Acta Neurochirurgica最新文献

{"title":"The bleeding weather: association of environmental changes with intracranial aneurysms’ rupture","authors":"Konstantinos Faropoulos,&nbsp;Georgios Kyriakou,&nbsp;Athina Kafritsa,&nbsp;Angeliki Papavasilopoulou,&nbsp;Andreas Grzeczinski,&nbsp;Artemios Artemiadis","doi":"10.1007/s00701-025-06494-8","DOIUrl":"10.1007/s00701-025-06494-8","url":null,"abstract":"<div><h3>Background</h3><p>Various studies have attempted to link aneurysmal subarachnoid hemorrhage (aSAH) with environmental factors, yielding inconsistent results.</p><h3>Methods</h3><p>We retrospectively collected clinical and demographic data from all patients who presented to our hospital with aSAH between January 1st, 2015, and December 31st, 2021.</p><h3>Results</h3><p>Our study found a significant variation in the occurrence of aneurysm ruptures based on the day of the week, with more ruptures occurring on Mondays compared to Fridays. Additionally, we discovered that the amount of dust in the air prior to the ictus influenced the severity of the aSAH. In contrast, other environmental parameters such as atmospheric pressure, temperature, humidity, rain, wind speed, and cloud cover did not significantly impact the prevalence or severity of aSAH.</p><h3>Conclusions</h3><p>To our knowledge, this is the first study to associate the severity of aSAH with atmospheric dust levels. Another key finding is the increased incidence of aneurysm ruptures on Mondays compared to Fridays.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06494-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143667974","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: Endoscopic transorbital resection of sphenoid osseous meningioma via the lateral orbital ‘sliding coach door’ approach","authors":"James M. W. Robins,&nbsp;Jiten Parmar,&nbsp;Asim J. Sheikh","doi":"10.1007/s00701-025-06484-w","DOIUrl":"10.1007/s00701-025-06484-w","url":null,"abstract":"<div><h3>Background</h3><p>A 63-year-old presented with reduced left visual acuity and V1 sensation. Imaging demonstrated left sphenoid osseous meningioma narrowing superior orbital fissure with intracranial extension to superior temporal gyrus.</p><h3>Method</h3><p>Endoscopic transorbital approach utilising novel lateral orbit ‘sliding coach door’ osteotomy performed. Lateral canthal incision with lateral canthal ligament division mobilises and decompresses globe infero-medially. Osteotomy performed, tethered by temporalis. Osteotomy slides postero-laterally creating working space lateral to inferior and superior orbital fissures.</p><h3>Conclusion</h3><p>This technique requires reduced soft tissue dissection and facilitates reconstruction. Adequate working space enabled satisfactory resection with residual dural tail requiring future surveillance. Cosmesis was satisfactory.\u0000</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06484-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655360","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: the frontal basal interhemispheric approach for craniopharyngioma resection","authors":"Ting Lei,&nbsp;Yang Yang,&nbsp;Zhongqing Zhou,&nbsp;Fangjun Liu","doi":"10.1007/s00701-025-06492-w","DOIUrl":"10.1007/s00701-025-06492-w","url":null,"abstract":"<div><h3>Background</h3><p>The frontal basal interhemispheric approach (FBIA) provides wide access to the chiasmatic cistern, retrochiasmatic space, and lamina terminalis for craniopharyngioma removal.</p><h3>Methods</h3><p>We introduce in detail the anatomical structure related to the FBIA, the surgical techniques of craniotomy, and how to prevent the surgical complications.</p><h3>Conclusion</h3><p>The FBIA provides a satisfactory surgical corridor for craniopharyngioma resection.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06492-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655250","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":"Complications following endoscopic transsphenoidal surgery for pituitary adenoma—special focus on intrasellar pressure","authors":"Gabriel Simander,&nbsp;Per Olof Eriksson,&nbsp;Sara Viirola,&nbsp;Peter Lindvall,&nbsp;Lars-Owe D. Koskinen","doi":"10.1007/s00701-025-06495-7","DOIUrl":"10.1007/s00701-025-06495-7","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study was to explore risk factors for intraoperative events and postoperative complications of endoscopic transsphenoidal surgery (ETS) for pituitary tumors, and the role of intrasellar pressure (ISP) in relation to complications.