Acta Neurochirurgica最新文献

{"title":"Accuracy of ultrasound and MRI in the diagnosis of common peroneal nerve injuries","authors":"Lauren E. Tagliero,&nbsp;Courtney R. Carlson Strother,&nbsp;Robert J. Spinner,&nbsp;Allen T. Bishop,&nbsp;Alexander Y. Shin","doi":"10.1007/s00701-025-06542-3","DOIUrl":"10.1007/s00701-025-06542-3","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to determine the accuracy of ultrasound (US) and MRI compared to intraoperative findings in patients who underwent surgery for their common peroneal nerve (CPN) injury.</p><h3>Methods</h3><p>Patients who underwent surgical management of a CPN injury with preoperative US were reviewed. The status of the CPN as interpreted by the radiologist in the preoperative US and MRI were recorded. The intraoperative findings of the CPN were compared to the imaging findings. The CPN was classified as intact, partial injury, or complete transection. The location of the injury, and presence of a neuroma-in-continuity or stump neuroma were recorded. The sensitivity and specificity of US for diagnosis of a complete transection and an intact CPN were calculated.</p><h3>Results</h3><p>Thirteen patients were included in this study. Preoperative US accurately diagnosed a complete transection in 3 out of 4 patients and an intact CPN in 4 out of 5 patients. MRI did not accurately identify the status of the CPN in any patients. US had 75% sensitivity and 78% specificity for detecting complete transection, and 80% sensitivity and 63% specificity for detecting an intact CPN. The level of injury was correctly identified in 7 out of 13 cases by US and 1 out of 8 cases by MRI. A neuroma was correctly identified in 7 of 11 cases by US and 1 out of 8 cases by MRI.</p><h3>Conclusion</h3><p>US has a high sensitivity and specificity when diagnosing CPN lesions and was more accurate than MRI.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06542-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892709","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":"Revisiting Härtel’s technique for percutaneous transoval glycerol injection","authors":"Haldor Slettebø,&nbsp;Tomas Sakinis","doi":"10.1007/s00701-025-06526-3","DOIUrl":"10.1007/s00701-025-06526-3","url":null,"abstract":"<div><h3>Purpose</h3><p>Percutaneous transoval glycerol injection (GI) has been widely used since 1981 in the treatment of patients with trigeminal neuralgia. However, outcomes have been more variable than with other percutaneous treatments. Although most authors state that they use Härtel’s technique, the variations are numerous—which may explain procedural problems and most of the poor results. The aim of the present imaging-based study, therefore, was to revisit Härtel’s technique and identify optimal landmarks for guiding the needle from the cheek to Meckel’s cave.</p><h3>Methods</h3><p>Eleven patients referred for trigeminal neuralgia were studied. We used CT- and MRI-based simulations to determine the optimal entry points in the cheek and trajectories through foramen ovale (FO) to reach Meckel’s cave – and compared our findings with the results from Härtel’s original study.</p><h3>Results</h3><p>The optimal entry point was located at 2 mm below the horizontal plane through the angle of the mouth and just in front of the anterior edge of the mandibular ramus. From this entry point—situated around 10 mm below Härtel’s preferred entry point—Meckel’s cave was easily accessible through the medial part of FO in 17 of 22 sides.</p><h3>Conclusion</h3><p>The findings from this study suggest that the technical results of transoval glycerol injection can be improved if we 1. Select the optimal entry point, 2. Guide the needle under fluoroscopy through the medial part of the foramen ovale, and 3. Minimize movement of the soft tissues in the cheek.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06526-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143888710","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":"Repeated stereotactic radiosurgery for residual intracranial dural arteriovenous fistulas","authors":"Tzu-Chiang Peng,&nbsp;Chun-Fu Lin,&nbsp;Ai Seon Kuan,&nbsp;Hsiu-Mei Wu,&nbsp;Cheng-Chia Lee,&nbsp;Chung-Jung Lin,&nbsp;Huai-Che Yang","doi":"10.1007/s00701-025-06536-1","DOIUrl":"10.1007/s00701-025-06536-1","url":null,"abstract":"<div><h3>Objective</h3><p>Stereotactic radiosurgery (SRS) is widely used for the treatment of intracranial dural arteriovenous fistulas (DAVFs); however, the outcomes of repeated SRS to deal with residual DAVFs are unclear. This study assessed the benefits and potential negative consequences of repeated SRS in patients with residual DAVFs.