British Journal of Neurosurgery最新文献

{"title":"Management of the skull base invasion in spheno-orbital meningiomas.","authors":"Giuseppe Mariniello, Giulio Bonavolontà, Fausto Tranfa, Adriana Iuliano, Sergio Corvino, Giuseppe Teodonno, Francesco Maiuri","doi":"10.1080/02688697.2022.2161472","DOIUrl":"10.1080/02688697.2022.2161472","url":null,"abstract":"<p><strong>Background: </strong>The tumor invasion of the skull base structures is very frequent in spheno-orbital meningiomas. The aim of the present study is to evaluate the invasion rate of skull base structures and the best surgical approach and management.</p><p><strong>Methods: </strong>The surgical series of 80 spheno-orbital meningiomas was reviewed. The tumors were classified according to the intraorbital location with respect to the optic nerve axes into three types: I-lateral: II-medial; III-diffuse. The invasion of the orbital apex, optic canal, superior orbital fissure, anterior clinoid, ethmoid-sphenoid sinuses, and infratemporal fossa was evaluated. The rate and extension of involvement of these structures was correlated with the intraorbital location and the surgical approach. The preoperative ophtalmological symptoms and signs and their outcome were also evaluated.</p><p><strong>Results: </strong>Proptosis was found in 79 patients (97%), variable decrease of the visual function in 47 patients (59%), and deficits of the eye movements in 28(35%). The invasion of the optic canal (74%), superior orbital fissure (65%), anterior clinoid (60%), and orbital apex (59%) was more frequently found, whereas the tumor extension into the ethmoid-sphenoid sinuses (4%) and infratemporal fossa (4%) was rare. Types II and III meningiomas showed significantly higher involvement of the skull base structures than type I ones, which only had 15% invasion of the optic canal. Remission or significant improvement of the visual function occurred postoperatively in 24 among 47 cases (51%), with a higher rate for type I meningiomas <i>vs.</i> other types (<i>p</i> = 0.021, <i>p</i> = 0.019) and worsening in 7 (15%).</p><p><strong>Conclusions: </strong>Spheno-orbital meningiomas growing in the lateral orbital compartment show no involvement of the skull base structures excepting the optic canal as compared to those growing medially or diffusely. The surgical resection of tumor invading the skull base structures should be more extensive as possible, but the risk of optic and oculomotor deficits must be avoided.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1359-1366"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10468921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relative survival after meningioma surgery. A French nationwide population-based cohort study.","authors":"Charles Champeaux-Depond, Panayotis Constantinou, Philippe Tuppin, Matthieu Resche-Rigon, Joconde Weller","doi":"10.1080/02688697.2022.2159925","DOIUrl":"10.1080/02688697.2022.2159925","url":null,"abstract":"<p><strong>Background: </strong>Survival after meningioma surgery is often reported with inadequate allowance for competing causes of death.</p><p><strong>Methods: </strong>We processed the Système National des Données de Santé, the French administrative medical database to retrieve appropriate patients' case of surgically treated meningiomas. The Pohar Perme relative survival (RS) method was implement.</p><p><strong>Results: </strong>A total of 28,778 patients were identified between 2007 and 2017 of which 75% were female. Median age at surgery 59 years. Cranial convexity was the most common (24.7%) location and, benign meningioma represented 91.5% of all meningioma. Median follow-up was 3.5 years interquartile range [3.4-3.5]. At data collection, 2,232 patients were dead. The five-year survival relative to the expected survival of an age- and gender-matched French standard population was 96.2% _95% confidence interval (CI)[95.7-96.8]. Meningioma absolute excess risk of death was 973/100,000 person-years _95%CI[887-1068] (<i>p</i>< .001). The related standardised mortality ratio was 1.8 _95%CI[1.7-1.9] (<i>p</i>< .001). In the adjusted model, male gender (hazard ratio [HR] =1.39, _95%CI[1.27-1.54], <i>p</i>< .001), age at surgery (HR=0.97, _95%CI[0.97-0.97], <i>p</i> < .001), type 2 neurofibromatosis (HR=2.95, _95%CI[1.95-4.46], <i>p</i> < .001), comorbidities HR=1.39, _95%CI[1.36-1.42], <i>p</i> < .001), location (HR=0.8, _95%CI[0.67-0.95], <i>p</i>= .0111), pre-operative embolization, (HR=1.3, _95%CI[1.08-1.56], <i>p</i>= .00507), cerebro-spinal fluid shunt, (HR=2.48, _95%CI[2.04-3.01], <i>p</i> < .001), atypical (HR=1.3, _95%CI [1.09-1.54], <i>p</i>= .00307) or malignant histology (HR=1.86, _95%CI[1.56-2.22], <i>p</i>< .001), redo surgery (HR=1.19, _95%CI[1.04-1.36], <i>p</i>= .0122) and radiotherapy (HR=1.43, _95%CI[1.26-1.62], <i>p</i> < .001) were established as independent predictors of RS.