Neurocirugia最新文献

{"title":"Unveiling the importance of the endoscope in the sealing of the superior canal dehiscence syndrome, how we do it","authors":"Carlos Doval-Rosa ,&nbsp;Francisco Javier Dorado-Capote ,&nbsp;Alvaro Toledano-Delgado ,&nbsp;Jose Miguel Sequí-Sabater ,&nbsp;Román Carlos-Zamora ,&nbsp;Juan Solivera-Vela","doi":"10.1016/j.neucir.2024.05.001","DOIUrl":"https://doi.org/10.1016/j.neucir.2024.05.001","url":null,"abstract":"<div><p>The superior canal dehiscence syndrome is a pathology that affects the arcuate eminence creating a “third window” between the inner ear and the middle fossa. This condition can lead to symptoms such as hearing loss, autophony, or sound-induced vertigo. Traditionally, surgical treatment has been performed by microscope-assisted temporal craniotomy, but when the dehiscence is in the medial part of the arcuate eminence the bone defect may not be seen.</p><p>We present case series treated at our institution diagnosed of superior canal dehiscence syndrome involving the medial slope of the arcuate eminence. During surgery, the bone defect could not be visible with traditional microscopic techniques. Nonetheless, by introducing the endoscope with the 0º and 30º optics, the dehiscence could be clearly observed and treated correctly.</p><p>Our results show a clinical improvement without side effects or complications in the patients undergoing this technique. Endoscope-assisted surgery is a safe procedure and provides a better visualization of medial defects.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 4","pages":"Pages 221-224"},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141480592","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":"Tailoring fenestrated aneurysm clips intraoperatively: Instant solution for a difficult problem","authors":"Pinar Eser,&nbsp;Ismail Seckin Kaya,&nbsp;Oguz Altunyuva,&nbsp;Hasan Kocaeli","doi":"10.1016/j.neucir.2023.09.001","DOIUrl":"10.1016/j.neucir.2023.09.001","url":null,"abstract":"<div><p>The anterior communicating artery (AcoA) aneurysms represent the most complex aneurysms of the anterior circulation. For years, surgical challenges including the intricate anatomy and narrow surgical corridor have been overcome using supplementary techniques including extended craniotomies, wide opening of the cisterns, gyrus rectus resection and special clips like fenestrated clips. However, imaginative solutions such as intraoperative clip modification may be inevitable in particular cases for safe clipping.</p><p>We retrospectively analyzed clinical records of two patients who required clip modification intraoperatively.</p><p><span><span>Case #1 underwent microsurgical clipping of a ruptured, 4-mm AcoA aneurysm. Unfortunately, given the short distance between the two A2s, it was not possible to clip the aneurysm without a compromise to the </span>contralateral A2 with the available shortest 3</span> <span>mm-fenestrated clip. We then used the clip modification technique intraoperatively by shortening the clip tips with mesh-plaque cutter and smoothening the remaining sharp ends using cautery sanding. Eventually, the aneurysm was clipped successfully with the modified-fenestrated clip. Post-clipping imagings confirmed complete occlusion of the aneurysm and patency of parent arteries. Case 2# underwent microsurgical clipping for a ruptured, 1-mm AcoA aneurysm. Like Case 1#, the initial clipping attempt with the available shortest 4</span> <!-->mm-fenestrated clip failed given the excessive length of the tips. The patient, thus, required clip modification as described above. The aneurysm was then clipped successfully using the modified-fenestrated clip, protecting bilateral A2s. Post-clipping imagings demonstrated patency of parent arteries with no residual aneurysm filling.</p><p>Clip modification seems to be an effective option in clipping the AcoA aneurysms when available clips are too long to secure them safely.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 4","pages":"Pages 205-209"},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139295286","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":"Pediatric atlas anatomy and its implications for fracture treatment: an anatomical and radiological study","authors":"Lucie Salavcová ,&nbsp;Jan Štulík ,&nbsp;Vojtěch Štulík ,&nbsp;Michaela Rybárová ,&nbsp;Gábor Geri ,&nbsp;Ondřej Naňka","doi":"10.1016/j.neucir.2024.01.001","DOIUrl":"https://doi.org/10.1016/j.neucir.2024.01.001","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>The objective of the study was: (1) to describe changes in the shape of the atlas during growth, including gender and side differences; (2) to assess the dimension essential for identification of the optimal entry point; (3) to determine the age limit for a safe insertion of 3.5-mm screws into the lateral masses according to our own limiting parameters.</p></div><div><h3>Materials and methods</h3><p>Dimensions of the atlas were measured on 200 CT scans of the craniocervical junction in individuals aged 0–18 years and on 34 anatomical specimens of the first cervical vertebra (aged 2.5–18 years). Both series were divided according to the gender and age. The values measured on CT scans were used for statistical comparison of data in boys and girls and comparison of the right and left sides.</p></div><div><h3>Results</h3><p>The atlas reaches its maximum growth rate between 0 and 2 years of age, then the growth decelerates and continues until the age of 18 years. The proportion of dimensions of C1 vertebral foramens changes with age. The youngest children show a relatively greater distance from the left to the right medial pedicle; around the age of 5 the values get even and subsequently the distance from the inner wall of anterior to posterior arch gets relatively greater. The transverse foramen has a slightly oval shape throughout the period of growth. Statistically significant differences between boys and girls were observed primarily between 12 and 18 years of age.