</p><h3>Methods</h3><p>This retrospective study examined all patients who underwent two SRS procedures for DAVFs in a single academic medical center between January 1998 and December 2022. Information related to patient demography, DAVFs characteristics, and clinical outcomes were obtained from medical records. The objective in this study was to obtain a preliminary overview of the results of repeated SRS for DAVFs.</p><h3>Results</h3><p>The study cohort of 19 patients included 14 patients with non-cavernous sinus (NCS) DAVFs and 5 patients with cavernous sinus (CS) DAVFs. The NCS group included 8 patients who were categorized as low-grade (Borden grade 1) and 6 as high-grade (Borden grade 2 or 3). The median follow up duration after the second session of SRS was 37 months. Symptomatic improvement was noted in 16 patients (84.2%) and total obliteration was identified in 11 patients (57.9%). No patient suffered from intracranial hemorrhage after the repeated SRS. One patient (5.3%) experienced symptomatic radiation-induced change mandating temporary course of medical treatment.</p><h3>Conclusions</h3><p>Repeated SRS appears to be a safe and effective approach to deal with residual DAVFs, resulting in symptomatic improvement and complete radiologic obliteration.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06536-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883739","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 experiences and accuracy of stereoelectroencephalography using the robotic arm Cirq","authors":"Kohei Kanaya,&nbsp;Asuka Nakamura,&nbsp;Daishiro Abe,&nbsp;Yutaro Sato,&nbsp;Mana Wakabayashi,&nbsp;Tomoya Shigehara,&nbsp;Daichi Watanabe,&nbsp;Yuki Yoshizawa,&nbsp;Tetsuhiro Fukuyama,&nbsp;Tetsuyoshi Horiuchi","doi":"10.1007/s00701-025-06541-4","DOIUrl":"10.1007/s00701-025-06541-4","url":null,"abstract":"<div><h3>Background</h3><p>Robot-assisted stereoelectroencephalography (SEEG) has become increasingly popular worldwide. Robotic arm Cirq (BrainLab, Munich, Germany) is an optional instrument for SEEG. This study aimed to evaluate the accuracy of electrode implantation using Cirq.</p><h3>Methods</h3><p>Data were retrospectively collected from 10 consecutive SEEG cases from July 2022 to August 2024 at our institute. Two cases of simultaneous SEEG and grid implantation via craniotomy were excluded. Eight SEEG cases (37 depth electrodes) were included in this study. We evaluated the accuracy of the electrode placement. The distances between the planned and actual site of entry and the target were measured in the anterior-posterior (Xe, Xt) and cranial-caudal (Ye, Yt) directions. The distance between the planned and the actual target site was measured at the surface depth (Zt). The two-dimensional differences of the entry (De₂) and target (Dt₂) and the three-dimensional differences, including the depth parameter of the target (Dt), were measured. The two-dimensional and three-dimensional Euclidean distances (ED₂, ED) were also calculated.</p><h3>Results</h3><p>The differences between the planned entry and the actual entry in Xe and Ye were 2.5 ± 1.6 mm and -0.6 ± 1.8 mm, respectively. De₂ was 3.2 ± 1.4 mm. The differences between the planned target and the actual target in Xt, Yt, and Zt were 2.1 ± 1.5 mm, 0.5 ± 1.5 mm, and 1.4 ± 2.9 mm, respectively. Dt₂ and Dt were 2.7 ± 1.4 mm and 4.1 ± 1.7 mm, respectively. ED₂ and ED were 1.8 ± 1.1 mm and 3.4 ± 1.8 mm, respectively.</p><h3>Conclusions</h3><p>We reported our initial experience with a high accuracy and features of the Cirq robotic arm for SEEG procedures using the standard surface matching method.