Neurochirurgie最新文献

{"title":"Injectable approaches to deliver innovative treatments for spinal cord: When regenerative medicine meets precision medicine","authors":"Serratrice Nicolas","doi":"10.1016/j.neuchi.2025.101730","DOIUrl":"10.1016/j.neuchi.2025.101730","url":null,"abstract":"<div><div>Delivering therapeutic agents to the spinal cord is crucial for treating conditions such as Spinal Cord Injury (SCI), chronic pain and neurodegenerative diseases. Various administration routes, including systemic, epidural, intrathecal, subarachnoid, localized and intraparenchymal injections, offer distinct advantages and challenges when it comes to achieving effective therapeutic outcomes. The invasiveness, precision and ability to bypass biological barriers, such as the Blood-Spinal Cord Barrier (BSCB), differ between these methods. This literature review summarizes the latest research on these delivery approaches, examining their principles, techniques, applications and associated risks. By analyzing the efficacy and limitations of each route for administering steroids, recombinant growth factors, gene therapies, stem cells and biomaterial scaffolds, the review aims to provide a comprehensive understanding of the most effective strategies for targeting the spinal cord. It will highlight key findings and identify areas for further investigation.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101730"},"PeriodicalIF":1.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a prediction model for pulmonary infection in elderly patients with traumatic brain injury","authors":"Shuai Tian ,&nbsp;Ali Shang ,&nbsp;Wenqian Zhou ,&nbsp;Zhen Xu ,&nbsp;Yunpeng Kou ,&nbsp;Zhenyu Guo ,&nbsp;Fan Chen ,&nbsp;Peigang Ji ,&nbsp;Yulong Zhai ,&nbsp;Wenjian Zhao ,&nbsp;Yang Jiao ,&nbsp;Zhipeng Song ,&nbsp;Shunnan Ge ,&nbsp;Yuan Wang ,&nbsp;Liang Wang ,&nbsp;Shaochun Guo","doi":"10.1016/j.neuchi.2025.101733","DOIUrl":"10.1016/j.neuchi.2025.101733","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to investigate risk factors associated with pulmonary infection (PI) in elderly patients with traumatic brain injury (TBI). Additionally, this study sought to develop and validate a predictive model for PI in elderly patients with TBI using clinical data obtained upon admission.</div></div><div><h3>Methods</h3><div>The study retrospectively analyzed elderly patients (≥65 years) with TBI at Tangdu Hospital between January 2011 and December 2021. These patients were randomly allocated to training and validation sets in a 7:3 ratio. A nomogram model was developed to predict the risk of PI in elderly patients with TBI. Internal validation was conducted using a verification set, while external validation was performed using patient data from a different hospital.</div></div><div><h3>Results</h3><div>A total of 592 elderly patients with TBI were included. The Glasgow coma scale score on admission, chest injury, hemoglobin, albumin, C-reactive protein, procalcitonin, B-type natriuretic peptide, troponin, and surgery was found to be independent predictors of PI in elderly patients with TBI. The nomogram demonstrated good discrimination ability, with a consistency index of 0.918 (95% confidence interval (CI): 0.891–0.944), which was verified to be 0.848 (95% CI: 0.786–0.910). The area under the curve for the external validation cohorts was 0.836 (95% CI: 0.770–0.903).</div></div><div><h3>Conclusions</h3><div>This study developed and validated a prediction model for PI in elderly patients with TBI. The nomogram model demonstrated a favorable discriminatory and predictive capacity for predicting PI in elderly patients with TBI.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101733"},"PeriodicalIF":1.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted MIS transiliac sacroiliac joint fusion: Technical note","authors":"A. Nguyen ,&nbsp;P. Haettel ,&nbsp;B. Ghannam ,&nbsp;R. Assaker ,&nbsp;H.-A. Leroy","doi":"10.1016/j.neuchi.2025.101715","DOIUrl":"10.1016/j.neuchi.2025.101715","url":null,"abstract":"<div><h3>Background</h3><div>Sacroiliac joint dysfunction (SIJD) accounts for 15–25% of chronic low back pain and often follows lumbar fusion. When conservative therapies fail, minimally invasive (MIS) SIJ fusion (SIJF) is indicated. The robot-assisted technique is feasible and safe, enhancing accuracy and reducing radiation exposure.</div></div><div><h3>Case description</h3><div>A 26-year-old woman, eight years after L4-S1 fusion, presented with bilateral SIJD refractory to physiotherapy and intraarticular steroids injection. SIJF was indicated. Here we describe the robot-assisted technique and its advantages.