World neurosurgery最新文献

{"title":"High False-Negative Rate of Intraoperative Neurophysiologic Monitoring in Blood Blister-Like Aneurysm Surgery: Insights from a Retrospective Case Series.","authors":"Yue Hu, Lu Ma, Yixuan Zong, Xiaofan Pang, Yuan Fang","doi":"10.1016/j.wneu.2024.11.025","DOIUrl":"10.1016/j.wneu.2024.11.025","url":null,"abstract":"<p><strong>Objective: </strong>Surgical management of blood blister-like aneurysm (BBA) is challenging and contentious because of high morbidity and mortality. Intraoperative neurophysiologic monitoring (IONM) is a well-established tool in intracranial aneurysm surgery, although its application in BBA surgery lacks reports. This study retrospectively analyzes the usefulness of IONM in BBA surgery between 2018 and 2023.</p><p><strong>Methods: </strong>We used somatosensory evoked potentials (SSEPs) and transcranial motor evoked potentials to monitor ischemia during operations. Neurologic outcomes were mainly assessed through daily assessment with the Glasgow Coma Scale, computed tomography within 24 hours, and modified Rankin Scale at discharge.</p><p><strong>Results: </strong>Thirteen patients with ruptured BBAs (9 Tibetan, 4 Han; 10 women, 3 men; mean age, 55 years) underwent surgical procedures involving 10 clippings (6 direct, 2 wrapping-assisted, and 2 balloon-assisted) and 3 trappings. There were 8 clipping procedures applied for temporary arterial occlusion ranging from 5 to 125 minutes. Irreversible change of SSEPs/transcranial motor evoked potential (tcMEPs) occurred in 3 clippings; all these patients developed postoperative neurologic deficits. Reversible signal change of SSEPs occurred in 3 clippings, with 1 neurologic deficit. As for 3 trapping surgeries, all showed significant deficits regardless of reversible signal change or unchanged signals in IONM.</p><p><strong>Conclusions: </strong>Our results show that IONM has low sensitivity (37.5%) and high specificity (100%) in detecting ischemic events during BBA surgery. The high rate of false-negative results in BBA-IONM suggests that its predictive value is limited particularly in complex maneuvers such as trapping and advanced vasoreconstruction, warranting cautious interpretation and further investigation of IONM modalities for BBA management.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123442"},"PeriodicalIF":1.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693664","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":"Spheno-Orbital Aneurysmal Bone Cyst in children: a report of 3 cases and literature review.","authors":"Zhendan Zhu, Wenhan Zheng, Hongxing Tang, Yuanjun Hu, Manting Li, Shuangqi Gao, Ying Guo, Huasheng Yang, Wensheng Li, Haiyong He","doi":"10.1016/j.wneu.2024.12.022","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.12.022","url":null,"abstract":"<p><strong>Background: </strong>Only 2% to 6% aneurysmal bone cyst (ABC) involve the cranial region, and even fewer show sphenoid and orbital involvement. The spheno-orbital ABC is prone misdiagnosis and can result in intraoperative bleeding and residual lesions. The study was to summarize the clinical and therapeutic characteristics of patients with spheno-orbital ABC in children.</p><p><strong>Method: </strong>We retrospectively analyzed three childhood-onset spheno-orbital ABC cases at our hospital. A literature review was conducted and the spheno-orbital ABC cases were retrieved. The characteristics of clinical manifestations, treatment outcomes, and follow-ups were analyzed.</p><p><strong>Result: </strong>All three cases involved the sphenoid and orbital bones, and had a history of surgery or biopsy before being transferred to our hospital. Two of them were terminated due to severe bleeding. The surgeries were performed through frontotemporal craniotomy, where the masses and the surrounding suspected diseased bones were removed. The pathological diagnosis was ABC. All the patient's eye symptoms improved. A review of the literature reveals that ABC typically presents as bone destruction, with some lesions containing fluid levels. Tumors that significantly enhance on contrast-enhanced MRI are often misdiagnosed. ABC is more prevalent in children. The ABC can lead to excessive intraoperative bleeding and residual lesions. Gross total resection is the treatment of choice.</p><p><strong>Conclusion: </strong>Spheno-orbital ABC should avoid transorbital approach in favor of craniotomy. It is imperative to remove as much of the affected bone as possible and to intensify subsequent monitoring. It is essential to prepare blood prior to surgery to manage potential severe bleeding.