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06541-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883737","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":"Brainshift correction using navigated intraoperative ultrasound informs intraoperative decision-making during glioma surgery","authors":"Ashwin Rai,&nbsp;Vikas Singh,&nbsp;Prakash Shetty,&nbsp;Aliasgar V Moiyadi","doi":"10.1007/s00701-025-06457-z","DOIUrl":"10.1007/s00701-025-06457-z","url":null,"abstract":"<div><h3>Background</h3><p>Brainshift can hamper the accuracy of neuronavigation systems in intra-axial tumor surgery. Correction of brainshift becomes imperative to avoid loss of accuracy and erroneous assessment of residual tumor as well as its relationship to critical eloquent substrates.</p><h3>Method</h3><p>This paper describes a case of a frontal tumor close to motor cortex. Workflow for rigid image fusion (RIF) based iUS-MR correction of brainshift is demonstrated highlighting its accuracy and clinical value in assessing tumor margins as well as functional boundaries.</p><h3>Conclusion</h3><p>iUS-MR fusion provides a cost-effective, accurate and practical solution for observation and correction of brainshift. </p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06457-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883738","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 indications and patient outcomes of intracranial venous sinus stenting beyond overt idiopathic intracranial hypertension: a scoping review","authors":"Shiva A. Nischal,&nbsp;Rocío Fernández-Méndez,&nbsp;Vasu Gautam,&nbsp;Shaan Patel,&nbsp;Catherine J. McMahon,&nbsp;Peter J. Hutchinson,&nbsp;John D. Pickard,&nbsp;J. Nicholas P. Higgins,&nbsp;Alexis J. Joannides","doi":"10.1007/s00701-025-06514-7","DOIUrl":"10.1007/s00701-025-06514-7","url":null,"abstract":"<div><h3>Background</h3><p>Intracranial venous sinus stenting (VSS) was initially developed as an alternative approach to addressing venous outflow obstruction in the context of idiopathic intracranial hypertension (IIH). In recent years, the technique has been increasingly used for other conditions involving venous compromise beyond overt IIH. The aim of this study was to describe the nature and volume of literature considering clinical applications and efficacy of VSS.</p><h3>Methods</h3><p>A scoping review was conducted using MEDLINE, EMBASE, Scopus, The Cochrane Library, and various grey literature sources. Articles published since the introduction of VSS in 2002 were included. Independent screening of articles occurred in two stages: title-and-abstract and full-text screening. Relevant data was extracted and evidence mapping with narrative synthesis followed.</p><h3>Results</h3><p>The search strategy yielded 1814 articles, of which 165 were included in this review. A total of 27 additional clinical indications of VSS beyond overt IIH were identified, spanning a diverse range of neurological pathology. Most evidence came from case reports, with the United States being the commonest study origin. Focal stenotic lesions and stenting locations were distributed throughout the dural sinus anatomy. An outline of patient outcomes reported by VSS providers is presented, with pulsatile tinnitus and visual impairment showing the greatest likelihood of clinical resolution.</p><h3>Conclusion</h3><p>This scoping review demonstrates the wider clinical utility and therapeutic potential of VSS beyond overt IIH. We also highlight the need for further studies to assess efficacy for each respective indication and clinical standardisation of VSS practice.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06514-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871383","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":"Gamma Knife radiosurgery for brain arteriovenous malformations – a single-center experience","authors":"Mirea Hancevic,&nbsp;Jakob Nemir,&nbsp;Sergej Marasanov,&nbsp;Hrvoje Hrsak,&nbsp;Luka Luketin,&nbsp;Ivan Peric,&nbsp;David Ozretic,&nbsp;Ivan Jovanovic,&nbsp;Marko Rados,&nbsp;Ervina Bilic,&nbsp;Goran Mrak,&nbsp;Zdravko Heinrich","doi":"10.1007/s00701-025-06523-6","DOIUrl":"10.1007/s00701-025-06523-6","url":null,"abstract":"<div><h3>Background</h3><p>Gamma Knife stereotactic radiosurgery (SRS) has emerged as a non-invasive and effective treatment for brain arteriovenous malformations (AVM), particularly in cases where surgical resection is not feasible. The factors influencing AVM obliteration following Gamma Knife radiosurgery remain incompletely understood and differing results across studies indicate the need for further research. This study reviews a single center’s 20-year experience with Gamma Knife radiosurgery for AVMs, evaluating factors associated with successful treatment outcomes.