Neurosurgery practice最新文献

{"title":"Multi-Level Uncinatectomies and Posterior Column Osteotomies to Correct a Cervical Kyphotic Deformity: Case Instruction With Intraoperative Picture and Video.","authors":"Harsh Jain, Hani Chanbour, Tyler Zeoli, Aaron M Yengo-Kahn, Scott L Zuckerman","doi":"10.1227/neuprac.0000000000000205","DOIUrl":"10.1227/neuprac.0000000000000205","url":null,"abstract":"<p><strong>Background and importance: </strong>Cervical deformity is a debilitating pathology that can result from trauma, infection, tumor, or previous surgery. The authors sought to provide a technical and visual description of an anterior-posterior fusion to correct a fixed cervical kyphotic deformity with multi-level anterior uncinatectomies and posterior column osteotomies (PCOs).</p><p><strong>Clinical presentation: </strong>A 71-year-old man with a history of diffuse idiopathic skeletal hyperostosis and a prior C5/6 fracture resulting in a fixed kyphotic deformity presented with severe mechanical neck pain and inability to maintain a horizontal gaze. Imaging revealed a kyphotic compression fracture at C6, with significant kyphosis from C5-T1, anterior/posterior ossification, and multiple level autofusion. The patient underwent a combined anterior-posterior procedure, starting with C4/5, C5/6, and C7/T1 anterior cervical discectomy and fusions with uncinatectomies, facilitating spinal realignment. The posterior approach included C2-T4 instrumented fusion and C2-T1 PCOs. The combined strategy achieved significant sagittal correction, restoring cervical lordosis and sagittal balance. At 1-year follow-up, the patient maintained improved alignment without neurologic deficits.</p><p><strong>Conclusion: </strong>A fixed cervical kyphotic deformity presents significant surgical challenges. We hereby provide a step-by-step description of the anterior-posterior approach with multi-level anterior uncinatectomies and PCOs to correct a fixed cervical kyphotic deformity in a patient with remote fractures and diffuse idiopathic skeletal hyperostosis. We described surgical nuances and key steps to achieve a safe and adequate deformity correction.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"7 1","pages":"e000205"},"PeriodicalIF":0.6,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144544","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":"Autologous Peripheral Nerve Tissue Grafts Implanted into the Nucleus Basalis of Meynert and Substantia Nigra at the Time of Bilateral Deep Brain Stimulation in Parkinson Disease: A Report of 2 Cases.","authors":"Samuel R Daly, Jorge E Quintero, Lisa Koehl, Elizabeth Wallace, Zain Guduru, Julie A Gurwell, Tripp Hines, Jaimie Hixson, Saad Hulou, John T Slevin, Frederick A Schmitt, Greg A Gerhardt, Craig G van Horne","doi":"10.1227/neuprac.0000000000000189","DOIUrl":"10.1227/neuprac.0000000000000189","url":null,"abstract":"<p><strong>Background and objectives: </strong>Cholinergic degeneration in the nucleus basalis of Meynert (NBM) is implicated in the cognitive impairment seen in Parkinson disease (PD) and is being examined as a potential therapeutic target. We have previously shown the safety of delivering investigational autologous cell-based therapy, ie, peripheral nerve tissue (PNT), to the substantia nigra (SN) at the time of deep brain stimulation (DBS) surgery in PD (DBS-Plus). In this study, we assessed the safety and feasibility of simultaneously delivering that PNT to both the NBM and SN at the time of DBS.</p><p><strong>Methods: </strong>Two patients with idiopathic PD and mild cognitive impairment, who underwent clinically indicated bilateral globus pallidus internus DBS, were consented for participation. At the time of lead placement, reparative autologous PNT (sural nerve) was harvested and stereotactically delivered to the NBM and SN contralateral to the patients' more severe motor symptoms.</p><p><strong>Results: </strong>Delivery of PNT to both the SN and NBM was successfully achieved in both participants. There were no serious adverse events related to the delivery of the graft, and no adverse radiologic effects were observed. Both participants showed stable performance on standard PD testing. Neurocognitive testing at 18 months postoperatively in one participant showed expected decrements in certain domains and unique improvements in others.</p><p><strong>Conclusion: </strong>We report the feasibility and preliminary safety data of stereotactic delivery of reparative autologous PNT to two separate unilateral targets at the time of DBS lead placement. We plan to continue exploring the potential for this investigational cell-based therapy to restore function to damaged networks in PD.