</p><h3>Methods</h3><p>The study was a single-center, retrospective, consecutive, observational study, with ISP data collected prospectively. After exclusions, the study population encompassed 69 patients. All had ISP measured intraoperatively during ETS for a pituitary adenoma and underwent standardized postoperative observations and follow-up. Data on complications within 3 months after surgery and some risk factors were collected retrospectively.</p><h3>Results</h3><p>Decreased risk of postoperative cerebrospinal fluid leakage was seen with higher age. Large tumor volume was associated with higher risk of intraoperative events. ISP was not associated with complication frequency, but patients with ISP &gt; 20 mmHg had increased frequency of postoperative epistaxis.</p><h3>Conclusion</h3><p>This study confirms earlier findings of low age as a possible risk factor for postoperative cerebrospinal fluid leakage. Tumor volume is suggested to be associated with higher complication risk. ISP does not seem to be a significant risk factor for intraoperative events or postoperative complications following ETS. Predictive risk factors for surgical complications after ETS are still not satisfactorily explained and heterogeneous definitions of complications are problematic in this context.\u0000</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06495-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655247","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 intraoperative SEEG and 18FDG-PET tailored temporal lobe resection (iSP-TR) for the tissue-spearing surgical treatment of drug-resistant mesial temporal lobe epilepsy: how we do it","authors":"Francesca Battista,&nbsp;Riccardo Carrai,&nbsp;Antonello Grippo,&nbsp;Alessandro Della Puppa","doi":"10.1007/s00701-025-06491-x","DOIUrl":"10.1007/s00701-025-06491-x","url":null,"abstract":"<div><h3>Background</h3><p>For drug-resistant mesial temporal lobe epilepsy (MTLE), surgery is recommended. There is no evidence of a seizure outcome advantage of temporal lobectomy over other strategies despite the high risks of this surgical procedure.</p><h3>Methods</h3><p>We describe a Temporal Resection guided by intraoperative stereo-electroencephalography (iSEEG) and the ¹⁸FluoroDeoxyGlucose PET (¹⁸FDG PET) (iSP-TR) to treat lesional MTLE. We avoided functional cortical areas using navigated Transcranial Magnetic Stimulation (nTMS).</p><h3>Conclusion</h3><p>iSP-TR allows for a spare brain parenchyma compared to temporal lobectomy without compromising seizure outcomes.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06491-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143645608","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 the lumboperitoneal shunt versus ventriculoperitoneal shunt for leptomeningeal metastasis-associated hydrocephalus in non-small cell lung cancer","authors":"Minjoon Kim,&nbsp;Chaejin Lee,&nbsp;Sang-Youl Yoon,&nbsp;Seong-Hyun Park,&nbsp;Jeong-Hyun Hwang,&nbsp;Kyunghun Kang,&nbsp;Eunhee Park,&nbsp;Sunha Choi,&nbsp;Shin Yup Lee,&nbsp;Seung Soo Yoo,&nbsp;Yee Soo Chae,&nbsp;Ki-Su Park","doi":"10.1007/s00701-025-06490-y","DOIUrl":"10.1007/s00701-025-06490-y","url":null,"abstract":"<div><h3>Purpose</h3><p>Leptomeningeal metastasis (LM)-associated hydrocephalus is a rare but severe complication of non-small cell lung cancer (NSCLC). The spread of malignant cells to the leptomeninges obstructs cerebrospinal fluid flow and increases intracranial pressure (ICP). This study compared the outcomes of lumboperitoneal (LP) and ventriculoperitoneal (VP) shunt surgeries in managing LM-associated hydrocephalus, focusing on symptom-free periods (SFPs) and overall survival (OS).</p><h3>Methods</h3><p>A retrospective analysis was conducted on 43 NSCLC patients with LM-associated hydrocephalus who underwent shunt surgery between 2017 and 2024. Patients were classified into LP (<i>n</i> = 23) and VP (<i>n</i> = 20) groups. Clinical characteristics, surgical outcomes, and survival rates were analyzed using Kaplan–Meier survival and Cox regression analyses. Karnofsky performance status (KPS), increased intracranial pressure (IICP) symptoms, and postoperative epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment were evaluated for prognostic significance.