Neurocirugia (English Edition)最新文献

{"title":"Langerhans cells histiocytosis with invasion into the brain parenchyma: A rare presentation.","authors":"Claudio Sebastián Iglesias Vargas, Tomas Quinzacara Aravena, Ingrid Trujillo Ramos, Sebastián Vigueras Alvares","doi":"10.1016/j.neucie.2025.500676","DOIUrl":"10.1016/j.neucie.2025.500676","url":null,"abstract":"<p><p>This case presents an unusual case of Langerhans cell histiocytosis with invasion into the brain parenchyma, a rare phenomenon documented in few cases worldwide. The relevance of this case lies in the contribution to the knowledge of this pathology in the paediatric neuro-oncologic context. An 11-year-old boy presented with increased volume in the left frontal region, without neurological deficit or systemic symptoms. CT and MRI revealed an aggressive osteolytic lesion with perilesional oedema and intracranial extension. Complete excision of the lesion was performed, confirming Langerhans cell histiocytosis by immunohistochemistry. Chemotherapy was started with good tolerance and no complications so far. This case highlights the need for timely diagnosis and treatment in cases of Langerhans cell histiocytosis with brain involvement, given its potential impact on prognosis and the scarcity of specific guidelines for this type of manifestations.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500676"},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786138","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":"Global neurosurgery training. Part 1: Skills and challenges for equity.","authors":"María J García-Rubio, Jose Piquer-Martínez, Jose Piquer-Belloch, Ruben Rodríguez-Mena","doi":"10.1016/j.neucie.2025.500702","DOIUrl":"10.1016/j.neucie.2025.500702","url":null,"abstract":"<p><p>Neurosurgery requires rigorous training, yet access remains limited in low-resource countries, particularly in Africa, creating a crisis in specialised care. This paper, grounded in the principles of global neurosurgery, examines the essential competencies required in neurosurgical training, distinguishing between clinical skills-such as technical proficiency and decision-making-and non-clinical skills, including leadership, emotional management, and communication. Deliberate practice is emphasised as a key methodology for improving skill acquisition through structured repetition, continuous feedback, and expert supervision. Additionally, the main challenges of specialisation in East Africa are analysed: inadequate infrastructure, overburdened health systems, limited and heterogeneous residency programmes, and a shortage of qualified mentors. Finally, the development of innovative educational strategies is proposed to enhance training in resource-constrained settings and contribute to the sustainable advancement of the specialty.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500702"},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762617","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":"Epilepsy surgery in children: Outcomes of patients with drug-resistant epilepsy at a paediatric hospital in Bogotá, Colombia, with 10 years of follow-up.","authors":"Kevin José Navarro Jaime, Bryan Gómez Cristancho, David C Gómez Cristancho, Nelson Andres Cuevas Morales, Armando Rojas Calderon, Oscar Fernando Zorro Guio","doi":"10.1016/j.neucie.2025.500701","DOIUrl":"10.1016/j.neucie.2025.500701","url":null,"abstract":"<p><strong>Introduction: </strong>Drug-resistant epilepsy is defined as the lack of response to two appropriately selected antiepileptic drugs that the patient has tolerated properly. Epilepsy is a common neurological disorder in the paediatric population, with an estimated prevalence ranging from 4.3 to 9.3 cases per 1000 children, affecting 1.2% of the global population. Despite pharmacological treatment, between 30% and 40% of patients fail to achieve adequate seizure control, and approximately half of these become candidates for epilepsy surgery.</p><p><strong>Objective: </strong>To determine the incidence of seizure freedom, considering the Engel classification, in paediatric patients undergoing epilepsy surgery at a level IV paediatric hospital in Bogotá, Colombia.</p><p><strong>Methodology: </strong>A retrospective observational cohort study was conducted with paediatric patients treated at a level IV paediatric hospital by the epilepsy surgery team between January 1, 2013, and July 31, 2024.