Acta Neurochirurgica最新文献

{"title":"Targeting health-related quality of life issues not found with functional outcome measures a year after aneurysm subarachnoid hemorrhage in a Swedish national cohort","authors":"Helena Aineskog,&nbsp;Bryndís Baldvinsdóttir,&nbsp;Ola G. Nilsson,&nbsp;Asgeir S. Jakola,&nbsp;Erik Kronvall,&nbsp;Elisabeth Ronne Engström,&nbsp;Paula Klurfan,&nbsp;Peter Alpkvist,&nbsp;Mikael Svensson,&nbsp;Jan Hillman,&nbsp;Peter Lindvall","doi":"10.1007/s00701-026-07059-z","DOIUrl":"10.1007/s00701-026-07059-z","url":null,"abstract":"<div><h3>Purpose</h3><p>Outcome after aneurysmal subarachnoid hemorrhage (aSAH) is often devastating with life time issues also for independent survivors. We aimed to identify health related quality of life (HRQoL) issues in this favorable functional outcome group compared to a sex and age matched general population.</p><h3>Methods</h3><p>We have analyzed data from 634 Swedish aSAH patients from a national prospective study ranging between 2014 and 2018. One year after ictus, functional outcome was analyzed using Glasgow Outcome Scale Extended (GOSE) and HRQoL assessed by Euro-quality of life—5 dimensions—3 levels (EQ-5D-3L). Favorable GOSE (5–8) were found in 471 patients. Age- and sex-matched populations were created by published data from a cross-sectional cohort of 32,597 people living in Stockholm County in 2006. Odds ratios (ORs) for rating a specific EQ-5D-3L level were calculated for each domain. Significance was set at α = 0.001.</p><h3>Results</h3><p>Patients reported less mobility problems than the matched general population (9.6% vs 14.7%; OR 0.62 <i>p</i> = 0.002). However, with usual activities significantly more difficulties with moderate, (<i>24.0% vs 10.9%;</i> OR 2.58, <i>p</i> &lt; .001) and any problems (27.0% vs 12.5%; OR 2.58, <i>p</i> &lt; .001) were reported. More issues with extreme anxiety/depression were also reported ((5.3% vs 2.8%; OR 1.94; <i>p</i> = 0.002). Unfavorable GOSE patients were doing worse than the matched population in all levels and dimensions measured (Online Resource 1, 2, 3 and 4).</p><h3>Conclusion</h3><p>Although patients with favorable functional outcome report good or better mobility compared to their age and sex matched general population, they have significantly more issues with usual activities a year after aSAH more extreme issues with anxiety/depression were also reported To our knowledge, this is the first time EQ-5D-3L data is compared in a national group of aSAH patients with favorable functional outcome to a sex and age matched general population.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"168 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-026-07059-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149189790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How I do it: meningioangiomatosis of the sylvian fissure. The need for a tailored functional neurosurgery","authors":"Sergio Corvino,&nbsp;Giuseppe Corazzelli,&nbsp;Tamara Ius,&nbsp;Giuseppe Catapano","doi":"10.1007/s00701-026-07007-x","DOIUrl":"10.1007/s00701-026-07007-x","url":null,"abstract":"<div><h3>Background</h3><p>Meningioangiomatosis is a formidable neurosurgical challenge due to its heterogeneous nature and anatomical localization which often make impossible gross total resection. Surgery is reserved for drug-resistant epileptic seizures aiming their control.</p><h3>Method</h3><p>We describe a case of meningioangiomatosis of the right sylvian fissure involving the M1-M2 segments of right middle cerebral artery. A subtotal lesion resection, completed with disconnection surgery through multiple subpial circumferential transections was performed.</p><h3>Conclusion</h3><p>To underline the efficacy of the disconnection surgery and the pivotal role of intraoperative electrophysiologic assessment for tailoring the surgical resection at the presumed ictal onset zone.