Chinese Neurosurgical Journal最新文献

{"title":"Correction: Dynamic plain abdominal film provides simple and effective diagnosis of delayed shunt insufficiency caused by abdominal adhesions after VP shunt.","authors":"Zhiqiang Liu, Jintao Chen, Chaoqun Weng, Bei Liu, Zhixiong Lin","doi":"10.1186/s41016-024-00382-3","DOIUrl":"https://doi.org/10.1186/s41016-024-00382-3","url":null,"abstract":"","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"10 1","pages":"29"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476760","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":"Efficacy of neuroendoscopy-assisted surgery in the treatment of chronic subdural hematoma: a meta-analysis.","authors":"Hou-Qiang Liu, Xue Bai, Fang-Ling Xiong, Ming-Ming Gao, Huai-Bing Zhang, Bao-Hua Liu","doi":"10.1186/s41016-024-00380-5","DOIUrl":"10.1186/s41016-024-00380-5","url":null,"abstract":"<p><strong>Background: </strong>Chronic subdural hematoma (CSDH) is one of the most common diseases in neurosurgery. It is the result of chronic intracranial hemorrhage that converges between the dura mater and arachnoid three weeks after externally injuring the head. Chronic subdural hematomas are a common complication in neurosurgery. With the gradual increase in the amount of hematoma, the surrounding brain tissue is pushed and compressed, resulting in corresponding clinical symptoms and signs. It is reported that the overall incidence rate of CSDH is 1.72 to 20.6 per 100,000 people every year, and the incidence rate of the elderly is particularly high.</p><p><strong>Methods: </strong>The computer retrieves eight databases to obtain controlled trials at home and abroad on the effects of neuroendoscopy-assisted surgery in patients with chronic subdural hematoma. After a rigorous literature quality evaluation, data analysis was performed using RevMan 5.3 software.</p><p><strong>Results: </strong>Twenty studies were ultimately included in this meta-analysis. Seventeen studies reported the Recurrence rate of the test group and the control group, which was significantly lower (OR 0.27; 95% Cl 0.18, 0.38; P < 0.01) than the control group, Recovery rate (OR 1.18; 95% Cl 1.01, 1.38; P = 0.03), Total effective rate (OR 1.11; 95% Cl 1.04, 1.17; P < 0.01), Operative time (SMD 15.78; 95% Cl 9.69, 21.86; P < 0.01), Hospital stay (SMD - 1.66; 95% Cl - 2.17, - 1.14; P < 0.01) and Complications (OR 0.48; 95% Cl 0.30, 0.78; P < 0.01).</p><p><strong>Conclusion: </strong>The results of this study suggest that neuroendoscopy-assisted surgery may be effective in patients with chronic subdural hematoma, as evidenced by recurrence rate, recovery rate, total effective rate, operative time, hospital stay, complications, and the above conclusions need to be verified by more high-quality studies.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"10 1","pages":"28"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393929","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":"The efficacy of surgery over stereotactic radiosurgery in the management of tumor-related trigeminal neuralgia.","authors":"Alexander Abouharb, Hasithe Rathnayake, Sachit Mehta","doi":"10.1186/s41016-024-00379-y","DOIUrl":"10.1186/s41016-024-00379-y","url":null,"abstract":"<p><p>Tumor-related trigeminal neuralgia (TN) is a deeply debilitating condition that severely impacts patient quality of life. Two principal treatment methods in use are open surgical resection of the causative tumor or the use of stereotactic radiosurgery (SRS). In this letter, we aim to evaluate the use of both treatment methods and highlight that in patients with commensurate anatomy, open surgical resection continues to provide greater rates of symptomatic relief, lower rates of recurrence, and complication compared to stereotactic radiosurgery.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"10 1","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355691","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":"Dynamic plain abdominal film provides simple and effective diagnosis of delayed shunt insufficiency caused by abdominal adhesions after VP shunt.","authors":"Zhiqiang Liu, Jintao Chen, Chaoqun Weng, Bei Liu, Zhixiong Lin","doi":"10.1186/s41016-024-00378-z","DOIUrl":"10.1186/s41016-024-00378-z","url":null,"abstract":"<p><strong>Background: </strong>Many complications may occur after placement of the ventriculoperitoneal shunt (VP shunt) for hydrocephalus, and delayed shunt insufficiency (DSI) is among the most common. It is often caused by abdominal adhesions, which increases the difficulty of diagnosis. This study aimed to explore the clinical value of dynamic plain abdominal radiography (DPAR) as a simple diagnostic method for patients with DSI due to terminal adhesion of the peritoneal shunt after VP surgery.