British Journal of Neurosurgery最新文献

{"title":"Outcomes of head trauma in children admitted to a tertiary paediatric intensive care unit in South Wales.","authors":"Leon Slade, Paul Leach, Milan Makwana, Chirag Patel, Anthony Jesurasa","doi":"10.1080/02688697.2024.2389856","DOIUrl":"10.1080/02688697.2024.2389856","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the demographics and outcomes of major paediatric head trauma managed in our Paediatric Intensive Care Unit (PICU) in South Wales and comparison is made with the existing published literature.</p><p><strong>Design and setting: </strong>A retrospective review of medical records and imaging of patients identified from the paediatric neurosurgical trauma database at University Hospital Wales (UHW) from March 2013 to July 2021. We assessed the GCS at admission, mechanism of injury, CT scan, type of surgery required and GOS after 12 months.</p><p><strong>Patients: </strong>A total of 46 children (<16 years old) who were admitted to intensive care secondary to a traumatic brain injury were identified. Mean age was 7.6 years (range 0 days-15.7 years).</p><p><strong>Results: </strong>Road traffic accidents (RTA) were the predominant mechanism of injury (56.5%), followed by falls (32.6%). Neurosurgical intervention, including stand-alone ICP monitoring was required in 69.6% of patients. Post discharge outcome was defined using the Glasgow Outcome Score (GOS), with a good functional outcome (GOS ≥4) accounting for 86.4% at 12 months follow-up. Survival rate was 93.4%.</p><p><strong>Conclusion: </strong>Demographics in South Wales are similar to the published literature, except falls had a higher mortality than RTA in our cohort. Head injury mechanisms, surgical interventions and outcomes show variation between patients from the pre-covid and lockdown periods. Outcomes are good for surgically and conservatively treated patients and very comparable to the published literature.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"61-64"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104552","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":"Successful surgical management of anterior cervical meningomyelocele associated with Klippel-Feil deformity using anterior vertebral reconstruction: a case report.","authors":"Thomas Perrot, Hassan El Hajj, Abdollah Yassine Moufid, Romain David, Maxime Billot, Philippe Rigoard","doi":"10.1080/02688697.2024.2430572","DOIUrl":"10.1080/02688697.2024.2430572","url":null,"abstract":"<p><strong>Case report: </strong>A rare case of Klippel-Feil syndrome associated with anterior cervical meningomyelocele is reported, treated successfully using partial cervical corpectomy, spinal cord microsurgical reinsertion into the spinal canal, and vertebral reconstruction. A 71-year-old patient presented with upper limb paraesthesia, chronic neck pain, and progressive motor distal impairment. Cervical spine imaging revealed an anterior cervical meningomyelocele digging into C7 vertebra and underlying adjacent congenital fusion blocks.</p><p><strong>Conclusion: </strong>An anterior cervical decompression combined with fusion led to excellent recovery in this patient and could be of potential interest for surgical management of spinal malformation combined with embryological neural structure abnormality. The current literature is reviewed, along with the different modes of surgical treatment available for this unusual clinical entity.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"145-147"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675209","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":"A review of acute symptomatic seizures during awake craniotomy for tumour resection.","authors":"Brin E Freund, Maria L Barrios, Anteneh M Feyissa, David Sabsevitz, Sanjeet S Grewal, William D Freeman, Erik H Middlebrooks, Jesus E Sanchez-Garavito, Alfredo Quinones-Hinojosa, William O Tatum","doi":"10.1080/02688697.2024.2410774","DOIUrl":"10.1080/02688697.2024.2410774","url":null,"abstract":"<p><strong>Purpose: </strong>Awake craniotomy (AC) is a procedure often performed concomitantly with direct electrical cortical stimulation (DES) and electrocorticography (ECoG) during functional brain mapping. Patients undergoing AC are at risk of acute symptomatic seizures, including intraoperative (IS) and early postoperative seizures (EPS) which can lead to higher risk of morbidity. Predicting those who are at risk of IS and EPS could alert clinicians and provide the ability to closely monitor and consider management changes in the acute setting to prevent seizures.</p><p><strong>Materials and methods: </strong>This is a narrative review of previous studies on IS and EPS during awake craniotomy, including a summary of studies from our center using a novel circular grid electrode.