Brain & spine最新文献

{"title":"Kinematic limitations during stair ascent and descent in patients with adult spinal deformity","authors":"Marc Fakhoury ,&nbsp;Rami Rachkidi ,&nbsp;Karl Semaan ,&nbsp;Krystel Abi Karam ,&nbsp;Maria Saadé ,&nbsp;Elma Ayoub ,&nbsp;Celine Chaaya ,&nbsp;Ali Rteil ,&nbsp;Elena Jaber ,&nbsp;Elio Mekhael ,&nbsp;Nabil Nassim ,&nbsp;Mohamad Karam ,&nbsp;Julien Abinahed ,&nbsp;Ismat Ghanem ,&nbsp;Abir Massaad ,&nbsp;Ayman Assi","doi":"10.1016/j.bas.2024.104153","DOIUrl":"10.1016/j.bas.2024.104153","url":null,"abstract":"<div><h3>Background</h3><div>Adults with spinal deformity (ASD) are known to have spinal malalignment, which can impact their quality of life and their autonomy in daily life activities. Among these tasks, ascending and descending stairs is a common activity of daily life that might be affected.</div></div><div><h3>Research question</h3><div>What are the main kinematic alterations in ASD during stair ascent and descent?</div></div><div><h3>Methods</h3><div>112 primary ASD patients and 34 controls filled HRQoL questionnaires and underwent biplanar X-from which spino-pelvic radiographic parameters were calculated. Patients were divided into 3 groups: 44 with sagittal malalignment (ASD-Sag: PT &gt; 25°, SVA&gt;5 cm or PI-LL&gt;10°), 42 with isolated thoracic hyperkyphosis (ASD-HyperTK: TK &gt; 60°), 26 with isolated frontal spine deformity (ASD-Front: Cobb&gt;20°). All participants underwent 3D motion analysis of the whole body while ascending and descending a stair step from which kinematic waveforms were extracted.</div></div><div><h3>Results</h3><div>During stair ascent, ASD-Sag exhibited an increased thorax flexion (20 vs 5°), a decreased lumbar lordosis L1L3-L3L5 (7 vs 14°), and an increased ROM of lumbo-pelvic joint (15 vs 10°, all p &lt; 0.05), compared to controls. Similar compensations were shown while descending the stairstep. ASD-HyperTK had similar kinematic limitations as ASD-Sag but to a lesser extent. ASD-Front had normal kinematic patterns. PCS-SF36 correlated to thorax flexion (r = −0.45) and ODI was correlated to pelvic tilt ROM (r = 0.46).</div></div><div><h3>Discussion and conclusion</h3><div>ASD subjects with sagittal malalignment tend to ascend and descend stairs with increased thorax flexion, making them more prone to falls. Compensation mechanisms occur at the head and lumbo-pelvic levels to maintain balance and avoid falling forward.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104153"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933954","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 onco-functional balance in diffuse gliomas: Evolution of the concept over the past decade – And the next steps","authors":"Hugues Duffau","doi":"10.1016/j.bas.2024.104170","DOIUrl":"10.1016/j.bas.2024.104170","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104170"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030362","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":"Sagittal changes in the dens significantly slowed after 12 years of age","authors":"Zhi-Jun Sha ,&nbsp;Sheng-Yu Fu ,&nbsp;Zhao-Rui Wang ,&nbsp;Hai-Feng Hang ,&nbsp;Ai-Bing Huang","doi":"10.1016/j.bas.2025.104233","DOIUrl":"10.1016/j.bas.2025.104233","url":null,"abstract":"<div><h3>Introduction</h3><div>The odontoid process is an important component of the upper cervical, and the process of ossification for odontoid does not cease completely until skeletal maturity.</div></div><div><h3>Research question</h3><div>The aim of the study was to obtain the inclination parameters of the dens in many healthy children and to analyze the trends and variations in the inclination of the dens.</div></div><div><h3>Material and methods</h3><div>All the CT data obtained from our hospital was reviewed for next measurement. Posterior edge of odontoid angle (PEOA), anterior edge of odontoid angle (AEOA), odontoid retroflection angle (ORA), posterior dens angulation angle (PDAA), screw insertion angle (SIA), and pB-C2 line were measured and analyzed.