Neurochirurgie最新文献

{"title":"Comprehensive pain management in spinal surgery: The role of botulinum toxin","authors":"Dominique Batifol ,&nbsp;Pierre-Jacques Finiels ,&nbsp;Sophie Galmiche ,&nbsp;Marie de Boutray","doi":"10.1016/j.neuchi.2025.101678","DOIUrl":"10.1016/j.neuchi.2025.101678","url":null,"abstract":"<div><div>The use of botulinum toxin in pre- and post-operative management of pain in spinal surgery is described, following a specific administration protocol. The initial encouraging results (particularly the absence of opioid use in the post-operative period) support the potential role of BoNT-A (Botulinum Neurotoxin type A) as a targeted therapeutic option in this specific clinical setting.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 4","pages":"Article 101678"},"PeriodicalIF":1.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948229","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":"From abstraction to inclusion: Rethinking the concept of population in mental health education","authors":"Riza Amalia ,&nbsp;Ronal Surya Aditya ,&nbsp;Basti Tetteng ,&nbsp;Eva Meizara Puspita Dewi ,&nbsp;Riskiyana Prihatiningsih ,&nbsp;Rusnila","doi":"10.1016/j.neuchi.2025.101675","DOIUrl":"10.1016/j.neuchi.2025.101675","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 3","pages":"Article 101675"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143888017","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 posterior inferior cerebellar artery aneurysms","authors":"Andreas Theofanopoulos ,&nbsp;Lucas Troude ,&nbsp;Katharina Faust ,&nbsp;Sajjad Muhammad","doi":"10.1016/j.neuchi.2025.101674","DOIUrl":"10.1016/j.neuchi.2025.101674","url":null,"abstract":"<div><h3>Introduction</h3><div>Giant posterior inferior cerebellar artery (PICA) aneurysms are rare lesions carrying 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 PICA aneurysms treated either microsurgically or by endovascular means. 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 24 studies including 24 patients was obtained. Mean patient age was 53.42 years, with a male-to-female ratio of approximately 1:2. Mean maximum aneurysm diameter was 33.43 mm. A favorable outcome (mRS 0–2) was reported on 66.7% of endovascular and 84.2% of microsurgical cases. Death rate was 0% for endovascular and 5.3% for open cases. The PICA was sacrificed in 33% of the patients without lasting morbidity. 87.5% of the aneurysms were partially thrombosed, 41.7% were debulked due to mass effect and 20.8% required a revascularization procedure.</div></div><div><h3>Conclusions</h3><div>Giant PICA aneurysms are amenable to both microsurgery and endovascular treatment. The latter may require PICA sacrifice which may be safely attempted in distal aneurysms. Proximal aneurysms which cannot be safely embolized or ones with significant mass effect may benefit from microsurgical occlusion and may require debulking and/or PICA bypass.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 4","pages":"Article 101674"},"PeriodicalIF":1.5,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874205","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":"From experimental to essential: The evolving role of augmented reality in neurosurgery (2012–2024)","authors":"Leonardo Di Cosmo ,&nbsp;Jad El Choueiri ,&nbsp;Francesca Pellicanò ,&nbsp;Hamza Salman ,&nbsp;Filippo Colella ,&nbsp;Ismail Zaed ,&nbsp;Delia Cannizzaro","doi":"10.1016/j.neuchi.2025.101672","DOIUrl":"10.1016/j.neuchi.2025.101672","url":null,"abstract":"<div><div>Recent years have seen augmented reality (AR) transition from experimental to clinical practice. Advancements in hardware, software, and its integration with complementary technologies such as machine learning and robotics have improved its workflow and integration into the neurosurgical environment. This systematic review evaluates shifts in trends in AR adoption in neurosurgery from 2022 to 2024. A systematic review of PubMed was conducted following PRISMA guidelines. Studies published between January 2022 and December 2024 that had direct clinical or educational applications were included. Extracted data included the clinical context and geographical context from each study, and was analyzed with data from a previous systematic review from 2012 to 2021 to assess research evolution. A total of 275 new studies were identified, revealing a substantial increase in AR-related publications. Research trends have shifted towards more clinical embedded topics, particularly centered around neuronavigation (101), education (87), and spinal surgery (70), with the subspecialties exhibiting the most growth being spinal surgery, vascular surgery and neuro-oncology. Research output remained concentrated in high-income countries, led by the United states (53%), Switzerland (18.55%) and the UK (9.45%), reinforcing an expanding global disparity. Topic clustering analysis identified education as a central point of focus across subspecialties. As AR continues to become increasingly integrated within the neurosurgical workflow, future research should emphasize standardizing its clinical implementation and addressing global disparities in access and adoption.