Surgical neurology international最新文献

{"title":"Reuse or replacement of incidentally dropped craniotomy bone flap: An institutional perspective and literature review.","authors":"Adam Marzouq, Muhammad Khalid B Ahmad, Rakan Bokhari, Saleh S Baeesa","doi":"10.25259/SNI_517_2025","DOIUrl":"10.25259/SNI_517_2025","url":null,"abstract":"<p><strong>Background: </strong>Incidental dropout of the craniotomy bone flap (ID-CBF) following craniotomy is a rare and unexpected occurrence in neurosurgery. Consequently, there is scant evidence to direct the surgeon on the most effective management of these events. Any strategy must strike a balance between under-treatment, which carries the risk of infection, and overly aggressive sterilization, which may increase the incidence of bone resorption. The objective of this study is to conduct a comprehensive review of our experience and evaluate it within the context of the extant literature.</p><p><strong>Methods: </strong>A single-center, retrospective study was conducted to review the electronic records pertaining to operative reports of craniotomies. The objective of this study was to identify instances where bone flaps were inadvertently dropped during surgical procedures. In addition, we conducted a comprehensive review of the extant literature pertaining to the management of ID-CBF.</p><p><strong>Results: </strong>During the study period, our Institutional Review Committee identified three instances of ID-CBF. One case occurred when the bone flap was inadvertently dropped during elevation, and two cases occurred when it was transferred to the scrubbed nurse. In this specific instance, the bone flap was inadvertently dropped to the ground and was subsequently promptly collected for the purpose of sterilization. The bone flaps underwent a meticulous chemical decontamination protocol. This protocol involved successive copious washing with normal saline, followed by immersion in 50% diluted hydrogen peroxide for a 15 min interval. Subsequently, the flaps were immersed in 10% betadine solution for another 15 min. Finally, they were soaked in normal saline containing gentamicin. Following the surgical procedure, the bone flaps were secured using miniplates and screws at the surgical incision. Subsequently, patients underwent a minimum of 2 years of follow-up care. No clinical, laboratory, or imaging evidence of surgical site infection was observed.</p><p><strong>Conclusion: </strong>Our series and literature review demonstrate that, in the majority of cases, the bone flap can be reused after undergoing chemical sterilization. Patients require meticulous monitoring to identify early or late surgical site infections. Nevertheless, prevention remains the most effective strategy.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"309"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984615","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":"Probable cerebral amyloid angiopathy-related inflammation presenting with dissociated hemorrhagic and inflammatory lesions in a middle-aged patient: A case report.","authors":"Toshihide Takahashi, Kiyoyuki Yanaka, Hitoshi Aiyama, Minami Saura, Hayato Takeda, Nobuyuki Takahashi, Aiki Marushima, Eiichi Ishikawa","doi":"10.25259/SNI_589_2025","DOIUrl":"10.25259/SNI_589_2025","url":null,"abstract":"<p><strong>Background: </strong>Cerebral amyloid angiopathy-related inflammation (CAA-ri) is a rare inflammatory encephalopathy associated with amyloid-β deposition in cerebral vessels, typically presenting in older adults with subacute cognitive decline, seizures, and lobar hemorrhages. It affects approximately 5% of patients with CAA, often showing asymmetric white matter hyperintensities, microbleeds, and leptomeningeal enhancement on magnetic resonance imaging (MRI). Vascular fragility in patients with CAA-ri increases rebleeding risk compared with those without CAA-ri, such as those with hypertensive intracerebral hemorrhage. This report describes a rare probable CAA-ri case in a middle-aged patient with an atypical presentation: younger age, absence of typical inflammatory symptoms, and spatially dissociated hemorrhagic and inflammatory lesions.</p><p><strong>Case description: </strong>A 50-year-old man with a history of childhood right frontal hemorrhage and epilepsy presented with right upper-limb numbness. Computed tomography revealed a left parietal subcortical hemorrhage, and MRI showed bilateral occipital white matter hyperintensities, microbleeds, and right occipital leptomeningeal enhancement. Biopsy of the right occipital lesion confirmed amyloid-β deposition with mild perivascular lymphocytic infiltration, indicating probable CAA-ri. He was managed conservatively owing to the minimal mass effect and received corticosteroids as outpatients. MRI at 19 months revealed resolution of occipital hyperintensities, without neurological deficits.</p><p><strong>Conclusion: </strong>This case highlights probable CAA-ri in a middle-aged adult, presenting with subcortical hemorrhage and spatially dissociated inflammatory lesions. Despite the subtle inflammatory findings, clinical, imaging, and histological evaluations supported the diagnosis. Early recognition and immunosuppressive therapy can achieve favorable outcomes, emphasizing CAA-ri's inclusion in the differential diagnosis of lobar hemorrhage in relatively younger patients without hypertension or vascular risk factors.