</div></div><div><h3>Conclusion</h3><div>Robot-assisted SIJF is a safe and accurate technique to treat SIJD while reducing radiation exposure. Trajectories planification and consideration of anatomical variations give the robot-assisted technique an advantage over conventional techniques such as fluoroscopy or navigation.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101715"},"PeriodicalIF":1.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016677","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":"5-year follow up after successful craniopagus separation: Review on hydrocephalus and venous system re-arrangement","authors":"Samsul Ashari ,&nbsp;Alvi Aulia ,&nbsp;Affan Priyambodo ,&nbsp;Setyo Widi Nugroho ,&nbsp;Amanda Aldilla","doi":"10.1016/j.neuchi.2025.101717","DOIUrl":"10.1016/j.neuchi.2025.101717","url":null,"abstract":"<div><h3>Introduction</h3><div>Craniopagus is one of the rarest congenital abnormalities. Separation of craniopagus twin is associated with high morbidity and mortality, especially in total type, where the twin had shared dural venous sinuses. One of the complications after separation surgery is hydrocephalus. While detailed cerebral vasculature imaging is needed pre-operatively to ensure most optimal surgical approach, post-operative vasculature imaging is no less important to assess changes in cerebral venous system after separation surgery.</div></div><div><h3>Case presentation</h3><div>Separation surgery was successfully accomplished in a total vertical craniopagus twin with shared dural venous sinuses. One twin experienced hydrocephalus after surgery, while the other twin had CSF leakage from the wound. LP shunt was placed in both twin and they had good recovery. We then compared the cerebral venous structure in both twins, before and after separation surgery using reconstruction of CT venography.</div></div><div><h3>Conclusion</h3><div>Successful separation of total vertical craniopagus twin where both twin developed well without any neurological deficit is a very rare occurrence. Based on follow up CTV, cerebral venous system underwent re-arrangement to accommodate changing hemodynamic needs after separation surgery. This might give us new insight about cerebral venous system that favors good prognosis for craniopagus twin.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101717"},"PeriodicalIF":1.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016691","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":"Early mechanical failure of posterior lumbar fusion: Literature review based on an illustrative case","authors":"Jean Guyot,&nbsp;Amandine Gavotto,&nbsp;Stéphane Litrico,&nbsp;Antoine Gennari","doi":"10.1016/j.neuchi.2025.101714","DOIUrl":"10.1016/j.neuchi.2025.101714","url":null,"abstract":"<div><h3>Background</h3><div>Posterior lumbar fusion (PLF) has become one of the most common spinal surgery procedures. Early symptomatic loosening of the pedicle screw could be a critical complication, leading to pseudarthrosis. However, revision strategies for pedicle screw loosening are still under debate.</div></div><div><h3>Objective &amp; methods</h3><div>Based on a clinical case, we conducted a literature review of pedicle screw loosening, its risk factors, aetiologies, surgical revision options and outcomes.</div></div><div><h3>Results</h3><div>We describe a clinical case of early mechanical failure of a posterior L4-L5 arthrodesis due to septic cause. Revision surgery consisted of circumferential surgery using ALIF, posterior larger screws and extension of the arthrodesis.</div><div>The review of the literature highlights numerous risk factors for screw loosening and underlines the importance of fitting an interbody device during index surgery in patients at risk.</div><div>In the event of a screw loosening, bacteriological samples should be systematic.</div><div>Symptomatic screw loosening should benefit from revision surgery. There are various options for revision surgery, including anterior revision and the revision of posterior screws.</div></div><div><h3>Conclusion</h3><div>This review highlights the key elements of initial PLF surgery, the importance of septic aetiology in pedicle screw loosening, and suggested surgical strategies in the face of early mechanical failure.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101714"},"PeriodicalIF":1.