Neurocirugia (English Edition)最新文献

{"title":"Contralateral subdural effusion following decompressive hinged craniotomy: A case report and narrative review.","authors":"Artem Kuptsov, Alessandra Rocca, Cristina Gómez-Revuelta, Ana Flores-Justa, J Fernández-Villa, J A Nieto-Navarro","doi":"10.1016/j.neucie.2025.500660","DOIUrl":"https://doi.org/10.1016/j.neucie.2025.500660","url":null,"abstract":"<p><p>Hinged craniotomy (HC) is an alternative surgical technique that can be used in place of decompressive craniectomy (DC) to treat refractory intracranial hypertension. This procedure has the advantage of avoiding the need for a second surgery to replace the bone, while giving a good control of intracranial pressure. However, there is no consistent literature about complications of HC. In particular, there are no reported cases of contralateral subdural effusion (CSE) after HC. In this article we present a case of a 55-years-old man who developed CSE after a hinged craniotomy (HC) for intracranial hypertension, and how we handled it. Therefore, we explored literature to better understand the pathogenesis of CSE, treatments and possible prevention strategies.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500660"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dr Máximo Poza y Poza.","authors":"Juan F Martínez-Lage Sánchez","doi":"10.1016/j.neucie.2025.500661","DOIUrl":"https://doi.org/10.1016/j.neucie.2025.500661","url":null,"abstract":"","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500661"},"PeriodicalIF":0.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Craniopharyngioma and abscess: When tumor and infection co-exist.","authors":"Luis Miguel Moreno-Gómez, Pablo M Munarriz, Aurelio Hernández-Laín, Alfonso Lagares","doi":"10.1016/j.neucie.2025.500657","DOIUrl":"10.1016/j.neucie.2025.500657","url":null,"abstract":"<p><p>Pituitary abscesses are rare entities that may occur in a previously healthy gland or in the setting of a pituitary tumor. Only eleven cases of abscesses associated with craniopharyngioma have been reported in the literature. The etiology is unknown and the diagnosis is difficult because there are no specific clinical or radiologic features that allow us to suspect the synchrony of both entities before surgery. Intraoperative findings and culture are the only definitive signs to confirm this association. Here we present the first surgical video showing this unique association and highlighting the technical pearls of the procedure. In a 9-year-old boy, we performed a transphenoidal approach to resect the tumor and saw pus during surgery. Pathology revealed a papillary craniopharyngioma, with microbiology showing Staphylococcus aureus. The tumor resection resulted in ophthalmologic improvement but pituitary insufficiency. A brief review of the literature is presented.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500657"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fully percutaneous posterior transarticular C1-C2 stand-alone screw instrumentation: A case series and technical note.","authors":"Ivan Lvov, Andrey Grin, Anton Kordonskiy, Zaali Barbakadze, Aleksandr Talypov, Aleksandr Tupikin","doi":"10.1016/j.neucie.2025.500665","DOIUrl":"10.1016/j.neucie.2025.500665","url":null,"abstract":"<p><p>Magerl's technique remains a widely accepted method for achieving C1-C2 fusion. Although two approaches using intermuscular corridors and biplanar X-ray guidance have been reported, there are no published studies dedicated to fully percutaneous techniques employing cannulated screws.</p><p><strong>Objective: </strong>To demonstrate the feasibility of a fully percutaneous C1-C2 fixation technique using cannulated screws and to analyze the short- and long-term outcomes of the initial case series.</p><p><strong>Material and methods: </strong>This case series included patients over 15 years of age who were presented with acute or subacute atlantoaxial instability at C1-C2 due to fractures of the odontoid process, C1 vertebra, or C2 vertebral body. Surgical details and fusion criteria were described. Due to the absence of comparison groups, only descriptive statistical methods were employed.</p><p><strong>Results: </strong>A total of 11 patients (8 men, 3 women; mean age 41.5 ± 18.2 years) underwent fully percutaneous transarticular C1-C2 fixation. The mean operative time was 115.0 ± 30.8 min for patients stabilized using a Halo device and 80.6 ± 33.2 min for those immobilized with a Mayfield clamp. The mean blood loss across all cases was 38.8 ± 8.7 mL. One patient died from concurrent cardiac pathology. Two patients were lost to follow-up due to relocation, leaving 8 patients for final assessment. At final follow-up, the mean VAS score was 2 ± 1.5 and the mean NDI score was 5.3 ± 5.2. All patients with preoperative neurological deficits improved by one level on the ASIA scale. Fusion was achieved in 7 of 8 cases (87.5%), and 1 patient (12.5%) developed a stable C1-C2 pseudoarthrosis.