Acta Neurochirurgica最新文献

{"title":"Socioeconomic influences on survival outcome in idh-wildtype glioma patients: examining the role of age, education, and lifestyle factors.","authors":"Matthias Demetz, Aleksandrs Krigers, Julia Klingenschmid, Claudius Thomé, Christian F Freyschlag, Johannes Kerschbaumer","doi":"10.1007/s00701-025-06594-5","DOIUrl":"https://doi.org/10.1007/s00701-025-06594-5","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic factors influence survival in different cancer types. This study aimed to assess the impact of various socioeconomic factors, including education, marital status, lifestyle, and social network, on survival in patients with Isocitrate dehydrogenase (IDH) wildtype gliomas.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 309 adult patients with de novo diagnosed IDH wildtype gliomas who underwent surgical treatment at our institution between 2014 and 2022. Socioeconomic factors, including education, marital status, employment, language, lifestyle (alcohol abuse, smoking, BMI), and social network were assessed. Progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier and Cox regression models.</p><p><strong>Results: </strong>Education, alcohol abuse, and age significantly influenced OS. Patients with higher education had significantly lower tumor volumes (p = 0.037) and longer survival (p = 0.001). Alcohol abuse was associated with significantly shorter OS (8.6 vs. 17.9 months, p = 0.034). Patients aged over 65 years showed significantly shorter OS in this study (14.9 months vs 33.2 months, p < 0.001). Native and non-native German speakers had similar outcomes. Marital status did not significantly affect survival.</p><p><strong>Conclusion: </strong>Socioeconomic and lifestyle factors, especially higher education and alcohol abuse, significantly impact survival in IDH wildtype glioma patients. These findings suggest that, in addition to molecular features and oncological treatment, socioeconomic and lifestyle factors also play a crucial role in influencing the prognosis of patients with IDH wildtype gliomas.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"178"},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video gaming facilitates adaptation to surgical exoscopes - a laboratory experiment.","authors":"Adam Yousfi, Anni Pohjola, Ville Vasankari, Ahmad Hafez, Martin Lehecka","doi":"10.1007/s00701-025-06589-2","DOIUrl":"10.1007/s00701-025-06589-2","url":null,"abstract":"<p><strong>Introduction: </strong>Digital 3D exoscopes are novel alternatives for operating microscopes in microneurosurgery. We studied the potential benefits of a background in video gaming on adaptation to exoscopic microsurgery. Such effects have not been reported before.</p><p><strong>Methods: </strong>Twenty preclinical medical and dental students with no surgical experience participated in our study. Eleven (gamer group) were proficient (> 1000 h) in video gaming, whereas nine (control group) had no to very little gaming experience (< 500 h). We developed a microsurgical training model for evaluating adaptation to exoscope use in a manual task. Each student completed the task thrice in a row. We evaluated handling of the exoscope, fine motor skills, and the duration of each performance.</p><p><strong>Results: </strong>Prior video gaming experience correlated with superior adaptation to the exoscope. Gamers moved and tilted the exoscope camera less often than the control group but nevertheless obtained good visuals. The gamer group also completed all tasks faster (median 10 min 14 s) than the control group (median 13 min 01 s). All students improved in their task completion times over the test period. Similar fine motor skills were observed in both the gamer and the control group.</p><p><strong>Conclusion: </strong>Prior experience in video gaming was associated with better adaptability to the exoscope. This may be due to superior 3D perception, acquired playing video games.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"177"},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144493398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression after aneurysmal subarachnoid hemorrhage: development of a screening tool and discharge user interface.","authors":"Stefan W Koester, Brandon K Hoglund, Joelle N Hartke, Robert F Rudy, Ashutosh P Jadhav, Andrew F Ducruet, Felipe C Albuquerque, Joshua S Catapano, Laura A Snyder, Michael T Lawton","doi":"10.1007/s00701-025-06567-8","DOIUrl":"10.1007/s00701-025-06567-8","url":null,"abstract":"<p><strong>Background: </strong>A method for identification of chronic depression after aneurysmal subarachnoid hemorrhage (aSAH), risk stratification, and counseling is needed. This study aimed to develop a scoring system for post-aSAH depression and a user interface to supplement discharge counseling for patients.