World neurosurgery最新文献_第7页

Endoscope-Assisted Microsurgical Removal of Trigeminal Schwannomas 内镜辅助下三叉神经鞘瘤显微手术切除。

IF 1.9 4区医学

World neurosurgery Pub Date : 2025-05-15 DOI: 10.1016/j.wneu.2025.124098

Berk Burak Berker , Abuzer Güngör , Yücel Doğruel , Serdar Rahmanov , Hatice Türe , Uğur Türe

{"title":"Endoscope-Assisted Microsurgical Removal of Trigeminal Schwannomas","authors":"Berk Burak Berker , Abuzer Güngör , Yücel Doğruel , Serdar Rahmanov , Hatice Türe , Uğur Türe","doi":"10.1016/j.wneu.2025.124098","DOIUrl":"10.1016/j.wneu.2025.124098","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to demonstrate that trigeminal schwannomas (TSchs) located in different cranial fossae can be resected entirely through Meckel's cave which is expanded by the tumor by taking either an endoscope-assisted pterional epidural approach (EA-PEA) or an endoscope-assisted lateral suboccipital retrosigmoid approach (EA-LSRA). Additionally, we describe a modified classification based on Jefferson's system to determine the surgical approach.</div></div><div><h3>Methods</h3><div>This is a retrospective study of 19 patients with TSchs in different cranial fossae who underwent EA-PEA or EA-LSRA. According to the proposed system, lesions in the middle fossa are classified as type A, those in the posterior fossa are type B, and lesions in both fossae are type C, the same as in Jefferson classification. Our modifications begin by classifying lesions extending into different fossae. Those located primarily in the middle cranial fossa are denoted type C1, whereas one predominantly occupying the posterior cranial fossa is type C2. Lesions with extracranial extensions are classified as type D. Patients with type A, type C1, and type D lesions underwent EA-PEA, while those with type B and C2 lesions were treated through EA-LSRA.</div></div><div><h3>Results</h3><div>Thirteen patients (68.4%) underwent EA-PEA and 6 (31.6%) underwent EA-LSRA. Gross total resection was accomplished in 16 patients (84.2%). No complications were observed.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates that EA-PEA and EA-LSRA can lead to gross total resection in patients with complex TSchs. Endoscope assistance facilitates the visualization of residual tumor. The proposed classification system is a guide for determining the surgical approach.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124098"},"PeriodicalIF":1.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094954","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}

引用次数: 0

Chiari III malformation: quantification of long-term outcome after early surgery. Chiari III型畸形：早期手术后远期疗效的量化。

IF 1.9 4区医学

World neurosurgery Pub Date : 2025-05-15 DOI: 10.1016/j.wneu.2025.124066

Oday Atallah, Joachim K Krauss, Constantin S von Kaisenberg, Hans Hartmann, Eva Bültmann, Elvis J Hermann

{"title":"Chiari III malformation: quantification of long-term outcome after early surgery.","authors":"Oday Atallah, Joachim K Krauss, Constantin S von Kaisenberg, Hans Hartmann, Eva Bültmann, Elvis J Hermann","doi":"10.1016/j.wneu.2025.124066","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124066","url":null,"abstract":"<p><p>Chiari malformation type III is a rare and severe congenital disorder characterized by herniation of posterior fossa contents into a posterior encephalocele and by other abnormalities. It is associated with a high rate of early mortality and survivors suffer from neurological deficits and mental retardation. There is only very limited data available on long-term outcome after surgery, and in general there is a lack of quantification of disability. In this technical note, we present the case of a female newborn diagnosed already during pregnancy with a Chiari malformation type III. Surgical management and a proposal for comparable standardized test battery for long-term outcome was presented. A cesarean section was performed at 37+1 weeks of gestation, followed by surgical repair of the meningoencephalocele and placement of a ventriculoperitoneal shunt. Despite an uncomplicated postoperative course, development was markedly delayed. At the last follow-up at 40 months, the patient exhibited severe deficits, including a total IQ of 65 (below the 1<sup>st</sup> percentile), along with significant impairments in memory and metacognitive development, as assessed by the Behavior Rating Inventory of Executive Function. The prenatal diagnosis of Chiari malformation type III is a challenge both with regard to parent counseling and treatment decisions. It is necessary to document the postoperative development of these patients with various degrees of disability according to standardized tests on long-term follow-up to gain more insight for future decision-making.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124066"},"PeriodicalIF":1.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094939","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}

