Surgical neurology international最新文献

{"title":"Anomalous origin of the thenar motor branch encountered during carpal tunnel release.","authors":"Megan Rajagopal, Emily Dunbar, Satya Siri Paruchuri, Robert Scott Graham","doi":"10.25259/SNI_3_2025","DOIUrl":"10.25259/SNI_3_2025","url":null,"abstract":"<p><strong>Background: </strong>This illustrative case demonstrates the thenar motor branch (TMB) arising from the median nerve proper through the palmaris fascia, visualized during a carpal tunnel release procedure.</p><p><strong>Case description: </strong>A 64-year-old with a history of hypertension and diabetes presents to the clinic with 1 year of neck pain, upper extremity numbness and tingling, wasting of hand muscles, and weakness of the left hand. Electromyography confirmed cubital tunnel syndrome bilaterally and right carpal tunnel syndrome. The patient underwent right cubital and carpal tunnel decompressions.</p><p><strong>Conclusion: </strong>Awareness of TMB anomalies and careful identification during surgery can prevent iatrogenic injury and further complications.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"180"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228169","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":"Primary intracranial cholesteatoma in the thalamus.","authors":"Nyoman Golden, Christopher Lauren, Angky Saputra, Ida Bagus Gede Adiguna Wibawa, I Gusti Ketut Agung Surya Kencana, Kristian Gerry Raymond Sinarta Bangun, Tjokorda Gde Bagus Mahadewa","doi":"10.25259/SNI_252_2025","DOIUrl":"10.25259/SNI_252_2025","url":null,"abstract":"<p><strong>Background: </strong>Primary intracranial cholesteatomas are rare, benign lesions of keratinizing squamous epithelium, often arising from middle ear extension. However, their occurrence in the thalamus is exceptionally rare, with only one prior case reported.</p><p><strong>Case description: </strong>A 48-year-old male presented with progressive headaches over 3 years and difficulty with upward gaze. Neurological examination revealed bilateral upward gaze palsy. Magnetic resonance imaging demonstrated an intra-axial cystic mass with a solid component in the right thalamus extending to the midbrain, causing obstructive hydrocephalus. A craniotomy with subtotal tumor resection was performed. Histopathology confirmed cholesteatoma. Postoperatively, the patient's symptoms improved, but hydrocephalus recurred, necessitating an endoscopic third ventriculostomy. Five months later, imaging showed an increase in residual mass size, but further, surgical intervention was declined due to financial constraints. The patient continued outpatient follow-up and maintained functional independence despite persistent symptoms.</p><p><strong>Conclusion: </strong>Thalamic cholesteatomas are rare and diagnostically challenging. Their deep-seated location complicates surgical resection, often necessitating subtotal removal to preserve neurological function. Close postoperative monitoring is essential due to the high recurrence risk. Further research is needed to optimize diagnostic strategies and explore alternative treatment approaches for these rare lesions.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"187"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228140","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":"Resection of a rare lumbar epithelioid schwannoma.","authors":"Samuel Nodal, Adham M Khalafallah, Joseph Yunga Tigre, Sakir Humayun Gultekinm, Bhavjeet Singh Sanghera, Allan D Levi, S Shelby Burks","doi":"10.25259/SNI_267_2025","DOIUrl":"10.25259/SNI_267_2025","url":null,"abstract":"<p><strong>Background: </strong>Schwannomas, along with meningiomas, constitute the most common type of intradural extramedullary tumors. They are rare, typically benign tumors that originate from Schwann cells. Symptoms and signs attributed to these tumors may include back/radicular pain, focal motor and/or sensory deficits, and bowel/bladder dysfunction. It is essential to obtain pathological confirmation of this lesion and to differentiate it from other benign (i.e., neurofibromas, lipomas, ganglion cysts, meningiomas, and giant cell tumors), and/ or infrequently malignant lesions (i.e., malignant peripheral nerve sheath tumors, and sarcomas). Epithelioid Schwannomas/Benign Epithelioid Schwannomas (BES) is a benign, rare histologic subtype of schwannoma that resembles epithelial cells and lacks classic features such as Antoni A and Antoni B areas.