Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献

{"title":"Clinical comparison of submuscular drainage versus non-drainage combined with compressed dressing clothes following posterior spinal fusion on adolescent idiopathic scoliosis","authors":"Duan Wenbo ,&nbsp;Fang Guofang ,&nbsp;Wu Jiachang ,&nbsp;Sang Hongxun ,&nbsp;Cao Lei","doi":"10.1016/j.inat.2026.102220","DOIUrl":"10.1016/j.inat.2026.102220","url":null,"abstract":"<div><h3>Objective</h3><div>This single-center retrospective analysis was designed to evaluate the outcome of closed-suction wound drainage following posterior spinal fusion with internal instrumentation for mild to moderate adolescent idiopathic scoliosis (AIS).</div></div><div><h3>Methods</h3><div>Eighty-six AIS patients undergoing posterior spinal fusion were divided into two cohorts: submuscular closed-suction wound drainage (n = 35) and simple compressed dressing clothes without wound drainage (n = 51). These two cohorts were thoroughly compared in terms of demographic distribution and perioperative blood loss, including hemoglobin and hematocrit levels and blood transfusion volumes. Additionally, the incidence of wound-related problems (pyrexia and wound complications), duration of hospital stay, and lumbar function evaluation (lumbar mobility and SRS-22 questionnaire scores) were assessed during long-term follow-up.</div></div><div><h3>Results</h3><div>The drainage group had significantly lower hemoglobin (93.73 g/L vs. 99.95 g/L, P = 0.01) and hematocrit levels (27.75% vs. 29.94%, P &lt; 0.01) on the third postoperative day, as well as a significantly higher postoperative blood transfusion volume (40.0 ml vs. 23.5 ml, P = 0.011) compared to the non-drainage group. Furthermore, the duration of hospital stay was significantly longer in the drainage group than in the non-drainage group (10.9 d vs. 8.0 d, P &lt; 0.01). In contrast, the two groups were statistically similar regarding duration of fever (0.9 d vs. 1.2 d, P = 0.268), incidence of wound problems, latest lumbar mobility (42.79° vs. 44.97°, P = 0.586), and scores of function/activity domain (2.39 vs. 2.08, P = 0.336) and pain domain (1.76 vs. 1.66, P = 0.734) in the SRS-22 questionnaire.</div></div><div><h3>Conclusions</h3><div>Routine closed-suction drainage significantly increased blood loss and hospital stay without obviously improving wound healing or functional outcomes. Utilizing simple compressed dressings without drainage was a clinically superior and resource-efficient alternative for posterior AIS fusion, particularly in uncomplicated primary surgeries for mild to moderate deformities.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102220"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147421157","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 factors of hematoma enlargement for patients with cerebral hemorrhage","authors":"Qinghao Wang ,&nbsp;Dongshuai Xia ,&nbsp;Yawei Rong ,&nbsp;Ruifang She ,&nbsp;Quan Hu ,&nbsp;Qian Chen","doi":"10.1016/j.inat.2026.102232","DOIUrl":"10.1016/j.inat.2026.102232","url":null,"abstract":"<div><div>Cerebral hemorrhage has a high rate of death and disability, in which hematoma enlargement is one of the major risk factors leading to poor prognosis of patients with cerebral hemorrhage. In this review, we summarize the recent studies about the predictors of hematoma enlargement from multiple dimensions including imaging characteristics, laboratory tests, clinical examination indexes, medications, lifestyle factors, comprehensive scoring algorithms and machine learning models, which provides an all-round understanding about early prediction of hematoma enlargement in patients with cerebral hemorrhage in the future.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102232"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420099","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":"Surgical management of flatback syndrome in adult spinal deformity: a collection of illustrative cases","authors":"Austin Q. Nguyen ,&nbsp;Thaddeus Woodard ,&nbsp;Varan Haghshenas ,&nbsp;Kevin Bondar ,&nbsp;Michael Spadola ,&nbsp;Ali K. Ozturk ,&nbsp;Vincent Arlet ,&nbsp;Comron Saifi","doi":"10.1016/j.inat.2026.102238","DOIUrl":"10.1016/j.inat.2026.102238","url":null,"abstract":"<div><h3>Background</h3><div>Flatback Syndrome (FBS) is a common type of adult spinal deformity (ASD) characterized clinical by loss of lumbar lordosis. This condition develops due to numerous reasons including complications from previous thoracolumbar instrumentation. Patients with FBS typically fail conservative measures and require surgical intervention. The goal of surgical management is normalization of radiographic parameters including lumbar lordosis, pelvic tilt, and age-adjusted sagittal vertical axis. Variations of osteotomies and interbody fusions have been used to treat FBS with variable outcomes. The objectives of this paper are to describe observations and lessons learned in the complex treatment of Flatback Syndrome through illustrating 5 unique cases.</div></div><div><h3>Observations</h3><div>5 illustrative cases of spinal deformity surgery for the treatment of flatback syndrome were presented and highlight surgical techniques and strategies for deformity correction including: various osteotomies, interbody placement, multi-rod constructs and anterior column reconstruction.