Chinese Neurosurgical Journal最新文献

{"title":"Early experience of a dedicated heart-brain integrated ward at Peking Union Medical College Hospital: a retrospective descriptive study.","authors":"Qi Liu, Yang Zhao, Yanxue Zhao, Sheng Yang, Jun Zheng, Yuanli Zhao","doi":"10.1186/s41016-026-00451-9","DOIUrl":"10.1186/s41016-026-00451-9","url":null,"abstract":"<p><strong>Background: </strong>Heart-brain comorbidities present unique diagnostic and therapeutic challenges because neurological and cardiac conditions often share pathophysiological mechanisms yet create conflicting treatment demands. Multidisciplinary wards integrating neurosurgery, cardiac surgery, cardiology, and neurology have been proposed, but real-world experience remains limited. We report the initial experience of a dedicated heart-brain integrated ward at a Chinese tertiary referral center.</p><p><strong>Methods: </strong>We conducted a retrospective descriptive study of all consecutive patients admitted to the Heart-Brain Integrated Ward at Peking Union Medical College Hospital between July 1 and August 21, 2026. Clinical data were entered prospectively into the electronic medical record during routine care and analyzed retrospectively. Variables included demographics, neurological and cardiac diagnoses, a six-category comorbidity classification, MDT decisions, treatment strategies, and discharge outcomes. Treatment categories were predefined as: (i) diagnostic procedures, (ii) therapeutic single-system interventions, (iii) staged dual-system treatment within the same admission, and (iv) synchronous dual-system treatment in a single session.</p><p><strong>Results: </strong>Fifty-six patients (42 males, 75.0%; mean age 62.4 ± 12.2 years, range 19-80) were enrolled. The most common category was I.1 (shared atherosclerotic vascular disease; 29/56, 51.8%), predominantly ischemic cerebrovascular disease with coronary artery disease (18/56, 32.1%). Category IV (psychocardiological disorders) accounted for 12 patients (21.4%), and Category V (therapeutically interactive) for 3 (5.4%). All patients underwent at least one MDT discussion (100%), and 55 (98.2%) required a second. Of 56 patients, 41 (73.2%) underwent surgical or endovascular intervention and 15 (26.8%) received medical management or remained under evaluation. Among treated patients, 4 (7.1%) received synchronous dual-system procedures, 13 (23.2%) completed staged procedures within the same admission, and 24 (42.9%) underwent single-system intervention. Fourteen patients (25.0%) required intervention for both organ systems. No in-hospital mortality or major procedure-related complications were observed among 38 discharged patients (67.9%); 18 patients (32.1%) remained hospitalized at data cutoff.</p><p><strong>Conclusions: </strong>Establishing a dedicated heart-brain integrated ward at a tertiary referral center appears operationally feasible and enables structured MDT-based care for complex neuro-cardiac patients. The early disease spectrum is dominated by atherosclerotic pan-vascular disease. Synchronous dual-system procedures were performed in a small selected subset without observed major early events among discharged patients, but this cannot establish safety or generalizability. Larger prospective studies with controlled comparisons and longer follow-up are needed.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"12 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infection and quality of life after local or full scalp shaving in microsurgical treatment for unruptured intracranial aneurysm sited in anterior circulation.","authors":"Yifei Hou, Yinghe Feng, Jing Zhang, Kaige Zheng, Jinhao Zhang, Qingyuan Liu, Peng Liu, Yan Zhang, Jun Wu, Shuo Wang, Donghong Zhao, Siyuan Chen","doi":"10.1186/s41016-026-00449-3","DOIUrl":"10.1186/s41016-026-00449-3","url":null,"abstract":"<p><strong>Background: </strong>Scalp shaving constitutes a crucial preoperative preparation measure for the microsurgical treatment of unruptured intracranial aneurysms (UIAs) located in the anterior circulation. This study aimed to investigate the infection and quality of life after local scalp shaving (LSS) or full scalp shaving (FSS) in microsurgery for UIAs in the anterior circulation.