Neurocirugia (English Edition)最新文献

{"title":"Preliminary experience with VITOM 3D exoscope during microsurgical treatment of cerebral aneurysms","authors":"Joel Caballero-García ,&nbsp;Justo Gonzáles Gonzáles ,&nbsp;Guillermo Sánchez Paneque ,&nbsp;Luis Horta Clavero","doi":"10.1016/j.neucie.2025.500729","DOIUrl":"10.1016/j.neucie.2025.500729","url":null,"abstract":"<div><h3>Background and objectives</h3><div>The use of a digital three-dimensional (3D) exoscope system in neurosurgery is increasing as an alternative to the operative microscope due to its similar visual fidelity but superior ergonomics. However, publications on cerebral aneurysms treated with this are scarce.</div></div><div><h3>Methods</h3><div>Clinical information, surgical records and, imaging of patients with cerebral aneurysms undergoing surgery by a single surgeon, from December 2023 to March 2025, using the VITOM 3D as a vision/magnification method exclusively, is analyzed. Postoperative follow-up included angio-CT scan. Descriptive statistics and data relating to operative time and complications were analyzed. An extensive discussion regarding other authors’ experience using 4K 3D exoscopes in microsurgical clipping of cerebral aneurysms was performed and compared with the present series.</div></div><div><h3>Results</h3><div>Eighty-eight patients with 107 cerebral aneurysms underwent surgery. Most patients were female (65.9%), with a mean age of 52.6 (±13.6) years. Grades I–III WFNS score was seen in 74 (84.1%) patients, with 14 (15.9%) having grade IV. Ruptured aneurysm rate was 94.3%, but up to 14.9% associated unruptured aneurysms were recorded. Complications rate was 9.1%. A favorable outcome was observed in 83.0% of patients based on modified Rankin Scale score at 30 days.</div></div><div><h3>Conclusion</h3><div>VITOM 3D exoscope is a valid alternative to the surgical microscope, since it offers comparable visualization but superior ergonomics, at a lower cost. Randomized comparative studies with a larger series of cases should be carried out to increase the level of evidence.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"37 2","pages":"Article 500729"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582228","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":"Brain necrosis induced by intranasal cocaine in a patient with a history of craniofacial resection: A case report.","authors":"Elena Marin-Diez, Jaime Viera-Artiles, David Mato-Mañas, Enrique Marco de Lucas","doi":"10.1016/j.neucie.2026.500774","DOIUrl":"10.1016/j.neucie.2026.500774","url":null,"abstract":"<p><p>A 57-year-old male woodworker was diagnosed with T3N0M0 intestinal-type nasal adenocarcinoma in 2021. He underwent endoscopic craniofacial resection and radiotherapy, with no recurrence for three years. In 2024, he presented with occipital headache and vomiting, revealing a frontal necrotic-hemorrhagic lesion with acute hydrocephalus, initially suspected to be a brain abscess. However, a history of cocaine use suggested brain necrosis facilitated by prior surgery. This unique case demonstrates brain necrosis directly attributable to intranasal cocaine use. Surgeons should consider substance use as a contributing factor in postoperative complications after skull base surgery.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500774"},"PeriodicalIF":0.0,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147273390","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":"Ganglioglioma mimicking a vestibular schwannoma: A rare entity of the cerebellopontine angle.","authors":"Marta Álvarez González, Javier Robla Costales, Adán González Álvarez, Guadalupe Iglesias Barrero","doi":"10.1016/j.neucie.2026.500756","DOIUrl":"10.1016/j.neucie.2026.500756","url":null,"abstract":"<p><p>Gangliogliomas are rare tumors of the central nervous system, representing 1.3% of all brain tumors. Gangliogliomas of the cerebellopontine angle (CPA) are exceptional, and most of them are an exophytic extension of a primary brainstem or cerebellar tumor. We present the case of a 33-year-old man with histologically confirmed CPA ganglioglioma. The tumor was a nodular lesion attached to the 7th and 8th cranial nerves. The resection was complete and the diagnosis was possible only after histopathologic examination of the resected mass. It is necessary to keep in mind these unusual tumors in the differential diagnosis of CPA lesions.