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"302"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984429","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":"Complications of brain tumor surgery.","authors":"Alpha Boubacar Bah, Lounceny Fatoumata Barry, Mohamed Cherif, Aïssatou Diallo, Aboubacar M'mah Camara, Djenaba Bah, Ibrahima Sory Souare, Aminata Rouguiatou Diallo, Souleymane Baldé, Alpha Aboulaye Baldé, Fatoumata Camara, Oumar Sow, Arnold Sagbo Kponou, Thierno Hamidou Bah, Luc Kezely Beavogui, Ibrahima Sory Souaré","doi":"10.25259/SNI_103_2025","DOIUrl":"10.25259/SNI_103_2025","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of information regarding the surgical outcomes of brain tumors in sub-Saharan Africa. This study sought to address some of the existing gaps in knowledge concerning the epidemiology and management of brain tumors as well as postsurgical complications in Guinea, in comparison with the existing literature.</p><p><strong>Methods: </strong>Three hundred seventy-four patients were diagnosed with brain tumors at the Department of Neurosurgery of a tertiary hospital in Conakry between July 2019 and June 2024. This retrospective study included patients who underwent surgical intervention in our operating room with at least one complication occurring within 30 days of surgery.</p><p><strong>Results: </strong>Sixty-five patients were included in this analysis, with a predominance of the 25-55 age subgroup and a male: female ratio of 37:28. Over 50% of the patients presented with a diagnostic delay of more than 3 months, and 73% underwent surgery with a further delay of more than 1 month. Of the patients, 76.9% had a World Health Organization score of ≥2, and 25% underwent emergency surgery. Gross total resection was performed in 41% of the cases, and 44.6% of the patients underwent surgery for more than 4 h. A total of 27 patients (41.5%) developed 32 complications including 10.7% neurological deterioration, 21.5% regional complications, and 9.2% systemic complications. Eleven patients died, seven patients recovered, and 19 patients remained in a stationary state, giving an overall rate of 67.2% favorable outcomes.</p><p><strong>Conclusion: </strong>These findings underscore the need for continued investment in the neurosurgical infrastructure, training, and technology to improve outcomes and reduce complications.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"301"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984606","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":"Cough syncope and central sleep apnea caused by CM1 with atlas assimilation in adult: An illustrative case.","authors":"Daigo Aso, Hisaaki Uchikado, Takehiro Makizono, Jin Kikuchi, Nobuhiro Hata","doi":"10.25259/SNI_610_2025","DOIUrl":"10.25259/SNI_610_2025","url":null,"abstract":"<p><strong>Background: </strong>Cough syncope, central sleep apnea (CSA), and Chiari type 1 malformations (CM1) with atlas assimilation are very rare in adults.</p><p><strong>Case description: </strong>A 48-year-old male taxi driver fainted. He was neurologically intact, but tested positive for mild sleep apnea confirmed by a polysonogram. The magnetic resonance imaging diagnosed a CM1 with syringomyelia and atlas occipitalization. The patient underwent an uneventful foramen magnum decompression/C1 laminectomy and remained intact 7 years later.</p><p><strong>Conclusion: </strong>A 48-year-old male presented after fainting with cough syncope, CSA and a CM1; following foramen magnum decompression/C1 laminectomy, the patient remained neurologically stable for the next 7 years.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"307"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984550","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":"Paraplegia due to epidural T3-T5 hemorrhage of cavernous hemangioma.","authors":"Ghassen Gader, Emna Mzoughi, Olfa Faten, Alia Zehani, Mouna Rkhami, Ihsèn Zammel","doi":"10.25259/SNI_504_2025","DOIUrl":"10.25259/SNI_504_2025","url":null,"abstract":"<p><strong>Background: </strong>Epidural cavernous hemangiomas (ECHs) are rare, benign vascular malformations. They account for 4% of all epidural lesions, and 5-12% of all spinal vascular malformations. Acute hemorrhages into extra-hepatic components may cause the acute onset of major neurological deficits.</p><p><strong>Case description: </strong>A 70-year-old male presented with 3 months of progressive paraparesis. The magnetic resonance showed a compressive epidural T3-T5 lesion that was successfully removed. The lesion proved histopathologically to be a benign cavernous angioma.</p><p><strong>Conclusion: </strong>For patients presenting with progressive myelopathy, early diagnosis and timely surgical resection of benign spinal epidural cavernous angiomas are critical to optimize outcomes.