Neurochirurgie最新文献

{"title":"Endoscopic transorbital approach for the management of spheno-orbital meningiomas: A systematic review and meta-analysis","authors":"Filipe Virgilio Ribeiro ,&nbsp;Marcelo Porto Sousa ,&nbsp;Bernardo Vieira Nogueira ,&nbsp;Helvécio Neves Feitosa Filho ,&nbsp;Laura Mora Montecino ,&nbsp;Lucca B. Palavani ,&nbsp;Filipi Fim Andreão ,&nbsp;Christian Ken Fukunaga ,&nbsp;Ary Rodrigues Neto ,&nbsp;Guilherme Cristiano Garcia ,&nbsp;Marcio Yuri Ferreira ,&nbsp;Herika Negri Brito ,&nbsp;Allan Dias Polverini","doi":"10.1016/j.neuchi.2025.101659","DOIUrl":"10.1016/j.neuchi.2025.101659","url":null,"abstract":"<div><h3>Introduction</h3><div>Meningioma is the most common benign tumor in the central nervous system and may arise from the sphenoid wing region. The tumor can involve the cavernous sinus medially, periorbital and orbital apex structures anteriorly, and infratemporal fossa inferiorly. Surgical approaches more currently used include the fronto-temporal approach, the pterional approach, and even the frontotemporal-orbitozygomatic approach. The results of safety and efficacy of Transorbital neuroendoscopic surgery for these cases are still unclear, with scarce literature on the subject.</div></div><div><h3>Objective</h3><div>We assessed the safety and efficacy of Endoscopic Transorbital Approach (TOA) for the Management of Spheno-Orbital Meningiomas (SOMs).</div></div><div><h3>Methods</h3><div>We searched Medline, Embase, Web of Science databases following PRISMA guidelines. We used single proportion analysis with 95% confidence intervals 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 endoscopic transorbital approach for the management of spheno-orbital meningioma.</div></div><div><h3>Results</h3><div>Of the 3520 studies initially identified, 9 were selected, involving 216 patients, with a median follow-up of 20 months. For subtotal resection, pooled analysis confirmed a rate of 40% (CI: 24% to 57%) and a total resection rate of 46% (CI: 27% to 65%). The analysis also confirmed a rate of visual deficits of 10% (CI: 0% to 24%). The rate of cerebrospinal fluid leak was 2% (CI: 0% to 5%), and diplopia occurred in 8% of cases (CI: 0% to 18%).</div></div><div><h3>Conclusion</h3><div>ETOA is a safe and minimally invasive approach for spheno-orbital meningiomas, with low complication rates and effective cranial nerve preservation. However, its tumor resection efficacy is inferior to non-minimally invasive techniques, potentially affecting long-term outcomes. Further studies are needed to clarify its role and optimize tumor control in selected cases.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 3","pages":"Article 101659"},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580454","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":"Virtual reality in neurosurgery training: A tool for honing skills or a hindrance to real-world preparation?","authors":"Gonzalo Callahuanca-Flores ,&nbsp;Johnny Mendoza-Riega ,&nbsp;Cesar Guzman-Carrasco ,&nbsp;Adrian Mendoza-Perez","doi":"10.1016/j.neuchi.2025.101653","DOIUrl":"10.1016/j.neuchi.2025.101653","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 2","pages":"Article 101653"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529557","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 rise of gamification in neurosurgical training","authors":"Gonzalo Callahuanca-Flores ,&nbsp;Johnny Mendoza-Riega ,&nbsp;Cesar Guzman-Carrasco ,&nbsp;Adrian Mendoza-Perez","doi":"10.1016/j.neuchi.2025.101654","DOIUrl":"10.1016/j.neuchi.2025.101654","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 2","pages":"Article 101654"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529619","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 impact of primary decompressive craniectomy in ruptured middle cerebral artery aneurysms with intraparenchymal hematoma","authors":"Thomas Metayer ,&nbsp;Charles-Henry Mallereau ,&nbsp;Charles Peltier ,&nbsp;Chloe Dumot ,&nbsp;Florian Bernard ,&nbsp;Pierre-Jean Le Reste ,&nbsp;Anne-Laure Bernat ,&nbsp;Helene Cebula ,&nbsp;Caroline le Guerinel ,&nbsp;Denis Vivien ,&nbsp;Michel Piotin ,&nbsp;Evelyne Emery ,&nbsp;Vianney Gilard ,&nbsp;Omer Eker ,&nbsp;Roberto Riva ,&nbsp;Arthur Leclerc ,&nbsp;Elsa Magro ,&nbsp;Francois Proust ,&nbsp;Isabelle Pelissou-Guyotat ,&nbsp;Stephane Derrey ,&nbsp;Thomas Gaberel","doi":"10.1016/j.neuchi.2025.101656","DOIUrl":"10.1016/j.neuchi.2025.101656","url":null,"abstract":"<div><h3>Background</h3><div>Ruptured middle cerebral artery aneurysm (MCAa) with intraparenchymal hematoma (IPH) can benefit at the same time from evacuation of the hematoma and exclusion of the aneurysm of a decompressive craniectomy (DC). To date, there are no clear recommendations for performing a DC in such cases.