</div></div><div><h3>Results</h3><div>A total of 219 patients were divided into 6 groups based on age at an interval of 3 years. The mean values of PEOA and PDAA dropped dramatically with age up to the ten to twelve-year group and then decreased slightly until 18 years old. Moreover, the AEOA and ORA declined gradually from birth to adulthood. These parameters were statistical significance within different age groups. However, the SIA was largely unchanged from birth to 18 years old and appeared to be independent of age. In contrast, the PB-C2 line has a distinguish distribution, with an increase up to the nine to twelve-year age group and then gradually decreased until 18 years old.</div></div><div><h3>Discussion and conclusion</h3><div>The inclination of dens was constantly changing during pediatric growth, but the trends were different. These developmental changes slow down significantly after the age of 12 years.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104233"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609858","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":"Validation of the Scandinavian neurotrauma committee guidelines – A retrospective study in region Örebro county","authors":"Samuel Jara Josefsson ,&nbsp;Dhanisha Trivedi ,&nbsp;Patrick Vigren ,&nbsp;András Büki","doi":"10.1016/j.bas.2025.104231","DOIUrl":"10.1016/j.bas.2025.104231","url":null,"abstract":"<div><h3>Introduction</h3><div>Traumatic Brain Injury (TBI) is a global health concern and a leading cause of trauma-related death worldwide. Computed tomography (CT) scan is the gold standard for screening for intracranial bleeding following TBI. Most cases of TBI are mild, with negative CT scans. Different instruments and guidelines are employed to better predict which patients need a CT scan and to minimise unnecessary radiation exposure and save resources. One such instrument is the Scandinavian Neurotrauma Committee guidelines.</div></div><div><h3>Research question</h3><div>To validate and examine adherence to the Scandinavian Neurotrauma Committee guidelines in Region Örebro County.</div></div><div><h3>Material and methods</h3><div>We executed a retrospective study with review of patient records and data analysis. Descriptive and comparative statistics were used, along with binary logistic regression analysis to account for confounding factors.</div></div><div><h3>Results</h3><div>A total of 505 cases were reviewed. Sensitivity of the guidelines was measured at 95% with specificity at 29%. The positive and negative predictive values were 0.77 and 0.69, respectively. A total of 17 false negative cases were found. One case required surgery, during which a chronic subdural hematoma was identified. Adherence to guidelines was 56%, with the lack of analysis of S100B primarily accounting for non-adherence. A total of 54 CT scans were performed outside of guideline indications.</div></div><div><h3>Discussion and conclusions</h3><div>The guidelines can effectively predict which patients need a CT scan. Increased adherence could potentially decrease the number of CT scans, while inclusion of older age limit as an independent rule-in law for CT scans would increase patient safety.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104231"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609934","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":"Functional outcome after surgical treatment for spontaneous intracerebral hemorrhages: Development of the HeMAtOma score","authors":"Magnus Sættem ,&nbsp;Ola Lønn Jenssen ,&nbsp;Øystein Vesterli Tveiten ,&nbsp;Stephanie Schipmann ,&nbsp;Rupavathana Mahesparan","doi":"10.1016/j.bas.2025.104240","DOIUrl":"10.1016/j.bas.2025.104240","url":null,"abstract":"<div><h3>Background</h3><div>Spontaneous intracerebral hemorrhage (sICH) is a critical medical emergency associated with significant morbidity and mortality. The role of surgical intervention in improving functional outcomes remains a subject of debate.</div></div><div><h3>Objective</h3><div>This study evaluates the functional outcomes of patients undergoing surgical treatment for sICH and identifies risk factors predictive of poor outcomes.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 100 patients treated surgically for sICH at Haukeland University Hospital between 2013 and 2022 was conducted. Baseline characteristics and clinical outcomes were collected. Functional outcomes were assessed using the modified Rankin Scale (mRS) at three months post-surgery. Independent risk factors for unfavorable outcomes (mRS ≥4) were identified through logistic regression.