</p><p><strong>Methods: </strong>This study included patients receiving microsurgical treatment for UIAs sited in the anterior circulation from a national, multicenter, prospective cohort study, conducted from December 2021 to December 2024. Propensity score matching was performed to form a nested case-control cohort regarding age, sex, diabetes mellitus, aneurysm site, and size, and surgical methods with a ratio of patients with LSS to patients with FSS as 1:2. The primary outcome was central nervous system infection within 90 days after surgery, and the secondary outcome was the Face-Q score on the 180th day after surgery. Logistic analysis was performed to compare the incidence of outcomes between LSS and FSS groups.</p><p><strong>Results: </strong>This study finally included 2157 patients receiving microsurgical treatment for UIAs in the anterior circulation, with 908 males and a median age of 59 years. 719 patients were assigned to the LSS group and 1438 to the FSS group. No significant difference was found in the 90-day central nervous system infection (25 of 719 [3.5%] vs. 49 of 1438 [3.4%]; odds ratio, 0.98; 95%CI, 0.60-1.60; P = 0.933). Patients in the LSS group had a higher 180-day Face-Q score compared with patients in the FSS group (4 vs. 2; ordinary odds ratio, 0.43; 95%CI, 0.40-0.47; P < 0.001).</p><p><strong>Conclusion: </strong>LSS is an appropriate preoperative scalp shaving protocol for patients receiving microsurgical treatment of UIAs sited in the anterior circulation, with no increasing risk of infection and improved quality of life after surgery.</p><p><strong>Trial registration: </strong>ChTUIA cohort (China Treatment Trial for Unruptured Intracranial Aneurysm, unique identifier: NCT05844163, Clinicaltrials.gov registry).</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"12 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surfer's myelopathy in Bali: a case series of three patients and review of the pathophysiology, proposed diagnostic criteria, and treatment.","authors":"Mira Yuniarti, Lorentia Harisusanti, Jeffrey Tanudjaja, Gilbert Sterling Octavius","doi":"10.1186/s41016-026-00450-w","DOIUrl":"10.1186/s41016-026-00450-w","url":null,"abstract":"<p><strong>Background: </strong>Surfer's myelopathy is a rare, nontraumatic spinal cord injury that predominantly affects young, novice surfers after prolonged spinal hyperextension. Owing to its low incidence and heterogeneous clinical and imaging features, the condition remains underrecognized, and its pathophysiology, diagnostic criteria, and optimal management strategies are not fully established. Increased awareness is particularly important in popular surfing destinations.</p><p><strong>Case presentation: </strong>We report three cases of surfer's myelopathy in previously healthy young women who developed acute lower back pain followed by rapidly progressive bilateral lower-limb weakness and urinary retention shortly after recreational surfing. None reported trauma or preceding illness. Neurological examination revealed paraparesis with preserved upper-limb function, corresponding to American Spinal Cord Injury Association Impairment Scale grade D in all patients. Thoracic magnetic resonance imaging performed within 10-18 h after symptom onset demonstrated central intramedullary T2-weighted hyperintensity extending from the mid-thoracic spinal cord toward the conus medullaris, without evidence of compressive pathology. Management consisted of hemodynamic optimization, intravenous corticosteroids, spinal immobilization, and supportive care. All patients showed partial neurological improvement before discharge.</p><p><strong>Conclusion: </strong>Surfer's myelopathy should be considered in young patients presenting with acute nontraumatic paraparesis and autonomic dysfunction following surfing. Characteristic MRI findings support the diagnosis and help exclude alternative etiologies. Our cases support the applicability of broader diagnostic criteria and highlight the importance of early recognition, supportive management, and preventive education, particularly in regions with high surfing activity.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"12 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical clipping for a recurrent perforator aneurysm of the A1 segment following endovascular electrocoagulation therapy: a case report.","authors":"Maogui Li, Zidong Wang, Qingke Cui, Donghai Wang","doi":"10.1186/s41016-026-00448-4","DOIUrl":"10.1186/s41016-026-00448-4","url":null,"abstract":"<p><strong>Background: </strong>Recently, endovascular electrocoagulation has been successfully used to treat ruptured aneurysms that cannot be catheterized with a microcatheter, but more research is needed to evaluate the efficacy of this technique. In this report, we present the first reported case of early aneurysm recurrence following electrocoagulation therapy and describe our experience of retreatment for this lesion.