Neurocirugia最新文献

{"title":"Aneurysmal subarachnoid haemorrhage: Volumetric quantification of the blood distribution pattern to accurately predict the ruptured aneurysm location","authors":"Alejandra Mosteiro ,&nbsp;Diego Culebras ,&nbsp;Alberto Vargas Solano ,&nbsp;Javier Luis Moreno Negrete ,&nbsp;Antonio López-Rueda ,&nbsp;Laura Llull ,&nbsp;Daniel Santana ,&nbsp;Leire Pedrosa ,&nbsp;Sergio Amaro ,&nbsp;Ramón Torné ,&nbsp;Joaquim Enseñat","doi":"10.1016/j.neucir.2023.11.003","DOIUrl":"https://doi.org/10.1016/j.neucir.2023.11.003","url":null,"abstract":"<div><h3>Background</h3><p>In spontaneous subarachnoid haemorrhage (SAH) accurate determination of the bleeding source is paramount to guide treatment. Traditionally, the bleeding pattern has been used to predict the aneurysm location. Here, we have tested a software-based tool, which quantifies the volume of intracranial blood and stratifies it according to the regional distribution, to predict the location of the ruptured aneurysm.</p></div><div><h3>Methods</h3><p>A consecutive series of SAH patients admitted to a single tertiary centre between 2012–2018, within 72 h of onset, harbouring a single intracranial aneurysm. A semi-automatized method of blood quantification, based on the relative density increase, was applied to initial non-contrast CTs. Five regions were used to define the bleeding patterns and to correlate them with aneurysm location: perimesencephalic, interhemispheric, right/left hemisphere and intraventricular.</p></div><div><h3>Results</h3><p>68 patients were included for analysis. There was a strong association between the distribution of blood and the aneurysm location (p &lt; 0.001). In particular: ACom and interhemispheric fissure (p &lt; 0.001), MCA and ipsilateral hemisphere (p &lt; 0.001), ICA and ipsilateral hemisphere and perimesencephalic cisterns (p &lt; 0.001), PCom and hemispheric, perimesencephalic and intraventricular (p = 0.019), and PICA and perimesencephalic and intraventricular (p &lt; 0.001). The internal diagnostic value was high (AUROC ≥ 0.900) for these locations.</p></div><div><h3>Conclusion</h3><p>Regional automatised volumetry seems a reliable and objective tool to quantify and describe the distribution of blood within the subarachnoid spaces. This tool accurately predicts the location of the ruptured aneurysm; its use may be prospectively considered in the emergency setting when speed and simplicity are attained.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 3","pages":"Pages 136-144"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140816743","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":"NEUROTRAUMATOLOGÍA Y CUIDADOS NEUROCRÍTICOS (PÓSTERES)","authors":"","doi":"10.1016/S1130-1473(24)00060-5","DOIUrl":"https://doi.org/10.1016/S1130-1473(24)00060-5","url":null,"abstract":"","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 ","pages":"Pages S273-S290"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239171","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":"NEUROTRAUMATOLOGÍA Y CUIDADOS NEUROCRÍTICOS (COMUNICACIONES ORALES CORTAS)","authors":"","doi":"10.1016/S1130-1473(24)00059-9","DOIUrl":"https://doi.org/10.1016/S1130-1473(24)00059-9","url":null,"abstract":"","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 ","pages":"Pages S269-S272"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239420","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 (PÓSTERES)","authors":"","doi":"10.1016/S1130-1473(24)00041-1","DOIUrl":"https://doi.org/10.1016/S1130-1473(24)00041-1","url":null,"abstract":"","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 ","pages":"Pages S144-S154"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239461","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":"Predicción del grado histológico en meningiomas sintomáticos mediante una estimación objetiva de la irregularidad de su superficie","authors":"Pedro David Delgado-López,&nbsp;Antonio Montalvo-Afonso,&nbsp;Javier Martín-Alonso,&nbsp;Vicente Martín-Velasco,&nbsp;Rubén Diana-Martín,&nbsp;José Manuel Castilla-Díez","doi":"10.1016/j.neucir.2023.10.003","DOIUrl":"10.1016/j.neucir.2023.10.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Predicting the histopathologic grade of meningioma is relevant because local recurrence is significantly greater in WHO grade II–III compared to WHO grade I tumors, which would ideally benefit from a more aggressive surgical strategy. It has been suggested that higher WHO grade tumors are more irregularly-shaped. However, irregularity is a subjective and observer-dependent feature. In this study, the tumor surface irregularity of a large series of meningiomas, measured upon preoperative MRI, is quantified and correlated with the WHO grade.</p></div><div><h3>Methods</h3><p>Unicentric retrospective observational study of a cohort of symptomatic meningiomas surgically removed in the time period between January 2015 and December 2022. Using specific segmentation software, the surface factor (SF) was calculated for each meningioma. SF is an objective parameter that compares the surface of a sphere (minimum surface area for a given volume) with the same volume of the tumor against the actual surface of the tumor. This ratio varies from 0 to 1, being 1 the maximum sphericity. Since irregularly-shaped meningiomas present proportionally greater surface area, the SF tends to decrease as irregularity increases. SF was correlated with WHO grade and its predictive power was estimated with ROC curve analysis.