Brain & spine最新文献

{"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":"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":"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":"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":"Current and emergent therapies targeting spinal cord injury","authors":"Giovanni Grasso,&nbsp;Luigi Cusimano,&nbsp;Manfredi Noto,&nbsp;Rosario Maugeri,&nbsp;Domenico Gerardo Iacopino","doi":"10.1016/j.bas.2025.104243","DOIUrl":"10.1016/j.bas.2025.104243","url":null,"abstract":"<div><div>Spinal cord injury (SCI) is a serious condition characterized by high rates of disability. The complexities of SCI repair arise from intricate pathological mechanisms and the challenges of neural regeneration within the central nervous system. In recent decades, researchers have sought to fully understand these mechanisms and develop effective strategies for promoting axon regeneration and reconstructing neural circuits, though outcomes have often fallen short. Surgical techniques have evolved considerably, with options such as early surgical decompression, effective bony decompression, and expansile duroplasty providing favorable results in enhancing neurological recovery for patients. Accordingly, surgical intervention should be undertaken within 24 h when medically feasible. In addition, there has been a concerted effort to improve non-surgical management, particularly in critical care.</div><div>In pre-clinical settings, a range of innovative therapies is currently being explored, with some showing enough promise to advance to clinical trials. In this regard, the use of riluzole and anti NOGO antibodies has shown promising results from secondary analyses of high quality RCTs. Moreover, technological innovations in biomechanics and bioengineering are playing an essential role in managing SCI with growing emphasis on creating intermediate neural networks to facilitate regeneration and circuit rebuilding.</div><div>This review presents an overview of SCI, current treatments, and illustrates future avenues for SCI repair and clinical application.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104243"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838538","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":"Challenges in studying neuroanatomy in sub-Saharan Africa: The case of Cameroon","authors":"Kelvine Nkenfou ,&nbsp;Nathan Kengo ,&nbsp;Berjo Takoutsing ,&nbsp;Ernestine Renée Bikono Atangana ,&nbsp;Josiane Ngouanfo ,&nbsp;Joy Noumedem ,&nbsp;Nformi Caleb ,&nbsp;Aka Elvira Nkenganyi ,&nbsp;Steve Kamdem ,&nbsp;Karen Yossa ,&nbsp;Roland Nchufor ,&nbsp;Eleonore Ngounou ,&nbsp;Joseph Eloundou Ngah ,&nbsp;Mathieu Motah ,&nbsp;Victor-Claude Eyenga ,&nbsp;Nathalie Ghomsi ,&nbsp;Ignatius Esene","doi":"10.1016/j.bas.2025.104259","DOIUrl":"10.1016/j.bas.2025.104259","url":null,"abstract":"<div><h3>Introduction</h3><div>Quality education is key in addressing the skilled neurological workforce gap in Africa. However, many medics are scared of the neurological sciences because of the challenges faced in medical schools in studying the neurosciences. Understanding its state and educational challenges is crucial for fostering interest in neurosurgery and related specialities on the continent.</div></div><div><h3>Research question</h3><div>What are the current state, challenges, and solutions to improve neuroanatomy education in Cameroon, Africa in miniature?</div></div><div><h3>Materials and methods</h3><div>A cross-sectional study using an 11-item electronic survey was conducted among medical students from all nine medical schools in Cameroon. Data were analysed using descriptive statistics and independent t-tests, with significance set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>Among 220 respondents, 40.1 % and 35.0 % respectively, reported cranial nerves/brainstem and neurovascular anatomy to be the most challenging, with a mean comprehension score of 5.83/10. Faculty predominantly relied on PowerPoint lectures (83.2 %), while most students supplemented learning with YouTube videos (77.7 %). 63.9 % of the respondents perceived classroom teaching alone to limit their understanding of neuroanatomy, and 85.8 % of students reported the time allocated for neuroanatomy teaching to be inadequate. The usage of cadaver dissection (69.5 %), and neurosimulation practicals (66.4 %) were the most recommended tools by students to improve neuroanatomy teaching.</div></div><div><h3>Discussion and conclusion</h3><div>Challenges in neuroanatomy education in Cameroon are perceived to arise from insufficient hands-on learning, time constraints, and limited access to specialised faculty. These suggest interactive teaching, increased curriculum time, and diverse resources as potential improvements, though further research is needed to assess their effectiveness and ultimately improve understanding, fostering a stronger neurological workforce.