Surgical neurology international最新文献

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Neurosurgery for mental conditions and pain: An historical perspective on the limits of biological determinism. 精神疾病和疼痛的神经外科:生物决定论限制的历史观点。
Surgical neurology international Pub Date : 2024-12-27 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_819_2024
Robert J Coffey, Stanley N Caroff
{"title":"Neurosurgery for mental conditions and pain: An historical perspective on the limits of biological determinism.","authors":"Robert J Coffey, Stanley N Caroff","doi":"10.25259/SNI_819_2024","DOIUrl":"https://doi.org/10.25259/SNI_819_2024","url":null,"abstract":"<p><p>Neurosurgical operations treat involuntary movement disorders (MvDs), spasticity, cranial neuralgias, cancer pain, and other selected disorders, and implantable neurostimulation or drug delivery devices relieve MvDs, epilepsy, cancer pain, and spasticity. In contrast, studies of surgery or device implantations to treat chronic noncancer pain or mental conditions have not shown consistent evidence of efficacy and safety in formal, randomized, controlled trials. The success of particular operations in a finite set of disorders remains at odds with disconfirming results in others. Despite expectations that surgery or device implants would benefit particular patients, the normalization of unproven procedures could jeopardize the perceived legitimacy of functional neurosurgery in general. An unacknowledged challenge in functional neurosurgery is the limitation of biological determinism, wherein network activity is presumed to exclusively or predominantly mediate nociception, affect, and behavior. That notion regards certain pain states and mental conditions as disorders or dysregulation of networks, which, by implication, make them amenable to surgery. Moreover, implantable devices can now detect and analyze neural activity for observation outside the body, described as the extrinsic or micro perspective. This fosters a belief that automated analyses of physiological and imaging data can unburden the treatment of selected mental conditions and pain states from psychological subjectivity and complexity and the inherent sematic ambiguity of self-reporting. That idea is appealing; however, it discounts all other influences. Attempts to sway public opinion and regulators to approve deep brain stimulation for unproven indications could, if successful, harm the public interest, making demands for regulatory approval beside the point.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"479"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960579","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}
引用次数: 0
Semi-sitting position and retrosigmoid approach for a large petroclival meningioma resection: 3-dimensional operative video. 半坐位乙状结肠后入路用于大岩石斜坡脑膜瘤切除术:三维手术影像。
Surgical neurology international Pub Date : 2024-12-27 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_911_2024
Rodrigo Uribe-Pacheco, Marcos Vinicius Sangrador-Deitos, Gerardo Yoshiaki Guinto-Nishimura, Juan Francisco Villalonga, Matias Baldoncini, Ramiro López Elizalde, Alvaro Campero
{"title":"Semi-sitting position and retrosigmoid approach for a large petroclival meningioma resection: 3-dimensional operative video.","authors":"Rodrigo Uribe-Pacheco, Marcos Vinicius Sangrador-Deitos, Gerardo Yoshiaki Guinto-Nishimura, Juan Francisco Villalonga, Matias Baldoncini, Ramiro López Elizalde, Alvaro Campero","doi":"10.25259/SNI_911_2024","DOIUrl":"https://doi.org/10.25259/SNI_911_2024","url":null,"abstract":"<p><strong>Background: </strong>Petroclival meningiomas are still a neurosurgical challenge due to their proximity to cranial nerves and cerebral vasculature along the surgical corridor. The usual extension of large petroclival meningiomas is along the posterior fossa, frequently compromising and displacing adjunct cranial nerves such as the sixth and seventh-eight cranial nerve complex with brainstem compression, causing progressive neurological deficit and severe headache. The goal of sizeable petroclival meningioma surgery treatment is a maximal resection with preservation of neurological function. Several surgical approaches to the petroclival region have been described, and decisions depend on the valuable hearing, tumor origin, and lesion extension. Alongside, the semi-sitting position is a simple and feasible adaptation for several posterior fossa interventions, reducing venous hemorrhage and preventing venous air embolism.