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"7 1","pages":"e000189"},"PeriodicalIF":0.6,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12700753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764787","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":"Departments of Neurosurgery are Leaders in Highly Cited Glioblastoma Research.","authors":"Masih Tazhibi, Rishab Ramapriyan, Parker Kotlarz, Samuel J Steuart, Adrian Kalaw, Mona Tazhibi, Bob S Carter, E Antonio Chiocca, Brian V Nahed, William T Curry, Bryan D Choi","doi":"10.1227/neuprac.0000000000000170","DOIUrl":"10.1227/neuprac.0000000000000170","url":null,"abstract":"<p><strong>Background and objectives: </strong>We conducted a bibliometric analysis of highly cited glioblastoma (GBM) research published between 2013 and 2023, focusing on identifying key academic departments and institutional contributions within the United States.</p><p><strong>Methods: </strong>A comprehensive search of the Web of Science database was performed to identify \"highly cited articles,\" defined as those receiving the top one percent for citations within their field each year. Primary research articles authored by researchers at U.S. institutions between 2013 and 2023 were included. We categorized articles by subject area and departmental contributions and used VOSviewer and R for data visualization and analysis.</p><p><strong>Results: </strong>Overall, 169 highly cited GBM articles were included in the study. Neurosurgery emerged as the largest contributing department type, accounting for 28.4% (48/169) of highly cited articles. This was followed by departments of biology or genetics (22/169), neurology or neuro-oncology (16/169), and radiology or radiation oncology (13/169). \"Immunology and Immunotherapy\" was the dominant subject area for highly cited papers, with 50.3% (85/169) investigating the immunological landscape of GBM or using immunotherapy as the primary treatment modality. Keyword analysis demonstrated a thematic shift toward tumor biology and immune-based therapies over the study period, highlighting emerging trends in GBM research.</p><p><strong>Conclusion: </strong>Departments of neurosurgery have established themselves as key drivers in GBM research. The prominence of tumor biology and immunotherapy reflect broader shifts in treatment approaches. Continued support for neurosurgical departments and targeted funding initiatives is essential for advancing GBM research, fostering innovation, and improving patient outcomes in this challenging field.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"6 4","pages":"e000170"},"PeriodicalIF":0.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12560700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403018","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":"Treatment of Therapy-Refractory, Symptomatic Vasospasm in a Radial Artery Bypass Graft With Balloon Angioplasty in a Patient With Severe Subarachnoid Hemorrhage: A Case Study.","authors":"Franziska Meinert, Patrick Dömer, Levent Tanrikulu, Simeon O A Helgers, Claudia Klüner, Johannes Woitzik, Christian Mathys","doi":"10.1227/neuprac.0000000000000158","DOIUrl":"10.1227/neuprac.0000000000000158","url":null,"abstract":"<p><strong>Background and importance: </strong>This case highlights the effectiveness of endovascular balloon dilatation (percutaneous transluminal angioplasty (PTA)) for treating vasospasm in a radial artery (RA) bypass graft from the internal carotid artery to the M2 branch of the middle cerebral artery in a patient with severe subarachnoid hemorrhage.</p><p><strong>Clinical presentation: </strong>A 69-year-old woman with severe subarachnoid hemorrhage due to a ruptured giant aneurysm in the ophthalmic segment of the right internal carotid artery underwent an extracranial-intracranial high-flow bypass with a RA graft, followed by trapping of the aneurysm. During her intensive care unit stay, vasospasms developed primarily in the intracranial radial graft and M2 branches. These spasms showed only minimal improvement after standard care and intra-arterial vasospasmolysis with nimodipine. Thus, after systemic anticoagulation, balloon PTA was performed, treating both the intracranial and extracranial sections of the graft, including areas near the anastomosis. The procedure was complication-free, with immediate morphological success and significant improvement in perfusion to the middle cerebral artery territory.</p><p><strong>Conclusion: </strong>Endovascular balloon PTA should be considered a rescue measure for vasospasm in extracranial-intracranial bypasses, particularly with RA grafts post-SAH. Owing to its muscular structure, the RA graft is especially prone to spasm, potentially compromising graft patency. When pharmacological treatments fail, balloon PTA offers a targeted intervention to restore vessel caliber, stabilizing blood flow and preventing ischemic complications, thus supporting the bypass's long-term success.