Operative Neurosurgery最新文献

{"title":"Microsurgical Resection of Trigeminal Schwannoma Through Transorbital Approach: 2-Dimensional Operative Video.","authors":"Mustafa Motiwala, Parvesh Konda, Jahangir Sajjad, Muhammad Waqas Saeed Baqai, Rebecca Ford, Cristina Cernei, Kumar Abhinav","doi":"10.1227/ons.0000000000001313","DOIUrl":"10.1227/ons.0000000000001313","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"590"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918101","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":"Letter: Interpretation and Strategy to Resolve Neuromonitoring Changes Associated With Brain Sag.","authors":"Nishanth Sampath, Gomathi Sivakumar, Vishwaraj Ratha, Suresh Bapu","doi":"10.1227/ons.0000000000001565","DOIUrl":"https://doi.org/10.1227/ons.0000000000001565","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765863","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":"Reappraisal of the Previously Described False Localizing Sign at C1-2 in Cases of Spontaneous Intracranial Hypotension.","authors":"Gianna Fote, Hania Shahin, Nolan J Brown, Joseph Falcone, Alexander Lopez, Edward C Kuan, Frank P K Hsu, Michael Y Oh, Ahmed Mohyeldin","doi":"10.1227/ons.0000000000001341","DOIUrl":"10.1227/ons.0000000000001341","url":null,"abstract":"<p><strong>Background and objectives: </strong>We present an illustrative case of spontaneous intracranial hypotension (SIH) in the setting of a suspected C1-2 cerebrospinal fluid (CSF) leak that was successfully treated with muscle, collagen, and epidural blood patch. We examined the literature to identify similar cases reporting Cl-2 retrospinal fluid collections identified on imaging in the setting of SIH and quantified the success of targeted treatment to this area despite previous reports that caution about a \"C1-2 false localizing sign.\"</p><p><strong>Methods: </strong>A systematic search was performed identifying cases of SIH resulting from CSF leak with C1-2 fluid collection observed on imaging. PubMed, Google Scholar, and Web of Science were queried, and articles were screened for possible inclusion by 2 authors and supervised by the senior author.</p><p><strong>Results: </strong>In total, 28 studies were included with a total of 32 patients. The number of patients in each study with C1-2 fluid collections, number of patients with fluid collections at multiple levels, specific intervention used, and outcomes of each intervention were recorded, with a focus on whether treatment occurred at the levels exhibiting fluid signal.</p><p><strong>Conclusion: </strong>Although the C1-2 fluid signal in SIH has previously been described as a \"false localizing sign,\" our study indicates that treating this level as the source of CSF leak results in successful and durable outcomes. Most SIH cases with signal at C1-2 did not have a fluid signal at any other level and were treated successfully and most commonly through epidural blood patch at the C1-2 level. Symptom resolution was also reported after direct repair of C1-2 CSF leaks through primary closure, Gelfoam patch, and muscle fragment with fibrin. In patients with SIH, C1-2 fluid signal, and no other source of CSF leak identified on imaging, surgical intervention at the C1-2 level seemed to have a high success rate.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"468-477"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300828","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":"Commentary: Interhemispheric Contralateral Transcallosal Approach to a Giant Thalamic Cavernous Malformation: 2-Dimensional Operative Video.","authors":"Nasser M F El-Ghandour","doi":"10.1227/ons.0000000000001311","DOIUrl":"10.1227/ons.0000000000001311","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"582-583"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005870","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":"Endoscopic Transsphenoidal Drainage for Rathke Cleft Cyst With Sellar Xanthogranuloma - Successful Cyst Drainage and Prevention of Postoperative Cerebrospinal Fluid Leakage: 2-Dimensional Operative Video.","authors":"Naokado Ikeda, Kunio Yokoyama, Yutaka Ito, Hidekazu Tanaka, Makoto Yamada, Akira Sugie, Toshihiro Takami, Masahiko Wanibuchi, Masahiro Kawanishi","doi":"10.1227/ons.0000000000001312","DOIUrl":"10.1227/ons.0000000000001312","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"588-589"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977175","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 Transtemporal Isthmus Approach for Insular Glioma Surgery.","authors":"Guochen Sun, Xujun Shu, Dongdong Wu, Kai Zhao, Zhe Xue, Gang Cheng, Ling Chen, Jianning Zhang","doi":"10.1227/ons.0000000000001308","DOIUrl":"10.1227/ons.0000000000001308","url":null,"abstract":"<p><strong>Background and objectives: </strong>Maximal and safe removal of insular gliomas by a transinsular cortex approach is challenging. In this article, a new transtemporal isthmus approach to resect insular gliomas is presented.