Neurocirugia (English Edition)最新文献

{"title":"Executive summary of the expert consensus document from the Spanish Society of Neurosurgery and the Spanish Society of Endocrinology and Nutrition: clinical recommendations on the perioperative management of pituitary tumors","authors":"Marta Araujo-Castro ,&nbsp;Víctor Rodríguez- Berrocal ,&nbsp;Elena Dios ,&nbsp;Ramon Serramito ,&nbsp;Betina Biagetti ,&nbsp;Ignacio Bernabeu","doi":"10.1016/j.neucie.2023.07.007","DOIUrl":"10.1016/j.neucie.2023.07.007","url":null,"abstract":"<div><p>Pituitary tumors (PT) account for 15% of intracranial tumors affect 10.7–14.4% of the population although the incidence of clinically relevant PT is 5.1 cases/100,000 inhabitants. Surgical treatment is indicated in PTs with hormone hypersecretion (except for prolactin-producing PTs) and those with local compressive or global neurological symptoms. Multidisciplinary care, is essential for patients with PTs, preferably delivered in a center of excellence and based on a well-defined care protocol. In order to facilitate and standardize the clinical procedures for this type of tumor, this document gathers the positioning of the Neuroendocrinology Knowledge Area of the Spanish Society of Endocrinology and Nutrition (SEEN) and the Spanish Society of Neurosurgery (SENEC) on the management of patients with PTs and their preoperative, surgical and postoperative follow-up.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 6","pages":"Pages 292-307"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685861","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":"Intradural extramedullary tumors. Retrospective cohort study assessing prognostic factors for functional outcome in adult patients","authors":"Mauro Ruella ,&nbsp;Guido Caffaratti ,&nbsp;Amparo Saenz ,&nbsp;Facundo Villamil ,&nbsp;Rubén Mormandi ,&nbsp;Andrés Cervio","doi":"10.1016/j.neucie.2022.11.025","DOIUrl":"10.1016/j.neucie.2022.11.025","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study is to analyze a series of patients with intradural extramedullary tumors (IDEM) and assess factors that may modify or determine the final long term outcome and management.</p></div><div><h3>Materials and methods</h3><p>Single Center, retrospective study of a series of surgical patients with IDEM lesions from our Institution operated between 2010 and 2021. Patients with less than 6 months of follow up were excluded. Several preoperative demographics, clinical, imaging and surgical features, as well as histopathology, recurrence and adjuvancy were assessed. Patients’ final clinical outcome was categorized using the McCormick scale.</p></div><div><h3>Results</h3><p>A total of 203 patients with a mean follow-up of 30.50 months (range 6–130) were included. 57.64% of the analyzed population was female and the mean age was 50.51 years.</p><p>The most frequent location of the tumors was dorsal (34.98%) followed by the lumbar region (32.02%). Total resection was achieved in 84.24% of cases, and the most frequent histopathology was Schwannoma (36.45%), followed by Meningioma (30.05%). Pain was the most usual initial symptom (63.05%).</p><p>In our analysis, functional outcome after surgery was associated with statistical significance with preoperative McCormick grade, tumor type, EOR and postoperative complications such as hematoma and sphincter involvement.</p></div><div><h3>Conclusion</h3><p>The management of these lesions depends on many factors. It is worthy of mention that clinical presentation, EOR, histopathology and postoperative complications have shown significant prognostic value for the final outcome. Early treatment with the intention of achieving GTR when possible, using carefully tailored approaches, should be considered before the onset of significant symptoms.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 5","pages":"Pages 256-267"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10146844","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":"Utilidad de la monitorización neurofisiológica intraoperatoria como valor pronóstico de la parálisis facial posquirúrgica en schwannomas vestibulares","authors":"Luis Torres-Carretero ,&nbsp;Álvaro Otero-Rodríguez ,&nbsp;María Victoria Alejos-Herrera ,&nbsp;Gemma Vázquez-Casares ,&nbsp;Andoni García-Martín ,&nbsp;Patricia Alejandra Garrido-Ruiz","doi":"10.1016/j.neucie.2022.09.004","DOIUrl":"https://doi.org/10.1016/j.neucie.2022.09.004","url":null,"abstract":"<div><h3>Background and objective</h3><p>Intraoperative neurophysiological monitoring allows us to predict the functional status of the facial nerve after vestibular schwannoma surgery. Due to the great variability of the neurophysiological protocols used for it, the goal of this study is to determine the prognostic ability of our neurophysiological protocol.