World neurosurgery最新文献

{"title":"Integrating Single-Cell Sequencing and Transcriptome Analysis to Investigate the Role of Ferroptosis in Ischemic Stroke and the Molecular Mechanisms of Immune Checkpoints.","authors":"Weidong Han, Xiaonan Bian, Haiyang Fu, Min Liu, Hongliang Wang, Haimei Liu","doi":"10.1016/j.wneu.2025.123908","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123908","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis of ischemic stroke remains challenging. Given the crucial role of ferroptosis in ischemic stroke, this study aims to identify key genes associated with ferroptosis in ischemic stroke, providing insights into its molecular mechanisms and potential biomarkers for early detection.</p><p><strong>Method: </strong>The single-cell transcriptome dataset GSE247474 from the Gene Expression Omnibus.Ferroptosis scores in astrocytes were calculated using the WP_FERROPTOSIS gene set, and differential analysis was conducted to compare ferroptosis activity between the disease and control groups. Key ferroptosis-related genes were identified using Lasso regression and support vector machine algorithms, and their diagnostic potential was assessed through ROC curve analysis. Additionally, we performed immune infiltration analysis and transcription factor network prediction. Pseudotime analysis was used to explore the differentiation trajectories of astrocytes and T cell subsets.</p><p><strong>Results: </strong>Astrocytes in the disease group showed significantly higher ferroptosis scores than those in the control group. Using machine learning algorithms, we identified three key ferroptosis-related genes-SLC3A2 (solute carrier family 3 member 2), FDFT1 (squalene synthase), and BACH1 (BTB and CNC homology 1)-and validated their diagnostic value (AUC > 0.9). Immune infiltration analysis revealed that SLC3A2 and BACH1 expression levels were positively correlated with CD4⁺ follicular T cells and negatively correlated with CD4⁺ memory T cells. FDFT1 showed positive correlations with both mast cells and CD4⁺ memory T cells. Pseudotime analysis demonstrated dynamic changes in key gene expression along the differentiation trajectories of astrocytes and T cells.</p><p><strong>Conclusion: </strong>SLC3A2, FDFT1, and BACH1 are potential molecular markers for IS diagnosis.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123908"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674607","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":"Ultrasound-guided EVD insertion after decompressive craniectomy.","authors":"Alick P Wang, Ryan Sandarage, Anne-Sophie Parent, Aneesh Karir, Husain Shakil, Brian J Drake, John Sinclair","doi":"10.1016/j.wneu.2025.123915","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123915","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound-guidance offers real-time visualization of patient-specific anatomy during external ventricular drain insertion. A craniectomy defect provides a sonolucent window, enabling the use of a large, low-frequency probe with deep penetration and wide field-of-view. While specialized burr-hole probes exist, use of a curvilinear probe through a craniectomy defect for bedside ventricular drain placement has not been previously described.</p><p><strong>Methods: </strong>Using a curvilinear probe, we performed ultrasound-guided bedside insertion of a left frontal external ventricular drain through a hemicraniectomy flap.</p><p><strong>Results: </strong>Bedside ultrasound enabled visualization of the entire supratentorial ventricular system. Drain insertion was successfully performed, with immediate sonographic visualization of the catheter tip in the left frontal horn. Placement was confirmed with a computed tomography scan.</p><p><strong>Conclusion: </strong>Bedside ultrasound-guided external ventricular drain insertion in post-craniectomy patients can be a valuable method for safely accessing the ventricle in the face of abnormal or distorted anatomy.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123915"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673658","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":"Utilization of a Telemetric Prechamber in the Management of Patients with Normal Pressure Hydrocephalus.","authors":"Miroslav Cihlo, Pavel Trávníček, Svatopluk Řehák, Lucie Kukrálová, Karel Zadrobílek, Jan Pospíšil, Pavel Dostál, Vlasta Dostálová","doi":"10.1016/j.wneu.2025.123914","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123914","url":null,"abstract":"<p><strong>Background/objectives: </strong>Normal pressure hydrocephalus (NPH) is a preventable and treatable cause of dementia. A telemetric prechamber allows individually tailored ventriculoperitoneal (VP) shunt valve adjustments in patients treated with the shunting procedure.</p><p><strong>Methods: </strong>In this pilot, prospective randomized trial, thirty-three adult patients were divided into Group A (with an implanted telemetric prechamber) and Group B (without an implanted telemetric prechamber). The overall condition, Mini-Mental-State-Examination (MMSE) score, and gait test were evaluated 3, 6, 9, and 12 months after surgery. Additionally, the total number of VP shunt valve adjustments and their impact on the patient's condition (assessed by the INPH scale) were assessed.</p><p><strong>Results: </strong>There were no differences in the proportion of patients showing improved gait, cognitive functions, or incontinence. Patients with a telemetric prechamber underwent significantly more valve adjustments (1.6 ± 1.1 vs. 0.8 ± 0.6, p = 0.037). Also, a greater difference (reduction) in the shunt initial and final valve setting was observed in the prechamber group (30.71 ± 24.95 vs 15.26 ± 13.07 mm H₂O, p = 0.049).</p><p><strong>Conclusions: </strong>A telemetric prechamber allowed more valve adjustments during the follow-up period and a greater difference (reduction) between the initial (perioperative) and final valve pressure settings. However, there was no difference in functional parameters between the groups at any time point of the study.