Neurocirugia (English Edition)最新文献

{"title":"Moyamoya disease and moyamoya syndrome: A case series from multicentre private hospitals in Indonesia","authors":"Rusli Muljadi ,&nbsp;Koesbandono ,&nbsp;Teodorus Alfons Pratama ,&nbsp;Gilbert Sterling Octavius","doi":"10.1016/j.neucie.2024.11.008","DOIUrl":"10.1016/j.neucie.2024.11.008","url":null,"abstract":"<div><h3>Background</h3><div>Moyamoya disease (MMD) and moyamoya syndrome (MMS) are considered rare in Indonesia, without any proper epidemiological data backing this claim. Hence, this case series aims to assess all MMD and MMS cases from the perspective of a multicentre private hospital in Indonesia.</div></div><div><h3>Methods</h3><div>This is a descriptive analysis using data from the picture archiving and communication system (PACS) from January 2019 to December 2023. The inclusion criteria included all patients who fulfilled the radiological criteria for MMD and/or MMS, while patients who only underwent brain non-contrast computed tomography (CT) scans were excluded.</div></div><div><h3>Results</h3><div>There are 58,905 unique MRI scans from 2019 to 2023. The cohort comprises 8 females and 2 males, with a median age of 37 (7–65) years old. Three cases are probable MMD. with six MMD cases and one MMS case. Therefore, the prevalence rate for the four years is approximately 11.9 cases per 100,000 scans. Out of the confirmed Moya-Moya cases, the majority (4/7) are ischemic subtypes, followed by epileptic (electroencephalography shows slowing brain waves) and TIA in one case each. The most common presenting symptom is weakness in the extremity (N = 7), followed by headache (N = 5). Four patients underwent operative procedures, with three of them being superior temporal artery to middle cerebral artery (STA-MCA) bypass procedures and one of them being encephalo-duro-myo-arterio-pericraniosynangiosis (EDMAPS).</div></div><div><h3>Conclusion</h3><div>The paucity of confirmed cases either points towards the low prevalence of MMD and MMS in Indonesia or the underdiagnosis of these cases.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 3","pages":"Pages 151-160"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693819","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":"Cord compression due to atypical T-cell lymphoma from paraspinal soft tissue: Report of a case","authors":"Alejandro Augusto Ortega Rodriguez,&nbsp;Santiago Nicolás Valbuena Dussan,&nbsp;José Luís Caro Cardera,&nbsp;Jordi de Manuel-Rimbau Muñoz","doi":"10.1016/j.neucie.2024.11.004","DOIUrl":"10.1016/j.neucie.2024.11.004","url":null,"abstract":"<div><div>During lymphoma’s natural history of disease, 5–10% of cases may develop Central Nervous affectation. We present the case of a 57-years-old man with less than 24 h of onset symptoms of paraparesis, lower limb hypoesthesia and sphincter dysfunction who was operated due to dorsal tumor with epidural component which caused severe cord compression. Pathological analysis concluded atypical T-cell lymphoblastic lymphoma, a rare subtype of lymphoma which accounts 1%−2% of all Non-Hodgkin Lymphomas. Our case was particularly aggressive and atypical due to its origin in paraspinal soft tissue. Despite specific treatment, the patient presented an early epidural relapse, frequent in this lymphoma subtype.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 3","pages":"Pages 199-203"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669967","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":"Utility of very high-pressure valves in persistent symptomatic shunt overdrainage","authors":"Iván Federico Narváez Moscoso,&nbsp;Bienvenido Ros López,&nbsp;Sara Iglesias Moroño,&nbsp;Julia Casado Ruiz,&nbsp;Raquel Simón Wolter,&nbsp;Miguel Ángel Arráez Sánchez","doi":"10.1016/j.neucie.2024.11.011","DOIUrl":"10.1016/j.neucie.2024.11.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Shunt overdrainage is one of the long-term complications associated with ventriculoperitoneal shunts. Treatment of refractory cases may require further upgrading of both the valve opening pressure and antisiphon device. The aim of this paper is to describe the results of this combination in a selected group of patients.