World Neurosurgery: X最新文献

{"title":"Ventriculoatrial shunt placement via internal jugular vein using a modified 8F vascular access sheath: A technical note","authors":"Md Shahidur Rahman Sikder,&nbsp;Momen Ali Khan,&nbsp;Mohammad Tanvir Hossen,&nbsp;Asish Kumer Das,&nbsp;Saad Ahmed,&nbsp;Muhammad Robiul Hoque,&nbsp;A.F.M Momtazul Haque","doi":"10.1016/j.wnsx.2026.100634","DOIUrl":"10.1016/j.wnsx.2026.100634","url":null,"abstract":"<div><div>Ventriculoatrial (VA) shunting is a valuable alternative when ventriculoperitoneal (VP) shunting is contraindicated. We describe a modified technique for VA shunt placement using a standard, non-peel-away 8F vascular access sheath, adapted intraoperatively into a functional peel-away system using a simple blade modification. A 26-year-old male with a chronically infected, exteriorized left VP shunt underwent conversion to a left-sided VA shunt. Through a 2.5 cm neck incision, the internal jugular vein (IJV) was accessed under direct vision using a Seldinger technique, without ultrasound or fluoroscopic guidance. The distal catheter was advanced using the sternal angle as an unvalidated, pragmatic surface landmark for insertion length; postoperative chest radiography confirmed the catheter tip lying at approximately T3-T4 level, within the superior vena cava, proximal to the accepted cavoatrial target. This technique avoids venous tributary sacrifice and reduces neck dissection using universally available equipment, offering a feasible, though imprecisely targeted and fluoroscopy-free, option where dedicated peel-away introducers and image guidance are unavailable. The postoperative course was uneventful. At 3-month follow-up, the patient had a Glasgow Outcome Scale (GOS) score of 5. No thrombotic events or cardiac arrhythmias were observed during the follow-up period.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"32 ","pages":"Article 100634"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149159549","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":"Peritumoral edema and imaging markers of aggressiveness in intracranial meningiomas: A combined predictive model","authors":"Moustafa A. Mansour,&nbsp;M. Wahid,&nbsp;Mohamed A.S. El Molla,&nbsp;Mohamed H. Helmy,&nbsp;Taha Mohammed Adel,&nbsp;Mohamed Said Elsanafiry,&nbsp;Hamdi Nabawi Mostafa","doi":"10.1016/j.wnsx.2026.100633","DOIUrl":"10.1016/j.wnsx.2026.100633","url":null,"abstract":"<div><h3>Introduction</h3><div>Peritumoral brain edema (PTBE) is a clinically significant finding in meningiomas, yet its relationship with radiological features and tumor biology remains incompletely understood. This study characterizes imaging features across a diverse meningioma cohort, emphasizing correlations between histological subtypes, PTBE severity, and markers of tumor aggressiveness.</div></div><div><h3>Methods</h3><div>We retrospectively evaluated 48 intracranial meningiomas from a radiological-pathological database. Imaging features and WHO histological subtypes were systematically evaluated. The edema index (EI) was calculated as the edema-to-tumor volume ratio. ROC analysis evaluated imaging features for predicting disproportionate edema (EI &gt; 3.0), followed by bootstrap resampling internal validation (1000 replicates) with optimism correction.</div></div><div><h3>Results</h3><div>Microcystic (mean EI 4.8 ± 1.9) and angiomatous (mean EI 5.2 ± 2.1) meningiomas demonstrated higher EIs versus other WHO grade I subtypes (<span><math><mrow><mi>p</mi><mo>&lt;</mo><mn>0.001</mn></mrow></math></span>), with 100% showing EI &gt; 3.0. Prominent flow voids correlated with PTBE severity (<span><math><mrow><mi>p</mi><mo>=</mo><mn>0.008</mn></mrow></math></span>). Loss of arachnoid plane and irregular margins occurred in 80–100% of microcystic/angiomatous cases versus 16.7% of meningothelial cases (<span><math><mrow><mi>p</mi><mo>&lt;</mo><mn>0.001</mn></mrow></math></span> and <span><math><mrow><mi>p</mi><mo>=</mo><mn>0.008</mn></mrow></math></span>). A combined model (loss of arachnoid plane, flow voids, irregular margins) demonstrated strong discrimination for disproportionate edema (AUC = 0.91, 95% CI: 0.81–0.97; 87.5% sensitivity, 83.3% specificity; optimism-corrected AUC ≈ 0.86; absolute volume AUC ≈ 0.87). Psammomatous meningiomas showed minimal edema (mean EI 0.8 ± 0.3).</div></div><div><h3>Conclusion</h3><div>Specific imaging features correlate with histological subtypes and predict aggressiveness. Microcystic and angiomatous subtypes exhibit severe PTBE and aggressive radiological traits despite WHO Grade I status. Identifying an “aggressive phenotype” may aid preoperative risk stratification and surgical planning.