</p><p><strong>Case presentation: </strong>A 51-year-old female presented with spontaneous subarachnoid hemorrhage, who was diagnosed with a rare tiny aneurysm arising from the A1 segment of anterior cerebral artery. Because of the sharp turning angle of parent artery and the extremely narrow aneurysm neck, attempts at catheterization of the aneurysm sac were unsuccessful. Thus, pure micro-guidewire electrocoagulation was selected as the salvage treatment approach. Initially, the aneurysm was successfully occluded by electrocoagulation, but follow-up angiography at 5 weeks postoperatively showed recanalization of the lesion. Eventually, the recurrent aneurysm was safely obliterated by surgical clipping, providing a direct view of the pathological changes following electrocoagulation therapy.</p><p><strong>Conclusions: </strong>Endovascular electrocoagulation carries a risk of aneurysm recanalization despite initial success. Close angiographic follow-up is warranted to ensure the efficacy of this technique.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"12 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender reassignment and neurosurgical implications: a narrative review.","authors":"Rajdeep Brahmachari, Chandrasekaran Kaliaperumal","doi":"10.1186/s41016-026-00447-5","DOIUrl":"10.1186/s41016-026-00447-5","url":null,"abstract":"<p><p>Gender dysphoria is characterized by a marked incongruence between an individual's experienced gender and assigned sex at birth. The global prevalence of transgender individuals is increasing, leading to greater interaction with healthcare systems across multiple specialties, including neurosurgery. Gender-affirming hormone therapy (GAHT), a cornerstone of treatment, has several neurological and neurosurgical implications. Nevertheless, neurosurgeons often report limited confidence in managing transgender patients because of insufficient awareness and training. This review explores the growing evidence of the broad neurobiological basis of gender identity, which involves variations in neuroanatomy and its contribution to the pathophysiology of gender incongruence. Moreover, the understanding of the neurovascular and neuropsychiatric effects of GAHT has provided a broad picture of the conditions under which a transgender patient can present to the neurosurgical outpatient department or emergency department. The review also discusses a holistic neurosurgical care plan for transgender patients (including gender dysphoria), which involves making a safe and conducive environment for the patient to open up during consultation, a proper method to obtain informed consent on the basis of the WPATH SOC 8 guidelines, and the identification of general and specific risk factors during the perioperative period and the subsequent optimization. Furthermore, this review identifies the factors that may affect proper intraoperative care such as anesthetic and antiviral drug interactions with GAHT hormonal agents, patient positioning and preparation issues, and thromboprophylaxis. This review provides an outlook for optimum postoperative care involving comfortable patient recovery for proper wound healing, pain management, and mental health support. In conclusion, transgender patients present unique challenges in neurosurgical practice owing to the combined effects of GAHT and psychosocial determinants. There is a critical need for improved education, inclusive clinical practices, and multidisciplinary collaboration to optimize patient outcomes. Further large-scale studies are needed to strengthen the evidence base and guide standardized neurosurgical care for this population.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"12 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LINAC-based stereotactic radiosurgery targeting the hippocampus in mesial temporal lobe epilepsy: a single-center case series.","authors":"Víctor Alberto García-García, Marco Vinicio Ramírez-Sánchez, Roberto Carlos García-Romero, Isaac Jasso-García, David Garcia-Martinez, Aldo Tavares-Ortega, Andrea Miriam Gonzalez-Gonzalez, Rubí Carolina Estrada-Hernández, María Fernanda Sánchez-Miranda, Guadalupe Castillo-Cardiel, Gabino Cervantes-Guevara, Enrique Cervantes-Pérez, Sol Ramírez-Ochoa, Alejandro González-Ojeda, Clotilde Fuentes-Orozco","doi":"10.1186/s41016-026-00446-6","DOIUrl":"10.1186/s41016-026-00446-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Epilepsy is a neurological disorder affecting over 50 million