World Neurosurgery: X最新文献

Combined Robotic Stereotactic Assistance (ROSA) with intraoperative mobile CT for intracerebral hemorrhage aspiration: technical note and case series 联合机器人立体定向辅助（ROSA）与术中移动CT用于脑出血抽吸：技术说明和病例系列

IF 2

World Neurosurgery: X Pub Date : 2026-04-01 Epub Date: 2026-04-06 DOI: 10.1016/j.wnsx.2026.100591

Charlton Chen-Ting Cheng , Tzu-Hao Yen , Chih-Hsiu Tu , Chien-Tung Yang , Jeng-Hung Guo , Yu-Kai Cheng , Hung-Lin Lin , Chun-Chung Chen

{"title":"Combined Robotic Stereotactic Assistance (ROSA) with intraoperative mobile CT for intracerebral hemorrhage aspiration: technical note and case series","authors":"Charlton Chen-Ting Cheng , Tzu-Hao Yen , Chih-Hsiu Tu , Chien-Tung Yang , Jeng-Hung Guo , Yu-Kai Cheng , Hung-Lin Lin , Chun-Chung Chen","doi":"10.1016/j.wnsx.2026.100591","DOIUrl":"10.1016/j.wnsx.2026.100591","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to present a novel technique combining robotic stereotactic assistance (ROSA) with intraoperative mobile CT (AIRO CT) for the aspiration of spontaneous intracerebral hemorrhage (ICH).</div></div><div><h3>Methods</h3><div>We present a case series of cases combining ROSA and AIRO CT for hematoma aspiration, with detailed procedural descriptions in basal ganglia and lobar ICH patients treated between 2024 and 2025.</div></div><div><h3>Results</h3><div>Twenty patients achieved satisfactory hematoma clearance confirmed by intraoperative AIRO CT. Two patients attained favorable neurological outcomes (modified Rankin Scale≤ 2), and four demonstrated intermediate recovery (mRS = 3), indicating partial functional improvement. One patient expired within 30 days due to non-neurological causes.</div></div><div><h3>Conclusions</h3><div>Our integrated technique combining ROSA and AIRO CT provides a feasible and practical approach for minimally invasive ICH evacuation. This method enhances hematoma clearance, improves intraoperative confidence, and increases overall surgical safety.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"30 ","pages":"Article 100591"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147656698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The maternal-fetal trade-off in pregnancy-associated meningioma management: A systematic review and meta-analysis 妊娠相关脑膜瘤治疗的母胎权衡：系统回顾和荟萃分析

IF 2

World Neurosurgery: X Pub Date : 2026-04-01 Epub Date: 2026-01-24 DOI: 10.1016/j.wnsx.2026.100571

Agung Budi Sutiono, Yulius Hermanto

{"title":"The maternal-fetal trade-off in pregnancy-associated meningioma management: A systematic review and meta-analysis","authors":"Agung Budi Sutiono, Yulius Hermanto","doi":"10.1016/j.wnsx.2026.100571","DOIUrl":"10.1016/j.wnsx.2026.100571","url":null,"abstract":"<div><div>The management of pregnancy-associated meningioma (PAM) necessitates a critical balance between preserving maternal neurological function and ensuring fetal safety. This study aims to systematically evaluate the maternal and fetal outcomes associated with different management strategies for PAM by synthesizing the available evidence. This systematic review and meta-analysis quantitatively synthesize evidence from 5 studies (144 patients) from January 1, 2010, to December 31, 2024, to evaluate trade-offs between maternal and fetal outcomes across three management pathways: antepartum surgery, planned early postpartum surgery (≤7 days post-delivery), and deferred surgery/conservative management. Maternal neurological recovery was similarly high across all groups (89 %, 90 %, and 86 %, respectively). However, a clear gradient in fetal risk was observed: preterm delivery (<37 weeks) occurred in 38 % (95 % CI: 30–46 %) of the antepartum surgery group, 15 % (95 % CI: 9–23 %) of the planned early postpartum group, and 10 % (95 % CI: 5–17 %) of the deferred management group. The risk ratio for preterm delivery was 3.2 (95 % CI: 2.0–5.1) for antepartum versus combined postpartum pathways. Vaginal delivery was most common in the deferred group (66 %) and planned early postpartum group (60 %). In conclusion, these findings support a risk-stratified approach: antepartum surgery remains effective for neurologically declining mothers but carries the highest fetal risk, while planned early postpartum intervention offers a middle-ground, and deferred management is safest for the fetus in stable patients. Clinical decision-making should be individualized and guided primarily by maternal neurological status within a multidisciplinary framework.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"30 ","pages":"Article 100571"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Analysis of risk factors for planned tracheal extubation failure in patients after posterior fossa surgery 后窝手术患者计划气管拔管失败的危险因素分析

