Neurocirugia (English Edition)最新文献

{"title":"A case report on a late diagnosis of pilocytic astrocytoma in a Dandy–Walker complex","authors":"Juan Sebastián Solis-Mata ,&nbsp;Fernando Castro-Soto ,&nbsp;José Alfonso Alvarez-Castro ,&nbsp;Sonia Iliana Mejía-Pérez","doi":"10.1016/j.neucie.2024.10.007","DOIUrl":"10.1016/j.neucie.2024.10.007","url":null,"abstract":"<div><div>Dandy–Walker malformation (DWM) and pilocytic astrocytoma are entities that manifest themselves at an early age. DWM is a cerebella type associated with several anatomical changes. Very few cases of concomitant occurrence of DWM and pilocytic astrocytoma have been reported on the literature. Male 20 years old, clinical history of 6 months of evolution with nausea, dizziness, headache, photophobia, phonofobia, vomiting, walking laterality, diplopia, tonic–clonic seizures, nystagmus, dysmetria, and dysdiadochokinesia. Cranial tomography was performed, reporting hydrocephaly data with significant dilation of the IV ventricle and the presence of a tumor lesion in the posterior fossa of the right cerebellar hemisphere. Pediatric tumors that manifest in adulthood are rare, with signs such as intracranial hypertension and compress the cranial nerves. The prognosis will be determined by the accompanying abnormalities as well as the effectiveness of the appropriate treatment.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 2","pages":"Pages 139-143"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527548","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":"Metabolomic markers of electrolytes, gases and internal environment of the content of chronic subdural hematomas","authors":"Angel Jesús Lacerda-Gallardo ,&nbsp;Daisy Abreu-Pérez ,&nbsp;Miguel de Jesús Mazorra Pazo ,&nbsp;Jose Antonio Galvez","doi":"10.1016/j.neucie.2024.12.004","DOIUrl":"10.1016/j.neucie.2024.12.004","url":null,"abstract":"<div><h3>Background and objective</h3><div>Chronic subdural hematoma is one of the most common diseases in neurosurgical practice. The content of electrolytes and gases in the collection could participate in the growth and expansion mechanism, however, there is no evidence that they have been studied before. The objective has been to identify electrolyte, gas and internal metabolomic markers of the content of chronic subdural hematomas, with the possibility of participating in their growth and expansion and to substantiate a pathophysiological hypothesis that interacts with existing ones.</div></div><div><h3>Material and method</h3><div>A descriptive study was carried out with 53 patients operated on for chronic subdural hematoma, at the “Roberto Rodríguez Fernández” General Teaching Hospital of Morón in Ciego de Ávila, Cuba, in the period between January 2019 and December 2023. The diagnoses were obtained with computed axial tomography. The electrolyte and blood gas components of hematomas are correlated with clinical and neuroimaging variables.</div></div><div><h3>Results</h3><div>Patients over 70 years of age predominated, 37 (69.81%) and males 38 (71.70%). The Markwalder scale upon admission showed a predominance of Grade III in 24 cases (45.28%). The Glasgow outcome scale showed a predominance of Grade V, 31 (58.49%).</div></div><div><h3>Conclusions</h3><div>Electrolyte and gasometric metabolomic markers of subdural blood can promote the phenomenon of progressive growth and expansion and have a synergistic effect with the rest of the pathophysiological mechanisms.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 2","pages":"Pages 104-111"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830918","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 NLR (Neutrophil/Lymphocyte ratio) value and clinical outcome in patients with external ventricular drainage due to intraventricular hemorrhage","authors":"Eylem Burcu Kahraman Özlü,&nbsp;Kaan Durmuş,&nbsp;Elçin Tuğce Mutlu,&nbsp;Ezgi Akar,&nbsp;Selin Tural,&nbsp;Arif Tarkan Çalışaneller","doi":"10.1016/j.neucie.2024.11.005","DOIUrl":"10.1016/j.neucie.2024.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Intraventricular hemorrhages (IVH) are common pathologies in neurosurgery practice and are associated with the worst clinical outcome among all intracranial hemorrhages. Blood in the ventricles is thought to worsen the clinical condition by triggering inflammatory processes. In recent years, NLR value is a frequently used inflammatory parameter, and there are many publications reporting that a high NLR value is an important marker in predicting the severity of inflammation.