</div></div><div><h3>Methods</h3><div>Retrospective cohort study that included 18 pediatric patients between 2003–2022. Previous shunts were exchanged for the combination of a SOPHYSA Polaris® SPVA-300 valve and upgraded fixed or adjustable antigravitatory devices. The following variables were collected: etiology of the hydrocephalus, age at first shunt and type of valve, number of shunt revisions, other surgical procedures, age at inclusion, clinical and radiological outcomes, and follow-up time. A descriptive analysis was done with means, medians and ranges for quantitative variables; percentages and frequencies for the analysis of qualitative data.</div></div><div><h3>Results</h3><div>The median age at first shunt was two months (0–67). The mean number of shunt revisions before inclusion was three. Shunt removal was attempted in seven patients without success; temporary success was observed in two patients who underwent ETV. Two patients had previous cranial expansions. The mean age at inclusion was 9.1 years (2.7–15.2). After the shunt system was exchanged and upgraded, clinical improvement was observed in 94.4% (17/18) of patients, and radiological improvement was observed in 83.3% (15/18) of patients. The median follow-up was 21 months.</div></div><div><h3>Conclusions</h3><div>Before considering more invasive therapeutic measures, shunt system optimization by the combination of very high-pressure valves and upgraded in-line antisiphon devices is a valid and safe strategy for refractory symptomatic shunt overdrainage.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 3","pages":"Pages 161-168"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693827","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":"Trigeminal neuralgia secondary to minor size lesion, anatomical considerations and pathophysiology","authors":"Adrián Fernández García,&nbsp;Carlos Alberto Rodríguez Arias,&nbsp;Estefanía Utiel Monsálvez,&nbsp;Herbert Daniel Jiménez Zapata","doi":"10.1016/j.neucie.2024.11.010","DOIUrl":"10.1016/j.neucie.2024.11.010","url":null,"abstract":"<div><div>Trigeminal neuralgia is a well-characterized disorder of high prevalence among the current population. It may be caused, among many other causes, by a tumor which contacts with the trigeminal nerve, often of large volume. We present the case of a middle-aged woman without any remarkable medical background who suffered a trigeminal neuralgia caused by a subcentimeter tumor which appeared to be a meningioma. Some small tumors like this one may be symptomatic whereas larger ones will not. We discuss the pathogenesis and characterization of the trigeminal neuralgia in such cases proposing some mechanisms that could be involved in the development of a secondary neuralgia.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 3","pages":"Pages 204-207"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693826","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":"Robotic spine surgery: Technical note and descriptive analysis of the first 40 cases","authors":"Víctor Rodríguez-Domínguez,&nbsp;Jorge Bedia Cadelo,&nbsp;Javier Giner García,&nbsp;María Luisa Gandía González,&nbsp;Catalina Vivancos Sánchez,&nbsp;Alberto Isla Guerrero","doi":"10.1016/j.neucie.2024.12.002","DOIUrl":"10.1016/j.neucie.2024.12.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The global incidence of spinal pathology is increasing due to the progressive aging of the population and increased life expectancy. Vertebral fixation with transpedicular screws is the most commonly used technique in unstable or potentially unstable pathologies. There are different implantation methods, the most recently developed being implantation guided by robotic navigation.</div></div><div><h3>Materials and methods</h3><div>We describe the technical aspects and the different workflows available with the ExcelsiusGPS® robotic navigation system (GlobusMedical, Inc, Audubon, PA, USA), as well as the results of the first 40 patients operated on at the Hospital Universitario la Paz between July 2023 and February 2024.</div></div><div><h3>Results</h3><div>A total of 250 screws were implanted at the thoracic and lumbar levels. 12 patients underwent minimally invasive surgery (MIS) (30%) and 28 patients underwent open surgery (70%). The median number of screws implanted per patient was 6.00 (4.00–6.00). The intraoperative malpositioning rate was 2.5% (1 case). The median duration of surgery was 143.00<!--> <!-->minutes (113.00–165.50). The median hospital stay was 4.00 days (3.00–5.50). The median intraoperative radiation delivered was 899<!--> <!