</p><p><strong>Results and conclusions: </strong>There are a number of clinical features with variable association with a higher risk of EPS and IS. Surgeries involving the anterior and central head regions are a risk factor for IS. EPS is more likely to occur in patients with perioperative intracranial hemorrhage. Improving grid/electrode technology for ECoG can allow for better sensitivity of detecting epileptiform activity which can help to diagnose and predict perioperative seizures.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"9-14"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458525","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":"Can common household devices alter the settings of programmable shunt valves?","authors":"Jack Ramsay, Georgios Bonanos, Alvaro Villabona, Nitin Mukerji","doi":"10.1080/02688697.2026.2624032","DOIUrl":"https://doi.org/10.1080/02688697.2026.2624032","url":null,"abstract":"<p><strong>Objective: </strong>Various household devices contain magnets or emit electromagnetic fields and it is hypothesised that the strength of these magnets may be enough to affect the settings on programmable cerebrospinal fluid shunt valves. The aim of this study is to identify changes to the valve settings of seven commonly used programmable valves, when they are near common household devices generating a magnetic field.</p><p><strong>Methods: </strong>Several commonly encountered household devices were used, with and without rotational movement, with reference to seven commonly used programmable valves (the Codman Certas and Hakim, Sophysa SPV and SM8, Medtronic Strata II Regular and Small, and the Miethke M.Blue Plus). The valve settings were checked before and after the interference with the household device, by using either the manufacturers tool kit for reading the settings or x-rays.</p><p><strong>Results: </strong>We demonstrated that the only valve which was not affected by any of the household devices, regardless of the distance or rotational movement, was the Miethke M. Blue Plus. In addition, the programmable shunts were more likely to experience change to their settings with rotational movement as opposed to no movement, and the two devices most likely to induce this change were a smart watch and kids toy magnets.</p><p><strong>Conclusions: </strong>Everyday household devices have the potential to affect the settings on programmable shunts, leading to concerns around the maintenance of shunt settings both in and out of hospital due to household and healthcare electromagnetic fields. Surgeons, and other healthcare professionals involved in the care of those with programmable CSF shunts, should be aware of the potential risks and utilise this information when making clinical decisions and advising patients.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-5"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099587","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":"Improvement in cranial neuropathies following stereotactic radiotherapy as primary treatment for skull base meningiomas.","authors":"Karim Hafazalla, Matthews Lan, Keenan Piper, Preston Carey, Omaditya Khanna, Wenyin Shi, James J Evans, David Andrews, Kevin Judy, Christopher J Farrell","doi":"10.1080/02688697.2024.2427720","DOIUrl":"10.1080/02688697.2024.2427720","url":null,"abstract":"<p><strong>Purpose: </strong>Many patients with skull base meningiomas (SBMs) develop cranial neuropathies, though there is a paucity in literature regarding cranial neuropathy improvement following treatment. This is even more profound when isolating for patients who received stereotactic radiotherapy (SRT) as their primary treatment without additional open surgery. Our goal was to investigate the effect of SRT on cranial neuropathies secondary to SBMs and identify predictors of favourable treatment response.</p><p><strong>Materials and methods: </strong>A single-center retrospective case-control study was performed assessing factors associated with cranial neuropathy improvement in patients with SBMs treated with SRT alone. Patients diagnosed with SBMs, having a cranial neuropathy, and treatment with radiation monotherapy were included. Patients without SBMs or who underwent surgery treatments were excluded. Patients with olfactory and vestibulocochlear neuropathies were ultimately excluded due to sample sizes. Subgroup analysis was performed assessing predictors of improvement for optic, extraocular, and trigeminal neuropathy. Statistical analysis was completed using R version 4.0 (R Foundation for Statistical Computing, Vienna, Austria).</p><p><strong>Results: </strong>Eighty-five patients met the inclusion criteria of SBMs treated with SRT alone. Forty-five patients (52.9%) had improvement in their symptoms. Among the entire cohort, there was no significant difference between gender, age, tumour location, type of neuropathy, duration of symptoms, tumour volume, total radiation dose, or follow-up duration between those who did and those who did not improve. Subgroup analysis demonstrated significant improvement with younger age at diagnosis of optic neuropathy (50.7 vs 59.6 years, <i>p</i> = 0.04), shorter duration of symptoms prior to radiation in those with extraocular neuropathy (3.0 vs 11.5 months, <i>p</i> = 0.02), and lower radiation dose in those with trigeminal neuropathy (50.0 vs 54.0 Gy, <i>p</i> = 0.01).