Neurocirugia最新文献

{"title":"Modelo de entrenamiento neuroquirúrgico en encéfalo bovino para resección de tumores intraaxiales","authors":"Miguel Nuñez Rodriguez,&nbsp;Alexis Tovar,&nbsp;Victoria Herrera Gunn,&nbsp;Pablo Kuchlewski,&nbsp;Guido Carlomagno,&nbsp;Florencia Beldi","doi":"10.1016/j.neucir.2025.500659","DOIUrl":"10.1016/j.neucir.2025.500659","url":null,"abstract":"<div><h3>Background</h3><div>Practice in simulation models optimizes learning and manual skills necessary in neurosurgical training.</div></div><div><h3>Objectives</h3><div>To describe a neurosurgical simulation model for the resection of brain tumors using easily accessible materials and to evaluate the acceptance of the model through a questionnaire.</div></div><div><h3>Material and methods</h3><div>An artificial tumor based on gelatin and spongostan with infiltrative characteristics was elaborated. It was injected into a bovine brain and the latter into a dry skull. Its location was studied to later operate it using microsurgical instruments. Dural opening, corticotomy, biopsy and debulking with supramarginal resection were performed and the participants evaluated the model through a Likert-type questionnaire.</div></div><div><h3>Results</h3><div>In vivo simulation models, cadaveric preparations, 3D printing, virtual reality and injection of artificial lesions into animal brains ex vivo are described. In the latter, the creation of tumors based on different materials, including gelatin, is mentioned. It is important that the tumor is easy to inject and resistant to heat, so a mixture of gelatin - spongostan was created. This model describes qualities to emulate tumor surgery as well as pre-surgical planning, reconstruction of the subarachnoid space and continuous instillation of artificial blood to the surgical bed.</div></div><div><h3>Conclusion</h3><div>An intraaxial tumor simulation model was described as a useful tool to improve surgical techniques in oncological neurosurgery. It proved to have a good degree of acceptance in the participants.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 4","pages":"Article 500659"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519003","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":"Dr. Máximo Poza y Poza","authors":"Juan F. Martínez-Lage Sánchez","doi":"10.1016/j.neucir.2025.500661","DOIUrl":"10.1016/j.neucir.2025.500661","url":null,"abstract":"","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 4","pages":"Article 500661"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519005","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":"Recurrent spinal subdural hematoma in granulomatosis with polyangiitis","authors":"Teresa Kalantari ,&nbsp;Celia Ortega-Angulo ,&nbsp;Raquel Gutiérrez-González","doi":"10.1016/j.neucir.2025.500670","DOIUrl":"10.1016/j.neucir.2025.500670","url":null,"abstract":"<div><div>Nervous system involvement is uncommon in granulomatosis with polyangiitis (GPA), a systemic autoimmune disease with episodes of necrotizing vasculitis. It is usually due to the compressive effect of dural or epidural masses. Spinal hemorrhagic presentation is exceptional. A 41-year-old woman diagnosed with GPA presented with three episodes of acute spinal subdural hematoma separated by eight years and ten months, respectively. The symptomatic debut was pain and paresis in all episodes. On all occasions, a lesion compatible with acute spinal subdural hematoma was diagnosed by magnetic resonance imaging (MRI). All episodes were treated conservatively with corticosteroids and immunosuppressants. The patient presented complete neurological recovery in the first two episodes. A mild residual left lower limb paresis remains after the last one. Follow-up MRI was performed after all episodes, and no focal intraspinal lesions were detected. Spinal subdural hemorrhage is a form of manifestation of GPA, either as a debut or in the course of the disease. We describe the third confirmed case of spontaneous spinal hemorrhage secondary to GPA published in the literature and the first with recurrence. Given the extraordinary response to immunosuppressive therapy, a high level of clinical suspicion is necessary to establish treatment as early as possible.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 4","pages":"Article 500670"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519049","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":"Case report: Central venous stenosis-induced intracranial hypertension","authors":"Santiago Cardona-Collazos ,&nbsp;Ashly Arias ,&nbsp;Sofia Torres-Figueroa ,&nbsp;Carlos Alberto Meneses ,&nbsp;Carlos Andres Varon","doi":"10.1016/j.neucir.2025.500652","DOIUrl":"10.1016/j.neucir.2025.500652","url":null,"abstract":"<div><div>Intracranial hypertension due to central venous stenosis (CVS) is an under-recognized but potentially morbid complication of central venous catheters that can have a benign course if recognized and treated early. Here we report a case of a 23-year-old woman requiring hemodialysis via right subclavian catheter who presented with an intracranial hypertension syndrome and sudden visual loss secondary to right innominate vein thrombosis that improved after angioplasty treatment. This case illustrates how CVS can alter the pressure gradient between the subarachnoid space and the cerebral venous sinuses by increasing venous pressure, affecting cerebrospinal fluid drainage. Since CVS is a common finding in patients receiving hemodialysis, intracranial hypertension due to central venous stenosis is a differential diagnosis to consider in patients of this type who present with intracranial hypertension syndrome.