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819421","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":"Prediction Model for Unfavorable Outcome in Primary Decompressive Craniectomy for Isolated Moderate to Severe Traumatic Brain Injury in India: A Prospective Observational Study.","authors":"Kirandeep Kaur, Nidhi Bidyut Panda, Shalvi Mahajan, Narender Kaloria, Venkata Ganesh, M Karthigeyan","doi":"10.1016/j.wneu.2024.11.006","DOIUrl":"10.1016/j.wneu.2024.11.006","url":null,"abstract":"<p><strong>Objective: </strong>Traumatic brain injury (TBI) prediction models have gained significant attention in recent years because of their potential to aid in clinical decision making. Existing models, such as Corticosteroid Randomization after Significant Head Injury and International Mission for Prognosis and Analysis of Clinical Trials, are currently losing external validity and performance, probably because of their diverse inclusion criteria and changes in treatment modalities over the years. There is a lack of models that predict outcomes strictly pertaining to primary decompression after TBI. In this study, we aimed to develop an easy-to-use prediction model for predicting the risk of poor functional outcomes at 3 months after hospital discharge in adult patients who had undergone primary decompressive craniectomy for isolated moderate-to-severe TBI.</p><p><strong>Methods: </strong>We conducted a prospective observational study at our tertiary care hospital. We trained and tested multiple prognostic logistic regression models with ten-fold cross validation to choose the model with the lowest Akaike information criterion, high sensitivity, and positive predictive value (PPV). Using the final model, we generated a nomogram to predict the risk of having a Glasgow outcome scale-extended (GOSE) 1-4 at three months after hospital discharge.</p><p><strong>Results: </strong>A total of 215 patients were included in this study. Variables with an absolute standardized difference >0·25 when grouped by GOSE 1-4/5-8 at three months were included in multivariable modeling. The model of choice had an accuracy of 87·91% (95% confidence interval of 82·78%-91·95%), a sensitivity of 84·42%, specificity of 89·86%, PPV of 82·28% (72·06%-89·96%), negative predictive value of 91·18% (85·09%-95·36%), LR+ of 8·32 (5·02-13·80), and LR-of 0·17 (0·10-0·29).</p><p><strong>Conclusions: </strong>Our study provides a ready-to-use prognostic nomogram derived from prospective data that can predict the risk of having a GOSE of 1-4 at three months following primary decompressive craniectomy with high sensitivity, PPV, and low LR-.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123423"},"PeriodicalIF":1.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710382","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":"IMProve-DURA: Investigations of Molecular Patient Profiles and Anatomical Cadaveric Characteristics of the Dura Mater-A Pilot Study Protocol.","authors":"Francesca Graziano, Gianluca Scalia, Bipin Chaurasia, Giuseppe E Umana, Rosa Maria Gerardi, Gianluca Galvano, Valeria Barresi, Giada Garufi, Salvatore Marrone, Roberta Costanzo, Salvatore Cardali, Giovanni Nicoletti","doi":"10.1016/j.wneu.2024.11.074","DOIUrl":"10.1016/j.wneu.2024.11.074","url":null,"abstract":"<p><strong>Background: </strong>The dura mater, a fibrous membrane protecting the brain and spinal cord, is prone to lacerations during spinal surgery, often leading to complications such as cerebrospinal fluid (CSF) leakage. Anatomical differences in the spinal dura mater, particularly in regions under high biomechanical stress, suggest that chronic inflammatory processes may compromise its structural integrity. This pilot study investigates the molecular and anatomical characteristics of the spinal dura mater, focusing on its response to inflammation and the challenges of surgical repair.</p><p><strong>Methods: </strong>The study involves the collection of 40-60 cadaveric spinal dura mater samples and 100 preoperative blood samples from patients undergoing major spinal surgery. Histological and biomolecular analyses will assess tissue integrity, elastin, collagen content, and the expression of inflammatory biomarkers (heat shock proteins and cytokines). Multiplex assays, mass spectrometry, and Western blot techniques will analyze biomarker profiles in both dura mater and blood samples. Comparative and correlation analyses will be performed to identify common molecular patterns between cadaveric tissue and patient blood samples, with statistical tests applied to detect significant differences.