</p><p><strong>Case description: </strong>Hereby, we present the case of a 39-year-old female patient with progressive intermittent headache and right-sided hemiparesis secondary to a large petroclival meningioma. After a careful case study, surgical treatment was performed employing a retrosigmoid approach, aiming for the safest and maximal resection possible.</p><p><strong>Conclusion: </strong>The retrosigmoid is an auditory sparing procedure that, with a semi-sitting position, provides direct visualization of the posterior fossa lateral triangles and the tumor and its dural implantation site with no blood and surgical view comprised of debris. This surgical video illustrates anatomical nuances and critical aspects of the retrosigmoid approach and semi-sitting position as safe and adequate access to complete resection and a favorable long-term clinical outcome. The patient consented to the procedure and the publication of his/her image.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"476"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960845","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}
引用次数: 0
Intradural extramedullary tuberculoma in a case of disseminated tuberculosis: A case report. 播散性结核的硬膜内髓外结核瘤1例。
Surgical neurology international Pub Date : 2024-12-27 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_664_2024
Chitranshu Shrivastava, Tushar Narayan Rathod, Rushikesh Bhanudas Shahade, Akshay Vasant Mohite, Bhushan Sunil Hadole, Deepika Jain
{"title":"Intradural extramedullary tuberculoma in a case of disseminated tuberculosis: A case report.","authors":"Chitranshu Shrivastava, Tushar Narayan Rathod, Rushikesh Bhanudas Shahade, Akshay Vasant Mohite, Bhushan Sunil Hadole, Deepika Jain","doi":"10.25259/SNI_664_2024","DOIUrl":"https://doi.org/10.25259/SNI_664_2024","url":null,"abstract":"<p><strong>Background: </strong>Intradural extramedullary tuberculoma of the spinal cord (IETSC) is an exceedingly rare manifestation of tuberculosis (TB) affecting the central nervous system.</p><p><strong>Case description: </strong>A 33-year-old immunocompetent female with disseminated TB, including pulmonary involvement and leptomeningeal tuberculomas, developed progressive paraplegia and urinary incontinence over 2 months. Magnetic resonance imaging revealed diffuse intradural extramedullary soft tissue from C7 to L2 vertebral levels, indicative of abscess formation and severe spinal cord compression. The surgical intervention involved posterior decompression and abscess removal from D7 to L2 vertebral levels, resulting in partial resolution of granulomatous lesions.</p><p><strong>Conclusion: </strong>This case emphasizes the importance of considering IETSC in the differential diagnosis of spinal cord compression in TB-endemic regions. Further research is warranted to elucidate optimal management strategies, including the role of surgical intervention, in improving long-term neurological outcomes for patients with this rare but debilitating form of spinal TB.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"477"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960573","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}
引用次数: 0
Efficacy of high-dose versus low-dose tranexamic acid for reduction of blood loss in adolescent idiopathic scoliosis surgery: A systematic review and meta-analysis. 高剂量与低剂量氨甲环酸在青少年特发性脊柱侧凸手术中减少失血量的疗效:一项系统回顾和荟萃分析。
Surgical neurology international Pub Date : 2024-12-27 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_644_2024
Abdulsalam Mohammed Aleid, Haneen Saleh Saeed, Saud Nayef Aldanyowi, Loai Albinsaad, Mohammed Alessa, Hasan AlAidarous, Zainab Aleid, Abbas Almutair
{"title":"Efficacy of high-dose versus low-dose tranexamic acid for reduction of blood loss in adolescent idiopathic scoliosis surgery: A systematic review and meta-analysis.","authors":"Abdulsalam Mohammed Aleid, Haneen Saleh Saeed, Saud Nayef Aldanyowi, Loai Albinsaad, Mohammed Alessa, Hasan AlAidarous, Zainab Aleid, Abbas Almutair","doi":"10.25259/SNI_644_2024","DOIUrl":"https://doi.org/10.25259/SNI_644_2024","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have suggested that high-dose tranexamic acid (TXA) may be an effective method for reducing blood loss during adolescent idiopathic scoliosis (AIS) surgery. This study aims to perform a systematic review and meta-analysis to compare the outcomes of high-dose versus low-dose TXA for AIS surgery.