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"32 ","pages":"Article 100633"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149159547","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":"Benju Rashmi Pradhan, the pioneering female neurosurgeon of Nepal","authors":"Keyvan Mostofi,&nbsp;Bipin Chaurasia","doi":"10.1016/j.wnsx.2026.100632","DOIUrl":"10.1016/j.wnsx.2026.100632","url":null,"abstract":"<div><div>Neurosurgery remains one of the most male-dominated specialties in medicine, and pioneering women who break through its barriers risk being overlooked without deliberate historical documentation. This article traces the career of Dr. Benju Rashmi Pradhan, recognized as Nepal's first practicing female neurosurgeon, from her medical training in Bangladesh to her postgraduate specialization in neurosurgery in 2011 and her subsequent practice at B.P. Koirala Memorial Cancer Hospital. Her trajectory is situated within the history of women's advancement in Nepali medicine, illuminating both individual achievement and the structural barriers pioneering women in South Asian medicine continue to navigate.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"32 ","pages":"Article 100632"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149159548","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":"Developing a neurointervention service in a resource-limited health system: A real-world single-center experience from Iraq","authors":"Khalid Amber,&nbsp;Ahmed A. Khawwam","doi":"10.1016/j.wnsx.2026.100635","DOIUrl":"10.1016/j.wnsx.2026.100635","url":null,"abstract":"<div><h3>Objective</h3><div>Neurointerventional capacity remains unevenly distributed across Iraq, and its development within existing catheterization infrastructure is poorly documented. We describe the establishment and early results of a neurointerventional service embedded within a cardiac catheterization center in Najaf, Iraq.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed consecutive neurointerventional procedures at a single center from January 2023 through June 2026. Angiographic results, periprocedural complications, and discharge functional status were abstracted from the primary clinical records using pathology-specific scales. Analysis was descriptive; 2026 data are partial.</div></div><div><h3>Results</h3><div>163 procedures were performed in 144 patients (mean age 45.2 years; 11.8% pediatric). Annual volume rose from 30 (2023) to 44 (2024) and 52 (2025), with 37 by June 2026. Aneurysm treatment was most frequent (<em>n</em> = 64; 39.3%), followed by arteriovenous malformation (<em>n</em> = 27) and diagnostic angiography (<em>n</em> = 26). Among 44 coil-based aneurysm treatments, adequate occlusion (Raymond–Roy 1 or 2) was achieved in 39 (88.6%); among 20 flow-diversion treatments, immediate O'Kelly–Marotta grade C or D in 6 (30.0%), consistent with its delayed occlusion. Complete obliteration was achieved in 3 of 23 arteriovenous malformations, and mTICI 2b–3 reperfusion in 7 of 9 thrombectomies. Complications occurred in 5 procedures (3.1%) and procedure-related death in 2 (1.2%). Discharge modified Rankin Scale 0–2 occurred in 40 of 62 aneurysm patients (64.5%).</div></div><div><h3>Conclusions</h3><div>A neurointerventional service was established and expanded within a cardiac catheterization center over 3.5 years, with angiographic and safety results within the range reported by established programs. With an account of device procurement, staff cross-training, and referral pathways, these data support neurointerventional capacity-building in a resource-limited setting.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"32 ","pages":"Article 100635"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149211058","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":"Ultrasound imaging of the radial artery for neurointervention","authors":"Aleisha J. Singh,&nbsp;Rohen Harrichandparsad,&nbsp;Lelika Lazarus","doi":"10.1016/j.wnsx.2026.100617","DOIUrl":"10.1016/j.wnsx.2026.100617","url":null,"abstract":"<div><h3>Aims and objectives</h3><div>The distal forearm and snuffbox radial arteries are increasingly used as alternatives to femoral artery access for neurointerventional procedures due to their lower complication rates. However, vessel diameter variability and sheath compatibility remain important anatomical considerations. Although previous studies have investigated these arteries, limited data are available within African populations. This study aimed to investigate the anatomical characteristics of the distal forearm and snuffbox radial arteries using ultrasound in a select hospital-based South African population.