</p><p><strong>Case description: </strong>A 29-year-old female presented with 1 year of severe, constant, sharp back pain (i.e., 5-10/10) that radiated down the left lower extremity. She also experienced bilateral leg numbness and tingling, along with weakness in the hips and right lower extremity. Diclofenac failed to provide any pain relief. Notably, symptoms progressed despite the utilization of physical therapy. Her neurological examination showed mild weakness (4+/5) in the left tibialis anterior and extensor hallucis longus distributions. The magnetic resonance imaging revealed a heterogeneously enhancing circumferential intradural extramedullary mass at the L2 level that caused cauda equina compression. The patient underwent an L1-L2 laminectomy, which was recommended for tumor resection. Pathologically, the lesion proved to be a BES; the epithelial cells stained positive for S-100. Three months postoperatively, the patient is asymptomatic.</p><p><strong>Conclusion: </strong>BES is a rare subtype of schwannoma. Patients with these lesions should undergo gross total tumor resection to achieve the best long-term postoperative outcomes.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"188"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228158","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":"Successful endovascular occlusion of multiple fusiform aneurysms on the persistent primitive lateral basilovertebral anastomosis.","authors":"Taichi Ikedo, Takaaki Itazu, Hirotoshi Imamura, Yuto Inoue, Shinya Tabata, Koji Shimonaga, Eika Hamano, Kiyofumi Yamada, Hisae Mori, Koji Iihara, Hiroharu Kataoka","doi":"10.25259/SNI_195_2025","DOIUrl":"10.25259/SNI_195_2025","url":null,"abstract":"<p><strong>Background: </strong>The primitive lateral basilovertebral anastomosis (PLBA) is a transient embryonic vessel in the vertebrobasilar system that typically regresses during cerebellar artery development. Persistent PLBA (PPLBA), which forms a vertebrobasilar duplication, is a rare vascular anomaly. This is the first reported case of multiple fusiform aneurysms associated with a PPLBA.</p><p><strong>Case description: </strong>A 14-year-old girl was diagnosed with intracranial aneurysms before undergoing coronary artery bypass grafting surgery for myocardial infarction. Digital subtraction angiography showed two fusiform aneurysms on a PPLBA, connecting the left vertebral artery (VA) and the left anterior inferior cerebellar artery (AICA). After 3 years of follow-up, a new aneurysm developed at the origin of the PPLBA, proximal to the existing two aneurysms. Due to the AICA blood flow originating mainly from the basilar artery (BA) rather than the PPLBA, endovascular parent artery occlusion of the PPLBA was planned to prevent aneurysmal rupture and subarachnoid hemorrhage. Complete occlusion of all three aneurysms was achieved without complications.</p><p><strong>Conclusion: </strong>Understanding the embryological anatomy of this rare vertebrobasilar duplication involving the PPLBA, AICA, BA, and VA facilitated the successful development of a therapeutic strategy. Aneurysms associated with PPLBA exhibit various vascular structures and can be treated effectively with tailored endovascular approaches.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"185"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228160","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":"Extra-neural metastases of recurrent myxopapillary ependymoma: A patient case and literature review.","authors":"Dinali Jayawardena, Joseph Yates, Enrico Clarke, Georges Sinclair","doi":"10.25259/SNI_190_2025","DOIUrl":"10.25259/SNI_190_2025","url":null,"abstract":"<p><strong>Background: </strong>Biologically and morphologically distinct from other ependymomas, myxopapillary ependymomas (MPEs) are rare, slow-growing glial tumors originating predominantly from the conus medullaris, cauda equina, or filum terminale. Gross total resection is the standard of care for primary MPE. Nevertheless, despite maximal resection, the risk of recurrence, usually within the neural axis, remains high. However, extra-neural metastases can also occur. Due to the rarity of the entity, there is a lack of consensus on the management of recurrences and extra-neural metastatic disease. We present a case report and literature review of this rare ependymal tumor.</p><p><strong>Case description: </strong>We describe a case of a male patient with MPE who developed multiple recurrences, treated with numerous surgical resections, radiotherapy, and salvage chemotherapy before eventually developing extra-neural metastatic disease to lungs, abdomen, and lymph nodes 37 years after initial diagnosis. A biopsy of an axillary lymph node confirmed histomorphology comparable to the primary histology.