</p><p><strong>Methods: </strong>Searches were conducted in major databases such as PubMed, Scopus, Google Scholar, and Cochrane Library for relevant studies comparing high-dose and low-dose TXA outcomes in terms of blood loss, red blood cell transfusions, and hemoglobin changes. This systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and registered with PROSPERO (CRD42024547735).</p><p><strong>Results: </strong>Four studies were included, published between 2009 and 2022, encompassing a total of 531 patients. High-dose TXA showed less blood loss compared to low-dose TXA, with a pooled mean difference of -0.40 (95% CI, -0.79--0.01). Neither the volume of blood products used nor the decrease in hemoglobin levels showed significant differences between the groups.</p><p><strong>Conclusion: </strong>High-dose TXA appears to be more effective in reducing blood loss during AIS surgery compared to low-dose TXA. Further robust clinical trials with larger sample sizes are necessary to confirm these results and establish optimal dosing regimens for maximizing efficacy while ensuring safety.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"473"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960894","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}
引用次数: 0
A comparative meta-analysis of mini-transverse versus longitudinal techniques in the treatment of carpal tunnel syndrome. 腕管综合征治疗中微型横向与纵向技术的比较荟萃分析。
Surgical neurology international Pub Date : 2024-12-20 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_897_2024
Abdulsalam Mohammed Aleid, Sultan Nawaf Alanazi, Abdulmajeed Abdulaziz Aljabr, Sami Fadhel Almalki, Hasan Ali Abdullah AlAidarous, Abdulwahab Ahmed Alzahrani, Zainab Mohammed Aleid, Yousef Khalaf A Alghamdi, Saud Nayef Aldanyowi
{"title":"A comparative meta-analysis of mini-transverse versus longitudinal techniques in the treatment of carpal tunnel syndrome.","authors":"Abdulsalam Mohammed Aleid, Sultan Nawaf Alanazi, Abdulmajeed Abdulaziz Aljabr, Sami Fadhel Almalki, Hasan Ali Abdullah AlAidarous, Abdulwahab Ahmed Alzahrani, Zainab Mohammed Aleid, Yousef Khalaf A Alghamdi, Saud Nayef Aldanyowi","doi":"10.25259/SNI_897_2024","DOIUrl":"https://doi.org/10.25259/SNI_897_2024","url":null,"abstract":"<p><strong>Background: </strong>Carpal tunnel syndrome (CTS) is a common nerve entrapment condition, and there is ongoing debate regarding the superiority of traditional open versus minimally invasive carpal tunnel surgery.</p><p><strong>Methods: </strong>This meta-analysis reviewed six studies involving 478 patients to compare recovery and functional outcomes between the traditional longitudinal technique and the minimally invasive mini-transverse technique. The primary outcomes included the functional status scale (FSS), symptoms severity scale (SSS), pain scores, time to return to work, duration of operation, and incidence of complications.</p><p><strong>Results: </strong>The mini-transverse technique was associated with lower FSS and SSS scores compared to the longitudinal technique, with mean differences (MD) of -0.32 (95% confidence level [CI]: -0.52, -0.12, <i>P</i> = 0.002) and -0.43 (95%CI: -0.6, -0.25, <i>P</i> < 0.00001), respectively. Pain scores were also lower with the mini-transverse technique (MD) of -0.5 (95%:CI: -0.71, -0.3, <i>P</i> < 0.00001). The mini-transverse group had a statistically significant shorter time to return to work (MD) of -8.34 (95%CI: -13.55, -3.13, <i>P</i> = 0.002). No significant differences were found in the duration of surgery (MD) of -6.96 (95%CI: -16.66, 2.74, <i>P</i> = 0.16) or incidence of complications (MD) of 0.46 (95%CI: 0.15, 1.4, <i>P</i> = 0.17).</p><p><strong>Conclusion: </strong>The mini-transverse approach for CTS resulted in better outcomes, including less pain, faster recovery, and improved hand function. There was no significant difference in surgery time or complications compared to the traditional technique, suggesting it may be the preferable option.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"468"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960833","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}
引用次数: 0
Utility of intraoperative fluorescence imaging with indocyanine green for diagnosing spinal schwannoma: A case report. 术中吲哚菁绿荧光显像诊断脊髓神经鞘瘤1例。
Surgical neurology international Pub Date : 2024-12-20 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_852_2024