</p><p><strong>Conclusion: </strong>This unique study highlights the excess mortality associated with meningioma disease. Many factors such as gender, age, location, histopathological grading, redo surgery influence the RS.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1345-1351"},"PeriodicalIF":16.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10790486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: late recovery of stereotactic radiosurgery induced perilesional edema of an arteriovenous malformation after Bevacizumab treatment.","authors":"Mário Vicente Guimarães, Ana Luiza Costa Zaninotto, Manoel Jacobsen Teixeira, Josué Andrade Martins, Jorge Maurício Bronze Batista Júnior, Natália Moreno Coelho de Sousa, Julia Souza E Costa, Feres Eduardo Aparecido Chaddad Neto, Wellingson Silva Paiva","doi":"10.1080/02688697.2023.2228890","DOIUrl":"10.1080/02688697.2023.2228890","url":null,"abstract":"","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1486-1487"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9802670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tethered cord secondary to focal nondisjunction of the primary neural tube: experience from a Singapore children's hospital.","authors":"Yi Wen Foo, Jia Xu Lim, Nishal K Primalani, Lee Ping Ng, Wan Tew Seow, David C Y Low, Sharon Y Y Low","doi":"10.1080/02688697.2022.2159931","DOIUrl":"10.1080/02688697.2022.2159931","url":null,"abstract":"<p><strong>Purpose: </strong>Tethered cord due to focal nondisjunction of primary neuralisation (FNPN) is a rare form of spinal dysraphism. We present our institutional experience in managing children diagnosed with FNPN.</p><p><strong>Materials and methods: </strong>This is a single institution, retrospective study approved by the hospital ethics board. Patients below 18 years of age diagnosed with CDS, LDM or their mixed lesions, and subsequently underwent intervention by the Neurosurgical Service, KK Women's and Children's Hospital, are included.</p><p><strong>Results: </strong>From 2001 to 2021, 16 FNPN patients (50% males) were recruited. Eight of them had CDS (50.0%), seven had LDM (43.8%), and one patient had a mixed CDS and LDM lesion (6.2%). The average duration of follow up was 5.7 years and the mean age of surgery was 6 months old. Thirteen patients underwent prophylactic intent surgery (81.2%) and three had therapeutic intent surgery (18.8%). All patients did not have new neurological deficit or required repeat surgery for cord retethering. We observed that detethering surgery performed at or less than three months old was associated with having a wound infection (<i>p</i> = .022).</p><p><strong>Conclusions: </strong>Our study reports that early recognition and timely intervention are mainstays of management for FNPN. We advocate a multi-disciplinary approach for good outcomes.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1352-1358"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10423827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tremor in triventricular hydrocephalus secondary to an aqueductal web with stenosis and response to third ventricular ventriculostomy.","authors":"L Harrison, J Walkden","doi":"10.1080/02688697.2022.2126435","DOIUrl":"10.1080/02688697.2022.2126435","url":null,"abstract":"<p><p>We demonstrate a case report of triventricular hydrocephalus due to an aqueductal web and stenosis which presented itself clinically solely with bilateral hand tremors in an adolescent male. The patient underwent Endoscopic third ventriculostomy (ETV) and the subsequent improvement in cerebrospinal fluid (CSF) flow resulted in complete resolution of his tremor. We propose a mechanism involving compression of the rubrospinal tract (or stretching of the frontal premotor area) and advise cranial imaging in cases of hand tremor to exclude this as a potential cause. Neurosurgical review and potential CSF diversion if triventriclar hydrocephalus is established should be considered as positive clinical outcome can be achieved.