</div><div>Our study aimed to evaluate the effect of NLR values at admission on the clinical outcome of patients undergoing EVD due to IVH in our clinic.</div></div><div><h3>Material and methods</h3><div>In our study, age and gender data, admission Glasgow Coma Scale (GCS), NLR value at the time of admission and clinical status at discharge of 36 patients, who underwent EVD following IVH in our hospital neurosurgery clinic between 2019 and 2024, were examined.</div></div><div><h3>Results</h3><div>Of the 36 cases in our study, 16 were female and 20 were male. For all cases, the mean age was 61.88, and the mean GCS values at admission were calculated as 8.5. In the laboratory of our hospital, the normal NLR range was determined as 0.78-3.53, and the mean NLR values at admission were evaluated as 16.57. When the clinical outcomes of the cases were examined, it was seen that 30 cases ended with exitus after intensive care follow-up, and 6 cases were discharged with good clinical outcomes (GCS:15). The mean NLR value was calculated as 18.00 for the patients who ended with exitus and 8.12 for the patients discharged with good clinical outcomes.</div></div><div><h3>Conclusion</h3><div>NLR, which has been used to determine the severity of inflammation in recent years, has been reported to be a marker that can predict clinical outcomes of many diseases. In our study, NLR was observed to be high at admission in all cases, but it was significantly higher in the cases ending with exitus than in the cases not ending with exitus. As a result, it is thought that NLR value is a parameter that can be used to predict the clinical course in IVH patients undergoing EVD.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 2","pages":"Pages 98-103"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689892","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":"Case report: Central venous stenosis-induced intracranial hypertension.","authors":"Santiago Cardona-Collazos, Ashly Arias, Sofia Torres-Figueroa, Carlos Alberto Meneses, Carlos Andres Varon","doi":"10.1016/j.neucie.2025.500652","DOIUrl":"10.1016/j.neucie.2025.500652","url":null,"abstract":"<p><p>Intracranial hypertension due to central venous stenosis (CVS) is an under-recognized but potentially morbid complication of central venous catheters that can have a benign course if recognized and treated early. Here we report a case of a 23-year-old woman requiring hemodialysis via right subclavian catheter who presented with an intracranial hypertension syndrome and sudden visual loss secondary to right innominate vein thrombosis that improved after angioplasty treatment. This case illustrates how CVS can alter the pressure gradient between the subarachnoid space and the cerebral venous sinuses by increasing venous pressure, affecting cerebrospinal fluid drainage. Since CVS is a common finding in patients receiving hemodialysis, intracranial hypertension due to central venous stenosis is a differential diagnosis to consider in patients of this type who present with intracranial hypertension syndrome.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500652"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538190","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":"Pilot study to assess the safety and efficacy of human acellular dermal matrix for Chiari surgery.","authors":"Pilar Teixidor-Rodríguez, Ferran Brugada-Bellsolà, Maria Luisa Pérez, Sebastián Menéndez-Girón, Jordi Busquets-Bonet, Carlos Javier Domínguez-Alonso","doi":"10.1016/j.neucie.2025.500653","DOIUrl":"10.1016/j.neucie.2025.500653","url":null,"abstract":"<p><strong>Purpose: </strong>Although there may be benefits to adult patients who have had Chiari surgery when duroplasty is indicated, there are also more risks involved. The complications derived from a non-hermetic dural closure in the posterior fossa can be significant, mainly cerebrospinal fluid (CSF) leakage, meningitis and pseudomeningocele. We explored the option of utilizing a different duroplasty that we typically utilized in order to reduce these risks. The aim of this study is to assess the safety and efficacy of two duraplasties used for Chiari malformation (ChM) surgery: Tutopatch®, and a human acellular dermal matrix (hADM). Tutopatch®, a well-known collagen membrane commonly used by our senior surgeon, and hADM, prepared by the tissue establishment and with potential properties for use as duraplasty.