Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"Dural fistula visualized by intradural reflux of epidural blood patch − potential role of atlantoaxial hypermobility in intracranial hypotension","authors":"Issei Shimamura ,&nbsp;Eiichi Nakai ,&nbsp;Hitoshi Fukuda ,&nbsp;Tetsuya Ueba","doi":"10.1016/j.inat.2026.102240","DOIUrl":"10.1016/j.inat.2026.102240","url":null,"abstract":"<div><h3>Background</h3><div>Intracranial hypotension can occur at any age and commonly presents with orthostatic headache. Dural rupture is a major underlying cause; however, its precise pathophysiological mechanisms remain incompletely understood. Although cerebrospinal fluid (CSF) leakage may be detected by imaging, direct identification of the responsible fistula is often difficult. In particular, the relationship between mechanical stress and the morphology or extent of dural disruption has not been fully elucidated. The aim of this report is to present a rare case in which intrathecal reflux during an epidural blood patch allowed direct visualization of a cervical dural defect, providing insight into possible mechanisms of dural sac disruption in intracranial hypotension.</div></div><div><h3>Case Description</h3><div>A 56-year-old woman presented with progressive orthostatic headache. Brain MRI demonstrated bilateral chronic subdural hematomas, and lumbar puncture revealed an unmeasurably low CSF pressure, leading to a diagnosis of intracranial hypotension. She had no history of trauma but reported habitual prolonged smartphone use in the prone position with cervical hyperextension. CT myelography suggested CSF leakage at the C1/2 level.</div><div>A targeted epidural blood patch (EBP) was performed at C1/2 using autologous blood mixed with 10% iopamidol. Post-procedural CT revealed continuous contrast passage across the dura beneath the left posterior arch of C1, indicating intrathecal reflux through a focal dural fistula. Although the first EBP provided only partial symptomatic relief, the radiological findings strongly suggested a large dural defect at the same level. A second targeted EBP was therefore performed at C1/2, resulting in complete symptom resolution. Follow-up imaging confirmed spontaneous resolution of the chronic subdural hematomas.</div></div><div><h3>Conclusions</h3><div>This case suggests that repetitive or excessive cervical mechanical stress may induce focal detachment at the dural–osseous interface, resulting in dural fistula formation and intracranial hypotension. Direct visualization of intrathecal contrast reflux during EBP allowed precise localization of a rare atlantoaxial dural fistula. These findings provide insight into a potential cervical pathomechanism of intracranial hypotension and may help refine diagnostic and therapeutic strategies.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102240"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420730","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":"Microsurgical treatment of intracranial dural arteriovenous fistula and prognosis analysis","authors":"Lijiu Chen,&nbsp;Zhiqiang Yu,&nbsp;Cheng Qiu,&nbsp;Guangxu Zhang,&nbsp;Jinbing Zhao,&nbsp;Shengxue He","doi":"10.1016/j.inat.2025.102175","DOIUrl":"10.1016/j.inat.2025.102175","url":null,"abstract":"<div><h3>Objective</h3><div>To summarize and analyze the curative effect of 46 patients with intracranial dural arteriovenous fistula (DAVF) treated by microsurgery, explore the prognostic factors of DAVF, and summarize the skills and experience of surgical treatment.</div></div><div><h3>Methods</h3><div>46 patients with DAVF admitted to the cerebrovascular disease Treatment Center of Nanjing Brain Hospital from March 2017 to September 2023 were retrospectively analyzed, and the curative effect was summarized. Gender, age, number of supplying arteries, cortical drainage veins, location of fistula and intracranial hemorrhage were selected as subvariables. Meanwhile, CT, MRI, DSA and prognostic follow-up data before discharge and 6 to 12 months after operation were collected for Logistic regression analysis.</div></div><div><h3>Results</h3><div>There were no deaths in 46 DAVF patients during the perioperative period, and 45 of them (97.83 %) reached the standard of imaging cure. The clinical symptoms of 42 cases (91.3 %) were significantly improved or disappeared, and the good prognosis rate (GOS ≥ 4 points) was 95.65 % (44/46).