Neurochirurgie最新文献

{"title":"Optimized intracerebral hematoma management with ultrasound-guided minimally invasive surgery (HUG-MIS): A technical note","authors":"Nourou Dine A. Bankole ,&nbsp;Raphael Ly ,&nbsp;Etienne Dugast ,&nbsp;Aymeric Amelot ,&nbsp;Marco Pasi ,&nbsp;Grégoire Boulouis ,&nbsp;Ilyess Zemmoura","doi":"10.1016/j.neuchi.2026.101819","DOIUrl":"10.1016/j.neuchi.2026.101819","url":null,"abstract":"<div><h3>Introduction</h3><div>Spontaneous Intracerebral hemorrhage (ICH) is a severe neurological emergency with high mortality and disability. While traditional craniotomy offers no clear functional benefit over medical treatment, minimally invasive surgery (MIS) has shown moderate outcome improvements in lobar ICH. However, its wider use is limited by challenges in device guidance, and high costs techniques. This technical note seeks to detail our original approach using “exclusive” ultrasound-guided MIS (US-guided MIS).</div></div><div><h3>Methods</h3><div>We present a technical note and preliminary results of US-guided MIS for ICH management, based on eight cases (four spontaneous and four secondary ICH). The procedure targeted hematomas in cerebellar, deep brain, and lobar regions, with intraventricular hemorrhage extension in five cases.</div></div><div><h3>Results</h3><div>At admission, patients had a mean GCS of 11 ± 4.7 and NIHSS of 14.7 ± 4.8. US-guided MIS was performed at a median delay of 5.6 h (IQR 3.8–22.7), with a mean procedure duration of 40 ± 19.1 min and an average hospital stay of 33.2 ± 25.9 days. Spontaneous ICH volume decreased from 67.7 ± 25.1 mL (31.2–86.4) to 15.7 ± 7 mL (7–22), corresponding to 76.8 ± 6% (69.4–84.03%) clearance. Spontaneous lobar hematomas exhibited a higher mean clearance rate (79.2 ± 4.2%) compared with the single case involving a deep hematoma (69.4%). No intraoperative complication was observed. The mean post-operative GCS and NIHSS were respectiveley 11 ± 4.3 and 12 ± 9.8. At discharge, two patients had favorable outcomes (mRS 0–2), three had severe disability (mRS 5), and three died during hospitalization (mRS 6).</div></div><div><h3>Conclusion</h3><div>US-guided MIS is simple and effective for intracerebral hematoma evacuation. Larger randomized controlled trials are needed to establish its place, especially compared to other MIS techniques, versus medical treatment in ICH management.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 3","pages":"Article 101819"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147797600","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":"The role of supramaximal resection in glioblastoma: A review","authors":"O. Tessier ,&nbsp;P. Menei ,&nbsp;J.M. Lemée","doi":"10.1016/j.neuchi.2026.101813","DOIUrl":"10.1016/j.neuchi.2026.101813","url":null,"abstract":"<div><h3>Background</h3><div>Glioblastoma remains a significant challenge in neurosurgery, with no consensus on the optimal extent of resection beyond MRI contrast-enhancing regions. Nevertheless, several studies suggest that supramaximal resection may confer a prognostic advantage. This review aims to synthesize the existing evidence on this topic.</div></div><div><h3>Methods</h3><div>A narrative review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [<span><span>1</span></span>]. The PubMed, ScienceDirect and Embase databases were searched using the keywords “glioblastoma AND (supramaximal OR supratotal OR extended resection OR FLAIR resection/FLAIRectomy OR lobectomy OR functional lobectomy OR resection beyond enhancement)”. The search was performed on January 24th, 2026.</div></div><div><h3>Results</h3><div>A total of 64 studies were included, predominantly small retrospective series that employed various techniques to achieve supramaximal resection, including awake surgery, fluorescein-guided resection, and lobectomy. Despite variations in the definition of supramaximal resection, most studies consistently reported a survival advantage for patients whose resection extended beyond the contrast-enhancing tumor.</div></div><div><h3>Conclusion</h3><div>Supramaximal resection (SMR) in glioblastoma (GB) is gaining interest and significantly improves overall and progression-free survival, but its definition remains challenging, and data on patients’ postoperative quality of life and neurological status remain limited.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 3","pages":"Article 101813"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845651","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":"Emergency cranial neurosurgery does not need one clock, but many","authors":"Fritz Fidel Váscones-Román ,&nbsp;Samanta Janet Fuentes-Garcia","doi":"10.1016/j.neuchi.2026.101817","DOIUrl":"10.1016/j.neuchi.2026.101817","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 3","pages":"Article 101817"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147797762","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":"Surgical management of cervical spine metastasis: an update","authors":"Maria Rossella Fasinella ,&nbsp;Louis Anzalone ,&nbsp;Alexandre Meynard ,&nbsp;Cédric Barrey","doi":"10.1016/j.neuchi.2026.101814","DOIUrl":"10.1016/j.neuchi.2026.101814","url":null,"abstract":"<div><h3>Background</h3><div>Management of cervical spine metastases (CSM) is uniquely challenging due to regional biomechanics and neurovascular proximity. This study evaluates surgical strategies, focusing on the shift from radicality to functional preservation and the importance of multidisciplinary integration.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted across PubMed, MEDLINE, and Google Scholar (2015–2025), using the string \"cervical\" AND \"spine\" AND \"metastases\". From an initial pool of 1134 articles, a multi-stage screening process based on title, abstract, and predefined eligibility criteria was performed. Inclusion was restricted to English-language studies reporting clear functional outcomes. A final selection of 18 high-quality articles was analyzed.