Acta neurochirurgica. Supplement最新文献

Educational Impact of an Annotation System Integrated with an Exoscope for Cerebral Aneurysm Surgery: Case Description. 结合外窥镜的注释系统对脑动脉瘤手术的教育影响：案例描述。

Acta neurochirurgica. Supplement Pub Date : 2025-01-01 DOI: 10.1007/978-3-031-89844-0_21

Yoji Tanaka, Motoki Inaji, Daisu Abe, Kazuhide Shimizu, Taketoshi Maehara

{"title":"Educational Impact of an Annotation System Integrated with an Exoscope for Cerebral Aneurysm Surgery: Case Description.","authors":"Yoji Tanaka, Motoki Inaji, Daisu Abe, Kazuhide Shimizu, Taketoshi Maehara","doi":"10.1007/978-3-031-89844-0_21","DOIUrl":"https://doi.org/10.1007/978-3-031-89844-0_21","url":null,"abstract":"Purpose: The three-dimensional (3D) exoscope has been reported to have better image quality, ergonomics, and educational outcomes than a microscope. However, whether the exoscope can improve communication between the main surgeon and the mentor remains unclear. This chapter introduces our experience with using an exoscope and an annotation system for surgical education during a left middle cerebral aneurysm surgery in a 63-year-old woman.Methods: We used an annotation system integrated with a 3D exoscope during aneurysm surgery. The mentor provided instruction by using the annotation system to write information on the surgical monitor.Results: The aneurysmal neck was broad and required two clips to achieve complete clipping. On a monitor, the mentor drew instructions for inserting the clips. The surgeon successfully accomplished the clipping as instructed. Intraoperative indocyanine green angiography revealed the complete occlusion of the aneurysm. The patient had no postoperative neurological deficit.Conclusion: A new system using an annotation system integrated with an exoscope for surgical education was introduced and applied to an aneurysm clipping surgery. This system is expected to improve communication between surgeons and mentors and improve surgical safety.","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"165-169"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590110","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}

引用次数: 0

Efficacy and Safety of Combined Revascularization Surgery for Moyamoya Disease: Standard Procedure and Perioperative Management. 烟雾病联合血运重建术的疗效和安全性：标准程序和围手术期管理。

Acta neurochirurgica. Supplement Pub Date : 2025-01-01 DOI: 10.1007/978-3-031-89844-0_12

Miki Fujimura, Masaki Ito, Haruto Uchino, Masahito Kawabori, Taku Sugiyama

{"title":"Efficacy and Safety of Combined Revascularization Surgery for Moyamoya Disease: Standard Procedure and Perioperative Management.","authors":"Miki Fujimura, Masaki Ito, Haruto Uchino, Masahito Kawabori, Taku Sugiyama","doi":"10.1007/978-3-031-89844-0_12","DOIUrl":"https://doi.org/10.1007/978-3-031-89844-0_12","url":null,"abstract":"Objective: Revascularization surgery such as superficial temporal artery-middle cerebral artery (STA-MCA) bypass is a standard management choice for symptomatic moyamoya disease (MMD) patients, with either ischemic or hemorrhagic presentation. We sought to clarify the efficacy and safety of institutional standardized revascularization procedures for MMD.Materials and methods: The present study includes 37 consecutive patients with MMD (2-60 years old, 42.0 on average) undergoing revascularization surgery on 42 affected hemispheres. Direct-indirect combined revascularization surgery was performed on most hemispheres (41/42, 97.6%), including STA-MCA bypass (39 hemispheres) and occipital artery-posterior cerebral artery bypass (2 hemispheres). All patients underwent standardized perioperative management with strict blood pressure control (110-130 mmHg) based on routine single-photon emission computed tomography (SPECT) 1 and 7 days after surgery. Then we investigated the outcome of surgeries, focusing mainly on that of combined revascularization procedures.Results: The outcome of 42 surgeries was favorable in all cases, except for one adult (2.3%) manifesting with cerebral hyperperfusion syndrome leading to neurological worsening. None of the patients developed perioperative cerebral infarction (0/42; 0%), and the patency of the direct bypass was confirmed via MRA in all patients undergoing combined procedure (41/41, 100%). Two patients suffered wound-healing delay, one of which required resuture.Conclusion: The combined revascularization surgery is a safe and effective treatment for MMD, while local cerebral hyperperfusion is a potential complication that should be avoided through intensive perioperative care.","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"99-104"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590111","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}