</p><p><strong>Results: </strong>Preliminary power analysis justifies the sample sizes, aiming to detect moderate effect sizes (Cohen's d = 0.5) with 80% power. Histological and biomolecular results will focus on the impact of chronic inflammation on spinal dura integrity, specifically its thinning and vulnerability to laceration. Key findings will include biomarker profiles correlating with tissue damage and postsurgical complications like CSF leakage.</p><p><strong>Conclusions: </strong>This pilot study aims to enhance our understanding of the inflammatory processes affecting the dura mater and their role in frequent lacerations during spinal surgery. Findings are expected to guide future clinical practices in dura repair strategies, potentially improving surgical outcomes and reducing complications related to CSF leakage.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123491"},"PeriodicalIF":1.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711304","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":"Gamma Knife Radiosurgery, Central Lateral Thalamotomy, and Chronic Neuropathic Pain: A Prospective Single-Center Study With Long-Term Follow-Up.","authors":"Monica Lara-Almunia, Nuria E Martinez Moreno, Cristina V Torres Diaz, Jorge Gutierrez Sarraga, Roberto Martinez Alvarez","doi":"10.1016/j.wneu.2024.11.028","DOIUrl":"10.1016/j.wneu.2024.11.028","url":null,"abstract":"<p><strong>Objective: </strong>We present our experience in using Gamma knife surgery (GKS) on the posterior part of the central lateral nucleus (CLp) for refractory neuropathic pain, examining its long-term efficacy and safety in patients with one of the longest pretreatment pain duration in the literature. Furthermore, we examined certain factors that might influence the outcome of this technique.</p><p><strong>Methods: </strong>We conducted a prospective study involving 9 patients who underwent GKS between 2020 and 2023. We employed Icon model GKS and Vantage stereotactic frame. The planning process encompassed a dual localization system. The assessments involved the use of both the visual analog and Barrow Neurological Institute (BNI) scales (6 months, 12 months, and then annually). Data analysis was developed using SPSS 25.</p><p><strong>Results: </strong>Our series consisted of 6 women and 3 men with an average age of 52.3 ± 17.4 years. A maximum dose of 130 Gy was administered. The mid-term postoperative period (1 year) showed that 8 patients (88.9%) experienced significant pain relief (visual analog scale P = 0.011; BNI IIIa). The median follow-up time was 24.8 ± 8.2. At the last assessment, all patients maintained their improvement (visual analog scale P = 0.018; BNI IIIa). We found no association between patient age (P = 0.329), duration of pretreatment pain (P = 0.469), multiple previous surgical treatments (P = 0.750) or the pain's etiology (P = 0.25), and poorer outcomes post CLp thalamotomy. None of the cases has experienced a recurrence so far. Both morbidity and mortality were 0%.</p><p><strong>Conclusions: </strong>Our findings suggest that bilateral ablation of the CLp using GKS is both effective and safe for treating drug-resistant neuropathic pain. This simple, accurate, and noninvasive surgical technique effectively achieves pain control across various localized areas and sustains a lasting clinical response, even in patients with multiple previous surgical interventions or prolonged pain duration.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123445"},"PeriodicalIF":1.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695860","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":"Optimized Bifrontal Craniotomy: Reducing Risks and Boosting Surgical Results.","authors":"Norito Fukuda, Hideyuki Yoshioka, Masakazu Ogiwara, Koji Hashimoto, Takuma Wakai, Mitsuto Hanihara, Toru Tateoka, Ryo Horiuchi, Hiroyuki Kinouchi","doi":"10.1016/j.wneu.2024.12.020","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.12.020","url":null,"abstract":"<p><strong>Background: </strong>Bifrontal craniotomy is one of the most common surgical approaches for dealing with anterior skull base lesions. However, this procedure occasionally present complications like anosmia, cerebrospinal fluid (CSF) leakage, infection, and cosmetic problems. Although previous reports suggested various solutions, there remains a need to further refine the procedure to ensure better outcomes. In this paper, we introduce our revised method and examine the clinical results.</p><p><strong>Method: </strong>Our protocol pays attention to preventing avulsion of the olfactory bulb by brain movement, such as avoiding preoperative administration of hyperosmotic diuretic solution, mobilizing the olfactory tract from the frontal lobe base, and fixing the olfactory bulb to the cribriform plate. On opening, the frontal sinus mucosa is separated from the bone components and pushed into the frontonasal duct. After removing the inner table, the frontal sinus is completely covered by the pericranial flap. To prevent cosmetic problems, a Gigli wire saw is used to cut the supraorbital edge to minimize the bone defect. Surgical complications in 38 patients who underwent bifrontal craniotomy using these methods in our institute from 2005 to 2020 were investigated.