Operative neurosurgery (Hagerstown, Md.)最新文献

{"title":"Commentary: A Rare Case of Hemifacial Spasm Due to Suprameatal Tubercle Hyperostosis.","authors":"Serdar Rahmanov, Badih Adada, Hamid Borghei-Razavi","doi":"10.1227/ons.0000000000002204","DOIUrl":"https://doi.org/10.1227/ons.0000000000002204","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stairstep Pericranial Incisions Are Associated With Reduced Wound Complications in Supratentorial Craniotomies for Malignant Brain Tumors: A Single-Institutional Comparative Cohort Analysis.","authors":"Nada Botros, Thomas Hosseini, Timothy F Boerger, Omar Hussain, Kate B Krucoff, Max O Krucoff","doi":"10.1227/ons.0000000000002199","DOIUrl":"https://doi.org/10.1227/ons.0000000000002199","url":null,"abstract":"<p><strong>Background and objectives: </strong>Patients undergoing supratentorial craniotomies for malignant brain tumors often receive steroids, undergo radiation, experience hyperglycemia, and receive chemotherapy, all of which inhibit soft tissue healing. Poor wound healing can then lead to morbid sequelae (ie, bone flap infections) that derail clinical care by requiring subsequent operations, readmissions, and delayed initiation of cancer treatments. To minimize the clinical impact of inevitable poor wound healing in this population, we previously described a novel, multilayer incision with a stairstep through the pericranium to prevent progression of poor superficial wound healing to deeper infections. Here we compare wound-related outcomes from 200 consecutive cases using the stairstep incision technique with 200 similar consecutive cases performed with standard incisions.</p><p><strong>Methods: </strong>We compared wound-related outcomes from 200 consecutive patients who underwent supratentorial craniotomies using the stairstep technique to a control group of 200 consecutive patients who underwent similar procedures using standard incisions at our institution.</p><p><strong>Results: </strong>Overall, patients with stairstep pericranial incisions had fewer culture-positive infections (1.0% vs 5.0%; P = .04) and fewer readmissions for IV antibiotics (1.0% vs 6.5%; P = .01). While rates of early superficial wound concerns (ie, scabbing, focal dehiscence, or cellulitis) were similar between groups (6.0% pericranial vs 7.5% standard; P = .7), progression to morbid sequelae in the subgroup of people with superficial wound concerns was markedly lower after stairstep closure (0.0% vs 86.7%; P < .001). Specifically, rates of culture-positive infection (0.0% vs 66.7%; P < .001), IV antibiotics (0.0% vs 86.7%; P < .001), and reoperation (0.0% vs 60.0%; P < .01) were significantly lower in the group with early wound concerns who had stairstep pericranial incisions.</p><p><strong>Conclusion: </strong>Here we provide evidence that stairstep pericranial incisions are associated with fewer wound complications in supratentorial brain surgery, potentially due to protection against superficial wound issues progressing to clinically morbid sequelae. Prospective, randomized studies will assess the causal impact of the technique on wound-related outcomes.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Location-Based Tailored Endovascular Strategy for Managing Posterior Inferior Cerebellar Artery Aneurysms: A Single-Center 46-Case Series.","authors":"Haibin Chen, Jian Chen, Zhongwei Xu, Kai Qiu, Guosai Zhang, Zhenyu Jia, Sheng Liu, Linbo Zhao","doi":"10.1227/ons.0000000000002136","DOIUrl":"https://doi.org/10.1227/ons.0000000000002136","url":null,"abstract":"<p><strong>Background and objectives: </strong>To evaluate the clinical and angiographic outcomes of endovascular treatment for posterior inferior cerebellar artery (PICA) aneurysms, emphasizing a location-specific treatment stratification based on PICA segmental anatomy.</p><p><strong>Methods: </strong>Patients with PICA aneurysms treated endovascularly between December 2016 and December 2024 were retrospectively analyzed. The PICA is classified into 5 segments, with the first 3 (P1-P3) designated as proximal and the P4-P5 as distal. We assessed the immediate and progressive aneurysm occlusion rates, procedure-related complications, and clinical outcomes.</p><p><strong>Results: </strong>Forty-six patients (each with 1 PICA aneurysm; 37 ruptured) were included. Twenty-five aneurysms (54.3%) were located in the proximal PICA and 21 (45.7%) in the distal segments. Technical success was achieved in all procedures. Parent artery preservation was accomplished in all proximal aneurysms, treated with either coiling (n = 16) or stent-assisted coiling (n = 9). Most distal aneurysms (66.7%, 14/21) were treated with parent artery occlusion. Intraprocedural ischemic events occurred in 4 patients (8.7%), with one fatal in-stent thrombosis. Intraprocedural aneurysm rupture occurred in one case (2.2%). Postprocedural infarction was observed in 3 patients (6.5%), all of whom had unfavorable clinical outcomes at follow-up. Immediate postprocedural angiography revealed complete occlusion (Raymond Grade I) in 67.4% (31/46) of cases, increasing to 97.3% (36/37) at follow-up, with no recurrence. Favorable clinical outcomes (modified Rankin Scale: 0-2) were achieved in 76.1% of patients.