World Neurosurgery: X最新文献

{"title":"Dermatological complications in superficial temporal artery embolization: An illustrative case and literature review","authors":"Verónica Garza-Rodríguez ,&nbsp;Andrea Ortiz ,&nbsp;Mariya Miteva ,&nbsp;Hector R. Martinez ,&nbsp;Nerea Martin del Campo ,&nbsp;Paloma Acacia Guzman-Garcia ,&nbsp;Beatriz Perez-Martinez ,&nbsp;Oscar Gutierrez-Trevino ,&nbsp;Rogelio E. Flores-Salcido ,&nbsp;Mario Benvenutti-Regato ,&nbsp;Jose A. Figueroa-Sanchez","doi":"10.1016/j.wnsx.2025.100555","DOIUrl":"10.1016/j.wnsx.2025.100555","url":null,"abstract":"<div><div>Endovascular embolization is the mainstay of treatment for multiple diseases affecting the superficial temporal artery (STA). However, it is not exempt from complications. While neurologic complications are vastly reported in the literature, dermatological complications are seldom described. Here, we present the case of a 16-year-old female who developed pustules, erythema, trichodynia and regional pain along the facial branch of the STA following endovascular treatment. On trichoscopy follicular crusts with microhemorrhagic areas, erythema, telangiectasia and patchy brown-gray areas were visualized with histopathologic findings compatible with vasculopathy and increased telogen count. Additionally, we performed a literature review of dermatological complications associated with endovascular treatment of the STA. A total of 16 cases were identified, most of which involved trans-arterial embolization (TAE). The most common dermatological complication was scalp necrosis (50 %), followed by secondary infection (18.75 %) and mass effect (18.75 %). The time of presentation varied, from immediately after embolization up to 46 days post-procedure. The most common embolic agent associated with complications was Onyx (50 %). According to our review, dermatologic complications seem to arise from multiple mechanisms, including tissue inflammation, cell wall rupture, radiation damage, and infusion rate of the embolic agents. We emphasize the need for greater attention and reporting of these complications, as they can impact cosmetic outcomes and overall quality of life of patients. Physicians should be aware of cutaneous manifestations following STA embolization as early recognition and appropriate management can significantly improve cosmetic outcomes.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"29 ","pages":"Article 100555"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683124","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}

{"title":"The cerebrospinal fluid leak illusion: Elevation of pulse pressure variation without true fluid deficit in foramen magnum decompression surgery","authors":"Bheemas B Atlapure,&nbsp;Subham Das,&nbsp;Ankita Medhi","doi":"10.1016/j.wnsx.2025.100560","DOIUrl":"10.1016/j.wnsx.2025.100560","url":null,"abstract":"","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"29 ","pages":"Article 100560"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737500","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}

{"title":"A descriptive analysis of endoscope-assisted endonasal, transorbital, and transcanal transpetrosal approaches to the pons","authors":"Bon-Jour Lin ,&nbsp;Hao-Yuan Hung ,&nbsp;Kuan-Yin Tseng ,&nbsp;Dueng-Yuan Hueng ,&nbsp;Yuan-Hao Chen ,&nbsp;Da-Tong Ju ,&nbsp;Hsin-I Ma ,&nbsp;Ming-Ying Liu ,&nbsp;Hong-Jaan Wang","doi":"10.1016/j.wnsx.2026.100566","DOIUrl":"10.1016/j.wnsx.2026.100566","url":null,"abstract":"<div><h3>Introduction</h3><div>This study sough to determine the anatomical extents of anterior petrosectomy and corresponding exposure of the pons afforded by endoscopic endonasal, transorbital, and transcanal transpetrosal approaches.</div></div><div><h3>Methods</h3><div>Anatomical dissections were performed in five human cadaveric heads. The expanded endoscopic endonasal transclival approach (EEA), endoscopic transorbital transpetrosal approach (ETOA), and endoscopic transcanal transpetrosal approach (ETCA) were executed consecutively in each cadaveric head. After that, the extents of anterior petrosectomy and surgical exposure of the pons were compared among the three approaches.</div></div><div><h3>Results</h3><div>For each endoscopic transpetrosal approach, the petrous segment of the internal carotid artery (petrous ICA) constituted the major limitation of anterior petrosectomy.</div><div>Because the petrous apex drilling was restricted superiorly and laterally by the paraclival segment of the ICA and the horizontal portion of the petrous ICA near the foramen lacerum, the EEA provided inferior anterior petrosectomy with exposure of the pons positioned medially to the inferior petrous sinus. The horizontal portion of the petrous ICA formed the inferior delimitation of superior anterior petrosectomy, and the ETOA predominately revealed the supratrigeminal zone of the pons. Otherwise, the vertical portion of the petrous ICA composed the anterior boundary of fully anterior petrosectomy, and the ETCA mainly disclosed the peritrigeminal zone of the pons.</div></div><div><h3>Conclusion</h3><div>The EEA, ETOA, and ETCA offer optimum visualization for different compartments of the pons. These three endoscopic transpetrosal approaches provide alternative means of access to safe entry zones of the pons.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"29 ","pages":"Article 100566"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977081","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}

