Acta Neurochirurgica最新文献

{"title":"Evaluating optic system compression in sellar tumors: A novel application of quantitative pupillometry","authors":"Pavlina Lenga, Martin Grutza, Daniel Kühlwein, Johannes Walter, Sandro M. Krieg, Christopher Beynon","doi":"10.1007/s00701-024-06401-7","DOIUrl":"10.1007/s00701-024-06401-7","url":null,"abstract":"<div><h3>Introduction</h3><p>Tumorous growths in the sellar region pose significant clinical challenges due to their proximity to critical visual structures such as the optic chiasm and optic nerves. Given their proximity to the optic system, these tumors are often diagnosed due to a progressive decrease in visual acuity. Thus, surgical intervention is crucial to prevent irreversible damage, as timely decompression can halt the progression of edema and subsequent optic atrophy. Although Quantitative Pupillometry (QP) has been employed in various clinical settings, its application in patients with sellar region neoplasms remains unexplored. This study aims to evaluate the utility of QP to enhance treatment approaches in patients undergoing surgical resection of these tumors.</p><h3>Methods</h3><p>Pupillometry assessments were conducted prospectively using the automated NPi 200® Pupillometer on 45 patients who underwent surgical resection of tumors in the sellar region at our institution. The Neurological Pupil Index (NPi) was measured pre- and post-operatively, with a focus on correlations with visual acuity and tumor volume. Concurrently, MRI findings were analyzed to assess optic chiasm compression.</p><h3>Results</h3><p>Of the patients, 73.3% were diagnosed with pituitary tumors, 22.2% with tuberculum sellae meningiomas, and 4.4% with craniopharyngiomas. 66.7% of patients presented with decreased visual acuity, and 42.2% demonstrated paresis of the third cranial nerve (CN III). Compression of the optic chiasm was noted in 55.6% of cases. Patients with visual disturbances and CN III paresis exhibited significantly reduced NPi scores compared to unaffected individuals. In patients with pituitary adenomas, pathological NPIs were observed exclusively in cases of optic chiasm compression; compression of cranial nerve III (CN III) did not significantly affect the NPIs. Conversely, in patients with tuberculum sellae meningiomas, pathological NPIs were associated specifically with CN III compression, while optic chiasm compression tended to show a difference, however the results are not significant. Postoperatively, NPi values normalized among those who had presented with decreased visual acuity.</p><h3>Conclusions</h3><p>This study contributes to the field of skull base surgery by evaluating the utility of QP as a diagnostic tool for neurological assessment in patients with sellar region tumors. The findings suggest that QP may help in assessing the extent of tumor-related compression on the optic system. It particularly points to differences in the effects of optic chiasm and CN III compression, with observed variations in NPI scores corresponding to the type of compression in specific tumors, such as pituitary adenomas and tuberculum sellae meningiomas. By providing rapid and non-invasive assessments, QP supports enhanced correlation with clinical and radiological evaluations, potentially improving targeted interventions for these complex conditions","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"166 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-024-06401-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142889866","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":"International web-based survey of patients with non-hydrocephalic symptomatic pineal cysts","authors":"Jessica Harding,&nbsp;Riccardo Masina,&nbsp;Anna Hill,&nbsp;Ali Ansanipour,&nbsp;Amber Steele,&nbsp;Angelos Kolias,&nbsp;Thomas Santarius","doi":"10.1007/s00701-024-06403-5","DOIUrl":"10.1007/s00701-024-06403-5","url":null,"abstract":"<div><h3>Objectives</h3><p>To report the results of an international patient-reported survey that adds to the growing body of evidence surrounding the role of surgery in the management of a subset of patients with non-hydrocephalic symptomatic pineal cyst.</p><h3>Design</h3><p>An international web-based survey of health outcomes in patients with nhSPC.