</div></div><div><h3>Results</h3><div>The mean age was 65.5 years (56 % males). At three months, 54 % of patients had an unfavorable outcome, including a 23 % mortality rate. Independent risk factors for poor outcomes included age ≥60 years (OR 7.8, 95 % CI 1.684–36.3, p = 0.009), oral anticoagulant use (OR 10.4, 95 % CI 1.495–72.665, p = 0.018), and hemorrhage location in the basal ganglia (OR 18.5, 95 % CI 3.398–100.717, p &lt; 0.001) or motor cortex (OR 8.6, 95 % CI 2.134–34.973, p = 0.003). These factors formed the basis of a new scoring system—the HeMAtOma score—which demonstrated good discriminatory ability (AUC 0.688) for predicting outcomes.</div></div><div><h3>Conclusion</h3><div>Functional outcomes following surgical treatment for sICH remain poor in many cases. The HeMAtOma score provides a practical tool for predicting surgical outcomes, aiding clinical decision-making in emergency settings. Future prospective studies are needed to validate the score.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104240"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769256","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":"Decompressive craniectomy following subarachnoid hemorrhage: A prospective Swedish multicenter study","authors":"Bryndís Baldvinsdóttir ,&nbsp;Erik Kronvall ,&nbsp;Elisabeth Ronne-Engström ,&nbsp;Per Enblad ,&nbsp;Paula Klurfan ,&nbsp;Johanna Eneling ,&nbsp;Peter Lindvall ,&nbsp;Helena Aineskog ,&nbsp;Steen Friðriksson ,&nbsp;Mikael Svensson ,&nbsp;Peter Alpkvist ,&nbsp;Jan Hillman ,&nbsp;Ola G. Nilsson","doi":"10.1016/j.bas.2025.104218","DOIUrl":"10.1016/j.bas.2025.104218","url":null,"abstract":"<div><h3>Introduction</h3><div>Decompressive craniectomy (DC) in patients with severe aneurysmal subarachnoid hemorrhage (aSAH) can be a life-saving procedure. The aim of this nationwide prospective study was to investigate the use of DC in aSAH patients in Sweden.</div></div><div><h3>Research question</h3><div>To explore the risk factors and functional outcome associated with DC in patients with aSAH.</div></div><div><h3>Material and methods</h3><div>Patients treated for aSAH at all neurosurgical centers in Sweden during a 3.5-year period (2014–2018) were prospectively registered. Clinical, radiological and treatment-related factors with regard to DC were analyzed using Chi-Square and logistic regression analysis. Functional outcome was assessed by the extended Glasgow outcome scale one year after the bleeding.</div></div><div><h3>Results</h3><div>During the study period, 1037 patients were treated for aSAH. Thirty-five patients (3.4%) underwent DC. At one year follow-up, 25 of these (71%) had unfavorable functional outcome. Multivariate logistic regression analysis revealed that poor clinical grade before aneurysm treatment, middle cerebral artery (MCA) aneurysm, edema on the initial computed tomography (CT), and adverse events during aneurysm occlusion were independent and significant risk factors for performing DC.</div></div><div><h3>Discussion and conclusion</h3><div>DC is relatively uncommon in aSAH patients and is related to increased risk of unfavorable outcome. However, favorable functional outcome was seen in 29% of patients with DC. Adverse events during aneurysm occlusion were significant risk factors for DC.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104218"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487943","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":"Is there a weekend effect in severe traumatic brain Injury? An observational, population-based study from the Norwegian Trauma registry","authors":"Joakim Stray Andreassen ,&nbsp;Mattis A. Madsbu ,&nbsp;David Andreas Thomas Werner ,&nbsp;Clemens Weber","doi":"10.1016/j.bas.2025.104263","DOIUrl":"10.1016/j.bas.2025.104263","url":null,"abstract":"<div><h3>Introduction</h3><div>Traumatic brain injury is prevalent and with severe injury the mortality is high. The aim of this study was to explore differences in mortality rates between weekday and weekend admissions for patients with severe traumatic brain injury (TBI) in Norway based on data from the National Trauma Registry of Norway (NTR).</div></div><div><h3>Research question</h3><div>Are mortality rates higher for patients with severe traumatic brain injury admitted on weekends compared to weekdays?