Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"Risk factors and treatment strategies for hyponatremia following aneurysm clipping in patients with aneurysmal subarachnoid hemorrhage: A Single Center experience","authors":"Kun Dai,&nbsp;Chengyuan Ji,&nbsp;Wei Wang,&nbsp;Pengfei Xia","doi":"10.1016/j.inat.2025.102032","DOIUrl":"10.1016/j.inat.2025.102032","url":null,"abstract":"<div><h3>Background</h3><div>Hyponatremia is one of the most common complications following aneurysmal subarachnoid hemorrhage (aSAH). This condition can exacerbate secondary injuries, such as cerebral edema, thereby leading to increased intracranial pressure and adversely affecting patient outcomes.</div></div><div><h3>Methods</h3><div>This study aims to investigate the factors associated with hyponatremia in patients following aSAH and to evaluate effective treatment strategies. We conducted a retrospective analysis of clinical data from 102 patients with aSAH. Based on the presence or absence of hyponatremia post-hemorrhage, patients were categorized into a hyponatremia group and a normonatremic group. Statistical analyses were performed on variables including gender, age, aneurysm location, Hunt-Hess grade, presence of hydrocephalus, duration of surgery, intraoperative blood loss, and postoperative lumbar cistern drainage. Treatment strategies were tailored according to the type of hyponatremia, distinguishing between Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) and Cerebral Salt-Wasting Syndrome (CSWS).</div></div><div><h3>Results</h3><div>Among 102 patients with aSAH, 40 cases developed hyponatremia. Through the implementation of appropriate treatment regimens, hyponatremia was successfully resolved in all affected patients. Univariate analysis revealed that the location of the aneurysm, Hunt-Hess grade, the presence of hydrocephalus, and lumbar cistern drainage were significant factors influencing postoperative hyponatremia. In contrast, variables such as sex, age, duration of surgery, and intraoperative blood loss were not statistically significant. Further analysis identified that aneurysms located in the anterior cerebral artery and anterior communicating artery, Hunt-Hess grade Ⅲ-IV, and the presence of hydrocephalus were independent risk factors for the development of hyponatremia in patients with aneurysmal SAH.</div></div><div><h3>Conclusion</h3><div>Patients with aSAH are particularly susceptible to developing hyponatremia. This risk is notably higher among individuals with aneurysms located in the anterior communicating artery or anterior cerebral artery, those presenting with high Hunt-Hess grade, or those with concurrent hydrocephalus. For such patients, vigilant monitoring and timely intervention are essential to mitigate the incidence of hyponatremia. Tailoring treatment strategies based on the specific subtype of hyponatremia can significantly improve clinical outcomes.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102032"},"PeriodicalIF":0.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838099","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":"Giant intra/extracranial facial nerve schwannoma: A case report and review of the literature","authors":"Bo Tan,&nbsp;Xiaohong Yin","doi":"10.1016/j.inat.2025.102029","DOIUrl":"10.1016/j.inat.2025.102029","url":null,"abstract":"<div><h3>Background</h3><div>Facial nerve schwannomas (FNSs) are rare, benign neoplasms arising from Schwann cells. While most FNSs are confined to the temporal bone or internal auditory canal, giant schwannomas extending across both intracranial and extracranial segments of the facial nerve are exceptionally rare and pose significant diagnostic and surgical challenges.</div></div><div><h3>Case presentation</h3><div>We report a 51-year-old woman with a 10-year history of progressive right-sided facial paralysis (House-Brackmann grade VI) and profound hearing loss. Imaging revealed a large, heterogeneous mass involving the right middle cranial fossa, external auditory canal, and mastoid, with destruction of adjacent bony structures. Electrophysiological studies confirmed severe facial nerve dysfunction. A combined subtemporal and mastoid approach enabled total tumor resection. Histopathology confirmed a WHO grade I schwannoma with strong S100, SOX10, and H3K27me3 positivity.