{"title":"Study on the relationship between CXCL1, CXCL10, and prognosis in hypertensive basal ganglia hemorrhage: A comparative analysis of drainage and non-drainage cohorts","authors":"Xiaoqian Yang ,&nbsp;Ranran Tang ,&nbsp;Zonglei Chong","doi":"10.1016/j.wnsx.2025.100564","DOIUrl":"10.1016/j.wnsx.2025.100564","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the relationship between serum CXCL1/CXCL10 levels and prognosis in hypertensive basal ganglia hemorrhage (HBGH), comparing patients treated with minimally invasive puncture and drainage (MIPD) to those managed conservatively.</div></div><div><h3>Methods</h3><div>This observational study enrolled 173 HBGH patients undergoing MIPD (Drainage Group), 50 HBGH patients managed conservatively (Non-Drainage Group), and 121 healthy volunteers (Control Group). Serum levels of CXCL1, CXCL10, and neural injury markers (NSE, GFAP, S100β) were measured via ELISA at admission. Clinical and radiographic data were collected. Functional outcome was assessed at 3 months using the modified Rankin Scale (mRS: 0–2 good, 3–6 poor). Statistical analyses included <em>t</em>-tests, chi-square tests, Pearson correlation, and multivariable logistic regression.</div></div><div><h3>Results</h3><div>Serum levels of all biomarkers were significantly elevated in both patient groups versus controls (all <em>P</em> &lt; 0.05), with the highest levels in the Drainage Group. Positive correlations existed between chemokines and neural injury markers in both cohorts (all <em>P</em> &lt; 0.05). In the Drainage Group, poor prognosis was associated with older age, higher LDL, larger hematoma volume, lower 24-h clearance rate, more frequent urokinase flushes, and elevated CXCL1/CXCL10 in univariate analysis. Multivariable analysis confirmed these as independent risk factors (all <em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Elevated serum CXCL1 and CXCL10 are associated with neural injury and independently predict poor prognosis in severe HBGH requiring surgical drainage. Their prognostic value, alongside key clinical factors, aids in early risk stratification.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"29 ","pages":"Article 100564"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077379","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}

{"title":"Full-endoscopic posterior cervical foraminotomy: Case-series and technical nuances","authors":"Sameer Nazeeruddin,&nbsp;Jean-Yves Fournier,&nbsp;Alexandre Simonin","doi":"10.1016/j.wnsx.2025.100559","DOIUrl":"10.1016/j.wnsx.2025.100559","url":null,"abstract":"<div><h3>Background</h3><div>Full-endoscopic posterior cervical foraminotomy (FEPCF) is the most minimally invasive procedure that allows to decompress a nerve root in the cervical spine from a posterior approach. We present to the best of our knowledge the first case-series of FEPCF in Switzerland and detail technical nuances including O-arm navigation.The objective of the study is to assess the patients' outcome after this novel procedure.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from a consecutive series of 6 patients who underwent a FEPCF in our institution, from October 2022 to May 2023. Primary outcome was pain reduction evaluated with the Visual Analog Scale (VAS) for neck and arm, as well as Neck Disability Index (NDI) preoperatively and one month postoperatively. Surgical time, length of stay, opioid consumption, complications were also analyzed.</div></div><div><h3>Results</h3><div>Median pre-operative arm and neck pain (VAS) was 9 and 8.5. One month post-operative arm and neck pain was 2 and 4. Pain reduction was significant for arm pain (mean 7.7 preoperative vs 3.2 postoperative, p = 0.02) but not for neck pain (mean 7.2 preoperative vs 4.2 postoperative, p = 0.14). NDI was 48.4 % ± 7.9 SEM pre-operatively, and 16.4 % ± 8.7 SEM postoperatively, which was highly significant (p = 0.0006). Mean length of stay was 2.3 days in average (avg). Mean surgical time was 126 min avg. Mean total oxycodone consumption during hospital stay was 9.8 mg avg. There was no complication.</div></div><div><h3>Conclusion</h3><div>Full-endoscopic posterior cervical foraminotomy (FEPCF) was a safe and effective procedure for cervical foraminal stenosis in a small group of patients. O-Arm navigation may be used for localization.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"29 ","pages":"Article 100559"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924995","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}

