Brain & spine最新文献

{"title":"Tumor resting-state fMRI connectivity to extralesional brain is associated with cognitive performance in glioma patients","authors":"Chuh-Hyoun Na ,&nbsp;Hans Clusmann ,&nbsp;Martin Wiesmann ,&nbsp;Kerstin Jütten ,&nbsp;Verena Mainz","doi":"10.1016/j.bas.2025.104202","DOIUrl":"10.1016/j.bas.2025.104202","url":null,"abstract":"<div><h3>Introduction</h3><div>Functional coupling of the tumor to extralesional brain areas and the pretherapeutic cognitive performance status have each independently been identified as prognostically relevant in glioma patients. It is however unclear, whether tumor-connectivity correlates with cognitive performance or the cognitive outcome.</div></div><div><h3>Research question</h3><div>To investigate potential associations between pre- and postoperative resting-state fMRI connectivity (FC) and cognitive functions in glioma patients compared to healthy controls.</div></div><div><h3>Material and methods</h3><div>18 patients and 18 age-matched, healthy controls underwent resting-state fMRI and neuropsychological testing pre- and 4.5 months (mean) postoperatively. FC of the tumor to extralesional brain (Tu-EL) was determined, as well as FC of extralesional brain (EL) and the contralesional hemisphere (conEL). Groups were compared with regard to behavioral and FC measures.</div></div><div><h3>Results</h3><div>Patients showed deficits in all cognitive domains tested. While postoperative performance tended to be worse, deterioration was not statistically significant between timepoints. EL FC did not differ between groups, but conEL FC (p &lt; .045) was increased in patients as compared to controls. Tu-EL FC was significantly associated with worse attention performance (p &lt; .001), and, by trend (p &lt; .058), with worse attentional outcome in patients.</div></div><div><h3>Discussion and conclusion</h3><div>Intrinsic functional coupling to the rest of the brain was associated with worse cognitive performance and might relate to pathological tumor-neuron interaction on the macroscale, reflecting the invasive nature of diffusely infiltrating glioma. Deepening our understanding of FC measures at the connectomic level in the context of cancer neuroscience may aid in identifying neurophysiological correlates of cognitive impairment and in prognosticating cognitive outcome in glioma patients.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104202"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143356981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of a transforaminal epidural injection in patients with lumbar disc herniation is not correlated with the presence of type II modic changes","authors":"E.J.A. Verheijen ,&nbsp;N.R.E. van der Vlist ,&nbsp;E.C. Bartels ,&nbsp;O.B.H.A.M. van Haagen ,&nbsp;C.L.A. Vleggeert-Lankamp","doi":"10.1016/j.bas.2025.104222","DOIUrl":"10.1016/j.bas.2025.104222","url":null,"abstract":"<div><h3>Introduction</h3><div>Transforaminal epidural steroid injections (TEI) have been suggested to alleviate symptoms in patients with lumbar disc herniation (LDH) through its anti-inflammatory effect. However, treatment effect varies among patients and reliable predictors are lacking. Modic changes (MC) are also associated with inflammatory processes and, therefore, we hypothesize that MC may be correlated with outcome after TEI.</div></div><div><h3>Research question</h3><div>To investigate the correlation between the presence of MC at the level of LDH and the effect of TEI.</div></div><div><h3>Material and methods</h3><div>Patients with unilateral lumbar radiculopathy secondary to LDH undergoing TEI were included. MC was graded by two independent assessors. Outcome measures included leg pain, back pain, disability and patient-received recovery at baseline, 30 min, 2 weeks and 6 weeks after treatment. Multivariate analysis was performed for all outcomes and for dichotomized scores using a cutoff of ≥30% improvement. A p-value of ≤0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>A total of 88 patients were included of whom 52.3% demonstrated MC. The vast majority was classified as type II (94%). The presence of MC was not correlated with any outcome measure when correcting for age, gender, duration of symptoms and the use of analgesics, nor for dichotomized scores.