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"168 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of endoscopic endonasal far-medial, far-lateral transcondylar and combined approaches to the foramen magnum region: volumetric analysis and quantitative insights on surgical exposure and maneuverability","authors":"Rachel Blue,&nbsp;Yan Zhou,&nbsp;Kamila Bond,&nbsp;Sonia Ajmera,&nbsp;Reinier Alvarez,&nbsp;Ross Moseley,&nbsp;Patrick Hosokawa,&nbsp;A. Samy Youssef","doi":"10.1007/s00701-026-07039-3","DOIUrl":"10.1007/s00701-026-07039-3","url":null,"abstract":"<div><h3>Background</h3><p>Surgical access to the anterior craniovertebral junction (CVJ) and foramen magnum region remains technically challenging due to dense neurovascular anatomy and limited working corridors. Although the far-lateral transcondylar and endoscopic far-medial approaches are both employed clinically, direct quantitative comparisons of maneuverability and volumetric exposure are still lacking.</p><h3>Objective</h3><p>To quantitatively assess and compare surgical maneuverability, anatomic limits and volume of exposure of the endoscopic far-medial, far-lateral, and combined approaches.</p><h3>Methods</h3><p>Five latex-injected cadaveric heads underwent dissection via an endoscopic endonasal far-medial approach (EEFM), contralateral far-lateral transcondylar approach (FL), and a combined approach. Surgical freedom, horizontal and vertical angles of attack, and volumetric exposure were measured using neuronavigation and 3D CT-based segmentation. Site-specific measurements were obtained at the hypoglossal canal, jugular foramen, and vertebrobasilar junction. Statistical comparisons were made using Wilcoxon rank-sum tests.</p><h3>Results</h3><p>The FL demonstrated significantly greater surgical freedom (363 mm² vs. 6.8 mm², <i>P</i> = .01), horizontal angle of attack (99° vs. 8.1°, <i>P</i> = .01), and vertical angle of attack (78° vs. 15.4°, <i>P</i> = .01) compared to the EEFM. The EEFM yielded the smallest mean total volume (5.53 ± 2.01 cm³), primarily concentrated in the anteromedial compartment (4.70 ± 1.67 cm³). The FL offered a significantly larger mean total exposure (15.12 ± 1.93 cm³, <i>p</i> &lt; 0.001), dominated by posterolateral access (12.60 ± 2.16 cm³, <i>p</i> &lt; 0.001). The combined approach provided the greatest overall exposure volume (18.76 ± 3.58 cm³), with substantial access to both the posterolateral (12.90 ± 2.32 cm³) and anteromedial (5.86 ± 1.95 cm³) compartments.</p><h3>Conclusion</h3><p>The far-lateral approach offers superior surgical freedom and posterolateral exposure, while the far-medial endoscopic approach provides a direct but limited midline corridor predominantly anteromedial foramen magnum lesions. The combined approach maximizes volumetric access and should be considered for extensive foramen magnum lesions particularly engulfing or anterior to neurovascular structures.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"168 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes following a hospital-wide transition from enoxaparin to tinzaparin for venous thromboembolism prophylaxis in neurosurgical patients","authors":"Leonard Ritter,&nbsp;Adrian Liebert,&nbsp;Jens Weigel,&nbsp;Karl M. Schebesch,&nbsp;Thomas Eibl","doi":"10.1007/s00701-026-07027-7","DOIUrl":"10.1007/s00701-026-07027-7","url":null,"abstract":"<div><h3>Objective</h3><p>Venous thromboembolism (VTE) prophylaxis is a key component of neurosurgical care, with low-molecular-weight heparins (LMWHs) representing the standard pharmacological approach. While enoxaparin is well established, the evidence regarding the efficacy and safety of tinzaparin in neurosurgical patients remains limited. This study aimed to compare the incidence of VTE and postoperative rebleeding between enoxaparin and tinzaparin in a large cohort of neurosurgical patients.</p><h3>Methods</h3><p>Following a standardized institutional switch from enoxaparin to tinzaparin in 2021, we conducted a retrospective cohort study including all adult patients undergoing neurosurgical procedures during the 2.5-year periods before and after the change. Patients were stratified according to their perioperative VTE risk. The primary outcome was imaging-confirmed symptomatic VTE during hospitalization, and the secondary outcome was postoperative rebleeding requiring surgical evacuation. A multivariable logistic regression analysis was performed to adjust for potential confounders.