</div></div><div><h3>Conclusion</h3><div>This case highlights the importance of integrating advanced neuroimaging, electrophysiological studies, and meticulous surgical planning in the management of extensive FNSs. Early diagnosis and timely intervention contribute to favorable outcomes, although functional recovery may require prolonged rehabilitation.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102029"},"PeriodicalIF":0.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847503","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 case report of vacuum sign surgery for the inner recess of lumbar spinal canal","authors":"Xu Zhai ,&nbsp;Ye Youchen ,&nbsp;Jie Zheng","doi":"10.1016/j.inat.2025.102027","DOIUrl":"10.1016/j.inat.2025.102027","url":null,"abstract":"<div><div>The formation of intervertebral disc vacuum sign can be observed in late stage degenerative changes of the lumbar disc. In 1937, Magnusson first proposed intervertebral disc vacuum sign, which refers to the accumulation of gas caused by disc dehydration and fissure formation during the degenerative process of the lumbar disc. The vacuum phenomenon can occur around the articular processes, within the spinal canal, and in the intervertebral disc, with the most common being in the intervertebral disc. The vacuum phenomenon causes the mechanical receptors, injury receptors, and pressure receptors around the intervertebral disc to react more strongly than usual, thereby increasing lower back pain. A small amount of vacuum phenomenon can also occur in the spinal canal and lateral recess, inducing lower limb numbness and pain, which needs to be distinguished from sciatica caused by intervertebral disc herniation. This article presents a case of vacuum syndrome in the inner recess of the lumbar spinal canal, which underwent surgical treatment and achieved good therapeutic effects. And the characteristics, diagnosis, and treatment of lumbar vacuum sign were discussed.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102027"},"PeriodicalIF":0.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844407","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":"Sagitta frame – A universal system for ventricular puncture. Clinical correlation – Initial experience","authors":"N. Gabrovsky ,&nbsp;M. Petrov ,&nbsp;M. Laleva ,&nbsp;Y. Sofronov ,&nbsp;G. Todorov","doi":"10.1016/j.inat.2025.102024","DOIUrl":"10.1016/j.inat.2025.102024","url":null,"abstract":"<div><h3>Introduction</h3><div>Ventricular puncture is one of the most common neurosurgical procedures. Most frequently it is conducted in emergency situations and in practice the freehand technique is applied. This allows fast and easy drainage of the ventricular system. The main problem of this technique is accuracy. Suboptimal or incorrect placement of the catheter occurs in 23–60 % of cases.</div><div>We present the first clinical application of the “Sagitta Frame” developed by the Department of Neurosurgery, University hospital “N. I. Pirogov”, Sofia, Bulgaria together with Technical university – Sofia.</div></div><div><h3>Materials and methods</h3><div>The “Sagitta Frame” was applied intraoperatively in 20 patients. All patients were fixed with the Mayfield head clamp and the preoperative images /CT or MRI/ were uploaded on a Brainlab navigation system, the navigation system was solely used to verify the accurate trajectory. The universal system for ventricular puncture was applied to each patient and the entry point was marked and after that verified on the Brainlab navigation system.</div></div><div><h3>Results</h3><div>The application of the universal system for ventricular puncture takes less than 5 min. The neuronavigational verification confirmed successful ventricular puncture in every patient.</div></div><div><h3>Conclusion</h3><div>Ventricular puncture is a life-saving procedure. In an emergency situation it could be performed in an intensive care unit or even in an emergency department. In many hospitals in small living areas, it is impossible to have 24/7 a neurosurgeon on call. With the universal system for ventricular puncture the placement of a catheter in the lateral ventricle could be performed in an emergency situation with great accuracy by a general surgeon or an ICU doctor.