</p><p><strong>Methods: </strong>A total of 30 patients with high suspicion of DSI due to abdominal adhesions after VP surgery were included. DPAR was used for prospective assessment. The interval between the first and second PAR was 4-6 h before surgery. If two plain abdominal radiography at different times indicated that the end of the shunt tube in the abdominal segment was fixed, it was diagnosed as DSI due to adhesion of the shunt tube at the abdominal end. The peritoneal end of the shunt tube was surgically repositioned. Postoperative DPAR was repeated to evaluate the distance of the shunt outlet within the abdominal segment.</p><p><strong>Results: </strong>All cases showed clinical symptoms or imaging findings of shunt insufficiency. The diagnostic accuracy of DPAR was 96.67% (29/30). The end of the shunt tube in the abdominal segment of the preoperative group was fixed with abdominal plain film twice with a mean difference of 1.74 ± 1.18 cm. The mean postoperative change in the position of the end of the shunt tube in the abdominal section was 9.36 ± 2.64 cm, showing a significant difference compared with the preoperative group (P < 0.001). The mean postoperative EVANs index (0.37 ± 0.08) was significantly lower than the preoperative (0.42 ± 0.08) (P = 0.007), Glasgow coma scale score (12.8 ± 2.69) was higher than the mean preoperative score (11.36 ± 2.43) (P = 0.013).</p><p><strong>Conclusion: </strong>DPAR is a simple and effective method for the diagnosis of shunt insufficiency caused by delayed abdominal end adhesion after VP shunt.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"10 1","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126789","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":"Factors associated with radiographic progression and neurologic decline in patients with isolated traumatic subarachnoid hemorrhage.","authors":"Kaushik Ravipati, Inamullah Khan, Wesley Chen, Ravi Nunna, Aaron Voshage, Sasidhar Karuparti, Ismail Ziu, Michael Ortiz","doi":"10.1186/s41016-024-00377-0","DOIUrl":"10.1186/s41016-024-00377-0","url":null,"abstract":"<p><strong>Background: </strong>Complicated mild traumatic brain injury (cmTBI) is a common neurosurgical disorder that consumes a significant amount of healthcare resources without a clearly established benefit. Best practices for the management of cmTBI regarding triage, hospital admission, and the necessity for repeat imaging are controversial. Our objective is to describe the rate of radiographic progression and neurologic decline for isolated traumatic subarachnoid hemorrhage (itSAH) patients admitted to the hospital. We hypothesized that only a minority of itSAH patients suffer radiographic progression and that radiographic progression is not necessarily associated with neurologic decline.</p><p><strong>Methods: </strong>Database queries and direct patient chart reviews were used to gather patient data. T-tests and Fisher's exact tests were performed.</p><p><strong>Results: </strong>A total of 340 patients with cmTBI associated with itSAH were included for analysis. The radiographic progression rate was 5.6%. There was no statistically significant association between age, gender, GCS at presentation, anticoagulation status, and risk of radiographic progression. However, subgroup analysis on anticoagulated patients did show those on warfarin had a statistically significant risk of radiographic progression (p = 0.003). No patient developed neurologic decline, irrespective of whether they developed radiographic progression.</p><p><strong>Conclusion: </strong>Secondary triaging, hospital admission, ICU stay, and repeat HCT might not be necessary for awake, GCS 13-15 patients with itSAH without any other significant injuries. In the case of anticoagulant use, but not necessarily antiplatelet use, the medication should be reversed, and admission should be considered.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"10 1","pages":"25"},"PeriodicalIF":0.