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500756"},"PeriodicalIF":0.0,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044459","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":"Atypical non-enhancing brain metastases from ALK-positive non-small cell lung carcinoma.","authors":"Serdar Solmaz, Cafer Ikbal Gulsever","doi":"10.1016/j.neucie.2026.500758","DOIUrl":"10.1016/j.neucie.2026.500758","url":null,"abstract":"<p><p>Brain metastases are a frequent complication of advanced non-small cell lung carcinoma (NSCLC), particularly in anaplastic lymphoma kinase (ALK)-positive cases, which show a strong tendency for central nervous system spread. Typically, such metastases demonstrate contrast enhancement on magnetic resonance imaging (MRI) due to disruption of the blood-brain barrier. We report a 45-year-old man with ALK-positive NSCLC presenting with a right temporal swelling and multiple non-contrast-enhancing brain lesions detected before any treatment. The temporal mass was excised and confirmed as metastatic adenocarcinoma. The patient received whole-brain radiotherapy (30Gy in 10 fractions), cisplatin-pemetrexed chemotherapy, and sequential targeted therapy with alectinib and lorlatinib. During three years of follow-up, MRI showed complete resolution of all lesions, and the patient remained neurologically intact and systemically stable. This case underscores the rarity of non-enhancing brain metastases in ALK-positive NSCLC and highlights the importance of recognizing this atypical imaging presentation for timely diagnosis and management.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500758"},"PeriodicalIF":0.0,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044427","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":"Diagnosis and surgical management of a pituitary adenoma coexisting with a persistent trigeminal artery: Case report and review of the literature.","authors":"Loreto Esteban Estallo, Amanda Avedillo Ruidiaz, Silvia Vázquez Sufuentes, Miguel Barrera Rojas, David Fustero de Miguel","doi":"10.1016/j.neucie.2026.500757","DOIUrl":"10.1016/j.neucie.2026.500757","url":null,"abstract":"<p><p>The persistent trigeminal artery (PTA) is the most frequent embryonic carotid-basilar anastomosis, with an incidence of 0.1-1%. Its coexistence with pituitary adenomas is extremely rare and may pose a significant surgical risk if unrecognized preoperatively. We describe a 58-year-old man incidentally diagnosed with a nonfunctioning pituitary macroadenoma compressing the optic chiasm. Computed tomography angiography demonstrated a PTA in close contact with the tumor's inferior aspect. Endoscopic endonasal resection was performed with neuronavigation and intraoperative Doppler ultrasound, enabling direct visualization and preservation of the artery. A small remnant firmly adherent to the vessel was intentionally left. This case highlights the importance of preoperative identification of vascular variants such as PTA. It also emphasizes the meticulous surgical planning to achieve safe pituitary tumor resection in the presence of high-risk vascular anomalies.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500757"},"PeriodicalIF":0.0,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044446","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":"Risk of haemorrhagic strokes in patients with psychiatric disorders: A systematic review and meta-analysis","authors":"Luis Ayerbe ,&nbsp;Quintí Foguet-Boreu ,&nbsp;Ivo Forgnone ,&nbsp;María Pérez-Piñar ,&nbsp;Rohini Mathur ,&nbsp;Salma Ayis","doi":"10.1016/j.neucie.2025.500738","DOIUrl":"10.1016/j.neucie.2025.500738","url":null,"abstract":"<div><h3>Objectives</h3><div>Strong evidence on the risk of haemorrhagic strokes for those with psychiatric conditions may lead to more effective interventions for mental health patients and inform future studies. This systematic review aimed to identify all the studies that compare the risk of haemorrhagic stroke for patients with and without depression, anxiety, schizophrenia, bipolar or personality disorders. It also aimed to provide a summary estimate of the risk, where possible, using meta-analysis.</div></div><div><h3>Methods</h3><div>Electronic searches were conducted in Embase, PsycINFO, PubMED, Scopus and the Web of Science, from database inception to the 11th of March 2025. A Random-effects model to estimate the pooled effect size with 95% confidence intervals was used.