</p><p><strong>Results: </strong>Between 2013 and 2024, a total of 326 patients were evaluated through the epilepsy surgery programme. Of these, 154 underwent surgery. The median postoperative follow-up was 40months. The type of surgery was significantly associated with a higher likelihood of achieving favourable outcomes at 6months (RR=3.54; 95%CI: 1.86-6.77; p<.001) and 12months of follow-up (RR=4; 95%CI: 1.96-8.08; p<.001). The presence of daily seizures and the need for treatment with more than three medications were associated with a lower likelihood of achieving favourable outcomes during the follow-up period.</p><p><strong>Conclusions: </strong>The loss of years of healthy life since the diagnosis of epilepsy and the type of surgery performed (palliative or curative) were identified as independent factors strongly associated with favourable outcomes in the treatment of drug-resistant epilepsy.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500701"},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762616","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":"Giant Intrabdominal Meningocele in a Patient with Marfan Syndrome: Case Description and Surgical Management.","authors":"Jorge Cabrera-Montes, Ricardo Díez-Valle","doi":"10.1016/j.neucie.2025.500713","DOIUrl":"10.1016/j.neucie.2025.500713","url":null,"abstract":"<p><p>Anterior sacral meningocele is a rare complication associated with Marfan syndrome. There is no consensus regarding management and surgical treatment. Here, we describe the case of a 44-year-old women with Marfan syndrome who presented a progressive abdominal mass with gastrointestinal and urinary symptoms. Abdominopelvic MRI revealed a 3cm S1 dural ectasia and a 19x17x15cm abdominal mass. A posterior sacral transdural approach was performed. Dural friability made ligation unfeasible. Obliteration with a fat flap and fibrin sealant was the treatment alternative. Postoperative MRI imaging performed 4 months after surgery evidenced complete resolution of the intrabdominal collection. The patient remains free of symptoms 2 years later. Here we present one of the largest meningoceles reported to date in the literature, and illustrate the surgical management in a patient with Marfan syndrome, where technical difficulties arose. Solely posterior sacral transdural approach with fat graft may be sufficient for the treatment of these patients even with voluminous pelvic meningoceles.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500713"},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755296","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":"Parent artery occlusion for ruptured dissecting aneurysm of anterior inferior cerebellar artery: Case report and literature review.","authors":"Taiki Ishikawa, Hiroshi Kagami, Mami Ishikawa, Kenichi Oyama","doi":"10.1016/j.neucie.2025.500712","DOIUrl":"10.1016/j.neucie.2025.500712","url":null,"abstract":"<p><p>Subarachnoid hemorrhage (SAH) caused by a dissecting aneurysm of the anterior inferior cerebellar artery (AICA) is rare. Partial coil embolization of the AICA may be an effective treatment. A 65-year-old woman presented at the emergency room with headache and vomiting for the past five days, after contracting coronavirus disease (COVID)-19. Computed tomography (CT) revealed SAH and intraventricular hemorrhage, and the patient was diagnosed with a dissecting aneurysm of the AICA. The patient underwent endovascular surgery, and the AICA was partially occluded using coiling, with no subsequent hearing disturbance, cranial nerve palsy, or infarction. Ventriculoperitoneal shunt surgery was performed for hydrocephalus at 7 weeks after SAH. The patient was discharged from hospital with no neurological deficit. We reported a rare case of ruptured AICA dissecting aneurysm, which was treated by partial coil embolization without neurological deficit or infarction.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500712"},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755298","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":"Male pudendal nerve release assisted by laparoscopy and intraoperative neurophysiologic monitoring.","authors":"Cláudia Fernandes, Vanessa Viegas, Alberto Artiles Medina, Carlos Martins Silva, Luis San José, Luis López-Fando Lavalle","doi":"10.1016/j.neucie.2025.500714","DOIUrl":"10.1016/j.neucie.2025.500714","url":null,"abstract":"<p><strong>Introduction: </strong>Pudendal nerve entrapment (PNE) is rare, and mostly affects women, with men accounting for only 1/3 of cases. The European guidelines advocate surgical decompression in select PNE cases. We aim to evaluate surgical outcomes in a group of male patients diagnosed with PNE who underwent laparoscopic decompression surgery supported by intraoperative neurophysiological monitoring (pIOM).