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123914"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674081","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":"Spinal Cord Injury in the 21st Century Part I: A New Demographic.","authors":"Angelica Alvarez Reyes, Sruti Bandlamuri, Travis M Dumont, Venkat Ganapathy, R John Hurlbert","doi":"10.1016/j.wneu.2025.123917","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123917","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123917"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674623","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":"Predictive Factors for Postoperative Cerebrospinal Fluid Drainage in Neurosurgical Management of Intracranial Aneurysms.","authors":"Xiaohong Guo","doi":"10.1016/j.wneu.2025.123913","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123913","url":null,"abstract":"<p><strong>Background: </strong>Management of intracranial aneurysms often requires complex neurosurgical interventions, with some patients necessitating postoperative cerebrospinal fluid (CSF) drainage. Identifying predictive factors for CSF drainage can enhance patient outcomes through targeted interventions and improved perioperative care.</p><p><strong>Methods: </strong>In this retrospective study, 151 patients who underwent surgical treatment for intracranial aneurysms were included. Demographic data, clinical presentation (Hunt-Hess grade, modified Fisher score), surgical details (operative time, intraoperative complications), and postoperative outcomes were reviewed. Both univariate and multivariable logistic regressions were conducted to identify predictors of postoperative CSF drainage. A subgroup analysis compared patients with anterior versus posterior circulation aneurysms.</p><p><strong>Results: </strong>Overall, 67 patients required postoperative CSF drainage. On multivariable analysis, age ≥60, high Hunt-Hess grade, operative time >5 hours, and intraoperative aneurysm rupture significantly increased the odds of drainage (P<0.05). Subgroup analysis revealed that these risk factors conferred an even higher likelihood of CSF drainage in posterior circulation aneurysms. Gender and modified Fisher score did not show significant associations with drainage.</p><p><strong>Conclusions: </strong>Advanced age, high Hunt-Hess grade, prolonged operative time, and intraoperative rupture predict postoperative CSF drainage in patients with intracranial aneurysms. Incorporating both global and subgroup-based risk assessments can help refine perioperative strategies to reduce complications and improve patient outcomes.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123913"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674617","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":"Comparison of unilateral and bilateral robot-assisted percutaneous kyphoplasty in treating Osteoporotic vertebral compression fracture.","authors":"Ruoyu Yang, Zhiwei Huang, Shanzhong Shao, Jinrun Liu, Shuyang Xia, Wei Li, Yinshun Zhang, Jun Qian, Fulong Dong, Cailiang Shen, Hui Tao","doi":"10.1016/j.wneu.2025.123911","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123911","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy and safety of unilateral and bilateral robot-assisted percutaneous kyphoplasty (RAPKP) in treating thoracolumbar osteoporotic vertebral compression fractures (OVCF).</p><p><strong>Methodology: </strong>Our study retrospectively analyzed 78 patients (unilateral group: 48, bilateral group: 30) with OVCF treated with RAPKP from January 2020 to July 2022. The operation time, X-ray exposure time, bone cement volume, postoperative bone cement distribution, preoperative and postoperative pain visual Analogue Scale scores (VAS), Oswestry Dysfunction Index (ODI), Cobb angle, and vertebral height, bone cement leakage, Adjacent Vertebral Fracture (AVF) and Postoperative CT in both groups were recorded.</p><p><strong>Results: </strong>All patients were successfully treated with RAPKP and followed up for (19.90±5.38) months. Our results showed that the VAS core, ODI, vertebral height, and Cobb angle at postoperative follow-up were significantly improved in both groups compared to the preoperative period (P <0.05). The operation time in the bilateral group (46.20±6.89) minutes was not statistically different from the unilateral group (42.54±10.16) minutes (P >0.05), while the volume of bone cement injected was significantly more in the bilateral group (5.93±1.81) mL than in the unilateral group (4.73±0.51) mL (P <0.05). In addition, the distribution of bone cement in the bilateral group was significantly better than in the unilateral group (P <0.05). X-ray exposure dose were no significant differences in the two groups (P>0.05). Bone cement leaked 9 cases (18.75%) in the unilateral group and 6 cases (20.00%) in the bilateral group (P >0.05). No neurovascular injury or infection occurred. Adjacent Vertebral Fracture 8 cases (16.67%) in the unilateral group and 4 cases (13.33%) in the bilateral group (P >0.05). Postoperative CT ratios of adjacent vertebrae(Operated vertebra/Upper adjacent vertebra: unilateral:10.65±2.7. bilateral:11.32±3.1; Operated vertebra/Lower adjacent vertebra: unilateral:11.67±3.0. bilateral:12.48±2.9)(P>0.05).</p><p><strong>Conclusions: </strong>Unilateral or bilateral RAPKP improves patients' VAS, ODI, sagittal index, and Cobb angle. Unilateral RAPKP possesses the advantage of fewer puncture injuries. Still, bilateral RAPKP has better postoperative cement distribution, and we believe that bilateral RAPKP has a better long-term prognosis, so we recommend bilateral RAPKP.