</p><p><strong>Results: </strong>Only one case (2.6%) experienced postoperative anosmia. There were no cases of CSF leakage, infections, or cosmetic problems.</p><p><strong>Conclusion: </strong>Through diligent practices and attention to minute details, such as gentle manipulations to preserve the olfactory nerve, reliable procedures for frontal sinus closure, and maximum attention to esthetic results, surgical techniques can be refined and developed to the level of highly skilled expertise with low rate of complications.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814399","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":"Complications of Middle Meningeal Artery Embolization - A Systematic Review and Meta-Analysis.","authors":"Mahnoor Shafi, Shrikar R Badikol, Jakob V E Gerstl, Noah L A Nawabi, Madhav Sukumaran, Ari D Kappel, Abdullah H Feroze, Timothy R Smith, Rania A Mekary, Mohammad Ali Aziz-Sultan","doi":"10.1016/j.wneu.2024.11.124","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.11.124","url":null,"abstract":"<p><strong>Background: </strong>Middle meningeal artery embolization (MMAE) is an established treatment option for chronic subdural hematoma (cSDH). The aim of this systematic review and meta-analysis was to establish estimates of the pooled incidence for complications following MMAE.</p><p><strong>Methods: </strong>PubMed, Embase and Cochrane were searched for studies reporting complications following MMAE through January 2023. A random effects model was utilized to calculate the pooled incidence of complications stratified based on whether studies excluded patients with comorbidities. PRISMA checklist was followed.</p><p><strong>Results: </strong>A final 34 studies containing 921 patients undergoing MMAE were included that reported 35 complications. Neurological complications were reported in seven studies with an overall pooled incidence of 3.8%(95%CI: 2.6%-5.5%). Across these studies, there was a pooled incidence of 4.9% (95%CI: 2.9%-8.0%), 3.0% (95%CI: 1.7%-5.3%), and 2.1% (95%CI: 0.4%-9.7%) in studies that did not exclude, did not mention, or excluded patients with comorbidities respectively. Similarly, seven studies reported cardiovascular complications with an overall pooled incidence of 3.6%(95%CI: 2.4%-5.4%), four studies reported infectious complications with an overall pooled incidence of 2.9%(95%CI: 1.9%4.5%), and three studies reported for miscellaneous complications with an overall pooled incidence of 3.1%(95%CI: 2.0%-4.8%). Further subgroup analysis revealed the pooled incidence of cardiovascular complications was3.2%(95%CI: 1.7%-6.1%) in studies that did not exclude patients with comorbidities, 4.1%(95%CI: 2.3%-7.1% in studies that did not specify the exclusion of such patients, and 1.8%(95CI: 0.2%-11.5% in studies that excluded these patients. Similarly, the incidence of infectious complications was 3.3%(95%CI: 1.7%-6.2%), 2.7%(95%CI: 1.5%-5.0%), and 1.8%(95%CI: 0.2%-11.5%) across these groups. respectively. Miscellaneous complications were reported at 4.0%(95%CI: 2.2%-7.2%), 2.3%(95%CI: 1.1%-4.6%), and 3.1%(95%CI: 0.9%-10.1%), respectively.</p><p><strong>Conclusions: </strong>The published literature suggests that MMAE is a generally well-tolerated procedure with a low risk of significant complications.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814442","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":"Surgery for Medication Refractory Epilepsy in Africa: A Review of Seizure Freedom Outcomes.","authors":"Prince Antwi, Kevin Bode Padron, Alvan-Emeka K Ukachukwu, Anthony T Fuller, Michael M Haglund","doi":"10.1016/j.wneu.2024.12.017","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.12.017","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy is a chronic condition that confers social stigma, reduced engagement in work and social activities, increased risks of comorbidities, and premature death. It is often treated with medications, but in about a third of patients, epilepsy may be refractory to medications. It is estimated that each year 211,456 new individuals across Africa meet criteria for surgically treatable epilepsy, and the current volume of surgically treatable epilepsy is 1,819,067 cases across the region. Here, we review previously published epilepsy surgery programs in Africa, noting their outcomes.