</div></div><div><h3>Conclusion</h3><div>Microsurgical treatment of DAVF can directly cut the fistula, with a high complete cure rate and a low recurrence rate. For patients with complex multiple fistula, intraoperative exploration and repeated application of ICG angiography can greatly reduce the risk of residual and recurrence, and effectively improve the prognosis of patients.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102175"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939389","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":"Rosai-Dorfman disease – Isolated intracranial localization: A case report and literature review","authors":"Kaloyan Ivanov ,&nbsp;Ivan Angelov ,&nbsp;Ridian Nedelko ,&nbsp;Deyan Dzhenkov","doi":"10.1016/j.inat.2025.102170","DOIUrl":"10.1016/j.inat.2025.102170","url":null,"abstract":"<div><div>Rosai-Dorfman Syndrome – Sinus histiocytosis is a benign disease with idiopathic etiology, primarily presenting with cervical lymphadenopathy and a febrile-intoxication syndrome but it can also affect other organs and systems such a skin, bones, orbit, central nervous system. Isolated intracranial localization is rare. It occurs more frequently in children and young adults but it can affect individuals of any age. In this article, we present a clinical case of a 67-year-old woman with a clinical picture of sudden-onset speech disturbances and a generalized tonic-clonic seizure. Imaging studies revealed an intracranial mass located in the left parietal region, appearing as a meningioma. Cytological and immunohistochemical examinations demonstrated an infiltrate of lymphocytes, plasma cells, and histiocytes expressing protein S-100 and CD68. Also described is the phenomenon of emperipolesis – the presence of intracytoplasmic lymphocytes within histiocytes.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102170"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939477","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":"Two cases of rare multinodular vacuolated neuronal tumors (MVNT)","authors":"Ruijie Ma ,&nbsp;Zheng-Qing Hu ,&nbsp;Xiaoting Xing ,&nbsp;Dayong Xia","doi":"10.1016/j.inat.2025.102178","DOIUrl":"10.1016/j.inat.2025.102178","url":null,"abstract":"<div><div>Multinodular vacuolar neurocytoma (MVNT) is a relatively uncommon benign neuroepithelial tumor with fewer than 200 documented cases in the literature to date^1,9. The present report details two cases of frontal lobe MVNT. A 37-year-old female patient incidentally revealed a left frontal cingulate lesion (previously misdiagnosed as enlarged perivascular spaces [PVSs]), with no history of seizures, trauma, or family history of tumours. The second case study concerned a 53-year-old female patient with a two-year history of right frontal lobe lesions and a one-year history of seizures, which were controlled with oxcarbazepine. The two tumours exhibited typical MVNT imaging features: T1-weighted low signal intensity (lower than adjacent gray/white matter signal), T2-weighted high signal intensity (approaching cerebrospinal fluid signal), T2-FLAIR non-suppressed high signal intensity, and no contrast enhancement. No peritumoral edema or mass effect was observed. No peritumoral edema or mass effect. Follow-up (3–24 months) confirmed lesion stability. In this case report, we aim to raise awareness of the disease and avoid misdiagnosis and overtreatment.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102178"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978166","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":"Primary mixed yolk sac tumor and germinoma arising from conus medullaris and filum terminale: A case report and literature review","authors":"Kazuya Morita ,&nbsp;Shingo Tanaka ,&nbsp;Sho Tamai ,&nbsp;Hiroko Ikeda ,&nbsp;Mitsutoshi Nakada","doi":"10.1016/j.inat.2026.102209","DOIUrl":"10.1016/j.inat.2026.102209","url":null,"abstract":"<div><h3>Background</h3><div>Primary spinal germ cell tumors are exceedingly rare, and standardized treatment strategies remain undefined.