引用次数: 0

Introducing Bayesian Analysis for Clinicians: Sex-Associated Risk Assessment of Intracranial Aneurysms. 为临床医生介绍贝叶斯分析：颅内动脉瘤的性别相关风险评估。

Acta neurochirurgica. Supplement Pub Date : 2025-01-01 DOI: 10.1007/978-3-031-89844-0_3

Philippe Bijlenga, Georg Ralph Spinner, Marco Scutari, Matteo Delucchi, Sven Hirsch

{"title":"Introducing Bayesian Analysis for Clinicians: Sex-Associated Risk Assessment of Intracranial Aneurysms.","authors":"Philippe Bijlenga, Georg Ralph Spinner, Marco Scutari, Matteo Delucchi, Sven Hirsch","doi":"10.1007/978-3-031-89844-0_3","DOIUrl":"https://doi.org/10.1007/978-3-031-89844-0_3","url":null,"abstract":"Introduction: Intracranial aneurysms (IAs) are critical vascular defects potentially leading to subarachnoid hemorrhage. A Bayesian framework assists clinicians in assessing IA risks by evaluating multiple factors, including sex, due to its higher prevalence in women.Methods: This study adopted the Bayesian theorem to quantify IA prevalence and the incidence of subsequent hemorrhage, examining sex as a pivotal risk factor for IA rupture stratification.Results: The Bayesian analysis revealed a greater incidence of IAs among women yet indicated that sex does not have a significant impact on the rupture risk in diagnosed patients. This finding suggests the necessity of considering other cofactors in risk evaluation.Conclusions: Bayesian approaches provide clinicians with refined tools for IA risk assessment, emphasizing the complex interplay of various risk factors beyond sex. Acknowledging the limited influence of sex on rupture probability is crucial in guiding IA management. Continuous research is warranted to advance Bayesian methods, improving their clinical applicability and enhancing patient treatment outcomes.","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"19-26"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590165","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}

引用次数: 0

Flow-Augmentation Bypass Surgery: Indications and Decision-Making. 血流增强搭桥手术：适应症和决策。

Acta neurochirurgica. Supplement Pub Date : 2025-01-01 DOI: 10.1007/978-3-031-89844-0_14

Giuseppe Esposito, Martina Sebök, Jorn Fierstra, Luca Regli

引用次数: 0

New Classification of the Degree of Cerebrovascular Insufficiency in Patients with Moyamoya Disease Measured According to ASL-MRI Perfusion. ASL-MRI灌注测量烟雾病患者脑血管功能不全程度的新分类。

Acta neurochirurgica. Supplement Pub Date : 2025-01-01 DOI: 10.1007/978-3-031-89844-0_15

Anna A Shulgina, Vasily A Lukshin, Anton A Korshunov, Dmitry Yu Usachev, Igor N Pronin

{"title":"New Classification of the Degree of Cerebrovascular Insufficiency in Patients with Moyamoya Disease Measured According to ASL-MRI Perfusion.","authors":"Anna A Shulgina, Vasily A Lukshin, Anton A Korshunov, Dmitry Yu Usachev, Igor N Pronin","doi":"10.1007/978-3-031-89844-0_15","DOIUrl":"https://doi.org/10.1007/978-3-031-89844-0_15","url":null,"abstract":"Introduction: We aimed to classify different degrees of cerebrovascular insufficiency (CVI) in patients with moyamoya disease (MMD) by measuring cerebral blood flow (CBF) and distinguishing arterial transit artifacts (ATAs) on arterial spin labeling (ASL) magnetic resonance imaging (MRI).Methods: The study included 121 images of patients with MMD who underwent ASL-MRI before and after surgical treatment (242 hemispheres). On ASL-CBF maps, regions of interest (ROIs) were manually drawn in each hemisphere in seven zones. Quantitative and qualitative patterns of arterial transit artifacts (ATA) were studied. Analysis of variance (ANOVA) was used for group comparisons.Results: Distinguished patterns were divided into four statistically significant degrees on the basis of CBF values and the presence of ATA: degree 0 with normal CBF values and without ATAs (n = 59) (CBF 60.37-68.64 mL/100gxmin); degree 1 with moderate decreased CBF and with ATAs (n = 97) (CBF 55.82-62.16); degree 2 with significantly decreased CBF and with ATAs (n = 64) (CBF 25.64-28.96); and degree 3 with very low CBF and without ATAs (n = 22) (CBF 15.58-19.97). All groups exhibited significant differences between the value of CBF in all cortical territories (p < 0.01). Distinguished patterns had high correlations between Suzuki stage, the severity of ischemic disease, and neurologic deficit.Conclusion: The revealed ASL-MRI patterns correspond to the degree of CVI, the stage of the disease, and the clinical symptoms and can be used for assessment in the patients with moyamoya disease.","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"121-127"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590168","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}