引用次数: 0

In Reply to the Letter to the Editor Regarding “Predictive Value of Dynamic Changes in Inflammatory Markers Within 24 Hours After Mechanical Thrombectomy for Outcome in Patients with Acute Ischemic Stroke” 回复关于“机械取栓后24小时内炎症标志物动态变化对急性缺血性卒中患者预后的预测价值”的致编辑的信。

IF 1.9 4区医学

World neurosurgery Pub Date : 2025-05-15 DOI: 10.1016/j.wneu.2025.124094

Baorui Zhang, Sisi Wang, Tong Lai, Yonglei Zhu

引用次数: 0

A Simple Technique of Cerebrospinal Fluid Leak Prevention Following Endoscopic Third Ventriculostomy: A Technical Note 内镜下第三脑室造口术后防止脑脊液泄漏的简单技术：技术说明。

IF 1.9 4区医学

World neurosurgery Pub Date : 2025-05-15 DOI: 10.1016/j.wneu.2025.124095

Dilshod Mukhammadvalievich Mamadaliev , Ulugbek Asadullaev , Gayrat Maratovich Kariev , Mahmoud Osama , Jakhongir Yakubov , Dilshod Naimovich Khodjimetov , Tohir Makhmudovich Akhmediev , Maruf Makhsudovich Matmusaev , Bipin Chaurasia

{"title":"A Simple Technique of Cerebrospinal Fluid Leak Prevention Following Endoscopic Third Ventriculostomy: A Technical Note","authors":"Dilshod Mukhammadvalievich Mamadaliev , Ulugbek Asadullaev , Gayrat Maratovich Kariev , Mahmoud Osama , Jakhongir Yakubov , Dilshod Naimovich Khodjimetov , Tohir Makhmudovich Akhmediev , Maruf Makhsudovich Matmusaev , Bipin Chaurasia","doi":"10.1016/j.wneu.2025.124095","DOIUrl":"10.1016/j.wneu.2025.124095","url":null,"abstract":"<div><h3>Background</h3><div>There are a variety of complications of endoscopic third ventriculostomy (ETV) that have been described in the literature. Cerebrospinal fluid leak is one of the common complications that need to be addressed properly and timely management plays a crucial role in prevention of meningitis/encephalitis.</div></div><div><h3>Objective</h3><div>To share our experience of using autologous bone (from burr hole) debris and “BloodSTOP” absorbable hemostatic agent as an effective tool in cerebrospinal fluid leak prevention.</div></div><div><h3>Methods</h3><div>We have observed 14 individuals who have undergone an ETV procedure using the abovementioned multilayered technique of burr hole closure at our institution in 2024.</div></div><div><h3>Results</h3><div>A watertight dural closure is a mandatory step in every case of neurosurgical procedure. But when primary dural closure is not possible in endoscopic intraventricular surgeries, there is a way out using more affordable hemostatic materials like BloodSTOP. There are plenty of strategies in surgical closure technique, including pericranial graft, dural allografts and synthetic substitutes, and various sealants but no single consensus on the best practice regarding dural closure. TachoSil is a hemostatic agent consisting of human fibrinogen and thrombin coated onto an equine collagen sponge and has proven efficacy as a sealant for easy repair of encephalocele, incidental spinal durotomy, transsphenoidal surgery, and intradural cranial and spinal lesions.</div></div><div><h3>Conclusions</h3><div>We report the use of a simple novel, sutureless BloodSTOP sandwich dural closure technique for post ETV dural defects, which has proven efficacy in our study when watertight primary dural closure is not technically feasible.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124095"},"PeriodicalIF":1.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094813","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}

引用次数: 0

Dual-Volume Cone Beam Computed Tomography Helps Elucidate Dural Arteriovenous Fistula Anatomy in the Presence of Tantalum-Opacified Liquid Embolic 双容积锥形束CT有助于阐明钽混浊液体栓塞存在下的硬脑膜AVF解剖。