</div></div><div><h3>Results</h3><div>17,214 references were initially identified. Eleven articles were included. Seven of them, five observational and two mendelian randomisation studies, investigated depression. In the meta-analysis depression showed a significant association with an increased risk of haemorrhagic stroke, with pooled HR: 1.28 (1.19–1.38) when only observational studies were included. When mendelian randomisation studies were added the result was a pooled HR: 1.26 (1.08–1.44). The risk of haemorrhagic stroke was increased in one of the three studies that investigated patients with anxiety disorders and in one of the three that looked at patients with schizophrenia. Two studies of bipolar disorder, and one of personality disorders, reported that patients with these conditions do not have an increased risk of haemorrhagic stroke.</div></div><div><h3>Conclusion</h3><div>Patients with depression have an increased risk of haemorrhagic stroke. The association of mental illness with haemorrhagic stroke needs further research.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"37 1","pages":"Article 500738"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656527","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":"Endoscopic 360° vision of the orbit: A comparative anatomical study of endonasal and transorbital approaches","authors":"Dario Gagliano ,&nbsp;Roberto Manfrellotti ,&nbsp;Nikolay Lasunin ,&nbsp;Alberto Prats-Galino ,&nbsp;Alberto Di Somma ,&nbsp;Joaquim Enseñat","doi":"10.1016/j.neucie.2025.500704","DOIUrl":"10.1016/j.neucie.2025.500704","url":null,"abstract":"<div><h3>Background and objective</h3><div>Treatment of lesions located within and surrounding the orbit pose considerable surgical challenges, due to the presence of critical neurovascular structures in such deep, confined spaces. Historically, transcranial and craniofacial approaches have been widely used to deal with orbital pathologies. However, in recent decades we have witnessed the emergence of minimally invasive techniques to reduce morbidity and hospitalization times. Among these techniques are the endoscopic endonasal approach (EEA) and the subsequently developed endoscopic transorbital approach (ETOA). This anatomical study aims to compare and combine the surgical view offered by these two endoscopic pathways to achieve a circumferential access to the orbit.</div></div><div><h3>Methods</h3><div>Anatomic dissections were performed at the Laboratory of Surgical NeuroAnatomy (LSNA) of the Human Anatomy and Embryology Unit, University of Barcelona (Barcelona, Spain) on five cadaveric specimens (10 sides), whose arterial and venous systems were injected with red and blue latex respectively. Dissections were made with microsurgical instruments and a surgical endoscope.</div></div><div><h3>Results</h3><div>After careful removal of the intraorbital fat, all the extraocular muscles were exposed and dissected, as well as the optic nerve, the ophthalmic artery, and the lacrimal gland. Special emphasis was given to dissecting the nerves’ course from the cavernous sinus to their muscle innervation: oculomotor and its branches, trochlear, abducent and ophthalmic nerve with its branches (frontal, nasociliary and lacrimal nerve). Each of the two endoscopic pathways provided a different perspective of the orbit and its structures. After both corridors were completed, a communication between the surgical pathways was highlighted, in a so-called connection area.</div></div><div><h3>Conclusions</h3><div>The combination of the EEA and ETOA provides a 360° view of the orbit and its contents. The EEA offers an inferior and medial view of the orbit, through the lamina papyracea of the ethmoid in the first case and through the roof of the maxillary sinus in the latter. At the same time, the ETOA shows a lateral perspective, removing the lateral rim of the orbit, allowing great maneuverability inside the orbit and a wide visualization. This study provides a detailed overview of the surgical neuroanatomy of the orbit, which is an essential and didactic baseline in preparation for practical clinical applications. Overall, EEA and ETOA seem adequate to gain optimal exposure of the orbit and can be adapted to treat a wide range of pathologies. Yet, surgical case series are necessary to establish the true clinical value of these endoscopic approaches in orbital and peri-orbital surgery. However, the limited number of specimens analyzed (5 cadavers, 10 sides) must be acknowledged as a limitation.