IF 2

World Neurosurgery: X Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI: 10.1016/j.wnsx.2026.100575

Haotian Wu, Xianglong Cai, Yi Ma, Yan Xu

{"title":"Analysis of risk factors for planned tracheal extubation failure in patients after posterior fossa surgery","authors":"Haotian Wu, Xianglong Cai, Yi Ma, Yan Xu","doi":"10.1016/j.wnsx.2026.100575","DOIUrl":"10.1016/j.wnsx.2026.100575","url":null,"abstract":"<div><h3>Objective</h3><div>To identify risk factors influencing planned tracheal extubation failure in patients after posterior fossa surgery.</div></div><div><h3>Methods</h3><div>A total of 74 patients admitted to the neurosurgical intensive care unit of a tertiary hospital between January 2022 and January 2024 were enrolled in this study using a convenience sampling method. Clinical data and parameters related to tracheal extubation were collected and analyzed. Risk factors for extubation failure were identified using univariate analysis and binary logistic regression analysis.</div></div><div><h3>Results</h3><div>Among the 74 patients, 18 experienced tracheal extubation failure. Univariate analysis revealed significant differences in pre-extubation Glasgow Coma Scale (GCS) score, pneumonia, cough strength scores, suction frequency, hypercapnia, and dysphagia after extubation (<em>P</em> < 0.05). Binary logistic regression identified weak cough strength, hypercapnia, and high suction frequency as risk factors for extubation failure in these patients.</div></div><div><h3>Conclusion</h3><div>Cough strength, Hypercapnia, and suction frequency are key determinants of tracheal extubation outcomes in patients after posterior fossa surgery.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"30 ","pages":"Article 100575"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Vascular loops and pulsatile tinnitus: Culprit or innocent bystander? – An illustrative case and systematic literature review 血管袢与搏动性耳鸣：罪魁祸首还是无辜的旁观者？-一个说明性的案例和系统的文献综述

IF 2

World Neurosurgery: X Pub Date : 2026-04-01 Epub Date: 2026-02-04 DOI: 10.1016/j.wnsx.2026.100574

Hector R. Martinez , Sofia L. Rivera-Torres , Carlos Cuilty-Siller , Cristo G. Sanchez , Alberto Tueme , Paola Velediaz , Nerea Martin de Campo , Guillermo Kenji Pons , Azalea G. Baez , Oscar Gutierrez-Trevino , Beatriz Perez-Martinez , Jose A. Moran Guerrero , Jose A. Figueroa-Sanchez

{"title":"Vascular loops and pulsatile tinnitus: Culprit or innocent bystander? – An illustrative case and systematic literature review","authors":"Hector R. Martinez , Sofia L. Rivera-Torres , Carlos Cuilty-Siller , Cristo G. Sanchez , Alberto Tueme , Paola Velediaz , Nerea Martin de Campo , Guillermo Kenji Pons , Azalea G. Baez , Oscar Gutierrez-Trevino , Beatriz Perez-Martinez , Jose A. Moran Guerrero , Jose A. Figueroa-Sanchez","doi":"10.1016/j.wnsx.2026.100574","DOIUrl":"10.1016/j.wnsx.2026.100574","url":null,"abstract":"<div><div>Vascular loops are a common finding on imaging and their clinical significance depends on whether they cause compression of nearby structures. The association of vascular loops as a direct cause of otological symptoms such as pulsatile tinnitus (PT) is currently under debate. PT can be an incapacitating condition, so efforts to correctly identify and classify its cause must be made to provide an appropriate intervention and symptom relief. We present 5 illustrative cases of patients who came to our institution with complaints of PT, where imaging studies revealed a vascular loop. Furthermore, we performed a literature search using the MEDLINE, Scopus and Web of Science databases to look for cases of PT associated with vascular loops. Our review yielded a total of 52 studies, with only 4 articles (31 patients), specifying a clinical presentation of both PT and vascular loop in the same patient. Although there appears to be a connection between the presence of vascular loops and the manifestation of pulsatile tinnitus, current studies have not proved direct causality.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"30 ","pages":"Article 100574"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk factors for optic neuropathy after clipping for paraclinoid aneurysms: A retrospective study 线旁动脉瘤夹闭后视神经病变的危险因素：回顾性研究