</p><p><strong>Method: </strong>Eligible studies reporting seizure freedom and/or quality of life outcomes after epilepsy surgeries conducted in Africa were identified through database searches on PubMed/MEDLINE, Google Scholar, and reviewing references in previously identified publications.</p><p><strong>Results: </strong>While more than a thousand articles were retrieved in the database search, 17 full-length articles were reviewed for eligibility, and 8 articles (likely representing 7 unique patient cohorts) were ultimately included in this study. The reviewed studies demonstrated successful implementation of programs to evaluate patients with epilepsy for surgical treatment. 60-100% of patients in these cohorts achieved good seizure freedom outcomes within a year from surgery and secondarily had improved quality of life and reduced severity of depression.</p><p><strong>Conclusion: </strong>This review demonstrates that it is feasible to establish and sustain epilepsy surgery programs in Africa, with seizure freedom outcomes comparable to those reported in studies conducted in parts of the world with higher income.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814409","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":"Postoperative Time-of-Flight Magnetic Resonance Angiography Classification is a Predictor of Postoperative Recanalization of Unruptured Cerebral Aneurysms.","authors":"Shoko Fujii, Kyohei Fujita, Mariko Ishikawa, Keigo Shigeta, Yuki Aizawa, Masataka Yoshimura, Shin Hirota, Kei Ito, Yoshikazu Yoshino, Kenji Yamada, Satoru Takahashi, Hirotaka Sagawa, Yuki Kinoshita, Yusuke Kobayashi, Sakyo Hirai, Kazutaka Sumita","doi":"10.1016/j.wneu.2024.11.079","DOIUrl":"10.1016/j.wneu.2024.11.079","url":null,"abstract":"<p><strong>Background: </strong>Endovascular treatment has become the preferred approach for managing unruptured cerebral aneurysms, with simple and balloon-assisted coil embolization as the standard first-line therapy. However, recanalization after coil embolization remains a major clinical concern. This study aimed to evaluate the predictive factors for recanalization using time-of-flight magnetic resonance (TOF-MR) angiography.</p><p><strong>Methods: </strong>This retrospective multicenter study analyzed data from 241 patients with unruptured cerebral aneurysms who underwent coil embolization at 5 stroke centers. Aneurysms were evaluated using TOF-MR angiography within 7 days postprocedure and at follow-up. The study investigated the role of aneurysm characteristics and the Postoperative TOF-MR Angiography (PTMA) classification in predicting recanalization.</p><p><strong>Results: </strong>Of the 241 aneurysms analyzed, 79 (32.7%) exhibited recanalization, and 15 (6.2%) required retreatment. Aneurysms with a maximum diameter of ≥10 mm were associated with a higher risk of recanalization (odds ratio, 3.27; 95% confidence interval (CI), 1.38-7.75; P < 0.01). The PTMA classification, which indicated incomplete occlusion (small residual neck/residual neck/partial occlusion), also showed a significant association with recanalization (odds ratio, 4.82; 95% confidence interval, 2.17-10.7; P < 0.01). The modified Raymond-Roy classification (Class IIIb) also contributed to the prediction of recanalization (odds ratio, 3.09; 95% confidence interval, 1.50-6.38; P < 0.01).</p><p><strong>Conclusions: </strong>Aneurysm size, the modified Raymond-Roy classification, and PTMA classification within 7 days of coil embolization were significant predictors of recanalization. This study suggests that TOF-MR angiography may be accurate, and that PTMA classification may serve as an appropriate predictor of aneurysm recanalization. Further prospective studies with larger cohorts are required to validate our findings.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123496"},"PeriodicalIF":1.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695863","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":"Characteristic Imaging Feature of Cortical Dysgenesis in Tubulinopathy.","authors":"Bheru Dan Charan, Shailesh B Gaikwad, Tanya Dixit","doi":"10.1016/j.wneu.2024.12.019","DOIUrl":"https://doi.org/10.1016/j.wneu.2024.12.019","url":null,"abstract":"<p><p>Tubulin-related cortical dysgenesis or tubulinopathies include a wide range of brain cortical malformations which result from defects in genes responsible for the tubulin protein. Tubulin is an integral part of the cell cytoskeleton, and the development of the central nervous system depends on it. Here, we presented a case with characteristic imaging features that suggested tubulinopathy.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814437","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}