Acta Neurochirurgica最新文献

{"title":"Paraclinoid aneurysm clipping: how I do it.","authors":"Bruno Vernile, Kyle McGrath, Sudhakar Vadivelu, Mario Zuccarello","doi":"10.1007/s00701-025-06609-1","DOIUrl":"https://doi.org/10.1007/s00701-025-06609-1","url":null,"abstract":"<p><p>Paraclinoid aneurysms continue to present a surgical challenge, even in the modern endovascular era. Although these aneurysms are uncommon, surgical clipping remains the treatment of choice in select cases. Successful surgical management requires both extensive experience and a comprehensive understanding of paraclinoid anatomy. In this report, we outline our approach to planning and surgical techniques for managing paraclinoid aneurysms.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"197"},"PeriodicalIF":1.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673704","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":"A scoping review of proton radiation therapy and mutant-isocitrate dehydrogenase-inhibitors in IDH mutated lower-grade gliomas: pushing beyond surrogate end-points.","authors":"Dima Harba, Alba Corell, Alireza Mansouri, Petter Brandal, Malin Blomstrand, Asgeir Store Jakola","doi":"10.1007/s00701-025-06612-6","DOIUrl":"10.1007/s00701-025-06612-6","url":null,"abstract":"<p><strong>Background: </strong>Proton radiation therapy (PRT) and mutant isocitrate dehydrogenase inhibitors (mIDH-inhibitors) are emerging therapies for mIDH lower grade gliomas (LGGs). Despite their substantial theoretical benefits, comparisons with current standards - particularly pertaining to patient-centred outcomes - are limited.</p><p><strong>Methods: </strong>Through PubMed and Scopus, a search strategy based on keywords focusing on PRT and mIDH-inhibitors was applied on December 3, 2024. Studies in English on at least 20 adult patients (≥ 18 years) with mIDH-LGG grade 2 or 3 and published between January 1, 2011 and August 31, 2024 were included. Review articles were excluded.</p><p><strong>Results: </strong>Of 6383 identified articles, seven per treatment strategy were included. Overall survival was not reported for mIDH-inhibitors. The lack of high-quality studies comparing PRT to photon radiation therapy precludes conclusions regarding efficacy, effectiveness or even post-PRT radiological manifestations. For the mIDH-inhibitor Vorasidenib (AG-881), the radiological objective response rate was 10.0-42.9%, although lower for contrast-enhancing tumors. Vorasidenib significantly delayed tumor progression (27.7 versus 11.1 months, p < 0.001) and time to next intervention (not reached versus 17.8 months, p < 0.001) when compared to placebo. Adverse events were mostly mild, including elevated liver enzymes (15.6-44.2%) and headache (26.9-46.2%). Only 1/14 studies included assessments related to quality of life (QoL)-domains with inconclusive research on cognitive outcomes.</p><p><strong>Conclusion: </strong>Studies reporting on patient-centred data including survival, cognition and QoL remain scarce. Larger, comparative prospective studies, preferably randomized controlled trials, with such outcomes are needed to inform clinicians whether the theoretical and radiological benefits can be translated to improved outcomes that matter to patients, i.e. living better and/or longer.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"196"},"PeriodicalIF":1.9,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666787","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":"Chokehold with 'rear naked choke' and delayed post-hypoxic leukoencephalopathy: a new form of assault in Mexico City.","authors":"Carlos Castillo-Rangel, Cristofer Zarate-Calderon, Carlos Castillo-Soriano, Karla Aketzalli Hernández-Contreras, Gerardo Marín-Márquez","doi":"10.1007/s00701-025-06601-9","DOIUrl":"10.1007/s00701-025-06601-9","url":null,"abstract":"<p><p>In Mexico City, a 49-year-old man underwent strangulation, which led to hypoxic-ischemic encephalopathy (HIE) and subsequently to delayed post-hypoxic leukoencephalopathy (DPHL), a rare demyelinating condition. Following the attack, he exhibited aphasia, dysphagia, and other neuropsychiatric symptoms that progressed to dementia. Imaging and brain biopsy analyses disclosed extensive ischemic damage and reactive gliosis. This case underscores the link between strangulation, acute HIE, and the subsequent development of DPHL, as well as an interpretation of the physiological implications of DPHL due to strangulation.