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102024"},"PeriodicalIF":0.4,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844405","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":"Cerebral hyperperfusion syndrome following combined aneurysm trapping and low-flow bypass for fusiform aneurysm of the middle cerebral artery","authors":"Yu Naruse ,&nbsp;Taku Sato ,&nbsp;Mio Endo ,&nbsp;Miho Kamamura ,&nbsp;Kiyoshi Saito","doi":"10.1016/j.inat.2025.102025","DOIUrl":"10.1016/j.inat.2025.102025","url":null,"abstract":"<div><div>The mechanism of cerebral hyperperfusion syndrome (CHS) following aneurysm surgery remains unclear. We report the case of a 66-year-old woman with an unruptured large fusiform-shaped aneurysm of the left middle cerebral artery. She underwent a combination of aneurysm trapping and superficial temporal artery to middle cerebral artery anastomosis. Postoperatively, she developed motor aphasia. Computed tomography perfusion imaging and single photon emission computed tomography showed increased cerebral blood flow in the left frontal lobe. A diagnosis of CHS was made following aneurysm trapping with low-flow bypass. This case highlights the importance of assessing the risk of CHS when performing this surgical procedure.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102025"},"PeriodicalIF":0.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833611","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":"Functional outcomes reporting using an adjusted outcomes index for mechanical thrombectomy in anterior cerebral artery occlusions – A case series","authors":"Michael Fana ,&nbsp;Praveen Sanmugananthan ,&nbsp;Giulia Santangelo ,&nbsp;Max Kole ,&nbsp;Alex B. Chebl ,&nbsp;Horia Marin","doi":"10.1016/j.inat.2025.102021","DOIUrl":"10.1016/j.inat.2025.102021","url":null,"abstract":"<div><h3>Introduction</h3><div>The decision to intervene with mechanical thrombectomy (MT) for anterior cerebral artery (ACA) strokes is often made based on anticipated long-term functional outcomes using modified Rankin scores (mRS) which is primarily based on ambulatory status. Here, we review our single-center experience with ACA MT and evaluate the utility of various functional outcomes reporting.</div></div><div><h3>Methods</h3><div>A case series of 15 patients undergone MT for ACA stroke using the Solitaire or Trevo stent-retrievers was completed. The data retrieved included patient demographics, initial National Institute of Health Stroke Scale (NIHSS), thrombolysis in cerebral infarction (TICI) scores and number of passes, post-procedure 24-hour NIHSS, intra-operative or post-operative complications, discharge NIHSS and mRS, and 90-day mRS.</div></div><div><h3>Results</h3><div>There were 87 % favorable ACA TICI scores (i.e. 2B/C and 3) and 80 % first pass recanalization rate. The Solitaire 4 mm stent-retriever was employed in the majority of cases (60 %). No procedural complications were noted in 73 % of cases and no hemorrhagic conversion in 87 % of cases. 90-day mRS scores of 0–2 were noted in 26 % of patients. Using an adjusted outcomes index, 80 % of patients had favorable outcomes based on the 24-hour baseline-adjusted NIHSS score decrease of ≥41 %.</div></div><div><h3>Conclusion</h3><div>Our preliminary findings here highlight successful radiographic and favorable functional outcomes using the Solitaire and Trevo stent-retrievers (3–6 mm luminal diameter) for ACA MT when reporting with the adjusted outcomes index as compared to the 90-day mRS score. Further studies comparing these outcomes reporting metrics with a larger sample size will be needed to further elucidate this notable difference.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102021"},"PeriodicalIF":0.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777107","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":"Surgical versus nonsurgical management of civilian craniocerebral gunshot injuries","authors":"Wesley Shoap ,&nbsp;George Austin Crabill ,&nbsp;Roboan Guillen ,&nbsp;Kaleb Derouen ,&nbsp;Jack Leoni ,&nbsp;Zhide Fang ,&nbsp;Berje Shammassian","doi":"10.1016/j.inat.2025.102022","DOIUrl":"10.1016/j.inat.2025.102022","url":null,"abstract":"<div><h3>Introduction</h3><div>Craniocerebral gunshot wounds in the civilian population constitute a devastating subset of traumatic<!--> <!