World neurosurgery最新文献

{"title":"In Reply to the Letter to the Editor Regarding “Radiologic Clue to Cavernous Sinus Hemangioma Diagnosis”","authors":"Cristiano Esteves , David Berhanu , Carla Guerreiro","doi":"10.1016/j.wneu.2025.123813","DOIUrl":"10.1016/j.wneu.2025.123813","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"196 ","pages":"Article 123813"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469197","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":"In Reply to the Letter to the Editor: \"Regarding Cognition in Meningioma: Effects of Tumor Location and Tumor Removal\".","authors":"Islay Barne, Christine E Wells, Miranda Wheeler, Helen Bairstow, Donald Brechin, Stephen Evans, Colin Lever","doi":"10.1016/j.wneu.2025.123892","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123892","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123892"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639880","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":"Ultrasonic Hemodynamics of Middle Meningeal Artery in Chronic Subdural Hematoma","authors":"Xinrun Wang ,&nbsp;Zhensheng Liu ,&nbsp;Tingyue Qi ,&nbsp;Yanhui Shi ,&nbsp;Wanwan Hou ,&nbsp;Wen Zhang","doi":"10.1016/j.wneu.2025.123793","DOIUrl":"10.1016/j.wneu.2025.123793","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the feasibility of color Doppler ultrasound (CDUS) in detecting the middle meningeal artery (MMA) and evaluate the clinical application of this method in chronic subdural hematoma (CSDH).</div></div><div><h3>Methods</h3><div>This study collected clinical data from 100 patients with CSDH who were admitted to our hospital between January 2023 and March 2024. Among these patients, 87 underwent drilling and drainage surgery. Postoperative follow-up categorized patients into a recurrence group and a nonrecurrence group. Additionally, 80 healthy volunteers and 60 patients with acute subdural hematoma were selected as the control group. Using CDUS technology, the MMA was assessed through the infratemporal fossa in the half-mouth position to obtain peak systolic flow velocity (PSV), end diastolic flow velocity, and resistance index (RI). Comparisons were conducted between the study group and the control group, as well as between the recurrence and nonrecurrence groups to evaluate hemodynamic differences. Multivariate logistic regression analysis was employed to identify risk factors for postoperative recurrence in patients with CSDH. Receiver operating characteristic curves were generated to assess the sensitivity and specificity of MMA hemodynamic parameters in predicting postoperative recurrence of CSDH.</div></div><div><h3>Results</h3><div>The MMA visualization rates for the CSDH group, healthy volunteer group, and acute subdural hematoma group were 84.43% (103/122), 85.00% (136/160), and 83.33% (70/84), respectively. Multivariate logistic regression analysis indicated that bilateral hematoma, increased PSV, and decreased RI were independent risk factors for the recurrence of CSDH following drilling and drainage (<em>P</em> &lt; 0.05). The maximum Youden index was achieved when the PSV predictive value was 30.85 cm/s and the RI predictive value was 0.78.</div></div><div><h3>Conclusions</h3><div>Utilizing CDUS in a half-open mouth position is a feasible method for evaluating extracranial MMA. Monitoring hemodynamic changes in the MMA of patients with CSDH postsurgery holds significant value in indicating the potential for postoperative recurrence.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"196 ","pages":"Article 123793"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433693","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":"Letter to the Editor: Mentorship has no boundary.","authors":"Durga Neupane, David J Park, Steven D Chang","doi":"10.1016/j.wneu.2025.123891","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123891","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123891"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639883","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":"Posterior clinoidectomy in the subtemporal trans-tentorial approach for a basilar bifurcation aneurysm: technical note.","authors":"Yuki Hirose, Hideyuki Yoshioka, Koji Hashimoto, Takuma Wakai, Toru Tateoka, Norito Fukuda, Ryo Horiuchi, Takashi Yagi, Hiroyuki Kinouchi","doi":"10.1016/j.wneu.2025.123894","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.123894","url":null,"abstract":"<p><strong>Objective: </strong>Although the endovascular approach has emerged as the first-choice treatment for basilar bifurcation aneurysms these days, there are situations where direct surgery remains necessary. Among several surgical approaches, the subtemporal trans-tentorial approach can be adapted for low-positioned aneurysms projecting posteriorly. Since surgeons observe the aneurysm from a lateral perspective in this approach, the posterior clinoid process (PCP) does not usually obstruct the surgical field, and posterior clinoidectomy in this approach has not been reported to date. We present the first report on the utility of posterior clinoidectomy to expand the surgical field of the subtemporal approach in a case involving a low-positioned basilar bifurcation aneurysm where a posterior petroclinoid ligament (PPL) obstructed the operative field.