</p><p><strong>Methods: </strong>A unicentric prospective study was designed with one group of patients treated with hADM and another group that retrospectively acquired surgical treatment with Tutopatch®. There were nineteen patients in each group. The patients in both groups were diagnosed with same pathology and were operated on by the same senior surgeon. This study was approved by the same hospital's Medical Ethics Committee. Demographics, clinical risk factors, clinical syndrome and pre/postoperative and postoperative events after surgery were analysed. All serious adverse events (SAEs) and adverse events (AEs) after surgery were recorded.</p><p><strong>Results: </strong>No differences were found between the two groups related to sex, clinical risk factors, clinical syndrome and clinical outcomes. Seven patients presented with complications, seven the Tutopatch® group (two of them requiring a new reoperation) and none in the hADM group.</p><p><strong>Conclusion: </strong>This pilot study shows that hADM is a safe and effective alternative to Tutopatch® duraplasty, as although the two materials performed equally well in the surgical repair of Chiari malformation, the former showed better clinical outcomes. Future studies are needed to confirm these outcomes in larger cohorts.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500653"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538191","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 optic nerve length and interoptic angle in the prediction of optic chiasm location","authors":"Reyhan Kasab ,&nbsp;Selcuk Yilmazlar ,&nbsp;Oguz Altunyuva ,&nbsp;Recep Fedakar","doi":"10.1016/j.neucie.2024.09.005","DOIUrl":"10.1016/j.neucie.2024.09.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The sellar region is an area in the base of the skull that is among the most common sites for tumors of the central nervous system. Surgical interventions are currently performed via different routes. While the optic chiasm occupies its expected position in 70% of the population, it can deviate from this position. In such cases, surgery involving this region becomes more difficult as the known surgical routes are narrowed. Advance awareness of these variations can help surgeons to identify the optimal route for safe surgical intervention in the sellar region. By performing simple measurements of both the lengths of the optic nerves and the angle between them, a surgeon can predict the location of the chiasm.</div></div><div><h3>Materials and methods</h3><div>Twenty specimens collected from autopsies performed at Bursa Forensic Medicine İnstitute were examined to determine the optic chiasm types and the relationships between the surrounding subchiasmal structures.</div></div><div><h3>Results</h3><div>Among the 20 specimens, we found two prefixed (10%), 10 normo-fixed (50%), and eight postfixed chiasms (40%). The mean interoptic angle was 81.03 (±17.41)⁰. Prefixed chiasms had angles in the range 115.36°–124.76 ° (mean 120.06 [±6.65]⁰), normo-fixed chiasm angles were between 83.11° and 97.53 ° (mean 86.07 [±6.73]⁰), and postfixed chiasms ranged between 53.01 ° and 78.71 ° (mean 69.20 [±9.13]⁰). The length of the right optic nerve ranged between 6.95 and 13.83 mm (mean 10.25 [±1.81] mm), and the length of the left between 7.25 and 12.51 mm (mean 10.40 [±1.47] mm). Obtuse angles indicated that the chiasm was prefixed, and acute angles were indicative of a postfixed chiasm. There was a strong negative correlation between optic nerve lengths and the interoptic angle; thus, as the length of the nerves increases, the interoptic angle becomes more acute.</div></div><div><h3>Conclusions</h3><div>We have proposed a simple measurement of the optic nerve lengths and the angle between them to predict the relative location of the OC, which can be done easily on MRI.