-->brain injuries (TBI). The aim of this study was to determine the association of mortality, intensive care unit length of stay (ICU LOS), and the Glasgow Outcome Scale Extended (GOS-E) among craniocerebral gunshot patients based on timing and type of intervention.</div></div><div><h3>Methods</h3><div>The<!--> <!-->trauma database was queried for GSWH<!--> <!-->patients ages 15 and older who received neurosurgical intervention from January 1st<!--> <!-->2016 to June 1st<!--> <!-->2023. Operative notes were reviewed and patients were then divided into three groups; intracranial pressure monitor only with medical treatment (ICP), primary decompressive craniectomy (pDC), or secondary decompressive craniectomy (sDC). The Surviving Penetrating Injury to the Brain (SPIN) score was calculated. Outcomes included mortality, ICU LOS, and GOS-E.</div></div><div><h3>Results</h3><div>Overall, 72 patients were identified who underwent either decompressive craniectomies or ICP monitoring. Mean SPIN scores were similar: ICP, pDC and sDC (30.5, 32.67, 31.55 (p = 0.4252)). When comparing two groups, the odds of death was higher in the ICP group compared to the pDC group (OR = 3.71, 95 % CI = 1.06, 14.35). With regard to hospital trajectory, ICU LOS (mean days) was different among the groups: ICP, pDC, sDC (16.7, 17.4, 23.4; p = 0.0002).</div></div><div><h3>Conclusion</h3><div>Mortality was reduced with primary decompressive craniectomy when compared to ICP monitoring with medical management alone and is associated with shorter ICU LOS compared to secondary decompressive craniectomy. In the appropriately selected patient, early and aggressive decompression should be considered.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102022"},"PeriodicalIF":0.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143758981","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":"Surgical management of sacral fractures: A comprehensive series and review at a Level I trauma center","authors":"Alejandro Carrasquilla ,&nbsp;Pemla Jagtiani ,&nbsp;Danielle Chaluts ,&nbsp;James Speed Rogers ,&nbsp;Salazar Jones ,&nbsp;Hang Byun ,&nbsp;David Joseph ,&nbsp;Zachary Hickman ,&nbsp;Konstantinos Margetis","doi":"10.1016/j.inat.2025.102020","DOIUrl":"10.1016/j.inat.2025.102020","url":null,"abstract":"<div><h3>Objective</h3><div>This case series aims to classify various sacral fractures and their surgical treatment to generate more comprehensive treatment strategies and improve standardization of care.</div></div><div><h3>Methods</h3><div>After obtaining IRB approval, sacral fractures managed surgically among five surgeons at a Level I trauma center in New York City were collected retrospectively from the five surgeons’ case logs from 2007 to 2021. Pre-operative imaging was retrospectively gathered for each sacral fracture and classified using the AO spine, Denis, Modified Roy-Camille, Isler and lumbosacral injury classification system (LSICS) schemas. Each classification was correlated to LSICS.</div></div><div><h3>Results</h3><div>A total of 42 patients were included; 14 patients were treated by neurosurgery alone, 17 patients were treated by orthopedics alone, and 11 patients were treated by both neurosurgery and orthopedic surgery. Lumbopelvic or iliosacral fixation was used independently or in combination. Roy-Camille classification significantly correlated with LSICS severity scores, while other systems did not. Fixation type was not predicted by any classification system, suggesting variability in surgical technique.</div></div><div><h3>Conclusion</h3><div>Sacral fractures represent an area of growing collaboration between neurosurgeons and orthopedic surgeons. This study suggests that the Roy-Camille and Denis classifications correlate with LSICS scores of sacral fractures. Classification systems inconsistently correlate with injury severity and do not predict fixation choice. Surgical management of sacral fractures should be individualized, highlighting the need for standardized fixation guidelines.