</p><p><strong>Methods: </strong>A 42-year-old female patient underwent neck clipping by the right subtemporal trans-tentorial approach for subarachnoid hemorrhage (SAH) due to a ruptured low-positioned basilar bifurcation aneurysm. In this case, despite incision of the tentorium posterior to the entrance of the right trochlear nerve, the PPL hindered the procedure. Posterior clinoidectomy using an ultrasonic aspirator with downward transition of the PPL successfully expanded the surgical field, enabling safe aneurysmal neck clipping.</p><p><strong>Results: </strong>The patient was discharged from our hospital without any neurological deficits.</p><p><strong>Conclusions: </strong>Even when using the subtemporal approach, the PPL could impede adequate aneurysmal exposure. Posterior clinoidectomy with downward PPL transition is an effective strategy in such cases.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123894"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639891","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":"Analysis of Long Noncoding RNA in Fatty Acid Metabolism to Identify Prognostic Markers and Predict Immunotherapy Response in Low-Grade Glioma","authors":"Yang Cui","doi":"10.1016/j.wneu.2025.123723","DOIUrl":"10.1016/j.wneu.2025.123723","url":null,"abstract":"<div><h3>Background</h3><div>Low-grade gliomas (LGGs) are notorious for their difficult early-stage diagnosis, limited treatment options, and poor prognosis, making them a focal point in cancer research. Long noncoding RNAs (lncRNAs) have been identified as regulators of metabolic reprogramming in tumor cells, offering new directions for LGG treatment.</div></div><div><h3>Methods</h3><div>This study employed data from The Cancer Genome Atlas, focusing on key fatty acid metabolism-related lncRNA. A risk scoring model was developed using univariate/multifactorial and least absolute shrinkage and selection operator Cox regression. Additionally, the study evaluated the role of these prognostic lncRNAs in LGG progression by assessing associations between LGG immune markers and tumor drug resistance. Finally, functional enrichment analysis highlighted the molecular roles of these lncRNAs.</div></div><div><h3>Results</h3><div>In this study, a total of 14 prognostic lncRNAs were obtained. The risk model demonstrated excellent validity and reliability, making it a superior predictor of prognosis among patients with varying LGG risks. Among the identified lncRNAs, GHET-1 was notably associated with LGG sensitivity to current chemotherapy options and might be a crucial lncRNA affecting LGG progression. High-risk patients exhibited T-helper cell-mediated immunosuppression, potentially paving new paths for future LGG immunotherapy.</div></div><div><h3>Conclusions</h3><div>Focusing on lncRNA regulation and fatty acid metabolism reprogramming, this study established an innovative prognostic prediction model for LGGs, showing outstanding validity and reliability. The findings offer new molecular and cellular targets for the future development of LGG treatments.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"196 ","pages":"Article 123723"},"PeriodicalIF":1.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426437","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":"Are Mildly Disabled Patients Appropriate for Spine Bundles? An Application of the Operative Value Index","authors":"Advith Sarikonda ,&nbsp;Ashmal Sami ,&nbsp;D. Mitchell Self ,&nbsp;Emily Isch ,&nbsp;Alexander Zavitsanos ,&nbsp;Anthony A. Fuleihan ,&nbsp;Ayra Khan ,&nbsp;Conor Dougherty ,&nbsp;Danyal Quraishi ,&nbsp;Jack Jallo ,&nbsp;Joshua Heller ,&nbsp;Srinivas K. Prasad ,&nbsp;Ashwini Sharan ,&nbsp;James Harrop ,&nbsp;Alexander R. Vaccaro ,&nbsp;Ahilan Sivaganesan","doi":"10.1016/j.wneu.2025.123797","DOIUrl":"10.1016/j.wneu.2025.123797","url":null,"abstract":"<div><h3>Background</h3><div>Many studies have evaluated the effect of preoperative disability status on functional outcomes following spine surgery. However, no research has compared the “value” (outcomes per dollar spent) of surgery for patients with different levels of diagnosis-specific disability.