</p><h3>Subjects</h3><p>All survey participants who self-reported a diagnosis of symptomatic pineal cyst without hydrocephalus after radiological imaging.</p><h3>Methods</h3><p>The survey was developed in collaboration with the patient group Pineal Cyst UK. It was publicised and distributed via several online platforms and social media. Data collected included demographics, cyst size, symptom frequency and severity, number of appointments with healthcare professionals, treatment options trialled, and whether patients underwent surgery.</p><h3>Results</h3><p>543 participants (mean age 38.6 years, range 1–83) were included in the analysis, of which 82 (mean age 38.9 years, range 16–72) had undergone cyst resection. After a median period of 18.3 months between date of surgery and date of questionnaire completion, 72 (90%) of the surgical cohort reported overall improvement, and all symptoms improved overall, whereas no symptoms improved overall in the non-surgical cohort. Of the non-surgical cohort (<i>n</i> = 461), 269 participants received some form of conservative treatment, of whom 194 (72.1%) did not experience symptom improvement on any treatment offered.</p><h3>Conclusions</h3><p>A cohort of patients with nhSPC who participated in this international survey reports substantial and durable improvement in symptom severity and quality of life after pineal cyst resection.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"166 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-024-06403-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142889867","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 and radiologic distinctions between familial cavernous malformation syndrome and cerebral amyloid angiopathy","authors":"KD Flemming,&nbsp;Jonathan Graff Radford,&nbsp;Ross Reichard,&nbsp;James Klaas,&nbsp;Sherri Braksick,&nbsp;Petrice Cogswell,&nbsp;Giuseppe Lanzino","doi":"10.1007/s00701-024-06400-8","DOIUrl":"10.1007/s00701-024-06400-8","url":null,"abstract":"<div><h3>Purpose</h3><p>Familial cerebral cavernous malformation syndrome (FCCM) is characterized by multiple hemorrhagic lesions and is sometimes mistaken for cerebral amyloid angiopathy (CAA).</p><h3>Methods</h3><p>We compared clinical and radiologic characteristics in patients with definite (<i>N</i> = 32) and presumed FCCM (<i>n</i> = 76) to patients with definite (<i>N</i> = 29) and probable CAA (<i>N</i> = 21).</p><h3>Results</h3><p>Patients with CAA were older (78.6 years CAA vs. 43.4 FCCM; <i>p</i> &lt; 0.0001), had cognitive complaints (66.0% CAA vs. 8.3% FCCM; <i>p</i> &lt; 0.0001), and less likely to have a family history (4.0% CAA vs. 50.9% FCCM; <i>p</i> &lt; 0.0001). FCCM patients were more likely to have at least 1 Zabramski type 2 lesion (0 CAA vs. 79.6% FCCM; <i>p</i> &lt; 0.0001). Presence of any subcortical white matter hemorrhagic lesion (23.0% CAA vs. 99.1% FCCM; <i>p</i> &lt; 0.0001), a lesion in either the basal ganglia, internal capsule or cerebellum (28.0% CAA vs 79.6% FCCM; <i>p</i> &lt; 0.0001) and a subcortical white matter to cortical ribbon distribution of hemorrhagic lesions ≥ 1.0 was predictive of FCCM (6.0% CAA vs 83.9% FCCM; <i>p</i> &lt; 0.0001). CAA patients more commonly had white matter disease, sulcal subarachnoid hemorrhage, and severely enlarged perivascular spaces in the centrum. However, none of the latter features were unique to CAA. FCCM patients meeting Boston 2.0 criteria for CAA (<i>n</i> = 14) had additional factors that helped distinguish them from CAA.</p><h3>Conclusions</h3><p>Patients with FCCM can be reliably distinguished from CAA by accurately applying the Boston 2.0 criteria, assessing hemorrhagic lesion distribution and types, and assessing for clinical features unique to FCCM. FCCM criteria are proposed. The frequent finding of leukoaraiosis and enlarged perivascular spaces in the centrum semiovale in FCCM patients deserves further investigation.