</div></div><div><h3>Case report</h3><div>We report a rare case of a mixed germ cell tumor composed of germinoma and yolk sac tumor located in the conus medullaris and filum terminale. The patient underwent partial resection followed by chemotherapy with cisplatin, etoposide, and cyclophosphamide, and craniospinal (23.4 Gy) plus local (50.6 Gy) irradiation. Post-treatment MR imaging showed marked regression of the residual tumor.</div></div><div><h3>Conclusion</h3><div>This case highlights the diagnostic importance of histopathology and suggests that combined chemotherapy and craniospinal plus local irradiation may be effective for tumor control in spinal germ cell tumors.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102209"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147419832","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":"Efficacy and safety of microendoscopic vs. microlumbar discectomy for patients with double-level lumbar disc prolapse: a randomized clinical trial","authors":"Moamen M. Morsy ,&nbsp;Omar B. Nasser ,&nbsp;Ayman M. Ismail ,&nbsp;Khalid A. Ismail ,&nbsp;Ahmed Soliman ,&nbsp;Ayman M. Basha","doi":"10.1016/j.inat.2026.102224","DOIUrl":"10.1016/j.inat.2026.102224","url":null,"abstract":"<div><h3>Background</h3><div>Lumbar disc prolapse (LDP) is a significant cause of low back pain and radiculopathy. While both Microlumbar Discectomy (MLD) and Microendoscopic Discectomy (MED) are established minimally invasive treatments, comparative data for double-level LDP is limited. This study aimed to compare the efficacy and safety of MED versus MLD for patients with double-level lumbar disc prolapse.</div></div><div><h3>Methods</h3><div>This randomized controlled trial included 50 patients with double-level LDP who failed 8 weeks of conservative treatment, randomized equally into two groups: MED group (n = 25) who underwent tubular microendoscopic interlaminar discectomy and MLD group (n = 25) who underwent standard microlumbar discectomy. Patients were followed for one year postoperatively. Primary outcomes included Visual Analogue Scale (VAS) scores for back and leg pain. Secondary outcomes encompassed Oswestry Disability Index (ODI), operative time, blood loss, wound length, hospital stay, return to work, and postoperative complications.</div></div><div><h3>Results</h3><div>Both MED and MLD significantly improved pain and disability. The MED group demonstrated statistically lower VAS scores for back pain at one month (2.1 ± 0.73 vs. 2.7 ± 0.84, p = 0.012), and consistently lower VAS scores for both back and leg pain at 6 and 12 months postoperatively. Operative time was significantly longer for MED (103 ± 15.6 mins vs. 73 ± 14.9 mins, p &lt; 0.001). However, MED was associated with significantly less blood loss (49.9 ± 10.1 mL vs. 87.2 ± 26.2 mL, p &lt; 0.001), smaller wound length (2.3 ± 0.4 cm vs. 4.7 ± 0.5 cm, p &lt; 0.001), shorter hospital stay (1.1 ± 0.61 days vs. 1.7 ± 0.58 days, p = 0.007), and earlier return to work (39.4 ± 7.24 days vs. 43.1 ± 3.6 days, p = 0.029).</div></div><div><h3>Conclusion</h3><div>Both microendoscopic and microlumbar discectomy are effective and safe for double-level lumbar disc prolapse. Microendoscopic discectomy offers superior short-term pain relief, reduced invasiveness, shorter hospital stays, and earlier returns to work, despite a longer operative time. These benefits suggest MED as a favorable option for patients with double-level LDP.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102224"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147419834","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":"Bilateral nucleus Accumbens–Anterior limb of the internal capsule stimulation combined with medial globus pallidus stimulation for the treatment of Obsessive‑Compulsive disorder with tardive Dyskinesia: A case report and therapeutic Exploration","authors":"Feierkaiti Abudukeyimu ,&nbsp;Zulimire Anniwaer ,&nbsp;Yinan Pei ,&nbsp;Lei Jiang ,&nbsp;Yiliyasijiang MaimaitiTuerxun ,&nbsp;Zhaohai Feng ,&nbsp;Xixian Wang","doi":"10.1016/j.inat.2026.102227","DOIUrl":"10.1016/j.inat.2026.102227","url":null,"abstract":"<div><h3>Objective</h3><div>To preliminarily explore the mid‑ to long‑term efficacy and safety of bilateral nucleus accumbens–anterior limb of the internal capsule (NAc–ALIC) stimulation combined with medial globus pallidus (GPi) stimulation for treating obsessive‑compulsive disorder (OCD) complicated by tardive dyskinesia (TD).