Neurochirurgie最新文献

{"title":"Development and validation of a prediction model for pulmonary infection in elderly patients with traumatic brain injury.","authors":"Shuai Tian, Ali Shang, Wenqian Zhou, Zhen Xu, Yunpeng Kou, Zhenyu Guo, Fan Chen, Peigang Ji, Yulong Zhai, Wenjian Zhao, Yang Jiao, Zhipeng Song, Shunnan Ge, Yuan Wang, Liang Wang, Shaochun Guo","doi":"10.1016/j.neuchi.2025.101733","DOIUrl":"https://doi.org/10.1016/j.neuchi.2025.101733","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate risk factors associated with pulmonary infection (PI) in elderly patients with traumatic brain injury (TBI). Additionally, this study sought to develop and validate a predictive model for PI in elderly patients with TBI using clinical data obtained upon admission.</p><p><strong>Methods: </strong>The study retrospectively analyzed elderly patients (≥ 65 years) with TBI at Tangdu Hospital between January 2011 and December 2021. These patients were randomly allocated to training and validation sets in a 7:3 ratio. A nomogram model was developed to predict the risk of PI in elderly patients with TBI. Internal validation was conducted using a verification set, while external validation was performed using patient data from a different hospital.</p><p><strong>Results: </strong>A total of 592 elderly patients with TBI were included. The Glasgow coma scale score on admission, chest injury, hemoglobin, albumin, C-reactive protein, procalcitonin, B-type natriuretic peptide, troponin, and surgery was found to be independent predictors of PI in elderly patients with TBI. The nomogram demonstrated good discrimination ability, with a consistency index of 0.918 (95% confidence interval (CI): 0.891-0.944), which was verified to be 0.848 (95% CI: 0.786-0.910). The area under the curve for the external validation cohorts was 0.836 (95% CI: 0.770-0.903).</p><p><strong>Conclusions: </strong>This study developed and validated a prediction model for PI in elderly patients with TBI. The nomogram model demonstrated a favorable discriminatory and predictive capacity for predicting PI in elderly patients with TBI.</p>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":" ","pages":"101733"},"PeriodicalIF":1.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interobserver reliability of the DESH score in idiopathic chronic hydrocephalus.","authors":"Elise Caron, Charlotte Rozenberg, Johann Peltier, Serge Metanbou, Julien Moyet, Olivier Balédent, Cyrille Capel","doi":"10.1016/j.neuchi.2025.101734","DOIUrl":"https://doi.org/10.1016/j.neuchi.2025.101734","url":null,"abstract":"<p><strong>Introduction: </strong>idiopathic chronic hydrocephalus (iCH) is underdiagnosed in older adults. The diagnosis of iCH is important because effective surgical treatment is available. Indeed, iCH is the only curable dementia. The disproportionately enlarged subarachnoid space hydrocephalus (DESH) score was recently developed on the basis of morphologic MRI data, as a guide to the diagnosis of iCH in adults.</p><p><strong>Patients and method: </strong>In a population of 68 patients having undergone placement of a ventriculoperitoneal shunt, the preoperative DESH score was calculated retrospectively by a senior neurosurgeon and a neurosurgery resident. To analyze inter-observer variability, the results obtained for each patient were compared. We calculated sensitivity, specificity, positive and negative predictive values of the DESH score.</p><p><strong>Results: </strong>DESH score of 7 or more present the best diagnostic performance (sensitivity: 83%, specificity: 40%, positive predictive value: 89%, negative predictive value: 29%). The interobserver reliability of the DESH score was excellent, with an intraclass correlation coefficient of 0.936. Similarly, the levels of interobserver agreement for each individual item were fair (for Sylvian fissure dilatation, local focal sulci dilatation, and tight high convexity) to excellent (for the callosal angle).</p><p><strong>Conclusion: </strong>The DESH score is a reliable score obtained by studying brain MRI and radiographic datasets. The score's excellent reliability means that it can be included in the routine diagnosis of iCH.</p>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":" ","pages":"101734"},"PeriodicalIF":1.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of sodium fluorescein in peripheral nerve tumor resection: a single institution experience.","authors":"Joseph N Frazzetta, Seunghyuk Daniel Yang, Oleksandr Strelko, William Y Shin, John T Tsiang, Miri Kim, Vikram C Prabhu","doi":"10.1016/j.neuchi.2025.101732","DOIUrl":"https://doi.org/10.1016/j.neuchi.2025.101732","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal management for symptomatic or enlarging peripheral nerve schwannomas is maximal, safe resection. Sodium Fluorescein (SF) has been utilized to facilitate tumor identification and removal.</p><p><strong>Methods: </strong>This single-institution study evaluated 17 patients with 19 tumors who underwent a microscope assisted peripheral nerve schwannoma resection with intravenous SF administration. White-light and the yellow-560 lens filter were used for microscope visualization. A grading scale was created to assess the utility of SF in differentiating tumor from normal nerve fascicles. In all patients, intraoperative neurophysiological monitoring and nerve stimulation to identify and preserve functional fascicles was utilized.