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"6 3","pages":"e000158"},"PeriodicalIF":0.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12560738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402833","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":"Comparison of an Electrical Cranial Access Drill With Autostop Technology to a Traditional Hand Crank Cranial Access Drill.","authors":"John L Kilgallon, Geoffrey R O'Malley, Daniel Monahan, Shayan Sadegh, Harshal Shah, Ira M Goldstein, Nitesh V Patel","doi":"10.1227/neuprac.0000000000000159","DOIUrl":"10.1227/neuprac.0000000000000159","url":null,"abstract":"<p><strong>Background and objectives: </strong>Craniostomies performed at bedside are one of the most important procedures in neurosurgery allowing for cranial access for monitoring of intracranial pressure, evacuation of subdural or epidural hematomas, or the placement of external ventricular drains. Although neurosurgery as a whole has seen rapid advances in its technology, craniostomies continue to be performed with hand crank drill technology similar to what was used in the 1600s. The purpose of this study was to compare the efficacy and safety profile of a novel electrical cranial access drill with autostop technology (ECAD) to that of traditional hand crank drills.</p><p><strong>Methods: </strong>Using both drills, holes were drilled into the cranial vault of human cadavers by a veteran cranial surgeon and by a medical student without prior experience in the procedure. Time to drill each hole and the number of dural violations was compared between drills.</p><p><strong>Results: </strong>Overall, 30 craniostomies were created with the hand crank drill and 61 were created with the ECAD. The average time to hole competition was significantly longer with the hand crank drill than with the ECAD (24.1 vs 16.5 seconds, <i>P</i> < .001). There were significantly more dural violations with the hand crank drill than with the ECAD (13 vs 2, <i>P</i> = .002), which engaged autostop in 100% of procedures.</p><p><strong>Conclusion: </strong>The electric drill with autostop technology demonstrated faster time to hole completion and significantly fewer dural violations than the traditional hand crank drill.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"6 3","pages":"e000159"},"PeriodicalIF":0.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12560711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403142","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":"Comparative Analysis of Disposable Cranial Perforators in Trepanation.","authors":"Kazufumi Ohmura, Noriyuki Nakayama, Tsuyoshi Izumo","doi":"10.1227/neuprac.0000000000000155","DOIUrl":"10.1227/neuprac.0000000000000155","url":null,"abstract":"<p><strong>Background and objectives: </strong>Cranial trepanation is a fundamental neurosurgical procedure that has evolved significantly with the development of disposable cranial perforators designed to enhance safety and efficiency. The aim of this study was to evaluate and compare the safety, efficiency, and cost-effectiveness of disposable cranial perforators used in neurosurgical procedures.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 129 trepanations performed by a single surgeon between May and December 2024, using 3 disposable cranial perforators: Codman (Integra LifeSciences Production Corporation), MERIDIAN (adeor medical AG), and ACRA-CUT (ACRA-CUT Inc.). Clinical parameters assessed included trepanation success rates, operative times, and complication rates. In addition, a cadaveric study examined the impact of varying drilling angles on dural integrity. Structural distinctions among perforators were investigated using digital microscopy.</p><p><strong>Results: </strong>ACRA-CUT was approximately twice as expensive as Codman and MERIDIAN. Clinically, Codman demonstrated the lowest success rate (69%) compared with MERIDIAN (97.7%) and ACRA-CUT (100%). ACRA-CUT also achieved the shortest median trepanation time (11.8 seconds) compared with Codman (74.6 seconds) and MERIDIAN (26.4 seconds). However, the cadaveric analysis revealed a higher incidence of dural injury with ACRA-CUT at oblique angles. Structural analysis highlighted ACRA-CUT's distinctive acute tip and tri-curved blade design, correlating with its superior performance but an increased risk profile.</p><p><strong>Conclusion: </strong>ACRA-CUT offers unparalleled efficiency and speed, but its high cost and greater propensity for dural injury at nonperpendicular angles necessitate cautious application. MERIDIAN emerges as a safer choice for routine procedures, whereas Codman, despite being cost-effective, is hindered by its lower success rate and potential for prolonged operative times. Further randomized studies are warranted to validate these findings and optimize perforator selection.