</p><p><strong>Methods: </strong>We retrospectively examined 53 patients with insular glioma who underwent resection through the temporal isthmus approach using magnetic resonance imaging and functional neuronavigation guidance and intraoperative electrophysiological monitoring. Extent of resection was determined using intraoperative magnetic resonance imaging.</p><p><strong>Results: </strong>Fifty-three patients were included for analysis, 30 men and 23 women. The median (range) age was 45 (26-70) years. Tumor laterality was left in 22 patients and right in 31. All tumors involved at least zone III or IV (Berger-Sanai classification system), including zones I-IV were involved in 29 (54.7%) and zones III and IV in 17 (32.0%). Among the 37 low-grade gliomas, preoperative median (IQR) volume was 45.7 (31.8, 60.3) cm 3 , and gross total resection was achieved in 24 (64.9%). Among the 16 high-grade gliomas, preoperative median (IQR) volume was 45.3 (40.1, 54.0) cm 3 , and gross total resection was achieved in 14 (87.5%). The median (IQR) extent of resection of the whole group was 100% (89%-100%). The median (IQR) postoperative Karnofsky performance score 3 months after surgery was 90 (80-90). Mean temporal isthmus width was significantly higher in the affected side (involving tumor) than the contralateral one (21.6 vs 11.3 mm; 95% CI: 9.3 to 11.3, P < .01). Muscle strength was grade 4 or higher, and speech was nearly normal in all patients 3 months after surgery.</p><p><strong>Conclusion: </strong>Insular glioma surgery using the transtemporal isthmus approach can achieve safe and maximum resection. A widened temporal isthmus provides a surgical pathway for transisthmic resection of insular tumor.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"478-486"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005833","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":"Amniotic Membrane Interposition Graft for Open Fetal Myelomeningocele Repair.","authors":"John P Andrews, Alex Yang Lu, Rachel Perry, Hanmin Lee, Michael Harrison, Nalin Gupta","doi":"10.1227/ons.0000000000001552","DOIUrl":"https://doi.org/10.1227/ons.0000000000001552","url":null,"abstract":"<p><strong>Background and objectives: </strong>Myelomeningocele (MMC) is a congenital anomaly frequently leading to motor deficits, urological dysfunction, and hydrocephalus. Fetal surgical repair improves motor function and reduces the need for cerebrospinal fluid diversion for hydrocephalus. One complication of MMC repair is spinal cord tethering at the site of surgical repair. Surgical techniques to reduce symptomatic tethering and achieve optimal motor function are an area of ongoing research. This study's objective is to evaluate a technique for interposing an amniotic membrane graft between the pia of the closed placode and the overlying dural closure in a prospectively treated cohort of patients with open fetal MMC closure. The theoretical advantage of this technique is that an amniotic membrane barrier may reduce the likelihood of tethering between surgically closed layers.</p><p><strong>Methods: </strong>Under an approved, prospective protocol, open fetal MMC repair with an amniotic membrane interposition graft was performed by a single surgeon at 1 institution over a 1-year period. At the time of surgery, amniotic membrane was harvested from the edges of hysterotomy. This membrane was cleaned, trimmed, and secured over the closed pial surface of the repaired placode. The dura and overlying layers were closed in a standard fashion. Outcomes were obtained by interviews with patients' families.</p><p><strong>Results: </strong>Open fetal MMC repairs were performed with amniotic membrane graft interposition. One of 8 patients with a 5-year follow-up subsequently underwent spinal cord detethering surgery.</p><p><strong>Conclusion: </strong>Amniotic patch interposition for fetal MMC repair can be performed safely alongside standard MMC repair techniques. Evidence for effectiveness on rates of subsequent detethering surgeries requires larger studies with longer follow-up.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765858","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":"Absence of Foramen Spinosum on Computed Tomography Scan Determines Feasibility of Middle Meningeal Artery Embolization.","authors":"Zachary S Hubbard, Conor M Cunningham, Guilherme Porto, Mohammad-Mahdi Sowlat, Sameh Samir Elawady, Sami Al Kasab, Kimberly Kicielinski, Jonathan Lena, Alejandro M Spiotta","doi":"10.1227/ons.0000000000001316","DOIUrl":"10.1227/ons.0000000000001316","url":null,"abstract":"<p><strong>Background and objectives: </strong>Middle meningeal artery embolization (MMAE) has emerged as a novel treatment of chronic subdural hematoma. In 0.5% of patients, however, there exists an ophthalmic origin of the middle meningeal artery (MMA) known as the recurrent meningeal artery. It is known that the recurrent MMA is associated with failure of its skeletal aperture, the foramen spinosum, to form during development. The aim of this study was to investigate MMAE feasibility as a function of the presence/absence of the foramen spinosum on preprocedure computed tomography (CT) scan.