</p><p><strong>Conclusion: </strong>An anatomy-based tailored endovascular approach for PICA aneurysms yields encouraging clinical and angiographic outcomes, with proximal lesions amenable to coiling or stent-assisted coiling and distal lesions effectively managed with parent artery occlusion.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Intraoperative Peripheral Nerve Surgery Navigation Technique Using Radar Reflector Localization: Case Series.","authors":"Katelyn Candido, Ben Gu, Chantal Chahine, Antje L Greenfield, Eric L Zager, Zarina S Ali","doi":"10.1227/ons.0000000000002200","DOIUrl":"https://doi.org/10.1227/ons.0000000000002200","url":null,"abstract":"<p><strong>Background and objectives: </strong>Intraoperative neuronavigation techniques are limited in peripheral nerve surgery compared with cranial and spinal neurosurgery. This study describes a multicenter, single institutional experience using a radar reflector system as a novel adjunct for intraoperative localization in peripheral nerve surgery.</p><p><strong>Methods: </strong>This is a retrospective multicenter, single institution case series of the first 21 patients who underwent peripheral nerve surgery with the use of radar reflector-guided localizer between September 2023 and June 2025. All surgeries and pre- and postoperative assessments were performed by 2 senior peripheral nerve neurosurgeons. Patients underwent preoperative ultrasound-guided percutaneous placement of 1 or more implantable radar reflectors by a single musculoskeletal radiologist at a specified anatomic location requested by the surgeon. Intraoperative localization was performed using a handheld radar detector providing real-time audio and distance feedback to reflector location. Data collection including demographics, indications for surgery, use of the nerve navigation system, success of intraoperative reflector localization and retrieval, and adverse outcomes were performed and descriptive results are presented.</p><p><strong>Results: </strong>Twenty-one patients (14 male, 7 female; mean age 57 years) were included in this feasibility analysis. Surgical indications were categorized into 3 groups: nerve tumor resection (n = 7), nerve exploration/neurolysis/repair (n = 10), and nerve transfer (n = 4). Radar reflector was placed 0-164 days before surgery (mean 19 days). Reflectors were successfully identified and removed in all cases, with no device-related complications.</p><p><strong>Conclusion: </strong>Radar reflector-guided navigation in peripheral nerve surgery facilitated identification of deep, nonpalpable lesions or anatomically distorted nerves, including in patients with previous surgery, trauma, radiation, or high body mass index. Use of this intraoperative nerve navigation technique is a feasible and safe adjunct for peripheral nerve surgeons. This technique shows promise as a valuable adjunct for enhancing surgical efficiency without compromising safety. Further studies are warranted to validate these findings in a larger cohort and establish best practices for implementation.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resection of a Pituitary Stalk Epidermoid Cyst Through an Endoscopic Endonasal Transsellar Approach With Splitting of the Pituitary Gland: 2-Dimensional Operative Video.","authors":"Khalil Alqadasi, Philippe Lavigne, Moujahed Labidi","doi":"10.1227/ons.0000000000002198","DOIUrl":"https://doi.org/10.1227/ons.0000000000002198","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Rural Residence Lead to Worse Outcomes After Adult Spinal Deformity Surgery?","authors":"Harsh Jain, Advith Sarikonda, Iyan Younus, Emma Ye, Nick De Oliveira, Omar Zakieh, Jordan Vanleuven, Austin Montgomery, Walter Navid, Hani Chanbour, Ranbir Ahluwalia, Tyler Zeoli, Alan R Tang, Keyan Peterson, Bayard R Wilson, Amir M Abtahi, Byron F Stephens, Scott L Zuckerman","doi":"10.1227/ons.0000000000002188","DOIUrl":"https://doi.org/10.1227/ons.0000000000002188","url":null,"abstract":"<p><strong>Background and objectives: </strong>In patients undergoing adult spinal deformity surgery, we aimed to evaluate the relationship between rural residence and: (1) perioperative outcomes, (2) postoperative alignment, and (3) complications.