people worldwide, with a global incidence of 7.6 per 1,000 individuals. Mesial temporal lobe epilepsy (MTLE) is characterized by recurrent, unprovoked seizures originating in the temporal lobe. The standard surgical treatment is anterior temporal lobectomy; however, many patients are not suitable candidates due to the risk of adverse effects, including significant memory impairment, language deficits, bilateral temporal involvement, or reluctance to undergo resective surgery. This study aimed to evaluate the anticonvulsant effect of linear accelerator (LINAC)-based radiosurgery in patients with drug-resistant unilateral MTLE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective, single-center, exploratory pilot case series was conducted from March 1, 2017, to March 1, 2020, at the Hospital de Especialidades, Centro Médico Nacional de Occidente. Patients aged 18-65 years with a confirmed diagnosis of drug-resistant unilateral MTLE were enrolled. The primary outcome was defined as the achievement of complete freedom from disabling seizures (Engel Class I and ILAE Class 1) at 24 months post-radiosurgery. Secondary efficacy outcomes included achieving a ≥ 50% reduction in seizure frequency. The prescribed dose of 22 Gy was normalized to the 50% isodose line at the isocenter, ensuring ≥ 90% target coverage (V100 ≥ 90%) and a dose gradient &lt; 10%, targeting the hippocampal head and anterior body.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seven patients were included. Median seizure frequency decreased from 12 seizures/month at baseline to 3.5 seizures/month at 24 months, corresponding to a median reduction of 75.6%.Longitudinal analysis demonstrated a significant reduction in seizure frequency over time (Friedman χ&lt;sup&gt;2&lt;/sup&gt; = 14.62, p = 0.006), with significant differences between baseline and all follow-up periods (p = 0.018). No patient achieved seizure freedom. Kaplan-Meier analysis demonstrated that 71.4% of patients maintained a clinically meaningful seizure reduction (≥ 50% from baseline) throughout the 24-month follow-up. Patients with preoperative auras exhibited a median aura reduction of 60%, whereas de novo auras developed in three previously aura-free patients. Adverse events included visual field deficits in three patients (42.8%), psychiatric complications in two (28.6%), and clinically significant memory decline in one patient with pre-existing cognitive impairment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;LINAC-based stereotactic radiosurgery targeting the hippocampal head and anterior body achieved a clinically meaningful reduction in seizure frequency in selected patients with drug-resistant MTLE. However, complete seizure freedom was not achieved, and delayed adverse events were observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;The study was approved by the ethics committee of the Hospital de Especialidades, Centro Médico Nacional de Occidente (approval numb","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"12 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological outcomes and survival in patients with intracranial lesions undergoing awake craniotomy: a descriptive retrospective single-center study.","authors":"Yajie Song, Kaiwen Yang, Yushun Zhang, Liang Shen, Yizhuo Guo, Zhennan Yu, Fang Liu","doi":"10.1186/s41016-026-00443-9","DOIUrl":"10.1186/s41016-026-00443-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;To descriptively evaluate short-term (48-72 h postoperatively) neurological functional outcomes in patients undergoing awake craniotomy for intracranial lesions located within eloquent brain areas, and conduct univariate exploratory analyses of clinical factors correlated with acute postoperative neurological deterioration. Secondary exploratory survival analyses are included solely for hypothesis generation; all survival-related findings carry no definitive clinical prognostic interpretation given the study's critical limitations of small sample size, pathological heterogeneity, absent long-term functional follow-up, and missing key perioperative covariates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A single-center descriptive retrospective analysis was performed on 30 patients who received awake craniotomy between January 2019 and November 2024. The primary predefined endpoint was new or exacerbated neurological deficits within 48-72 h after surgery, quantified via Karnofsky Performance Status (KPS), Glasgow Coma Scale (GCS), Mini-Mental State Examination (MMSE), and manual muscle strength