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"37 1","pages":"Article 500704"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303895","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":"Measures to prevent surgical site infections in neurosurgery: Survey and comparative analysis","authors":"Cristina Sánchez-Viguera ,&nbsp;Josep M. Badia","doi":"10.1016/j.neucie.2025.500678","DOIUrl":"10.1016/j.neucie.2025.500678","url":null,"abstract":"<div><h3>Introduction</h3><div>Surgical site infections (SSI) are among the most common type of healthcare-associated infections and are involved with an increase in morbidity, mortality and higher healthcare costs.</div></div><div><h3>Methods</h3><div>The Observatory of Infection in Surgery has conducted a survey to assess the level of awareness and implementation of the preventive measures for SSI. A 64-question questionnaire was given to SENEC (Sociedad Española de Neurocirugía) members.</div></div><div><h3>Results</h3><div>The survey was answered by 123 neurosurgeons. There is a gap between clinical guidelines and neurosurgery practice (67%), even though neurosurgeons place a high value on international (81.7%) or national (78.7%) clinical guidelines. There are still practices not supported by scientific evidence that some of our respondents follow, including antibiotic prophylaxis<!--> <!-->≥<!--> <!-->24<!--> <!-->h (10.6%), the habit of not allowing the antiseptic solution to air dry (38.2%) or the use of transparent plastic adhesive drape on the surgical field (77.4%). The most widespread practice for hair management is the selective removal from the surgical area (83.3%). It is most commonly performed by the neurosurgeon himself, in the operating room, which is a significant difference from the use of other surgical specialties (68.5% vs 3.5%, <em>P</em> <!-->&lt;<!--> <!-->.001). There are only 37% of respondents who use alcohol solutions. Double-gloving is utilised by 16.7% of neurosurgeons. The usual use of drainage is quite widespread (60.7%), while the rate of nutritional assessment prior to major surgery is very low (7.5%). Only 37.2% report providing feedback on SSI rates to surgical teams, and a small 16.5% have received specific training programmes on SSI.</div></div><div><h3>Conclusion</h3><div>Scientific evidence-supported measures are not fully incorporated into neurosurgical practice, and there is a lack of specific training in surgical infection prevention. Additionally, a specific issue has been identified, particularly regarding hair management. Neurosurgeons should actively participate in SSI prevention programmes and analyse the reasons why they do not implement certain strategies into their clinical practice.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"37 1","pages":"Article 500678"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562218","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":"Patient perception and clinically meaningful change following simple cervical laminectomy for degenerative cervical myelopathy: A prospective cohort study","authors":"Antonio Montalvo-Afonso ,&nbsp;Vicente Martín-Velasco ,&nbsp;Javier Martín-Alonso ,&nbsp;Rubén Diana-Martín ,&nbsp;Jerónimo González-Bernal ,&nbsp;Pedro David Delgado-López","doi":"10.1016/j.neucie.2025.500735","DOIUrl":"10.1016/j.neucie.2025.500735","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Validated clinical scales for cervical myelopathy (CM) assess disease severity and treatment efficacy, but often fail to capture the patient's subjective perception of treatment effects. This study aimed to correlate commonly used clinical scales for CM with patient-perceived outcomes after surgical treatment. Additionally, it sought to establish minimum clinically important difference (MCID) thresholds for scales strongly correlating with patient perception.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patients and methods&lt;/h3&gt;&lt;div&gt;A prospective, single-center observational study followed 47 patients with degenerative CM who underwent simple cervical laminectomy for one year. Patients were assessed using the mJOA, Nurick, cervical and brachial Visual Analogue Scales (VAS), the Neck Disability Index (NDI), and the EuroQol-5D (EQ5D). Patient perception of global effect (PGE) was assessed at 6 months and 1-year post-surgery using an anchor question asking if they perceived improvement, worsening, or no change. MCID was calculated using three anchor-based methods: mean difference, change difference, and the Youden Index from receiver operating characteristic (ROC) curves. Definitive MCID thresholds were the average of these three methods.