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"195"},"PeriodicalIF":1.9,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666788","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":"Multicentre study of the role of lumbar puncture in the diagnosis of spontaneous subarachnoid haemorrhage.","authors":"Daniel Thompson, Sara Venturini, Peter C Whitfield, Peter Hutchinson, Nihal Gurusinghe, Rikin Trivedi, Adel Helmy","doi":"10.1007/s00701-025-06602-8","DOIUrl":"10.1007/s00701-025-06602-8","url":null,"abstract":"<p><strong>Objectives: </strong>This study identified the proportion of spontaneous subarachnoid haemorrhage (SAH) patients diagnosed by Lumbar Puncture (LP). Furthermore reporting the incidence of aneurysmal SAH if a CT scan performed within 6 h was reported as negative, and finally investigated if there has been a change in practice since the new NICE guidance for the diagnosis of SAH was published in November 2022.</p><p><strong>Methods: </strong>A pragmatic multicentre audit was conducted in the UK and Ireland capturing referrals to 25 Neurosurgical centres between 1st November 2020-31st October 2023. Case referral identification was done in each unit using local medical records and referral databases based on local protocols.</p><p><strong>Results: </strong>10,187 cases of spontaneous SAH were diagnosed within the study period: 9,357 were diagnosed by CT and 717 by LP. 7% of all confirmed SAH cases underwent lumbar punctures to return a diagnosis of spontaneous SAH when a CT head scan was non-diagnostic. This yielded 213 (3%) diagnoses of aneurysmal SAH. 55 cases(1%) of aneurysmal SAH initially had negative CT head scans within 6 h of ictus and a positive LP. We did not identify any evidence of a change in practice following the introduction of the NICE guidance in November 2022.</p><p><strong>Conclusion: </strong>This study shows that LP continues to be an important diagnostic test that will confirm a diagnosis of aneurysmal SAH in a small, but significant number of patients with thunderclap headache. We provide new data that may impact the current NICE guidelines on the diagnosis of SAH.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"193"},"PeriodicalIF":1.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658116","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":"Risk factors for in-stent stenosis after flow-diverter implantation for intracranial aneurysm: a single center analysis of 161 consecutive patients.","authors":"Rabab Alshahrani, Spyridon Karadimas, Mohammed Ali Alvi, Patrick Joseph Nicholson, Timo Krings","doi":"10.1007/s00701-025-06597-2","DOIUrl":"10.1007/s00701-025-06597-2","url":null,"abstract":"<p><strong>Introduction: </strong>Flow diverters (FD) are used for the treatment of intracranial aneurysms, by redirecting flow and serving as a scaffold for endothelial coverage of the aneurysm ostium. However, in-stent stenosis has been observed in some patients treated with these devices, the cause of which and the epidemiology remaining elusive. In the current study we aimed to elucidate potential factors leading to higher degree of in-stent stenosis including gender, location, and type of FD.</p><p><strong>Methods: </strong>The authors queried their institutional Electronic Health Record (EHR) for all patients undergoing FD for intracranial saccular aneurysms. We excluded cases where an FD was performed for a dissecting aneurysm, or other indications. We also excluded patients who had no available follow up.</p><p><strong>Results: </strong>We identified 161 patients undergoing FD for aneurysms, with a mean age of 57.4 (SD = 12.94) and141 (87.6%) of which were females. A total of 24 patients (14.9%) had an in-stent stenosis at a median interval of 10 months; 9 (5.6%) had a severe (i.e. symptomatic or requiring treatment) stenosis. When subsetting for females, we found that females with any in-stent stenosis were significantly younger compared to those without stenosis (51.045, SD = 15.7 vs 58.5, SD = 12.31, p = 0.013). Females with severe in-stent stenosis were even younger (42.2, SD = 14.2 vs 58.3, SD = 12.54; p < 0.001) compared to the rest of the females. Patients presenting with ruptured aneurysm had a higher rate of severe in-stent stenosis (16.7%, n = 4/24, p = 0.014). Regarding devices, patients who underwent treatment with a high-braid FD were more likely to have severe in-stent stenosis (18.8%, n = 3/16; p = 0.016).</p><p><strong>Conclusion: </strong>Our findings indicate that younger age, presentation with rupture and high-braid FD may be associated with higher risk of severe in-stent stenosis. These findings may provide more insight into the selection of treatment modality and/or device in patients undergoing management of their cerebral aneurysms.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"194"},"PeriodicalIF":1.