</p><p><strong>Conclusion: </strong>Our initial clinical experience demonstrated that fully percutaneous posterior transarticular C1-C2 stand-alone screw fixation using cannulated instruments could be a feasible and safe procedure. Critical requirements for this technique include complete reduction of atlantoaxial dislocation, compression in the lateral joint region, adequate intraoperative visualization, and strict adherence to specific screw trajectories.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500665"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ALIF in a Spanish female cohort: No urinary and sexual complications or a gender bias?","authors":"Cristina Romero-López, Santiago Rocha-Romero, María de Los Ángeles Cañizares-Méndez, Julio Valencia-Anguita","doi":"10.1016/j.neucie.2025.500662","DOIUrl":"10.1016/j.neucie.2025.500662","url":null,"abstract":"<p><strong>Background: </strong>The objective of the present study is to analyze urinary and sexual functions in females treated with ALIF and to describe possible complications not previously reported in the literature.</p><p><strong>Methods: </strong>We conducted a retrospective study of urinary and sexual functions in females treated with this technique in our hospital between 2019 and 2022. Inclusion criteria were: females treated with ALIF who provided informed consent.</p><p><strong>Results: </strong>22 patients consented to participate. The median age was 51.5 years, the median follow-up was 11.5 months, and there was an improvement in low back pain of 4 points on the postoperative (postop) visual analogue scale (VAS). Overall, 36.3% of patients reported postoperative urinary deterioration, including 27.3% with new-onset urinary incontinence. The international consultation on incontinence questionnaire-short form score worsened by 3.5 points. 77.2% maintained an active sexual life; within this group, there was a worsening of 2.4 points in the postop female sexual function index and 35.2% described worsening in sexual function. We hypothesized that age, underlying lumbar pathology and changes in postoperative VAS scores could be confounding factors; however, only the relationship between age and postoperative urinary deterioration reached statistical significance (p = 0.034).</p><p><strong>Conclusions: </strong>The present study describes deterioration in urinary function in 36.3% and in sexual function in 35.2% after the procedure, findings also supported by specific scales. In view of the above, we cannot discount a possible gender bias in the literature. Despite that, we believe that ALIF is still an adequate technique, but studies of higher level of evidence should be conducted to improve the information process of our patients.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500662"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Missed diagnosis; non-traumatic retroclival haematoma in adults, brief case report with review and evaluation of similar cases in the literature.","authors":"Ali Rıza Güvercin, Mehmet Aktoklu, Mehmet Orbay Bıyık, Uğur Yazar","doi":"10.1016/j.neucie.2025.500664","DOIUrl":"10.1016/j.neucie.2025.500664","url":null,"abstract":"<p><p>Retroclival subdural haematomas (RSH) are a rare occurrence, accounting for 0.3% of acute extra-axial haematomas. Although typically associated with trauma, non-traumatic causes include coagulopathy, pituitary apoplexy and vascular anomalies.The presence of cases due to non-traumatic causes can present significant diagnostic challenges. This article aims to shed light on the intricacies of non-traumatic RSH by conducting a review of the literature and presenting a case study of a 74-year-old woman on anticoagulants. The primary objective is to enhance our understanding of the diagnosis and treatment of this condition, emphasising the significance of bleeding in a location that often goes unnoticed, particularly in Computed Tomography (CT) scans, with the exception of trauma. A comprehensive review of the literature revealed 28 cases of non-traumatic RSH in adults. A detailed analysis was conducted on the demographic characteristics, causes, presentations and outcomes of these cases.The mean patient age was found to be 59 years, with a slight male predominance of 57.57%. The primary causes were identified as pituitary apoplexy (39.28%) and anticoagulants (21.42%), while 25% of cases had an unknown aetiology. Spinal canal extension occurred in 10.71% of cases, which increased morbidity.The recovery rate was 92.85% and the mortality rate was 3.57%.Non-traumatic RSH is under-recognised and often missed on standard imaging.Conservative treatment is effective without spinal cord compression.Awareness is very important, especially for diagnosis and treatment.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500664"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical and systemic effects of medical ozone therapy on epidural fibrosis: Experimental research.","authors":"Nur Balcin, Mine Ozsen, Pinar Eser, Tamer Kala, Gokhan Ocakoglu, Seref Dogan","doi":"10.1016/j.neucie.2025.500663","DOIUrl":"10.1016/j.neucie.2025.500663","url":null,"abstract":"<p><strong>Introduction: </strong>Epidural fibrosis (EF) causes adhesions in the epidural distance, resulting in chronic low back and leg pain symptoms during the postoperative period. Currently, ozone is used for treating lumbar disk herniation and low back pain. However, its effect on epidural fibrosis is largely unknown.