Neurochirurgie最新文献

{"title":"Evolution of neurosurgical on-call activity at caen university hospital between 2014 and 2024: a retrospective monocentric comparative study","authors":"Joshua Marchal ,&nbsp;Marc-Antoine Pasquet ,&nbsp;Marie Horeau ,&nbsp;Louis Vincent ,&nbsp;Louis Vielpeau ,&nbsp;Mohammed Znazen ,&nbsp;Amadou Wahabou ,&nbsp;Chanel Avocevohoun ,&nbsp;Mourad Masmoudi ,&nbsp;Joséphine Malczuk ,&nbsp;Evelyne Emery ,&nbsp;Arthur Leclerc","doi":"10.1016/j.neuchi.2026.101770","DOIUrl":"10.1016/j.neuchi.2026.101770","url":null,"abstract":"<div><h3>Background</h3><div>Neurosurgical on call systems provide continuous access to specialised emergency care. International series report rising referral volumes, especially for spine, trauma, and low acuity consultations, but French decade long data within a continuous 24 h duty model are scarce.</div></div><div><h3>Methods</h3><div>We performed a retrospective single centre comparison at Caen University Hospital including all neurosurgical on call referrals over two 3 month periods (2014 and 2024). We recorded referral volume and origin, patient age, cranial versus spinal orientation, urgency level, operations during duty (including after midnight), and admissions. Groups were compared with standard tests for categorical and continuous variables.</div></div><div><h3>Results</h3><div>Referrals increased from 432 to 1,354 (+214%), and mean calls per duty rose from 6.4 to 18.1 (p &lt; 0.001). Referrals from peripheral hospitals increased (58%–69.5%), and community physician calls rose (1.1%–5.3%). Patients older than 85 years increased (7.2%–12.6%). Spinal referrals increased and reached parity with cranial referrals in 2024. Non urgent calls rose from 11.1% to 49.6%. Immediate emergency operations increased from 33 to 82, and post midnight procedures from 5 to 23.</div></div><div><h3>Conclusions</h3><div>Over 10 years, on call workload nearly tripled in our centre, with more spine cases, more low acuity requests, and more night time surgery. These trends support reorganising emergency pathways, implementing structured tele expertise, and adapting staffing to maintain sustainable neurosurgical emergency care.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 2","pages":"Article 101770"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020440","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":"Risk factors and predictive model development for intracranial infection following surgical clipping of unruptured intracranial anterior circulation aneurysms","authors":"Kun Dai ,&nbsp;Chengyuan Ji ,&nbsp;Pengfei Xia,&nbsp;Youjia Qiu","doi":"10.1016/j.neuchi.2026.101775","DOIUrl":"10.1016/j.neuchi.2026.101775","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative intracranial infection (ICI) is a serious complication that occurs after craniotomy, typically caused by the invasion of microorganisms such as bacteria into the sterile cranial cavity. Aneurysm clipping is one of the primary treatment methods for intracranial aneurysms, and ICI can significantly impact patient prognosis. Our investigation aims to systematically identify the determinants of postoperative ICI after aneurysm clipping and develop a robust predictive model for clinical risk assessment. To eliminate potential confounding factors introduced by aneurysm rupture and subarachnoid hemorrhage, our study focuses exclusively on patients with unruptured intracranial anterior circulation aneurysms.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of clinical data from 428 patients with anterior circulation aneurysms. Based on the occurrence of postoperative ICI, patients were stratified into non-infected group and infected group. Univariate and multivariate statistical analyses were performed to evaluate the following variables: gender, age, body mass index (BMI), hypertension, diabetes mellitus, aneurysm location, number of aneurysm clips applied, operative duration, intraoperative blood loss, cerebrospinal fluid (CSF) leakage, and postoperative intracranial hemorrhage or cerebral infarction in the surgical region. Subsequently, a predictive nomogram was constructed based on the multivariate regression results to generate a robust predictive model.</div></div><div><h3>Results</h3><div>Among 428 patients with anterior circulation aneurysms, 38 developed postoperative ICI. Univariate analysis revealed that BMI, diabetes mellitus, operative duration, intraoperative blood loss, CSF leakage, and postoperative cerebral hemorrhage or infarction were significant factors influencing ICI. In contrast, variables such as gender, age, hypertension, and the number of aneurysm clips applied demonstrated no statistically significant association. Subsequent logistic regression analysis identified elevated BMI, diabetes mellitus, prolonged operative duration, substantial intraoperative blood loss, and postoperative CSF leakage as independent risk factors for ICI in UIA patients. A receiver operating characteristic (ROC) curve was constructed based on the predicted probabilities of ICI, yielding an area under the curve (AUC) of 0.8756, indicating strong predictive accuracy.