{"title":"Correlation of intra- and postoperative best active contact and its implication for STN-DBS outcome","authors":"Robert Nickl ,&nbsp;Hannah Mais ,&nbsp;Ghadir Abbas ,&nbsp;Hazem Eldebakey ,&nbsp;Jonas Roothans ,&nbsp;Martin Reich ,&nbsp;Cordula Matthies ,&nbsp;Patrick Fricke","doi":"10.1016/j.wnsx.2025.100558","DOIUrl":"10.1016/j.wnsx.2025.100558","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the relationship between intraoperative test stimulation sites and postoperative best active contacts in STN-DBS for Parkinson's disease and to evaluate whether intraoperative VTAs predict long-term outcome.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 92 hemispheres in 46 patients undergoing bilateral STN-DBS. Coordinates of the best intraoperative stimulation point and the best active contact at one year postoperatively were compared using vector analysis. Corresponding VTAs were modeled and visualized in normalized MNI space using Guide XT and MATLAB-based tools. Response ratios were calculated based on motor improvement (UPDRS-III) at one year.</div></div><div><h3>Results</h3><div>The intraoperative and postoperative best stimulation points differed significantly (<em>p</em> &lt; 0.001), with a consistent dorsolateral shift of the chronic stimulation site relative to the intraoperative test position. Group-level COG analysis showed a 1.61 mm Euclidean shift. VTA overlap between intraoperative and chronic stimulation sites was low (Dice index 0.26). Intraoperative VTAs did not predict clinical outcome. Mean motor improvement was 44 % (range 10–80 %). No significant difference in outcome was observed between patients with bilateral central trajectories and those with non-central implantations guided by intraoperative testing (<em>p</em> = 0.49).</div></div><div><h3>Conclusion</h3><div>Our findings demonstrate a systematic spatial difference between intraoperative and postoperative best active contact. Intraoperative VTAs, derived primarily from rigidity-based testing, did not predict global one-year motor improvement, underscoring the limited role of intraoperative testing as a universal predictor of long-term outcome. Imaging-based targeting achieved outcomes comparable to intraoperative test-guided implantation, supporting the feasibility of simplified, image-guided workflows in DBS planning.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"29 ","pages":"Article 100558"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683020","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}

{"title":"Delivery management and related complications in pregnant women with brain arteriovenous malformation: A systematic review","authors":"Mahdi Arjipour ,&nbsp;Mohammadamin Rezaei ,&nbsp;Soheil Abdollahi Yeganeh ,&nbsp;Mohammadmahdi Sabahi ,&nbsp;Amin Doosti Irani ,&nbsp;Scott Y. Rahimi","doi":"10.1016/j.wnsx.2025.100551","DOIUrl":"10.1016/j.wnsx.2025.100551","url":null,"abstract":"<div><h3>Objective</h3><div>Brain arteriovenous malformation (BAVM) is a rare condition. Regarding considerable risk of hemorrhage and subsequent complications, pregnant women with BAVMs are classified as high-risk patients. The aim of this review is to evaluate different aspects of BAVM during pregnancy leading to an appropriate comparison of delivery methods in those patients.</div></div><div><h3>Methods</h3><div>A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria, reviewing 784 articles between 1974 and 2024. Articles were selected by searching the MEDLINE, Embase, Scopus, Web of Science, and Cochrane electronic bibliographic databases. 18 papers were included for systematic review. Outcome results were discussed via Glasgow Outcome Scale and Apgar score.</div></div><div><h3>Results</h3><div>Out of 171 patients with age reference of 27–31 (25th-75th percentile) and median of 28, cesarean section (CS), normal vaginal delivery (NVD) and abortion were reported in 75, 55, and 26 patients, respectively. The status of delivery in three patients was not reported. Most patients had headaches while nausea, vomiting, and dizziness were also reported as other symptoms. Newborns had similar stable condition after birth in both groups. Maternal postpartum and postprocedural status was good except for 6 maternal deaths.</div></div><div><h3>Conclusion</h3><div>Based on available data there is no demonstration of a clear difference between CS or NVD in clinically stable patients. While, in cases of instability, CS is preferred to minimize the complications. Conclusively, delivery plan should be individualized for each patient, considering both neurosurgical and obstetric conditions for optimal outcome.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"29 ","pages":"Article 100551"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683123","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}