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 4","pages":"Article 500652"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519004","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":"Missed diagnosis; non-traumatic retroclival haematoma in adults, brief case report with review and evaluation of similar cases in the literature","authors":"Ali Rıza Güvercin,&nbsp;Mehmet Aktoklu,&nbsp;Mehmet Orbay Bıyık,&nbsp;Uğur Yazar","doi":"10.1016/j.neucir.2025.500664","DOIUrl":"10.1016/j.neucir.2025.500664","url":null,"abstract":"<div><div>Retroclival subdural haematomas (RSH) are a rare occurrence, accounting for 0.3% of acute extra-axial haematomas. Although typically associated with trauma, non-traumatic causes include coagulopathy, pituitary apoplexy and vascular anomalies.The presence of cases due to non-traumatic causes can present significant diagnostic challenges. This article aims to shed light on the intricacies of non-traumatic RSH by conducting a review of the literature and presenting a case study of a 74-year-old woman on anticoagulants. The primary objective is to enhance our understanding of the diagnosis and treatment of this condition, emphasising the significance of bleeding in a location that often goes unnoticed, particularly in Computed Tomography (CT) scans, with the exception of trauma. A comprehensive review of the literature revealed 28 cases of non-traumatic RSH in adults. A detailed analysis was conducted on the demographic characteristics, causes, presentations and outcomes of these cases.The mean patient age was found to be 59 years, with a slight male predominance of 57.57%. The primary causes were identified as pituitary apoplexy (39.28%) and anticoagulants (21.42%), while 25% of cases had an unknown aetiology. Spinal canal extension occurred in 10.71% of cases, which increased morbidity.The recovery rate was 92.85% and the mortality rate was 3.57%.Non-traumatic RSH is under-recognised and often missed on standard imaging.Conservative treatment is effective without spinal cord compression.Awareness is very important, especially for diagnosis and treatment.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 4","pages":"Article 500664"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519048","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 role of Glucose/Potassium Ratio and Neutrophil/Lymphocyte Ratio in the prognosis of patients with aneurysmal subarachnoid hemorrhage","authors":"Mónica Maldonado-Luna ,&nbsp;Ana María Castaño-León ,&nbsp;Andrea Emanuela Baciu ,&nbsp;Luis Alzamora-Llull ,&nbsp;Elvira Vallés-Núñez ,&nbsp;Alfonso Lagares","doi":"10.1016/j.neucir.2025.500655","DOIUrl":"10.1016/j.neucir.2025.500655","url":null,"abstract":"<div><h3>Antecedents and objective</h3><div>Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high morbidity and mortality. Traditional factors strongly associated with poor outcome are neurological condition and the amount of bleeding. Inflammation is considered a relevant mechanism of brain injury after aSAH. This study aims to investigate the potential role of new laboratory indexes related to inflammation for predicting the prognosis of aSAH patients, complementing established prognostic models.</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective observational study including adults admitted for aSAH at a single neurosurgery center from 2002 to 2023. Demographic data, clinical parameters, and blood test results at admission were collected. The main outcome variable was Glasgow Outcome Scale (GOS) six month post-bleeding. A second outcome variable was in-hospital mortality. Univariable analyses were performed to identify new laboratory predictors of poor prognosis. The independent association with outcome was evaluated after adjustment of traditional risk factors by logistic regression analysis. The additional value of new laboratory predictors was determined by comparison of the area under the receiver operating curve (AUROC).