</p><h3>Results</h3><p>A total of 4,888 patients were included. Overall, 51 symptomatic VTE events occurred (1.04%). In low risk patients (Group A), VTE incidence did not differ significantly between enoxaparin and tinzaparin (0.44% vs. 0.86%, <i>p</i> = 0.35). In moderate-to-high risk patients (Group B), VTE occurred significantly more frequently with tinzaparin than enoxaparin (1.67% vs. 0.84%, <i>p</i> = 0.04), driven predominantly by PE (1.05% vs. 0.18%, <i>p</i> = 0.01), while DVT rates were comparable (0.62% vs. 0.67%, <i>p</i> = 0.87). Multivariable analysis in Group B confirmed lower odds of VTE with enoxaparin (OR 0.475, 95% CI 0.246–0.919, <i>p</i> = 0.027). Postoperative rebleeding rates did not differ significantly between treatment groups. The increase in PE coincided with increased CTA utilization and showed no clear temporal step change following the switch to tinzaparin.</p><h3>Conclusion</h3><p>Both enoxaparin and tinzaparin were associated with low VTE rates and comparable postoperative rebleeding rates. Although higher VTE rates with tinzaparin were observed in the medium-to-high risk group, the predominance of PE, increased CTA utilization, and absence of a temporal step change limit a causal interpretation. These findings should therefore be considered hypothesis-generating rather than evidence of superior efficacy of either agent.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"168 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How I do it: microsurgical extraforaminal sequestrectomy through a midline intertransverse approach","authors":"Victor E. Staartjes,&nbsp;Adrian Elmi-Terander,&nbsp;Gunnar Nilsson,&nbsp;Mario Ruiz","doi":"10.1007/s00701-026-07040-w","DOIUrl":"10.1007/s00701-026-07040-w","url":null,"abstract":"<div><h3>Background</h3><p>Several surgical approaches exist for extraforaminal (far lateral) lumbar disc herniations, including paraspinal Wiltse-type, interlaminar, lateral intertransverse, and combined medial–lateral techniques.</p><h3>Method</h3><p>We present microsurgical extraforaminal sequestrectomy through a midline intertransverse approach, chosen for familiar anatomy, minimal facet joint resection, and avoidance of a muscle-splitting trajectory. Unilateral subperiosteal dissection exposes the isthmus, facet margin, and transverse processes with the intertransverse ligament; the facet margin is removed with a straight osteotome, the ligament resected, the intertransverse artery coagulated, and the nerve root and disc space exposed for sequestrectomy.</p><h3>Conclusion</h3><p>This approach provides effective sequestrectomy while preserving spinal stability using familiar midline anatomy.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"168 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-026-07040-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The retrosigmoid trans–middle cerebellar peduncle approach for pontine cavernous malformations: multicenter experience","authors":"Shadi Al-Afif,&nbsp;Elvis J. Hermann,&nbsp;Anton Früh,&nbsp;Julius Oltmanns,&nbsp;Johannes Woitzik,&nbsp;Peter Vajkoczy,&nbsp;Joachim K. Krauss","doi":"10.1007/s00701-026-07043-7","DOIUrl":"10.1007/s00701-026-07043-7","url":null,"abstract":"<div><h3>Background</h3><p>Intrinsic pontine cavernous malformations represent one of the most challenging entities in neurosurgery because of their deep location and close proximity to critical brainstem nuclei and long tracts. Traditional surgical approaches are associated with considerable morbidity due to transgression of eloquent neural tissue. The identification of the trans-middle cerebellar peduncle (trans-MCP) approach, has enabled safer access to selected pontine lesions. However, apart from publications of the center where the trans-MCP approach was introduced (Phoenix), little is known about its use and surgical outcome.</p><h3>Methods</h3><p>Patients with symptomatic intrinsic pontine cavernous malformations were treated via a retrosigmoid trans-MCP approach at three academic neurosurgical centers. Data were obtained from institutional databases and included clinical presentation, imaging characteristics, surgical details, and follow-up outcomes.