</p><p><strong>Conclusions: </strong>This study demonstrates that SRT alone resulted in cranial neuropathy improvement in more than half of patients with SBM and identifies factors predictive of symptom resolution.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"127-131"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766439","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":"Strategic insights and survival outcomes: a systematic review of CNS metastases in uterine cervical cancer.","authors":"Giuseppe Corazzelli, Luca Zanuttini, Damiano Balestrini, Sara Quercia, Matteo Martinoni","doi":"10.1080/02688697.2024.2418490","DOIUrl":"10.1080/02688697.2024.2418490","url":null,"abstract":"<p><strong>Introduction: </strong>Uterine cervical cancer, predominantly caused by HPV, is the fourth most common malignancy in women, rarely leading to Central Nervous System (CNS) metastases with a poor prognosis. This study analyzes 137 cases, focusing on the clinical progression, treatment efficacy, and survival outcomes, highlighting the need for a multi-disciplinary approach to extend patient survival in the face of inconsistent evidence and management practices.</p><p><strong>Materials and methods: </strong>This systematic review meticulously adhered to PRISMA guidelines, analysing all existing evidence on CNS metastasis from Uterine Cervical Cancer (UCC) through a comprehensive literature search up to August 2023. Articles were selected based on stringent criteria, including compliance with CARE and STROBE guidelines. The study employed rigorous statistical analyses, including the Shapiro-Wilk, T-Student, and ANOVA tests, alongside Kaplan-Meier curves, to evaluate variables like patient age, lesion location, and treatment efficacy.</p><p><strong>Results: </strong>A review of 137 UCC patients revealed CNS metastases predominantly in the cerebral lobes, with headache and hemiparesis as common symptoms. The study found no significant survival difference across histopathological subtypes, but surgery, with or without WBRT, significantly improved outcomes. Age over 50 was associated with better survival, while the FIGO stage at diagnosis correlated with recurrence-free survival. Overall, surgical intervention on CNS lesions was the most significant factor for improved survival.</p><p><strong>Conclusion: </strong>This study reveals that CNS metastases from UCC are critical, with younger patients at worse prognosis. It suggests surgery plus WBRT or SRS as effective treatments and calls for targeted CNS screening and more research for better outcomes.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"15-28"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495517","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":"ALK-positive ALCL: first described adult case of synchronous CNS and systemic involvement at presentation: a case report and review of the literature.","authors":"William Ju, Claudio De Tommasi, Maya Wernick, Kern Chai","doi":"10.1080/02688697.2025.2611165","DOIUrl":"https://doi.org/10.1080/02688697.2025.2611165","url":null,"abstract":"<p><strong>Background: </strong>Anaplastic large cell lymphoma (ALCL) represents a group of heterogenous CD30+ mature T Cell lymphomas, which vary in their clinical, histological, and molecular characteristics. A majority of ALCL are ALK positive, which is characterised by translocation t(2;5) leading to the fusion of the ALK gene to the nucleophosmin gene. CNS presentations of ALCL are rare and restricted to case reports. A synchronous CNS and systemic presentation in an adult has never been reported.</p><p><strong>Case presentation: </strong>A 31-year-old woman presented with headache and tonic-clonic seizures. MRI revealed a 15-mm enhancing left frontal convexity lesion with broad dural contact. A left frontal craniotomy was performed, and pathological analysis was conducted. Initially the diagnosis was unclear, with the most likely diagnosis being thought to be ALK-positive histiocytosis, with a differential of ALK-positive ALCL. The patient was treated with a modified MARIETTA protocol (without rituximab) and consolidated with a carmustine-based autologous stem cell transplant. End of treatment PET-CT and MRI brain showed a complete metabolic response. shows complete metabolic response on PET-CT and MRI brain.</p><p><strong>Conclusions: </strong>This case presents the first successful treatment of a synchronous presentation of CNS and systemic ALK-positive ALCL, and the importance of a multidisciplinary approach for diagnosis.