testing. Early postoperative dysfunction was categorized into three distinct phenotypes: transient global systemic functional decline, focal motor neurological deficits, and isolated language impairment (aphasia). Secondary exploratory endpoints included overall survival and all-cause mortality, with follow-up completed by February 28, 2025. Univariate logistic regression screened correlates of acute neurological decline; Kaplan-Meier survival curves, log-rank subgroup comparisons, and Cox proportional hazards regression were applied for exploratory survival modeling. All survival analyses are interpreted as purely descriptive and hypothesis-generating, with no confirmatory clinical value; the specific constraints are addressed in the Limitations section.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The cohort contained 30 patients, with an awake craniotomy intraoperative mapping completion rate of 90.0% (27/30). Within 48-72 h postoperatively, 30.0% (9/30) of patients developed new or aggravated acute neurological dysfunction. Most acute impairments reflected transient global functional decline, including KPS reduction (30.0%) and MMSE cognitive decline (26.7%), while permanent focal injury surrogates (new motor weakness 16.7%; new-onset aphasia 10.0%) were far less frequent. We emphasize that early KPS/MMSE reductions largely stem from temporary perioperative cerebral edema, postoperative fatigue, and residual sedation recovery rather than irreversible focal brain injury. Patients with successful intraoperative awake mapping exhibited a numerically lower rate of acute neurological decline (25.9%) versus patients with mapping failure (66.7%), though this trend did not reach statistical significance (P = 0.20). Univariate logistic regression identified no statistically significant independent predictors of acute postoperative neurological deficits. M","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"12 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scoping review of pharmacological and non-pharmacological management of agitation in post traumatic brain injury patients.","authors":"Irrum Aneela, Priya Kadam, Chandrasekaran Kaliaperumal","doi":"10.1186/s41016-026-00445-7","DOIUrl":"10.1186/s41016-026-00445-7","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. Agitation is a common complication after moderate to severe TBI and managing it in the acute hospital setting can be challenging.</p><p><strong>Aim: </strong>Currently, there are no standardised interventions to manage agitation in TBI. This review aims to evaluate contemporary research over the past 10 years which addresses pharmacological and non-pharmacological strategies for managing agitation post-TBI.</p><p><strong>Method: </strong>A scoping review literature search was conducted using PRISMA guidelines. The protocol was pre-registered on PROSPERO (ID 1295903). The literature search used Mesh and Boolean keywords 'traumatic brain injury and 'agitation management' in PubMed, and a free-text search of 'traumatic brain injury and agitation management' with 'map term to subject heading' in Embase (Ovid) and Cochrane, covering studies from 01 January 2015 to 09 March 2026. Findings were analysed and discussed between two reviewers.</p><p><strong>Results: </strong>A total of 65 studies were identified, and after careful review, 13 papers were selected from PubMed and Embase for our Scoping Review. Non-pharmacological strategies highlighted the importance of orienting the patient and the supportive role of family during the acute recovery period. Pharmacological strategies included found that the antipsychotic olanzapine was helpful in managing agitation in moderate to severe TBI. Valproic acid in a small male sample [1] and a separate study using dextromethorphan and quinidine [2] found that these medications were also helpful in managing agitation in TBI. DISCUSSION AND CONCLUSION: Clinicians and health professionals reported that treating the patient holistically, with the medical, social, and psychiatric history was of benefit. Antipsychotic Olanzapine and Valproic acid may have their uses in the short-term, interim acute setting under supervision. Future research with larger sample sizes further investigating these medications would be useful, along with personalisation of medications to the patient's medical history. Most of the studies included in the review are observational and reviews, rather than randomised controlled trials, with a lack of primary evidence which may be a limitation.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD 1295903.