</p><h3>Results</h3><p>Five patients (3 men, 2 women; mean age 44.8 years) were included. All lesions were intrinsically located within the pons without pial or ependymal surface presentation and demonstrated typical hemorrhage MRI characteristics with mass effect on adjacent structures. The median preoperative mRS was 4 (range 1–4), and recurrent hemorrhage before surgery occurred in 3/5 patients. The retrosigmoid trans–MCP approach was performed with neurophysiological monitoring. Gross total resection was achieved in all instances. Postoperative neurological morbidity occurred in all five patients but was predominantly transient. At follow-up (range 4–14 months), no residual or recurrent cavernous malformations were detected on MRI. Neurological status had improved in all cases. Residual symptoms were minor and included mild ataxia, facial hypesthesia, dysarthria, or vertigo. Functional outcomes were favorable, with a median follow-up mRS of 1 (range 1–2).</p><h3>Conclusion</h3><p>The retrosigmoid trans–MCP approach represents a relatively safe, effective, and reproducible surgical strategy for selected pontine cavernous malformations. When performed by experienced surgeons, this approach can be successfully implemented across specialized centers.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"168 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-026-07043-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How I do it. Foramen magnum meningiomas. Surgical tenets for a unique pathology of a transition zone","authors":"Sergio Corvino,&nbsp;Antonio Bernardo,&nbsp;Giuseppe Corazzelli,&nbsp;Giuseppe Catapano","doi":"10.1007/s00701-026-07006-y","DOIUrl":"10.1007/s00701-026-07006-y","url":null,"abstract":"<div><h3>Background</h3><p>Foramen magnum meningiomas (FMMs) represent significant neurosurgical challenge because of their intimate relationship with highly functional and vital neurovascular structures.</p><h3>Method</h3><p>We discuss and illustrate technical nuances to resect type 3 FMMs with anterolateral dural attachment, causing compression and displacement of the medulla oblongata, accessory nerve and upper cervical spinal cord, with encasement of vertebral artery, through far lateral approach.</p><h3>Conclusion</h3><p>Proper extradural preparation, early cerebrospinal fluid drainage, sectioning of dentate ligament, working between the nerve rootlets from caudal to rostral and from lateral to medial can enhance the safety and extent of resection.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"168 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal changes in pain catastrophizing and multidimensional health outcomes after passive-recharge burst spinal cord stimulation: a cohort study with follow-up to two years","authors":"Johan Wänman,&nbsp;Jakob Östman,&nbsp;Pedram Tabatabaei","doi":"10.1007/s00701-026-07033-9","DOIUrl":"10.1007/s00701-026-07033-9","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate longitudinal changes in pain catastrophizing following spinal cord stimulation (SCS) and to determine whether baseline pain catastrophizing was associated with patient-reported outcomes over two years after implantation.</p><h3>Methods</h3><p>A retrospective cohort study using prospectively collected data from 58 patients undergoing SCS implantation. Pain catastrophizing was assessed using the Pain Catastrophizing Scale (PCS), and pain intensity and multidimensional health outcomes were assessed using the Numeric Rating Scale (NRS) and PROMIS-29, respectively. The primary outcome was change in PCS from baseline. Analyses of PCS were restricted to patients with available baseline PCS data (<i>n</i> = 38). PCS was assessed at baseline and at 3, 6, 12, and 24 months after SCS implantation. Changes from baseline were evaluated using paired t-tests. Associations between baseline PCS and post-implant outcomes were assessed using Spearmans rank correlation.</p><h3>Results</h3><p>Among the 38 patients with baseline PCS data, mean PCS scores decreased from 24 ± 12 at baseline to 14.0 ± 11 at 24 months (<i>p</i> &lt; 0.001), with reductions across all three PCS subgroups. Physical function, pain interference, pain intensity, fatigue, anxiety, depression, and participation in social roles also improved significantly during follow-up, whereas sleep disturbance showed no significant change. Baseline PCS was not correlated with most post-implant PROMIS-29 domains.