</div></div><div><h3>Materials and methods</h3><div>This cross-sectional study included 256 participants (subset A: 128 adults; subset B: 128 paediatric participants) recruited from a central regional hospital in Durban, South Africa. Ultrasound measurements of the distal forearm and snuffbox radial arteries were obtained bilaterally.</div></div><div><h3>Results</h3><div>In subset A, the average diameter of the distal forearm radial artery was 1.94 ± 0.39 mm. Males demonstrated significantly larger diameters than females (2.12 ± 0.39 mm <em>vs.</em> 1.82 ± 0.34 mm, <em>p</em> &lt; 0.001). The average snuffbox radial artery diameter was 1.33 ± 0.31 mm. In subset B, the average diameters of the distal forearm and snuffbox radial arteries were 1.12 ± 0.32 mm and 0.77 ± 0.20 mm, respectively. Body surface area, height, and wrist circumference correlated with vessel diameter, whereas BMI showed no significant association. Notably, 55% of adults and 99% of paediatric participants had distal forearm radial artery diameters below 2.00 mm.</div></div><div><h3>Conclusion</h3><div>These findings may provide anatomical reference data regarding radial artery calibre and sheath dimension relationships within this select hospital-based population.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"31 ","pages":"Article 100617"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148539379","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":"Reduced risk of CSF leak via minimally invasive approaches in posterior fossa surgeries: 10-year experience","authors":"Dzmitry Kuzmin,&nbsp;Iván N. Camal Ruggieri,&nbsp;Daniel Staribacher,&nbsp;Guenther C. Feigl","doi":"10.1016/j.wnsx.2026.100606","DOIUrl":"10.1016/j.wnsx.2026.100606","url":null,"abstract":"<div><h3>Background</h3><div>CSF leaks are one of the postoperative complications after cranial surgeries which can have severe and potentially lethal consequences for the patient. This is particularly true for posterior fossa surgeries. According to various reports, the complication rate is as high as 33%. This is due to the increased intracranial pressure in the posterior fossa and the presence of many basal cisterns. Adequate watertight duraplasty prevents CSF leaks. Therefore, the smaller the dural defect is, the easier it is to achieve a watertight duraplasty. And that in turn depends also on the size of the craniotomy. As minimally invasive posterior fossa surgery has represented the institutional surgical philosophy in our department for many years, we present our long-term experience and CSF leak rates associated with these approaches.</div></div><div><h3>Materials</h3><div>We estimated the rate of postoperative CSF leaks in patients operated on for posterior fossa pathologies between 2015 and 2024. We evaluated the gender and age of the patients, the indications for surgery and urgency thereof, the size of a surgical approach, and the method of duraplasty.</div></div><div><h3>Results</h3><div>Over a ten-year period, 275 surgeries were performed on the posterior cranial fossa. 118 (42.9% of cases) of the patients were male, 157 (57.1% of the cases) of the patients were female. The mean age was 59 years (Median 59). The following pathologies were identified: acoustic neuromas, cerebellopontine angle meningiomas, trigeminal neuralgia, hemifacial spasm, cerebellar tumors, cerebellar infarction, cerebellar hemorrhages, and rarer pathologies. The mean size of the craniotomy was 2.15 × 1.9 cm. In all cases, duraplasty was performed using alloplastic materials. CSF leaks were reported in 6 (2.18 %, 95% CI 1.00–4.68%) cases: 5 (1.82 %, 95% CI 0.78–4.18%) cases of incisional CSF leaks and 1 (0.36 %, 95% CI 0.06–2.03%) non-incisional. All cases of incisional CSF leak required reoperations.</div></div><div><h3>Conclusions</h3><div>The use of minimally invasive approaches in posterior fossa surgery may be associated with a low risk of postoperative cerebrospinal fluid leakage. In this context, adequate dural closure can be achieved when the dural defect is limited and appropriate duraplasty techniques are applied.