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102020"},"PeriodicalIF":0.4,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143740026","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":"Comparative study of cases with and without C5 palsy after cervical spine surgery","authors":"Kosuke Fukuzawa,&nbsp;Masashi Uehara,&nbsp;Shota Ikegami,&nbsp;Yoshinari Miyaoka,&nbsp;Hiroki Oba,&nbsp;Terue Hatakenaka,&nbsp;Daisuke Kurogochi,&nbsp;Takuma Fukuzawa,&nbsp;Shinji Sasao,&nbsp;Keisuke Shigenobu,&nbsp;Tetsuhiko Mimura,&nbsp;Jun Takahashi","doi":"10.1016/j.inat.2025.102019","DOIUrl":"10.1016/j.inat.2025.102019","url":null,"abstract":"<div><h3>Objective</h3><div>C5 palsy is a known complication after cervical spine surgery, although incidence rates range widely from 0 to 30% in the literature. The causes of C5 palsy also remain unknown, with many studies describing contradictory risk factors. This comparative investigation sought to clarify the incidence and risk factors of C5 palsy in patients receiving cervical spine surgery.</div></div><div><h3>Methods</h3><div>The medical data of 433 consecutive patients (305 male and 128 female; mean age: 67.7 years) who underwent their first cervical spine surgery were retrospectively examined. The cohort was divided into the C5 palsy group and the non-C5 palsy group, and associated factors were examined by multivariate analysis.</div></div><div><h3>Results</h3><div>Postoperative C5 palsy was observed in 57 of 433 (13.2 %) patients. Atlantoaxial subluxation (AAS) was significantly more common in the C5 palsy group (10.5 %) than in the non-C5 palsy group (3.7 %) (p = 0.035). Regarding procedural details, surgical range including C4-5 was significantly more common in the C5 palsy group (80.7 % vs. 63.8 %, p = 0.015). Multivariate analysis revealed significant associations with C5 palsy for male gender (p = 0.025), AAS (p &lt; 0.001), and surgical range including C4-5 (p = 0.002).</div></div><div><h3>Conclusion</h3><div>C5 palsy occurred in 13.2% of patients undergoing cervical spine surgery. Significant associations with male gender, AAS, and surgical range including C4-5 suggest the need for additional perioperative considerations in such patients.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102019"},"PeriodicalIF":0.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714681","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":"Brainstem lesion diagnostic Dilemma: The role of multiparametric magnetic resonance imaging","authors":"Xuanxuan li ,&nbsp;Benjamin Butler ,&nbsp;Jhanvi Sawlani ,&nbsp;Samer Al-Ali ,&nbsp;Michael Bowen ,&nbsp;Markand Patel ,&nbsp;Robert Flintham ,&nbsp;Jane Herbert ,&nbsp;Nigel Davies ,&nbsp;Vijay Sawlani","doi":"10.1016/j.inat.2025.102018","DOIUrl":"10.1016/j.inat.2025.102018","url":null,"abstract":"<div><h3>Objectives</h3><div>Brainstem lesions pose a significant diagnostic challenge. The critical nature of the brainstem renders invasive biopsy difficult, often yielding inconclusive results. Multiparametric magnetic resonance imaging (MRI) is a useful addition to standard MRI sequences and can aid in the differentiation between neoplastic and non-neoplastic lesions. Although few studies have examined its utility for this purpose. Here we present our experience in characterising brainstem lesions using multiparametric MRI at a tertiary neurosciences centre.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed multiparametric MRI studies performed at our institution between 2015–2020. Brainstem lesion characterists on standard contrast-enhanced T1- and T2-weighted sequences, Dynamic Susceptibility Contrast (DSC) MRI, Diffusion Weighted Imaging (DWI), including Apparent Diffusion Co-efficient (ADC) maps, and MR spectroscopy were examined.</div></div><div><h3>Results</h3><div>Multiparametric MRI was performed on 560 patients, 31 (5.5%) of whom were assessed for indeterminate brainstem lesions. Of these, 18 (58%) provided useful additional diagnostic information to correctly differentiate neoplastic and inflammatory lesions. Cases of note include a low-grade glioma, non-enhancing high-grade glioma (transforming glioma), enhancing high-grade glioma, Bickerstaff encephalitis and neurosarcoidosis.</div></div><div><h3>Conclusion</h3><div>Standard MRI sequences in combination with multiparametric data can provide an accurate and non-invasive means of differentiating between inflammatory and neoplastic brainstem lesions, potentially avoiding biopsy in some cases.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"40 ","pages":"Article 102018"},"PeriodicalIF":0.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768421","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}