</p></div><div><h3>Material and methods</h3><p>We have performed a statistical analysis of the neurophysiological monitoring data collected from patients operated between March 2009 and July 2021 at the Neurosurgery Service of Salamanca according to their functional status, both in the immediate post-surgical period and one year after surgery.</p></div><div><h3>Results</h3><p>A number of 51 patients between 46 and 63 years old (median: 54) were analyzed. We have found significant differences studying the threshold value of the stimulation intensity of the facial nerve and the variation of the Cortico-bulbar Evoked Motor Potentials (<em>P</em> <!-->=<!--> <!-->0.043 and <em>P</em> <!--> <!-->=<!--> <!-->0.011, respectively) between the patients with good and bad clinical situation after surgery. The most discriminating intensity threshold value was 0.35<!--> <!-->mA (Sensitivity: 85%; Specificity: 48%). No statistical relationship was found in the study group one year after surgery.</p></div><div><h3>Conclusions</h3><p>Our intraoperative monitoring protocol allows us to predict the clinical situation of patients in the immediate postoperative period and improve information for the patient and her relatives after surgery. We cannot, however, use these parameters to predict the functional situation one year after surgery and make clinical decisions in this regard.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 5","pages":"Pages 238-246"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50190764","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 intraoperative imaging guided versus microelectrode recording guided deep brain stimulation for Parkinson's disease: A meta-analysis","authors":"Tsung-Che Chuang ,&nbsp;Jia-Qi Tan ,&nbsp;Shu-Mei Chen","doi":"10.1016/j.neucie.2022.09.003","DOIUrl":"10.1016/j.neucie.2022.09.003","url":null,"abstract":"<div><h3>Background</h3><p>Traditionally, most centers would use microelectrode<span> recording (MER) to refine targeting in deep brain stimulation (DBS) surgery. In recent years, intraoperative imaging (IMG) guided DBS has become an alternative way to verify lead placement. Currently, there is still controversy surrounding the necessity of MER or IMG for DBS. This meta-analysis aims to explore lead accuracy, clinical efficacy and safety between IMG and MER guided DBS for Parkinson's disease (PD).</span></p></div><div><h3>Methods</h3><p>PubMed, Embase, Web of Science, Cochrane Library were searched up to Mar, 2021 for studies reporting comparisons between IMG and MER guided DBS for PD. Subgroup analysis was conducted to assess effects of different IMG technology and DBS targeting site.</p></div><div><h3>Results</h3><p><span>Six studies, comprising of 478 patients were included in our analysis. The mean difference between the two implantation techniques in stereotactic accuracy, lead passes per trajectory, improvement% of Unified Parkinson's Disease Rating Scale part III and levodopa equivalent daily dose were −0.45 (95% confidence interval, CI</span> <!-->=<!--> <!-->−1.11 to 0.20), −0.18 (95% CI<!--> <!-->=<!--> <!-->−0.41 to 0.06), 3.40 (95% CI<!--> <!-->=<!--> <!-->−5.36 to 12.16), and 5.00 (95% CI<!--> <!-->=<!--> <!-->−1.40 to 11.39), respectively. No significant differences were observed in each adverse event and operation/procedure time between the two implantation techniques.</p></div><div><h3>Conclusions</h3><p>Both IMG and MER guided DBS offered effective control of motor symptoms for PD. Besides, IMG guided is comparable to MER guided DBS, in terms of safety, accuracy and efficiency. It is recommended for each hospital to select DBS guidance technology based on available resources and equipment.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 5","pages":"Pages 228-237"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10144629","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":"Long insular artery damage might be a key sign for predicting functional prognosis of putaminal hemorrhage","authors":"Yuki Amano,&nbsp;Yohei Yamaguchi,&nbsp;Toshiaki Osato,&nbsp;Toshiichi Watanabe,&nbsp;Kenji Kamiyama,&nbsp;Hirohiko Nakamura","doi":"10.1016/j.neucie.2022.08.002","DOIUrl":"10.1016/j.neucie.2022.08.002","url":null,"abstract":"<div><h3>Objective</h3><p>Although the putamen is the most common area of spontaneous intracerebral hemorrhage, previous reports about the effects of surgery are limited. We sometimes experience a poor prognosis in patients in whom there is no damage to the internal capsule, but with injury in the long insular artery (LIA) region. The purpose of this study was to confirm the relationship between LIA damage and patient prognosis following surgery for putaminal hemorrhage.