</p><h3>Results</h3><p>No significant difference was observed between VP and LP shunt surgeries regarding SFP (VP: 5.02 ± 1.29 months, LP: 7.50 ± 2.86 months, <i>p</i> = 0.906) or OS (VP: 8.43 ± 1.89 months, LP: 9.62 ± 3.20 months, <i>p</i> = 0.820). High preoperative KPS, absence of ICP symptoms, and postoperative EGFR-TKI treatment were significantly associated with improved SFP and OS (<i>p</i> &lt; 0.05). LP shunt surgery had shorter anesthesia and fewer complications compared to VP shunt surgery, representing a viable option for patients unsuitable for general anesthesia.</p><h3>Conclusion</h3><p>LP and VP shunt surgeries are equally effective for patients with LM-associated hydrocephalus in NSCLC. LP shunt surgery under local anesthesia could be recommended for its safety and patient acceptability. Favorable prognostic factors, including high KPS, absence of ICP, and postoperative EGFR-TKI treatment, should guide individualized treatment strategies to enhance patient outcomes and quality of life.\u0000</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06490-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143645607","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":"Traumatic brain injuries in people falling from trees in Ziguinchor: a pathology in a rural area of a developing country","authors":"Yakhya Cisse,&nbsp;Abdoulaye Diop,&nbsp;Mohameth Faye,&nbsp;Diana Diop,&nbsp;Maguette Mbaye,&nbsp;Daouda Wague,&nbsp;Lounceny Fatoumata Barry,&nbsp;El Hadji Cheikh Ndiaye Sy,&nbsp;Roger Ilunga Mulumba,&nbsp;Remy Ngarnayal Mbaiorkad,&nbsp;Mbaye Thioub,&nbsp;Alioune Badara Thiam,&nbsp;Momar Codé Ba,&nbsp;Seydou Boubakar Badiane","doi":"10.1007/s00701-025-06482-y","DOIUrl":"10.1007/s00701-025-06482-y","url":null,"abstract":"<div><h3>Background</h3><p>Traumatic brain injury (TBI) in people falling from trees is a condition rarely reported in the literature and is often observed in rural areas of developing countries such as Senegal. Ziguinchor, a heavily forested and agricultural region, experiences seasonal fruit harvesting activities that expose populations to the risk of falling from trees. The aim of our study was to highlight the epidemiological, diagnostic, therapeutic, evolutionary, and prognostic aspects of this pathology in Ziguinchor over a period of 3 years and 8 months, with the goal of identifying preventive measures.</p><h3>Materials and methods</h3><p>This was a cross-sectional retrospective, descriptive, and analytical study conducted from April 1, 2019, to December 31, 2022. The study included complete records of patients admitted for TBI due to falling from trees at the neurosurgery unit of Ziguinchor Regional Hospital. Morbidity refers to all the subsequent effects of trauma, often described as functional sequelae.</p><h3>Results</h3><p>Among 83 patients, 72 were male, with an average age of 17.7 ± 13.1 years. There was a statistically significant correlation between season (quarter) and the type of tree involved (<i>P</i> = 0.012). The average fall height was 4 ± 2.9 m. Most patients (77.6%) had a Glasgow Coma Scale (GCS) Score ≥ 13. There was a significant relationship between fall height and the presence of scalp wounds (<i>P</i> = 0.023). The average hospital stay was 7.5 ± 6.3 days (range: 1–30 days). The mortality rate was 8.4%, and the morbidity rate was 12%.</p><h3>Conclusion</h3><p>Climbing trees remains a hazardous activity, as it can lead to falls, causing injuries such as traumatic brain injuries. Educational programs should focus on safe practices for fruit and leaf harvesting to prevent injuries associated with these activities.\u0000</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06482-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143645615","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: exoscopic disconnection of anterior fossa dural arteriovenous fistulae","authors":"Sergio García-García,&nbsp;Hrvoje Barić,&nbsp;Anni Pohjola,&nbsp;Martin Lehecka","doi":"10.1007/s00701-025-06493-9","DOIUrl":"10.1007/s00701-025-06493-9","url":null,"abstract":"<div><h3>Background</h3><p>Brain Dural Arteriovenous Fistulae (DAVF) are acquired abnormal connections between dural arteries and cerebral veins or venous sinuses. Disconnection of the pathological shunt is recommended for high-grade fistulae and cases with intolerable symptoms or previous bleedings. Surgical disconnection remains the preferred method for anterior fossa DAVF.