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1329-1331"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10384386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repeat resection for recurrent glioblastoma in the temozolomide era: a real-world multi-centre study.","authors":"Peter Y M Woo, Tiffany H P Law, Kelsey K Y Lee, Joyce S W Chow, Lai-Fung Li, Sarah S N Lau, Tony K T Chan, Jason M K Ho, Michael W Y Lee, Danny T M Chan, Wai-Sang Poon","doi":"10.1080/02688697.2023.2167931","DOIUrl":"10.1080/02688697.2023.2167931","url":null,"abstract":"<p><strong>Introduction: </strong>In contrast to standard-of-care treatment of newly diagnosed glioblastoma, there is limited consensus on therapy upon disease progression. The role of resection for recurrent glioblastoma remains unclear. This study aimed to identify factors for overall survival (OS) and post-progression survival (PPS) as well as to validate an existing prediction model.</p><p><strong>Methods: </strong>This was a multi-centre retrospective study that reviewed consecutive adult patients from 2006 to 2019 that received a repeat resection for recurrent glioblastoma. The primary endpoint was PPS defined as from the date of second surgery until death.</p><p><strong>Results: </strong>1032 glioblastoma patients were identified and 190 (18%) underwent resection for recurrence. Patients that had second surgery were more likely to be younger (<70 years) (adjusted OR: 0.3; 95% CI: 0.1-0.6), to have non-eloquent region tumours (aOR: 1.7; 95% CI: 1.1-2.6) and received temozolomide chemoradiotherapy (aOR: 0.2; 95% CI: 0.1-0.4). Resection for recurrent tumour was an independent predictor for OS (aOR: 1.5; 95% CI: 1.3-1.7) (mOS: 16.9 months versus 9.8 months). For patients that previously received temozolomide chemoradiotherapy and subsequent repeat resection (137, 13%), the median PPS was 9.0 months (IQR: 5.0-17.5). Independent PPS predictors for this group were a recurrent tumour volume of >50cc (aOR: 0.6; 95% CI: 0.4-0.9), local recurrence (aOR: 1.7; 95% CI: 1.1-3.3) and 5-ALA fluorescence-guided resection during second surgery (aOR: 1.7; 95% CI: 1.1-2.8). A National Institutes of Health Recurrent Glioblastoma Multiforme Scale score of 0 conferred an mPPS of 10.0 months, a score of 1-2, 9.0 months and a score of 3, 4.0 months (log-rank test, <i>p</i>-value < 0.05).</p><p><strong>Conclusion: </strong>Surgery for recurrent glioblastoma can be beneficial in selected patients and carries an acceptable morbidity rate. The pattern of recurrence influenced PPS and the NIH Recurrent GBM Scale was a reliable prognostication tool.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1381-1389"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10545254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management of anterior sacral meningoceles: an illustrated case series and review of the literature.","authors":"Muhmmad Ahmad Kamal, Mohamed Eltayeb, Ian Coulter, Alistair Jenkins","doi":"10.1080/02688697.2022.2162852","DOIUrl":"10.1080/02688697.2022.2162852","url":null,"abstract":"<p><strong>Background: </strong>Anterior sacral meningocele (ASM) is an uncommon variant of spinal dysraphism. Surgical correction for this condition is challenging and optimal corrective approaches are uncertain.</p><p><strong>Objective: </strong>To share our experience of managing this rare condition using the posterior trans-sacral approach and provide a contemporary review of the literature.</p><p><strong>Methods: </strong>Retrospective review of case notes, operative records, and imaging of eligible patients treated via the posterior trans-sacral approach between 2006 and 2020 at our regional neurosciences centre.</p><p><strong>Results: </strong>Three patients, two females and one male with a mean age of 30 years (range 16-38), were treated. Presenting symptoms included lower abdominal pain and recurrent miscarriages. Patients underwent corrective surgery using the posterior approach involving a sacral laminectomy, durotomy and closure of the communicating fistula. A single patient required reoperation due to early recurrence. Another patient proved challenging because of a very large sacral fistula and required two procedures due to the development of high-pressure headaches secondary to a recurrence. All patients improved symptomatically postoperatively and remained symptom free at the last clinic follow-up and have been discharged. Following review of the literature, only two other non-syndromic cases have been described.