</div></div><div><h3>Discussion and conclusion</h3><div>The findings indicate that type II MC is not associated with outcome within six weeks after TEI. Therefore, type II MC cannot be used as a predictor for TEI outcome. Future studies should include longer follow-up and investigate the correlation between the type of MC and the effect of TEI.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104222"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic and prognostic value of navigated transcranial magnetic stimulation to assess motor function in patients with acute traumatic spinal cord injury","authors":"Maximilian Schwendner ,&nbsp;Marianne Kanaris ,&nbsp;Anthony M. DiGiorgio ,&nbsp;Michael C. Huang ,&nbsp;Geoffrey T. Manley ,&nbsp;Phiroz E. Tarapore","doi":"10.1016/j.bas.2025.104229","DOIUrl":"10.1016/j.bas.2025.104229","url":null,"abstract":"<div><h3>Introduction</h3><div>Traumatic spinal cord injuries (SCI) represent a profoundly life-altering diagnosis.</div></div><div><h3>Research question</h3><div>The aim of this study was to evaluate the diagnostic and prognostic value of navigated transcranial magnetic stimulation (nTMS) in assessing motor function in the management of patients with acute SCI.</div></div><div><h3>Material and methods</h3><div>nTMS motor mapping of both upper extremities (UE) and lower extremities (LE) was performed in patients suffering from acute traumatic SCI. Data from intraoperative neuromonitoring (IONM) and patient outcomes, including American Spinal Injury Association Impairment Scale (AISA) scores, were analyzed.</div></div><div><h3>Results</h3><div>The patients had a mean age of 68.9 ± 15.6 years (range: 28–94 years). Preoperatively, 7 patients (35.0%) were classified as AISA A or B, and 13 (65.0%) were classified as AISA C or D. At follow-up, 5 patients (25.0%) had improved.</div><div>In all patients motor evoked potentials (MEPs) were elicited. MEPs of UE muscles were observed in 38 (61.3%) muscles in IONM and 41 (66.1%) muscles in TMS. MEPs of LE muscles were observed in 5 (19.2%) and 7 (26.9%) muscles, respectively. e</div><div>Combining the results of IONM and nTMS, a sensitivity of 0.852 and a specificity of 0.889 for motor function of the tested muscle at follow-up was achieved for upper extremity muscles. For lower extremity muscles, a sensitivity of 0.571 and a specificity of 1.00 was achieved.</div></div><div><h3>Discussion and conclusion</h3><div>nTMS in patients with acute SCI provides an objective assessment of motor system integrity. Despite a relatively low sensitivity, potentially due to decreased excitability, this technique exhibited excellent specificity in predicting short-term and long-term motor outcomes.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104229"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first EANS vascular and skull base hands-on course in East Africa: Review from the global and humanitarian neurosurgical committee initiative","authors":"Magalie Cadieux ,&nbsp;Andreas K. Demetriades ,&nbsp;Lukas Rasulic ,&nbsp;Nicephorus Rutabasibwa ,&nbsp;Alpha Kinghomella ,&nbsp;Aingaya Kaale ,&nbsp;Boaz Yonah ,&nbsp;Christian Preuss-Hernández ,&nbsp;Roger Härtl ,&nbsp;Nicolò Marchesini ,&nbsp;Magnus Tisell ,&nbsp;Ondra Petr","doi":"10.1016/j.bas.2025.104210","DOIUrl":"10.1016/j.bas.2025.104210","url":null,"abstract":"<div><h3>Introduction</h3><div>Cerebrovascular pathologies in East Africa have a poorly known prevalence and incidence. The treatment remains sparse. When they apply, microneurosurgical techniques are prioritized over endovascular procedures due to lack of resources. Considering an increasing number of neurosurgeons in East Africa, the EANS Global Humanitarian Committee (GHC) has endorsed the creation of the Vascular and Skull base Hands-on Neurosurgery Course.