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"166 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-024-06400-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142875162","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":"Mini-strokes within Broca-caudate connections during left insular glioma awake surgery cause transient severe naming deficits","authors":"Valéry Mandonnet,&nbsp;François Rheault,&nbsp;Marion Barberis,&nbsp;Cécile Prevost,&nbsp;Sophie Letrange,&nbsp;Isabelle Poisson,&nbsp;Sébastien Froelich,&nbsp;Emmanuel Mandonnet","doi":"10.1007/s00701-024-06374-7","DOIUrl":"10.1007/s00701-024-06374-7","url":null,"abstract":"<div><h3>Objective</h3><p>To provide an explanation for the intraoperative onset of severe naming deficits in the course of awake resection of left insular glioma.</p><h3>Methods</h3><p>We retrospectively reviewed a series of 14 patients operated on in awake conditions for a left insular IDH-mutated glioma. Preoperative MRI included high-resolution diffusion sequences, to which constrained spherical deconvolution pipeline was applied, to obtain a whole brain tractogram. Whole brain T1 parcellation was obtained by Freesurfer, allowing to dissect the tractogram and identify the connections between the caudate nucleus and Broca’s area. Postoperative MRI standard diffusion the day after surgery was performed, allowing to delineate and register to the preoperative MRI any area of hyperintense diffusion with low apparent diffusion coefficient. The pathway between pars triangularis (resp. opercularis) and Broca’s area were considered as damaged whenever more than 50% of streamlines were passing through the mini-strokes. Patients’ language abilities (including a picture naming task) were assessed and reported before, during and after surgery by certified speech therapists. Severe postoperative naming deficits were defined as a score lower than 40/80 items. Contingency tables were analyzed with Fisher exact test (statistical significance set at 0.05).</p><h3>Results</h3><p>Out the 14 patients, 8 patients had a mini-stroke on the immediate postoperative MRI. None of the 6 patients without any stroke had postoperative naming severe deficits. Five out the 8 patients with a mini-stroke had a severe postoperative naming deficit, characterized by strong verbal perseverations. This difference was statistically significant (exact Fisher test, <i>p</i> = 0.03). For the five patients with a deficit, the mini-stroke damaged either the pars triangularis – caudate pathway or the pars opercularis – caudate pathway, whenever the pars triangularis was resected after negative cortical mapping. For the three patients without severe postoperative naming deficit, the mini-stroke spared the Broca-caudate pathway. All patients recovered quasi-normal naming abilities at the 4-month postoperative evaluation.</p><h3>Conclusions</h3><p>The occurrence of mini-strokes within the connections between Broca’s area and the caudate nucleus explains the sudden naming deficits observed intraoperatively in some patients during awake resection of IDH-mutated insular glioma. Further studies are needed to better predict such event and to assess its impact on other cognitive functions.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"166 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845114","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":"Treatment of unruptured intracranial vertebral artery dissection aneurysms with Flow Diverter compared with conventional stent-assisted coiling—a single-center study","authors":"Tongfu Zhang,&nbsp;Weiying Zhong,&nbsp;Donglin Zhou,&nbsp;Yangyang Xu,&nbsp;Maogui Li,&nbsp;Jianfeng Zhuang,&nbsp;Donghai Wang,&nbsp;Wandong Su,&nbsp;Yunyan Wang","doi":"10.1007/s00701-024-06398-z","DOIUrl":"10.1007/s00701-024-06398-z","url":null,"abstract":"<div><h3>Aim</h3><p>Flow diverters (FDs) are being increasingly used off-label for treatment of intracranial vertebral artery dissection aneurysms (IVADAs). However, the safety and efficacy of FDs for unruptured IVADAs remain unclear. This study was performed to investigate whether FDs-alone are safer and more effective than conventional stent-asisted coiling.</p><h3>Methods</h3><p>We retrospectively analyzed 152 patients who underwent endovascular stenting from December 2011 to December 2022. The baseline data, aneurysm characteristics, surgical details, perioperative complications, follow-up angiography, and clinical outcomes were collected and compared between patients who underwent stenting with FD-alone versus conventional stent-asisted coiling. Propensity score matching was also conducted.