Jun Hashimoto, Toshinari Kawasaki, Yoshihiko Ioroi, Tamaki Kobayashi, Motohiro Takayama
{"title":"Utility of intraoperative fluorescence imaging with indocyanine green for diagnosing spinal schwannoma: A case report.","authors":"Jun Hashimoto, Toshinari Kawasaki, Yoshihiko Ioroi, Tamaki Kobayashi, Motohiro Takayama","doi":"10.25259/SNI_852_2024","DOIUrl":"https://doi.org/10.25259/SNI_852_2024","url":null,"abstract":"<p><strong>Background: </strong>The delayed-window indocyanine green (DWICG) technique is useful for the removal of brain and spinal tumors.</p><p><strong>Case description: </strong>A 41-year-old female presented with lower left back and radicular pain. An magnetic resonance imaging (MRI) revealed an extramedullary L3 lesion located ventrally in the spinal canal that appeared to be a schwannoma. Intravenous indocyanine green (dose, 0.25 mg/kg) was administered 1 h before the L2-L4 laminectomy and L3/L4 posterior lumbar fusion. At surgery utilizing a strong near-infrared (NIR) signal, the tumor was clearly visualized through the dura. Complete tumor excision was confirmed when the NIR signal could no longer be detected. Pathologically, the lesion proved to be a schwannoma. A postoperative MRI scan further confirmed complete tumor excision.</p><p><strong>Conclusion: </strong>In a 41-year-old female, the DWICG technique intraoperatively facilitated localization of a L3 schwannoma through the dura and expedited gross total tumor removal.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"471"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960802","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}
引用次数: 0
Penetrating orbital trauma: Comprehensive review and meta-analysis of bullet injuries. 穿透性眶外伤:子弹伤的综合回顾和荟萃分析。
Surgical neurology international Pub Date : 2024-12-20 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_632_2024
Injam Ibrahim Sulaiman, Ahmed Shakir Ali Al-Wassiti, Mohammed Bani Saad, Mohammed Tareq Mutar, Rokaya H Abdalridha, Sajjad G Al-Badri, Toka Elboraay, Mustafa Ismail
{"title":"Penetrating orbital trauma: Comprehensive review and meta-analysis of bullet injuries.","authors":"Injam Ibrahim Sulaiman, Ahmed Shakir Ali Al-Wassiti, Mohammed Bani Saad, Mohammed Tareq Mutar, Rokaya H Abdalridha, Sajjad G Al-Badri, Toka Elboraay, Mustafa Ismail","doi":"10.25259/SNI_632_2024","DOIUrl":"https://doi.org/10.25259/SNI_632_2024","url":null,"abstract":"<p><strong>Background: </strong>Orbital bullet injuries resulting from high-velocity trauma pose significant clinical challenges due to the potential for severe ocular and systemic complications. This meta-analysis consolidates the existing body of knowledge on direct orbital bullet injuries with respect to clinical outcomes, management strategies, and long-term effects.</p><p><strong>Methods: </strong>The literature search was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, using databases such as PubMed and Scopus. Seventeen articles were reviewed, out of which six studies met the inclusion criteria. Extracted data included details on study design, sample size, patient demographics, projectile type, clinical presentation, imaging modalities used in establishing the diagnosis, surgical interventions performed, duration of follow-up, and the outcomes achieved. Data synthesis was done using fixed and random effects models; heterogeneity testing was assessed using the I<sup>2</sup> statistic.</p><p><strong>Results: </strong>A total of 688 patients with orbital bullet injuries were analyzed. The average age years ranged from 7 to 58, with a predilection for the male gender, about 70%. These injuries caused marked visual impairment, which included optic nerve injuries, legal blindness, cornea injuries, hyphema, orbital fractures, vitreous hemorrhage, lid lacerations, cataracts, and retinal injuries. Optic nerve injuries exhibited substantial variability (I<sup>2</sup> = 100%, H<sup>2</sup> = 1.254 × 10<sup>8</sup>). Legal blindness was common (I<sup>2</sup> = 100%, H<sup>2</sup> = 1.628 × 10<sup>7</sup>), with high rates reported in conflict zones. Corneal injuries and hyphema were also prevalent, with significant heterogeneity observed (I<sup>2</sup> = 100%, H<sup>2</sup> = 8.183 × 10<sup>6</sup> for corneal injuries and I<sup>2</sup> = 99.861%, H<sup>2</sup> = 721.638 for hyphema). Only orbital fractures, vitreous hemorrhage, lid lacerations, cataracts, and retinal injuries showed very high heterogeneity with varying clinical presentation. Early surgical intervention and advanced imaging techniques played a very vital role in the management of these injuries and those which improved the prognosis of outcome.