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 4","pages":"Article 101672"},"PeriodicalIF":1.5,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860627","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":"On the origin of olfactory schwannomas: A systematic review and analysis of attachment site variability and clinical implications","authors":"Brandon Edelbach ,&nbsp;Rasha Elbadry ,&nbsp;Dave Galel ,&nbsp;Miguel Angel Lopez-Gonzalez","doi":"10.1016/j.neuchi.2025.101673","DOIUrl":"10.1016/j.neuchi.2025.101673","url":null,"abstract":"<div><h3>Background</h3><div>Olfactory schwannomas (OS) attachment sites include the olfactory groove and cribriform plate, the anterior skull base, falx cerebri, crista galli, orbit and the planum sphenoidale. This literature review aims to characterize outcomes associated with OS attachment sites.</div></div><div><h3>Methods</h3><div>A literature review was conducted utilizing PubMed. Only studies describing OS and the tumor's origin were included. The primary outcomes of interest were anosmia outcomes and tumor characteristics.</div></div><div><h3>Results</h3><div>Thirty-eight studies including 42 cases of OS were included. 71.4% (n = 30) of OS originated from the olfactory groove or cribriform plate, while the remaining 28.6% (n = 12) had attachment sites elsewhere in the anterior fossa. 59.5% of cases eroded into the ethmoid bone, 45.2% of tumors had cystic components, 42.9% were encapsulated, 21.4% were hypervascular, and 21.4% had associated calcification. Dural attachment was described in 35.7% of cases. All patients reported subjective improvement in symptoms and there was no significant morbidity or mortality. Gross total resection was reported in 93.0% cases. Post-operative complications occurred in 11.9%. Persistent of anosmia was noted in 24.1% cases and improved anosmia was documented in 31.0% cases. OS site of origin had no impact on risk of anosmia or post-operative complications.</div></div><div><h3>Conclusions</h3><div>Microsurgical resection of OS is associated with excellent clinical outcomes, resection rates, and low morbidity and recurrence rates. Contrary to prior assertions, there was no statistically significant difference in outcomes based on tumor attachment site.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 4","pages":"Article 101673"},"PeriodicalIF":1.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905844","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 clipping of ruptured basilar artery perforator aneurysms in the endovascular era: A single-center experience","authors":"Ahmed Abdelsalam ,&nbsp;Soliman Oushy ,&nbsp;Alex Lu ,&nbsp;Ian A. Ramsay ,&nbsp;Jacob Young ,&nbsp;Sai Sanikommu ,&nbsp;Lorenzo Rinaldo ,&nbsp;Atakan Orscelik ,&nbsp;Soumya Shrigiri ,&nbsp;Luis E. Savastano ,&nbsp;Robert M. Starke ,&nbsp;Adib A. Abla","doi":"10.1016/j.neuchi.2025.101669","DOIUrl":"10.1016/j.neuchi.2025.101669","url":null,"abstract":"<div><h3>Background</h3><div>Basilar artery perforator aneurysms (BAPAs) are a rare subset of intracranial aneurysms, accounting for &lt;1% of cases. The natural history of BAPAs is unknown, and a standardized management approach is lacking. This report presents the largest cohort of surgically treated BAPAs to date, addressing gaps in the literature and guiding management strategies.</div></div><div><h3>Methods</h3><div>A single-center retrospective analysis was conducted utilizing a prospectively maintained, IRB-approved database, which included a series of seven consecutive patients treated for BAPAs. The dataset included patient characteristics, surgical details, postoperative outcomes, complication rates, and imaging and clinical follow-up data. It also featured case illustrations.</div></div><div><h3>Results</h3><div>A total of seven patients were included, all presenting with subarachnoid hemorrhage. The median age was 60 years (IQR: 56.5, 69), and 57% were female. The most common location of the perforators was mid-basilar (43%). Five cases (71.4%) had aneurysms that went undetected on the initial angiogram. All patients underwent microsurgical clipping as their treatment. Post-surgery, oculomotor nerve palsy was observed in four patients (57.1%), and three (42.8%) experienced hemiparesis, which improved during their hospital stay. Follow-up diagnostic angiograms revealed a complete aneurysm occlusion of all aneurysms with no residual filling.</div></div><div><h3>Conclusion</h3><div>Microsurgical clipping is an effective treatment option for BAPAs when observation and endovascular interventions are not feasible. Treatment decisions should be guided by presentation, aneurysm characteristics, and overall risk profile. A multicenter registry is needed to establish standardized management guidelines. A multidisciplinary, tailored approach is recommended to optimize individual patient outcomes.