</p><p><strong>Methods: </strong>We performed a retrospective review of 100 consecutive patients undergoing MMAE from January 2022 to December 2023 at the Medical University of South Carolina. Preprocedure CT scan of the head was reviewed, and the presence or absence of the foramen spinosum, along with laterality, was recorded. Subsequently, angiographic studies were reviewed.</p><p><strong>Results: </strong>All patients (n = 100) had preprocedural CT scan available for review. The incidence of an absent foramen spinosum was 3% (n = 3). All absent foramen spinosum were left sided (2F, 1M). All embolization attempts in these patients were aborted due to recurrent meningeal artery. 97% of patients had patent bilateral foramen spinosum (n = 97). Two of these patients possessed partial ophthalmic contribution to the MMA (2%), and embolization was not performed. In patients with patent foramen spinosum, successful embolization was achieved in 92/97 patients (94.8%).</p><p><strong>Conclusion: </strong>The review of preprocedure CT scan may serve as an opportunity to identify patients with ophthalmic arterial origin of the MMA, subverting unnecessary risks associated with catheter angiography.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"564-570"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005866","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":"Frameless Stereotactic Biopsy of Brainstem Tumors Using the Stealth Autoguide: A Technical Note.","authors":"Ajay Patel, Nicholas Hux, Piiamaria S Virtanen, Hailey Budnick, Fezaan Kazi, Jignesh K Tailor","doi":"10.1227/ons.0000000000001314","DOIUrl":"10.1227/ons.0000000000001314","url":null,"abstract":"<p><strong>Background and objectives: </strong>In the molecular era of neuro-oncology, it is increasingly necessary to obtain tissue for next-generation sequencing and methylome profile for prognosis and targeted oncological management. Brainstem tumors can be technically challenging to biopsy in the pediatric population. Frame-based and frameless techniques have previously been described and proven to be safe and efficacious in children. Recent cranial robotic guidance platforms have augmented the fluency of frameless stereotactic approaches, but the technical nuances of these procedures in children are not often discussed. We present a technical workflow for frameless stereotactic biopsy of brainstem tumors in children using the Medtronic Stealth Autoguide cranial robotic guidance platform and examine safety and efficacy of this surgical approach.</p><p><strong>Methods: </strong>A minimally invasive, frameless, transcerebellar approach is described, including operative steps and workflow. We assessed operative times, diagnostic accuracy and yield, and complication rates.</p><p><strong>Results: </strong>Five patients underwent biopsy with the technique described. The youngest patient in our series was of 2 years. The intended target was achieved on postoperative imaging in all cases, and diagnostic tissue was obtained in all 5 patients. One patient had a clinically insignificant hemorrhage.</p><p><strong>Conclusion: </strong>Frameless stereotactic biopsy of the brainstem can be performed safely, efficiently, and accurately using the Medtronic Stealth Autoguide robotic platform in children as young as 2 years.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":" ","pages":"558-563"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005872","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":"Combined Endovascular-Microsurgical Treatment for a Parietal Brain Arteriovenous Malformation and Neuropsychological Implications: An Operative 2-Dimensional Video Case: 2-Dimensional Operative Video.","authors":"René Alejandro Apaza-Tintaya, Luis Gustavo Biondi-Soares, Luis Ángel Canache Jiménez, Talita Helena Martins Sarti, Edgar David Tenelema Aguaisa, Felipe Pereira Salvagni, Daniela de Souza Coelho, José Maria de Campos Filho, Feres Chaddad-Neto","doi":"10.1227/ons.0000000000001289","DOIUrl":"https://doi.org/10.1227/ons.0000000000001289","url":null,"abstract":"","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":"28 4","pages":"575-576"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626939","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}