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"6 3","pages":"e000155"},"PeriodicalIF":0.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12560696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403198","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":"Microvascular Decompression in a Patient With Positional Hemifacial Spasm: Case Report.","authors":"Christopher Adams, Ali Samii, Turner Peckham, Manuel Ferreira","doi":"10.1227/neuprac.0000000000000163","DOIUrl":"10.1227/neuprac.0000000000000163","url":null,"abstract":"<p><strong>Background and importance: </strong>Hemifacial spasm (HFS) is known to be caused by certain activities and, in rare cases, has been shown to be position-dependent. This is the first case of HFS caused in a patient when lying in a prone position that completely resolved after surgical decompression.</p><p><strong>Clinical presentation: </strong>A 29-year-old female presented with HFS when lying in the prone position. In this case, the trigeminal, facial, and vestibulocochlear nerves were abutted by the anterior inferior cerebellar artery, posterior inferior cerebellar artery, and 2 small vessels. Microvascular decompression resulted in relief from the HFS.</p><p><strong>Conclusion: </strong>In cases where vessels abut but do not compress the facial nerve, there can still be position-dependent HFS because of position-dependent compression of the facial nerve, which can be relieved by surgical decompression.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"6 3","pages":"e000163"},"PeriodicalIF":0.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12560691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402774","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":"Case Study of an Unusual Intracranial Mesenchymal Neoplasm.","authors":"Camille Carlisle, Alexandra Lesko, Vassil Kaimaktchiev, Vivek Deshmukh","doi":"10.1227/neuprac.0000000000000149","DOIUrl":"10.1227/neuprac.0000000000000149","url":null,"abstract":"<p><strong>Background and importance: </strong>A 51-year-old woman with multiple sclerosis (MS) presented for MS management and follow-up, including repeat MRIs. On imaging, a slowly growing enhancing lesion was noted in the left posterior insula. Histopathology reported this tumor as a low-grade mesenchymal neoplasm, not elsewhere classified. The case reported here will add to the library of central nervous system tumors, which may help identify other previously unclassifiable tumors.</p><p><strong>Clinical presentation: </strong>The lesion was inconsistent with MS plaques, and MRI and computed tomography angiography showed no signs of aneurysm. After evaluation, we recommended surgery to remove the lesion. Surgical excision posed a challenge as the dominant hemisphere posterior insula can be difficult to access. We used a trans-sylvian approach, sparing vasculature within the sylvian fissure with clean excisional margins. The trans-sylvian approach enabled minimal manipulation of brain tissue surrounding the lesion, including the receptive speech center. The patient recovered without complications. Postsurgical follow-up revealed no new neurological symptoms or deficits and no sign of tumor recurrence.</p><p><strong>Conclusion: </strong>The trans-sylvian approach we used to excise the tumor resulted in a favorable outcome for the patient. This case supports that the trans-sylvian approach, while technically more demanding, is feasible and potentially beneficial.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"6 3","pages":"e000149"},"PeriodicalIF":0.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12560737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403167","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":"Preoperative Neurological Changes on Outcomes in Large-Vessel Occlusion Due to Intracranial Atherosclerotic Disease.","authors":"Takeshi Yoshimoto, Kanta Tanaka, Junpei Koge, Kazutaka Uchida, Hirotoshi Imamura, Kazunori Toyoda, Hiroshi Yamagami, Nobuyuki Sakai, Manabu Shirakawa, Mikiya Beppu, Yuji Matsumaru, Yasushi Matsumoto, Kenichi Todo, Mikito Hayakawa, Seigo Shindo, Masafumi Morimoto, Masataka Takeuchi, Hiroyuki Ikeda, Hideyuki Ishihara, Hiroto Kakita, Takanori Sano, Hayato Araki, Tatsufumi Nomura, Fumihiro Sakakibara, Shinichi Yoshimura","doi":"10.1227/neuprac.0000000000000156","DOIUrl":"10.1227/neuprac.0000000000000156","url":null,"abstract":"<p><strong>Background and objectives: </strong>We aimed to clarify the association between neurological deterioration pre-endovascular therapy (EVT) and outcome in patients with large-vessel occlusion due to intracranial atherosclerotic disease (ICAD-LVO) undergoing EVT.