</p></div><div><h3>Methods</h3><p>We retrospectively collected data of 287 surgical cases who presented with putaminal hemorrhage between January 2004 and March 2022. Among them, we chose patients without initial damage to the posterior limb of the internal capsule, and divided these patients into two groups, those without (Group A) and with (Group B) final damage in the LIA region. We compared positivity rates of final manual muscle test (MMT) scores<!--> <!-->≥<!--> <!-->3 and related factors.</p></div><div><h3>Results</h3><p>Sixty-three of the 287 patients were included in this study. Of them, 11 cases in Group A were positive for MMT scores<!--> <!-->≥<!--> <!-->3 (68.8%) and 9 cases (19.1%) in Group B had MMT scores<!--> <!-->≥<!--> <!-->3 seven days after surgery. Group A thus had a significantly higher rate of MMT scores<!--> <!-->≥<!--> <!-->3 than group B (<em>p</em> <!-->=<!--> <!-->0.00).</p></div><div><h3>Conclusion</h3><p>In patients without initial damage to the internal capsule, LIA injury might be a key sign for predicting the functional prognosis of putaminal hemorrhage.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 5","pages":"Pages 221-227"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10141094","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":"Catastrophising in spinal surgery and the impact of radiology reports","authors":"Pedro David Delgado-López ,&nbsp;Carlos Fernández Carballal ,&nbsp;Igor Paredes ,&nbsp;Héctor Roldan Delgado ,&nbsp;David Suárez Fernández ,&nbsp;Alfonso Vázquez Míguez","doi":"10.1016/j.neucie.2023.07.005","DOIUrl":"10.1016/j.neucie.2023.07.005","url":null,"abstract":"","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 5","pages":"Pages 217-220"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10141193","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":"Craniofacial fibrous dysplasia and aneurismal bone cyst in a patient with McCune-Albright syndrome. A case report and review of the literature","authors":"Julián Castro Castro ,&nbsp;Juan Manuel Villa Fernández ,&nbsp;Jesús Patricio Agulleiro Díaz","doi":"10.1016/j.neucie.2022.09.002","DOIUrl":"10.1016/j.neucie.2022.09.002","url":null,"abstract":"<div><p><span>McCune-Albright syndrome (MAS) is a rare heterogeneous genetic disorder that is characterized by a triad of polyostotic fibrous dysplasia (FD), </span>café au lait spots<span> (CAL), and multiple hyperfunctional endocrinopathies. In general, it is diagnosed clinically. From the triads, 2 of the findings are enough to make the diagnosis.</span></p><p>Craniofacial fibrous dysplasia is a term that is used to describe the fibrous dysplasia, which was localized at the craniofacial skeleton and is common in MAS patients.</p><p><span>Aneurysmal bone cyst<span> (ABC) is a rare non-neoplastic bone lesion that involves mostly the long bones and </span></span>vertebrae and may occur very rarely in the craniofacial bones. ABCs may occur as secondary bony pathologies in association with various benign and malignant bone tumors and with fibrous dysplasia. Secondary ABC occurring in craniofacial FD is extremely rare. We present the case of a 21-year-old patient treated at our center for a right orbital aneurysmal bone cyst associated with MAS and provide a review of the relevant literature.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 5","pages":"Pages 268-272"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10144070","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":"Posterior-only approach in patients with poor general condition and spinal metastatic vertebral fracture","authors":"Mustafa Onur Ulu ,&nbsp;Mehmet Yigit Akgun ,&nbsp;Orkhan Alizada ,&nbsp;Eren Fatma Akcil ,&nbsp;Tufan Kartum ,&nbsp;Murat Hanci","doi":"10.1016/j.neucie.2022.10.002","DOIUrl":"10.1016/j.neucie.2022.10.002","url":null,"abstract":"<div><h3>Purpose</h3><p>The surgical treatment of spinal metastases is mostly palliative in nature and focuses on improving the quality of life of patients. The posterior transpedicular surgical approach provides circumferential 360° decompression, allows reconstruction and stabilisation to be achieved in a single session and can be performed using an open, mini-open or minimally invasive approach. We present and discuss the surgical techniques and outcomes for patients with single-level metastatic spinal disease and in poor general condition who underwent surgery via the posterior-only transpedicular corpectomy approach and reconstruction with expandable corpectomy cages.