</div></div><div><h3>Conclusion</h3><div>Postoperative ICI in patients with anterior circulation aneurysms is influenced by multiple factors, including BMI, diabetes mellitus, operative duration, intraoperative blood loss, and CSF leakage. A predictive model constructed based on the relative impact of these factors may assist clinicians in anticipating potential infection events during the perioperative period.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 2","pages":"Article 101775"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013360","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":"Translabyrinthine versus middle fossa approaches for vestibular schwannoma surgery: a systematic review and comparative meta-analysis","authors":"Rudolfh Batista Arend ,&nbsp;Emanuel Abrantes Barros ,&nbsp;Filipe Virgilio Ribeiro ,&nbsp;Marcelo Porto Sousa ,&nbsp;Laura Mora ,&nbsp;Maria Antônia Oliveira Machado Pereira ,&nbsp;André Nishizima ,&nbsp;Helvécio Neves Feitosa Filho ,&nbsp;Stefeson Gomes Cabral Junior ,&nbsp;Bruno Zilli Peroni ,&nbsp;Arthur Vinicius C. Marinho ,&nbsp;Natan Lucca Lima ,&nbsp;Martin Batista Coutinho da Silva ,&nbsp;Alex Roman ,&nbsp;Herika Negri Brito","doi":"10.1016/j.neuchi.2026.101787","DOIUrl":"10.1016/j.neuchi.2026.101787","url":null,"abstract":"<div><h3>Introduction</h3><div>Vestibular schwannomas (VS) are tumors in which surgery via translabyrinthine (TL) or middle cranial fossa (MCF) is standard, but the optimal approach remains debated. This meta-analysis evaluated TL and MCF approaches for VS management, emphasizing reoperation rate and complications.</div></div><div><h3>Methods</h3><div>PubMed, Embase, Web of Science, and Cochrane Library search. I² statistics were used to assess heterogeneity. Odds Ratios (OR) were used for binary event analyses, with Baujat and leave-one-out analyses applied to identify heterogeneity sources.</div></div><div><h3>Results</h3><div>The analysis of patients returning to the operating room included 230 patients in the MCF group and 592 in the TL group, demonstrating a lower reoperation rate with the MCF approach (OR 0.41, 95% CI 0.18–0.91, I² = 0%). For complications, 9 studies involving 448 patients in the MCF group and 990 in the TL group showed similarity (OR 0.92, 95% CI 0.50–1.68, I² = 54%). Cerebrospinal fluid leaks were analyzed in 3,323 (833 in MCF, 2,490 in TL), showing no statistical difference (OR 0.75, 95% CI 0.49–1.13, I² = 21%). Facial nerve preservation, assessed in 3 studies involving 516 patients in the MCF group and 614 in the TL group, revealed similarity (OR 1.43, 95% CI 0.48–4.27, I² = 88%). Wound infection rate was analyzed in 2,310 patients (657 in MCF, 1653 in TL), being comparable (OR 0.91, 95% CI 0.31–2.69, I² = 34%).</div></div><div><h3>Conclusion</h3><div>Both approaches demonstrated comparable outcomes, suggesting that individual patient characteristics and surgeon expertise can guide the choice of treatment. However, the MCF approach may be associated with fewer reoperations.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 2","pages":"Article 101787"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203736","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 Use of Indocyanine Green (ICG) in Endoscopic Pituitary Surgery: A Systematic Review","authors":"Yousif F. Jubouri ,&nbsp;Rohan Chikhal ,&nbsp;Shahzada Ahmed ,&nbsp;Karan Jolly","doi":"10.1016/j.neuchi.2026.101783","DOIUrl":"10.1016/j.neuchi.2026.101783","url":null,"abstract":"<div><h3>Background and aims</h3><div>Indocyanine Green (ICG) fluorescence imaging is increasingly utilised in endoscopic pituitary surgery to enhance intraoperative visualisation and surgical accuracy. This systematic review evaluates the efficacy and clinical utility of ICG in improving tumour delineation, extent of resection, and anatomical orientation during pituitary surgery.</div></div><div><h3>Materials and methods</h3><div>A systematic PRISMA-guided search of multiple electronic databases was conducted through February 2025. Eligible studies included adult patients undergoing endoscopic pituitary surgery with intraoperative ICG use and reported surgical or diagnostic outcomes. Eleven studies, comprising 150 patients, met the inclusion criteria. Data on patient demographics, tumour characteristics, ICG administration protocols, fluorescence metrics, surgical and endocrine outcomes were extracted and analysed using weighted and proportional methods.