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104259"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859447","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":"Increase in (semi-) acute non-instrumented lumbar spine surgeries during the COVID-19 pandemic","authors":"C.L.C. Gallé ,&nbsp;A.Y.J.M. Smeets ,&nbsp;E.A. Krekels-Huijbregts ,&nbsp;H. van Santbrink ,&nbsp;R.H.L. Haeren","doi":"10.1016/j.bas.2025.104270","DOIUrl":"10.1016/j.bas.2025.104270","url":null,"abstract":"<div><h3>Introduction</h3><div>Due to the COVID-19 pandemic healthcare resources were reallocated, thereby reducing elective surgery capacity. An increase in acute surgeries due to postponed elective surgeries was expected. Since elective lumbar spine surgery for degenerative indications was among the cancelled or postponed surgical interventions, we hypothesized that the number of acute and semi-acute surgeries would increase during the pandemic.</div></div><div><h3>Research question</h3><div>What was the effect of the COVID-19 pandemic on the number of (semi-)acute lumbar spinal surgeries?</div></div><div><h3>Material and methods</h3><div>This prospective cohort study included patients who underwent non-instrumented degenerative lumbar spine surgery, i.e. interlaminar decompression, laminectomy or lumbar microdiscectomy. We distinguished a pre-COVID cohort (between 01.03.2019 and 29.02.2020) and a COVID-cohort (between 01.03.2020 and 28.02.2021).</div></div><div><h3>Results</h3><div>We included 313 patients in the pre-COVID cohort and 194 in the COVID-cohort, reflecting a decline of 38.7 %. The number of (semi-)acute indications increased with 300 % in the COVID-cohort, which was mainly the result of more surgeries for severe and intractable radiculopathy. We also noted an increase in good clinical outcome and a decline in complications in the COVID-cohort.</div></div><div><h3>Discussion and conclusion</h3><div>The number of elective degenerative lumbar spine surgeries declined due to the COVID-19 pandemic, while the rate of (semi)-acute lumbar spinal surgeries increased strongly. The latter may be due to altered patients’ clinical presentations and surgical decision making in times of severe health care scarcity of elective surgical care.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104270"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906275","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":"Cementation strategies in the osteoporotic, metastatic, or ankylosing thoracolumbar spine in older adults: Cement-associated complications and implant failure","authors":"Ulrich J.A. Spiegl ,&nbsp;Philipp Gomon ,&nbsp;Georg Osterhoff,&nbsp;Christoph-E. Heyde,&nbsp;Philipp Pieroh","doi":"10.1016/j.bas.2025.104227","DOIUrl":"10.1016/j.bas.2025.104227","url":null,"abstract":"<div><h3>Background</h3><div>Although cement augmentation of pedicle screws increases stability, complications, such as pulmonary embolism, must be considered. One possible approach to minimize complication risk is not augmenting all pedicle screws. It remains unclear whether full augmentation is necessary or if restricted cement augmentation is sufficient regarding cement-associated complications, implant failure, or adjacent fractures.</div></div><div><h3>Research question</h3><div>Is there a difference in cement-associated complications, implant failure rate, and revision rates in non-cemented, fully augmented, and restricted cement-augmented long-segment posterior stabilization of the thoracolumbar spine?</div></div><div><h3>Methods</h3><div>In a single-center retrospective observational study, patients aged ≥60 years who underwent pedicle screw fixation of ≥3 segments in the thoracic/lumbar spine treating an osteoporotic fracture, metastatic lesion, or ankylosing spondylitis fracture were enrolled and categorized into no, full, and restricted cementation groups. Demographics, cement-associated complications, revision surgeries, implant failures, adjacent fractures, and other complications were also recorded.</div></div><div><h3>Results</h3><div>Cement leakage rate was significantly higher in the full than in the restricted cementation group (p &lt; 0.05), with no sign of pulmonary embolism in either group. Patients with osteoporotic fractures experienced implant failure and adjacent fractures significantly more frequently than those with other pathologies (p &lt; 0.05). In the full cementation group, the rate of screw cut-out with fractures of the last instrumented vertebra and adjacent fractures was the highest (p &lt; 0.05).</div></div><div><h3>Discussion and conclusion</h3><div>Restricted cementation does not result in a higher rate of complications, particularly cement-associated complications, screw cut-out, or implant failure, and appears more favorable than full cementation.