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658117","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 NeVa Net stent-retriever - initial report of 20 cases from two high volume centres.","authors":"Pervinder Bhogal, Marco Mancuso-Marcello, Rory Fairhead, Nadia Shah, Keng Siang Lee, Christos Nikola, Katherine Parkin, Giovanna Klefti, Levansri Makalanda, Ken Wong, Joe Lansley, Michael Przyszlak, Oliver Spooner, Branimir Čulo, Vladimir Kalousek","doi":"10.1007/s00701-025-06586-5","DOIUrl":"10.1007/s00701-025-06586-5","url":null,"abstract":"<p><strong>Background: </strong>Various different technologies have been developed to optimise the mechanical thrombectomy procedure and first pass recanalisation. We report our initial experience with the NeVa NET - a novel stent-retriever with built in distal microfiltration net.</p><p><strong>Materials and methods: </strong>We performed a retrospective review of our prospectively maintained databases to identify all patients treated with the NeVa NET 4 × 30 mm device. We recorded the baseline demographics, NIHSS, ASPECT score and clot characteristics, first pass and final eTICI scores, complications and 90 day mRS.</p><p><strong>Results: </strong>We identified 20 patients (50% male), average age 67.9 ± 16.2 yrs, and median NIHSS 18 (range 6-29). 30% of patients received tPA. Average clot length was 21.6 ± 8.9 mm and median ASPECT score 9 (range 5-10). In 18 cases the NeVa NET could be tracked into position, however, in 2 cases it could not be tracked into position within the 0,021inch microcatheter. First pass recanalization (eTICI ≥ 2c) was seen in 94% (n = 17) and the average number of NeVa NET passes was 1. A final eTICI score of ≥ 2c was achieved in 17 patients (94%). There were no emboli to new territories. No cases of vessel rupture or dissections occured due to the NeVa NET. 50% of patients achieved mRS 0-2. SAH was seen in 31.3% and SICH in 6.3% of the 16 patients for whom a 24 h CT head was available.</p><p><strong>Conclusion: </strong>The NeVa Net stent-retriever is uniquely designed to prevent distal embolisation and our initial experience demonstrates a very high FPE and mFPE. We believe this is the first publication on the use of this novel technology and larger studies are warranted.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"192"},"PeriodicalIF":1.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635962","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":"Full-endoscopic dural repair using drain catheter: technical note.","authors":"Peter Van Daele, Piya Chavalparit, Borriwat Santipas, Jin-Sung Kim","doi":"10.1007/s00701-025-06613-5","DOIUrl":"10.1007/s00701-025-06613-5","url":null,"abstract":"<p><strong>Background: </strong>Repairing dural tears through a uniportal endoscopic approach presents significant technical challenges. This technical note describes a novel endoscopic suturing technique using standard instruments commonly available in most operating rooms.</p><p><strong>Method: </strong>We describe the instrument preparation, operative steps, and a case illustration. The dural suturing technique is performed using standard endoscopic instruments with a custom-made knot pusher adapted from a No. 8 surgical drain catheter.</p><p><strong>Conclusion: </strong>Our proposed surgical workflow and suturing technique enable effective endoscopic dural repair without the need for specialized equipment. It offers a practical solution that may reduce the need for conversion to open surgery.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"190"},"PeriodicalIF":1.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625268","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":"Long-term prognosis of preserved hearing function after surgery in patients with cerebellopontine angle tumors other than vestibular schwannoma.","authors":"Norio Ichimasu, Michihiro Kohno, Nobuyuki Nakajima, Kyosuke Matsunaga, Ken Matsushima, Kiyoaki Tsukahara","doi":"10.1007/s00701-025-06507-6","DOIUrl":"10.1007/s00701-025-06507-6","url":null,"abstract":"<p><strong>Background: </strong>In our previous study on vestibular schwannomas (VSs), we found that preserved useful hearing function in patients immediately after surgery gradually deteriorated in long-term period, and was lost in 13% of patients 5 years after surgery. In this retrospective study, we aimed to investigate the long-term hearing prognosis of patients with cerebellopontine angle (CPA) tumors other than VSs, and clarify whether the phenomenon of hearing deterioration after surgery occurs only in patients with VSs.