</div></div><div><h3>Results</h3><div>ICG fluorescence visualised targets in 93.6% of cases (n = 87/93, range 75–100 %) with onset 20 seconds to 32.5 min post-injection. Non-functioning adenomas were most common (55%, n = 68/124), predominantly macroadenomas. ICG improved margin delineation, enabled mapping of the internal carotid artery and cavernous sinus, and aided real-time differentiation of adenoma from normal gland. Where studies reported diagnostic performance, Delayed-Window ICG (DWIG) demonstrated sensitivity 89% and specificity 75%, while Second-Window ICG (SWIG) showed sensitivity 100% with specificity 20–29 %. Complications were low; transient diabetes insipidus was most frequent (n = 6). Gross total resection was achieved in most cases (n = 53/65, range 80–87.5 %), and no ICG-specific adverse events were reported.</div></div><div><h3>Conclusions</h3><div>ICG fluorescence appears to be a promising adjunct for endoscopic pituitary surgery, improving intraoperative visualisation and anatomical guidance. Distinct from prior narrative reviews, we present a technique-stratified synthesis (bolus, DWIG, SWIG) that integrates clinical outcomes. Standardised protocols and high-quality prospective studies are needed to validate diagnostic performance and define routine use.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 2","pages":"Article 101783"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133539","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":"Impact of chronotherapy and time-of-day on surgical and adjuvant outcomes in glioblastoma and mixed high-grade glioma patients: a systematic review","authors":"Siddharth Shah ,&nbsp;Anuraag Punukollu ,&nbsp;Brandon Lucke-Wold","doi":"10.1016/j.neuchi.2026.101782","DOIUrl":"10.1016/j.neuchi.2026.101782","url":null,"abstract":"<div><h3>Background</h3><div>Circadian rhythms regulate DNA repair, cell-cycle progression, metabolism, and immune function processes central to glioblastoma (GBM) treatment response. Aligning therapy with intrinsic biological timing (“chronotherapy”) may improve efficacy without increasing toxicity. This systematic review evaluated the impact of treatment time-of-day on outcomes in GBM, focusing on temozolomide (TMZ) administration, radiotherapy (RT) scheduling, and surgical timing.</div></div><div><h3>Methods</h3><div>Following PRISMA 2020 guidelines, PubMed, Embase, and Google Scholar were searched through October 2025 for original human studies of adults with GBM or high-grade glioma comparing outcomes by time-of-day exposure (PROSPERO-CRD420251185806). Eligible endpoints included overall survival (OS), progression-free survival (PFS), postoperative complications, and length of stay (LOS). Randomized and observational studies were assessed using RoB 2 and ROBINS-I tools, respectively, and synthesized narratively due to heterogeneity.</div></div><div><h3>Results</h3><div>Six studies met inclusion criteria: three on TMZ timing, two on RT timing, and one on surgical timing. Morning TMZ was associated with longer OS in a retrospective cohort (median 1.43 vs 1.13 years; HR 0.67, 95% CI 0.46–0.98) and a similar trend in a feasibility trial (20.3 vs 16.4 months), though a large pooled analysis from two EORTC trials showed no OS/PFS difference but higher myelosuppression with morning dosing. Afternoon RT improved OS (25.6 vs 18.5 months, <em>p</em> = 0.014) and PFS (20.6 vs 13.3 months, <em>p</em> = 0.022) in a circadian-synchronized cohort, while other RT and surgical studies reported no time-dependent effects.</div></div><div><h3>Conclusion</h3><div>Available evidence suggests that treatment time-of-day may be associated with modest and context-dependent differences in adjuvant therapy outcomes in glioblastoma. Signals favoring morning temozolomide administration and afternoon radiotherapy are biologically plausible but inconsistent, while current data do not support a clinically meaningful effect of surgical timing. These findings should be considered hypothesis-generating, underscoring the need for prospective, biomarker-guided chronotherapy trials before clinical implementation.