</div></div><div><h3>Research question</h3><div>What are essential elements to extend knowledge to sub-Suharan neurosurgeons on cerebrovascular pathologies?</div></div><div><h3>Material and methods</h3><div>In November 2023 was held the first course in collaboration with the Muhimbili Orthopaedic Institute (MOI) in Dar es Salaam, Tanzania. The course consisted of lectures from international and local faculty in the morning with surgical cases in the afternoon. Plus/delta type of feedback was obtained at the end. Challenges and proposed improvement based on comments are reported.</div></div><div><h3>Results</h3><div>The course lasted over five days and each day had a different theme of neurovascular or skull base neurosurgery. There was a total of 32 presenting faculty and ten surgical cases. For this first edition, a total of 39 healthcare workers were in attendance. The participants felt that the hands-on portion was very useful (56%) and wished to have more cases for more exposure. Comments from the plus/delta feedback emphasized on having in-person faculty rather than virtually.</div></div><div><h3>Discussion and conclusion</h3><div>The first edition of the EANS Vascular and Skull base Hands-on Neurosurgery Course in East Africa successfully run in Dar es Salaam. Subsequent editions should focus on more targeted in-person lectures better adapted to LMICs.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104210"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BOOTStrap-SCI: Beyond One option of treatment for spinal trauma and spinal cord injury: Consensus-based stratified protocols for pre-hospital care and emergency room (part I)","authors":"Nicolò Marchesini ,&nbsp;Andreas K. Demetriades ,&nbsp;Oscar Alves ,&nbsp;Riya Mandar Dange ,&nbsp;Harold Mauricio Choco ,&nbsp;Edinson Dussan Lozada ,&nbsp;Dumar Javier Figueredo Sanabria ,&nbsp;Angélica Gamboa ,&nbsp;Luz Llined Mendoza Victoria ,&nbsp;Enoc Noscue Montealegre ,&nbsp;Jonathan A. Pardo Carranza ,&nbsp;Jonathan Velásquez Quintero ,&nbsp;Andrès M. Rubiano ,&nbsp;the BOOTStraP-SCI Study Group","doi":"10.1016/j.bas.2025.104251","DOIUrl":"10.1016/j.bas.2025.104251","url":null,"abstract":"<div><h3>Introduction</h3><div>Spinal trauma (STx), with or without spinal cord injury (SCI), represents a significant global health burden, particularly in low- and middle-income countries (LMICs). Existing guidelines often rely on tools and resources that are not always universally available, especially in less resourced settings, contributing to disparities in care and outcomes. A pragmatic, resource-adapted approach may help optimize management in these contexts.</div></div><div><h3>Research question</h3><div>This study aimed to develop resource-adapted protocols for pre-hospital and emergency room management of STx and <span>SCI</span>, addressing challenges specific to LMICs while supported by clinical evidence and expert based practices.</div></div><div><h3>Material and methods</h3><div>A multidisciplinary Delphi consensus combined international evidence-based guidelines with expert opinions. Iterative discussions and voting by healthcare providers from LMICs and high-income countries (HICs) ensured the development of context-sensitive protocols. These were tailored to varying levels of training, resource availability, and healthcare infrastructure.</div></div><div><h3>Results</h3><div>The resulting protocols address key areas of pre-hospital and emergency management, including initial resuscitation, immobilization, clinical interventions, and timely referral. These protocols emphasize adaptability, providing structured plus flexible guidance for optimizing care according to specific contexts from low to high resourced clinical settings.</div></div><div><h3>Discussion and conclusion</h3><div>The proposed protocols are not intended as gold-standard guidelines but as adaptable frameworks to guide management of STx/SCI in contexts with different availability of resources. By addressing disparities in resource availability and clinical competencies, they can serve as a foundation for local adaptations and improvements in care. Future research should evaluate their implementation and impact on outcomes.