</p><h3>Results</h3><p>All 152 patients underwent successful endovascular therapy. Forty patients were treated with FDs-alone, and 112 were treated with conventional stent-asisted coiling (including 62 with double stents). The complete occlusion rate was 93.75% in the FD group and 93.61% in the conventional stent group (<i>p</i> = 0.979). The complication rate was 5.00% in the FD group and 8.93% in the conventional stent group (<i>p</i> = 0.653). The in-stent restenosis rate was 3.13% in the FD group and 5.32% in the conventional stent group (<i>p</i> = 0.615). The procedure duration was significantly shorter in the FD than conventional stent group (<i>p</i> = 0.034). After propensity score matching, 37 patients with FDs were successfully matched, and the procedure duration was still significantly shorter in the FD group (<i>p</i> = 0.042).</p><h3>Conclusion</h3><p>FD placement is a safe and effective treatment for IVADAs. It is also a simpler procedure with a shorter operation time than conventional stent placement.</p><p>Trial registration number: ChiCTR2300074171</p><p>ClinicalTrials.gov ID:NCT06134557</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"166 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-024-06398-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845115","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":"Machine learning for predicting post-operative outcomes in meningiomas: a systematic review and meta-analysis","authors":"Siraj Y. Abualnaja,&nbsp;James S. Morris,&nbsp;Hamza Rashid,&nbsp;William H. Cook,&nbsp;Adel E. Helmy","doi":"10.1007/s00701-024-06344-z","DOIUrl":"10.1007/s00701-024-06344-z","url":null,"abstract":"<div><h3>Purpose</h3><p>Meningiomas are the most common primary brain tumour and account for over one-third of cases. Traditionally, estimations of morbidity and mortality following surgical resection have depended on subjective assessments of various factors, including tumour volume, location, WHO grade, extent of resection (Simpson grade) and pre-existing co-morbidities, an approach fraught with subjective variability. This systematic review and meta-analysis seeks to evaluate the efficacy with which machine learning (ML) algorithms predict post-operative outcomes in meningioma patients.</p><h3>Methods</h3><p>A literature search was conducted in December 2023 by two independent reviewers through PubMed, DARE, Cochrane Library and SCOPUS electronic databases. Random-effects meta-analysis was conducted.</p><h3>Results</h3><p>Systematic searches yielded 32 studies, comprising 142,459 patients and 139,043 meningiomas. Random-effects meta-analysis sought to generate restricted maximum-likelihood estimates for the accuracy of alternate ML algorithms in predicting several postoperative outcomes. ML models incorporating both clinical and radiomic data significantly outperformed models utilizing either data type alone as well as traditional methods. Pooled estimates for the AUCs achieved by different ML algorithms ranged from 0.74–0.81 in the prediction of overall survival and progression-/recurrence-free survival, with ensemble classifiers demonstrating particular promise for future clinical application. Additionally, current ML models may exhibit a bias in predictive accuracy towards female patients, presumably due to the higher prevalence of meningiomas in females.</p><h3>Conclusion</h3><p>This review underscores the potential of ML to improve the accuracy of prognoses for meningioma patients and provides insight into which model classes offer the greatest potential for predicting survival outcomes. However, future research will have to directly compare standardized ML methodologies to traditional approaches in large-scale, prospective studies, before their clinical utility can be confidently validated.