{"title":"Current practices in the diagnosis and management of primary spinal cord tumors: A cross-sectional assessment of algorithm utilization in Yaoundé, Cameroon","authors":"Ghislain Guea Ngbwa,&nbsp;Sandjong Ngoudjou Maxwell,&nbsp;Sandjong Nganso Steve,&nbsp;Ruth Rosine Meka'h Mapenya,&nbsp;Guegang Goujou Emillienne","doi":"10.1016/j.wnsx.2026.100570","DOIUrl":"10.1016/j.wnsx.2026.100570","url":null,"abstract":"<div><h3>Background</h3><div>Primary spinal cord tumors (PSCTs) present diagnostic and management challenges, particularly in low-resource settings. This study assessed current diagnostic and treatment practices, with a specific focus on the use of standardized management algorithms for PSCTs in Yaoundé, Cameroon.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis was conducted on 67 consecutive patients with newly diagnosed PSCTs in Yaoundé between November 1, 2011, and December 31, 2023. Data collected included demographics (mean age 43.28 ± 9.8 years; 34 % female), clinical parameters (median admission delay 405 days, interquartile range 248–541; 13.4 % insured), tumor histology, and WHO grade. Five predefined management algorithms were used to classify care pathways, incorporating diagnostic imaging, staging, surgical intervention, and chemotherapy. We evaluated completion of the algorithmic care pathway and applied multivariate logistic regression to identify factors associated with adherence.</div></div><div><h3>Results</h3><div>Tumor histologies were ependymoma (41.2 %), meningioma (23.5 %), plasmacytoma/multiple myeloma (19.6 %), and other types (15.7 %). WHO grade II tumors predominated (76.5 %). Overall, 76.1 % of patients completed the prescribed algorithmic care pathway. In multivariate analysis, strong family support was the strongest predictor of algorithm completion (odds ratio 12.6, 95 % confidence interval 2.45–64.8 for high vs. low support). Age, gender, and insurance status were not significantly associated with completion of care. Given the limited sample size and wide 95 % confidence intervals, these associations should be interpreted as exploratory and hypothesis-generating rather than definitive.</div></div><div><h3>Conclusion</h3><div>In Yaoundé, Cameroon, PSCT diagnosis and management were characterized by prolonged delays and limited insurance coverage, yet standardized algorithmic care was largely achievable. Importantly, family support substantially influenced algorithm completion. These findings highlight the need to integrate social support mechanisms and improve access to diagnostic and therapeutic resources to optimize PSCT care in low-resource settings.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"29 ","pages":"Article 100570"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077380","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}