</div></div><div><h3>Methods</h3><div>We retrospectively collected data from nine French neurosurgical units from January 1, 2013 to December 31, 2020. All MCAa patients with IPH requiring evacuation of the IPH were included in this study. Poor outcomes were defined by an mRs score of 3–6 at 6 months. Propensity score matching was used to analyze the potential effects of DC.</div></div><div><h3>Results</h3><div>Between January 2013 and December 2020, 198 MCAa ruptured with IPH were treated, including 162 MCAa requiring evacuation of the IPH. 50 were treated with DC and 112 without DC. After matching 72 patients, poor neurological prognosis was observed in 27/36 patients (75%) in the DC group versus 18/36 (50%) in the non-DC group (p = 0.026).</div></div><div><h3>Conclusion</h3><div>Primary decompressive craniectomy in patients with ruptured MCAa and IPH requiring surgical evacuation increases the risk of poor neurological outcome. RCT are needed to confirm this hypothesis.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 2","pages":"Article 101656"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562279","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":"Predictive outcome factors in the treatment of subarachnoid hemorrhage with hematoma caused by ruptured anterior circulation aneurysms: A monocentric experience","authors":"Antoine Devalckeneer ,&nbsp;Pierre Haettel ,&nbsp;Philippe Poidevin ,&nbsp;Martin Bretzner ,&nbsp;Théo Dufresne ,&nbsp;Alexandre Poulain ,&nbsp;Tomas Menovsky ,&nbsp;Nadira Delhem ,&nbsp;Rabih Aboukaïs","doi":"10.1016/j.neuchi.2025.101655","DOIUrl":"10.1016/j.neuchi.2025.101655","url":null,"abstract":"<div><h3>Introduction</h3><div>Intracranial aneurysm (IA) rupture accounts for 3% of strokes and is associated with a concerning mortality rate. Subarachnoid hemorrhage with cerebral hematoma (CSAH) often results in a higher mortality rate; however, the optimal treatment approach remains unclear. This study aims to identify factors predicting poor outcomes and mortality in cases of CSAH due to ruptured aneurysms in the anterior cerebral circulation.</div></div><div><h3>Methods</h3><div>This study retrospectively included 102 patients with anterior circulation aneurysm ruptures, treated between 2017 and 2019. A multidisciplinary team determined the treatment strategies. Statistical analyses were performed to assess outcomes.</div></div><div><h3>Results</h3><div>In the bivariate analysis of CSAH related to anterior circulation aneurysm rupture, significant factors associated with morbidity (mRS &gt;2 at one year follow-up) and mortality were: WFNS score severity, mydriasis, Tako-Tsubo, and the presence of hydrocephalus. In the multivariate analysis, significant factors for mortality were hydrocephalus (p &lt; 0.01) and Tako-Tsubo (p &lt; 0.001), while significant factors for morbidity were hydrocephalus (p &lt; 0.01) and hematoma volume (p = 0.012).</div></div><div><h3>Conclusion</h3><div>Our study analyzed a series of cases involving CSAH from anterior circulation aneurysms. We emphasize the importance of prompt treatment for hydrocephalus and suggest that the diagnosis of Tako-Tsubo should delay but not prevent treatment. Depending on local ethical standards, treatment abstention could be considered in patients with severe WFNS scores, the presence of mydriasis, hematoma &gt;45 mL, and hydrocephalus. Our findings indicate that life-threatening hematomas are best managed surgically, while smaller, non-life-threatening cases may benefit from endovascular treatment, though further randomized trials are needed for validation.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 3","pages":"Article 101655"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520612","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":"Translation and interrater reliability of the structured interview for the extended glasgow outcome scale among Moroccan patients with traumatic brain injury","authors":"Younes Iderdar,&nbsp;Soumia Marzouk,&nbsp;Nadia Al Wachami,&nbsp;Maryem Arraji,&nbsp;Karima Boumendil,&nbsp;Yassmine Mourajid,&nbsp;Amina Aquil,&nbsp;Elmadani Saad,&nbsp;Mohamed Chahboune","doi":"10.1016/j.neuchi.2025.101658","DOIUrl":"10.1016/j.neuchi.2025.101658","url":null,"abstract":"<div><h3>Objective</h3><div>The Extended Glasgow Outcome Scale (GOSE) is a commonly used assessment tool to evaluate the outcome following traumatic brain injury (TBI). This study aims to evaluate the applicability of the GOSE structured interview in the Moroccan context and to examine its reliability.