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"166 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-024-06344-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142826195","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":"Relationship between the pelvic incidence and the modified Oxford Hip score: a computed tomographic analysis","authors":"Joseph F. Baker","doi":"10.1007/s00701-024-06394-3","DOIUrl":"10.1007/s00701-024-06394-3","url":null,"abstract":"<div><h3>Purpose</h3><p>There is scant data on the relationship between skeletal maturity and pelvic parameters such as the pelvic incidence (PI). The aim of this study was to report on the relationship between PI and the modified Oxford Hip Score (mOHS) as a measure of skeletal maturity. We hypothesised a significant correlation would be determined between the mOHS and PI.</p><h3>Methods</h3><p>CT performed for major trauma or abdominal pathology was assessed. The PI and segmental vertebral body angles, L1-L5, were obtained. The mOHS was used to assess maturity with total scores ranging from 16 to 25 (least-most mature). 193 scans were analysed. The mean age 9.7 years (range 4.0 - 15.7); 62 female (32%).</p><h3>Results</h3><p>There were significant positive correlations between age and all components of the mOHS: FH (<i>r</i> = 0.765; <i>p</i> &lt; 0.001), GT (<i>r</i> = 0.749; <i>p</i> &lt; 0.001), LT (<i>r</i> = 0.704; <i>p</i> &lt; 0.001), TC (<i>r</i> = 0.775; <i>p</i> &lt; 0.001), IL (<i>r</i> = 0.642; <i>p</i> &lt; 0.001) and mOHS (<i>r</i> = 0.811; <i>p</i> &lt; 0.001). Mean PI for the cohort was 40.8 (s.d. 9.1; range 19.3–69.4). There were significant albeit weak correlations with FH (<i>r</i> = 0.213; <i>p</i> = 0.003), GT (<i>r</i> = 0.209; <i>p</i> = 0.004), LT (<i>r</i> = 0.247; <i>p</i> &lt; 0.001), TC (<i>r</i> = 0.263; p = &lt; 0.001), IL (<i>r</i> = 0.221; <i>p</i> = 0.002) and total mOHS (<i>r</i> = 0.255; <i>p</i> &lt; 0.001). Multivariable linear regression indicated TC and LT the best predictors of PI. Significant correlations noted between L1 segmental lordosis and all components of the mOHS, strongest with triradiate (<i>r</i>=-0.406; <i>p</i> &lt; 0.001).</p><h3>Conclusions</h3><p>In this CT-based study, the mOHS correlated weakly with PI and proximal vertebral body lordosis. Of the mOHS components, triradiate and lesser trochanter cartilage status appeared to be best correlated with PI and may be anatomic variables to focus on in future research.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"166 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142826291","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":"Exploration of simultaneous transients between cerebral hemodynamics and the autonomic nervous system using windowed time-lagged cross-correlation matrices: a CENTER-TBI study","authors":"Agnieszka Uryga,&nbsp;Cyprian Mataczyński,&nbsp;Adam I. Pelah,&nbsp;Małgorzata Burzyńska,&nbsp;Chiara Robba,&nbsp;Marek Czosnyka,&nbsp;CENTER-TBI high-resolution sub-study participants and investigators","doi":"10.1007/s00701-024-06375-6","DOIUrl":"10.1007/s00701-024-06375-6","url":null,"abstract":"<div><h3>Background</h3><p>Traumatic brain injury (TBI) can significantly disrupt autonomic nervous system (ANS) regulation, increasing the risk for secondary complications, hemodynamic instability, and adverse outcome. This retrospective study evaluated windowed time-lagged cross-correlation (WTLCC) matrices for describing cerebral hemodynamics–ANS interactions to predict outcome, enabling identifying high-risk patients who may benefit from enhanced monitoring to prevent complications.</p><h3>Methods</h3><p>The first experiment aimed to predict short-term outcome using WTLCC-based convolution neural network models on the Wroclaw University Hospital (WUH) database (P_training = 31 with 1,079 matrices, P_val = 16 with 573 matrices). The second experiment predicted long-term outcome, training on the CENTER-TBI database (P_training = 100 with 17,062 matrices) and validating on WUH (P_val = 47 with 6,220 matrices). Cerebral hemodynamics was characterized using intracranial pressure (ICP), cerebral perfusion pressure (CPP), pressure reactivity index (PRx), while ANS metrics included low-to-high-frequency heart rate variability (LF/HF) and baroreflex sensitivity (BRS) over 72 h. Short-term outcome at WUH was assessed using the Glasgow Outcome Scale (GOS) at discharge. Long-term outcome was evaluated at 3 months at WUH and 6 months at CENTER-TBI using GOS and GOS-Extended, respectively. The XGBoost model was used to compare performance of WTLCC-based model and averaged neuromonitoring parameters, adjusted for age, Glasgow Coma Scale, major extracranial injury, and pupil reactivity in outcome prediction.