Neurochirurgie最新文献

{"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":"2025-09-01","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":"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":"2025-09-01","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":"Foix-Alajouanine syndrome: A systematic review and meta-analysis of presentation, management, and outcomes","authors":"Sean O’Leary ,&nbsp;Nathan Fredricks ,&nbsp;Peace Odiase ,&nbsp;Sonia Pulido ,&nbsp;Usama AlDallal ,&nbsp;Ariadna Robledo ,&nbsp;Christopher Thang ,&nbsp;Umaru Barrie ,&nbsp;Salah Aoun","doi":"10.1016/j.neuchi.2025.101710","DOIUrl":"10.1016/j.neuchi.2025.101710","url":null,"abstract":"<div><h3>Objective</h3><div>Foix-Alajouanine syndrome (FAS) is a grouping of rare, progressive spinal arteriovenous malformations causing significant neurological morbidity.</div></div><div><h3>Methods</h3><div>A systematic review of PubMed, Google Scholar, Embase, Science Direct, and Web of Science following PRISMA guidelines identified 30 articles addressing FAS presentation, management, and outcomes.</div></div><div><h3>Results</h3><div>In 27 case reports covering 46 patients (mean age 55.1 years, 71.7% male), common symptoms included lower extremity weakness (84.8%), bladder dysfunction (69.6%), sensory deficits (65.2%), and gait disturbance (65.2%). Imaging (MRI in 82.5%, angiography in 70.0%) frequently revealed dural arteriovenous fistulas and spinal cord hyperintensities, primarily in the thoracolumbar region. Among these patients, 58.7% improved, 13.1% showed no change, 21.7% worsened, and 6.5% died. Surgical clipping (OR 10.67, 95% CI [2.12–68.04], p = 0.002) and resection (OR 5.74, 95% CI [1.18–36.47], p = 0.029) were associated with neurological improvement, whereas lesions in the mid-thoracic region (T6–T9) had reduced likelihood of improvement (OR 0.18, 95% CI [0.04–0.76], p = 0.017). Conservative management correlated with higher mortality (OR 33.89, 95% CI [1.39–826.08], p = 0.023). In three retrospective studies covering 66 patients (mean age 61.5 years, 80.3% male), primary interventions were surgical or endovascular; 63.6% improved, 35.0% worsened, and 1.5% died at follow-up.</div></div><div><h3>Conclusions</h3><div>Early detection by clinical and radiologic signs with quick intervention in the subtypes of FAS are crucial. Surgical clipping and resection demonstrated particularly favorable results, whereas conservative management was associated with increased mortality. Clinicians should maintain a high index of suspicion for subacute myelopathy to facilitate timely diagnosis and improve long-term prognosis.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 5","pages":"Article 101710"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818124","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 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":"2025-09-01","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":"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":"2025-09-01","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":"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":"2025-09-01","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":"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":"2025-09-01","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":"4D-DSA for the assessment of the rupture point of delayed rupture of a large cavernous carotid aneurysm following pipeline placement","authors":"Atsushi Fujita,&nbsp;Hiroki Goto,&nbsp;Masaaki Kohta,&nbsp;Takashi Sasayama","doi":"10.1016/j.neuchi.2025.101708","DOIUrl":"10.1016/j.neuchi.2025.101708","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 5","pages":"Article 101708"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750541","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":"Attachment ≠ Origin: A Critical Appraisal of the Olfactory Schwannoma Literature","authors":"Shankar Vangipuram,&nbsp;Harshil Sai Vangipuram,&nbsp;Shamshudheen Cholayil","doi":"10.1016/j.neuchi.2025.101706","DOIUrl":"10.1016/j.neuchi.2025.101706","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 5","pages":"Article 101706"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750542","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":"Response to Critique of “On the Origin of Olfactory Schwannomas: A Systematic Review and Analysis of Attachment Site Variability and Clinical Implications”","authors":"Brandon Edelbach ,&nbsp;Miguel Angel Lopez-Gonzalez","doi":"10.1016/j.neuchi.2025.101707","DOIUrl":"10.1016/j.neuchi.2025.101707","url":null,"abstract":"","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 5","pages":"Article 101707"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750540","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}