</div></div><div><h3>Methods</h3><div>In this prospective validation study, we assessed the inter-rater reliability of GOSE scoring for 123 TBI patients who attended Avicenna University Hospital's outpatient unit. Interrater agreement of the GOSE was assessed, with Cohen's weighted κ, between the rater with the structured interview and the rater without the structured interview and between the rater specialized in TBI and the non-specialized rater.</div></div><div><h3>Results</h3><div>The findings demonstrated a high level of agreement (weighted kappa = 0.96) between the rater specialized in TBI and the non-specialized rater with (p &lt; 0.001) and a high level of agreement (weighted kappa = 0.85) between the rater with the structured interview and the neurosurgeon without the structured interview. The Moroccan version is capable of assessing the GOSE Score at a level similar to the original version.</div></div><div><h3>Conclusion</h3><div>The use of this version has the potential to expedite the process of evaluating outcomes in patients with TBI in both clinical practice and research settings.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 3","pages":"Article 101658"},"PeriodicalIF":1.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532192","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 necker cranial injury scale as a predictor of prognosis in children with severe traumatic brain injury: A retrospective cohort study","authors":"José Roberto Tude Melo ,&nbsp;Isadora Araújo Santos Lobo ,&nbsp;Luíza Malheiros Montagna ,&nbsp;Sophia Totaro ,&nbsp;Valentina Ponchio Vasques ,&nbsp;Luciana Andrea Digieri Chicuto ,&nbsp;Jean Gonçalves de Oliveira ,&nbsp;José Carlos Esteves Veiga","doi":"10.1016/j.neuchi.2025.101657","DOIUrl":"10.1016/j.neuchi.2025.101657","url":null,"abstract":"<div><h3>Background and objective</h3><div>The management of children with severe traumatic brain injury (TBI) is a challenge for the health team, and the use of scales and algorithms in clinical practice help in making certain decisions. The aim of this study is to evaluate the performance of the Necker Cranial Injury Scale (NCIS) in pediatric patients with severe TBI.</div></div><div><h3>Methods</h3><div>Retrospective cohort study with review of medical records of pediatric patients &lt;17 years with severe TBI treated between January 2016 and December 2023 at a Brazilian reference trauma center. The analysis of the area under the curve (AUC) of the Receiver operating characteristic (ROC) was performed to check the performance of the NCIS and the Glasgow coma scale (GCS) as mortality predictive scales.</div></div><div><h3>Results</h3><div>We identified 45 pediatric patients with severe TBI, with a median age of 9 years (IQR 5–14), and a predominance of males (71%). There was a predominance of accidents on public roads (22 of 45, 49%) followed by home accidents (21 of 45, 47%). With a median score of 6 (IQR 5–8) on the GCS, the performance of the NCIS (AUC 0.92) was superior to the performance of the GCS (AUC 0.86). The NCIS 3 cutoff point showed a specificity of 89%, negative predictive value of 97%, and accuracy of 89%.</div></div><div><h3>Conclusions</h3><div>With excellent performance and high negative predictive value, the NCIS is efficient for use in clinical practice in children with severe TBI.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 3","pages":"Article 101657"},"PeriodicalIF":1.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520613","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":"Addendum to “Synergistic effects of laser interstitial thermal therapy (LITT) and immunotherapy for brain tumor recurrence: A systematic review and meta-analysis” [Neurochir. 71 (2025), 101629] https://doi.org/10.1016/j.neuchi.2025.101629","authors":"Eshita Sharma ,&nbsp;Oguz Kagan Sahin ,&nbsp;Paweł Łajczak ,&nbsp;Numa Rajab ,&nbsp;Aisha Rizwan Ahmed ,&nbsp;Yasmin Picanço Silva ,&nbsp;Ayesha Bakhsh ,&nbsp;Anoushka Chatterjee ,&nbsp;Mohammed Raake ,&nbsp;Walter Fagundes","doi":"10.1016/j.neuchi.2025.101648","DOIUrl":"10.1016/j.neuchi.2025.101648","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 2","pages":"Article 101648"},"PeriodicalIF":1.