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 1","pages":"Pages 39-46"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376395","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":"Our experience in petroclival lesions using a contralateral transmaxillary approach","authors":"Juan Ramón Gras-Cabrerizo ,&nbsp;Maria Casasayas Plass ,&nbsp;Katarzyna Kolanczak ,&nbsp;Fernando Muñoz Hernández ,&nbsp;María Martel Martin ,&nbsp;Esther Granell Moreno","doi":"10.1016/j.neucie.2024.10.006","DOIUrl":"10.1016/j.neucie.2024.10.006","url":null,"abstract":"<div><div>Petroclival lesions represent a surgical challenge during the endonasal endoscopic approach, as they may involve maneuvers with severe comorbidity. To avoid the morbidity caused by these maneuvers, a contralateral transmaxillary approach (CTA) has been proposed to complement the endoscopic endonasal approach. The aim of our study is to review the safety and efficacy of this approach.</div><div>We included three patients with lesions affecting the petroclival region, one cholesterol granuloma and two macroadenomas, who were surgically treated with a combined ipsilateral transpterygoid approach and a CTA. The latter was performed by wide osteotomy on the anterior wall of the maxillary sinus through a gingivolabial incision.</div><div>Complete resection was achieved in the patient with a cholesterol granuloma and subtotal resection in the two patients diagnosed with macroadenoma. One patient presented ecchymosis of the malar area as the only complication.</div><div>The contralateral transmaxillary approach may improve exposure and dissection of the petroclival area compared to the homolateral endoscopic endonasal approach allowing reaching the most lateral and posterior region of this territory without the need to manipulate the internal carotid artery.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 1","pages":"Pages 54-58"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822802","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":"Endovascular treatment of chronic subdural hematoma in a dual-trained neurosurgical unit: Results and proposal of a randomized controlled trial protocol","authors":"Sergio García García ,&nbsp;Ignacio Arrese Regañón ,&nbsp;Santiago Cepeda Chafla ,&nbsp;Rosario Sarabia Herrero","doi":"10.1016/j.neucie.2024.09.002","DOIUrl":"10.1016/j.neucie.2024.09.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic subdural hematoma (cSDH) is a prevalent neurosurgical condition with an increasing incidence due to the rising life expectancy and the widespread use of anticoagulant and antiplatelet therapies. Insights into the inflammatory origins of cSDH led to the exploration of Middle Meningeal Artery (MMA) embolization as a therapeutic strategy. In recent years the endovascular treatment of MMA has gained momentum. Herein we present the initial experience of a dual trained neurovascular unit implementing this therapeutic technique.</div></div><div><h3>Methods</h3><div>This single-center, prospective pilot study aimed to evaluate the feasibility, safety, and efficacy of MMA embolization in the treatment of cSDH. Following ethical approval and informed consent, demographic, clinical, and radiological data were collected. Patients requiring emergent surgical treatment were excluded. The study focused on assessing clinical outcomes, including the Modified Rankin Score (mRS) and volumetric analysis of cSDH, before and after embolization.</div></div><div><h3>Results</h3><div>Fifteen patients underwent MMA embolization, with a predominance of males (80%) and a mean age of 72.4 years. The most common presenting symptom was headache (53.3%). The average hospital stay was 3.9 days. Various embolization techniques were employed, with DMSO-EVOH being the most frequent. All procedures were successfully conducted without complications. Although not statistically significant, trends suggested better outcomes in patients with homogeneous cSDH on the CT scan, displaying the cotton wool sign on angiography and treated with EVOH-DMSO.</div></div><div><h3>Conclusion</h3><div>MMA embolization for cSDH demonstrates promise as a safe and effective treatment, potentially reducing the need for surgical intervention and recurrence rates. This study lays the groundwork for a larger, randomized controlled trial which protocol is herein presented.