引用次数: 0

Novel Hemodynamic Parameters for Cerebral Ischemia in Patients with Occlusive Cerebrovascular Disease Using Dual ASL Perfusion Imaging. 用双ASL灌注成像诊断闭塞性脑血管病患者脑缺血的新血流动力学参数。

Acta neurochirurgica. Supplement Pub Date : 2025-01-01 DOI: 10.1007/978-3-031-89844-0_17

Jyoji Nakagawara

{"title":"Novel Hemodynamic Parameters for Cerebral Ischemia in Patients with Occlusive Cerebrovascular Disease Using Dual ASL Perfusion Imaging.","authors":"Jyoji Nakagawara","doi":"10.1007/978-3-031-89844-0_17","DOIUrl":"https://doi.org/10.1007/978-3-031-89844-0_17","url":null,"abstract":"Perfusion MRI via arterial spin labeling (ASL) could not precisely estimate cerebral ischemia severity in patients with occlusive cerebrovascular disease (CVD), because the delayed arrival of arterial blood spins (AB spins) in the affected vascular territories could not be corrected v single post-labeling delay (PLD) setting. In this study, new hemodynamic parameters for cerebral ischemia using dual ASL perfusion imaging under double PLD setting will be proposed.In 67 patients with moyamoya disease (MMD) and 22 patients with large artery atherosclerosis (LAA), hemodynamic parameters were investigated by using dual ASL perfusion imaging via 3.0 T MRI. PLD was fixed to 1525 ms (early image) and 2525 ms (late image). In early images, early slow-in of AB spins into cerebral tissue, and the early stagnation of AB spins within cortical arteries were investigated. In late images, late filling up (complete or incomplete) and both late stagnation and overstagnation were estimated.Early slow-in (65/67 = 97% in MMD, 22/22 = 100% in LAA) and early stagnation (48/67 = 72% in MMD, 7/22 = 32% in LAA) were observed in early images. Late incomplete filling up (22/67 = 33% in MDD, 3/22 = 14% in LAA), late complete filling up (45/67 = 67% in MMD, 19/22 = 86% in LAA), late stagnation (48/67 = 72% in MMD, 10/22 = 45% in LAA), and overstagnation (8/67 = 12% in MMD, 2/22 = 9% in LAA) were identified in late images. Late incomplete filling up (suspected moderate ischemia) in MDD was observed more frequently than was LAA.By using dual ASL perfusion imaging, early slow-in and late filling up as well as early and late stagnation could be identified separately as novel hemodynamic parameters in patients for cerebral ischemia with occlusive CVD.","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"135-140"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590169","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}

引用次数: 0

Role and Efficacy of Direct Surgery in the Management of Intracranial Dural Arteriovenous Fistulas. 直接手术治疗颅内硬脑膜动静脉瘘的作用和疗效。

Acta neurochirurgica. Supplement Pub Date : 2025-01-01 DOI: 10.1007/978-3-031-89844-0_7