</p><p><strong>Methods: </strong>Based on a published prediction model for posttreatment depression risk among aSAH patients, a scale was developed using the beta coefficients of the final predictive model. The 5-point scale was based on 4 characteristics: tobacco use (2 points), chronic obstructive pulmonary disease (1 point), diabetes (1 point), and nonsaccular aneurysm type (1 point). A score of 1 was defined as low risk, a score of 2 or 3 was defined as medium risk, and a score of 4 or 5 was defined as high risk. The scale was then validated in a cohort of 514 patients treated at a single center. An interactive application was developed.</p><p><strong>Results: </strong>The rate of posttreatment depression among aSAH patients was 29.6% (152 of 514). The low-risk group had a nonsignificant increase in depression risk (relative risk [RR] [95% CI] = 0.89 [0.59-1.33], p = 0.71) compared with those with a score of 0. Significant increases in depression risk were found in the medium-risk (RR [95% CI] = 1.78 [1.34-2.37], p < 0.001) and high-risk (RR [95% CI] = 2.29 [1.28-4.09], p < 0.001) groups.</p><p><strong>Conclusions: </strong>A substantial percentage of patients in our cohort experienced major depressive disorder symptoms after aSAH treatment. An easy-to-use prediction and risk stratification tool for posttreatment depression among aSAH patients is available.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"176"},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473739","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":"NOVA2 expression in pituitary gland and in functioning and non-functioning pituitary adenomas: a preliminary study.","authors":"Pasquale De Bonis, Francesca Ghidoni, Veronica Tisato, Erika Rimondi, Roberta Gafà, Michele Picciocchi, Maria Chiara Zatelli, Alba Scerrati, Michele Alessandro Cavallo, Alba Madoglio","doi":"10.1007/s00701-025-06576-7","DOIUrl":"10.1007/s00701-025-06576-7","url":null,"abstract":"<p><strong>Purpose: </strong>Pituitary adenomas (PAs) are generally benign tumors with varying clinical presentations. While functioning PAs (FPAs) secrete hormones leading to distinct endocrine disorders, non-functioning PAs (NFPAs) often manifest with mass effect symptoms. Current medical therapies for PAs have limited efficacy, particularly for NFPAs. This highlights the need for new diagnostic and therapeutic targets. This study aimed to investigate the expression of Neuro-Oncological Ventral Antigen 2 (NOVA2), a factor involved in alternative splicing, in normal pituitary glands and PAs, to evaluate its potential as a novel therapeutic target.</p><p><strong>Methods: </strong>Tissue samples from 12 PA patients (9 NFPAs and 3 FPAs) and 8 normal pituitary glands were collected. Immunohistochemical analysis was performed to assess NOVA2 expression. Semi-quantitative evaluation of NOVA2 staining was conducted using Histoscore.</p><p><strong>Results: </strong>NOVA2 was expressed in the endothelial cells of both PAs and normal pituitary glands, with higher expression in PAs. Notably, NOVA2 was present in PA cells regardless of adenoma type, while normal pituitary epithelial cells were negative for NOVA2 expression. There was no statistically significant difference in NOVA2 expression between FPAs and NFPAs.</p><p><strong>Conclusions: </strong>This is the first study to demonstrate that NOVA2 is expressed in PA cells but not in normal pituitary epithelial cells. These findings suggest that NOVA2 could serve as a potential target for diagnostic and therapeutic strategies in PAs, especially considering the lack of specific biomarkers and effective medical therapies for these tumors. Further research with a larger sample size is warranted to validate these preliminary findings.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"175"},"PeriodicalIF":1.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473740","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":"Advances of MR imaging in glioma: what the neurosurgeon needs to know.","authors":"Anna Falk Delgado","doi":"10.1007/s00701-025-06593-6","DOIUrl":"10.1007/s00701-025-06593-6","url":null,"abstract":"<p><p>Glial tumors and especially glioblastoma present a major challenge in neuro-oncology due to their infiltrative growth, resistance to therapy, and poor overall survival-despite aggressive treatments such as maximal safe resection and chemoradiotherapy. These tumors typically manifest through neurological symptoms such as seizures, headaches, and signs of increased intracranial pressure, prompting urgent neuroimaging. At initial diagnosis, MRI plays a central role in differentiating true neoplasms from tumor mimics, including inflammatory or infectious conditions. Advanced techniques such as perfusion-weighted imaging (PWI) and diffusion-weighted imaging (DWI) enhance diagnostic specificity and may prevent unnecessary surgical intervention. In the preoperative phase, MRI contributes to surgical planning through the use of functional MRI (fMRI) and diffusion tensor imaging (DTI), enabling localization of eloquent cortex and white matter tracts. These modalities support safer resections by