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 2","pages":"Article 101782"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133536","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":"Intraoperative contrast-enhanced ultrasound-assisted resection of brain tumors: a systematic review and meta-analysis","authors":"Márcio Yuri Ferreira ,&nbsp;Leonardo Januário Campos Cardoso ,&nbsp;Shayan Huda ,&nbsp;Netanel Ben-Shalom","doi":"10.1016/j.neuchi.2026.101774","DOIUrl":"10.1016/j.neuchi.2026.101774","url":null,"abstract":"<div><h3>Background</h3><div>Given the critical importance of optimizing the extent of resection (EoR) in brain tumor surgery, intraoperative imaging techniques continue to evolve, enhancing tumor localization and margin delineation to enable maximal safe resection. Among these, intraoperative contrast-enhanced ultrasound (iCEUS) has recently been introduced into neurosurgical practice, with emerging evidence supporting its role in improving EoR. This systematic review and meta-analysis aim to evaluate the impact of iCEUS on the EoR in intracranial tumor surgery.</div></div><div><h3>Methods</h3><div>The literature was searched for studies on iCEUS use in intracranial tumor resection. The primary endpoints were the gross total resection (GTR) rate among iCEUS patients and its comparison with non-iCEUS patients. The secondary endpoint was the ultrasound contrast agent (UCA)-related adverse events (AEs). Subgroup analyses were performed for all gliomas and specifically for high-grade gliomas (HGG).</div></div><div><h3>Results</h3><div>Five studies with 193 patients, including 106 (54.1%) undergoing iCEUS-assisted resection, were analyzed. The GTR rate in iCEUS-assisted cases was 81.13% (95% CI: 70.41%–91.84%; I² = 51%), significantly higher than in non-iCEUS cases (OR: 5.37; 95% CI: 2.41–11.97; I² = 0%). Among patients with gliomas (all grades), the GTR rate was 76.12% (95% CI: 58.82%–93.84%; I² = 61%), while in the HGG subgroup, it reached 79.26% (95% CI: 61.39%–97.13%; I² = 37%). No UCA-related AEs were reported.</div></div><div><h3>Conclusion</h3><div>iCEUS is a valuable intraoperative imaging tool with the potential to improve GTR rates in brain tumor surgery. Further research, particularly randomized controlled trials, is needed to clarify its impact on resection and survival outcomes across tumor types and to establish its comparative effectiveness against other intraoperative imaging modalities.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 2","pages":"Article 101774"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981248","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":"Repeated salvage high precision radiotherapy for repeated recurrence of high-grade glioma","authors":"Mami Ishikawa ,&nbsp;Yukihiro Hama ,&nbsp;Etsuko Tate ,&nbsp;Masahiro Uematsu ,&nbsp;Masaki Takahashi ,&nbsp;Heiji Naritaka ,&nbsp;Gen Kusaka","doi":"10.1016/j.neuchi.2026.101784","DOIUrl":"10.1016/j.neuchi.2026.101784","url":null,"abstract":"<div><h3>Background</h3><div>Repeated high precision radiotherapy may be an additional salvage treatment for patients with recurrent high-grade glioma, delivering a low minimum radiation dose to brain and a high effective dose to tumor.</div></div><div><h3>Materials</h3><div>24 patients with high-grade gliomas (grade 3: 8 patients, grade 4: 16 patients) were treated by surgery, chemotherapy, and tomotherapy (CT-guided intensity-modulated radiotherapy (IMRT)). A total dose of 60 Gy was prescribed to PTVh (planning tumor volume h) and 40 Gy to PTV1 in 15 fractions each. PTVh and PTV1 were defined as the MRI contrast-enhanced area plus a margin and as high intensity area on the double inversion recovery images plus a margin, respectively. The planning for distant recurrence was performed as well as the first tomotherapy, and for invasive recurrence, 40 Gy or lower was prescribed to PTVh.</div></div><div><h3>Results</h3><div>The tomotherapy was performed for 14 of the 24 patients for the first recurrence, and for 7 of those 14 patients for the second or subsequent. Stepwise multiple regression analysis showed that patients with repeated tomotherapy had long survival time (<em>p</em> &lt; 0.0001). Median survival time from the first tomotherapy (based on Kaplan-Meier estimates) was 18 months in the 14 patients with repeated tomotherapy versus 5.5 months in the 10 patients without repeated tomotherapy (<em>p</em> &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>Repeated tomotherapy may be one of the additional salvage treatments without symptomatic adverse events for patients with repeated recurrences of glioma. Accurate and precise tomotherapy planning and neurosurgery for eloquent areas are essential for the comprehensive treatment of glioma patients.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 2","pages":"Article 101784"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133576","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":"Modern concepts of CSF disorders in monosutural craniosynostosis","authors":"Paolo Frassanito ,&nbsp;Marco Galeazzi ,&nbsp;Gianpiero Tamburrini","doi":"10.1016/j.neuchi.2026.101773","DOIUrl":"10.1016/j.neuchi.2026.101773","url":null,"abstract":"<div><h3>Introduction</h3><div>Although hydrocephalus is randomly encountered in monosutural craniosynostosis (CS), CSF disorders may present more subtly and accompany these pictures. Indeed, dilation of subarachnoid spaces is frequently reported. The pathogenesis of these disorders is still under debate, as well as their prognostic significance.