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143478998","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":"Predictive factors of surgical adjacent segment disease in the cervical spine: A nested case-control study","authors":"Henri-Arthur Leroy ,&nbsp;Pierre De Buck ,&nbsp;Tuong Lu ,&nbsp;Amélie Toubol ,&nbsp;Boulos Ghannam ,&nbsp;Pierre Haettel ,&nbsp;Richard Assaker","doi":"10.1016/j.neuchi.2025.101651","DOIUrl":"10.1016/j.neuchi.2025.101651","url":null,"abstract":"<div><h3>Study design</h3><div>Nested case-control study.</div></div><div><h3>Objective</h3><div>Radiological adjacent segment degeneration is reported in a significant proportion of patients operated on following ACDF. Only a part of them will experience clinical symptoms, ultimately requiring a second cervical spine surgery (_SASD). Our retrospective observational study, with prospective data collection, aims at considering the potential influence of cervical sagittal balance on post-ACDF second surgery based on postoperative imaging follow-up. Four key potential predictive factors were evaluated between cases and controls.</div></div><div><h3>Methods</h3><div>Between January 1st, 2014, to January 1st, 2020, 1078 patients were operated on for ACDF in the Spine Department of Lille University Hospital. We identified 19 cases and 76 matched controls. Cases were defined as follow: &gt;18 y/o, operated on for a second ACDF related to a _SASD. Controls patients did not undergo a second cervical surgery during the study period.</div></div><div><h3>Results</h3><div>The prevalence of _SASD was 1.76%. Neither the cervical sagittal axis (p = 0.12), nor the cervical lordosis (p = 0.40) were related to _SASD. However, we reported a strong tendency for the numbers of levels operated on and the postoperative local kyphosis to be risk factors of _SASD (respectively p = 0.056 and p = 0.06).</div></div><div><h3>Conclusion</h3><div>We did not report a clear impact of the cervical spine balance parameters such as cervical lordosis or cSVA on the risk of second cervical surgery at 2 years. Though, we highlighted the potential correlation between the initial number of cervical spine levels operated on and the occurrence of sASD and the presence of early local kyphosis.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 3","pages":"Article 101651"},"PeriodicalIF":1.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525093","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":"Step by step teaching anatomy for anterior approach of the lumbar spine: A cadaveric study","authors":"Romain Quéhan ,&nbsp;Hodabalo Essosolim Bakondé ,&nbsp;Ariane Weyl ,&nbsp;Antonio Francisco ,&nbsp;Marina Poinsignon ,&nbsp;Lubin Klotz ,&nbsp;Patrick Chaynes ,&nbsp;Amaury De Barros","doi":"10.1016/j.neuchi.2025.101650","DOIUrl":"10.1016/j.neuchi.2025.101650","url":null,"abstract":"<div><h3>Purpose</h3><div>The authors described detailed relevant anatomy for anterior approach of the lumbosacral spine emphasizing all critical structures at risk for surgical injuries.</div></div><div><h3>Methods</h3><div>Two fresh adult male cadavers were dissected at the Toulouse anatomy department. For each specimen, a step-by-step surgical approach followed by broader anatomical dissection was performed.</div></div><div><h3>Results</h3><div>Results were divided into three compartments: anterior abdominal wall, latero/retroperitoneal space, lumbosacral prevertebral space. Each compartment was analyzed and visually described according to surgical and wider anatomical approach. Each region has critical anatomical structures that need to be well managed during surgery avoiding surgical complications. In the lumbosacral prevertebral space, the vascular anatomy is the most critical point to know to avoid potentially fatal surgical complications for patients. Ureter embedded into the posterior part of the peritoneum is also a critical structure to manage correctly during lumbosacral anterior approach. Different neural structures are also encountered with potential painful complications in case of injury.</div></div><div><h3>Conclusions</h3><div>In reference to anterior lumbosacral approach, critical structures to manage are peritoneum, ureter, prevertebral venous structures and hypogastric plexus. Their surgical anatomy has to be known and well recognized during surgery. Our surgical then broader anatomical dissections provide pragmatic pictural pedagogic content for teaching surgeons practicing anterior lumbosacral approach.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 2","pages":"Article 101650"},"PeriodicalIF":1.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463571","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}