informing trajectory planning and risk assessment. Emerging MR techniques, including magnetic resonance spectroscopy, amide proton transfer imaging, and 2HG quantification, offer further potential in delineating tumor infiltration beyond contrast-enhancing margins. Postoperatively, MRI is important for evaluating residual tumor, detecting surgical complications, and guiding radiotherapy planning. During treatment surveillance, MRI assists in distinguishing true progression from pseudoprogression or radiation necrosis, thereby guiding decisions on additional surgery, changes in systemic therapy, or inclusion into clinical trials. The continued evolution of MRI hardware, software, and image analysis-particularly with the integration of machine learning-will be critical for supporting precision neurosurgical oncology. This review highlights how advanced MRI techniques can inform clinical decision-making at each stage of care in patients with high-grade gliomas.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"174"},"PeriodicalIF":1.9,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339801","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":"Predicting intraoperative meningioma consistency using features from standard MRI sequences: a preoperative evaluation.","authors":"Donata Biernat, Robin Antony Birkeland Bugge, Jon Ramm-Pettersen, Till Schellhorn, Pål Andre Rønning, Eirik Helseth, Kyrre Eeg Emblem, Karoline Skogen","doi":"10.1007/s00701-025-06582-9","DOIUrl":"10.1007/s00701-025-06582-9","url":null,"abstract":"<p><strong>Background: </strong>Symptomatic meningiomas may require surgical resection to save or improve neurological function. The extent of tumor resection depends on multiple factors, including the tumor's consistency, its location, and the patient's overall condition. This prospective study aims to explore new criteria in combination with previously proposed tumor features on MRI to establish a rapid approach to tumor consistency characterization pre-operatively.</p><p><strong>Methods: </strong>Forty-eight patients with meningiomas were prospectively included and underwent a dedicated MRI protocol prior to surgery. Qualitative and quantitative MRI characteristics of the tumor were correlated to a previously proposed surgical tumor consistency grading.</p><p><strong>Results: </strong>Soft tumors were associated with homogeneous contrast enhancement, high T2 signal, absence of peritumoral edema (PTE), the presence of tumor cysts, and a uniformly dark appearance on fractional anisotropy (FA) maps. In contrast, firmer tumors were characterized by heterogeneous contrast enhancement, low T2 signal, the presence of PTE, absence of tumor cysts and a heterogeneous appearance on FA maps, requiring supranormal ultrasonic aspirator settings. Tumor signal quantification on T2 and Apparent Diffusion Coefficient maps (ADC) correlated moderately to tumor consistency. T1 sequences did not contribute in determining tumor consistency.</p><p><strong>Conclusion: </strong>An array of simple qualitative meningioma characteristics on MRI can assist in swift discrimination of soft and hard tumors preoperatively. These have been displayed in a figure that can easily be implemented clinically for optimal surgical planning.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"173"},"PeriodicalIF":1.9,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339802","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":"In reply: Comment on \"Intraoperative superb microvascular ultrasound imaging in glioma: novel quantitative analysis correlates with tumor grade\".","authors":"Matteo Palermo, Francesco Dimeco, Francesco Prada","doi":"10.1007/s00701-025-06585-6","DOIUrl":"10.1007/s00701-025-06585-6","url":null,"abstract":"","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"172"},"PeriodicalIF":1.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324154","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":"A narrative review and scoring proposal for secondary lumbar instability after lumbar decompression surgery.","authors":"Anto Abramovic, Sara Lener, Sebastian Hartmann, Claudius Thomé","doi":"10.1007/s00701-025-06590-9","DOIUrl":"10.1007/s00701-025-06590-9","url":null,"abstract":"<p><strong>Purpose: </strong>Lumbar spinal stenosis (LSS) is a common condition in the aging population, where decompressive surgery (DS) is widely regarded as the gold standard due to its effectiveness in relieving symptoms. However, DS carries the risk of secondary lumbar instability (SLI), while fusion surgery, although mitigating this risk, may lead to overtreatment and complications such as adjacent segment disease. The aim of the present study was to review the current literature on preoperative radiological and clinical variables, thus accounting for SLI after lumbar decompression surgery and to derive a score for SLI risk prediction.