</p></div><div><h3>Conclusion</h3><p>The study has proved adequate size of lateral masses for insertion of 3.5-mm screws in all patients from the age of 5 years. In younger children, the patient´s anatomy should be respected and the surgical technique tailored accordingly.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 4","pages":"Pages 186-195"},"PeriodicalIF":0.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141480595","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":"CIRUGÍA ESPINAL (VÍDEOS)","authors":"","doi":"10.1016/S1130-1473(24)00038-1","DOIUrl":"https://doi.org/10.1016/S1130-1473(24)00038-1","url":null,"abstract":"","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 ","pages":"Pages S120-S124"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141243433","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":"CIRUGÍA BASICRANEAL (COMUNICACIONES ORALES CORTAS)","authors":"","doi":"10.1016/S1130-1473(24)00032-0","DOIUrl":"https://doi.org/10.1016/S1130-1473(24)00032-0","url":null,"abstract":"","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 ","pages":"Pages S15-S21"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141243436","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":"Factores perioperatorios asociados al desarrollo de complicaciones agudas tras reposición ósea en la craniectomía descompresiva","authors":"Antonio Montalvo-Afonso,&nbsp;José Manuel Castilla-Díez,&nbsp;Vicente Martín-Velasco,&nbsp;Javier Martín-Alonso,&nbsp;Rubén Diana-Martín,&nbsp;Pedro David Delgado-López","doi":"10.1016/j.neucir.2024.02.002","DOIUrl":"10.1016/j.neucir.2024.02.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Bone flap replacement after a decompressive craniectomy is a low complexity procedure, but with complications that can negatively impact the patient's outcome. A better knowledge of the risk factors for these complications could reduce their incidence.</p></div><div><h3>Patients and methods</h3><p>A retrospective review of a series of 50 patients who underwent bone replacement after decompressive craniectomy at a tertiary center over a 10-year period was performed. Those clinical variables related to complications after replacement were recorded and their risk factors were analyzed.</p></div><div><h3>Results</h3><p>A total of 18 patients (36%) presented complications after bone flap replacement, of which 10 (55.5%) required a new surgery for their treatment. Most of the replacements (95%) were performed in the first 90 days after the craniectomy, with a tendency to present more complications compared to the subsequent period (37.8% vs. 20%, <em>p</em> <!-->&gt;<!--> <!-->0.05). The most frequent complication was subdural hygroma, which appeared later than infection, the second most frequent complication. The need for ventricular drainage or tracheostomy and the mean time on mechanical ventilation, ICU admission, or waiting until bone replacement were greater in patients who presented post-replacement complications. Previous infections outside the nervous system or the surgical wound was the only risk factor for post-bone flap replacement complications (<em>p</em> <!-->=<!--> <!-->0.031).</p></div><div><h3>Conclusions</h3><p>Postoperative complications were recorded in more than a third of the patients who underwent cranial bone flap replacement, and at least half of them required a new surgery. A specific protocol aimed at controlling previous infections could reduce the risk of complications and help establish the optimal time for cranial bone flap replacement.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 3","pages":"Pages 145-151"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279111","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":"CIRUGÍA NEUROVASCULAR (COMUNICACIONES ORALES)","authors":"","doi":"10.1016/S1130-1473(24)00042-3","DOIUrl":"https://doi.org/10.1016/S1130-1473(24)00042-3","url":null,"abstract":"","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 ","pages":"Pages S155-S171"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239460","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":"CIRUGÍA FUNCIONAL Y ESTEREOTÁXICA (COMUNICACIONES ORALES CORTAS)","authors":"","doi":"10.1016/S1130-1473(24)00040-X","DOIUrl":"https://doi.org/10.1016/S1130-1473(24)00040-X","url":null,"abstract":"","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 ","pages":"Pages S137-S143"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239462","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":"Pseudotumor inflamatorio, el gran imitador: a propósito de un caso","authors":"María José Castelló Ruiz ,&nbsp;Ascensión Contreras Jimenez ,&nbsp;Iñigo Gorrostiaga Altuna ,&nbsp;Jose Masegosa Gonzalez","doi":"10.1016/j.neucir.2023.05.004","DOIUrl":"10.1016/j.neucir.2023.05.004","url":null,"abstract":"<div><p>Inflammatory pseudotumor is a rare lesion, especially at the level of the central nervous system. Its etiology is unknown and the most accepted hypothesis is that it is the consequence of an exaggerated immune response. We present the clinical case of a young Senegalese male, with a history of epilepsy secondary to severe cranioencephalic trauma in childhood, who presented with new epileptic seizures. Imaging tests showed a lesion in the anterior fossa intimately attached to the meninges, so the initial diagnosis was meningioma. A bifrontal craniotomy and microsurgical excision were performed. The definitive anatomopathological analysis concluded that the lesion is an inflammatory pseudotumor whose origin is secondary to a disproportionate reparative process after cranioencephalic trauma.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 3","pages":"Pages 164-168"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126957488","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":"NERVIO PERIFÉRICO (COMUNICACIONES ORALES)","authors":"","doi":"10.1016/S1130-1473(24)00052-6","DOIUrl":"https://doi.org/10.1016/S1130-1473(24)00052-6","url":null,"abstract":"","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 ","pages":"Page S238"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141241367","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}