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;At the end of the follow-up, 25 patients (53.2%) had perceived clinical improvement with surgery, 15 (31.9%) had perceived no changes, and 7 (14.9%) had perceived worsening. The scales that showed the best correlation with patient perception were mJOA (&lt;em&gt;η&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.25; &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.002), Nurick (&lt;em&gt;η&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.19; &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.009), and NDI (&lt;em&gt;η&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.17; &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.016). The definitive MCID thresholds for improvement were an increase in score ≥1.5 points in mJOA, a reduction of ≥0.56 points in the Nurick scale, and a reduction of ≥5 points in NDI. The definitive MCID thresholds for worsening were an increase of ≤0.23 points or a loss of score in mJOA, an increase of ≥0.33 points in the Nurick scale, and an increase of ≥1.26 points in NDI. According to the MCID thresholds, the majority of patients achieved clinically significant improvement: 59.6% in mJOA (compared to 25.5% with worsening), 27.7% in the Nurick scale (compared to 6.4% who worsened), and 42.5% in the NDI (versus 19.1% who worsened).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Patient perception of outcome following cervical laminectomy for spondylotic cervical myelopathy significantly correlates with functional scales like mJOA, Nurick, and NDI. The MCID thresholds indicate that patients require a more substantial change to perceive improvement than worsening, highlighting an asymmetry in subjective perception of treatment effects. These findings support using MCID, anchored in subjective perceptions, as a complementary tool to interpret the clinical relevance of quantitati","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"37 1","pages":"Article 500735"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703028","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":"Epileptogenicity post stereoelectroencephalography and subdural grids invasive monitoring: A retrospective analysis of adult and pediatric patients with refractory epilepsy","authors":"Sonia Pulido ,&nbsp;Sven Ivankovic ,&nbsp;Nolan Winslow ,&nbsp;Andres Maldonado","doi":"10.1016/j.neucie.2025.500703","DOIUrl":"10.1016/j.neucie.2025.500703","url":null,"abstract":"<div><h3>Objective</h3><div>To assess if removal of stereoelectroencephalography (SEEG) or subdural grids (SDG) is associated with an increased seizure frequency in patients with refractory epilepsy during the immediate postoperative period.</div></div><div><h3>Methods</h3><div>37 patients with refractory epilepsy that underwent monitoring with SEEG or SDG during November 2012–March 2022 were identified using electronic medical records from a single institution. Seizure history, duration of intracranial monitoring, and monitored brain regions were recorded.</div></div><div><h3>Results</h3><div>5.0% and 5.9% of SEEG and SDG patients had a seizure within 48<!--> <!-->h post-termination of monitoring. 25% and 11.8% of SEEG and SDG patients had a seizure between 48<!--> <!-->h and 1-week after surgery. Between 1 week and 1 month after SEEG or SDG removal, 35% and 41.2% of patients had a seizure. 30% and 50% SEEG or SDG patients had a seizure between 1- and 2-months following removal. Overall change in postoperative seizure frequency was not significant. Seizure frequency increased for 11.8% of SDG patients while frequency remained unchanged for 5.9% and decreased for 82.4%. No patients post-SEEG removal in our cohort experienced an increased seizure frequency. 95% experienced a decrease in seizure frequency and no change was observed in 5%.</div></div><div><h3>Conclusion</h3><div>SEEG is not associated with increased epileptogenicity after termination of monitoring. Two patients post-SDG removal experienced an increase in seizure frequency. While patients with refractory epilepsy may continue to have seizures during the immediate postoperative period, it is likely that patients will experience a decrease in seizure frequency after removal of SEEG or SDG.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"37 1","pages":"Article 500703"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303896","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}