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using fluid mechanics to reduce postoperative pneumocephalus during chronic subdural hematoma burr hole surgery: Technical note","authors":"Nathan Beucler ,&nbsp;Anis Choucha ,&nbsp;Julien Tinois ,&nbsp;Antoine Do Tran ,&nbsp;Michel Mouramba ,&nbsp;Benjamin Guyot ,&nbsp;Cédric Bernard ,&nbsp;Arnaud Dagain","doi":"10.1016/j.neuchi.2025.101726","DOIUrl":"10.1016/j.neuchi.2025.101726","url":null,"abstract":"<div><div>Symptomatic chronic subdural hematoma is a prevalent conditions among the elderly, making burr hole surgical evacuation a very frequent cranial neurosurgical procedure. Recurrence of chronic subdural hematoma requiring revision surgery is associated with higher morbidity and mortality. Decreasing postoperative pneumocephalus is a simple but helpful mean allowing to reduce chronic subdural hematoma recurrence. A few years ago, our team has already described the use of the subdural drain to fill the subdural drain with saline, thus helping pneumocephalus out. Zhou and colleagues present an ingenious system using fluid mechanics principles, with an opened syringe connected to the subdural drain and held above the level of the burr hole in order to make saline flow into the subdural space; then held below the level of the burr hole to make pneumocephalus out, the remaining saline acting as a one-way-valve like the drainage bag of a pneumothorax. Nevertheless, in order to optimize this system, the burr hole should be placed in the horizontal plane at the highest point of the skull to be able to fill the subdural space with saline completely.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101726"},"PeriodicalIF":1.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Thrombosed Middle Meningeal Artery Aneurysm Mimicking a Meningioma","authors":"Mauricio Guerrero-Ocampo,&nbsp;Marcos Peña,&nbsp;Ana Riquelme,&nbsp;Fabrizio Frutos","doi":"10.1016/j.neuchi.2025.101723","DOIUrl":"10.1016/j.neuchi.2025.101723","url":null,"abstract":"<div><h3>Introduction</h3><div>True middle meningeal artery aneurysms (MMAAs) are extremely rare, with fewer than 20 documented cases and only one previously described as a giant aneurysm in a patient with fibrous dysplasia. Typically measuring under 10 mm, these lesions can be mistaken for other vascular abnormalities such as intracranial aneurysms, arteriovenous malformations (AVMs), or dural arteriovenous fistulas (DAVFs). This report describes a unique vascular lesion combining four rare features: (1) true MMAA, (2) giant in size, (3) completely thrombosed, and (4) mimicking a tumor (pseudotumoral behavior).</div></div><div><h3>Material and methods</h3><div>A 70-year-old male with no history of cranial trauma presented with right hemiparesis following a seizure. Imaging revealed a 266cc extra-axial mass in the left fronto-parieto-temporal region, causing significant midline shift (18 mm) and ventricular compression. CT and MRI findings showed a well-circumscribed lesion with post-contrast enhancement and a dural tail sign, raising suspicion for a meningioma. Surgical resection was performed using standard meningioma techniques. During microsurgical dissection and debulking, intraoperative pathology revealed non-neoplastic tissue.</div></div><div><h3>Conclusion</h3><div>This case highlights the potential for true MMAAs to mimic other intracranial pathologies. Due to their location and dural involvement, a high index of suspicion is essential. We recommend specific preoperative and intraoperative considerations for surgeons encountering similar presentations to avoid misdiagnosis and guide appropriate management. These include invasive imaging techniques, acceptable subtotal resection of the lesion given the lack of regrowth possibilities and optimal dural reconstruction to avoid complications such as cerebrospinal fluid fistulae.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101723"},"PeriodicalIF":1.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding dizziness: Non-Vestibular Influences Following Radiosurgical Management of Vestibular Schwannoma","authors":"Shamsudheen Cholayil ,&nbsp;Vangipuram Harshil Sai ,&nbsp;Shankar Vangipuram","doi":"10.1016/j.neuchi.2025.101731","DOIUrl":"10.1016/j.neuchi.2025.101731","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101731"},"PeriodicalIF":1.