IF 2

World Neurosurgery: X Pub Date : 2026-04-01 Epub Date: 2026-01-27 DOI: 10.1016/j.wnsx.2026.100568

Junya Iwama , Hiroki Sato , Seiji Kuribara , Makoto Mizushima , Takumi Hirabayashi , Ryosuke Tsuchiya , Takafumi Shindo , Keisuke Ohnaka , Takanori Hayakawa , Katsumi Takizawa

{"title":"Risk factors for optic neuropathy after clipping for paraclinoid aneurysms: A retrospective study","authors":"Junya Iwama , Hiroki Sato , Seiji Kuribara , Makoto Mizushima , Takumi Hirabayashi , Ryosuke Tsuchiya , Takafumi Shindo , Keisuke Ohnaka , Takanori Hayakawa , Katsumi Takizawa","doi":"10.1016/j.wnsx.2026.100568","DOIUrl":"10.1016/j.wnsx.2026.100568","url":null,"abstract":"<div><h3>Background</h3><div>Anterior clinoidectomy (AC) is an important technique for the management of aneurysms in the paraclinoid region. Conventional drill-based AC technique (Drill AC) can cause optic neuropathy. Therefore, starting in July 2017, we transitioned to a drill-less method, using a rongeur-based AC technique (Rongeur AC). Herein, we aimed to compare the outcomes of these two techniques in our institution.</div></div><div><h3>Methods</h3><div>This retrospective study included 81 patients with paraclinoid aneurysms who underwent craniotomy with AC between January 2012 and September 2023. The patients were divided into two groups for the primary analysis: Drill AC (<em>n</em> = 41) and Rongeur AC (<em>n</em> = 40). For a secondary analysis to identify risk factors, the patients were regrouped based on the presence (<em>n</em> = 16) or absence (<em>n</em> = 65) of postoperative optic neuropathy. Patient characteristics, surgical techniques, and outcomes were compared.</div></div><div><h3>Results</h3><div>The incidence rate of postoperative optic neuropathy was significantly lower in the Rongeur AC group than in the Drill AC group (10.0 % vs. 29.3 %, <em>P</em> = 0.049). In the analysis of the risk factors for optic neuropathy, superior and medial incisions of the distal dural ring were significantly more common in patients with optic neuropathy than in those without optic neuropathy (<em>P</em> = 0.018 and <em>P</em> = 0.009, respectively).</div></div><div><h3>Conclusion</h3><div>Rongeur AC may help reduce the risk of optic neuropathy, and the distal dural ring incision trajectory appears to modulate this risk. Confirmation in multicenter cohorts is a priority.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"30 ","pages":"Article 100568"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146191379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Revisiting decompressive craniectomy thresholds in traumatic brain injury: Are we operating too early or too late? 重新审视创伤性脑损伤的减压颅骨切除术阈值：我们手术太早还是太晚？

IF 2

World Neurosurgery: X Pub Date : 2026-04-01 Epub Date: 2026-02-05 DOI: 10.1016/j.wnsx.2026.100576

Rita Sangtani

引用次数: 0

Gut–brain axis in Parkinson's and Alzheimer's disease: Emerging clinical and therapeutic implications 帕金森病和阿尔茨海默病的肠脑轴：新出现的临床和治疗意义

IF 2

World Neurosurgery: X Pub Date : 2026-04-01 Epub Date: 2026-02-10 DOI: 10.1016/j.wnsx.2026.100578

Dr Sneha Pawar

引用次数: 0

Brain thermodynamics 大脑热力学

IF 2

World Neurosurgery: X Pub Date : 2026-04-01 Epub Date: 2026-03-30 DOI: 10.1016/j.wnsx.2026.100593