</p><h3>Methods</h3><p>A retrospective analysis was conducted on 241 patients treated with Gamma Knife SRS for intracranial AVMs at University Hospital Center Zagreb between 2004 and 2021. Patient demographics, AVM characteristics, prior treatments, radiosurgical parameters, and clinical outcomes were analyzed. AVM obliteration was assessed using MR angiography and digital subtraction angiography. Binary logistic regression and Cox regression analysis were performed to identify factors associated with treatment success and shorter time to obliteration.</p><h3>Results</h3><p>AVM obliteration was achieved in 171 patients (71%), with a mean time to complete obliteration of 3 years. Higher prescription doses correlated with increased obliteration rates (<i>p</i> &lt; 0.05), as did hemispheric AVM location (<i>p</i> &lt; 0.05) while smaller nidus volumes were associated with faster obliteration times (<i>p</i> &lt; 0.05). 75.5% of previously embolized AVMs achieved obliteration vs 68.2% of non-embolized AVMs, however the difference was not statistically significant. The introduction of cone beam CT angiography in treatment planning improved obliteration rates (69.1% to 75.8%), though statistical significance was not reached. The overall complication rate was 15.4%, with 5.8% experiencing post-SRS hemorrhage.</p><h3>Conclusion</h3><p>Higher prescription doses correlated with improved obliteration rates, and smaller AVMs achieved faster obliteration. The use of additional imaging modalities in treatment planning possibly contributed to non-inferior obliteration rates in previously embolized AVMs.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06523-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865456","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":"Reducing cerebrospinal fluid leak in vestibular schwannoma surgery via a retrosigmoid approach: a retrospective clinical study","authors":"Louise Deboeuf,&nbsp;Michel Kalamarides,&nbsp;Olivier Sterkers,&nbsp;Bruno Law-Ye,&nbsp;Ghizlène Lahlou,&nbsp;Daniele Bernardeschi,&nbsp;Lauranne Alciato","doi":"10.1007/s00701-025-06519-2","DOIUrl":"10.1007/s00701-025-06519-2","url":null,"abstract":"<div><h3>Objective</h3><p>Cerebrospinal fluid leak can occur after retrosigmoid craniectomy and lead to substantial patient morbidity. The aim of this study was to compare two closure techniques for vestibular schwannoma resection in terms of cerebrospinal fluid leak and other procedure-related issues.</p><h3>Methods</h3><p>This retrospective monocentric study included patients who underwent surgery for vestibular schwannoma resection via a retrosigmoid approach by the same oto-neurosurgical team. Before 2019, the retrosigmoid approach consisted of a craniectomy and the closure involved autologous abdominal fat graft obliteration (previous procedure). After 2019, the authors performed a craniotomy and used S53P4 bioactive glass granules to close the craniotomy site (new procedure).</p><h3>Results</h3><p>We included 193 patients, 79 with the previous procedure and 114 the new procedure. Cerebrospinal fluid leak developed postoperatively in 3 patients with the new procedure and 14 with the previous procedure (<i>p</i> &lt; 0.01). Need for surgical revision to treat the leak was lower with the new than previous procedure (1 vs 6 patients, <i>p</i> = 0.02) and the median length of hospital stay was reduced by 2 days with the new procedure (&lt; 0.001).</p><h3>Conclusion</h3><p>The craniotomy/bioactive glass obliteration technique was associated with less cerebrospinal fluid leak as compared with craniectomy/autologous fat graft obliteration, less revision surgery and a shorter hospital stay.