</p><p><strong>Material and methods: </strong>This rodent study examined the histopathological and biochemical effects of ozone therapy on epidural fibrosis. Forty-seven male Sprague-Dawley rats were divided into four groups, as follows: Control Group (CG) (n = 12): Laminectomy was performed, and no substance was applied. Saline Group (SG) (n = 11): Rats underwent intraoperative washing with 50 mL saline after laminectomy. Local Ozone Group (LOG) (n = 12): Rats underwent intraoperative washing with 50 mL ozonated distilled water after laminectomy. Systemic Ozone Group (SOG) (n = 12): Ozone was administered intraperitoneally (0.7 mg/kg) for 7 consecutive days postoperatively. At the end of 4 weeks, all subjects were sacrificed. Histopathological and biochemical data obtained from the tissues were analyzed in terms of EF.</p><p><strong>Results: </strong>No statistically significant differences regarding EF, spinal cord retraction, inflammation, and fibroblast density were observed between the groups (p = 0.728; p = 0.813; p = 0.152; and p = 0.226, respectively). Hydroxyproline levels were higher in LOG than in SOG (p = 0.007); however, no statistically significant differences were observed among other groups (p > 0.05).</p><p><strong>Conclusions: </strong>In our study, we could not record the positive effect of ozone therapy in terms of histopathology and biochemistry with the current doses and application methods. We think that caution should be exercised in the ozone dose and method of application in the clinical approach. In addition, we are of the opinion that statistically significant results can be obtained by creating a treatment protocol that includes different dose applications.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500663"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous sitting position during the postoperative period as an intervention to reduce risk of cerebrospinal fluid leak after endoscopic endonasal surgery.","authors":"José de Jesús Martínez-Manrique, Ricardo A Palacios-Rodríguez, Luis A Rodríguez-Hernández, Jorge F Aragón-Arreola, Marcos V Sangrador-Deitos, Juan Luis Gómez-Amador","doi":"10.1016/j.neucie.2025.500658","DOIUrl":"10.1016/j.neucie.2025.500658","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>In recent decades, endoscopic endonasal surgery for skull base tumours has modified the way in which this region is approached. One of the most feared complications is the cerebrospinal fluid leak. It has been shown in different publications about CSF physiology that changes in the position modify the pressure of the CSF (pCSF). With this background, it is proposed as a viable, noninvasive, and very low-risk option, the continuous sitting position in patients during their hospital stay after endoscopic endonasal surgery as an adjuvant intervention to reduce the risk of CSF leak in patients considered to be at high risk. The objective is to demonstrate that the continuous sitting position in the postoperative period is a useful adjuvant intervention for the prevention of CSF leak in endoscopic endonasal surgery.</p><p><strong>Methods: </strong>This is a retrospective, observational, cross-sectional, comparative study. It included patients over 18 years of either sex, intervened by endoscopic endonasal surgery with intraoperative CSF leak observed and with advanced reconstruction technique realized. A continuous sitting position (between 70 ° and 90 °) was considered when the patient remained in this position from the immediate postoperative period until the hospital discharge.</p><p><strong>Results: </strong>A total of 60 patients were included. No statistically significant difference was found on all the variables studied, except when patients were stratified into sitting and non-sitting patients (p = 0.045). OR of 0.12 (95% CI 0.002-1.03) was observed. In the sitting group, only 1 patient (6.67%) had CSF leak, which was resolved with non-surgical treatment. The average length of hospital stay was 18 days (7-38) for sitting patients and 14 days (5-80) for non-sitting patients, with statistical significance stablished by the dispersion of the data (p = 0.023).</p><p><strong>Conclusions: </strong>The continuous sitting position during the immediate postoperative period is an intervention that shows a decrease in the risk of CSF leak in patients intervened by endoscopic endonasal approach, included extended routes.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500658"},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Short-segment lumbar fusion\" vs.