Neurochirurgie最新文献

{"title":"Impact of dural closure on postoperative complications in cerebellar metastasis surgery: A retrospective cohort study","authors":"Frédérick Rault ,&nbsp;Mathilde Ducloie ,&nbsp;Mathieu Lozouet ,&nbsp;Elise Lopvet ,&nbsp;Anaïs R. Briant ,&nbsp;Evelyne Emery ,&nbsp;Thomas Gaberel","doi":"10.1016/j.neuchi.2025.101682","DOIUrl":"10.1016/j.neuchi.2025.101682","url":null,"abstract":"<div><h3>Introduction</h3><div>Cerebellar metastases represent the second most common location for brain metastases. Surgery is a key therapeutic option, but the rate of postoperative complications remains high. The impact of dural closure techniques on these complications has not yet been specifically evaluated.</div></div><div><h3>Methods</h3><div>We conducted a retrospective single-center study including all patients who underwent surgical resection of cerebellar metastasis between 2012 and 2021 at Caen University Hospital. The primary outcome was the occurrence of a postoperative complication withing 30 days (death, reoperation, or meningitis). We analyzed surgical data, particularly focusing on the type of dural closure: watertight (with sutured closure ± suturable duraplasty) versus non-watertight (non-sealing suture ± non-suturable patch).</div></div><div><h3>Results</h3><div>A total of 125 surgeries were analyzed. Postoperative complications occurred in 25% of cases, including hydrocephalus (10%), meningitis (9%), and cerebrospinal fluid leaks (8%). Watertight dural closure was significantly associated with a higher rate of complications (<em>p</em> = 0.039). Median overall survival was 10 months and complications were associated with shorter survival (<em>p</em> = 0.011).</div></div><div><h3>Conclusion</h3><div>Watertight dural closure appears to increase the risk of postoperative complications in cerebellar metastasis surgery. These findings question the relevance of systematic watertight dural suturing in the posterior fossa.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 4","pages":"Article 101682"},"PeriodicalIF":1.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090435","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":"Iatrogenic pseudoaneurysm after surgery: Stay away from the evil. Case report and review of the literature","authors":"Anis Mansourt,&nbsp;Adrien May,&nbsp;Francesco Travaglini,&nbsp;Henry Dufour,&nbsp;Thomas Graillon,&nbsp;Kaissar Farah","doi":"10.1016/j.neuchi.2025.101680","DOIUrl":"10.1016/j.neuchi.2025.101680","url":null,"abstract":"<div><h3>Background</h3><div>Intracranial pseudoaneurysms are rare and account for less than 2% of all intracranial aneurysms. They most frequently occur after head injury, but they also can be caused by iatrogenic arterial injury during neurosurgical or ENT procedures. No clear guidelines are established concerning the treatment and surveillance of such aneurysms.</div></div><div><h3>Methods</h3><div>In this article, we present 2 cases of iatrogenic pseudoaneurysms treated conservatively and we propose a review of literature of the management and outcome of intracranial iatrogenic pseudoaneurysms.</div></div><div><h3>Case report and results</h3><div>The first case is one during a transcranial approach and the second one during a transsphenoidal approach, that were both conservatively treated with a close follow-up and a spontaneous healing of the aneurysm.</div></div><div><h3>Conclusion</h3><div>Endovascular treatment or surgical clipping are 2 valid therapeutic options in iatrogenic pseudoaneurysms, which should be preferred when feasible with a reasonable risk. In contrast, in case of a small pseudoaneurysm, important risk and complex procedures, conservative treatment with a close follow-up appears to be a valuable alternative.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 4","pages":"Article 101680"},"PeriodicalIF":1.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144067949","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":"Robotic hydrocephalus surgery: A systematic review of the effectiveness in neurosurgical interventions","authors":"Paweł Łajczak ,&nbsp;Anna Łajczak ,&nbsp;Stanisław Buczkowski,&nbsp;Kamil Jóźwik,&nbsp;Przemysław Nowakowski","doi":"10.1016/j.neuchi.2025.101677","DOIUrl":"10.1016/j.neuchi.2025.101677","url":null,"abstract":"<div><h3>Background</h3><div>Hydrocephalus is an abnormal buildup of cerebrospinal fluid (CSF) deep within the brain, resulting in clinical symptoms, including disorientation, vision disturbances, headaches, cognitive and developmental impairment. Traditional non-navigated surgical treatment, with ventriculoperitoneal (VP) shunt and endoscopic third ventriculostomy (ETV), may lead to complications such as shunt obstruction and inaccurate catheter placement. Robotics-assisted (RA) surgery has potential to improve precision of procedures. The objective of this systematic review is to assess the clinical effectiveness, complications, and benefits of RA surgical interventions in the case of hydrocephalus.