Taku Sugiyama, Toshiya Osanai, Masaki Ito, Haruto Uchino, Miki Fujimura

{"title":"Role and Efficacy of Direct Surgery in the Management of Intracranial Dural Arteriovenous Fistulas.","authors":"Taku Sugiyama, Toshiya Osanai, Masaki Ito, Haruto Uchino, Miki Fujimura","doi":"10.1007/978-3-031-89844-0_7","DOIUrl":"https://doi.org/10.1007/978-3-031-89844-0_7","url":null,"abstract":"Purpose: Although endovascular treatment (EVT) is often the treatment of choice for intracranial dural arteriovenous fistula (dAVF), direct surgery is an efficient option for many types of dAVFs. Herein, we present a relatively large case series of direct surgical patients to discuss the role and efficacy of direct surgery in managing intracranial dAVFs.Methods: 43 consecutive patients with dAVFs (ethmoid, n = 11; middle fossa, n = 1; convexity, n = 2; tentorium, n = 11; superior sagittal sinus, n = 2; transverse-sigmoid sinus, n = 11; and cranio-vertebral junction [CVJ], n = 5) treated with direct surgery were retrospectively assessed. Here, 21 (48.8%) and six (14.0%) patients presented with intracranial hemorrhage (ICH) and nonhemorrhagic neurological deficits, respectively. Factors for the selection of direct surgery, prior EVT, surgical procedure, and surgical outcomes were investigated.Results: The ethmoidal location and massive ICH presentation were associated with the predominant selection of direct surgery. Incomplete obliteration via prior EVT was frequently observed in CVJ dAVF, as well as in tentorial dAVFs with pial arterial supply. Permanent surgery-related complications and incomplete obliteration were observed in 7.0% and 2.4% of the patients, respectively. Regarding long-term outcomes, recurrence was not observed postoperatively during the 1336 patient-month follow-up period, and favorable outcomes (modified Rankin scale of 0-2) at the last evaluation were achieved in 82.5% of patients.Conclusion: Direct surgery is an effective therapeutic option for dAVFs located in the ethmoid, CVJ, or tentorium; those presenting with massive ICH; and those with pial arterial supply.","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"61-67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590171","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}

引用次数: 0

Epidemiology and Aetiology of Cerebral Cavernous Malformations. 脑海绵状血管瘤的流行病学和病因学。

Acta neurochirurgica. Supplement Pub Date : 2025-01-01 DOI: 10.1007/978-3-031-89844-0_18

Hiroki Hongo, Satoru Miyawaki, Nobuhito Saito

引用次数: 0

Paraspinal Arteriovenous Shunt Associated with PTEN Hamartoma Tumor Syndrome: A Case Report and Literature Review. 椎旁动静脉分流合并PTEN错构瘤综合征1例报告及文献复习。

Acta neurochirurgica. Supplement Pub Date : 2025-01-01 DOI: 10.1007/978-3-031-89844-0_8

Sayaka Ito, Naoki Hatsuda

引用次数: 0

Tenascin-C as a Target for Intervention in Delayed Cerebral Ischemia After Subarachnoid Hemorrhage. Tenascin-C作为干预蛛网膜下腔出血后迟发性脑缺血的靶点。

Acta neurochirurgica. Supplement Pub Date : 2025-01-01 DOI: 10.1007/978-3-031-89844-0_2

Hidenori Suzuki, Fumihiro Kawakita, Hideki Nakajima, Hiroki Oinaka, Mai Nampei, Yume Suzuki

{"title":"Tenascin-C as a Target for Intervention in Delayed Cerebral Ischemia After Subarachnoid Hemorrhage.","authors":"Hidenori Suzuki, Fumihiro Kawakita, Hideki Nakajima, Hiroki Oinaka, Mai Nampei, Yume Suzuki","doi":"10.1007/978-3-031-89844-0_2","DOIUrl":"https://doi.org/10.1007/978-3-031-89844-0_2","url":null,"abstract":"The outcomes of aneurysmal subarachnoid hemorrhage (SAH) remain poor, and delayed cerebral ischemia (DCI) is the most important treatable determinant for a poor outcome. Clinical and experimental findings have shown that more-severe SAH induces more tenascin-C (TNC) in brain parenchyma, cerebral artery walls, cerebrospinal fluid, and peripheral blood, which is involved in the development of DCI. TNC belongs to inducible, nonstructural, and multifunctional matricellular proteins. TNC is known to regulate multiple signaling pathways and upregulate inflammatory molecules, including some matricellular proteins and the receptors, all of which potentially contribute to the development of DCI with and without cerebral vasospasm. TNC may also form positive feedback mechanisms to induce TNC furthermore, which may lead to the aggravation of DCI at multiple levels. Recently, an antiplatelet drug, cilostazol, and an antiepileptic drug, perampanel, both of which are clinically available and inhibit TNC induction experimentally, were reported to prevent DCI in clinical settings. Many other medications that potentially inhibit TNC upregulation are clinically available. TNC may be promising as a target for intervention in DCI after aneurysmal SAH. Until technological progress develops new TNC-targeting drugs, many already clinically available drugs would be worth repurposing to inhibit TNC induction for the prevention and/or treatment of DCI after SAH.","PeriodicalId":6913,"journal":{"name":"Acta neurochirurgica. Supplement","volume":"136 ","pages":"11-17"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590172","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}

引用次数: 0