</p><p><strong>Methods: </strong>A literature review using online databases was performed in order to identify risk factors for the emergence of SLI. Risk factors were then graded for relevance. Consequently, a risk score for predicting SLI was developed from these results.</p><p><strong>Results: </strong>25 studies including 9754 patients were identified. The most commonly described predictors for SLI were preoperative instability, disc height > 6.5 mm, surgical invasiveness as well as patient-related risk factors such as BMI, age, gender and presence of mechanical low back pain. Based on these results, a 14-point scale was created using the most relevant risk factors selected by the research group using a peer-review process.</p><p><strong>Conclusion: </strong>The proposed score identifies known risk factors for SLI, rated according to their importance on clinical decision making. This represents an initial theoretical approach that has to be validated by prospective clinical studies. Nevertheless, decision making may already be supported by the awareness of the characterized risk factors.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"171"},"PeriodicalIF":1.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324153","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":"Effect of routine extradural optic canal decompression performed by skull base trained surgeons on visual outcomes in patients with anterior skull base meningiomas.","authors":"Yasmin Sadigh, Lailla Talbi, Juliette Monchen, Ayca Cozar, Kelsey Gori, Eelke M Bos, Ruben Dammers, Victor Volovici","doi":"10.1007/s00701-025-06584-7","DOIUrl":"10.1007/s00701-025-06584-7","url":null,"abstract":"<p><strong>Purpose: </strong>Optic canal decompression is a surgical option in anterior skull base tumors with optic nerve involvement. Meningiomas may grow into the optic canal even without evidence of involvement on MRI studies. We aim to investigate the effect of routine optic canal unroofing performed by skull base trained surgeons versus general neurosurgeons on the postoperative visual outcomes in anterior skull base meningiomas.</p><p><strong>Methods: </strong>Between January 2013 and October 2023, consecutive patients in our institution who underwent craniotomies due to visual impairment were retrospectively reviewed. Patient records were screened for data on optic nerve compression, patient characteristics, lesion characteristics, intraoperative factors, the exact preoperative and postoperative visual acuity, as well as the postoperative clinical course. The primary outcome was the change in visual acuity postoperatively compared to the preoperative visual acuity. Multivariable linear regression analysis was performed with best postoperative visual acuity as a dependent adjusting for prognostic factors.</p><p><strong>Results: </strong>Out of 709 patients who underwent craniotomies for anterior skull base meningiomas, 94 patients showed optic nerve involvement on MRI. In total, 59 cases were treated by skull base trained surgeons and 35 by general neurosurgeons. Optic canal decompression was performed in 65% of the patients. There was no significant difference between patients treated by skull base surgeons and general neurosurgeons in terms of postoperative permanent complications. In patients with tuberculum sellae or anterior clinoid process meningiomas, postoperative secondary deterioration of visual acuity occurred in 40% (n = 10) of the cases treated by general neurosurgeons versus 11% (n = 4) in the group treated by skull base trained surgeons. In cases with a preoperative visual acuity of 0.2 or lower (35%, n = 33), 42% (n = 14) reached a best postoperative visual acuity of 0.5 or higher. Nineteen (20%) cases presented with functional blindness preoperatively. Of these, nine (47%) cases showed significant vision improvement postoperatively. Multivariable linear regression analysis revealed that patients with higher preoperative visual acuity reached a higher best visual acuity postoperatively.</p><p><strong>Conclusion: </strong>Patients with tuberculum sellae and anterior clinoid process meningiomas benefit from skull base surgeons trained in extradural optic canal decompression, as reflected by lower postoperative secondary visual acuity deterioration in patients treated by skull base trained surgeons. All cases presenting with tumors with optic apparatus involvement should be managed by skull base trained surgeons to maximize postoperative visual acuity preservation.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"170"},"PeriodicalIF":1.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300952","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":"Comment on: B-waves in noninvasive capacitance signal correlate with B-waves in ICP.","authors":"Sai Batchu, Ajith J Thomas","doi":"10.1007/s00701-025-06588-3","DOIUrl":"10.1007/s00701-025-06588-3","url":null,"abstract":"","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"169"},"PeriodicalIF":1.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293152","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}