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104227"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890684","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":"Fusion of 3D photorealistic lateral-to-medial brain white matter dissection and diffusion tensor imaging for dynamic visualization of key fiber tracts","authors":"Daniele Armocida ,&nbsp;Toma Spiriev ,&nbsp;Milko Milev ,&nbsp;Francesco Carbone ,&nbsp;Michael Wolf-Vollenbröker ,&nbsp;Michael Sabel ,&nbsp;Marion Rapp ,&nbsp;Jan Frederick Cornelius","doi":"10.1016/j.bas.2025.104261","DOIUrl":"10.1016/j.bas.2025.104261","url":null,"abstract":"<div><h3>Introduction</h3><div>Knowledge of fiber tract organization is vital for understanding brain connectivity and function. Integrating traditional anatomical dissection with advanced imaging methods like diffusion tensor imaging (DTI) and 3D-photographic surface scanning (photogrammetry) provides detailed visualization of white matter (WM) pathways. However, both modalities are typically presented as separate 3D-models. This study presents photorealistic 3D photogrammetric models of lateral-to-medial dissections of clinically relevant fiber tracts combined with 3D DTI fiber tract data.</div></div><div><h3>Research question</h3><div>Can the integration of photorealistic 3D photogrammetric models and DTI data enhance the understanding of WM fiber tract anatomy and improve its educational and neurosurgical applications?</div></div><div><h3>Material and methods</h3><div>One brain fixed using Klingler's method was dissected. Stepwise identification of the arcuate, superior longitudinal, inferior fronto-occipital fasciculi, uncinate fascicle, anterior commissure, Mayer's loop, and the internal capsule was documented with detailed 3D-photogrammetric models generated at each dissection step. Relevant fiber tracts were also generated from population-averaged DTI data using open-access databases and software.</div></div><div><h3>Results</h3><div>Seven photorealistic models and five integrated DTI-photogrammetry fusion 3D models were produced. Data fusion in 3D software enabled integrated models showing spatial relationships and boundaries between fiber tracts, adjustable by viewing angle and opacity changes. Combining photogrammetry with DTI-segmentation added educational value for understanding 3D-localization and fiber tract trajectories.</div></div><div><h3>Discussion and conclusion</h3><div>The photogrammetric models and DTI data presented enhance the comprehension of critical WM fiber tracts, benefiting education and surgical planning. Customizable views allow straightforward comparisons between Klingler dissection models and fully explorable DTI models, providing a comprehensive understanding of WM anatomy.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104261"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923457","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":"Radiological progression of medulloblastoma from non-existence to symptomatic mass in 42 days: Case report, kinetic analysis, and literature review","authors":"Yousef M. Odeibat ,&nbsp;Mohammad Y. Hiasat ,&nbsp;Mohammad H.M. Alhazaimeh ,&nbsp;Ala Marji ,&nbsp;Ammar S. Al-Omary ,&nbsp;Ajwad Obeidat ,&nbsp;Amer A. Alomari","doi":"10.1016/j.bas.2025.104188","DOIUrl":"10.1016/j.bas.2025.104188","url":null,"abstract":"<div><h3>Introduction</h3><div>Medulloblastoma (MB) is the most common malignant brain tumor in children, characterized by its aggressive nature and rapid growth. However, the standard practice of immediate surgical intervention limits opportunities to study the tumor's doubling time (DT), thereby restricting our understanding of its growth kinetics.</div></div><div><h3>Research question</h3><div>This study presents a pediatric case of MB that developed within 42 days of a normal MRI, with a focus on analyzing the tumor's DT and comparing it with values reported in the literature.</div></div><div><h3>Materials and methods</h3><div>Tumor kinetics were assessed using volumetric measurements obtained via 3D Slicer software. A literature review identified six studies that examined the radiological DT of medulloblastoma for comparative analysis.</div></div><div><h3>Results</h3><div>The estimated DT for the presented case ranged between 2 and 6.5 days, indicating exceptionally rapid tumor proliferation. This is shorter than previously reported cases, where DTs ranged from 6.84 to 353 days. Including the current case, the mean DT across all cases is 53.8 days.</div></div><div><h3>Discussion and conclusion</h3><div>This case highlights the potential for extremely rapid progression in MB, underscoring the aggressive nature of this tumor. The findings emphasize the importance of prompt diagnosis and intervention in MB cases. Further research into the genetic and molecular mechanisms driving its aggressive growth could support the development of targeted therapeutic strategies.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104188"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474040","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}