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 4","pages":"Article 101669"},"PeriodicalIF":1.5,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792499","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":"Understanding prognostic models: The example of the PHASES score for unruptured intracranial aneurysms","authors":"François Zhu ,&nbsp;Tim E. Darsaut ,&nbsp;Jean Raymond","doi":"10.1016/j.neuchi.2025.101666","DOIUrl":"10.1016/j.neuchi.2025.101666","url":null,"abstract":"<div><h3>Background</h3><div>Prognostic studies may inform individuals about the future course of their disease and help clinical decision making, but problems abound.</div></div><div><h3>Methods</h3><div>We summarize a study on the natural history of unruptured intracranial aneurysms (UIAs) and review the various steps in the construction of prognostic models. We emphasize the fundamental inductive problems of prognostic studies that attempt to use the backward road from the extension of patients suffering an event to create a new intensional definition of classes of patients at risk.</div></div><div><h3>Results</h3><div>The first step in a prognostic model is to identify candidate baseline variables to be entered into the model, according to background knowledge, previous studies, and statistical associations with the event of interest. This is a multivariate task. The modeler already knows the outcomes the model is supposed to ‘predict’, so that multiple models are tested against the data until a satisfactory fit is obtained. The variables used to construct the model should not be added in an <em>ad hoc</em> fashion to fit heterogeneous studies. They should be selected in such a fashion as to be exportable outside the study to new patients. An infinite number of models can fit the same data. Thus, the most important step is to validate the prognostic value of the model in patients that were not used to construct the model. In the case of UIAs, this has never been done.</div></div><div><h3>Conclusion</h3><div>Prognostic studies present multiple problems. Unvalidated models should not be used in clinical practice.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 4","pages":"Article 101666"},"PeriodicalIF":1.5,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New 3D printed simulator for training of endoscopic transsphenoidal surgery used in a dedicated pituitary course: Comment","authors":"Hinpetch Daungsupawong ,&nbsp;Viroj Wiwanitkit","doi":"10.1016/j.neuchi.2025.101670","DOIUrl":"10.1016/j.neuchi.2025.101670","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 3","pages":"Article 101670"},"PeriodicalIF":1.5,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783902","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":"Model-based ‘personalized’ care or pragmatic trials?","authors":"Jean Raymond ,&nbsp;François Zhu ,&nbsp;Tim E. Darsaut","doi":"10.1016/j.neuchi.2025.101668","DOIUrl":"10.1016/j.neuchi.2025.101668","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 3","pages":"Article 101668"},"PeriodicalIF":1.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767981","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":"Understanding decision making for preventive interventions: The unruptured intracranial aneurysm example","authors":"Jean Raymond ,&nbsp;François Zhu ,&nbsp;Tim E. Darsaut","doi":"10.1016/j.neuchi.2025.101667","DOIUrl":"10.1016/j.neuchi.2025.101667","url":null,"abstract":"<div><h3>Background</h3><div>Decision making for preventive interventions in asymptomatic patients, such as the treatment of incidental intracranial aneurysms, is eminently uncertain and at risk of over-treatment. One approach suggests that the weighing of the natural risk of the disease against the risk of intervention should be replaced by a comparison of outcomes measured as expected quality-adjusted life-years survival.</div></div><div><h3>Methods</h3><div>We review the problems of over-diagnosis and over-treatment and how prognostic studies can help address the clinical uncertainty. We examine and compare the assumptions that underlie the mathematical transformations that are involved in the so-called outcome-based approach with the risk-based approach when they are both derived from observational data. Finally, we propose a more pragmatic approach.</div></div><div><h3>Results</h3><div>Both risk-based and outcome-based models depend on two strong assumptions: exchangeability of patients selected to be observed and patients selected to be treated (in other words ignorability of treatment assignment), and ii) dominance of time-to-event data (the only thing pertinent for decision making is the time to the first event in the patient’s history). The outcome-based approach needs an additional assumption: fatality (once a patient suffers a poor outcome from an event, recovery is impossible). These three theoretical assumptions are rarely verified in practice.</div></div><div><h3>Conclusion</h3><div>Clinical decision-making based on observational data relies on unrealistic assumptions. Clinical practice should instead be guided by conducting pragmatic clinical trials.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 4","pages":"Article 101667"},"PeriodicalIF":1.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}