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"303"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984451","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":"Polymorphous low-grade neuroepithelial tumor of the young.","authors":"Ahoud Alharbi, Ali Alassiri, Ali Alkhaibary, Saad AlQahatani","doi":"10.25259/SNI_1061_2024","DOIUrl":"10.25259/SNI_1061_2024","url":null,"abstract":"<p><strong>Background: </strong>Polymorphous low-grade neuroepithelial tumor of the young (PLNTY) is a newly recognized entity first described in 2017. This article reports the clinical, radiological, histological, and molecular characteristics of PLNTY diagnosed in a young female.</p><p><strong>Case description: </strong>A 20-year-old female, not known to have any medical illness, presented to the emergency department with speech arrest that progressed to generalized tonic-clonic seizures. Brain magnetic resonance imaging showed a T2 hyperintense nonenhancing cortical-based heterogeneous mass in the left medial temporal lobe and adjacent inferior temporal gyrus measuring 2.7 × 2 × 2.5 cm with no susceptibility signal or diffusion restriction. Electroencephalogram (EEG) showed left temporal epileptiform discharges. She underwent left frontotemporal craniotomy and tumor resection. The light microscopic examination of the tumor revealed a low-grade infiltrative neoplasm. There was a classical appearance of round cells with perinuclear halo, immunopositive for olig-2, glial fibrillary acidic protein (<i>GFAP)</i>, and cluster of differentiation-34. There was B-Raf protooncogene, serine/threonine kinase (<i>BRA</i>F) c.1799T>A (p.V600E) point mutation and absence of isocitrate dehydrogenase (<i>IDH)</i> 1 and 2 hotspot mutations. The overall findings were diagnostic of PLNTY.</p><p><strong>Conclusion: </strong>This article reports an additional case of PLNTY, a newly defined central nervous system tumor entity, describing its clinical, radiological, histological, and molecular features.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"300"},"PeriodicalIF":0.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984439","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":"Intrinsic brainstem epidermoid cyst in childhood.","authors":"Tybault Hollanders, Sarah Hendrickx, Edward Baert","doi":"10.25259/SNI_198_2025","DOIUrl":"10.25259/SNI_198_2025","url":null,"abstract":"<p><strong>Background: </strong>Epidermoid cysts are slow-growing, rare congenital lesions. They are most seen in the cerebellopontine angle, fourth ventricle, or parasellar regions. Patients typically become symptomatic between 20- and 40 years of age. We present a rare case of a symptomatic intrinsic brainstem epidermoid cyst in a 12-year-old girl with atypical radiological features.</p><p><strong>Case description: </strong>A 12-year-old girl presented with progressive gait disturbances, disequilibrium, diplopia due to right-sided abducens paresis, left-sided facial paresis (HB grade II), headaches, nausea, and vomiting over the past 6 months. Magnetic resonance imaging (MRI) revealed an intrinsic lesion of the brainstem not present on MRI 4 years prior. A microsurgical gross total resection, including resection of cyst wall, was performed. The pathology report diagnosed the lesion as an epidermoid cyst. The patient improved significantly after resection.</p><p><strong>Conclusion: </strong>This pathology represents <1% of all intracranial tumors, and with only 21 documented pediatric intrinsic brainstem cases in medical literature, very rarely has an intrinsic brainstem location. We detail the medical history, work-up, surgical management, and postoperative outcomes, contributing to the limited body of knowledge regarding this exceptional entity.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"290"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984422","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":"Long-term insights into brain abscess management: An 8-year study from a single center in India.","authors":"Anurag Srivastava, Anmol S Randhawa, Manoj Agarwal, Swarjith Nimmakayala, Viraj D Narola, Sameer Narad, Sandharbh Gautam, Jitendra Singh Verma, Pankaj Gupta, Rohin Bhatia, Yogesh Agarwal, Bhawani Shankar Sharma, Atibhi Goel","doi":"10.25259/SNI_100_2025","DOIUrl":"10.25259/SNI_100_2025","url":null,"abstract":"<p><strong>Background: </strong>Both industrialized and developing nations continue to face difficulties in diagnosing and treating brain abscesses. Their etiology and management are still complicated and uncertain, which make treatment and result challenging.</p><p><strong>Methods: </strong>To ascertain management, demographics, and factors influencing the outcome of subjects with brain abscesses, we performed a retrospective analysis of data from 48 individuals who underwent surgical treatment for brain abscesses at Mahatma Gandhi Hospital in Jaipur between January 2015 and December 2023 using image-guided aspiration, craniotomy, and excision. Independent analyses were conducted on variables such as age, gender, clinical presentation, location, number of lesions, predisposing factors, etiological agent, infection mechanism, therapy, and Glasgow Coma Scale (GCS) score during admission.