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06519-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865515","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":"Difference in clinical presentation and surgical outcomes in pediatric and adult patients with Chiari malformation type 1: a single center retrospective study","authors":"Erik Öhlén,&nbsp;Victor Gabriel El-Hajj,&nbsp;Victor E. Staartjes,&nbsp;Pascal Jabbour,&nbsp;Erik Edström,&nbsp;Adrian Elmi-Terander","doi":"10.1007/s00701-025-06534-3","DOIUrl":"10.1007/s00701-025-06534-3","url":null,"abstract":"<div><h3>Introduction</h3><p>Chiari malformation type 1 (CM1) is a common congenital disorder affecting both children and adults. Although pediatric and adult CM1 patients share many characteristics, the differences between the groups are not fully described.</p><h3>Method</h3><p>A comparative analysis was made of two previously defined cohorts of adult and pediatric non-syndromic CM1, surgically treated at the study center. Clinical outcomes were assessed using the Chicago Chiari outcome scale (CCOS) and radiological outcomes were measured as change in cerebellar tonsil and syringomyelia status.</p><h3>Results</h3><p>A total of 209 patients (73 pediatric, 136 adults) were included, with median ages of 11 and 33 years, respectively. The proportion of female patients (62% vs 78%) was higher in the adult population (p = 0.012). Headache (p = 0.007), neck pain (p = 0.000), vertigo (p = 0.007), and sensory symptoms (p = 0.000) were more common in adults, while scoliosis (p = 0.000) and sleep apnea (p = 0.015) were more common in the pediatric population. Preoperative imaging findings did not differ significantly. After posterior fossa decompression, both groups scored a median CCOS of 15 at early follow-up (3 vs 4 months), though the pediatric population had a more favorable distribution of CCOS scores (p = 0.003). Postoperatively, syringomyelia status did not differ significantly between groups, but cerebellar tonsil status improved more frequently in adults (64% vs 88%, p = 0.000).</p><h3>Conclusion</h3><p>This study demonstrates that while headache is the most common presenting symptom in both pediatric and adult CM1 patients, pediatric patients are more likely to present with scoliosis and sleep apnea. In contrast adult patients more frequently experience headache, neck pain, vertigo, and sensory symptoms. There were no differences in other preoperative imaging variables and outcomes were favorable for most patients in both groups.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06534-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865476","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 after Gamma Knife Radiosurgery for Brain AVMs: Predictive factors for symptomatic radionecrosis","authors":"Popadic Branko,&nbsp;Amedeo Cervo,&nbsp;Antonio Macera,&nbsp;Guglielmo Pero,&nbsp;Giada Valente,&nbsp;Florian Scheichel,&nbsp;Camillo Sherif,&nbsp;Marco Picano,&nbsp;Marco Cenzato,&nbsp;Alessandro La Camera,&nbsp;Mariangela Piano","doi":"10.1007/s00701-025-06532-5","DOIUrl":"10.1007/s00701-025-06532-5","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study is to investigate complications after Gamma Knife Radiosurgery (GKRS) for AVMs and predictive factors for symptomatic radionecrosis.</p><h3>Methods</h3><p>A retrospective single centre study on AVMs treated with GKRS between 2008 and 2016 was performed.</p><h3>Results</h3><p>A total of 209 patients were included. AVM obliteration was seen in 70%, while radiation induced changes (RIC) were detected in 45%. Symptomatic radionecrosis was found in 13 patients (6.2%). Furthermore, 12 patients (5.7%) experienced latent period haemorrhage. Predictors of symptomatic radionecrosis were 12 Gy volume (<i>p</i> = 0.007), RIC grade (<i>p</i> =  &lt; 0.0001) and ≥ 2 endovascular treatments (<i>p</i> = 0.001) in univariate analysis, while age (<i>p</i> = 0.043), RIC grade (<i>p</i> = 0.0002) and ≥ 2 endovascular procedures (<i>p</i> = 0.002) were identified in multivariate analysis.</p><h3>Conclusion</h3><p>Complication after GKRS for AVMs were latent period haemorrhage in 5.7% and symptomatic radionecrosis in 6.2%. Age, RIC grade and ≥ 2 endovascular procedures were risk factors for symptomatic radionecrosis. Due to the unclear benefits of endovascular procedures in addition to GRKS and its potential negative effects, the indication for endovascular treatment should be weighed carefully.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"167 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-025-06532-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861411","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}