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"31 ","pages":"Article 100606"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148539376","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":"Plasma metabolomic profiling reveals systemic metabolic dysregulation and its association with cognitive impairment in moyamoya disease","authors":"Jun Shen,&nbsp;Sisi Peng,&nbsp;Juan Du,&nbsp;Ziwei Xu,&nbsp;Dan Wang,&nbsp;Mingxuan Lv,&nbsp;Yu Duan,&nbsp;Wenshi Wei","doi":"10.1016/j.wnsx.2026.100613","DOIUrl":"10.1016/j.wnsx.2026.100613","url":null,"abstract":"<div><h3>Abstract</h3><div>Moyamoya disease (MMD) is a progressive cerebrovascular disorder that accounts for a rare cause of ischemic, hemorrhagic stroke and cognitive impairment. However, the association between plasma metabolic changes and cognitive decline in patients with MMD has yet to be fully elucidated.</div></div><div><h3>Methods</h3><div>A total of 30 MMD patients with asymptomatic, ischemic and hemorrhagic subtypes and 10 healthy controls were recruited. Global and domain-specific cognitive functions were assessed. Plasma samples were subjected to untargeted Liquid chromatography–mass spectrometry (LC-MS/MS) metabolomics to identify metabolic disturbances. Multivariate statistical analyses and correlation analyses were performed to explore the association between metabolic profiles and cognitive deficits, and the metabolic changes among MMD subtypes.</div></div><div><h3>Results</h3><div>MMD patients presented obvious impairments in general cognition, immediate memory, delayed recall and recognition, with no cognitive differences across subtypes. In total, 120 upregulated and 22 downregulated plasma metabolites were identified in MMD. Key changes involved elevated bile acids, decreased purine nucleotides, and disrupted lipid and energy metabolism. 11-Cis-Retinol was closely correlated with cognitive dysfunction. Each subtype showed exploratory metabolic alterations: asymptomatic MMD showed disrupted bile acid and neurotransmitter metabolism; ischemic MMD displayed inflammatory imbalance and energy shortage; hemorrhagic MMD showed mitochondrial and metabolic dysfunction.</div></div><div><h3>Conclusion</h3><div>MMD is associated with cognitive impairment and systemic metabolic dysregulation. Exploratory subtype-related metabolic differences were observed, while abnormal bile acid metabolism and disrupted energy homeostasis may be associated with cognitive decline. This study may provide novel metabolic evidence and potential biomarkers for MMD classification and cognitive intervention.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"31 ","pages":"Article 100613"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148539374","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":"Grief in the neurosurgical lineage: A son's ode to his father, Dr. Shou-Ning Jiang","authors":"Yng Jiang","doi":"10.1016/j.wnsx.2026.100611","DOIUrl":"10.1016/j.wnsx.2026.100611","url":null,"abstract":"<div><div>Prof. Shou-Ning Jiang, a pioneering Chinese neurosurgeon, passed away in January 2026 after a nearly six-decade career that paralleled and helped shape the modernization of neurosurgery in China. He devoted his life to alleviating the suffering of patients and their families. He was a resilient man who fought his way out of early poverty and through multiple periods of social turmoil. He was also a loving husband and father, pouring all his love into the family and wholeheartedly supporting his son – the author - to pursue the same profession and strive for greater achievements in medicine. Yet, he could not halt the Alzheimer's disease (AD) in its progression, a profound sorrow that underpins this work. Beyond honoring Prof. Jiang's legacy, this vignette urges greater public awareness that AD is not merely a disorder of memory loss, but a life-limiting neurodegenerative disease marked by progressive cognitive, functional, and neuropsychiatric decline. Its trajectory imposes profound physical, emotional, and socioeconomic burdens on patients and family caregivers alike.