</div></div><div><h3>Results</h3><div>Strategy is strictly region-dependent: C0-C2 requires posterior fusion to manage translational instability; subaxial (C3-C6) ventral decompression via anterior corpectomy often necessitates posterior reinforcement for torsional control; and cervicothoracic (C7-T1) lesions are best managed via posterior-only long-segment fixation to avoid invasive manubriotomy. Modern \"tissue-sparing\" tools, such as Separation Surgery, ECT, and Carbon-PEEK implants, significantly enhance the \"oncological window\" by facilitating safe, high-dose SBRT. Despite a 20% morbidity rate, surgery markedly improves Quality of Life within the first 6 months.</div></div><div><h3>Conclusions</h3><div>Surgical intervention for CSM should prioritize functional restoration and \"oncological window\" preservation. In patients with favorable performance status, proactive stabilization is justified regardless of tumor aggressiveness, provided that surgical goals remain realistic and a reasonable risk-benefit ratio is maintained within the limits of clinical appropriateness.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 3","pages":"Article 101814"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788456","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":"Trepanation is not decompressive craniectomy: The danger of false historical continuity","authors":"Fritz Fidel Váscones-Román ,&nbsp;Samanta Janet Fuentes-Garcia ,&nbsp;Jack Váscones-Román ,&nbsp;Alejandra Olivera-Llenque ,&nbsp;Demy Váscones-Román","doi":"10.1016/j.neuchi.2026.101816","DOIUrl":"10.1016/j.neuchi.2026.101816","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 3","pages":"Article 101816"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788536","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":"Safe removal of three deeply penetrating intracranial nails after nail-gun injury: Technical considerations","authors":"Daisuke Yamazaki,&nbsp;Yu Fujii,&nbsp;Satoshi Kitamura,&nbsp;Kohei Kanaya,&nbsp;Tetsuyoshi Horiuchi","doi":"10.1016/j.neuchi.2026.101815","DOIUrl":"10.1016/j.neuchi.2026.101815","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 3","pages":"Article 101815"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147797599","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":"A contemporary reappraisal of a 1st c. AD. polytrauma on a 65-year-old male from Qumran (Near-East): from archaeology to clinical practice","authors":"E.M. Conlon ,&nbsp;P. Charlier ,&nbsp;I. Huynh ,&nbsp;V. Reina ,&nbsp;J.B. Humbert","doi":"10.1016/j.neuchi.2026.101771","DOIUrl":"10.1016/j.neuchi.2026.101771","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 2","pages":"Article 101771"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957881","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":"Comment on: “Understanding non-inferiority trials: lessons from trials comparing thrombectomy with or without intravenous thrombolysis”","authors":"Fabiano Cavalcante ,&nbsp;Johannes Kaesmacher ,&nbsp;Kilian Treurniet ,&nbsp;Yvo B. Roos ,&nbsp;Urs Fischer","doi":"10.1016/j.neuchi.2026.101780","DOIUrl":"10.1016/j.neuchi.2026.101780","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 2","pages":"Article 101780"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159101","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":"Factors associated with 30-day readmission in patients treated for unruptured intracranial aneurysms: a systematic review and meta-analysis","authors":"Leonardo Di Cosmo ,&nbsp;Jad El Choueiri ,&nbsp;Christopher Peter Imbrogno ,&nbsp;Pedro Lucas Machado Magalhães ,&nbsp;Andrea Cardia ,&nbsp;Ismail Zaed","doi":"10.1016/j.neuchi.2026.101779","DOIUrl":"10.1016/j.neuchi.2026.101779","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Unplanned 30-day readmission after elective treatment of unruptured intracranial aneurysms (UCAs) represents a significant clinical and economic burden. Reported readmission rates vary significantly, and the predictors of early rehospitalization remain elusive. This meta-analysis evaluates the prevalence of 30-day unplanned readmission and identifies predictors associated with increased readmission risk.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, databases were searched through October 2025, reporting 30-day unplanned readmission after microsurgical clipping or endovascular treatment of UCAs. Random-effects models were applied. Risk ratios (RR) were used for dichotomous variables, mean differences (MD) for continuous variables, and pooled prevalence estimates were produced using a generalized linear mixed model.</div></div><div><h3>Results</h3><div>Our analysis included 70,463 patients treated for UCAs across seven studies; 3,655 experienced a 30-day unplanned readmission. The prevalence of readmission was 4.8% (95% CI, 3.0–7.5%), and rates did not differ significantly between microsurgical and endovascular treatment (5.9% vs 3.4%; P = 0.26). Several comorbidities were significantly associated with increased readmission risk, including hypertension, hyperlipidemia, diabetes mellitus, and anticoagulant use. Length of index hospital stay was also associated with higher readmission risk. Age, sex, smoking status, and antiplatelet use were not significant predictors.</div></div><div><h3>Conclusion</h3><div>This meta-analysis identified a 4.8% prevalence of unplanned 30-day readmission following elective treatment of UCAs. These findings suggest the need for careful risk stratification and preoperative comorbidity management for patients undergoing UCA repair, particularly among those with cardiometabolic comorbidities and complicated index hospitalizations. Implementing these strategies in high-risk patients may help reduce preventable readmissions and improve healthcare resource utilization.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 2","pages":"Article 101779"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090262","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":"Relational precision in neurosurgery: a patient-safety and liability imperative","authors":"Fritz Fidel Váscones-Román ,&nbsp;Jack Váscones-Román ,&nbsp;Gonzalo Jair Callahuanca-Flores ,&nbsp;Johnny Alejandro Mendoza-Riega ,&nbsp;Adrian Elioth Mendoza-Peréz","doi":"10.1016/j.neuchi.2026.101769","DOIUrl":"10.1016/j.neuchi.2026.101769","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 2","pages":"Article 101769"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957882","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}