</p><p><strong>Material and methods: </strong>This retrospective and multicentric study included 138 patients with suspected PNE syndrome. The diagnosis of PNE was established based on neurophysiological tests and response to pudendal nerve block. Patients who experienced symptom relief following the nerve block underwent laparoscopic pudendal nerve decompression surgery, with pIOM utilized during the procedure. Symptom progression was tracked over a 12-month follow-up period.</p><p><strong>Results: </strong>A total of 84 (60%) were diagnosed with PNE. Of these, 20 (24%) were male, with 14 (70%) receiving pudendal nerve infiltration. Six men (46%) later underwent laparoscopic pudendal nerve decompression surgery with pIOM. At the 12-month follow-up, five patients (83%) reported significant pain reduction, while one (17%) noted no improvement. Visual Analog Scale ranged between 2 and 5. Bladder dysfunction resolved in 2 of the 3. Two patients ceased all medications by the 12-month mark. In terms of satisfaction, four patients expressed complete satisfaction, one reported partial satisfaction, and one did not provide feedback.</p><p><strong>Conclusion: </strong>Laparoscopic PNE decompression surgery, combined with pIOM is an effective intervention for male PNE patients with significant pain relief and enhanced quality of life. Further research is needed to validate these results and refine the criteria for patient selection.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500714"},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755297","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":"Relationship between the incidence of glioblastoma and natural radiation.","authors":"Jose Alberto Escribano Mesa, Leidy Vanessa Fajardo Güiza, Cristina Muñoz Romero, Juan Solivera Vela","doi":"10.1016/j.neucie.2025.500711","DOIUrl":"10.1016/j.neucie.2025.500711","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the relationship between the impact of high-grade gliomas (HGG) on the population in Córdoba from 2008 to 2019 and the natural radiation background, estimated using radon maps and water origin according to the supply reservoir. Correlation of the results with other prognostic factors. The survival study based on exposure to radon.</p><p><strong>Material and methods: </strong>Observational, cross-sectional, retrospective 11-year study on 365 patients diagnosed with HGG at the Reina Sofía Hospital in Córdoba, exposed or not, to significant radiation, to estimate the impact that this could have on HGG.</p><p><strong>Results: </strong>The incidence of patients diagnosed with glioblastoma multiforme (GBM) in those exposed to radon was 41.6 versus 31.4 cases/100,000 inhabitants in those not exposed (p=0.02). The global incidence of HGG was 52.8 cases in those exposed to radon compared with 45 cases/1000 inhabitants in the unexposed ones (p=0.12). It was found that 56.8/100,000 were supplied by reservoirs significant for radon, compared to 31.4 cases/100,000 inhabitants that were not (p=0.23). A Cox regression was performed, leaving IDH mutation and type of intervention in the model: survival is six times higher in positive IDH mutation (p=0.021) and three in surgically intervened (p<0.001).</p><p><strong>Conclusions: </strong>Long-term exposure to natural radiation does seem to increase the risk factor for the appearance of GBM. However, other factors influencing such exposure must be considered, such as reliable measurements of radiation and time spent in that place.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500711"},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755299","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":"Recurrent spinal subdural hematoma in granulomatosis with polyangiitis","authors":"Teresa Kalantari ,&nbsp;Celia Ortega-Angulo ,&nbsp;Raquel Gutiérrez-González","doi":"10.1016/j.neucie.2025.500670","DOIUrl":"10.1016/j.neucie.2025.500670","url":null,"abstract":"<div><div>Nervous system involvement is uncommon in granulomatosis with polyangiitis (GPA), a systemic autoimmune disease with episodes of necrotizing vasculitis. It is usually due to the compressive effect of dural or epidural masses. Spinal hemorrhagic presentation is exceptional. A 41-year-old woman diagnosed with GPA presented with three episodes of acute spinal subdural hematoma separated by eight years and ten months, respectively. The symptomatic debut was pain and paresis in all episodes. On all occasions, a lesion compatible with acute spinal subdural hematoma was diagnosed by magnetic resonance imaging (MRI). All episodes were treated conservatively with corticosteroids and immunosuppressants. The patient presented complete neurological recovery in the first two episodes. A mild residual left lower limb paresis remains after the last one. Follow-up MRI was performed after all episodes, and no focal intraspinal lesions were detected. Spinal subdural hemorrhage is a form of manifestation of GPA, either as a debut or in the course of the disease. We describe the third confirmed case of spontaneous spinal hemorrhage secondary to GPA published in the literature and the first with recurrence. Given the extraordinary response to immunosuppressive therapy, a high level of clinical suspicion is necessary to establish treatment as early as possible.