gt;549 × 10^–6 mm²/second was associated with a higher rate of good prognosis. Combining ADC values with unilateral infarction resulted in the highest area under the curve and Youden Index of 0.766, with sensitivity and specificity of 89.36% and 87.23%, respectively (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>High ADC values and unilateral infarction are independent predictive factors for the prognosis of patients with PCS after EVT. Combining these factors provides the highest predictive accuracy, aiding in clinical decision making for PCS treatment.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123458"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693636","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}