</p><p><strong>Conclusion: </strong>To our knowledge, there are <30 cases of extra-craniospinal metastatic MPE reported since 1955. Consequently, there is no major consensus on the treatment of extra-neural metastatic MPE. Case reports and series remain of utter importance to share experience and help customize management. From this angle, surgery, and radiotherapy are still used in the face of central nervous system recurrence and \"limited\" extra-neural spread, depending on the patterns of invasion. Chemotherapy has shown a modest effect so far; however, positive outcomes from targeted agents and immunotherapy (alone or combined) have been reported, which warrants further exploration.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"182"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228116","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":"Postoperative management of diabetes insipidus in a pediatric patient with Rathke's cleft cyst undergoing transsphenoidal endonasal surgery.","authors":"Eko Nofiyanto, Radian Ahmad Halimi, Iwan Fuadi","doi":"10.25259/SNI_156_2025","DOIUrl":"10.25259/SNI_156_2025","url":null,"abstract":"<p><strong>Background: </strong>Postoperative Rathke cleft cyst surgery can cause injury to the pituitary gland or impaired secretion of antidiuretic hormone (ADH), leading to central diabetes insipidus (DI). This case report describes the successful postoperative management of DI in pediatric patients with Rathke's cleft cyst who underwent transsphenoidal endonasal tumor surgery.</p><p><strong>Case description: </strong>An 8-year-old girl with diabetes insipidus (DI) following transsphenoidal endonasal surgery for a Rathke's cleft cyst was admitted to the intensive care unit (ICU) for postoperative management. Initially, the patient received oxytocin infusion at 20 mU/min. Between the 13th and 15th hour postoperatively, urine output increased to 100-200 mL/h (5-10 mL/kgBW/h). In response, oral desmopressin therapy was initiated at a dose of 0.05 mg once daily. Twelve-hour evaluations showed stable urine output at approximately 500 mL/h (2.5 mL/kgBW/h). Based on this, the decision was made to discontinue oxytocin and prepare for transfer to the high care unit (HCU). In the HCU, urine output was monitored every 24 hours, and oral desmopressin was continued at the same dosage. On the third day of treatment, urine output increased significantly to 6400 mL/24 h (14.03 mL/kgBW/h). Consequently, the desmopressin dose was increased to 0.05 mg twice daily. This adjusted therapy was maintained. By the fifth day, urine output began to decrease, reaching 6 mL/kgBW/h.</p><p><strong>Conclusion: </strong>Postoperative management of DI using desmopressin therapy yields favorable outcomes during both intensive care and high-care treatment in pediatric patients undergoing transsphenoidal endonasal surgery for Rathke's cleft cyst.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"178"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228137","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":"The trinity of the internal carotid artery: Unifying terminologies of the main classifications to improve its surgical understanding.","authors":"Carlos Salvador Ovalle Torres, Gervith Reyes Soto, Álvaro Campero, Carlos Castillo Rangel, Alejandro Gonzalez, Iype Cherian, Maximiliano Núñez, Luis Arnulfo Perez, Vladimir Nikolenko, Alfredo Espinosa Mora, José Adonai García Campos, Raúl Neri Alonso, Andreina Rosario Rosario, Danil Nurmukhametov, Manuel De Jesus Encarnacion Ramirez, Agustín Dorantes Argandar","doi":"10.25259/SNI_27_2025","DOIUrl":"10.25259/SNI_27_2025","url":null,"abstract":"<p><strong>Background: </strong>The internal carotid artery (ICA) has multiple classification systems; it is essential for brain blood supply, which has bone/neurovascular relationships of wide neurosurgical interest; its anatomy must be known in detail, its angiographic-imaging aspect (endovascular), its ventral aspect (endoscopic endonasal approaches); and its lateral aspect (anterolateral skull base surgery). Our objectives were to identify coincidences/differences between the main classifications of the ICA to improve its surgical-anatomical understanding, unify the terminology of ICA segments, avoid confusion, and carry out a simple description.