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123911"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674606","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 “Risk Factors of Pulmonary Embolism in Long-Segment Posterior Thoracolumbar Fusion: Scoring System for Prophylactic Inferior Vena Cava Filter Placement”","authors":"Jonah Heidel ,&nbsp;H. Francis Farhadi ,&nbsp;Ryan Hofler ,&nbsp;R. Carter Cassidy ,&nbsp;Rouzbeh Motiei-Langroudi","doi":"10.1016/j.wneu.2025.123803","DOIUrl":"10.1016/j.wneu.2025.123803","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"196 ","pages":"Article 123803"},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459665","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":"An institutional experience of genomic analysis and methylation profiling of thoracic spinal meningiomas.","authors":"Prabhath Mannam, Jimin Shin, Nathan K Leclair, Patrick Halloran, Arijit Chakraborty, Qian Wu, Bruce Chozick, Hilary Onyiuke, Ian T McNeill, Ketan Bulsara","doi":"10.1016/j.wneu.2025.123919","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123919","url":null,"abstract":"<p><strong>Objective: </strong>Spinal meningiomas are less frequently diagnosed than intracranial meningiomas. While recent advancements in tumor biology have identified key driver genes in spinal meningiomas through targeted sequencing, few studies have yet to characterize the genomic profiles of these tumors together with their methylation signatures. In this study, we present our institutional experience of a combined genomic and epigenetic analysis of 8 thoracic spinal meningiomas.</p><p><strong>Methods: </strong>We performed targeted genomic sequencing and DNA methylation profiling on 8 primary spinal meningiomas. We further collected relevant clinical information and tumor imaging through retrospective chart review.</p><p><strong>Results: </strong>All tumor samples were characterized as WHO Grade I intradural extramedullary meningiomas localized to the thoracic spine. Targeted genomic sequencing revealed mutations in meningioma-driver genes NF2 (62.5%), AKT1 (12.5%), and SMARCB1 (25%), in addition to several mutations in genes involved in various signaling pathways. DNA methylation profiling classified 6 samples with a benign signature and 2 with an intermediate signature. All patients were treated through surgical excision of the tumor, and clinical follow-up and imaging demonstrated no tumor recurrence or significant residual symptoms.</p><p><strong>Conclusion: </strong>Our data, in concordance with prior studies, demonstrates a diverse genomic and epigenetic landscape of thoracic spinal meningiomas despite a seemingly homogenous clinical presentation. Understanding and identifying the molecular underpinnings can lead to a more precise and clinically significant classification of spinal meningiomas, which can further contribute to the development of targeted and improved therapeutic strategies.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123919"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671073","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":"Utilising Natural Language Processing to Identify Brain Tumour Patients for Clinical Trials: Development and Initial Evaluation.","authors":"James Booker, Jack Penn, Kawsar Noor, Richard J B Dobson, Naomi Fersht, Jonathan P Funnell, Ciaran S Hill, Danyal Z Khan, Nicola Newall, Tom Searle, Siddharth Sinha, Lewis Thorne, Simon C Williams, Michael Kosmin, Hani J Marcus","doi":"10.1016/j.wneu.2025.123907","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123907","url":null,"abstract":"<p><strong>Background: </strong>Identifying patients eligible for clinical trials through eligibility screening is time and resource intensive. Natural Language Processing (NLP) models may enhance clinical trial screening by extracting data from Electronic Health Records (EHR).</p><p><strong>Objective: </strong>We aimed to determine whether an NLP model can extract brain tumor diagnoses from outpatient clinic letters and link this with ongoing clinical trials.</p><p><strong>Methods: </strong>This retrospective cohort study reviewed outpatient neuro-oncology clinic letters, to detect brain tumor diagnoses. We used an NLP model to perform named-entity-recognition + linking algorithm that identified medical concepts in free text and linked them to a Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) ontology, which we used to search a clinical trials database. Human annotators reviewed the accuracy of the concepts extracted and the relevance of recommended clinical trials. Search results were shown on a notification dashboard accessible by clinicians and patients on the EHR. We report the model's performance using precision, recall and F1 scores.</p><p><strong>Results: </strong>The model recognized 399 concepts across 196 letters with macro-precision=0.994, macro-recall=0.964 and macro-F1=0.977. Linking the model results with a clinical trials database identified 1,417 ongoing clinical trials, of these 755 were highly relevant to the individual patient, who met the eligibility criteria for trial recruitment.</p><p><strong>Conclusions: </strong>NLP can be used effectively to extract brain tumor diagnoses from free-text EHR records with minimal additional training. The extracted concepts can then be linked to ongoing clinical trials. While further analysis is required to assess the impact on clinical outcomes, these findings suggest a potential application for integrating NLP algorithms into clinical care.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123907"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671116","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":"Spinal Cord Injury in the 21^st Century Part II: Deficiencies in Data.","authors":"Angelica Alvarez Reyes, Sruti Bandlamuri, Travis M Dumont, R John Hurlbert","doi":"10.1016/j.wneu.2025.123918","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123918","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123918"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671166","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}