</div></div><div><h3>Methods</h3><div>In May 2023, one patient with OCD complicated by TD underwent bilateral NAc–ALIC and GPi deep brain stimulation (DBS) at the Department of Neurosurgery IV, the First Affiliated Hospital of Xinjiang Medical University. Clinical efficacy and safety were retrospectively analyzed. The Yale–Brown Obsessive‑Compulsive Scale (Y‑BOCS) was used to assess OCD symptoms, and the Abnormal Involuntary Movement Scale (AIMS) was used to assess TD severity. The patient was followed for 30 months to evaluate outcomes and possible adverse events.</div></div><div><h3>Results</h3><div>At 6 months after stimulator activation, Y‑BOCS and AIMS improvement rates were 73.07% and 70%, respectively; at 12 months, 88.46% and 90%; and at 30 months, 96.15% and 95%. No serious complications such as intracranial hemorrhage, infection, or permanent neurological deficit occurred.</div></div><div><h3>Conclusion</h3><div>Bilateral NAc–ALIC combined with GPi DBS may represent a safe and effective therapeutic option for treatment‑resistant OCD accompanied by TD, showing stable mid‑ to long‑term efficacy.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102227"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420729","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":"Postoperative changes in cervical paraspinal muscle electromyography after thoracolumbar corrective surgery in dropped head syndrome: a report of 2 cases","authors":"Soji Tani ,&nbsp;Takeshi Kuroda ,&nbsp;Yutaro Momma ,&nbsp;Shimpei Koyama ,&nbsp;Yohei Miyamoto ,&nbsp;Koki Tsuchiya ,&nbsp;Chikara Hayakawa ,&nbsp;Ryo Yamamura ,&nbsp;Ichiro Okano ,&nbsp;Tomoaki Toyone ,&nbsp;Hidetomo Murakami ,&nbsp;Yoshifumi Kudo","doi":"10.1016/j.inat.2026.102219","DOIUrl":"10.1016/j.inat.2026.102219","url":null,"abstract":"<div><h3>Background and study objectives</h3><div>Dropped head syndrome (DHS) is traditionally considered a cervical paraspinal muscle disorder, often associated with isolated neck extensor myopathy (INEM). However, emerging evidence suggests that thoracolumbar malalignment may contribute to its pathology. This study presents two DHS cases in which symptoms improved after thoracolumbar corrective surgery with cervical electromyography (EMG) changes, suggesting a possible secondary etiology related to global spinal malalignment.</div></div><div><h3>Case presentation</h3><div>Two older adults with DHS and a history of thoracolumbar compression fractures presented with progressive neck pain and difficulty maintaining horizontal gaze. Neurological evaluation and EMG revealed myopathic changes in the cervical extensors without systemic neuromuscular disease. Conservative treatment, including physical therapy and cervical orthosis, was ineffective. Both patients underwent thoracolumbar surgery for spinal realignment. Postoperatively, symptoms improved significantly, and follow-up EMG showed reduced spontaneous activity of cervical extensor.</div></div><div><h3>Conclusion</h3><div>These cases suggest that thoracolumbar malalignment may contribute to DHS and that symptom improvement can be observed after thoracolumbar corrective surgery without direct cervical intervention. The observed EMG changes following surgical correction indicate this dysfunction may be improved by addressing the underlying global spinal malalignment. These observations are hypothesis-generating and support careful assessment of global spinal alignment in DHS diagnosis and management.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102219"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420731","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":"Comparing longitudinal and transverse wound closure methods for spina bifida","authors":"Ali Tarik Abdul Wahid","doi":"10.1016/j.inat.2026.102244","DOIUrl":"10.1016/j.inat.2026.102244","url":null,"abstract":"<div><h3>Background</h3><div>Spina bifida, a neurological disorder affecting approximately 1 in 1,000 births worldwide, is the most severe form of myelomeningocele, often causing significant neurological disabilities. Early surgical intervention is required to decrease the risk of infection and prevent further tissue damage. This study aims to compare longitudinal and transverse wound closure methods, focusing on their impact on healing, scarring, and revision rates to improve patients’ quality of life and reduce healthcare burdens.