</p><h3>Conclusion</h3><p>PCS decreased substantially and persistently following SCS implantation among patients with available baseline PCS data. Baseline PCS was not significantly associated with subsequent pain response or most patient-reported outcomes. PCS may represent a dynamic outcome measure that complements conventional pain-intensity assessment.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"168 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-026-07033-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood C-reactive protein and white blood cells trajectories and associations with clinical parameters and complications in the acute phase after subarachnoid hemorrhage","authors":"Pavlos Vlachogiannis,&nbsp;Anders Hånell,&nbsp;Johan Wikström,&nbsp;Per Enblad,&nbsp;Lars Hillered,&nbsp;Elisabeth Ronne-Engström","doi":"10.1007/s00701-026-07034-8","DOIUrl":"10.1007/s00701-026-07034-8","url":null,"abstract":"<div><h3>Background</h3><p>Inflammation holds a central role in the pathophysiology of subarachnoid hemorrhage (SAH). Two common non-specific inflammatory markers, C – reactive protein (CRP) and White Blood Cells (WBC), were analyzed in blood of SAH patients and their temporal patterns and associations with bleeding severity and complications were studied.</p><h3>Methods</h3><p>The charts of 552 SAH patients admitted between 01.01.2015 – 31.12.2019 were retrospectively analyzed through our clinic’s database. Blood concentrations of CRP (reference range &lt; 5 mg/L) and WBC counts (reference range 3.5–9 × 10⁹/L) were extracted and their temporal trajectories from Day 1 to Day 10 post ictus were recorded. Associations of Day 1 and Day 4 CRP and WBC values with clinical parameters including age, sex, identifiable bleeding source, bleeding severity based on Fisher scale, neurologic status on admission based on Reaction Level Scale-85 (RLS-85) score, occurrence of External Ventricular Drainage (EVD), infections, and Delayed Ischemic Neurologic Deficit (DIND) were examined. Mann Whitney U test was used for univariate analyses in dichotomized groups and General linear/nonlinear models with best subsets of variables based on Akaike’s Information Criterion for multivariate analyses.</p><h3>Results</h3><p>CRP peaked on Day 4 and WBC on Day 1. Univariate analyses showed that patients with more severe hemorrhage (i.e., identifiable bleeding source, Fisher 3–4, RLS 4–8, EVD indication) and complications (infections, DIND) had significantly higher CRP and WBC values on Day 1 and Day 4. Multivariate analyses showed that DIND was among the variables included in the three models most likely to be associated with higher Day 4 WBC but not CRP values.</p><h3>Conclusions</h3><p>More severe bleeding and occurrence of complications in the early phase of SAH are associated with a more intense inflammatory response. An increase in WBC (rather than CRP) around Day 4 post ictus may be associated with the occurrence of DIND.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"168 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-026-07034-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dissection of superficial temporal artery for STA-M4 bypass, an integrated method. How I do it","authors":"Mohammed O. Alalfi,&nbsp;Sajjad Muhammad","doi":"10.1007/s00701-026-07025-9","DOIUrl":"10.1007/s00701-026-07025-9","url":null,"abstract":"<div><h3>Background</h3><p>Extracranial-intracranial (EC-IC) bypass is an effective revascularization technique for flow augmentation in conditions including Moyamoya disease and ischemic cerebrovascular disorders. Preparation of donor vessel is a key step for EC-IC Bypass surgery. This procedure involves careful dissection and liberation of the Superficial Temporal Artery with subsequent anastomosis to branches of the middle cerebral artery re-establishing flow.</p><h3>Methods</h3><p>This article outlines a comprehensive surgical strategy, emphasizing anatomical considerations, procedural nuances, and integration of different schools of dissection with video demonstration making it didactically efficient.</p><h3>Conclusion</h3><p>Combined technique for STA dissection is fast, effective and ideal to avoid complications or adverse events.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"168 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-026-07025-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}