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"12 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retractions of publications on central nervous system tumors based on the Retraction Watch Database.","authors":"Xiaoyan Gao, Renjie Mao, Fa Lin, Jing Shang, Jingjing Wu, Lu Chen, Hao Wang","doi":"10.1186/s41016-026-00444-8","DOIUrl":"10.1186/s41016-026-00444-8","url":null,"abstract":"<p><strong>Background: </strong>Retraction serves as a critical mechanism for correcting flawed publications and preserving the integrity of the scientific literature. Systematic analysis focused on retractions in Central Nervous System (CNS) tumor research is still lacking. This study characterized retracted CNS tumor publications regarding temporal trends, geographic distribution, retraction reasons, citation patterns, and retraction lag.</p><p><strong>Methodology: </strong>Retraction data were downloaded from the Crossref/Retraction Watch Database on December 31, 2025. CNS tumor‑related retractions were identified using tumor terms derived from the 2021 WHO Classification of Tumors of the Central Nervous System. Eligible records were screened manually, and tumor type, article type, retraction reason, first-author country, author count and time to retraction were extracted. Citation data were retrieved from Web of Science, and journal impact factor (JIF) and quartile were obtained from the 2024 Journal Citation Reports. Descriptive statistics, the Mann-Kendall test and Kruskal‑Wallis test were used.</p><p><strong>Results: </strong>582 CNS tumor articles were included. CNS tumor retractions increased over time and peaked in 2023. \"Gliomas, glioneuronal tumors, and neuronal tumors\" accounted for 74.57% (434/582). 80.58% (469/582) were retracted due to misconduct. In terms of absolute numbers, China was the leading first‑author country, followed by USA and India. Basic research accounted for 75.26% (438/582). The median time to retraction was 805.5 days (IQR: 423.25-1,711 days). A total of 515 articles received at least one citation (total citations 12,151), and 89.71% (462/515) had citation after retraction. The median pre‑retraction, post‑retraction, and total citations were 5 (IQR: 1-17), 3 (IQR: 1-7), and 10 (IQR: 3-24), respectively. Significant differences were observed in normalized citation counts and retraction lag across most retraction reason categories, JIF and quartiles, article types, author counts, and first‑author countries.</p><p><strong>Conclusions: </strong>CNS tumor retractions have increased markedly as the primary driver. The persistent post-retraction citation of flawed research highlights a critical gap threatening evidence-based neuro-oncology.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"12 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatty acid metabolism in glioma: a review of novel targets and therapeutic strategies.","authors":"Xiao Zhou, Di Wang, Wei Zhang, Guanzhang Li","doi":"10.1186/s41016-026-00442-w","DOIUrl":"10.1186/s41016-026-00442-w","url":null,"abstract":"<p><p>Glioma is the most common primary malignant brain tumor in adults, among which glioblastoma (GBM) shows the highest degree of malignancy and the worst prognosis. Although standard therapeutic approaches, including surgical resection, radiotherapy, and chemotherapy, are routinely applied, the prognosis of glioma, especially GBM, remains poor. Metabolic rewiring is widely recognized as a major characteristic of malignant tumors and is especially evident in glioma. Recent studies have shown that fatty acid metabolic rewiring is a widespread feature of glioma and plays an important role in its pathogenesis and therapeutic resistance. Therefore, targeting metabolic reprogramming, particularly aberrant fatty acid metabolism, may have potential therapeutic implications in glioma. This review systematically synthesizes the molecular mechanisms underlying abnormal fatty acid metabolism in glioma pathogenesis and treatment responses. It also elucidates the regulatory networks governing key fatty acid metabolic pathways and integrates emerging strategies targeting these pathways to enhance the therapeutic sensitivity of glioma cells. Ultimately, this review aims to provide a conceptual framework and future research directions for overcoming the current limitations of glioma treatment through metabolic therapy.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"12 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13425957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}