IF 1.9 4区医学

World neurosurgery Pub Date : 2025-05-14 DOI: 10.1016/j.wneu.2025.124082

Blake W. Riley , Daniel P. Gibson , Krishna Amuluru , Andrew J. DeNardo , Troy D. Payner , Charles G. Kulwin , Kushal J. Shah , Eytan Raz , Daniel H. Sahlein

{"title":"Dual-Volume Cone Beam Computed Tomography Helps Elucidate Dural Arteriovenous Fistula Anatomy in the Presence of Tantalum-Opacified Liquid Embolic","authors":"Blake W. Riley , Daniel P. Gibson , Krishna Amuluru , Andrew J. DeNardo , Troy D. Payner , Charles G. Kulwin , Kushal J. Shah , Eytan Raz , Daniel H. Sahlein","doi":"10.1016/j.wneu.2025.124082","DOIUrl":"10.1016/j.wneu.2025.124082","url":null,"abstract":"<div><div>The presence of tantalum-opacified liquid embolic in incompletely treated dural arteriovenous fistulae (dAVFs) limits visibility of critically important angioarchitectural features. Modern cone beam computed tomography (CBCT) imaging can resolve the anatomy of dAVFs, allowing for a targeted embolic approach. However, distortion from beam hardening artifact is particularly limiting in CBCT imaging. We present a case of a dAVF embolized 4 times without cure at an outside hospital and ultimately referred to our practice for treatment. In this case, dual volume CBCT imaging (vs. the traditional single volume technique), combined with postprocessing tools on a modern workstation, enabled clear resolution of critical angioarchitectural features of the dAVF, leading to a targeted cure. This technique has the potential to vastly improve dAVFs resolution in the context of partial treatment, a challenging and not uncommon diagnostic and treatment challenge.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124082"},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086860","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}

引用次数: 0

Love 爱

IF 1.9 4区医学

World neurosurgery Pub Date : 2025-05-14 DOI: 10.1016/j.wneu.2025.124089

Ed Benzel

引用次数: 0

Pathogen Diagnostic Value of Nanopore Sequencing in Postoperative Central Nervous System Infections. 纳米孔测序在术后中枢神经系统感染中的病原诊断价值。

IF 1.9 4区医学

World neurosurgery Pub Date : 2025-05-14 DOI: 10.1016/j.wneu.2025.124090

Dongcheng Xie, Yiran Liu, Wenkai Cong, Guanghong Qi, Cangshan Mu

{"title":"Pathogen Diagnostic Value of Nanopore Sequencing in Postoperative Central Nervous System Infections.","authors":"Dongcheng Xie, Yiran Liu, Wenkai Cong, Guanghong Qi, Cangshan Mu","doi":"10.1016/j.wneu.2025.124090","DOIUrl":"https://doi.org/10.1016/j.wneu.2025.124090","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic performance of nanopore sequencing in postoperative central nervous system infections (PCNSIs).</p><p><strong>Methods: </strong>A total of 34 patients with suspected PCNSIs after craniocerebral surgery were included from the Aviation General Hospital between June 2022 and October 2023. Cerebrospinal fluid (CSF) samples were collected immediately. Clinical information was gathered for all patients, and tests including blood routine examination, biochemical analysis, microbial culture, mNGS, and nanopore sequencing were performed. Relevant data were compiled.</p><p><strong>Results: </strong>Among 34 patients suspected of PCNSIs,nanopore sequencing identified specific pathogenic sequences in 27 (79.41% positivity), surpassing both mNGS (73.53%) and microbial culture (55.88%). Compared to microbial culture and mNGS, nanopore sequencing demonstrated superior sensitivity (79.41%) and diagnostic performance, thereby minimizing the missed diagnosis rate of microbial culture (36.67% vs. 11.76%).Nanopore sequencing combined with microbial culture shows significant consistency with the final clinical diagnosis (K=0.717, P<0.05). In contrast, the consistency of using microbial culture alone with the final clinical diagnosis is lower (K=0.289, P<0.05), suggesting that microbial culture may have limitations in certain situations.</p><p><strong>Conclusion: </strong>Compared to microbial culture and mNGS, nanopore sequencing has a higher pathogen detection rate and a lower missed diagnosis rate. In clinical practice, using nanopore sequencing as a supplement to microbial culture can aid in the diagnosis of PCNSIs.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124090"},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086864","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}