</div></div><div><h3>Lessons</h3><div>Restoration of sagittal balance postoperatively is critical in reducing the risks of flatback syndrome and proximal junctional kyphosis. Patient-specific risk factors and preoperative radiographic parameters should be used to tailor individualized treatment plans prior to surgical management of flatback syndrome. Improved awareness of the number of technical options available for patients with ASD is critical to selecting a patient-specific plan.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102238"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420732","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":"Brachial plexus Schwannoma: a case report involving the middle trunk","authors":"Masoud Yavari ,&nbsp;Amir Bisadi ,&nbsp;Fatemeh Abbasi ,&nbsp;Mohammad Abbasalizadeh ,&nbsp;Negar Emamzadeh ,&nbsp;Morteza Gholipour","doi":"10.1016/j.inat.2025.102161","DOIUrl":"10.1016/j.inat.2025.102161","url":null,"abstract":"<div><h3>Background</h3><div>Schwannomas arising from the middle trunk of the brachial plexus represent an exceptionally rare subset of peripheral nerve sheath tumors. While brachial plexus schwannomas account for approximately 5% of all schwannomas, those originating specifically from the trunks constitute only 4–5% of peripheral nerve sheath tumors. The middle trunk, formed exclusively by the C7 nerve root, is particularly uncommon as a site of origin, making detailed documentation of such cases clinically valuable due to the unique surgical challenges and risk of compromising critical motor function.</div></div><div><h3>Case presentation</h3><div>A 28-year-old female presented with a 2-year history of a painless, gradually enlarging 5 cm mass in the left supraclavicular region. Core needle biopsy and MRI confirmed a schwannoma. The patient underwent microsurgical excision via an anterolateral approach with intraoperative neurophysiological monitoring. The tumor was completely excised while preserving the middle trunk integrity. Histopathological examination confirmed schwannoma with characteristic biphasic Antoni A and Antoni B patterns. The patient experienced no postoperative neurological deficits, had uneventful wound healing, and returned to normal activities within three weeks.</div></div><div><h3>Conclusion</h3><div>Complete microsurgical resection of middle trunk schwannomas with preservation of neurological function is achievable through meticulous dissection and intraoperative monitoring. The anterolateral approach provides optimal exposure while protecting surrounding neurovascular structures. Given the rarity of middle trunk involvement and the low recurrence rate following complete excision, early surgical intervention in symptomatic cases is recommended. Continued documentation through detailed case reports remains essential for advancing surgical understanding and optimizing patient outcomes in this challenging anatomical location.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102161"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799097","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":"Liliequist’s membrane anatomical variations impact the probability of successful endoscopic third ventriculostomy: discussion of surgical techniques with novel illustrations and 3D animation","authors":"Austin J. Allen ,&nbsp;Olivia E. Gilbert ,&nbsp;Carolyn S. Quinsey","doi":"10.1016/j.inat.2026.102229","DOIUrl":"10.1016/j.inat.2026.102229","url":null,"abstract":"<div><h3>Background</h3><div>A naked basilar artery has been demonstrated to improve ETV success rates; however, existing literature does not adequately convey variation in Liliequist’s Membrane (LM) anatomy in relationship to performing a successful ETV. This publication summarizes published literature examining LM anatomy and adds novel illustrations and discussion on surgical technique to improve the probability of ETV success.</div></div><div><h3>Methods</h3><div>A qualitative literature review was undertaken to elucidate anatomical descriptions of LM. Information from this review, along with insights from a pediatric neurosurgeon and cadaveric dissections, guided development of novel illustrations of LM and other relevant ETV anatomy.</div></div><div><h3>Results</h3><div>LM has been reported to have either 2 or 3 leaflets that separate the suprasellar, interpeduncular/intercrural, and prepontine cisterns. There is some variability in the attachment sites of LM; however, classical definitions report the dorsum sella as the anterior attachment, the mamillary bodies and ventral midbrain-pontine junction as posterior attachments, and the oculomotor nerves as the lateral attachments. Variation in positioning of LM leaflets in relationship to the floor of the third ventricle and basilar artery influences the probability of successful ETV.</div></div><div><h3>Conclusions</h3><div>A naked basilar artery is defined by a clear pathway for CSF flow from the third ventricle into prepontine cistern, with no unpunctured arachnoid membranes or leaflets of LM remaining as a barrier to flow. There is variable favorability in LM and other arachnoid membrane anatomy for achieving a naked basilar artery. Novel illustrations in this manuscript highlight this variation and discuss techniques for improving the probability of ETV success.