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 429 patients who underwent neurosurgical anterior cervical discectomy and fusion. Time-driven activity-based costing was used to calculate total intraoperative costs. Neck Disability Index (NDI) scores were recorded at baseline and 3 months postsurgery. Patients were categorized into groups based on their preoperative NDI score. Our primary outcome was a novel Operative Value Index (OVI), defined as the percent change in NDI per $1000 spent intraoperatively. Generalized linear mixed model regression was used to determine if severe-to-complete (“high”) baseline neck disability was significantly associated with OVI and total cost.</div></div><div><h3>Results</h3><div>Compared to patients with “high” preoperative neck disability, the OVI was significantly lower for patients with no neck disability (β-coefficient: −14.0; <em>P</em> &lt; 0.001) and mild neck disability (β-coefficient: −4.06; <em>P</em> &lt; 0.001). There were no significant associations between the NDI groups and total intraoperative cost.</div></div><div><h3>Conclusions</h3><div>Surgery provided the most value for patients with “high” baseline neck disability, with more favorable outcomes per dollar spent compared to those with low baseline neck disability. Patients with low baseline neck disability may therefore be suboptimal candidates for bundled payments, emphasizing the importance of careful patient selection to optimize resource use and outcomes in value-based care models.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"196 ","pages":"Article 123797"},"PeriodicalIF":1.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473114","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":"Reproduction of Original Glioblastoma and Brain Metastasis Research Findings Using Synthetic Data","authors":"William Davalan ,&nbsp;Roy Khalaf ,&nbsp;Roberto Jose Diaz","doi":"10.1016/j.wneu.2025.123808","DOIUrl":"10.1016/j.wneu.2025.123808","url":null,"abstract":"<div><h3>Objective</h3><div>Synthetic data (SD) is artificially generated information that mimics the statistical characteristics and correlations of real-world data, enabling researchers to simulate variables that are challenging to obtain in routine practice while overcoming confidentiality barriers. This study aims to evaluate the utility, validity, and potential limitations of SD in glioblastoma (GBM) and brain metastases (BM) research.</div></div><div><h3>Methods</h3><div>Three published neuro-oncology studies focusing on prognostic factors were selected: 2 involving GBM patients and 1 with BM patients. These studies were replicated using the <em>MDClone</em> platform, a healthcare data exploration tool that enables the creation of SD. Real-world data and SD were compared across patient demographic and outcome variables using summary statistics, normality testing, and <em>t</em>-test as required.</div></div><div><h3>Results</h3><div>452 GBM patients and 1320 BM patients were generated with SD. Among GBM patients, longer median overall survival was associated with younger age (age&lt;50: 16.3 months [95% CI: 12.8–19.8]; age 50–59: 15.6 [95% CI: 13.1–18.1]; age 60–69: 13.9 [95% CI: 12.1–15.7]; age&gt;70: 8.8 [95% CI: 7.4–10.2], <em>P</em> &lt; 0.001), greater extent of resection (debulking: 16.8 months [95% CI 14.9–18.7] vs. biopsy: 10.9 months [95% CI: 9.6–12.3], <em>P</em> &lt; 0.001), and higher serum albumin (sAlb) (sAlb&lt;30 g/L: 7.0 months [95% CI: 4.8–9.3]; sAlb 30–40 g/L: 12.9 [95% CI: 11.6–14.1]; sAlb&gt;40: 16.2 [95% CI: 13.4–19.1], <em>P</em> &lt; 0.05). Among BM patients, lower systemic inflammation scores (neutrophil-lymphocyte-ratio, leukocyte-lymphocyte-ratio, platelet-lymphocyte-ratio, monocyte-lymphocyte-ratio, and C-reactive-protein/albumin-ratio) were associated with longer overall survival (<em>P</em> &lt; 0.05). These results aligned with the findings reported in the literature.</div></div><div><h3>Conclusions</h3><div>Integrating SD into clinical research offers potential for providing accurate predictive insights without compromising patient privacy.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"196 ","pages":"Article 123808"},"PeriodicalIF":1.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472586","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":"Causal Relationship Between Mitochondrial DNA Copy Number and Intervertebral Disc Degeneration: A Bidirectional 2-Sample Mendelian Randomization Study","authors":"Chengjie Ma,&nbsp;Junhua Fang,&nbsp;Rui Xu,&nbsp;Langtao Ma,&nbsp;Guiqian Zhang,&nbsp;Xionggang Yang,&nbsp;Zhi Peng,&nbsp;Sheng Lu","doi":"10.1016/j.wneu.2025.123732","DOIUrl":"10.1016/j.wneu.2025.123732","url":null,"abstract":"<div><h3>Objective</h3><div>The causal relationship between mitochondrial DNA copy number (mtDNA-CN) and intervertebral disc degeneration (IVDD) remains unclear. The study aimed to investigate the causal relationship between mtDNA-CN and IVDD using Mendelian randomization (MR) analyses.