</div></div><div><h3>Methods</h3><div>This prospective cohort study included 48 neonates with myelomeningocele requiring surgical closure. Closure technique (longitudinal or transverse) was determined by intraoperative assessment of the defect size, shape, and available skin tissue, rather than randomized allocation. Healing time, infection rate, cerebrospinal fluid (CSF) leakage, and scar formation were evaluated using standardized scales. Patients requiring urgent ventriculoperitoneal (VP) shunting were not excluded to maintain clinical representativeness.</div></div><div><h3>Results</h3><div>The study involved 48 patients, predominantly female (58.3%), aged between 2 and 14 days, with 66.7% presenting within the first 6 days. All patients exhibited myelomeningocele lesions, primarily in the thoracolumbar region (62.5%). Surgical results showed that despite longitudinal closure techniques significantly reduced both operative time (2.5 h versus 3.0 h) and healing time (4 weeks versus 6 weeks) compared with a transverse technique, there was a lower infection rate in the longitudinal group (4.2% versus 25.0%), as were cerebrospinal fluid leakages (8.3% vs. 20.8%). The assessment of Scar visibility was significantly better in the longitudinal group (1.2 vs. 3.5), with 100% achieving satisfactory wound healing compared with 75% in the transverse group.</div></div><div><h3>Conclusions</h3><div>The longitudinal wound closure techniques are the preferred approach in spina bifida repair clinical guidelines for pediatric neurosurgery. Future research should emphasize assessing long-term effects on neurological function, quality of life, and patient satisfaction.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102244"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147421078","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 clinical outcomes of microvascular decompression for neurovascular compression syndromes: A single surgeon approach and insights from an Indonesian tertiary level single neurosurgical center","authors":"Rivan Dwiutomo ,&nbsp;Muhammad Adam Pribadi ,&nbsp;Akhmad Imron","doi":"10.1016/j.inat.2026.102234","DOIUrl":"10.1016/j.inat.2026.102234","url":null,"abstract":"<div><h3>Background</h3><div>Neurovascular compression syndrome (NCS) is a disorder caused by the compression of cranial nerves at the root entry zone (REZ), manifesting primarily as trigeminal neuralgia (TN) and hemifacial spasm (HFS). Despite the established efficacy of microvascular decompression (MVD), the application of this procedure in Indonesia is still under-explored, with limited data on its outcomes in local populations.</div></div><div><h3>Objectives</h3><div>To evaluate the outcomes of patients with primary TN and HFS who underwent MVD and to present our experience with a single-surgeon approach.</div></div><div><h3>Patients and methods</h3><div>This study retrospectively analyzed 32 patients who underwent MVD for TN and HFS between 2021 and 2025. We evaluated their clinical and operative findings, and outcomes.</div></div><div><h3>Results</h3><div>Among the 25 patients with TN, MVD resulted in good post-operative pain control (BNI grade I–II) in 88% of TN cases and favorable numbness outcomes in 92%. Severe neurovascular conflict (NVC) grades were significantly associated with improved pain (p = 0.038) and numbness (p = 0.003). The presence of basilar artery or complex vascular involvement showed less favorable outcomes (pain: p = 0.101; numbness: p &lt; 0.001). For 7 patients with HFS, age and pre-operative SMC grades were significantly associated with good outcomes (age: p = 0.003; SMC: p = 0.008).</div></div><div><h3>Conclusion</h3><div>MVD under single-surgeon protocol delivers high efficacy and safety for TN and HFS with low complication rates and NVC severity contributes significantly in predicting success of this procedure.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102234"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147421152","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}