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11302199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898492","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":"Planning a sustainable neurosurgery mentorship program in a war-torn country: experience from Iraq.","authors":"Teeba A Al-Ageely, Mustafa Ismail, Zinah A Alaraji, Jaafar Abdulwahid, Fatima Ayad, Huda Jaafar, Awfa Aktham, Hayder R Salih, Samer Hoz","doi":"10.1186/s41016-024-00376-1","DOIUrl":"10.1186/s41016-024-00376-1","url":null,"abstract":"<p><p>The importance of mentorships in medical education and neurosurgery is highly attributed to the support and encouragement of the advances and learning opportunities for medical students and junior neurosurgeons. Planning a mentorship program according to the target audience offers to satisfy different interests and enhance education. One of the main issues with most of the already implemented programs is the sustainability and inability to maintain continuous cycles of mentorship, which have a negative impact and have led to an interrupted pattern of learning which eventually leads to a decline in the engagement of participants and loss of interest. This problem is most pronounced in war-torn countries, with Iraq as an example, where external circumstances lead to an arrest in the educational process and a depletion of the resources useful for such programs and training courses. This paper aims to address the main pathways essential in planning a sustainable mentorship program in a war-torn country by highlighting our experience in maintaining an ongoing mentorship with nine consecutive courses over the last 6 years in Iraq.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"10 1","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876232","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":"Stellate ganglion block: what else is necessary to include in the treatment of subarachnoid hemorrhage patients?","authors":"Leonardo C Welling, Nicollas Nunes Rabelo, Mateus Gonçalves de Sena Barbosa, Beatriz Rodrigues Messias, Carolina Guimarães Pinto, Eberval Gadelha Figueiredo","doi":"10.1186/s41016-024-00374-3","DOIUrl":"10.1186/s41016-024-00374-3","url":null,"abstract":"<p><p>Cerebral vasospasm is determined as a temporary narrowing of cerebral arteries a few days after an aneurysmal subarachnoid hemorrhage. The onset of this vascular event usually evolves with new neurological deficits or progression of ischemic areas. The success of interventions to treat or revert this condition is not satisfying. In addition to cerebral vasospasm, early brain injury plays an important role as a contributor to subarachnoid hemorrhage's mortality. In this sense, stellate ganglion block appears as an alternative to reduce sympathetic system's activation, one of the main pathophysiological mechanisms involved in brain injury. Over the past few years, there is growing evidence that stellate ganglion block can contribute to decline patient morbidity from subarachnoid hemorrhage. Is it time to include this procedure as a standard treatment after aneurysm rupture?</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"10 1","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861094","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":"MGMT promoter methylation is a strong prognostic factor for survival after progression in high-grade gliomas.","authors":"Jing Zhang, Xiaoguang Qiu, Jin Feng, Yanwei Liu","doi":"10.1186/s41016-024-00375-2","DOIUrl":"10.1186/s41016-024-00375-2","url":null,"abstract":"<p><strong>Background: </strong>High-grade gliomas (HGGs) have a rapid relapse and short survival. Studies have identified many clinical characteristics and biomarkers associated with progression-free survival (PFS) and over-survival (OS). However, there has not yet a comprehensive study on survival after the first progression (SAP).</p><p><strong>Methods: </strong>From CGGA and TCGA, 319 and 308 HGGs were confirmed as the first progression. The data on clinical characteristics and biomarkers were analyzed in accordance with OS, PFS, and SAP.</p><p><strong>Results: </strong>Analysis of 319 patients from CGGA, significant predictors of improved OS/PFS/SAP were WHO grade, MGMT promoter methylation, and Ki-67 expression in univariate analysis. Further multivariate analysis showed MGMT promoter methylation and Ki-67 expression were independent predictors. However, an analysis of 308 patients from TCGA found MGMT promoter methylation is the only prognostic marker. A longer SAP was observed in patients with methylated MGMT promoter after standard chemoradiotherapy. In our data, HGGs could be divided into low, intermediate, and high-risk groups for SAP by MGMT methylation and Ki-67 expression.</p><p><strong>Conclusions: </strong>Patients with MGMT promoter methylation have a prolonger SAP after standard chemoradiotherapy. HGGs could be divided into low, intermediate, and high-risk groups for SAP according to MGMT status and Ki-67 expression.