Neurocirugia (English Edition)最新文献

{"title":"Endothelial dysfunction and vascular abnormalities in acromegaly. A case report","authors":"Ana Irigaray Echarri ,&nbsp;M. Dolores Ollero García-Agulló ,&nbsp;José Jorge Ortez Toro ,&nbsp;Idoya Zazpe Cenoz","doi":"10.1016/j.neucie.2024.10.005","DOIUrl":"10.1016/j.neucie.2024.10.005","url":null,"abstract":"<div><div>In patients with acromegaly, the pleiotropic effects of GH and IGF-1 have been associated with the development of endothelial dysfunction and vascular abnormalities.</div><div>We present the case of a 45-year-old male diagnosed with acromegaly. Magnetic resonance imaging identified a marked dilatation and medialization of both cavernous internal carotid arteries (ICA), leading to a narrow intercarotid distance, a phenomenon known as “carotid kisses”.</div><div>This vascular alteration has been described in greater proportion in patients with acromegaly. The anomalies that are also present with greater prevalence in these patients are: aneurysms of the ICA, protrusion of the ICA into the sphenoid sinus, narrow intercarotid distance, fusiform dilatation of the ICA and dehiscence of this artery in the bony canal. The presence of such alterations increases the risk of injury to the ICA.</div><div>Pre-surgical detection of such abnormalities is essential to ensure the safety of the surgical approach.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 2","pages":"Pages 135-138"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549398","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 anterior fusion still necessary in patients with neurologically intact thoracolumbar burst fractures? A systematic review and meta-analysis","authors":"Andrey Grin,&nbsp;Vasily Karanadze,&nbsp;Ivan Lvov ,&nbsp;Aleksandr Talypov,&nbsp;Anton Kordonskiy,&nbsp;Rinat Abdrafiev","doi":"10.1016/j.neucie.2024.11.006","DOIUrl":"10.1016/j.neucie.2024.11.006","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To conduct a systematic review and single-arm meta-analysis to evaluate and compare radiological indicators, as well as short-term and long-term outcomes, in patients with neurologically intact thoracolumbar burst fractures (TLBF) who underwent anterior fusion, combined anterior-posterior procedure, or short-segment pedicle screw fixation (PSF).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A systematic review following PRISMA guidelines was conducted. Inclusion criteria comprised articles published between 2004 and 2023, full-text availability in English, burst fractures without spinal cord or nerve root injuries at admission, short-segment PSF without fusion, anterior or combined fusion methods, patients aged 18 or older, and a minimum 12-month follow-up.&lt;/div&gt;&lt;div&gt;Meta-analysis was carried out using Comprehensive Meta-Analysis software. Using a single-arm meta-analysis method, pooled indicators of short- and long-term outcomes for each studied group were determined. The obtained data were then compared using simple comparison.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The pooled mean Cobb angle at admission for the anterior, combined, and PSF groups was 18.2° (95% CI, 14.6−21.8), 11.7° (95% CI, 9.7−13.5), and 17.1° (95% CI, 15.1–19.1), respectively. Anterior fusion achieved a greater degree of kyphosis correction across all groups, but only the combined group showed a nonsignificant loss of correction after discharge (SMD = 0.809 [95% CI, 0.270, 1.348]). The anterior vertebral body compression rate at admission was 55.2% (95% CI, 46.3−64.0) in the combined group and 37.8% (95% CI, 33.7−41.9) in the PSF group.&lt;/div&gt;&lt;div&gt;Operative time, blood loss, and hospitalization duration were lowest in the percutaneous PSF group, with means of 96.5 min (95% CI, 82.4–110.6), 83.8 ml (95% CI, 71.7–95.9), and 6.6 days (95% CI, 4.7–8.5), respectively. All techniques demonstrated a similar incidence of deep wound infections and implant-related complications.&lt;/div&gt;&lt;div&gt;The pooled Oswestry Disability Index (ODI) scores were 17.2 (95% CI, 10.4−23.9) for the anterior group, 15.4 (95% CI, 11.5–19.3) for the combined group, and 13.4 (95% CI, 10.4–16.3) for the PSF group.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;For patients with neurologically intact thoracolumbar burst fractures, with a kyphotic angle of less than 19.1° and an anterior vertebral body compression rate of less than 41.9%, short-segment pedicle screw fixation without fusion may be preferable option due to reduced intraoperative blood loss, shorter operation duration, shorter hospital stay, and better ODI scores at final follow-up. Routine anterior fusion has demonstrated high potential for kyphosis correction. The loss of the Cobb angle from surgery to final follow-up was nonsignificant only in patients who underwent combined surgery. When determining the surgical approach, surgeons should carefully weigh the advantages of anterior and combined fusion against the significantly higher sur","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 2","pages":"Pages 112-128"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689891","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":"Comparison of clinical efficacy of MMA embolization combined with subdural perforation drainage and subdural perforation drainage in the treatment of CSDH","authors":"Wen Cheng,&nbsp;Quanlong Yang,&nbsp;Xiaodong Yuan,&nbsp;Jiangbin Wu","doi":"10.1016/j.neucie.2024.11.001","DOIUrl":"10.1016/j.neucie.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Chronic subdural hematoma is a frequent neurosurgical illness, and current treatment options mostly include subdural trepanation and drainage alone, as well as middle meningeal artery embolization in conjunction with subdural trepanation and drainage. However, there is currently a lack of extensive study and data support for comparing the clinical results of the two surgical treatment techniques.</div></div><div><h3>Objective</h3><div>The goal of this study is to compare the clinical effects of middle meningeal artery embolization combined with subdural trepanation and drainage versus simple subdural trepanation and drainage in the treatment of chronic subdural hematoma, in order to provide a reliable foundation for clinical selection of appropriate surgical treatment methods.</div></div><div><h3>Methods</h3><div>This study included 71 patients with chronic subdural hematoma, who were divided into two groups according to the procedure: observation group (n = 25) and control group (n = 46). The control group received only basic subdural drilling and drainage.</div></div><div><h3>Conclusions</h3><div>This study found that MMA embolization combined with subdural trepanation and drainage provides a greater therapeutic benefit in the treatment of chronic subdural hematoma. The observation group outperformed the control group in terms of postoperative CT results, Barthel index, and clinical effect, as well as operating time. Furthermore, the observation group's complications and recurrence rate were much lower than the control group’s.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 2","pages":"Pages 75-82"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649765","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}

{"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":"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":"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":"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}