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104251"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821499","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":"Additional dorsal interspinous stabilisation has no advantage after decompression of degenerative lumbar spinal stenosis","authors":"Josephin Cebulla ,&nbsp;Lukas P. Staub ,&nbsp;Thomas Barz","doi":"10.1016/j.bas.2024.104166","DOIUrl":"10.1016/j.bas.2024.104166","url":null,"abstract":"<div><h3>Introduction</h3><div>Interspinous devices are an alternative to instrumented fusion for the treatment of lumbar spinal stenosis (LSS) with radiological instability or deformity. The devices claim to improve clinical symptoms by indirect foraminal decompression with fewer complications and similar functional outcomes compared to conventional fusion techniques, and by avoiding a (further) deterioration of the anatomy of the spine while being less invasive than instrumented fusion.</div></div><div><h3>Research question</h3><div>Do interspinous devices provide a benefit in combination with a decompression of degenerative LSS?</div></div><div><h3>Material and methods</h3><div>In this observational study, 117 patients were treated by decompression surgery alone (n = 37), decompression plus instrumented spinal screw fixation and anterior cage support (n = 41) or decompression plus stabilisation with interspinous devices (n = 39). Pelvic tilt, pelvic incidence, lumbar lordosis, and spondylolisthesis were measured on X-ray scans before surgery, 3 and 12 months postoperative. The Oswestry Disability Index, back and leg pain were also assessed. Generalized Estimating Equation regression models were used to determine the relationship between the outcomes and treatment group over time.</div></div><div><h3>Results</h3><div>After interspinous stabilisation surgery the mean pelvic tilt remained at 22.7°, and the difference between the pelvic incidence and lumbar lordosis (PI-LL) remained at 10.5°. In all three groups, the ODI decreased by 14–18 points (p&lt;0.01), and the pain levels decreased by 2.6–3.2 points (p&lt;0.01).</div></div><div><h3>Conclusion</h3><div>We found no scientific evidence to support the use of interspinous devices. The sagittal profile could not be stabilised by this intervention, and no clinical advantage over decompression surgery alone was evident.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104166"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PD-L1 expression in PitNETs: Correlations with the 2022 WHO classification","authors":"Ethan Harel ,&nbsp;Ekkehard Hewer ,&nbsp;Stefano La Rosa ,&nbsp;Jean Philippe Brouland ,&nbsp;Nelly Pitteloud ,&nbsp;Federico Santoni ,&nbsp;Maxime Brunner ,&nbsp;Roy Thomas Daniel ,&nbsp;Mahmoud Messerer ,&nbsp;Giulia Cossu","doi":"10.1016/j.bas.2024.104171","DOIUrl":"10.1016/j.bas.2024.104171","url":null,"abstract":"<div><h3>Introduction</h3><div><u>and research question</u>: Prognostic factors to predict the behavior of pituitary neuroendocrine tumors (PitNET) are scarce. PD-L1 expression was associated with prognosis in other neuroendocrine neoplasms and we analyzed PD-L1 expression in PitNET, according to the 2022 WHO classification.</div></div><div><h3>Material and methods</h3><div>A retrospective analysis was performed. Immunohistochemistry was used to define PD-L1 expression, which was quantified as TPS (tumor proportion score). The primary outcome was to assess the correlation between PD-L1 expression and transcription factors (TF), namely T-pit, Pit-1, SF-1 and GATA-3. As secondary outcomes, we evaluated the association between PD-L1 expression and proliferation indexes.