</p></div><div><h3>Methods</h3><p>Patients with a single level thoracolumbar metastatic disease (T3-L5) and a Karnofsky score of ≤70, who underwent a complete posterior transpedicular corpectomy with expandable cage reconstruction of the anterior spinal column were retrospectively reviewed. Patients’ demographics, SINS, modified Tokuhashi scores as well as preoperative and postoperative ASIA scale, Karnofsky scores, VAS scores and vertebral height/Cobb angle values were analysed.</p></div><div><h3>Results</h3><p>A total of 44 patients (24 M/20 F) (mean age 53.25<!--> <!-->±<!--> <!-->21.26 years) met the inclusion criteria. The modified Tokuhashi scores were as follows: score 0–8, 5 (11.4%) patients; score 9–11, 14 (31.8%) patients; and score 12–15, 25 (56.8%) patients. There were significant improvements in the postoperative VAS scores (mean 7.7–2.9), Karnofsky scores (mean 63.3–79.6) as well as the Cobb angles (18.6–12.8°) and vertebral height. Thirtyfive patients showed improved neurological function by at least one ASIA grade, whereas 9 showed no improvement during the postoperative period.</p></div><div><h3>Conclusions</h3><p>This technique, which has a low complication rate and a short recovery time, can help achieve satisfactory results even in patients with poor metabolic profiles and Karnofsky scores in the preoperative period. Further clinical studies with large patient groups are warranted to confirm the results of this study.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 5","pages":"Pages 247-255"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10197817","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":"Cavernous hemangioma of the peripherical nerve: A case report","authors":"Alejandra Arévalo-Sáenz ,&nbsp;Fernando J. Rascón-Ramírez ,&nbsp;Manuel Pedrosa Sánchez","doi":"10.1016/j.neucie.2022.09.001","DOIUrl":"10.1016/j.neucie.2022.09.001","url":null,"abstract":"<div><p>Cavernous hemangiomas<span><span><span><span>, also known as deep hemangiomas are benign tumors of blood vessels, including normal and abnormal </span>vascular structures, that develop in skin tissue and sometimes even in deep tissues. Its intraneural development in the </span>peripheral nerve is very rare with less than 50 cases reported in the literature. We present a case of a cavernous hemangioma of the medial </span>sural nerve<span><span> in a patient with symptoms of severe pain and allodynia with complete resolution of symptoms with </span>microsurgery.</span></span></p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 4","pages":"Pages 213-216"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9913789","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":"Hemorrhagic presentation of previously silent brain tumors","authors":"Alper Turkkan ,&nbsp;Marzieh Karimi Khezri ,&nbsp;Pinar Eser ,&nbsp;Turgut Kuytu ,&nbsp;Sahsine Tolunay ,&nbsp;Ahmet Bekar","doi":"10.1016/j.neucie.2022.11.023","DOIUrl":"10.1016/j.neucie.2022.11.023","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Acute presentation with intracranial hemorrhage owing to a previously silent brain tumor (BT) is rare. Although any BT can bleed, the frequency and type of bleeding varies across tumor types.</p></div><div><h3>Materials and methods</h3><p>We aimed to retrospectively review our experience with 55 patients with BTs presenting with ICH.</p></div><div><h3>Results</h3><p>Signs of increased intracranial pressure were the most common symptoms. The temporal lobe was the most common lesion site (<em>n</em> <!-->=<!--> <!-->22). Hemorrhages were mainly confined to the tumor margins (HCTs) (<em>n</em> <!-->=<!--> <!-->34). Extensive intraparenchymal hemorrhages (EIHs) were mainly associated with moderately/severely decreased levels of consciousness (LOCs) (<em>n</em> <!-->=<!--> <span>15/16). High-grade glioma (HGGT) (</span><em>n</em> <!-->=<!--> <!-->25) was the leading pathological diagnosis followed by metastasis (MBT) (<em>n</em> <!-->=<!--> <!-->16/55). The hemorrhage type was associated with the pathological diagnosis of the tumor. Patients with HGGT (<em>n</em> <!-->=<!--> <!-->19/25) and MBT (<em>n</em> <!-->=<!--> <!-->9/16) mainly presented with HCTs, whereas low-grade gliomas (LGGT) primarily caused EIHs (<em>n</em> <!-->=<!--> <!-->6/7).</p></div><div><h3>Conclusions</h3><p>Hemorrhagic presentation is a rare occurrence in BTs. Among all, MBT and HGGT are responsible for majority of the cases. Importantly, despite their relatively benign characteristics, LGGTs mainly result in extensive parenchymal destruction once they bleed. Maximum surgical resection of hemorrhagic BTs and decompression of the affected brain regions followed by histological confirmation of the diagnosis should be the main goals of treatment in cases with hemorrhagic BTs.</p></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"34 4","pages":"Pages 177-185"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10217908","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}