</p><p><strong>Methods: </strong>There are differences between classifications; however, these may overlap each other and determine the correspondence between segments, regardless of their purpose. Literature on ICA classifications was reviewed; a cadaver endonasal endoscopic and anterolateral skull base dissection was performed, obtaining representative images of the ICA, as well as angiography. The main terminology of ICA segments was collected, and artistic-anatomical illustrations were created to facilitate the study of ICA.</p><p><strong>Results: </strong>We compared the endoscopic roadmap to the ICA by Labib/Kassam, the extradural ICA at its lateral aspect by Cherian, and the classic classification by Bouthillier (as well as a small reference to the classification by Gibo/Rhoton). We found the shared characteristics and differences between classifications, with a total of 17 interrelated segments, with a variety of nomenclature and anatomical extension. Initially, we except the extradural ICA by Cherian because it uses almost the same nomenclature that Labib, varying in one segment, which coincides with the nomenclature of Bouthillier and does not change the total summary. The initial and terminal segments were nominative/anatomically equivalent, and there is anatomical nominal variation in the intermediate segments and its relation/correspondence has been easily demonstrated.</p><p><strong>Conclusion: </strong>Anatomical knowledge of all aspects of ICA using its main classifications, the relation between them, and its diversity of nomenclature is essential to improve its anatomical-surgical understanding and avoid anatomical nominal confusion. It can be achieved through our comparative tables/illustrations.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"177"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228164","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":"An atypical intradiploic epidermoid cyst, radiological findings, and surgical management.","authors":"Ahmed Adel Farag, Mohammad Ghazi Abdoh, Yoseri Jameel Alhamss, Abdelmoneim Almoatazbellah Kamar, Zaina Brinji, Alaa Alkhotani, Yahya Mubasher Mir, Hussein Kheshaifati","doi":"10.25259/SNI_170_2025","DOIUrl":"10.25259/SNI_170_2025","url":null,"abstract":"<p><strong>Background: </strong>Epidermoid cysts are benign, slow-growing, and extra-axial lesions that typically develop between the brain structures. Intradiploic and intra-axial involvement is exceptionally rare. We present a case of an intradiploic epidermoid cyst with distinct clinical and radiological features. This case highlights an unusual location and radiological presentation of an epidermoid cyst located within the skull base and may be misdiagnosed as other pathologies.</p><p><strong>Case description: </strong>A 44-year-old male presented with a dull, aching frontal headache and slowly growing right frontal swelling, worsening over several months. On examination, the patient had a hard, non-tender, non-mobile right frontal swelling above the right orbit, with an unremarkable neurological examination. Computed tomography brain revealed an extra-axial hypodense lesion in the right frontal region, causing bony thinning and focal defects in the roof of the right orbit and the zygomatic process of the frontal bone. A mild mass effect on the superior rectus muscle and adjacent brain parenchyma was noted, with the left midline shift and effaced sulci. Magnetic resonance imaging (MRI) brain showed heterogeneous signals in both T1 and T2 as well as a central area of restricted diffusion in diffusion-weighted imaging, the blood products indicated by susceptibility-weighted imaging blooming artifacts, which were suggestive of hemorrhage. The radiological differential diagnosis included an epidermoid cyst, arachnoid cyst, dermoid cyst, abscesses, metastasis, and an aneurysmal bone cyst. The patient underwent a right frontal craniotomy and excision of the cyst. Intraoperative gross inspection and histopathological analysis confirmed the diagnosis of an intradiploic epidermoid cyst.</p><p><strong>Conclusion: </strong>Epidermoid cysts occurring outside their usual locations are exceptionally rare, exhibiting atypical imaging characteristics, including unusual signal intensities on T1- and T2-weighted MRI sequences, along with the absence of the typical pattern of complete restricted diffusion. These findings may be indicative of a mixture of blood products and proteinaceous substances within the cyst. Subsequently, it may be misdiagnosed as other intracranial pathologies.