</div></div><div><h3>Methods</h3><div>PRISMA-guided literature search was done in databases including PubMed, Web of Science, Cochrane Reviews, Scopus, and Embase. Inclusion criteria encompassed English language, original, peer-reviewed journal articles in robotic-assisted surgical interventions in hydrocephalus. Patient demographics, robotic systems used, and results were extracted.</div></div><div><h3>Results</h3><div>In total, 12 of the articles discussed robotic-assisted interventions for hydrocephalus. The robotic systems used included ROSA, NaoTrac, Remebot, and more. The findings established that the robotic systems are accurate. Almost all the studies showed successful outcomes with minimum robot-related complications like minor bleeding or conversion to manual surgery.</div></div><div><h3>Conclusions</h3><div>The evidence supporting the use of robot-assisted surgery for hydrocephalus management remains very limited in the literature. There is currently insufficient evidence to suggest that it offers any significant additional benefits in terms of patient outcomes, safety, or cost-effectiveness compared to conventional neurosurgical methods. Moreover, given the high maintenance costs of robotic workstations and prolonged surgery times, well-designed prospective controlled trials are needed to evaluate robotic effectiveness, compared to navigation-based techniques.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 4","pages":"Article 101677"},"PeriodicalIF":1.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941149","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":"Endonasal endoscopic surgical approach for treating trigeminal schwannomas: A systematic review and meta-analysis","authors":"Filipe Virgilio Ribeiro ,&nbsp;Marcelo Porto Sousa ,&nbsp;Lucca B. Palavani ,&nbsp;Filipi Fim Andreão ,&nbsp;Ary Rodrigues Neto ,&nbsp;Maria Antônia Oliveira Machado Pereira ,&nbsp;Christian Ken Fukunaga ,&nbsp;Luis F. Fabrini Paleare ,&nbsp;Laura Mora Montecino ,&nbsp;Stefeson Gomes Cabral Júnior ,&nbsp;Leonardo O. Brenner ,&nbsp;Marcio Yuri Ferreira ,&nbsp;Herika Negri Brito","doi":"10.1016/j.neuchi.2025.101676","DOIUrl":"10.1016/j.neuchi.2025.101676","url":null,"abstract":"<div><h3>Introduction</h3><div>Trigeminal schwannomas (TSs) are the second most common type of intracranial schwannoma. Surgical approaches are chosen depending on the type of tumor extension. The middle fossa extradural approach, infratemporal extradural approach, transmaxillary approach, transmandibular approach, and transcervical approach have been used. However, these approaches are associated with a variety of complications including other cranial nerve dysfunction. Recently, with the wide application of endoscopic technology, the endoscopic endonasal approach (EEA) seems to be an alternative skull base surgical approach for skull base pathology.</div></div><div><h3>Objective</h3><div>The objective of the present study is to evaluate the safety and efficacy EEA approach for TSs.</div></div><div><h3>Methods</h3><div>We searched Medline, Embase, and Web of Science databases following PRISMA guidelines. We used single proportion analysis with 95% confidence intervals (CI) under a random-effects model, I2 to assess heterogeneity, and Baujat and sensitivity analysis to address high heterogeneity. Eligible studies included those with ≥4 patients treated with the endoscopic endonasal approach for trigeminal schwannomas.</div></div><div><h3>Results</h3><div>Of the 2550 initially identified studies, 9 were selected, involving 195 patients, with a median follow-up of 36 months. The combined analysis showed a 29% (CI: 11%–49%) partial resection rate, while a pooled analysis for complete resection demonstrated an 84% rate (CI: 68%–99%). Preservation of cranial nerves reached a 99% rate (CI: 96%–100%) with a 100% preservation of facial function rate (CI: 97%–100%) and a 5% complications rate (CI: 0%–13%).</div></div><div><h3>Conclusion</h3><div>Based on these findings, our meta-analysis identified that the endonasal endoscopic approach for the treatment of trigeminal schwannomas presents a low rate of complications, favorable results regarding the preservation of facial function and cranial nerves, and, a high rate of effectiveness, demonstrated by the results of complete resection.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 5","pages":"Article 101676"},"PeriodicalIF":1.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941595","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":"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}