</p><p><strong>Methods: </strong>A retrospective cohort study (2009-2023) was performed for patients with the following inclusion criteria: ≥5-level fusion, sagittal/coronal deformity, and 2-year follow-up. Primary exposure was rural residence based on Economic Research Service designated Rural-Urban Commuting Area codes: 1 to 6-urban, 7 to 10-rural. Primary outcomes were: (1) perioperative outcomes, (2) postoperative alignment, including sagittal vertical axis, coronal vertical axis, and L1-pelvic angle within target range, and (3) complications. Multivariable regression controlled for age, sex, body mass index, preoperative sagittal vertical axis/coronal vertical axis, and operative time.</p><p><strong>Results: </strong>Of 288 patients, 36 (13%) were rural residents. Rural patients had a higher body mass index (32 ± 9 vs 28 ± 6, P = .011) and diabetes rate (33% vs 17%, P = .024). Preoperatively, rural patients had lower hematocrit (35.4 ± 6.5 vs 37.4 ± 5.2, P = .048) and required more frequent (78% vs 58%, P = .023; odds ratio = 3.1, 95% CI: 1.1-8.5, P = .031) and greater (4 ± 5 vs 2 ± 4 units, P = .019) intraoperative transfusions. Postoperatively, rural residents had higher sagittal vertical axis ≥5 cm (69% vs 48%, P = .037; β = 16.1, 95% CI: 0.0-32.2, P = .050), with no significant association with postoperative coronal malalignment (25% vs 19%, P = .688). No difference was seen in rates of complications, or reoperation.</p><p><strong>Conclusion: </strong>In patients undergoing adult spinal deformity surgery, rural residence was independently associated with increased intraoperative blood transfusions and worse postoperative sagittal alignment. These findings suggest that socioeconomic and geographic factors may play a role in surgical outcomes, potentially because of disparities in preoperative health status and access to perioperative care.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Graftless Internal Maxillary Artery-Middle Cerebral Artery Bypass via a Combined Sublabial Transmaxillary-Pterional Corridor: Cadaveric Study With 3-Dimensional Models.","authors":"Ebubekir Akpınar, Aysu İyigün Kabakcı, Semih Fidan, Lütfi Şinasi Postalcı, Akın Akakın, Türker Kılıç, Bin Xu, Michael T Lawton, Abuzer Güngör","doi":"10.1227/ons.0000000000002195","DOIUrl":"https://doi.org/10.1227/ons.0000000000002195","url":null,"abstract":"<p><strong>Background and objectives: </strong>Bypass surgery has become one of the essential techniques in neurosurgery. The internal maxillary artery (IMAX) has emerged as an increasingly used donor vessel for large-caliber extracranial-intracranial bypass. However, the limited donor length reported in previously described techniques often necessitates the use of interposition grafts. This study describes a novel graftless direct IMAX-middle cerebral artery (MCA) bypass technique using a combined endoscopic sublabial transmaxillary and pterional approach.</p><p><strong>Methods: </strong>Six silicone-injected, embalmed cadaveric heads were dissected in 3 stages: (1) endoscopic sublabial transmaxillary exposure of the IMAX, (2) microsurgical pterional exposure of the MCA divisions, and (3) graftless direct IMAX-MCA bypass. The diameter of the pterygopalatine segment of IMAX and the total available donor length were measured using digital calipers. The surgical corridor and vessel transposition were additionally demonstrated through anatomic modeling to support spatial orientation.</p><p><strong>Results: </strong>The pterygopalatine segment of IMAX is defined via an endoscopic sublabial transmaxillary approach, transposed intracranially through a craniectomy performed superolateral to the foramen rotundum. Then direct graftless IMAX-MCA bypass was performed microscopically via pterional transsylvian approach. The mean diameter of the pterygopalatine segment of IMAX segment was 2.19 ± 0.34 mm (95% CI: 1.98-2.40 mm), and the total available donor length measured 5.40 ± 0.82 cm (95% CI: 4.88-5.91 cm). This length permitted tension-free transposition to the distal M1 without the need for interposition graft.</p><p><strong>Conclusion: </strong>This combined approach demonstrates the anatomic feasibility of a direct graftless large-caliber IMAX-MCA bypass by providing sufficient donor length.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Posterior Cervical Fusion for the Treatment of Atlantoaxial Pathologies.","authors":"Yi-Guo Yan, Jin-Ting Yao, Li-Min Zhu, Ming-Xiang Zou, En Song, Zhi-Hua Ouyang","doi":"10.1227/ons.0000000000002194","DOIUrl":"https://doi.org/10.1227/ons.0000000000002194","url":null,"abstract":"<p><strong>Background and objectives: </strong>Surgery for the upper cervical spine (atlantoaxial region) is a significant challenge because of its complex anatomy and proximity to vital neurovascular structures. Traditional posterior approaches require extensive muscle dissection, leading to considerable tissue trauma. Although endoscopic techniques have revolutionized minimally invasive spine surgery, their application for simultaneous decompression, fusion, and internal fixation in the atlantoaxial region has not been previously documented. This study aims to preliminarily investigate the technical feasibility, safety, and early clinical outcomes of a newly developed endoscopic posterior cervical fusion procedure.