</p></div><div><h3>Results</h3><p>A total of 176 patients (64.7% females) were included in the study; 120 WHO grade I (71.9%), 43 WHO grade II (25.7%) and 4 WHO grade III (2.4%). A statistically significant difference was found between the mean SF of WHO grade I and WHO grade II–III tumors (0.8651<!--> <!-->±<!--> <!-->0.049 versus 0.7081<!--> <!-->±<!--> <!-->0.105, <em>p</em> <!-->&lt;<!--> <!-->0.0001). Globally, the SF correctly classified more than 90% of cases (area under ROC curve 0.940) with 93.3% sensibility and 80.9% specificity. A cutoff value of 0.79 yielded the maximum precision, with positive and negative predictive powers of 82.6% and 92.6%, respectively. Multivariate analysis yielded SF as an independent prognostic factor of WHO grade.</p></div><div><h3>Conclusion</h3><p>The <em>surface factor</em> is an objective and quantitative parameter that helps to identify aggressive meningiomas preoperatively. A cutoff value of 0.79 allowed differentiation between WHO grade I and WHO grade II–III with high precision.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 3","pages":"Pages 113-121"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135371222","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":"DOCENCIA, COOPERACIÓN Y ÉTICA NEUROQUIRÚRGICA (PÓSTERES)","authors":"","doi":"10.1016/S1130-1473(24)00048-4","DOIUrl":"https://doi.org/10.1016/S1130-1473(24)00048-4","url":null,"abstract":"","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 ","pages":"Page S212"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239421","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":"Abordajes mínimamente invasivos para meningiomas de la base craneal","authors":"Carlos Roberto Vargas Gálvez,&nbsp;Omar López Arbolay,&nbsp;Marlon Manuel Ortiz Machín","doi":"10.1016/j.neucir.2023.11.002","DOIUrl":"10.1016/j.neucir.2023.11.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Skull base meningiomas constitute a complex group of skull base tumors. The endoscopic endonasal approaches (EEA) and endoscopic Keyhole have a minimally invasive philosophy with high effectiveness, safety, and a significant decrease in postoperative morbidity in these tumors.</p></div><div><h3>Objective</h3><p>To describe the results of the use of minimally invasive approaches to skull base meningiomas.</p></div><div><h3>Method</h3><p>A descriptive, retrospective study was carried out in 140 patients at the Hermanos Ameijeiras Hospital who underwent surgery for cranial base meningiomas using minimally invasive approaches to the cranial base. The degree of tumor resection, tumor recurrence, reinterventions, and complications were evaluated.</p></div><div><h3>Results</h3><p>EEA were used in 72.8% of the study, while endoscopic Keyholes were used in 26.4% and combined approaches in 0.7%. In relation to total tumor resection, 91.9% was generally achieved. Overall tumor recurrence and reinterventions were less than 8.5% and 4%, respectively. Complications in EEA were: cerebrospinal fluid fistula (2.1%), diabetes insipidus, hydrocephalus, cerebral infarction, surgical site hematoma, worsening of cranial nerves <span>i-iv</span> (1.4%) respectively. While in the Keyhole type approaches: seizures (2.9%), hydrocephalus (1.4%), cerebrospinal fluid fistula (1.4%), worsening of nerves <span>ix-xii</span> (0.7%).</p></div><div><h3>Conclusions</h3><p>The following study reaffirms that minimally invasive approaches for skull base meningiomas constitute advanced surgical techniques for these tumors, associated with a low rate of postoperative complications.</p></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 3","pages":"Pages 127-135"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139395926","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 CORTAS)","authors":"","doi":"10.1016/S1130-1473(24)00043-5","DOIUrl":"https://doi.org/10.1016/S1130-1473(24)00043-5","url":null,"abstract":"","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 ","pages":"Pages S172-S179"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239459","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":"ONCOLOGÍA (COMUNICACIONES ORALES)","authors":"","doi":"10.1016/S1130-1473(24)00061-7","DOIUrl":"https://doi.org/10.1016/S1130-1473(24)00061-7","url":null,"abstract":"","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 ","pages":"Pages S291-S305"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239974","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":"ONCOLOGÍA (PÓSTERES)","authors":"","doi":"10.1016/S1130-1473(24)00063-0","DOIUrl":"https://doi.org/10.1016/S1130-1473(24)00063-0","url":null,"abstract":"","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"35 ","pages":"Pages S320-S387"},"PeriodicalIF":0.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239976","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}