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"183"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228167","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":"Craniocervical hypertrophic pachymeningitis.","authors":"Murilo Dos Santos Mancilha, Filipi Fim Andreão, Bárbara de Ávila Costa Januário, Filipe Virgilio Ribeiro, Matheus Nepomuceno Fernandes, Luis Flavio Fabrini Paleare, Bruno Pasqualino Aguilar da Silva, Marcelo Medeiros Felippe, Danilo Gomes Quadros","doi":"10.25259/SNI_179_2025","DOIUrl":"10.25259/SNI_179_2025","url":null,"abstract":"<p><strong>Background: </strong>Hypertrophic pachymeningitis (HP) is a rare neurological disorder characterized by dural thickening. Here, we discuss the diagnosis and surgical management of a 38-year-old whose myelopathy was attributed to dorsally compressive HP extending from the lower cerebellar fossa to C3.</p><p><strong>Case description: </strong>A 38-year-old male with Sjögren's syndrome presented with cervical pain, upper limb paresis, dysphagia, and left-sided tongue/palate paralysis. The cervical magnetic resonance (MR) showed a dorsally compressive lower cerebellar fossa to C3 lesion. When the biopsy revealed HP, and once conservative treatment failed, the patient successfully underwent a posterior surgical decompression, lesion debulking, and craniocervical fusion.</p><p><strong>Conclusion: </strong>Cervical HPs should be diagnosed early on MR, and those with significant myelopathy, aggressively surgically treated.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"179"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228186","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":"The correlation of optic nerve sheath diameter with clinical outcomes in patients undergoing decompressive craniectomy for cerebral infarction.","authors":"Muhammet Elveren, Caner Fahrettin Kara, Yakup Çağlaroğlu, Ufuk Temtek","doi":"10.25259/SNI_327_2025","DOIUrl":"10.25259/SNI_327_2025","url":null,"abstract":"<p><strong>Background: </strong>This study aims to investigate the relationship between optic nerve sheath diameter (ONSD) measurements and clinical outcomes in patients undergoing decompressive craniectomy (DC) due to cerebral infarction. The study evaluated the effect of ONSD on intracranial pressure (ICP) and neurological recovery after DC and determined the prognostic value of this measurement.</p><p><strong>Methods: </strong>This study was conducted on 54 patients who underwent DC for cerebral infarction between 2018 and 2024 at a tertiary university hospital, Atatürk university faculty of medicine. Demographic data (age, gender), clinical data (preoperative and postoperative Glasgow Coma Scale [GCS] scores, Glasgow Outcome Scale [GOS] scores), and ONSD measurements were obtained from patient records. ONSD measurements were taken at preoperative 1 h, postoperative 1 h, postoperative 24 h, and postoperative 72 h. Measurements were performed with an ultrasound probe on both eyes while patients were in a supine position with their eyes closed. Patients were divided into two groups based on their GCS scores: Group 1 (GCS > 8) and Group 2 (GCS ≤ 8). Statistical analyses of the data were performed using Student's <i>t</i>-test and Mann-Whitney U-test, with <i>P</i> < 0.05 considered statistically significant.</p><p><strong>Results: </strong>Group 1 consisted of 26 patients (mean age 67.2 ± 6.4 years), and Group 2 consisted of 28 patients (mean age 72.4 ± 5.8 years) (<i>P</i> = 0.019). Preoperative ONSD was significantly wider in Group 2 (6.3 ± 0.5 mm) compared to Group 1 (5.2 ± 0.4 mm) (<i>P</i> ≈ 0). Postoperative 1-h ONSD values were also significantly wider in Group 2 (6.0 ± 0.6 mm) compared to Group 1 (4.8 ± 0.5 mm) (<i>P</i> ≈ 0). At 24 and 72 h, ONSD values in Group 2 remained significantly wider compared to Group 1. GOS scores were lower in Group 2 (2.1 ± 0.9) compared to Group 1 (3.2 ± 0.8) (<i>P</i> ≈ 0). There was a strong negative correlation between ONSD measurements and GOS scores.</p><p><strong>Conclusion: </strong>ONSD is an important non-invasive indicator in the assessment of ICP and clinical outcomes. High ONSD values are associated with poor clinical outcomes, and a reduction in postoperative ONSD reflects the success of surgical intervention. ONSD measurements can be used as a prognostic tool in clinical practice and play a crucial role in the management and monitoring of patients with high ICP. It is recommended that these findings be validated in larger patient groups and different clinical scenarios.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"184"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228161","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}