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"10 1","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11267829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761473","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":"The hybrid operation based on microsurgery assisted by intraoperative spinal angiography in patients with spinal dural arteriovenous fistula: a series of 45 cases from multicenter research.","authors":"Xiaorong Sun, Li Yu, Wenqing Jia, Wei Dai","doi":"10.1186/s41016-024-00372-5","DOIUrl":"10.1186/s41016-024-00372-5","url":null,"abstract":"<p><strong>Background: </strong>To assess the clinical effects of hybrid surgery, which includes spinal angiography-assisted microsurgery, in the treatment of spinal dural arteriovenous fistulas (SDAVF).</p><p><strong>Methods: </strong>We retrospectively reviewed 45 patients who underwent hybrid Spinal dural arteriovenous fistula (SDAVF) resection between September 2019 and June 2022. The hybrid surgery involved intraoperative digital subtraction angiography (DSA) of the spinal vessels to determine the source of the blood-supplying artery, location of the fistula and draining vein, indocyanine green fluorescence (ICG)-assisted microsurgical resection of the fistula, and postoperative DSA to verify therapeutic efficacy. The Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Visual Analog Scale (VAS), Barthel score, modified Rankin Scale (mRS) and modified Aminoff-Logue score (key indicator) were used to assess the clinical effects of SDAVF resection.</p><p><strong>Results: </strong>A series of 45 patients with SDAVF were successfully treated with hybrid surgery without fistula recurrence. There were no intraoperative complications related to spinal angiography, and none of the patients died. Postoperatively, two patients experienced clinical deterioration of spinal cord function, which manifested as bilateral lower extremity paralysis and bladder sphincter dysfunction. Postoperatively, improvement in mALS scores was observed in 16 cases (35.6%) within 1-2 days, 12 cases (26.7%) at 1 week, and 7 cases (15.6%) at 6 months. No SDAVF recurrence was detected in the spinal MRA examination 6 months after surgery. When compared with preoperative mALS scores, 35 cases (77.8%) showed significant improvement in symptoms, 8 cases (17.8%), remained unchanged, and 2 cases (4.4%) deteriorated. Compared with the preoperative scores, the postoperative mALS score was significantly decreased [postoperative vs. preoperative: 2(1,3) vs. 3(2,4)], HAMD score [(12.2 ± 5.5) vs. (19.6 ± 6.3)], HAMA score [(15.6 ± 5.5) vs. (20.5 ± 6.5)], and VAS score [3(2,5) vs. 5(4,8)]. Conversely, Barthel scoresshowed significant increase [(74.6 ± 8.7) vs. (67.8 ± 9.2)] (P < 0.05). However, the mRS scores were lower than preoperatively [1(1,2) vs. 2(1,2.5)], but the difference was not statistically significant (P > 0.05). There was a significant increase in \"good\" neurological outcomes at follow-up compared with preoperative function (62.2% vs. 33.3%) (P = 0.023).</p><p><strong>Conclusion: </strong>Hybrid surgery is a safe and effective treatment for patients with SAVF, which is beneficial for improving anxiety, depression, spinal cord, and neurological function, and relieving pain. However, the treatment of patients with SDAVF is a complex, long-term process requiring further multidisciplinary interventions, including clinical care, psychosocial interventions, and neurorehabilitation.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"10 1","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11264783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727911","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":"Rivaroxaban's vascular dose for the neurovascular clinician.","authors":"Ji Y Chong, Kalimullah Jan","doi":"10.1186/s41016-024-00373-4","DOIUrl":"10.1186/s41016-024-00373-4","url":null,"abstract":"<p><p>Rivaroxaban, a direct oral anticoagulant, has proven efficacy and safety at its standard dose in the treatment and prevention of various vascular conditions. These include the treatment of venous thromboembolism and stroke prevention in non-valvular atrial fibrillation. A \"very low\" vascular dose of rivaroxaban, when combined with low-dose aspirin, has been demonstrated to reduce major adverse cardiovascular events, including stroke, in both acute and chronic coronary syndrome. The combination of rivaroxaban and low-dose aspirin could potentially offer an additional strategy for stroke prevention in selected non-atrial fibrillation patients who are at a high risk of stroke.</p>","PeriodicalId":36700,"journal":{"name":"Chinese Neurosurgical Journal","volume":"10 1","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11221019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499182","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}