</p><h3>Results</h3><p>For short-term outcome prediction, the best-performing WTLCC-based model used ICP-LF/HF matrices. It had an area under the curve (AUC) of 0.80, vs. 0.71 for averages of ANS and cerebral hemodynamics metrics, adjusted for clinical metadata. For long-term outcome prediction, the best-score WTLCC-based model used ICP-LF/HF matrices. It had an AUC of 0.63, vs. 0.66 for adjusted neuromonitoring parameters.</p><h3>Conclusions</h3><p>Among all neuromonitoring parameters, ICP and LF/HF signals were the most effective in generating the WTLCC matrices. WTLCC-based model outperformed adjusted neuromonitoring parameters in short-term but had moderate utility in long-term outcome prediction.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"166 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00701-024-06375-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142826290","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? surgical resection of craniocervical junction dural arteriovenous fistula","authors":"Zixiao Yang,&nbsp;Xingfen Su,&nbsp;Zhicheng Wang,&nbsp;Jianping Song","doi":"10.1007/s00701-024-06399-y","DOIUrl":"10.1007/s00701-024-06399-y","url":null,"abstract":"<div><h3>Background</h3><p>Craniocervical junction (CCJ) dural arteriovenous fistulas (DAVFs) represent a rare yet critical vascular anomaly that may result in significant neurological impairments.</p><h3>Method</h3><p>We report the case of a 52-year-old male with a history of medullary hemorrhage who underwent surgical intervention for a left CCJ DAVF. Through comprehensive surgical planning and meticulous intraoperative monitoring, multiple feeders of the DAVF were safely coagulated and transected, with successful DAVF obliteration confirmed by intraoperative angiography.</p><h3>Conclusion</h3><p>The patient demonstrated full recovery, underscoring the efficacy of surgical management in complex cases facilitated by advanced techniques in a hybrid operating theatre.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"166 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142826292","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":"Neuroplasticity in glioblastoma: there is more to plasticity than just low grade glioma","authors":"Sally-Ann Price,&nbsp;Dimitrios Kalaitzoglou,&nbsp;Kapil Rajwani,&nbsp;Sabina Patel,&nbsp;Hilary Wren,&nbsp;Richard Gullan,&nbsp;Keyoumars Ashkan,&nbsp;Ranjeev Bhangoo,&nbsp;Francesco Vergani,&nbsp;José Pedro Lavrador","doi":"10.1007/s00701-024-06396-1","DOIUrl":"10.1007/s00701-024-06396-1","url":null,"abstract":"<div><p>Neuroplasticity is well established in low grade glioma patients. Less is known about functional plasticity in glioblastomas. A 56-year-old lady presented with a recurrent speech deficit seventeen months after her initial craniotomy for a language eloquent glioblastoma (GBM). Pre-operative navigated trans-cranial magnetic stimulation (n-TMS) for language mapping, tractography and intra-operative language mapping were performed. During her second admission, preoperative n-TMS revealed positive responses anterior and posterior to the tumour recurrence. Tractography revealed a decrease in the anterior extension of the Arcuate Fasciculus (AF) in the inferior frontal gyrus and a more anterior component of the Frontal-Aslant Tract (FAT) showed anterior to the tumour itself. A second resection was carried out and the patient was discharged with no language deficit for second line treatment with Lomustine. Intraoperatively, speech arrest was found in a new position posterior to the previous surgical cavity and away from tumour recurrence (where speech arrest was previously located). This case report shows language function neuroplasticity in glioblastoma. This is supported by preoperative cortical and subcortical mapping.</p></div>","PeriodicalId":7370,"journal":{"name":"Acta Neurochirurgica","volume":"166 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142810993","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}