-->mGy/cm² (523.25–1595.00). The median blood loss was 150.00<!--> <!-->ml (100.00–300.00) and the blood transfusion rate was 0%.</div></div><div><h3>Discussion</h3><div>Compared to conventional techniques, Robotic spine surgery increases accuracy to 96–100% and reduces the radiation dose received by the patient and surgical team. In addition, it allows the implantation of larger screws, which has been associated with increased biomechanical strength and reduced risk of loosening. Initially, it may involve an increase in total surgical time, but this is reduced once the learning curve is reached, around 40 cases.</div></div><div><h3>Conclusions</h3><div>ExcelsiusGPS® is the most recent robot model on the market and different studies have demonstrated its effectiveness in different techniques and indications. Unlike other robotic systems used exclusively in dorsolumbar spine pathology, it can be used in the pathology of the entire spinal axis (from C1 to the sacrum) and brain pathology (deep electrode implantation, brain biopsy, SEEG, among others).</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 3","pages":"Pages 169-178"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824972","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":"Association of the C-reactive protein/albumin ratio with the prognosis of Aneurysmal Subarachnoid Hemorrhage: A systematic review","authors":"Gerardo Luna-Peralta ,&nbsp;Alvaro Lopez-Luza ,&nbsp;Claudia Cruzalegui-Bazán ,&nbsp;Miguel Cabanillas-Lazo","doi":"10.1016/j.neucie.2024.11.009","DOIUrl":"10.1016/j.neucie.2024.11.009","url":null,"abstract":"<div><div>The C-Reactive Protein/Albumin Ratio (CAR) is being studied as a potential predictor of severe outcomes in various diseases. Our study aimed to review current evidence on the prognostic value of CAR in patients with aneurysmal subarachnoid hemorrhage (aSAH). We conducted a systematic search in PubMed, Embase, Scopus, Web of Science, and Google Scholar up to April 2023 and assessed the risk of bias using the NewCastle-Ottawa tool. A narrative synthesis was performed, and the GRADE system was used to evaluate the certainty of the evidence. Out of 534 articles, 4 were selected. We found that a higher CAR level is moderately associated with a lower score on the Glasgow Outcome Scale at 3 months and a higher incidence of in-hospital mortality. However, no significant association was found with the modified Rankin scale or delayed cerebral ischemia. Although the evidence is limited, CAR could be a useful tool for predicting poor prognosis in aSAH patients, but more prospective studies are needed to determine optimal cut-off points and include CAR in long-term prognostic models.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 3","pages":"Pages 185-193"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693589","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":"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":"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":"Cauda equina malignant peripheral nerve sheath tumor presenting with subarachnoid hemorrhage: a case report","authors":"Rafael Aponte-Caballero ,&nbsp;Julian Alfonso Sierra-Peña ,&nbsp;Juan Felipe Abaunza-Camacho ,&nbsp;William Mauricio Riveros-Castillo ,&nbsp;Javier M. Saavedra","doi":"10.1016/j.neucie.2024.10.001","DOIUrl":"10.1016/j.neucie.2024.10.001","url":null,"abstract":"<div><div>Malignant peripheral nerve sheath tumors (MPNST) are uncommon aggressive neoplasms, frequently associated with type I neurofibromatosis. This is the first case of intradural lumbar spine MPNST with intraoperative findings of associated subarachnoid hemorrhage (SAH). A 72-year-old man presented to the emergency department with severe acute low back pain. Neurological examination was unremarkable. Gadolinium-enhanced MRI of the lumbar spine showed an irregularly shaped intradural lesion extending from L3 to L5. The lesion exhibited a medium signal both on T1 and T2-weighted imaging with peripheral enhancement. Through an L3-L5 laminectomy, a diffuse SAH, and a tumor tightly adherent to cauda equina nerve roots were found. Specimen examination revealed a fusocelular tumor with pleomorphic and hyperchromatic nuclei, positive for S100, and SOX10. On an 8-month follow-up, he had no neurological deficit, with a Karnofsky performance score of 90 points. Surgical evidence of SAH in lumbar spine intradural MPNST is a novel finding.