Neurochirurgie最新文献

{"title":"A Novel Technique for Eliminating Pneumocephalus in Chronic Subdural Hematoma Burr-hole Surgery","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.2025.101703","DOIUrl":"10.1016/j.neuchi.2025.101703","url":null,"abstract":"<div><h3>Background</h3><div>Chronic subdural hematoma (cSDH) is a common neurosurgical condition with increasing prevalence in the aged population. Burr-hole surgery is the most common and effective treatment. However, subsequent pneumocephalus is a complication and has been a cause leading to recurrence and reoperation. This study aims to describe a novel technique to eliminate pneumocephalus via subdural catheter following subdural hematoma evacuation, as a method to reduce subdural potential space and decrease recurrence.</div></div><div><h3>Methods</h3><div>In this retrospective study, 52 patients who underwent burr-hole craniotomy evacuation of cSDH between January 2023 and September 2024 were assessed. Ten patients underwent modified intraoperative pneumocephalus elimination. Quantitative volumetric analysis was performed on preoperative, postoperative, and one-month follow-up computed tomography scans to assess the volume of pneumocephalus.</div></div><div><h3>Results</h3><div>There were no differences in baseline characteristics between the present technique and control groups. The present technique resulted in decreased pneumocephalus volume (5.6 mL vs 16.6 mL; P = .035) and subdural air ratio (0.05 vs 0.19; P = .010) on post-operative day 1. At three-month follow-up, the recurrence rate was lower in the present technique group, though this difference did not reach statistical significance (0.0% vs 4.7%; P = 1.000).</div></div><div><h3>Conclusion</h3><div>In conclusion, we present an innovative surgical technique that demonstrates remarkable efficacy in eliminating subdural air during cSDH burr-hole surgery. This technique offers a safe, streamlined approach that not only simplifies the surgical procedure but also shows promise in reducing cSDH recurrence rates.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 5","pages":"Article 101703"},"PeriodicalIF":1.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656872","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":"Robot-assisted MIS surgery in a pregnant woman with lumbar traumatic fracture: A technical note","authors":"J. Bride ,&nbsp;R. Assaker ,&nbsp;B. Ghannam ,&nbsp;P. Haettel ,&nbsp;B. Bouyer ,&nbsp;H.A. Leroy","doi":"10.1016/j.neuchi.2025.101702","DOIUrl":"10.1016/j.neuchi.2025.101702","url":null,"abstract":"<div><div>The occurrence of a vertebral fracture in a pregnant woman presents unique challenges in terms of diagnosis and therapeutic. Managing such cases requires multidisciplinary collaboration to minimize x-rays and preserve fetus development while ensuring efficient treatment of the fracture in the mother.</div><div>We report the case of an 18 y/o primiparous woman at 20 weeks of gestation who suffered a polytrauma without neurological deficit. Full body CT-scan reported an A2 M1 <em>(AO Spine Classification)</em> fracture of L3 and an A1 fracture of L2.</div><div>In this situation, both patient positioning and irradiation were challenging. The surgeons, anesthesiologists and physicists discussed the pros and cons between conservative treatment and various types of surgery (open technique, percutaneous). A left lateral decubitus robot-assisted percutaneous L2-L4 osteosynthesis was performed. We depict the procedure as well as the patient outcome and follow-up.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 5","pages":"Article 101702"},"PeriodicalIF":1.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656873","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":"Short-segment percutaneous osteosynthesis with long pedicle screw fixation of the injured vertebra for thoracolumbar and lumbar non neurological fractures: The Trident Fixation","authors":"Félix Barbier ,&nbsp;David Giber ,&nbsp;Michel Dagher ,&nbsp;Charles Henri Flouzat Lachaniette ,&nbsp;Marc Khalifé ,&nbsp;Arnaud Dubory","doi":"10.1016/j.neuchi.2025.101700","DOIUrl":"10.1016/j.neuchi.2025.101700","url":null,"abstract":"<div><h3>Study design</h3><div>Prospective cohort study</div></div><div><h3>Objective</h3><div>This study aimed to assess the interest of a short percutaneous monaxial pedicle screw (PS) osteosynthesis, named the Trident Fixation (TF): fixation of one vertebra above and below the vertebral fracture and including two long monoaxial PS into the injured vertebra to treat thoracolumbar (TL) and lumbar (L) fractures.