</div></div><div><h3>Methods</h3><div>The causal relationship between mtDNA-CN and IVDD was estimated using a bidirectional 2-sample MR method. The inverse-variance weighted method was employed as the main MR method. Sensitivity analyses were conducted to validate the robustness and reliability of the MR results.</div></div><div><h3>Results</h3><div>The MR results by inverse-variance weighted revealed that genetically predicted mtDNA-CN was not associated with IVDD (odds ratio = 0.91; 95% confidence interval = 0.79–1.04; <em>P</em> = 0.1731). Similar results were observed in other 4 MR methods (<em>P</em> &gt; 0.05). Heterogeneity was found in the analysis of IVDD on mtDNA-CN (<em>P</em> &lt; 0.05), while no horizontal pleiotropy was observed (<em>P</em> &gt; 0.05). Furthermore, the leave-one-out analysis indicated the robustness of MR results not biased by a single nucleotide polymorphism. Moreover, the reverse MR analysis did not reveal any significant causal association of IVDD on mtDNA-CN.</div></div><div><h3>Conclusions</h3><div>The study revealed that there is no causal relationship of mtDNA-CN on the risk of IVDD, nor does IVDD have a significant causal effect on mtDNA-CN. Although the study did not find a significant causal relationship, it provides valuable insights into the complex interplay between genetic factors and IVDD. Further research is needed to explore to better understand the underlying mechanisms of this condition.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"196 ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415270","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":"Ischemic Stroke May Increase the Risk of Crohn's Disease and Ulcerative Colitis: Evidence from a Bidirectional Mendelian Randomization Study","authors":"Xin Luo,&nbsp;Liping Yao,&nbsp;Yinchao Chen,&nbsp;Yanju Song","doi":"10.1016/j.wneu.2025.123718","DOIUrl":"10.1016/j.wneu.2025.123718","url":null,"abstract":"<div><h3>Background</h3><div>The bidirectional causal relationship between ischemic stroke (IS) and inflammatory bowel disease (IBD) remains unclear, prompting us to propose a bidirectional Mendelian randomization (MR) study to investigate this relationship further.</div></div><div><h3>Methods</h3><div>We obtained IS data from the MEGASTROKE consortium and IBD data, including its subtypes ulcerative colitis (UC) and Crohn's disease (CD), from the International Inflammatory Bowel Disease Genetics Consortium. In this study, we utilized IBD and its subtypes as exposure variables and IS as the outcome variable, and vice versa, to explore the bidirectional relationship between them. We used the IBD genetic data from the FinnGen database as replication data to further explore the causality. In this study, we employed the inverse variance weighting method as our primary approach. For sensitivity analyses, we utilized additional methods including MR-Egger regression, weighted median estimation, MR pleiotropy residual sum and outlier (MR-PRESSO), and MR-Robust adjusted profile score. Furthermore, we conducted a random effects meta-analysis to combine the causal relationships derived from both the International Inflammatory Bowel Disease Genetics Consortium and FinnGen datasets, aiming to ascertain more robust causal associations.</div></div><div><h3>Results</h3><div>The initial phase of the bidirectional MR study revealed a causal relationship between IS and the risk of CD (odds ratio [OR] = 1.56, 95% confidence interval [CI]: 1.20–2.02, <em>P</em> = 0.0008) and UC (OR = 1.33, 95% CI: 1.05–1.69, <em>P</em> = 0.0179), but did not find a causal relationship between IBD as a whole and the risk of IS, nor between IBD subtypes and the risk of IS. During the replication phase, the FinnGen database did not reveal any significant correlation between IS and the risk of IBD, including its subtypes CD and UC. However, additional meta-analysis of the combined data from both databases indicated that IS is significantly associated with an increased risk of CD (OR inverse-variance weighted _(IVW) = 1.38, 95% CI: 1.07–1.69, <em>P</em> &lt; 0.05) and UC (OR_IVW = 1.27, 95% CI: 1.04–1.50, <em>P</em> &lt; 0.05), but not with the overall risk of IBD (OR_IVW = 1.05, 95% CI: 0.87–1.16, <em>P</em> &gt; 0.05). No significant effects were observed between IBD and IS risk, nor were there significant effects between IS and the risks of IBD, CD, or UC. To ensure the robustness of these findings, heterogeneity and pleiotropy tests were conducted.</div></div><div><h3>Conclusions</h3><div>IBD and its subtypes were not found to be causally associated with the risk of IS, whereas IS was found to be causally associated with the risk of CD and UC. This suggests that the risks of CD and UC should be closely monitored in patients with IS.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"196 ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391739","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}