</div></div><div><h3>Methods</h3><div>A thorough review of the literature has been performed. Accordingly, pathogenic theories, eventual impact of surgical strategy, and prognostic significance are discussed.</div></div><div><h3>Results</h3><div>Most data come from scaphocephaly and trigonocephaly. Focal dilation of subarachnoid spaces is the most encountered CSF disorder in monosutural CS, followed by general dilation of subarachnoid spaces. Arachnoid cysts are exclusively associated to trigonocephaly. On the other side, overt hydrocephalus is a fortuitous occurrence, its pathogenesis being unrelated to monosutural CS. Pathogenesis of these CSF disorders has been related to CSF malabsorption, secondary to venous hypertension, and compensatory phenomenon. However, it is likely that local mechanisms, namely local venous hypertension and passive expansion, may better explain these pictures. Dilation of subarachnoid spaces usually resolve or at least improve after cranial remodeling and expansion. On the other side, arachnoid cysts may enlarge after fronto-orbital advancement.</div></div><div><h3>Conclusions</h3><div>Future study should clarify the pathogenesis of CSF disorder in monosutural CS and possibly assess the risk of raised intracranial pressure if the CS is left untreated. Furtherly, the impact on timing and surgical strategy should be carefully explored.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 2","pages":"Article 101773"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981249","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":"Review of treatment modalities and clinical outcome of giant saccular superior cerebellar artery aneurysms","authors":"Andreas Theofanopoulos ,&nbsp;Ben Waldau ,&nbsp;Marc Ronald Schneider ,&nbsp;Katharina Faust ,&nbsp;Sajjad Muhammad","doi":"10.1016/j.neuchi.2026.101781","DOIUrl":"10.1016/j.neuchi.2026.101781","url":null,"abstract":"<div><h3>Introduction</h3><div>Giant superior cerebellar artery (SCA) aneurysms are rare lesions with significant morbidity due to mass effect and present therapeutic challenges due to proximity to critical neurovascular structures.</div></div><div><h3>Materials and methods</h3><div>A systematic literature review through the PubMed and Scopus databases was performed according to the PRISMA guidelines to identify cases of giant saccular SCA aneurysms treated either microsurgically or by endovascular techniques. Patients’ demographics, aneurysm size, preoperative and postoperative neurologic status, clinical outcomes as well as follow-up information were retrieved.</div></div><div><h3>Results</h3><div>Data from 5 studies including 6 patients were obtained. Mean patient age was 53.83 years, with a male-to-female ratio of 2:1. Mean maximum aneurysm diameter was 31.3 mm. All patients presented at mRS 3 or more. A favorable outcome (mRS 0–2) was reported on 50% of cases. Two patients underwent microsurgery (one resulting in a favorable outcome), while two underwent endovascular treatment with both achieving a favorable outcome. Two more underwent a combination of microsurgical STA-SCA bypass followed by endovascular aneurysm treatment, both with unfavorable outcomes. All aneurysms were at least partially thrombosed; the ones treated microsurgically were debulked due to mass effect.</div></div><div><h3>Conclusions</h3><div>Giant SCA aneurysms may cause severe, often persistent neurologic morbidity due to brainstem compression and may be approached by either microsurgery or endovascular treatment. Advanced endovascular techniques may be required to prevent recurrence. Thrombosed aneurysms which cannot be safely embolized or ones with significant mass effect may benefit from microsurgical clip occlusion and may require debulking, while hybrid techniques should be used judiciously.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 2","pages":"Article 101781"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133557","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 neurosurgeon as athlete, gentleman, and physician: Thierry de Martel (1875–1940) as a model for contemporary practice","authors":"Johan Pallud","doi":"10.1016/j.neuchi.2026.101772","DOIUrl":"10.1016/j.neuchi.2026.101772","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 2","pages":"Article 101772"},"PeriodicalIF":1.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981247","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}