引用次数: 0

Endovascular Sealing of the Third Window: A Novel Approach to Pulsatile Tinnitus in Superior Semicircular Canal Dehiscence 血管内封闭第三窗口：一种治疗上半规管破裂的搏动性耳鸣的新方法

IF 1.9 4区医学

World neurosurgery Pub Date : 2025-05-14 DOI: 10.1016/j.wneu.2025.124087

Baptiste Donnard, Fouzi Bala

引用次数: 0

Demographics and Etiologies of Patients Evaluated in a Multidisciplinary Brachial Plexus Clinic: A Ten-Year Experience 在多学科臂丛临床评估患者的人口统计学和病因学：十年的经验。

IF 1.9 4区医学

World neurosurgery Pub Date : 2025-05-14 DOI: 10.1016/j.wneu.2025.124081

James S. Lin , Kevin Tabatabaei , Allen T. Bishop , Robert J. Spinner , Nicholas A. Pulos , Alexander Y. Shin

{"title":"Demographics and Etiologies of Patients Evaluated in a Multidisciplinary Brachial Plexus Clinic: A Ten-Year Experience","authors":"James S. Lin , Kevin Tabatabaei , Allen T. Bishop , Robert J. Spinner , Nicholas A. Pulos , Alexander Y. Shin","doi":"10.1016/j.wneu.2025.124081","DOIUrl":"10.1016/j.wneu.2025.124081","url":null,"abstract":"<div><h3>Objective</h3><div>The epidemiological distribution of patients with brachial plexus injury (BPI) has not been well described. We categorized new consultations at our specialty clinic, aiming to offer insights into demographics and presentations to guide those considering establishing brachial plexus clinics in understanding the types of patients they may encounter.</div></div><div><h3>Methods</h3><div>All new consultations seen at a single quaternary center's brachial plexus clinic were reviewed over a 10-year period. Patients were categorized into groups of BPI.</div></div><div><h3>Results</h3><div>A total of 1415 new patients were evaluated including 1009 (71.3%) males and 406 (28.7%) females with a mean age of 43.7 (standard deviation 21.1). Eight hundred and sisty-one (60.8%) cases were traumatic. One hundred and fifty-nine (11.2%) cases were iatrogenic, often due to orthopedic shoulder surgery (n = 87). Obstetric BPI comprised 150 (10.6%) cases. Parsonage-Turner syndrome was encountered in 111 (7.8%). Ninety-nine (7.0%) were believed to be a nonbrachial plexus condition. Five hundred and seventy-seven (40.8%) patients underwent surgery by our team, with common procedures being nerve transfer, tendon transfer, neurorrhaphy, arthrodesis, and free functioning muscle transfer. Types of surgery varied based on time to presentation in traumatic BPI. Underinsured status was associated with delayed presentation, and it was an independent predictor of not undergoing surgery.</div></div><div><h3>Conclusions</h3><div>Our experience suggests that trauma is the most common cause of BPI. Patients often present delayed, affecting type of surgical intervention rendered. A considerable number did not have a brachial plexus lesion, and the surgeon must be cognizant of alternative diagnoses. Future studies should further evaluate how demographics and socioeconomic deprivation may affect care and outcomes of BPI.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"199 ","pages":"Article 124081"},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086858","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}

引用次数: 0

Optimizing Ventricular Catheterization with Real-Time Ultrasound via Burr Hole 通过Burr孔实时超声优化心室置管。

IF 1.9 4区医学

World neurosurgery Pub Date : 2025-05-14 DOI: 10.1016/j.wneu.2025.124084

Noritaka Sano , Sadaharu Torikoshi , Takahiro Kitahara , Yusuke Nakajima , Makoto Hayase , Masaki Nishimura

引用次数: 0