\"microsurgical bilateral decompression via unilateral approach\" after removal of the spinal fixators in patients with adjacent segment disease: Clinical retrospective study.","authors":"Turgut Kuytu, Ahmet Karaoğlu","doi":"10.1016/j.neucie.2025.500654","DOIUrl":"10.1016/j.neucie.2025.500654","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>In cases where adjacent segment disease (ASD) develops following lumbar fusion surgery, various surgical approaches can be employed. In such cases, removal of the instrumentation can positively impact lumbar pain syndrome. One frequently used method is short-segment fixation-decompression (SSFD). One of minimally invasive methods is microsurgical bilateral decompression via unilateral approach (MBDU). This study aims to determine which method is more effective and safe in cases that developed ASD following fusion surgery by comparing SSFD and MBDU after instrumentation removal.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 47 cases treated with SSFD and 29 cases treated with MBDU. The groups were analyzed for gender, age, preoperative symptom duration, duration of hospitalization, and Visual Analogue Scale (VAS) scores and Oswestry Disability Index (ODI) scores during the preoperative and postoperative intermittent follow-up periods.</p><p><strong>Results: </strong>Duration of hospitalization was higher in the SSFD group compared to the MBDU group (p = <0.001 CI = 56,42-76,24 and 22,04-25,13 respectively), mean transverse canal diameter ratio in the decompressed segment was lower in the SSFD group (p = 0,03 IC = 0,24-0,31 for SSFD y 0,40-0,47 for MBDU), and ODI indices were higher in the SSFD group in all follow-ups (p = <0.001). During the follow-up period, symptomatic ASD was observed in 3 of 47 patients in the SSFD group, whereas no symptomatic ASD was observed in the MBDU group.</p><p><strong>Conclusion: </strong>In selected patients who develop ASD after fusion surgery MBDU after instrumentation removal can be considered as a minimally invasive option that does not exacerbate postoperative lumbar pain syndrome or lead to the development of new ASD. To the best of our knowledge, this is the first comparison of these two techniques in literature after removal of spinal fixators in lumbar ASD cases.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500654"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of Glucose/Potassium Ratio and Neutrophil/Lymphocyte Ratio in the prognosis of patients with aneurysmal subarachnoid hemorrhage.","authors":"M Maldonado-Luna, A M Castaño-León, A E Baciu, Alzamora-Llull Luis, Vallés-Núñez Elvira, A Lagares","doi":"10.1016/j.neucie.2025.500655","DOIUrl":"10.1016/j.neucie.2025.500655","url":null,"abstract":"<p><strong>Antecedents and objective: </strong>Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high morbidity and mortality. Traditional factors strongly associated with poor outcome are neurological condition and the amount of bleeding. Inflammation is considered a relevant mechanism of brain injury after aSAH. This study aims to investigate the potential role of new laboratory indexes related to inflammation for predicting the prognosis of aSAH patients, complementing established prognostic models.</p><p><strong>Materials and methods: </strong>We conducted a retrospective observational study including adults admitted for aSAH at a single neurosurgery center from 2002 to 2023. Demographic data, clinical parameters, and blood test results at admission were collected. The main outcome variable was Glasgow Outcome Scale (GOS) six month post-bleeding. A second outcome variable was in-hospital mortality. Univariable analyses were performed to identify new laboratory predictors of poor prognosis. The independent association with outcome was evaluated after adjustment of traditional risk factors by logistic regression analysis. The additional value of new laboratory predictors was determined by comparison of the area under the receiver operating curve (AUROC).</p><p><strong>Results: </strong>Among 542 patients with aSAH, 417 met inclusion criteria (age >18 years old and complete laboratory test available upon admission with aSAH confirmed by CT angiography (CTA) or digital subtraction angiography (DSA)). Elevated glucose/potassium ratio (GKR) in the first blood test at admission was significantly associated with unfavorable outcome and in-hospital mortality according to univariate analysis. The GKR was significantly associated with a worse final prognosis (OR 1.033, 95% CI 1.008-1.040) adjusted for age, WFNS and Fisher scales, history of diabetes mellitus and kidney disease, and prior use of diuretics, oral antidiabetic medications and insulin. Additionally, the inclusion of the GKR improved the predictive accuracy of a prognostic model compared to a model including only clinical and radiological data. The neutrophil-lymphocyte ratio (NLR) was not significantly different between subgroups of patients regarding their outcome.</p><p><strong>Conclusion: </strong>GKR measured in the first 24 h after aSAH may improve the discrimination of patients with higher risk of experiencing poor outcome at six month after the bleeding.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500655"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}