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102229"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147420716","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 relationship between pain level and satisfaction following lumbar spinal stenosis surgery and psychiatric medication use","authors":"Bilal Ertuğrul,&nbsp;Harun Kömürcü","doi":"10.1016/j.inat.2026.102243","DOIUrl":"10.1016/j.inat.2026.102243","url":null,"abstract":"<div><h3>Background</h3><div>Lumbar spinal stenosis is a common degenerative spinal disorder that often requires surgery. In addition to technical factors, postoperative pain perception and patient satisfaction are influenced by psychosocial and psychiatric factors. However, the relationship between psychiatric medication use and postoperative outcomes remains unclear.</div></div><div><h3>Objective</h3><div>To examine the association between the use of psychiatric medication, postoperative pain, and patient satisfaction following surgery for lumbar spinal stenosis.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 202 patients who underwent surgery for degenerative lumbar spinal stenosis. Patients were divided into a psychiatric medication group (n = 98) and a control group (n = 104). Pain was assessed using the Visual Analogue Scale preoperatively and at 24 h, one week, and one month postoperatively. Patient satisfaction was evaluated at one month using a 0–10 Likert scale.</div></div><div><h3>Results</h3><div>Postoperative pain scores were significantly higher in patients using psychiatric medication at all time points (p &lt; 0.001). At one month, patient satisfaction was significantly lower in the psychiatric medication group compared to controls (6.3 ± 1.7 vs. 8.1 ± 1.4, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Psychiatric medication use was associated with higher early postoperative pain scores and lower short-term patient satisfaction following lumbar spinal stenosis surgery. These findings should be interpreted cautiously, as psychiatric medication use may reflect underlying psychiatric disease burden rather than a direct pharmacological effect.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102243"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147421079","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":"Help from outer space: Denoising of confocal laser endomicroscopic images of brain tissue using pretrained astronomy software","authors":"Leon Colin Hoffmann ,&nbsp;Roberta Galli ,&nbsp;Sven Richter ,&nbsp;Ilker Eyüpoglu ,&nbsp;Ortrud Uckermann","doi":"10.1016/j.inat.2026.102222","DOIUrl":"10.1016/j.inat.2026.102222","url":null,"abstract":"<div><h3>Background</h3><div>Confocal laser endomicroscopy (CLE) allows imaging of tissue autofluorescence (AF) in situ and is promising for brain tumor margin detection and diagnosis. However, comprehensive analysis of CLE images beyond visual inspection is restricted by their high noise level. Because image acquisition parameters cannot be accordingly optimized in medical devices, image preprocessing constitutes an option for noise removal. Here, we utilized an AI-based algorithm trained on astronomy images and investigated its capacity to denoise AF images of brain tumors.</div></div><div><h3>Methods</h3><div>Tissue samples of human brain tumors and non-neoplastic brain were investigated. Images of tissue AF (518–573 nm) were acquired on bulk tissue samples using a clinical CLE system with 488 nm excitation. Multiphoton microscopy was employed to investigate tissue sections and image averaging was used to modify the noise level in AF images (500–550 nm). Signal to noise ratio (SNR) of AF images were compared before and after denoising with NoiseXTerminator software.</div></div><div><h3>Results</h3><div>Denoising improved SNR of multiphoton and CLE images and intensity plots indicated a profound improvement in the visibility of structures. Comparison of denoised high noise (4× and 8× averaging) with low noise (16× averaging) multiphoton images confirmed that image structures were correctly extracted. Upon the introduction of synthetic noise, Gaussian noise was eliminated, however limitations were identified in the ability to remove bright pixels induced by salt-and-pepper noise.</div></div><div><h3>Conclusions</h3><div>Efficient denoising of CLE images of tissue AF constitutes the basis for mathematical analysis and will allow the development of objective clinical protocols for intraoperative decision support in neurosurgery.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102222"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147421154","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":"Arteriovenous fistula involving the foramen cecum vein","authors":"Chloe F. Looman ,&nbsp;Stephen Duggan ,&nbsp;Aaron Kucinski ,&nbsp;Theresa A. Elder ,&nbsp;Joseph G. Adel","doi":"10.1016/j.inat.2026.102200","DOIUrl":"10.1016/j.inat.2026.102200","url":null,"abstract":"<div><h3>Background</h3><div>Dural arteriovenous fistulas (dAVF) arising in the anterior fossa require treatment as they inherently possess cortical venous drainage. The foramen cecum (FC) contains a venous structure that is infrequently observed in humans due to its small size, and dAVF rarely involve the FC.