Zamzuri Idris

{"title":"Brain thermodynamics","authors":"Zamzuri Idris","doi":"10.1016/j.wnsx.2026.100593","DOIUrl":"10.1016/j.wnsx.2026.100593","url":null,"abstract":"<div><div>Thermodynamics is the branch of physics concerned with heat, temperature and energy. There are three major thermodynamic systems: open, closed, and isolated systems. Our brain is an open system which follows four laws of thermodynamics: a) zeroth law defines thermal equilibrium; b) first law is about energy quantity; c) second law is about energy quality; and d) third law is related to thermal fluctuations. Since thermodynamics is dealing with thermal energy in equilibrium and in transit, heat production and dissipation via heat transfer processes are also important to comprehend. Pertaining to the brain, heat production is directly linked to brain metabolism and information processing, while heat dissipation occurs through conduction involving blood vessels, through CSF and air convection, and through radiation which is largely prevented by the presence of glistening inner dura and layers covering the brain. Therefore, the following features may modulate brain temperature: a) brain blood supply; b) presence of venous sinuses and plexuses surround or near main arteries; c) glymphatic system; d) air and air sinuses at skull base; and e) the black box-like cranium. The insights gained from this review are a) decompressive craniectomy could also work by augmenting heat dissipation through radiation; b) early cranioplasty to recreate optimal brain thermodynamic system; c) direct brain cooling for the injured brain; d) basal cisternostomy could also reduce brain heat via convection, radiation and conduction; e) innovation related to brain thermodynamics such as focal cooling and light therapy; and f) provide basic knowledge related to MR brain-thermometry.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"30 ","pages":"Article 100593"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147600310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hemiparesis to quadriplegia in NF 1 patient: A case report of endovascular thromboembolization and literature review NF - 1患者偏瘫至四肢瘫痪：血管内血栓栓塞1例并文献复习

IF 2

World Neurosurgery: X Pub Date : 2026-04-01 Epub Date: 2026-03-31 DOI: 10.1016/j.wnsx.2026.100594

Manisha Das, Progga Parmita Roy

{"title":"Hemiparesis to quadriplegia in NF 1 patient: A case report of endovascular thromboembolization and literature review","authors":"Manisha Das, Progga Parmita Roy","doi":"10.1016/j.wnsx.2026.100594","DOIUrl":"10.1016/j.wnsx.2026.100594","url":null,"abstract":"<div><h3>Introduction</h3><div>NF-1 with VVAVF is a rare neurological disorder with multimodal presentation. The safety and efficacy of endovascular thromboembolization in vertebro-vertebral arteriovenous fistulas (VVAVF) associated with NF-1(neurofibromatosis) remains controversial. Here, we have reported a case presentation and management including clinically effective surgical approach in NF-1 associated VVAVF.</div></div><div><h3>Methods</h3><div>A literature review of the published literature using PubMed, Google scholar and Scopus was performed to identify case reports of VVAVF over the last 10 years (2015-2025). We extracted clinical, imaging information and outcome following treatment to evaluate the efficacy of thromboembolization.</div></div><div><h3>Case presentation</h3><div>The patient presented with neck pain and bilateral limb weakness. MRI revealed spinal cord compression and gross myelopathy. After proper preoperative preparation, embolization was performed using embolic agents and microcatheters followed by uneventful post operative period (MRC grade 5/5 in both extremities) and diminished limb weakness. As well as, through literature review, seven VVAVF cases were reported associated with NF-1, showing manifestations, post operative outcome with selected materials and procedure.</div></div><div><h3>Conclusion</h3><div>The outcome highlights the significance of thromboembolization due to the less recurrence of occlusion. Additionally, this review also appreciates selection of proper and sustained materials and embolic agents or following hybrid approach according to clinical scenario and location of fistula.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"30 ","pages":"Article 100594"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147600308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artificial intelligence–enhanced neuronavigation: Clinical applications and current limitations in neurosurgery 人工智能增强神经导航：神经外科的临床应用和当前限制

IF 2

World Neurosurgery: X Pub Date : 2026-04-01 Epub Date: 2026-02-04 DOI: 10.1016/j.wnsx.2026.100573

Sufiya S. Mulla

引用次数: 0