</p><p><strong>Methods: </strong>We performed a retrospective analysis of patients with upper cervical pathologies who underwent this novel technique. Using a single-portal unilateral or bilateral approach based on the arthroscopic-assisted uniportal spinal surgery/uniportal non-coaxial spinal endoscopic surgery technique, the entire procedure-including neural decompression, preparation of the atlantoaxial joint surfaces, bone grafting, and the placement of a screw-rod construct (using C1/C2 pedicle screws, C1 posterior arch screws, or C2 laminar screws)-was completed under continuous endoscopic visualization.</p><p><strong>Results: </strong>Ten patients underwent successful surgery without conversion to an open procedure. A total of 40 screws were placed. Postoperative imaging revealed 2 left C1 pedicle screws positioned slightly medially; all other screws were correctly placed. One case of postoperative cerebrospinal fluid leak was managed conservatively. No vertebral artery injuries, neurological deterioration, or infections occurred. All patients showed significant clinical improvement in pain and function scores, and follow-up imaging confirmed solid bony fusion in every case.</p><p><strong>Conclusion: </strong>Endoscopic posterior cervical fusion is technically feasible. This technique effectively merges the advantages of endoscopic minimally invasive surgery with the requirement for rigid spinal fixation, showing promising early results with satisfactory fusion rates and clinical outcomes.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Open Surgical and Endovascular Embolization of Complex Carotid-Cavernous Fistula: 2-Dimensional Operative Video.","authors":"Mohamed Emara, Khalil W Zahra, Florian Roser, Mohamed Samy Elhammady","doi":"10.1227/ons.0000000000002189","DOIUrl":"https://doi.org/10.1227/ons.0000000000002189","url":null,"abstract":"","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Epileptogenic Cavernous Malformations: A Multicenter Study.","authors":"Nathan A Shlobin, Adrian E Jimenez, W Elorm Yevudza, Alexander Agopyan-Miu, Salil Bhole, Jon T Willie, Daniel E Couture, Adrian W Laxton, Kevin Hines, Chengyuan Wu, H Isaac Chen, Thomas Lisko, Robert A McGovern, E Sander Connolly, Guy M McKhann, Brett E Youngerman","doi":"10.1227/ons.0000000000002190","DOIUrl":"https://doi.org/10.1227/ons.0000000000002190","url":null,"abstract":"<p><strong>Background and objectives: </strong>Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is an emerging minimally invasive alternative for epileptogenic cerebral cavernous malformations (CCMs). Available evidence is limited to small, single-center series. This multicenter study aimed to evaluate the efficacy and safety of MRgLITT for epileptogenic CCMs (eCCMs) in heterogeneous real-world practice and identify factors that may guide patient selection and technique.</p><p><strong>Methods: </strong>In this multicenter retrospective cohort study with no overlap to previous series, 23 adult patients with eCCMs underwent MRgLITT at 6 institutions between 2015 and 2023. Seizure outcomes were analyzed for 19 patients with ≥ 1-year follow-up. Patient characteristics and adverse events were reported for all patients.</p><p><strong>Results: </strong>Of 23 patients, 60.9% (14/23) were men, and median age was 50.5 (range 18.0-70.4 years). The median duration from epilepsy diagnosis to treatment was 10 years (range 1-42 years). Lesions were targeted in the left hemisphere in 60.9% (14/23) and to the temporal lobe in 65.2% (15/23). Engel class I seizure freedom was achieved in 57.8% (11/19) at 1 year, all of whom remained seizure free at last follow-up (median 2.2 years, range 1.0-8.6 years). Engel class I-II (favorable) outcomes were achieved in 68.4% (13/19) at 1 year and 73.7% (14/19) at last follow-up. Shorter duration of epilepsy before treatment was associated with seizure freedom (median 8.4 vs 25.5 years, P = .026). Fully concordant presurgical workup was associated with favorable outcome (odds ratio not estimable, 95% CI [0.81, ∞], P = .045) at last follow-up. Perioperative hemorrhage was detected in 3 patients (13.0%), all asymptomatic, with no subsequent hemorrhage during follow-up. Three patients (13.0%) experienced transient neurological deficits. One (4.3%) had a persistent deficit at last follow-up.</p><p><strong>Conclusion: </strong>MRgLITT is a promising minimally invasive option for carefully selected patients with eCCMs. Shorter epilepsy duration and concordant presurgical evaluation may predict favorable outcome.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}