</div></div><div><h3>Case Presentation</h3><div>We report a unique case of an ethmoidal dAVF with venous drainage via the FC vein. This fistula was successfully treated through a bicoronal craniotomy for disconnection.</div></div><div><h3>Conclusions</h3><div>The FC vein is clinically relevant when involved in the drainage pathway of dAVF. Given the predictable location of anterior fossa dAVF draining via the foramen cecum vein, more minimally invasive surgical approaches exposing the foramen cecum are sufficient to disconnect the fistula.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102200"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188906","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":"Idiopathic intradural extramedullary epidermoid cyst at the conus medullaris","authors":"Berkay Bozkurt ,&nbsp;Halit Alioglu ,&nbsp;Mahmoud Osama ,&nbsp;Mert Yavuz ,&nbsp;Zuhal Kuş Silav ,&nbsp;Baris Ozoner","doi":"10.1016/j.inat.2025.102184","DOIUrl":"10.1016/j.inat.2025.102184","url":null,"abstract":"<div><h3>Background</h3><div>Spinal epidermoid cysts are uncommon, comprising &lt; 1 % of all spinal tumors. Involvement of the conus medullaris and cauda equina is particularly rare, often presenting with nonspecific symptoms and posing diagnostic and surgical challenges.</div></div><div><h3>Case Presentation</h3><div>A 32-year-old woman presented with chronic low back pain and distal limb numbness without weakness or sphincter dysfunction. MRI showed an intradural extramedullary lesion at L1 compressing the conus and displacing cauda equina roots. Gross total excision via hemilaminectomy with neuromonitoring confirmed an epidermoid cyst. Symptoms resolved completely, with no recurrence at 9 months.</div></div><div><h3>Clinical<!--> <!-->Discussion</h3><div>Spinal epidermoid cysts may mimic other intradural lesions and are best identified with MRI, where DWI improves diagnostic confidence. Reported cases most often present with back pain or sensory disturbance, while delayed diagnosis may result in motor or sphincter involvement. Surgical excision remains the treatment of choice, though capsule adherence can limit removal. Our case illustrates these observations, with complete recovery following timely microsurgical excision.</div></div><div><h3>Conclusion</h3><div>Epidermoid cysts of the conus medullaris region are rare intradural lesions. This case highlights the importance of recognizing their subtle clinical presentation and demonstrates that timely microsurgical excision can achieve symptom resolution with a favourable short-term outcome.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102184"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939475","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":"Open surgery algorithm for carotid-cavernous fistula","authors":"Diana Jovett Sanchez,&nbsp;Alaric Emmanuel M. Salonga,&nbsp;Juan Silvestre G. Pascual,&nbsp;Gerardo D. Legaspi,&nbsp;Peter Paul P. Rivera","doi":"10.1016/j.inat.2025.102173","DOIUrl":"10.1016/j.inat.2025.102173","url":null,"abstract":"<div><h3>Background</h3><div>Traumatic carotid-cavernous fistulas (CCFs) are abnormal arterio-venous communication between the internal carotid artery (ICA) and the cavernous sinus. Standard treatment of CCFs is endovascular embolization with the goal of isolating the fistula and protecting cerebral circulation. The economic burden of this treatment in low-middle income countries such as ours, led our team to devise different open surgical strategies for the management of CCFs.</div></div><div><h3>Case description</h3><div>Three patients with CCFs were selected to represent the different surgical strategies employed, with their outcomes serving as the basis for the development of a treatment algorithm. Patients who underwent Hunterian ligation alone had persistent fistula, while those who underwent ICA trapping (with or without bypass) had resolution of the CCF. A treatment algorithm was formed after panel discussion by experts. After establishing the diagnosis of CCF, the absence or presence of collateral circulation was evaluated next. Once collateral circulation was determined to be present, the adequacy will be tested via gradual occlusion of the ICA. Appearance of neurologic symptoms during gradual occlusion will qualify the patient for an EC-IC bypass followed by ICA trapping. If no neurologic symptoms arise, ICA trapping will be done. In contrast, if collateral circulation were absent on angiography, bypass followed by ICA trapping was performed.</div></div><div><h3>Conclusion</h3><div>The primary goals in treatment of CCF are isolation of the fistula and preservation of cerebral circulation. To achieve these objectives, our findings indicate that ICA trapping was the most effective method to isolate the fistula, while cerebral protection may be ensured by assessing the adequacy of collateral circulation via progressive gradual occlusion of the ICA. Endovascular treatment still remains the gold standard in management of CCFs, however, open surgery can be a safe and cost-effective treatment option in circumstances where the standard treatment is unavailable.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"43 ","pages":"Article 102173"},"PeriodicalIF":0.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939470","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}