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Stereotactic Radiosurgery for Jugular Foramen Schwannomas: A Systematic Review and Meta-Analysis","authors":"Bardia Hajikarimloo ,&nbsp;Salem M. Tos ,&nbsp;Ibrahim Mohammadzadeh ,&nbsp;Dorsa Najari ,&nbsp;Azin Ebrahimi ,&nbsp;Ehsan Bahrami Hezaveh ,&nbsp;Fatemeh Ghorbanpouryami ,&nbsp;Mohammad Amin Habibi","doi":"10.1016/j.neuchi.2025.101725","DOIUrl":"10.1016/j.neuchi.2025.101725","url":null,"abstract":"<div><h3>Background</h3><div>Jugular foramen schwannomas (JFS) are infrequent cranial nerve (CN) lesions accounting for up to 4% of intracranial schwannomas. The management of the JFS is challenging due to its proximity to critical neurovascular structures. Stereotactic radiosurgery (SRS) has emerged as a minimally invasive alternative to resection; however, the available data regarding the outcomes of SRS in JFS is limited. This study aims to evaluate the role of SRS in JFS.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Embase, Scopus, and Web of Science was performed following PRISMA guidelines. Pooled estimates for local control (LC), cranial nerve (CN) deterioration, progression-free survival (PFS), and adverse radiation effects (ARE) were calculated using the R program.</div></div><div><h3>Results</h3><div>Seventeen studies with 529 patients were included. The pooled LC rate was 94% (95% CI: 91%–96%), with a CN deterioration rate of 9% (95% CI: 3%–16%). The pooled 1-year PFS rate was 98% (95% CI: 96%–100%), 3-year PFS rate was 95% (95% CI: 92–97%, 5-year PFS rate was 92% (95% CI: 88–95%), and 10-year PFS rate was 84% (95% CI: 76–90%). The pooled ARE rate was 6% (95% CI: 2–11%).</div></div><div><h3>Conclusion</h3><div>SRS results in promising LC and PFS rates along with low CN deterioration and ARE rates in JFS patients. Surgery remains the primary choice for those with larger lesions or mass-related symptoms, while SRS can be the first-line option for small to medium-sized lesions.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101725"},"PeriodicalIF":1.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093040","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":"Evaluation of the necessity of systematic ICU after intracranial meningioma surgery: Towards a risk-based approach. Toulouse University Hospital experience","authors":"Remi Raclot ,&nbsp;Jean-Christophe Sol ,&nbsp;Franck-Emmanuel Roux ,&nbsp;Maxime Pommier ,&nbsp;Nicolas Astafieff ,&nbsp;Lubin Klotz ,&nbsp;Amaury De Barros","doi":"10.1016/j.neuchi.2025.101718","DOIUrl":"10.1016/j.neuchi.2025.101718","url":null,"abstract":"<div><h3>Background</h3><div>Intracranial meningiomas are the most common benign central nervous system tumors, often managed with elective surgical resection. While outcomes are generally favorable, postoperative management remains variable, particularly regarding routine Intensive-Care Units (ICU) admission. Given increasing pressure on critical care resources, identifying patients who truly require ICU-level monitoring is essential.</div></div><div><h3>Objective</h3><div>To evaluate early postoperative complications after meningioma surgery and develop a practical risk-based score to guide ICU admission.</div></div><div><h3>Methods</h3><div>We performed a retrospective single-center study of 203 intracranial meningioma resections (2020–2022). Patients were included if they had scheduled surgery and at least one night of postoperative ICU monitoring. A composite endpoint defined ICU-relevant complications within 24 h, including seizures, new deficits, delayed awakening, reintubation, transfusion, intra-veinous (IV) antihypertensives, and urgent imaging or reoperation. Twenty-two clinical, radiological, and surgical factors were analyzed.</div></div><div><h3>Results</h3><div>Postoperative complications requiring ICU-level care occurred in 19.2% of cases, mostly neurological (13.8%). Two-thirds of events occurred upon awakening or in the post-anesthesia care unit (PACU). Univariate analysis identified seven significant predictors: intracranial hypertension, falcine location, motor cortex involvement, operative time ≥3 h, blood loss &gt;500 mL, osmotherapy use, and transfusion. A 10-item risk score demonstrated high sensitivity (92.3%) and negative predictive value (95.9%) using a cut-off of 1 or more points. Using this model, in our population, 36.5% of patients could have safely avoided ICU admission.</div></div><div><h3>Conclusion</h3><div>A risk-based approach to ICU admission after meningioma surgery appears both safe and feasible. Implementation of this score, combined with extended PACU monitoring, could optimize resource use without compromising patient safety. Prospective validation is warranted.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 6","pages":"Article 101718"},"PeriodicalIF":1.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016668","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}