</div></div><div><h3>Methods</h3><div>Patients operated by this surgical method were prospectively included. Preoperative data and immediate, one-year follow-up, and two-year follow-up postoperative data were collected. The surgical correction was studied, evaluating the radiologic parameters as follows: vertebral body angle, regional traumatic kyphosis, regional traumatic angulation, Anterior/Middle Column Vertebral Body Compression Ratio (VBCR) and Anterior Vertebral Body Compression Percentage and the mid sagittal diameter of the spinal canal. PS placement, bone fusion and the occurrence of instrumentation failure were sought.</div></div><div><h3>Results</h3><div>Sixty-six patients were included (mean follow-up of 1.9 years (95% CI [1.9–2.6]). Regarding the accurate position of the PS, 11 of them (16.7%) presented a cortical bone violation. At the last follow-up, 3 patients (4.5%) presented a screw loosening, but no one progressed to a screw pull-out. One patient (1.5%) suffered from a rod breakage. All the radiologic parameters improved postoperatively, except the VBCR, which remained unchanged, despite the surgery. Vertebral fracture was healed for 54 patients (82%). Twenty (30.3%) patients presented an intervertebral fusion, either posterior facet fusion (12 patients [18.2%]) or interbody fusion (11 patients [16.6%]).</div></div><div><h3>Conclusion</h3><div>TF gives relevant postoperative radiological outcomes and is an alternative to the kyphoplasty, which remains an expensive method.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 5","pages":"Article 101700"},"PeriodicalIF":1.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568070","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":"Performance of the Marshall and Rotterdam scales as predictors of mortality in children with severe traumatic brain injury","authors":"Júlia Calviello Giordano ,&nbsp;José Roberto Tude Melo ,&nbsp;Chiara Maria Brito Tischer ,&nbsp;Larah Domingos de Oliveira ,&nbsp;Max Yunio Orsi Salazar ,&nbsp;Antônio José da Rocha ,&nbsp;Jean Gonçalves de Oliveira ,&nbsp;José Carlos Esteves Veiga","doi":"10.1016/j.neuchi.2025.101699","DOIUrl":"10.1016/j.neuchi.2025.101699","url":null,"abstract":"<div><h3>Objective</h3><div>Traumatic brain injury (TBI) is a public health problem and the Glasgow Coma Scale (GCS) is recognized as the gold standard tool for grading TBI severity, but it may underestimate severity when applied in the pediatric population. The combined use of the GCS with criteria established in brain CT scan images enhances the ability to predict prognosis in this group of patients. The Marshall and Rotterdam scales are the most commonly used for this purpose. This study aims to evaluate and compare the performances of these scales as predictors of in-hospital mortality in children with severe TBI.</div></div><div><h3>Methods</h3><div>This was a retrospective study using data from consecutive medical records of children and adolescents (&lt;17 years old) with severe TBI (GCS score ≤8) hospitalized between January 2016 and December 2023 at a Brazilian trauma reference center. Brain CT scan images were retrospectively analyzed for calculation of scores in the Marshall and Rotterdam scales. The cutoff score of 4 established as a predictor of prognosis was used to dichotomize the group. We calculated the performance and accuracy of both scales as predictors of prognosis.</div></div><div><h3>Results</h3><div>The area under the receiver operating characteristic curve (AUC) of the 37 children with severe TBI included in the study was 0.65 in the Marshall scale and 0.73 in the Rotterdam scale, considering in-hospital mortality as the outcome. In both scales the mortality rate was higher in children with scores ≥4, being 42% (42% vs. 12%; p = 0.05; OR 5.23; 95% CI 0.9910–27.6872) in the Marshall scale, and 50% (50% vs. 11%; p = 0.01; OR 8; 95% CI 1.4247–44.9212) in the Rotterdam scale.