Neurochirurgie最新文献

{"title":"Risk of Hydrocephalus after Head Trauma: A nationwide cohort study in South Korea.","authors":"Youngoh Bae, Sung Ho Park, Hohyun Jung, Min Soo Kim","doi":"10.1016/j.neuchi.2025.101738","DOIUrl":"https://doi.org/10.1016/j.neuchi.2025.101738","url":null,"abstract":"<p><strong>Background: </strong>This study assessed the long-term risk of acquired hydrocephalus in individuals with head trauma to identify time-specific risk patterns and to evaluate high-risk subgroups using a nationwide cohort in South Korea.</p><p><strong>Methods: </strong>Data from the Korean National Health Insurance Service cohort (2005-2013) were analyzed. The study included 53,567 patients with head trauma and 535,668 matched controls. This study analyzed the incidence of hydrocephalus in patients with head trauma, and time-stratified Cox proportional hazards models were employed to calculate the adjusted hazard ratios (aHRs) for hydrocephalus across 9 years, adjusting for demographic and clinical covariates.</p><p><strong>Results: </strong>The incidence of hydrocephalus was significantly higher in the head trauma group than in the control group (incidence rate ratio, 3.92). Male patients and those aged ≥60 years exhibited the highest risk. The risk of hydrocephalus was highest within the first 3 years after trauma and decreased gradually thereafter. Furthermore, smokers and ex-smokers were at a higher risk than nonsmokers.</p><p><strong>Conclusions: </strong>Patients with head trauma are at a significantly higher risk of posttraumatic hydrocephalus, particularly within the first 3 years. These findings highlight the need for early monitoring and intervention. Further research is required to improve our understanding of hydrocephalus risk.</p>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":" ","pages":"101738"},"PeriodicalIF":1.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318842","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 Epidermoid Cyst of the Cerebellopontine Angle: Value of Endoscopic Assistance in Microsurgical Resection.","authors":"Lotfi Boublata, Mohamed Lamine Boukhanoufa, Nassim Mezlah","doi":"10.1016/j.neuchi.2025.101736","DOIUrl":"https://doi.org/10.1016/j.neuchi.2025.101736","url":null,"abstract":"<p><strong>Background: </strong>Epidermoid cysts of the cerebellopontine angle (CPA) are rare benign congenital lesions derived from ectodermal inclusions during early embryogenesis. Despite their slow growth, they may become giant and cause progressive cranial nerve dysfunction due to their close relationship with critical neurovascular structures.</p><p><strong>Case presentation: </strong>We report the case of a 60-year-old woman who presented with cochleovestibular symptoms, including vertigo, tinnitus, and hearing loss, in association with cerebellar static ataxia. Preoperative examination revealed intact facial and lower cranial nerve function. Magnetic resonance imaging (MRI) revealed a giant CPA epidermoid cyst.</p><p><strong>Surgical management: </strong>The lesion was resected via a retrosigmoid approach in a semi-sitting position under continuous intraoperative facial nerve monitoring. Microsurgical dissection enabled near-total removal of the tumor while preserving the surrounding neurovascular structures. Endoscopic inspection of the surgical cavity revealed residual tumor remnants in blind spots, which were subsequently removed, ensuring complete resection.</p><p><strong>Conclusion: </strong>The combination of microsurgical and endoscopic techniques offers a safe and effective approach to the management of giant CPA epidermoid cysts. Complete resection, including capsule removal, remains the key to minimizing recurrence while preserving neurological function.</p>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":" ","pages":"101736"},"PeriodicalIF":1.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318831","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":"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":"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":"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":"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}