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"31 ","pages":"Article 100611"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148539375","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":"Umbrella review of middle meningeal artery embolization and surgery outcomes in chronic subdural hematoma","authors":"Ali Msheik,&nbsp;Alaaeldin Ahmed,&nbsp;Fatima Al Sada,&nbsp;Ruben Peralta,&nbsp;Amr El Mohamad,&nbsp;Zeinab Al Mokdad,&nbsp;Muhammad Mohsin Khan,&nbsp;Noman Shah,&nbsp;Aisha AlKubaisi,&nbsp;Ghanem Al Sulaiti,&nbsp;Ghaya Al Rumaihi","doi":"10.1016/j.wnsx.2026.100615","DOIUrl":"10.1016/j.wnsx.2026.100615","url":null,"abstract":"<div><div>Middle meningeal artery embolization has been investigated as a minimally invasive alternative or adjunct to conventional surgery for chronic subdural hematoma. This umbrella review aimed to synthesize and critically appraise published systematic reviews and meta-analyses comparing embolization with surgery, with emphasis on methodological quality, consistency of findings, overlap of primary studies, and umbrella-level GRADE-informed certainty judgments. Following PRISMA 2020 and Joanna Briggs Institute guidance for umbrella reviews, we searched PubMed, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews for English-language eligible reviews published between January 1, 2015, and July 15, 2025, and screened the reference lists of included reviews. Methodological quality was assessed using AMSTAR 2, umbrella-level GRADE-informed certainty judgments were applied and overlap of primary studies was quantified using the corrected covered area method. Twenty-three systematic reviews comprising 108 unique primary studies were included. Across reviews, middle meningeal artery embolization was generally associated with lower recurrence and reoperation rates than surgery or conventional management, although these findings were constrained by review overlap, heterogeneity, mixed primary study designs, and variable methodological quality. Functional outcomes and complication rates were broadly similar across treatment strategies, whereas evidence for mortality and hospital length of stay remained less certain. Overall, the most consistent review-level evidence suggested an association between embolization and lower recurrence and reoperation. These findings suggest that middle meningeal artery embolization may be associated with favorable outcomes for selected endpoints, but the evidence remains insufficient to establish definitive superiority across clinical domains. Further high-quality prospective studies are needed.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"31 ","pages":"Article 100615"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148539371","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 clinical value of preoperative MRI measurement of Meckel's cave volume in percutaneous balloon compression surgery for trigeminal neuralgia","authors":"Yazhou Wang,&nbsp;Shuo Wen,&nbsp;Xiaolong Wang,&nbsp;Qiling Xu,&nbsp;Bingzhou Cui,&nbsp;Bo Wang","doi":"10.1016/j.wnsx.2026.100612","DOIUrl":"10.1016/j.wnsx.2026.100612","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the clinical value of magnetic resonance imaging (MRI)-measured Meckel's cave volume in percutaneous balloon compression (PBC) for the treatment of trigeminal neuralgia (TN).</div></div><div><h3>Methods</h3><div>A total of 51 patients with primary TN receiving PBC from May 2021 to May 2024 were retrospectively enrolled. Preoperative MRI was used to measure Meckel's cave volume. Patients' clinical data, pain severity, mental status, and quality of life before and after treatment were analyzed.</div></div><div><h3>Results</h3><div>All 51 patients successfully underwent the surgery, with a success rate of 100% and an overall effective rate of 98.04%. The postoperative pain score was significantly lower than that before the operation (<em>p</em> &lt; 0.05), and the quality of life was significantly improved (<em>p</em> &lt; 0.05). The average follow-up time was 19.20 ± 7.68 months. The overall recurrence rate was 17.65% (9/51), with recurrence rates of 1.96% (1/51) at 6 months, 3.92% (2/51) at 12 months, and 11.76% (6/51) at 24 months. For all patients and non-recurrent patients, the compression coefficient (balloon volume/Meckel's cave volume) was 1.079–1.790 and 1.401–1.709, respectively. The compression coefficient was an independent risk factor for recurrence (<em>p</em> &lt; 0.001), and the smaller the compression coefficient, the higher the risk of recurrence.</div></div><div><h3>Conclusion</h3><div>MRI measurement of Meckel's cave volume is valuable for guiding individualized balloon inflation during PBC surgery. A compression coefficient of 1.401–1.790 may represent the optimal range for favorable PBC outcomes. Further prospective studies are warranted.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"31 ","pages":"Article 100612"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148539373","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}