</div></div><div><h3>Conclusion</h3><div>The Rotterdam scale performed better as a predictor of in-hospital mortality (AUC 0.73) when compared to the Marshall scale (AUC 0.65) in the group of children with severe TBI analyzed. The cutoff point of 4 in the Marshall and Rotterdam scales can be used in clinical practice as a predictor of mortality with accuracy of 73% and 78% respectively.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 5","pages":"Article 101699"},"PeriodicalIF":1.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568069","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":"Cervical intradural extramedullary cavernoma as a rare cause of acute hydrocephalus – a case report and systematic review","authors":"Antoine Keraudy ,&nbsp;Victor Legrand ,&nbsp;Marie Csanyi ,&nbsp;Quentin Vannod-Michel ,&nbsp;Rabih Aboukais","doi":"10.1016/j.neuchi.2025.101698","DOIUrl":"10.1016/j.neuchi.2025.101698","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 5","pages":"Article 101698"},"PeriodicalIF":1.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530932","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 rare cause of intracranial hypertension: Intradiploic epidermoid cyst with superior sagittal sinus compression","authors":"Frédérick Rault ,&nbsp;Jean Bouchart ,&nbsp;Mohammad Ismail ,&nbsp;Marie-Alice Laville ,&nbsp;Thomas Gaberel","doi":"10.1016/j.neuchi.2025.101694","DOIUrl":"10.1016/j.neuchi.2025.101694","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 5","pages":"Article 101694"},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365250","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":"In memoriam: Professor M. Gazi Yaşargil (1925–2025)","authors":"Mejdeddine Al Barajraji ,&nbsp;Sami Barrit ,&nbsp;Thibault Remacle","doi":"10.1016/j.neuchi.2025.101696","DOIUrl":"10.1016/j.neuchi.2025.101696","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 4","pages":"Article 101696"},"PeriodicalIF":1.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144364781","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":"Primary central nervous system lymphoma: A 7 years single-center experience","authors":"Etienne Dugast ,&nbsp;Cédric Aumont ,&nbsp;Ilyess Zemmoura","doi":"10.1016/j.neuchi.2025.101697","DOIUrl":"10.1016/j.neuchi.2025.101697","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Primary central nervous system lymphoma (PCNSL) is a rare hematological malignancy, affecting the central nervous system (CNS), meninges, or eyes. Advancements in treatment, particularly with IV high-dose methotrexate, have improved patient survival. Diagnosis is primarily based on contrast-enhanced brain MRI, followed by confirmation through brain biopsy. However, biological markers such as cerebrospinal fluid (CSF) or vitreous humor lymphocyte immunophenotyping and interleukin levels (IL-6 and IL-10) can aid diagnosis, especially in cases where biopsy is difficult.</div></div><div><h3>Methods</h3><div>This retrospective observational study examines the diagnostic features of PCNSL patients at CHRU de Tours from 2017 to 2023. It focuses on MRI feature, ophthalmological examination, brain biopsy results and biomarker findings in CSF and vitreous humor.</div></div><div><h3>Results</h3><div>65 adult patients with a confirmed PCNSL were included. Brain biopsy, performed in 34 cases (52%), remained the gold standard. Cytological confirmation, including immunophenotyping, was decisive in 17% of cases with vitreous samples and 14% with cerebrospinal fluid (CSF) samples. Elevated interleukin levels alone guided treatment in 6% of patients with vitreous samples and 5% with CSF samples. Lastly, 6% of patients, without definitive biological markers, were treated based on clinical presentation and characteristic MRI features after ruling out major differential diagnoses.</div></div><div><h3>Conclusions</h3><div>PCNSL diagnosis can be achieved through various methods. Indirect biological markers like interleukin 6 and 10, while helpful, remain supplementary diagnostic tools. A standardized diagnostic protocol could enhance rapid diagnosis and timely treatment, which is crucial for improving therapeutic outcomes.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 4","pages":"Article 101697"},"PeriodicalIF":1.