</div></div><div><h3>Results</h3><div>Among 542 patients with aSAH, 417 met inclusion criteria (age &gt;18 years old and complete laboratory test available upon admission with aSAH confirmed by CT angiography (CTA) or digital subtraction angiography (DSA)). Elevated glucose/potassium ratio (GKR) in the first blood test at admission was significantly associated with unfavorable outcome and in-hospital mortality according to univariate analysis. The GKR was significantly associated with a worse final prognosis (OR 1.033, 95% CI 1.008–1.040) adjusted for age, WFNS and Fisher scales, history of diabetes mellitus and kidney disease, and prior use of diuretics, oral antidiabetic medications and insulin. Additionally, the inclusion of the GKR improved the predictive accuracy of a prognostic model compared to a model including only clinical and radiological data. The neutrophil-lymphocyte ratio (NLR) was not significantly different between subgroups of patients regarding their outcome.</div></div><div><h3>Conclusion</h3><div>GKR measured in the first 24 h after aSAH may improve the discrimination of patients with higher risk of experiencing poor outcome at six month after the bleeding.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 4","pages":"Article 500655"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519046","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":"Global trends in neurosurgical research: Insights from the top 100 most-cited articles","authors":"Roser Garcia-Armengol ,&nbsp;Sebastian Andres Menéndez-Girón ,&nbsp;Cristina Hostalot ,&nbsp;Ana Cristina Pérez-Balaguero ,&nbsp;Carlos Javier Dominguez ,&nbsp;Ana Rodriguez-Hernandez","doi":"10.1016/j.neucir.2025.500656","DOIUrl":"10.1016/j.neucir.2025.500656","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to identify and analyze the 100 most-cited articles in neurosurgical journals over the past 20 years.</div></div><div><h3>Methods</h3><div>The Thomson Reuters Web of Science citation index was used to analyze articles from high-impact neurosurgical journals identified via Journal Citation Reports. Data extracted included citations, citations per year, title, authors, year, country, institution, journal, study type, and thematic area. Citation analysis identified the most impactful articles. A bibliometric analysis compared trends between 2012–2022 and 2001–2011. Descriptive statistics and Pearson correlation were applied to examine the relationship between publication year and citation count. Stata V14.2 was used for statistical analysis.</div></div><div><h3>Results</h3><div>Citations for the top 100 articles ranged from 194 to 1,501. “Journal of Neurosurgery” and “Neurosurgery” published the most-cited articles, with peak productivity in 2012 and 2013. The USA was the leading country in article contributions. Neuro-oncology, especially tumor studies, was the dominant thematic field.</div></div><div><h3>Conclusions</h3><div>The bibliometric analysis highlighted a strong centralization in neurosurgical research, with most highly cited articles coming from two major journals, largely from the United States. This reveals the significant influence of a few key contributors in global neurosurgery.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 4","pages":"Article 500656"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519047","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 lumbar fusion” vs.“microsurgical bilateral decompression via unilateral approach” after removal of the spinal fixators in patients with adjacent segment disease: Clinical retrospective study","authors":"Turgut Kuytu ,&nbsp;Ahmet Karaoğlu","doi":"10.1016/j.neucir.2025.500654","DOIUrl":"10.1016/j.neucir.2025.500654","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>In cases where adjacent segment disease (ASD) develops following lumbar fusion surgery, various surgical approaches can be employed. In such cases, removal of the instrumentation can positively impact lumbar pain syndrome. One frequently used method is short-segment fixation-decompression (SSFD). One of minimally invasive methods is microsurgical bilateral decompression via unilateral approach (MBDU). This study aims to determine which method is more effective and safe in cases that developed ASD following fusion surgery by comparing SSFD and MBDU after instrumentation removal.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 47 cases treated with SSFD and 29 cases treated with MBDU. The groups were analyzed for gender, age, preoperative symptom duration, duration of hospitalization, and Visual Analogue Scale (VAS) scores and Oswestry Disability Index (ODI) scores during the preoperative and postoperative intermittent follow-up periods.</div></div><div><h3>Results</h3><div>Duration of hospitalization was higher in the SSFD group compared to the MBDU group (p = &lt;0.001 CI = 56,42–76,24 and 22,04–25,13 respectively), mean transverse canal diameter ratio in the decompressed segment was lower in the SSFD group (p = 0,03 IC = 0,24–0,31 for SSFD y 0,40–0,47 for MBDU), and ODI indices were higher in the SSFD group in all follow-ups (p = &lt;0.001). During the follow-up period, symptomatic ASD was observed in 3 of 47 patients in the SSFD group, whereas no symptomatic ASD was observed in the MBDU group.