</p><p><strong>Conclusions: </strong>ASM is an uncommon congenital abnormality, typically presenting with mass effect symptoms secondary to a presacral cystic mass. Surgical management using a posterior approach to close the meningeal sac is feasible and less invasive than an anterior approach. Long term clinical outcomes in our series were satisfactory.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1374-1380"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10834550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anchoring of a mental nerve stimulator for treatment of facial neuropathic pain: a case illustration.","authors":"Miles H McCaffrey, Tillman Wolf Boesel, Antonio Di Ieva","doi":"10.1080/02688697.2022.2064428","DOIUrl":"10.1080/02688697.2022.2064428","url":null,"abstract":"<p><strong>Introduction: </strong>Mental nerve stimulation is recognised as a treatment option for neuropathic facial pain. Historically however, lead migration across the mobile temporomandibular joint has prevented this procedures utility.</p><p><strong>Methods: </strong>We describe a new method of insertion and anchoring of a mental nerve stimulator for the management of refractory neuropathic pain in the distribution of the mental nerve. We anchored the stimulator lead to the mandibular body.</p><p><strong>Results: </strong>Significant analgesic effect was achieved and no lead migration had occurred at 1 year post-operatively.</p><p><strong>Conclusions: </strong>This report describes in detail the procedure of mental nerve stimulator insertion, with a novel technique of mandibular anchoring of the lead.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":"1 1","pages":"1483-1485"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41505398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic third ventriculostomy compared to ventriculoperitoneal shunt as treatment for idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis.","authors":"Ladina Greuter, Timo Schenker, Raphael Guzman, Jehuda Soleman","doi":"10.1080/02688697.2022.2149697","DOIUrl":"10.1080/02688697.2022.2149697","url":null,"abstract":"<p><strong>Background: </strong>The accepted treatment for idiopathic normal pressure hydrocephalus (iNPH) is the insertion of a ventriculoperitoneal shunt (VPS). Recently, some studies examined endoscopic third ventriculostomy (ETV) for the treatment of iNPH with controversial results. The aim of this systematic review and meta-analysis was to compare ETV to VPS regarding complications and outcome for the treatment of iNPH.</p><p><strong>Methods: </strong>We searched Medline, Embase and Scopus. Due to the scarcity of data, we did not include only randomized controlled trials, but also retro- and prospective studies. The primary outcome was failure of cerebrospinal fluid diversion method. Secondary endpoints were clinical postoperative improvement rate, morbidity and mortality.</p><p><strong>Results: </strong>Out of 311 screened studies, three were included in the quantitative analysis including one RCT and two retrospective cohort studies. No statistically significant difference concerning failure rate of CSF diversion method (ETV 27.5% vs. VPS 33.2%, RR 1.19, 95% CI [0.69-2.04], <i>p</i> = 0.52) or postoperative improvement was found (68% for ETV vs. 72.8% for VPS, RR 0.81, 95% CI [0.57-1.16], <i>p</i> = 0.26). ETV showed a significantly lower complication rate compared to VPS (7.5% vs. 51.1%, RR 0.25, 95% CI [0.08-0.76], <i>p</i> = 0.02).</p><p><strong>Conclusion: </strong>ETV and VPS did not differ significantly regarding their failure rate for iNPH, while ETV showed a significantly lower complication rate than VPS. However, the data available is scarce with only one RCT investigating this important matter. Further well-designed trials are necessary to investigate the clinical outcome of ETV in iNPH.</p><p><strong>Trial registration number: </strong>PROSPERO (ID: CRD42020199173).</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1276-1282"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10751937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plagiarism-lessons learnt.","authors":"Nitin Mukerji","doi":"10.1080/02688697.2024.2413297","DOIUrl":"10.1080/02688697.2024.2413297","url":null,"abstract":"","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1267-1268"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}