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 1","pages":"Pages 28-38"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302802","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":"Electromagnetic neuronavigation in neuroendoscopy. Navigation proposal for the LOTTA ventriculoscope. Technical note","authors":"Mario Gomar-Alba ,&nbsp;José Javier Guil-Ibáñez ,&nbsp;Fernando García-Pérez ,&nbsp;María José Castelló-Ruíz ,&nbsp;Leandro Saucedo ,&nbsp;Antonio José Vargas-López ,&nbsp;José Masegosa-González","doi":"10.1016/j.neucie.2024.10.003","DOIUrl":"10.1016/j.neucie.2024.10.003","url":null,"abstract":"<div><h3>Background and objective</h3><div>Neuronavigation in ventriculoscopy has been described in several papers. However, there are different ventriculoscopes and navigation systems. Because of these different combinations, it is difficult to find detailed navigation protocols for each ventriculoscope. We describe, step by step, a simple method to navigate both the trajectory to reach the ventricular system and the intraventricular work for the LOTTA ventriculoscope.</div></div><div><h3>Methods</h3><div>We used a rigid ventriculoscope (LOTTA, KarlStorz) with an electromagnetic stylet (S8-StealthSystem, Medtronic) as the main navigation tool. The protocol is based on a 3D printed trocar or alternatively, on a modification of the original trocar for extraventricular phase navigation and a modified pediatric nasogastric tube for intraventricular phase navigation.</div></div><div><h3>Results</h3><div>The protocol can be set up in less than 10<!--> <!-->min. The extraventricular part is navigated by inserting the electromagnetic stylet inside the 3D printed trocar or inside the original modified trocar. Intraventricular navigation is performed by combining a modified pediatric nasogastric tube with the electromagnetic stylet inside the working channel of the endoscope. The most critical point is to obtain a blunt, bloodless approach to the ventricle and to achieve perfect alignment of all target structures by means of previously planned pure straight trajectories.</div></div><div><h3>Conclusions</h3><div>This protocol is easy to set up, avoids rigid head fixation, bulky optical navigation accessories, while allows continuous navigation of both parts of the surgery. Since we have implemented this protocol, we have seen a significant improvement in both simple and complex neuroendoscopy procedures as the surgery is dramatically simplified.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 1","pages":"Pages 17-27"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549397","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":"Review of therapeutic failures of microvascular decompression in trigeminal neuralgia at a tertiary hospital","authors":"Emilio González Martínez,&nbsp;Giancarlo Mattos-Piaggio,&nbsp;David Santamarta Gómez","doi":"10.1016/j.neucie.2024.10.004","DOIUrl":"10.1016/j.neucie.2024.10.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Microvascular decompression (MVD) is a non-ablative technique aimed at relieving pain in trigeminal neuralgia (TN) by resolving a neurovascular conflict. Despite reported high success rates, a significant percentage of patients experience therapeutic failure.</div></div><div><h3>Methods</h3><div>Retrospective observational study of patients with suspected TN undergoing MVD was performed with the goal of identifying factors contributing to the persistence and recurrence of pain.</div></div><div><h3>Results</h3><div>In the present study, 31 patients undergoing 38 MVD procedures for TN were included (7 patients underwent reoperation after the failure of the initial operation). The mean age was 58.5 years with a male predominance (58.1%). The mean duration of pain was 6.4 years, mainly affecting branches V2 and V3 (46.7%). The most frequently described neurovascular conflict was with the superior cerebellar artery (54.8%), predominantly resolved with Teflon (75.9%).</div><div>In our case series, MVD achieved pain control in 80.6% of patients at one-year post-intervention and 61.3% at the end of the follow-up period. Twelve patients experienced MVD failure: 5 cases of persistent pain and 7 cases of pain recurrence. A detailed analysis of these failures identified misdiagnosis as the reason of persistent pain in 4 patients, while inadequate surgical technique could be the cause of pain recurrence in 6 patients.</div></div><div><h3>Conclusion</h3><div>In our study, therapeutic failures could mainly be attributed to two factors: misdiagnosis or the use of inappropriate materials. These factors should be considered when optimizing the management of DMV in patients with NT.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 1","pages":"Pages 47-53"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549400","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}