</div></div><div><h3>Conclusion</h3><div>In selected patients who develop ASD after fusion surgery MBDU after instrumentation removal can be considered as a minimally invasive option that does not exacerbate postoperative lumbar pain syndrome or lead to the development of new ASD. To the best of our knowledge, this is the first comparison of these two techniques in literature after removal of spinal fixators in lumbar ASD cases.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 4","pages":"Article 500654"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519109","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":"Pilot study to assess the safety and efficacy of human acellular dermal matrix for Chiari surgery","authors":"Pilar Teixidor-Rodríguez ,&nbsp;Ferran Brugada-Bellsolà ,&nbsp;Maria Luisa Pérez ,&nbsp;Sebastián Menéndez-Girón ,&nbsp;Jordi Busquets-Bonet ,&nbsp;Carlos Javier Domínguez-Alonso","doi":"10.1016/j.neucir.2025.500653","DOIUrl":"10.1016/j.neucir.2025.500653","url":null,"abstract":"<div><h3>Purpose</h3><div>Although there may be benefits to adult patients who have had Chiari surgery when duroplasty is indicated, there are also more risks involved. The complications derived from a non-hermetic dural closure in the posterior fossa can be significant, mainly cerebrospinal fluid (CSF) leakage, meningitis and pseudomeningocele. We explored the option of utilizing a different duroplasty that we typically utilized in order to reduce these risks. The aim of this study is to assess the safety and efficacy of two duraplasties used for Chiari malformation (ChM) surgery: Tutopatch®, and a human acellular dermal matrix (hADM). Tutopatch®, a well-known collagen membrane commonly used by our senior surgeon, and hADM, prepared by the tissue establishment and with potential properties for use as duraplasty.</div></div><div><h3>Methods</h3><div>A unicentric prospective study was designed with one group of patients treated with hADM and another group that retrospectively acquired surgical treatment with Tutopatch®. There were nineteen patients in each group. The patients in both groups were diagnosed with same pathology and were operated on by the same senior surgeon. This study was approved by the same hospital’s Medical Ethics Committee. Demographics, clinical risk factors, clinical syndrome and pre/postoperative and postoperative events after surgery were analysed. All serious adverse events (SAEs) and adverse events (AEs) after surgery were recorded.</div></div><div><h3>Results</h3><div>No differences were found between the two groups related to sex, clinical risk factors, clinical syndrome and clinical outcomes. Seven patients presented with complications, seven the Tutopatch® group (two of them requiring a new reoperation) and none in the hADM group.</div></div><div><h3>Conclusion</h3><div>This pilot study shows that hADM is a safe and effective alternative to Tutopatch® duraplasty, as although the two materials performed equally well in the surgical repair of Chiari malformation, the former showed better clinical outcomes. Future studies are needed to confirm these outcomes in larger cohorts.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 4","pages":"Article 500653"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519108","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":"La génesis de la Neurocirugía académica. Parte I: el llamado «periodo gestacional» y las contribuciones de Harvey Cushing","authors":"Ramiro D. Lobato ,&nbsp;Alfonso Lagares ,&nbsp;Pedro A. Gómez López ,&nbsp;José A.F. Alén ,&nbsp;Pedro González León ,&nbsp;Angel Pérez Núñez ,&nbsp;Beatriz Pascual","doi":"10.1016/j.neucir.2025.500671","DOIUrl":"10.1016/j.neucir.2025.500671","url":null,"abstract":"<div><div>This is the first of five papers describing the origin and evolution of the so-called Academic Neurosurgery which will appear consecutively in the journal Neurocirugía. The three firsts focuse on the emergence of the specialty in Europe and the United States and its development in the last country between the origins and the present moment, paying special attention to the foundation of the neurosurgical societies (SNS, AANS, CNS) with their respective journals and the configuration of the residency programs. The fourth analyzes the same issues in Europe and, most specifically in Spain, also from the beginnigs to the XXI century. The fifth describes the development of Academic Neurosurgery in a neurosurgical unit of one of hospitals created by the National Social Security System in the early 1970s).</div><div>The present paper describes the initiatives, difficulties and achievements of the pioneers at both sides of the Atlantic during the so called Gestational Period for creating the new and independent specialty of Neurosurgey conceived as a scientific and clínico-surgical activiy with an academic profil.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 4","pages":"Article 500671"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519050","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}