</p><p><strong>Methods: </strong>Consecutive patients with acute ischemic stroke due to ICAD-LVO within 24 h of onset who underwent EVT were enrolled in the Japanese multicenter registry from 2017 to 2019. Patients were grouped according to neurological severity transition as follows: mild symptoms (baseline National Institutes of Health Stroke Scale [NIHSS] score <6 and NIHSS score pre-EVT <6), symptom deterioration (baseline NIHSS score <6 and NIHSS score pre-EVT ≥6), and severe symptoms (baseline NIHSS score ≥6 and NIHSS score pre-EVT ≥6). Outcomes included favorable outcomes (modified Rankin Scale [mRS] score of 0-2 at 90 days), ordinal mRS shift, and symptomatic intracranial hemorrhage. Multivariable logistic regression assessed the association of outcomes with the transition of neurological severity by calculating odds ratios and 95% CIs, with mild symptoms as reference.</p><p><strong>Results: </strong>In total, 480 patients with acute ICAD-LVO who underwent EVT (150 women [31.2%]; median age, 72 years IQR, 66-80) and had median baseline NIHSS score 12 (IQR, 6-20) were analyzed. Patients with symptom deterioration (n = 34) and severe symptoms (n = 375) had lower favorable outcomes (deterioration 38.2% vs mild 62.9%; adjusted odds ratio 0.30, 95% CI 0.09-0.97, severe 35.3%; 0.47, 0.33-0.65) and a significant mRS shift (deterioration vs mild; 3.63, 1.46-9.03, severe; 2.27, 1.74-2.96) than those with mild symptoms (n = 71). Symptomatic intracranial hemorrhage rates did not differ (mild 0%; deterioration 0%; severe 1.9%).</p><p><strong>Conclusion: </strong>Patients with ICAD-LVO who experienced worsening symptoms were less likely to achieve favorable outcomes after EVT than those with mild symptoms. Early identification of neurological deterioration and EVT intervention may improve outcomes in these patients.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"6 3","pages":"e000156"},"PeriodicalIF":0.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12560719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402815","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":"Trends in Subdural Hemorrhage-Related Mortality and Its Geodemographic Disparities Among Older Adults in the United States.","authors":"Martin G McCandless, Anand A Dharia, Jonathan Swiastyn, Siddharth Shah, Paul J Camarata","doi":"10.1227/neuprac.0000000000000154","DOIUrl":"10.1227/neuprac.0000000000000154","url":null,"abstract":"<p><strong>Background and objectives: </strong>Subdural hemorrhage (SDH) is a common and potentially devastating intracranial injury routinely treated in neurosurgical practice. There are limited data regarding the mortality rates associated with SDH in older adults. Quantifying SDH-related mortality is crucial, especially considering the potential financial burden from ongoing medical and rehabilitative care associated with SDH morbidity and mortality in the elderly.</p><p><strong>Methods: </strong>Adults aged 65 years or older in the United States whose deaths attributed to SDH occurred between 1999 and 2020 were extracted from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiological Research database. Ethnicity and race were divided into exclusive categories as Hispanic or Latino, non-Hispanic Black or African American, or non-Hispanic White. SDH-related age-adjusted mortality rate (AAMR) per 100 000 persons was determined by standardizing the crude mortality rate to the 2000 US population. Overall population and subgroup segmented regression analyses were performed using Joinpoint Regression Program.</p><p><strong>Results: </strong>Total of 203 295 SDH-related deaths occurred in older adults between 1999 and 2020 (AAMR 22.1 per 100 000 individuals). Of the total deaths, 110 684 (54.4%) were men, 92 611 (45.6%) women, 170 953 (84.1%) non-Hispanic White, 14 654 (7.2%) non-Hispanic Black or African American, and 9656 (4.7%) Hispanic or Latino. Overall AAMR increased from 17.4 in 1999 to 24.6 in 2020 with an average annual percent change of 1.3%; 95% CI (0.9, 1.8). The AAMR had an increase from 1999 to 2005 (annual percent change, 3.4%; 95% CI [2.0, 4.9]) followed by a slower increase from 2005 to 2020 (annual percent change, 0.5%; 95% CI [2.0, 4.9]).</p><p><strong>Conclusion: </strong>There is an alarming rise in overall SDH-related mortality among the elderly population in the United States, and notable disparities in SDH outcomes across various demographic and geographic sectors continue to exist. Future health interventions aimed at SDH need to address the disparities as highlighted in this study.</p>","PeriodicalId":74298,"journal":{"name":"Neurosurgery practice","volume":"6 3","pages":"e000154"},"PeriodicalIF":0.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12560715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402917","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}