</div></div><div><h3>Results</h3><div>Eighty-eight patients were included. The largest group belonged to the SF-1-lineage (48%), followed by tumors of the Pit-1 lineage (32%) and T-pit lineage (17%). PD-L1 expression was associated with Pit-1 expression (p &lt; 0.001) and with the somatotroph, lactotroph and mammosomatotroph subgroups. A TPS ⩾35% showed a 100% sensitivity for the mammosomatotroph subtype, while the optimal cut-off point was 20% for somatotroph and 15% for lactotroph tumors. PD-L1 expression was negatively associated with SF-1 and GATA3 expression(p &lt; 0.001), with an optimal cut-point ≤5%. No association was found between PD-L1 expression and immunohistochemical proliferative factors but PD-L1 expression was associated with female sex and a younger age at diagnosis.</div></div><div><h3>Conclusion</h3><div>PD-L1 expression was associated with PIT-1 lineage, while it was downregulated in SF-1-lineage tumors. No correlation was found with proliferative factors. The role of PD-L1 expression in determining the biological behavior of PitNET remains debated and larger studies are necessary to further confirm these findings.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104171"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple isolated spinal aneurysms – A rare condition with uncertain treatment strategies: A case report and literature review","authors":"F.M.C. Lioi ,&nbsp;D. Dahlberg ,&nbsp;J. Sundseth ,&nbsp;K.B. Olsen ,&nbsp;H.L. Lilleby ,&nbsp;B. Nedregaard ,&nbsp;M.K.H. Wiedmann","doi":"10.1016/j.bas.2025.104192","DOIUrl":"10.1016/j.bas.2025.104192","url":null,"abstract":"<div><h3>Purpose</h3><div>Isolated spinal aneurysms (iSAs) are rare, with an uncertain natural history and no established treatment guidelines. Multiple iSAs are even more uncommon, complicating treatment decisions.</div></div><div><h3>Methods</h3><div>This study reports a case of a ruptured radiculo-pial artery aneurysm in a patient with multiple iSAs, treated with surgical excision, assisted by intraoperative neurophysiological monitoring (IONM). Further, we review and analyze all previously reported cases of multiple iSAs.</div></div><div><h3>Results</h3><div>A 67-year-old woman with spinal subarachnoid hemorrhage and spinal cord compression due to a ruptured radiculo-pial artery aneurysm was treated surgically. Digital subtraction angiography (DSA) showed three spinal aneurysms. Intraoperative indocyanine green video-angiography (ICG-VA) revealed an aneurysm contributing to the left posterior spinal artery. The aneurysm was excised after proximal inflow occlusion under IONM. The other aneurysms spontaneously regressed, and the patient had a good functional outcome. Through a systematic literature review, we analyzed 13 multiple iSAs including our case, involving 34 aneurysms in total.</div></div><div><h3>Conclusions</h3><div>There is no standardized treatment approach for multiple iSAs. These aneurysms are often fusiform and clustered in contiguous metameric regions. They can be classified into flow-related and wall-weakening aneurysms. Surgery offers definitive treatment for ruptured iSAs and relieves spinal cord compression. Due to the common fusiform shape, parent vessel sacrifice may be necessary, and should include IONM and ICG-VA to minimize complications. Conservative treatment is viable as spontaneous regression often occurs.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104192"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microsurgical resection of intracranial meningiomas in patients aged 80 years old or more: A systematic review and meta-analysis","authors":"Simon Diaz ,&nbsp;Marc Levivier ,&nbsp;Nicolas Reyns ,&nbsp;Constantin Tuleasca","doi":"10.1016/j.bas.2025.104201","DOIUrl":"10.1016/j.bas.2025.104201","url":null,"abstract":"<div><h3>Introduction</h3><div>The incidence of intracranial meningiomas rises with advancing age, raising the question of whether similar surgical outcomes in morbidity and mortality can be expected compared to younger population. We conducted a systematic review and meta-analysis of research examining microsurgical outcomes in those aged 80 years or older.