</p><p><strong>Results: </strong>Improved visualization of the tumor and normal fascicles were noted using the operating microscope with white-light. It was possible to distinguish tumor tissue from normal nerve fascicles under both white-light and the yellow-560 lens.Administration of SF imparted a distinct bright-green fluorescence to tumor tissue under the yellow-560 lens. No side effects from SF use were observed. The cost of SF was $32.64 per vial. 1 patient experienced a new motor deficit, and 1 patient developed a new sensory deficit post-operatively that did not resolve at last follow up.</p><p><strong>Discussion: </strong>Microsurgical resection of peripheral nerve schwannomas with the use of SF and the microscope yellow-560 les may be helpful in differentiating tumor from normal healthy nerve fascicles. However, white-light illumination also allowed good visualization of the tumor and normal nerve fascicles. Intraoperative neurophysiological monitoring and nerve stimulation are indispensable to facilitate tumor resection with preservation of normal nerve fascicles.</p>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":" ","pages":"101732"},"PeriodicalIF":1.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microsurgical approach versus endovascular treatment of craniocervical junction arteriovenous fistulas: A Systematic Review and Meta-analysis","authors":"Filipe Virgilio Ribeiro ,&nbsp;Rudolfh Batista Arend ,&nbsp;Bruno Zilli Peroni ,&nbsp;Helvécio Neves Feitosa Filho ,&nbsp;Maria Fernanda P. Santana ,&nbsp;Leonardo Januario Campos Cardoso ,&nbsp;Leandro Vieira Lessa ,&nbsp;André Nishizima ,&nbsp;Marcelo Porto Sousa ,&nbsp;Alex Roman","doi":"10.1016/j.neuchi.2025.101729","DOIUrl":"10.1016/j.neuchi.2025.101729","url":null,"abstract":"<div><h3>Introduction</h3><div>Craniocervical junction arteriovenous fistulas (CCJ AVFs) are rare and complex vascular lesions that pose significant diagnostic and therapeutic challenges. Despite advances in neuroimaging, optimal treatment strategies remain controversial. This systematic review and meta-analysis aimed to compare the safety and efficacy of microsurgical versus endovascular approaches for treating CCJ AVFs.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Embase, Web of Science, and Cochrane Library was conducted up to March 2024. Studies were included if they reported outcomes of microsurgical or endovascular treatment for CCJ AVFs, including neurological improvement, complete obliteration, recurrence, and complications. Data were synthesized using a random-effects meta-analysis, and heterogeneity was assessed using the I² statistic.</div></div><div><h3>Results</h3><div>Seven studies with 451 patients were included (microsurgery: n = 348; endovascular: n = 103). Microsurgery showed no statistically significant advantage in neurological improvement compared to endovascular treatment (OR = 2.10, 95% CI: 0.83–5.31, p = 0.5651, I² = 0%). Complete obliteration rates were significantly higher in the microsurgical group (OR = 11.93, 95% CI = 2.12–66.97, p = 0.0049; I² = 70.6%). Recurrence rates did not differ significantly (OR = 0.22, 95% CI: 0.02–2.81, p = 0.2416). Overall complications were similar (OR = 0.63, 95% CI: 0.09–4.62, p = 0.0007, I² = 79.1%), although microsurgery had significantly fewer ischemic complications (OR = 0.23, 95% CI: 0.07–0.70, p = 0.0104). Mortality rates were also comparable (RR = 1.87, 95% CI: 0.28–12.66, p = 0.5213, I² = 25.9%).</div></div><div><h3>Conclusion</h3><div>Microsurgery offers higher obliteration rates and fewer ischemic complications, while overall outcomes support individualized treatment planning.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101729"},"PeriodicalIF":1.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injectable approaches to deliver innovative treatments for spinal cord: When regenerative medicine meets precision medicine","authors":"Serratrice Nicolas","doi":"10.1016/j.neuchi.2025.101730","DOIUrl":"10.1016/j.neuchi.2025.101730","url":null,"abstract":"<div><div>Delivering therapeutic agents to the spinal cord is crucial for treating conditions such as Spinal Cord Injury (SCI), chronic pain and neurodegenerative diseases. Various administration routes, including systemic, epidural, intrathecal, subarachnoid, localized and intraparenchymal injections, offer distinct advantages and challenges when it comes to achieving effective therapeutic outcomes. The invasiveness, precision and ability to bypass biological barriers, such as the Blood-Spinal Cord Barrier (BSCB), differ between these methods. This literature review summarizes the latest research on these delivery approaches, examining their principles, techniques, applications and associated risks. By analyzing the efficacy and limitations of each route for administering steroids, recombinant growth factors, gene therapies, stem cells and biomaterial scaffolds, the review aims to provide a comprehensive understanding of the most effective strategies for targeting the spinal cord. It will highlight key findings and identify areas for further investigation.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101730"},"PeriodicalIF":1.