</p><p><strong>Method: </strong>Patient backgrounds and otologic data were investigated in 70 patients (meningioma: 37; trigeminal schwannoma: 9; facial nerve schwannoma: 4; jugular foramen schwannoma: 9; and epidermoid cysts: 11) with preserved useful hearing function after surgery (American Academy of Otolaryngology-Head and Neck Surgery classification Class A or B).</p><p><strong>Results: </strong>Of the 70 patients (average age: 44 years; tumor diameter: 35 mm; resection rate: 96%; follow-up period: 62 months; 61 patients in Class A and 9 patients in Class B immediately after surgery), 60 patients (86%) had unchanged, 5 patients (7%) had improved, and 5 patients (7%) had worsened hearing class during the follow-up period. Only 1 patient (facial nerve schwannoma) experienced a change from Class B to C, and was out of useful-hearing range at the final follow-up (the useful hearing preservation rate: 99%). Distortion product otoacoustic emissions (DPOAEs) reflecting inner ear function were detected in 61 patients (87%) at the final follow-up, and only 4 patients (6%) demonstrated a worsening of DPOAEs during the postoperative follow-up period.</p><p><strong>Conclusions: </strong>Useful hearing function after surgery was preserved at a high rate during a long-term postoperative period in patients with typical CPA tumors other than VSs. Compared with patients with VSs, in whom hearing loss owing to inner ear dysfunction is not rare in the long-term after surgery, patients with CPA tumors demonstrated a apparently lower incidence of inner ear dysfunction and a more favorable long-term hearing prognosis. In patients with CPA tumors, not only hearing improvement by the surgery but also its long-term preservation can be expected. In this study, we confirmed that the phenomenon of postoperative hearing deterioration occurs only in patients with VSs among all CPA tumors.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"191"},"PeriodicalIF":1.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625269","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":"Anthropometrics, cancer risks, and survival outcomes in adult patients with glioma - a systematic review and meta-analysis.","authors":"Jaehyun Ahn, Joonseok Kim, Christopher Shin, Stephen Ahn","doi":"10.1007/s00701-025-06579-4","DOIUrl":"10.1007/s00701-025-06579-4","url":null,"abstract":"<p><strong>Purpose: </strong>The association between anthropometric measures including BMI, height and cancer has been widely discussed. However, the role of these in the development and prognosis of glioma remains controversial. We aimed to study these relationships.</p><p><strong>Methods: </strong>We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Papers reporting relationship between anthropometric measures and the risk of glioma, both incidence and survival, were considered relevant. Those published until January 31, 2024, were selected from PubMed, EMBASE, and the Cochrane Library. Studies were evaluated according to the modified Newcastle Ottawa Scale. Hazard ratios, relative risks, and 95% confidence intervals were pooled and synthesized using a random effects model.</p><p><strong>Results: </strong>Among 940 screened articles, 23 were selected. Taller height was significantly associated with an increased risk of both glioma (HR per 10 cm, 1.19; CI, 1.16 to 1.23) and glioblastoma (HR per 10 cm, 1.25; CI, 1.18 to 1.31). Higher BMI was positively correlated with an increased risk of glioma, both in categorical (RR, 1.08; CI, 1.03 to 1.12) and continuous measures (HR per 5 kg/m², 1.01; CI, 1.00 to 1.03). Glioblastoma demonstrated a higher incidence risk (HR per 5 kg/m², 1.02; 95% CI 1.00 to 1.05) and better survival outcomes (HR 0.75; 95% CI 0.59 to 0.96) with increasing BMI.</p><p><strong>Conclusion: </strong>This study provides critical insights into the relationship between glioma and anthropometric measures. Glioma and glioblastoma were associated with these measures in terms of both incidence and survival. Further research is necessary to uncover the mechanisms and develop preventative or therapeutic strategies.</p>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"188"},"PeriodicalIF":1.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599134","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":"Ostene® on, bleeding off: Discussing the indications and benefits of a water-soluble bone hemostasis material.","authors":"Flavia C Morone Pinto","doi":"10.1007/s00701-025-06607-3","DOIUrl":"10.1007/s00701-025-06607-3","url":null,"abstract":"","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":"189"},"PeriodicalIF":1.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599135","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}