</p><p><strong>Results: </strong>The risk of developing a brain abscess was higher for male patients over 40. The outcome was influenced by the admission GCS score. Only 16 instances (33.3%) had positive cultures, despite the low incidence of successful infectious agent culture. The most frequent isolates in these cases were <i>Streptococcus</i> sp. and tubercular abscess. While the death rate was 10.4%, 89.5% of the participants had favorable outcomes. Five patients had poor outcomes because of immunosuppression in two of them, a 1.8-year-old child had ventriculitis, and the other two had low GCS scores.</p><p><strong>Conclusion: </strong>An efficient treatment for brain abscesses that have generally positive results is medical care combined with image-guided suction. excision and craniotomy are rarely necessary. Neither surgical technique nor surgery was directly associated with brain abscess mortality.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"288"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984510","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":"Subarachnoid hemorrhage secondary to Chiari 1 malformation in a patient presenting with recurrent severe headache: A case report, imaging, and anatomic considerations.","authors":"Alireza Habibi, Michael Anthony Rizzuto, Michael K Tso","doi":"10.25259/SNI_374_2025","DOIUrl":"10.25259/SNI_374_2025","url":null,"abstract":"<p><strong>Background: </strong>Chiari 1 malformation (CM1) is a structural anomaly characterized by cerebellar tonsillar herniation through the foramen magnum. While typically associated with syringomyelia or hydrocephalus, its potential relationship with subarachnoid hemorrhage (SAH) remains poorly reported in the literature.</p><p><strong>Case description: </strong>We present the case of a 77-year-old woman who experienced recurrent episodes of thunderclap headache, which eventually progressed to altered consciousness following admission. Neuroimaging revealed a SAH involving the fourth ventricle and basal cisterns, alongside cerebellar tonsillar herniation and obstructive hydrocephalus, with no arterial source identified on serial angiography. Magnetic resonance imaging confirmed CM1, with tonsillar descent to the C1 level. The patient underwent suboccipital decompression for refractory intracranial hypertension that prevented weaning from the external ventricular drain. Intraoperative exploration revealed an abnormal posterior spinal vein traversing the arachnoid membrane, which was suspected to be the source of the hemorrhage and was successfully coagulated.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the first documented case of CM1 presenting with recurrent SAH in the absence of aneurysmal or arteriovenous pathology. Our findings suggest a possible venous etiology related to anomalous posterior spinal venous drainage, which may have contributed to the hemorrhage and obstructive hydrocephalus. The patient's clinical improvement following Chiari decompression supports the role of surgical intervention in relieving cerebrospinal fluid outflow obstruction and elevated intracranial pressure in such cases. This case highlights the importance of considering venous anomalies in the differential diagnosis of non-aneurysmal SAH and underscores the need for heightened awareness of vascular variations in CM1 patients presenting with acute neurological symptoms.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"292"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984554","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":"Use of Target Tetra with an understanding of its novel structure.","authors":"Naoki Omura, Yusuke Kinoshita, Takumi Hoshimaru, Masashi Yoshikawa, Yoko Matsushita, Atsushi Doi, Makoto Yamada, Tohru Ikenaga, Masahiko Wanibuchi","doi":"10.25259/SNI_401_2025","DOIUrl":"10.25259/SNI_401_2025","url":null,"abstract":"<p><strong>Background: </strong>Coil embolization for cerebral aneurysms is an important technique and is not likely to be replaced in the foreseeable future. Recently, the Target Tetra detachable coil (TTDC) has become available, thereby raising expectations for a safer embolization in small aneurysms. Based on our experience, we report the behavioral characteristics and effective utilization of TTDCs.</p><p><strong>Methods: </strong>We analyzed 28 patients who underwent surgery using the TTDC for intracranial aneurysms between December 2023 and November 2024.</p><p><strong>Results: </strong>Five cases were treated using the TTDC only. In four of five cases, the aneurysm height was <3 mm. In terms of complications, intraprocedural rupture occurred in two cases and thrombosis in two. None of the patients presented with delayed hemorrhage during the follow-up period.</p><p><strong>Conclusion: </strong>The TTDC coils cluster at the tip of the microcatheter. Thus, effective embolization can be achieved by filling from the deeper available space. Based on the behavioral characteristics of TTDCs, it is not only beneficial as a finishing coil but also plays a role in filling. We believe that TTDCs may be a useful option for embolizing small aneurysms, including ruptured ones that were previously challenging to treat, and cases in which microcatheter stability are compromised.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"295"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984521","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}