</div></div><div><h3>Materials and methods</h3><div>This study is an observational cohort study based on prospectively collected, population-based data from the NTR. The study period was between January 01, 2017 and December 31, 2020 and included all patients with severe TBI registered in the database.</div></div><div><h3>Results</h3><div>During the 4 years-study period 627 patients with severe TBI were identified; the median age was 53.0 years (IQR 32.0-71.0). Weekend admissions involved significantly younger patients with a median age of 50.0 years compared to a median age of 57.0 years on weekdays (p = 0.013). Overall, the 30-day mortality rate was 39 %, with higher mortality observed on weekdays compared to weekends (43 % vs. 34 %; p = 0.025). Logistic regression analysis showed that age and higher AIS head injury severity were significantly associated with 30-day mortality, while admission timing (weekend vs. weekday) showed no association.</div></div><div><h3>Discussion and conclusion</h3><div>Weekend admissions in severe TBI are frequent and involves younger patients compared to weekdays. Our study did not find a weekend effect on the mortality rate for severe TBI in Norway based on data from the NTR.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104263"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912626","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":"Artificial intelligence and chordoma: A scoping review of the current landscape and future directions","authors":"Eddie Guo ,&nbsp;Rafael D. Sanguinetti ,&nbsp;Lyndon Boone ,&nbsp;Jiawen Deng ,&nbsp;Husain Shakil ,&nbsp;Mehul Gupta","doi":"10.1016/j.bas.2025.104271","DOIUrl":"10.1016/j.bas.2025.104271","url":null,"abstract":"<div><h3>Introduction</h3><div>Chordomas are rare, locally aggressive tumours that present significant treatment challenges due to their proximity to critical neurovascular structures. Artificial intelligence (AI) methodologies have shown promise in enhancing diagnostic precision, surgical planning, and prognostication in various cancers.</div></div><div><h3>Research question</h3><div>What is the current landscape of AI applications in chordoma management, and what are the key limitations and future directions for integrating AI into clinical practice for this rare malignancy?</div></div><div><h3>Materials and methods</h3><div>We conducted a scoping review following the PRISMA-ScR guidelines and the Arksey and O'Malley framework. A search of five databases with an end date of November 9, 2024, identified peer-reviewed studies assessing AI or machine learning applications in chordoma management. Data extraction focused on study characteristics, methodologies, clinical tasks, and performance metrics.</div></div><div><h3>Results</h3><div>Twenty-one studies published between 2017 and 2024 were included, encompassing 5486 patients. The studies addressed diverse clinical tasks: 7 focused on differentiating chordomas from other tumours or classifying subtypes, 6 on survival prediction, 2 on tumour segmentation, 2 on outcome prediction, and 4 miscellaneous tasks. Common algorithms used included convolutional neural networks, support vector machines, random forests, and clustering algorithms. Limitations identified across studies included small sample sizes, single-center data, reliance on single data modalities, and issues with model interpretability.</div></div><div><h3>Discussion and conclusion</h3><div>AI applications in chordoma management show potential in improving diagnostic accuracy, surgical planning, and prognostication. Future research should focus on collaborative efforts for larger, diverse datasets with external validation cohorts, interpretable multimodal models, and validation through prospective clinical trials.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104271"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906277","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":"Resolution of tonsillar herniation and syringomyelia after resection of supratentorial large meningioma","authors":"Chengjian Lou,&nbsp;Linkai Wang,&nbsp;Xiaoli Pan,&nbsp;Dan Xu,&nbsp;Yili Chen","doi":"10.1016/j.bas.2025.104312","DOIUrl":"10.1016/j.bas.2025.104312","url":null,"abstract":"<div><h3>Background</h3><div>Chiari malformation type I (CM1) with syringomyelia caused by supratentorial lesions is extremely rare, and the mechanism has not been well explained.