{"title":"Spinal Epstein–Barr virus-related smooth muscle tumors: Narrative review and case study","authors":"Giorgio Cracchiolo ,&nbsp;Clifford Pierre ,&nbsp;Luke L. Jouppi ,&nbsp;Julius Gerstmeyer ,&nbsp;Colin Gold ,&nbsp;Mark Kraemer ,&nbsp;Angela Kantor ,&nbsp;Arnav Gambhir ,&nbsp;Amir Abdul-Jabbar ,&nbsp;Andrea Fanti ,&nbsp;Carlo Brembilla ,&nbsp;Rod Oskouian ,&nbsp;Jens R. Chapman","doi":"10.1016/j.wnsx.2025.100553","DOIUrl":"10.1016/j.wnsx.2025.100553","url":null,"abstract":"<div><h3>Background</h3><div>Epstein–Barr Virus (EBV) is associated with smooth muscle tumors (SMT) in immunocompromised individuals, including those with HIV or post-transplant status. EBV-related SMTs are rare in the spine, making diagnosis and treatment challenging. This study provides updated insights into their diagnosis and treatment.</div></div><div><h3>Methods</h3><div>A formal PubMed literature review was conducted using search terms related to EBV-SMTs with screening performed based on the JBI Critical Appraisal Criteria. We included systematic reviews, literature reviews, case series, and case reports while excluding any studies that were not related to EBV-SMTs. Included literature was analyzed for epidemiology, pathogenesis, histopathology, imaging, clinical presentation, management, and prognosis, with a focus on spinal cases.</div></div><div><h3>Results</h3><div>Between 1995 and 2023, 98 general articles were identified, 62 meeting our specific inclusion criteria. An updated treatment algorithm, including a multidisciplinary approach, was outlined. A pertinent clinical case of a 55-year-old HIV-positive female with multiple thoracic spine lesions and biopsy confirmation of EBV-SMT was presented. Following vertebroplasty, tumor excision, and antiretroviral therapy, she developed recurrent lesions four years later, requiring further treatment.</div></div><div><h3>Conclusion</h3><div>Spinal EBV-SMTs are rare CNS tumors to consider as differential diagnosis for immunocompromised patients with spine-related pain and/or neurological deficits. Neuroimaging for lesion detection followed by biopsy confirmation using specialized staining can confirm diagnosis. Multimodal treatment with efforts at optimizing immune competency, surgical resection, and emerging therapies such as mTOR inhibitors (sirolimus) and radiotherapy have been recommended. Our comprehensive review supports ongoing research efforts using multi-institutional databases to allow for enhanced scientific insights into these rare tumors.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"29 ","pages":"Article 100553"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683122","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}

{"title":"Predictive value of maximum hemorrhage area and orthogonal diameter on non-contrast CT for assessing long-term unfavorable functional outcome in intracerebral hemorrhage","authors":"GuoLi Ren ,&nbsp;ShuNing Liu ,&nbsp;Xiao Gao ,&nbsp;Bo Wang ,&nbsp;Daliang Liu ,&nbsp;XueHuan Liu ,&nbsp;Hao Wang ,&nbsp;Jun Liu","doi":"10.1016/j.wnsx.2025.100556","DOIUrl":"10.1016/j.wnsx.2025.100556","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Intracerebral hemorrhage (ICH) volume is a primary concern in acute ICH management, as timely prognostic assessment correlates with increased risk of long-term unfavorable functional outcome. This study aimed to evaluate the predictive value of the maximum hemorrhage area (sICH-MaxA) and orthogonal diameters (sICH-OD) on the slice with the largest hemorrhage area on non-contrast computed tomography (NCCT) for long-term (12-month) unfavorable functional outcome in supratentorial spontaneous intracerebral hemorrhage (sICH).</div></div><div><h3>Methods</h3><div>A total of 113 patients with supratentorial sICH admitted between June 2022 and June 2024 were enrolled. Patients were categorized into an unfavorable outcome group (modified Rankin Scale score &gt;3, <em>n</em> = 41) and a favorable outcome group (modified Rankin Scale score ≤3, <em>n</em> = 72). sICH-MaxA and sICH-OD were measured on NCCT and compared with sICH volume. The efficacy of these metrics for assessing long-term unfavorable functional outcome in supratentorial sICH was evaluated.</div></div><div><h3>Results</h3><div>Correlation analysis revealed significant associations between sICH-MaxA, sICH-OD, and sICH volume (<em>r</em> = 0.957 and 0.954, respectively; <em>p</em> &lt; 0.001). The thresholds of sICH-MaxA and sICH-OD for predicting long-term unfavorable outcome were ≥4.705 cm² (<em>p</em> &lt; 0.001) and ≥9.255 cm² (<em>p</em> &lt; 0.001), respectively. The thresholds for determining the need for surgical intervention were sICH-MaxA &gt;5.56 cm² (<em>p</em> &lt; 0.001) and sICH-OD &gt;9.85 cm² (<em>p</em> &lt; 0.001). The areas under the curve (AUC) for predicting long-term unfavorable functional outcome were: sICH volume = 0.873, sICH-MaxA = 0.866, sICH-OD = 0.855.</div></div><div><h3>Conclusion</h3><div>sICH-MaxA and sICH-OD measured on NCCT demonstrate predictive value for long-term unfavorable functional outcome in patients with supratentorial sICH.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"29 ","pages":"Article 100556"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617557","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}