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding dizziness: Non-Vestibular Influences Following Radiosurgical Management of Vestibular Schwannoma","authors":"Shamsudheen Cholayil ,&nbsp;Vangipuram Harshil Sai ,&nbsp;Shankar Vangipuram","doi":"10.1016/j.neuchi.2025.101731","DOIUrl":"10.1016/j.neuchi.2025.101731","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101731"},"PeriodicalIF":1.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding: “Awake surgery for isolated parenchymal degenerating neurocysticercosis - Case report and focused review of misdiagnosis of neurocysticercosis”","authors":"Sean O’Leary ,&nbsp;Takara Newsome-Cuby ,&nbsp;Sami Al-Horani ,&nbsp;Usama AlDallal ,&nbsp;Mazin E. Khalil ,&nbsp;Umaru Barrie","doi":"10.1016/j.neuchi.2025.101728","DOIUrl":"10.1016/j.neuchi.2025.101728","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101728"},"PeriodicalIF":1.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using fluid mechanics to reduce postoperative pneumocephalus during chronic subdural hematoma burr hole surgery: Technical note","authors":"Nathan Beucler ,&nbsp;Anis Choucha ,&nbsp;Julien Tinois ,&nbsp;Antoine Do Tran ,&nbsp;Michel Mouramba ,&nbsp;Benjamin Guyot ,&nbsp;Cédric Bernard ,&nbsp;Arnaud Dagain","doi":"10.1016/j.neuchi.2025.101726","DOIUrl":"10.1016/j.neuchi.2025.101726","url":null,"abstract":"<div><div>Symptomatic chronic subdural hematoma is a prevalent conditions among the elderly, making burr hole surgical evacuation a very frequent cranial neurosurgical procedure. Recurrence of chronic subdural hematoma requiring revision surgery is associated with higher morbidity and mortality. Decreasing postoperative pneumocephalus is a simple but helpful mean allowing to reduce chronic subdural hematoma recurrence. A few years ago, our team has already described the use of the subdural drain to fill the subdural drain with saline, thus helping pneumocephalus out. Zhou and colleagues present an ingenious system using fluid mechanics principles, with an opened syringe connected to the subdural drain and held above the level of the burr hole in order to make saline flow into the subdural space; then held below the level of the burr hole to make pneumocephalus out, the remaining saline acting as a one-way-valve like the drainage bag of a pneumothorax. Nevertheless, in order to optimize this system, the burr hole should be placed in the horizontal plane at the highest point of the skull to be able to fill the subdural space with saline completely.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101726"},"PeriodicalIF":1.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: Using fluid mechanics to reduce postoperative pneumocephalus during chronic subdural hematoma burr hole surgery: Technical note","authors":"Jiankuai Zhou,&nbsp;Huimin Shen,&nbsp;Jianchen Jin,&nbsp;Guotao Peng,&nbsp;Dan Xu,&nbsp;Yili Chen,&nbsp;Jun Mo","doi":"10.1016/j.neuchi.2025.101722","DOIUrl":"10.1016/j.neuchi.2025.101722","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101722"},"PeriodicalIF":1.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Thrombosed Middle Meningeal Artery Aneurysm Mimicking a Meningioma","authors":"Mauricio Guerrero-Ocampo,&nbsp;Marcos Peña,&nbsp;Ana Riquelme,&nbsp;Fabrizio Frutos","doi":"10.1016/j.neuchi.2025.101723","DOIUrl":"10.1016/j.neuchi.2025.101723","url":null,"abstract":"<div><h3>Introduction</h3><div>True middle meningeal artery aneurysms (MMAAs) are extremely rare, with fewer than 20 documented cases and only one previously described as a giant aneurysm in a patient with fibrous dysplasia. Typically measuring under 10 mm, these lesions can be mistaken for other vascular abnormalities such as intracranial aneurysms, arteriovenous malformations (AVMs), or dural arteriovenous fistulas (DAVFs). This report describes a unique vascular lesion combining four rare features: (1) true MMAA, (2) giant in size, (3) completely thrombosed, and (4) mimicking a tumor (pseudotumoral behavior).</div></div><div><h3>Material and methods</h3><div>A 70-year-old male with no history of cranial trauma presented with right hemiparesis following a seizure. Imaging revealed a 266cc extra-axial mass in the left fronto-parieto-temporal region, causing significant midline shift (18 mm) and ventricular compression. CT and MRI findings showed a well-circumscribed lesion with post-contrast enhancement and a dural tail sign, raising suspicion for a meningioma. Surgical resection was performed using standard meningioma techniques. During microsurgical dissection and debulking, intraoperative pathology revealed non-neoplastic tissue.</div></div><div><h3>Conclusion</h3><div>This case highlights the potential for true MMAAs to mimic other intracranial pathologies. Due to their location and dural involvement, a high index of suspicion is essential. We recommend specific preoperative and intraoperative considerations for surgeons encountering similar presentations to avoid misdiagnosis and guide appropriate management. These include invasive imaging techniques, acceptable subtotal resection of the lesion given the lack of regrowth possibilities and optimal dural reconstruction to avoid complications such as cerebrospinal fluid fistulae.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101723"},"PeriodicalIF":1.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}