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 4","pages":"Article 500670"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733469","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":"Neurosurgical training model in bovine brain for resection of intraaxial tumors","authors":"Miguel Nuñez Rodriguez,&nbsp;Alexis Tovar,&nbsp;Victoria Herrera Gunn,&nbsp;Pablo Kuchlewski,&nbsp;Guido Carlomagno,&nbsp;Florencia Beldi","doi":"10.1016/j.neucie.2025.500659","DOIUrl":"10.1016/j.neucie.2025.500659","url":null,"abstract":"<div><h3>Background</h3><div>Practice in simulation models optimizes learning and manual skills necessary in neurosurgical training.</div></div><div><h3>Objectives</h3><div>To describe a neurosurgical simulation model for the resection of brain tumors using easily accessible materials and to evaluate the acceptance of the model through a questionnaire.</div></div><div><h3>Methods</h3><div>An artificial tumor based on gelatin and spongostan with infiltrative characteristics was elaborated. It was injected into a bovine brain and the latter into a dry skull. Its location was studied to later operate it using microsurgical instruments. Dural opening, corticotomy, biopsy and debulking with supramarginal resection were performed and the participants evaluated the model through a Likert-type questionnaire.</div></div><div><h3>Results</h3><div>In vivo simulation models, cadaveric preparations, 3D printing, virtual reality and injection of artificial lesions into animal brains ex vivo are described. In the latter, the creation of tumors based on different materials, including gelatin, is mentioned. It is important that the tumor is easy to inject and resistant to heat, so a mixture of gelatin - spongostan was created. This model describes qualities to emulate tumor surgery as well as pre-surgical planning, reconstruction of the subarachnoid space and continuous instillation of artificial blood to the surgical bed.</div></div><div><h3>Conclusion</h3><div>An intraaxial tumor simulation model was described as a useful tool to improve surgical techniques in oncological neurosurgery. It proved to have a good degree of acceptance in the participants.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 4","pages":"Article 500659"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000114","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":"Is there such a thing as black disc disease?","authors":"Giancarlo Mattos Piaggio, Esteban Quevedo Orrego, Emilio González Martínez, Javier Ibañez Plágaro, José García-Cosamalón","doi":"10.1016/j.neucie.2025.500673","DOIUrl":"10.1016/j.neucie.2025.500673","url":null,"abstract":"<p><p>The study of degenerative pathology of the intervertebral disc (IVD) with magnetic resonance imaging (MRI) has generated such an extensive and ambiguous terminology that it causes confusion. The loss of the nucleus pulposus signal intensity (ISNP) in the T2 sequence of MRI, secondary to the early decrease in water content, is generally described as \"black disc\", a term spread as a synonym for degenerative disc disease. On the other hand, to designate a supposedly symptomatic dehydrated disc, the following names have been introduced: \"painful black disc\", \"black disc syndrome\" and \"black disc disease\". In this way, the physiological dehydration of the NP present in the entire population from the third decade on, is arbitrarily considered a presumed radiological marker of discogenic back pain, with the consequent risk of being the target of unnecessary interventions. Dehydrated discs suspected of being a source of pain present, in addition to the decrease in ISNP, other radiological signs such as a high intensity zone (HIZ) in the posterior part of the annulus fibrosus (AF), protrusion, loss of height or Modic changes.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500673"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562217","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}