</p><h3>Method</h3><p>Microsurgical disconnection of anterior fossa DAVF is performed with the assistance of a robotic exoscope. Intraoperative aniography is implemented to confirm the exclusion of DAVF.</p><h3>Conclusion</h3><p>The exoscope provides excellent lighting and magnification in challenging surgical fields improving surgeon's ergonomics and enabling tailored, minimally invasive approaches without compromising procedural safety or effectiveness.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06493-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143645616","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":"Neuroplastics approach to cerebrovascular bypass surgery: the way forward for centres with small to medium volume caseload","authors":"Jia Xu Lim,&nbsp;Cindy Siaw Lin Goh,&nbsp;Rambert Guan Mou Wee,&nbsp;John Jiong Yang Zhang,&nbsp;Yee Siang Ong,&nbsp;Min Wei Chen","doi":"10.1007/s00701-025-06462-2","DOIUrl":"10.1007/s00701-025-06462-2","url":null,"abstract":"<div><h3>Purpose</h3><p>Cerebral bypasses are technically challenging procedures essential in the neurosurgeon’s armamentarium. Decreasing surgical indications leading to reduced caseload has resulted in less than ideal clinical outcomes, particularly in low to medium volume centres. We describe the neuroplastics approach to cerebral bypasses in the largest retrospective series to date and demonstrate how this approach has been able to smoothen the learning curve and achieve consistent outcomes approximating that of high-volume centres.</p><h3>Methods</h3><p>A retrospective study was conducted. All patients who received a bypass were classified into those with bypasses performed using the neuroplastics approach (NP group) and those performed by solo neurosurgeons (Solo group). Technical outcomes and clinical outcomes were compared.</p><h3>Results</h3><p>There were 19 patients in the NP group and 50 patients in the Solo group. There were 17 patients in the NP group with double-barrel bypasses and 2 with single-barrel bypasses (total of 36 direct anastomoses) and 45 patients of the Solo group with single-barrel bypasses and 5 patients with conversion to indirect bypasses. Patients in the Solo group were more likely to experience a postoperative stroke in the bypassed territory (Solo, 17.8%; NP, 0%; <i>p</i> = 0.008). Although not statistically significant, there was a difference in the proportion of patients with conversion to indirect bypass (Solo, 10.0%; NP, 0%), postoperative anastomotic bleed (Solo, 8.9%; NP, 0%), and long-term patency (Solo, 93.9%; NP, 100%). Patients in the NP group had a shorter median length of stay (NP, 3 [2 – 7] days; Solo, 6 [5 – 9] days; <i>p</i> = 0.005) and 1-year modified Rankin scale approached significance (NP, 0 [0 – 0]; Solo, 0 [0 – 2]).</p><h3>Conclusion</h3><p>Our experience supports the adoption of a neuroplastics approach to the training and execution of cerebrovascular bypasses in small to medium volume centres. This collaboration allowed us to deliver cerebral bypasses to indicated patients with excellent outcomes.\u0000</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06462-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143638305","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: combined interposition-transposition technique for microvascular decompression in primary hemifacial spasm","authors":"Francesco Tengattini,&nbsp;Fabio Calbucci,&nbsp;Ignazio Borghesi,&nbsp;Riccardo Draghi","doi":"10.1007/s00701-025-06472-0","DOIUrl":"10.1007/s00701-025-06472-0","url":null,"abstract":"<div><h3>Background</h3><p>Two surgical microvascular decompression techniques to treat primary hemifacial spasm (HFS) are described in literature. The “interposition” uses different materials as “spacers” while the “transposition” consists in suturing the offending vessel to the petrous bone dura mater. In the literature is described a transposition surgery adopting self-adhesive materials reporting promising results.</p><h3>Method</h3><p>We describe a combination of these two techniques using autologous muscle and Tachosil^®. The step-by-step surgical principles are described in the article and clarified in a video.</p><h3>Conclusion</h3><p>This procedure is effective to cure the HFS especially in case of large arteries when interposition only is insufficient.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06472-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143645617","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}