</div></div><div><h3>Methods</h3><div>Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we reviewed articles published between January 1995 and January 2024, referenced in PubMed or Embase. Inclusion criteria were peer-reviewed clinical studies of series reporting microsurgical resection of intracranial meningiomas in patients aged 80 years or more, written in English. Primary outcome was EOR (extend of resection), classified as tumor total resection versus partial resection. Secondary outcomes were morbidity and mortality.</div></div><div><h3>Results</h3><div>Ten studies reported 690 patients. Total tumor resection was achieved in 88% of cases (range 85–91; I² = 56; p heterogeneity = 0.02; p &lt; 0.01). Tumor partial resection was achieved in 12% (range 9–15; I^2 = 56; p heterogeneity = 0.02 and p &lt; 0.001). Postsurgical intracerebral hemorrhage was encountered in 1% of cases (range 0–2; I^2 = 69; p heterogeneity = &lt; 0.01). Surgical mortality was encountered in 5% of cases (range 3–7; I^2 = 61; p heterogeneity = &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Current data suggests that achieving high total resection rates, up to 88%, is feasible. The surgical mortality rate was 5%. A key unresolved neurosurgical dilemma is whether to operate on patients over 80 years old. Future studies are essential to assess all relevant risk factors comprehensively.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104201"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood biomarkers to identify patients with different intracranial lesion combinations after traumatic brain injury","authors":"Pia Koivikko ,&nbsp;Ari J. Katila ,&nbsp;Riikka SK. Takala ,&nbsp;Iftakher Hossain ,&nbsp;Teemu M. Luoto ,&nbsp;Rahul Raj ,&nbsp;Mari Koivisto ,&nbsp;Olli Tenovuo ,&nbsp;Kaj Blennow ,&nbsp;Peter Hutchinson ,&nbsp;Henna-Riikka Maanpää ,&nbsp;Mehrbod Mohammadian ,&nbsp;Virginia F. Newcombe ,&nbsp;Jean-Charles Sanchez ,&nbsp;Jussi Tallus ,&nbsp;Mark van Gils ,&nbsp;Henrik Zetterberg ,&nbsp;Jussi P. Posti","doi":"10.1016/j.bas.2025.104195","DOIUrl":"10.1016/j.bas.2025.104195","url":null,"abstract":"<div><h3>Introduction</h3><div>There is a lack of studies examining the most promising blood biomarkers for traumatic brain injury (TBI) in relation to gross pathology types.</div></div><div><h3>Research question</h3><div>To examine whether the admission levels of blood biomarkers can discriminate patients with different combinations of traumatic intracranial findings from patients with negative computed tomography (CT) scans.</div></div><div><h3>Material and methods</h3><div>One hundred thirty patients with all severities of TBI were studied. Seventy-five had CT-positive and 55 CT-negative findings. CT-positive patients were divided into three clusters (CL) using the Helsinki CT score: focal lesions (CL1), mixed lesions (CL2) and mixed lesions + intraventricular haemorrhage (CL3). CT scans were obtained upon admission and blood samples taken within 24 h from admission. S100 calcium-binding protein B (S100B), glial fibrillary acidic protein (GFAP), heart fatty-acid binding protein (H-FABP), neurofilament light (NF-L), interleukin-10 (IL-10), total-tau (t-tau), and β-amyloids 1–40 (Aβ40) and 1–42 (Aβ42) were analysed from plasma samples. CT-negative cluster was used as control.</div></div><div><h3>Results</h3><div>GFAP, Aβ40 and Aβ42 levels differed between the clusters, but not significantly. NF-L and t-tau discriminated CL1 from CT-negative cluster with AUCs of 0.737 and 0.771, respectively. NF-L, t-tau and GFAP discriminated CL2 from CT-negative cluster with AUCs of 0.839, 0.781 and 0.840, respectively. All biomarkers analysed were able to discriminate CL3 and CT-negative cluster.</div></div><div><h3>Discussion and conclusion</h3><div>All studied biomarkers distinguished the most severely injured cluster, CL3, from CT-negative cluster. The results may reflect the severity of TBI but also show that biomarkers have a variable ability to identify patients with combinations of intracranial traumatic lesions in the examined time window.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104195"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}