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-11"},"PeriodicalIF":0.8,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096724","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":"Shredded vs. pledget teflon in microvascular decompression for trigeminal neuralgia: a retrospective comparative study.","authors":"V Vanaclocha, J M Gallego-Sanchez, N Saiz-Sapena, L Vanaclocha","doi":"10.1080/02688697.2026.2621807","DOIUrl":"https://doi.org/10.1080/02688697.2026.2621807","url":null,"abstract":"<p><strong>Objective: </strong>Trigeminal neuralgia (TN) is a debilitating craniofacial pain disorder that often necessitates surgical intervention when medical therapy fails. This study evaluates the impact of two Teflon implantation techniques - pledget interposition and shredded Teflon - on clinical outcomes following microvascular decompression (MVD).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 121 patients with classical trigeminal neuralgia (TN) who underwent microvascular decompression (MVD) between 2001 and 2020. Patients were grouped based on the Teflon technique used: pledget interposition (<i>n</i> = 55) or shredded Teflon (<i>n</i> = 66). Outcomes were assessed using the Barrow Neurological Institute (BNI) pain scale, Modified Rankin Scale (mRS), and postoperative MRI. Statistical comparisons included Fisher's exact test, chi-square test, and <i>t</i>-tests.</p><p><strong>Results: </strong>Shredded Teflon was associated with significantly lower recurrence (4.54% vs. 16.36%) and complication rates (9.09% vs. 14.55%) compared to pledget interposition. Reoperation was required in 12.72% of pledget cases, primarily due to implant displacement and arachnoid adhesions; no reoperations were needed in the shredded group. MRI-confirmed recurrent neurovascular compression correlated with clinical recurrence (<i>p</i> = 0.033). Patient satisfaction was significantly higher in the shredded group (87.87% vs. 69.09%, <i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>MVD using shredded Teflon yields superior long-term outcomes with fewer complications and recurrences compared to pledget interposition. Avoiding direct nerve contact and minimizing implant volume may reduce inflammatory risks. Postoperative MRI is crucial for detecting recurrence and guiding subsequent interventions.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":0.8,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084357","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":"Association of social determinants of health for normal pressure hydrocephalus: a single institution retrospective cohort study.","authors":"James Kelbert, Kristin Nosova, Tyler Krall, Ganesh Murthy, Robert W Bina","doi":"10.1080/02688697.2026.2621806","DOIUrl":"https://doi.org/10.1080/02688697.2026.2621806","url":null,"abstract":"<p><strong>Introduction: </strong>Normal pressure hydrocephalus (NPH) is a reversible cause of dementia which may be treated with CSF diverting shunts. Identification of specific barriers to diagnosis and treatment may allow for formation of targeted programs to increase rates of accurate, timely diagnosis to restore functional status and independence.</p><p><strong>Methods: </strong>135 patients with a confirmed diagnosis of NPH were reviewed for symptom onset, demographic characteristics, presence of comorbidities as well as time to treatment.</p><p><strong>Results: </strong>Patients undergoing ventriculoperitoneal shunt (VPS) placement for NPH were slightly more likely to be male (42% vs 58%), with an overall median age of 76 years old (median of 78 years for men and 76 years for women; p-value 0.90). Median time to treatment from symptoms onset reported by the patients was 24 months (range 4-72 months). However, median time to treatment was lower for women than for men (12 vs 24 months; p-value: 0.056), but statistically significant in multivariate regression using a Gamma distribution when controlling for demographic variables (p-value: 0.004).</p><p><strong>Conclusion: </strong>Although men and women report symptoms onset at a similar age, there appears to be a delay in time to diagnosis or treatment among men and rural inhabitants with no difference in age at surgery.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-7"},"PeriodicalIF":0.8,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084336","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":"Proactive engineering for ventriculo-biliary shunt safety: learning from biliary reflux complications to mandate anti-reflux mechanisms.","authors":"Xiaofang Tao, Manhong Guan, Wenting Zhu","doi":"10.1080/02688697.2026.2620403","DOIUrl":"https://doi.org/10.1080/02688697.2026.2620403","url":null,"abstract":"","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-2"},"PeriodicalIF":0.8,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040425","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}