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369522","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":"Rural Health: What can and cannot be done in an isolated rural neurosurgical unit","authors":"Lorenzo Mongardi ,&nbsp;Etienne Lefevre ,&nbsp;Stéphane Litrico ,&nbsp;Marie-Charlotte Hesler ,&nbsp;Ugo Torrente ,&nbsp;Guillaume Coll ,&nbsp;Léo Nanty ,&nbsp;Jean-Rodolphe Vignes ,&nbsp;Stephane Fuentes ,&nbsp;Paul Roblot","doi":"10.1016/j.neuchi.2025.101695","DOIUrl":"10.1016/j.neuchi.2025.101695","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of the study is to ascertain which neurosurgical procedures can be safely and effectively performed in an isolated rural neurosurgical unit, despite the lack of advanced technological infrastructure available in tertiary neurosurgical departments in high-income countries.</div></div><div><h3>Methods</h3><div>The authors draw upon their experience of establishing a first-line neurosurgical unit in a remote Pacific archipelago, which was accomplished without significant technological investments. All the patients operated in the neurosurgical unit of the Territorial Hospital of Nouméa, New Caledonia, from December 1, 2023, to February 1, 2025, were included. The primary outcome measure was a composite endpoint, including the mortality within three months post-surgery, reoperation within three months post-surgery, secondary transfer due to postoperative complications.</div></div><div><h3>Results</h3><div>134 patients underwent 155 procedures. Among them, 129 patients underwent cranial surgery while 5 patients underwent spinal cord surgery. Among the 155 procedures, 107 (69.0%) were emergency surgeries, 48 (31.0%), were planned surgeries. The most frequent indications for emergency surgery were traumatic brain injuries (TBI) (47/107–43.9%), CSF disorders (24/107–22.4%), and spontaneous cranial infections (13/107–12.1%). Among the planned surgeries, 31 were tumor resection (31/48–64.5 %) while 12 were heterologous cranioplasties (12/48−25.0%). The postoperative course was favorable for 93.8% of planned surgeries. Among the 107 emergency surgeries, 14 (14/107−13.1%) required reoperation (4 postoperative infections, 2 postoperative hematomas, 1 postoperative intracranial hypertension, 2 recurrences of chronic subdural hematomas and 5 wound infections).</div></div><div><h3>Conclusion</h3><div>Our experience confirmed that the majority of neurosurgical cases can be safely manage on site without all the technological tools even if the possibility to transfer high complexity cases in a center equipped with advanced surgical devices still plays a fundamental role.</div><div>In isolated regions where transfer to a tertiary center within four hours is impossible, the presence of such a unit is not only safe but essential to improve the quality of healthcare services.</div><div>Having a resident neurosurgeon in a rural unit can also be beneficial in reducing the need for secondary transfers due to the possibility to manage on-site post operative complication.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 4","pages":"Article 101695"},"PeriodicalIF":1.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314582","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":"Masquelet induced cranial membrane under silicone layer during cranioplasty: Toward a natural technique for regeneration of meninges after decompressive craniectomy","authors":"Nathan Beucler ,&nbsp;Antoine Do Tran ,&nbsp;Benjamin Guyot ,&nbsp;Arnaud Dagain","doi":"10.1016/j.neuchi.2025.101691","DOIUrl":"10.1016/j.neuchi.2025.101691","url":null,"abstract":"<div><div>Reconstruction of the meninges and secondary hydrocephalus are salient issues following decompressive craniectomy. We propose a simple technique using a silicone sheet leaning on the opened dura mater and the brain during decompressive craniectomy. During cranioplasty, the removal of the silicone layer reveals that a new translucent and highly vascularized membrane has been naturally generated underneath, covering the dura mater flaps and the brain. We believe that this new cranial membrane arising from Masquelet’s technique could allow covering large meningeal defects notably after wartime craniocerebral injury, and could also help reducing the occurrence of secondary hydrocephalus thanks to better cerebrospinal fluid circulation underneath.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 4","pages":"Article 101691"},"PeriodicalIF":1.5,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230306","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}