</div></div><div><h3>Methods</h3><div>A 25-year-old female patient with no significant medical history who presented with progressive pain in the left neck for one month. MRI examination showed a giant meningioma in the trigone of the lateral ventricle accompanied with CM1 and syringomyelia.</div></div><div><h3>Results</h3><div>The patient underwent left parietal-occipital cortical approach surgery to remove the giant tumor in the trigone of the left lateral ventricle. The neck pain and left upper limb numbness were relieved immediately. CM1 and syringomyelia disappeared without posterior fossa decompression after surgical resection of the supratentorial tumor.</div></div><div><h3>Conclusion</h3><div>This case shows that supratentorial space-occupying lesions (SOLs) causing acquired Chiari malformation (ACM) and syringomyelia is closely related to the tumor oppresses and increases the pressure of the posterior cranial fossa. Posterior fossa decompression was not needed for ACM and syringomyelia.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104312"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579378","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":"Anterior temporal lobectomy and selective AmygdaloHippocampectomy complications across Europe: review, meta-analysis, and Delphi consensus","authors":"Maria D. Karagianni ,&nbsp;Olaf E.M.G. Schijns ,&nbsp;Alexandros Brotis ,&nbsp;Anastasia Tasiou ,&nbsp;Christian Auer ,&nbsp;Thomas Blauwblomme ,&nbsp;Marcelo Budke ,&nbsp;Alexandre Rainha Campos ,&nbsp;Santiago Candela-Cantó ,&nbsp;Hans Clusmann ,&nbsp;Alessandro Consales ,&nbsp;Massimo Cossu ,&nbsp;Daniel Delev ,&nbsp;Christian Dorfer ,&nbsp;Georg Dorfmüller ,&nbsp;Arild Egge ,&nbsp;Lorand Eröss ,&nbsp;Sarah Ferrand-Sorbets ,&nbsp;Flavio Giordano ,&nbsp;Cihan Isler ,&nbsp;Marie Krüger","doi":"10.1016/j.bas.2025.104304","DOIUrl":"10.1016/j.bas.2025.104304","url":null,"abstract":"<div><h3>Introduction</h3><div>Epilepsy is a neurological disorder affecting over 50 million people globally, with around 30 % of them classified as having drug-resistant epilepsy (DRE). Temporal lobe epilepsy (TLE) is the most frequently encountered type of surgically treated epilepsy. The primary surgical approaches for TLE include anterior temporal lobectomy (ATL) and selective amygdalohippocampectomy (selAH).</div></div><div><h3>Research question</h3><div>This study sought to gather expert European consensus on surgical strategies and complication rate for ATL and selAH, in both adult and pediatric patients.</div></div><div><h3>Materials and methods</h3><div>A modified Delphi technique was employed, with 39 experienced epilepsy surgeons from 35 different European centers. A 22-item questionnaire addressed key surgical considerations, including mortality, morbidity, neurological deficits, infection rates, and potential psychiatric and cognitive complications.</div></div><div><h3>Results</h3><div>The survey had a 43 % response rate. Mortality rates for both surgical approaches ranged between 0 and 1 %. Visual field deficits (VFDs) were more frequently observed after ATL (over 16 %) compared to selAH (2–10 %). Permanent motor deficits were rare (&lt;2 %), while complications such as infections and hematomas were reported in 0–2 % and less than 5 % of cases, respectively for both procedures. While psychiatric and cognitive complications were acknowledged, no consensus was reached regarding their prevalence or screening methods.</div></div><div><h3>Discussion</h3><div>The results underscore the value of advanced imaging, thorough preoperative evaluation, and intraoperative monitoring. Future research is needed to refine outcome optimization and standardize training protocols.</div></div><div><h3>Conclusions</h3><div>Consensus was achieved on critical aspects of surgical planning and complication management, providing support for the development of standardized practices in temporal lobe epilepsy surgery.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"5 ","pages":"Article 104304"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570285","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}