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 2","pages":"Pages 129-134"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482519","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":"Acute subdural hematoma from ruptured middle cerebral artery aneurysm: A rare and critical analysis of 25 cases","authors":"Cristina Romero-López ,&nbsp;Javier Ros de San Pedro ,&nbsp;Francisco Arteaga-Romero ,&nbsp;Beatriz Cuartero-Pérez ,&nbsp;Ignacio Martín-Schrader","doi":"10.1016/j.neucie.2024.11.002","DOIUrl":"10.1016/j.neucie.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>An acute subdural hematoma (aSDH) is a rare presentation of a ruptured intracranial aneurysm with pathophysiology and prognosis poorly defined. According to literature, prognosis might be improved with prompt diagnosis, hematoma evacuation and aneurysm treatment. The objective is to specify pathophysiology, prognostic factors and management of this pathology.</div></div><div><h3>Methods</h3><div>We reported 23 cases of aSDH due to ruptured MCA aneurysm from literature revision and 2 cases from our center.</div></div><div><h3>Results</h3><div>Median age was 51 years and 48% (12/25) were females. At their arrival, 76% (19/25) presented decreased level of consciousness and 55.55% (10/18) neurological deficits. Aneurysmal location was left MCA in 57.14% (8/14) and MCA segments were M4 in 76.92% (10/13) and bifurcation in 23.07% (3/13), median aneurysmal size was 6 mm, median hematoma size was 10 mm, median midline shift was 9 mm, aneurysmal projection and MCA concavity were anterior in 100% (3/3), subarachnoid hemorrhage (SAH) was present in 52.17% (12/23). The treatment was surgery in 84% (21/25), endovascular in 12% (3/25) and in 20% (5/25) decompressive craniectomy (DC) was necessary. Glasgow Outcome Scale (GOS) was &gt;3/favorable in 66.66% (16/24) and death in 16.66% (4/2).</div></div><div><h3>Conclusions</h3><div>Anterior MCA concavity and aneurysmal projection might be related with aSDH presentation in proximal MCA aneurysms. We should suspect aneurysm origin when there is no history or stigma of trauma, and CT shows disproportionately massive aSDH. Hematoma evacuation solves the compressive mechanism which is the main cause of neurological deterioration in pure aSDH cases, because of that, immediate hematoma evacuation could justify better outcome in these patients.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 2","pages":"Pages 83-92"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649761","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":"Lateralization in visualization among neurosurgeons","authors":"Hrvoje Barić ,&nbsp;Sara Komljenović ,&nbsp;Helena Ljulj","doi":"10.1016/j.neucie.2024.11.003","DOIUrl":"10.1016/j.neucie.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Handedness is an epiphenomenon of brain lateralization which has been researched in the context of surgical performance, yet the same does not hold true for lateralization at a more fundamental level. We aimed to investigate whether neurosurgeons are biased in visualizing and depicting anatomy and pathology.</div></div><div><h3>Methods</h3><div>This was a two part study consisting of an online survey and image analysis. An online questionnaire was used to collect basic sociodemographic data and prompt subjects to visualize surgical approaches and pathological entities and report on the side of the visualized topics. Prominent neurosurgical literature was screened for depictions of the same entities and approaches and the depicted side was noted.</div></div><div><h3>Results</h3><div>There were 49 responses, most from Croatia (n = 26), men (n = 38), right-handed (n = 42), of average age 37 years, and with 9 years of neurosurgical experience. Ambidexterity was more prevalent than in the general population. The respondents imagined the right side more commonly in all cranial-related questions, and the left side in spine-related questions. Images in neurosurgical literature showed correspondingly biased laterality.</div></div><div><h3>Conclusion</h3><div>There is a significant bias among neurosurgeons in laterality in processing topographical information on anatomy and pathology. Research is warranted to investigate the causes and real life implications of this phenomenon.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 2","pages":"Pages 93-97"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}