</p><p><strong>Conclusion: </strong>Orbital bullet injuries remain a great clinical challenge and are very variable in nature. This huge variability of injury patterns and outcomes enjoins that treatment must be individualized, with very early intervention, evolved imaging modalities, and thorough surgical management for the best possible improvement in the patient's outcomes and prevention of long-term sequelae. Further studies should be done to come up with unified guidelines regarding the evaluation and treatment of such complex injuries.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"465"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960821","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}
引用次数: 0
Efficacy of radiosurgery with and without angioembolization: A subgroup analysis of effectiveness in ruptured versus unruptured arteriovenous malformations - An updated systematic review and meta-analysis. 放疗伴血管栓塞和不伴血管栓塞的疗效:破裂与未破裂动静脉畸形疗效的亚组分析——一项最新的系统综述和荟萃分析。
Surgical neurology international Pub Date : 2024-12-20 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_737_2024
Hamza Khan, Abdul Basit Sangah, Roua Nasir, Saad Akhtar Khan, Shazia Saleem Shaikh, Ikhlas Ahmed, Mohad Kamran Abbasi, Asma Ahmed, Dua Siddiqui, Syeda Ayesha Hussain, Naveed Zaman Akhunzada, Oswin Godfrey
{"title":"Efficacy of radiosurgery with and without angioembolization: A subgroup analysis of effectiveness in ruptured versus unruptured arteriovenous malformations - An updated systematic review and meta-analysis.","authors":"Hamza Khan, Abdul Basit Sangah, Roua Nasir, Saad Akhtar Khan, Shazia Saleem Shaikh, Ikhlas Ahmed, Mohad Kamran Abbasi, Asma Ahmed, Dua Siddiqui, Syeda Ayesha Hussain, Naveed Zaman Akhunzada, Oswin Godfrey","doi":"10.25259/SNI_737_2024","DOIUrl":"https://doi.org/10.25259/SNI_737_2024","url":null,"abstract":"<p><strong>Background: </strong>Congenital arterial defects such as cerebral arteriovenous malformations (AVMs) increase brain bleeding risk. Conservative therapy, microsurgical removal, percutaneous embolization, stereotactic radiosurgery (SRS), or a combination may treat this serious disease. This study compares angioembolization with SRS to SRS alone in ruptured or unruptured brain ateriovenous malformations (BAVM) patients.</p><p><strong>Methods: </strong>We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations for this study. Until September 2023, PubMed/Medline, Cochrane, and Clinicaltrials.gov were searched for literature. English-language studies comparing SRS alone to embolization with SRS on ruptured or non-ruptured AVMs that could not be operated on were considered. The Newcastle-Ottawa Scale assessed research study quality.</p><p><strong>Results: </strong>Results included 46 studies with a total of 7077 participants. There was a greater obliteration rate in the SRS-only group (60.4%) than in the embolization plus SRS group (49.73%). Particularly in the SRS-only group, ruptured AVMs showed a noticeably greater obliteration rate than unruptured AVMs (<i>P</i> = 0.002). However, no notable differences were found in hemorrhagic events or radiation-induced changes between the two groups; however, the SRS-only group had a slightly greater, yet not statistically significant, mortality rate.</p><p><strong>Conclusion: </strong>Our data showed that ruptured brain AVMs had a much greater obliteration rate than unruptured ones, mostly due to SRS alone, without embolization. The aggregated data showed no significant changes, whereas SRS alone decreased radiation-induced alterations and hemorrhagic rates but with increased mortality. SRS alone may have a higher risk-to-reward ratio for nidus obliteration in ruptured brain AVM patients, so it should be used without embolization, although more research is needed to determine the effects of immediate and late complications.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"467"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960635","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}
引用次数: 0
Use of "enhanced contact endoscopy for pituitary surgery" in a collision sellar tumor (papillary craniopharyngioma + non-functional pituitary adenoma): Representative case illustration and two-dimensional operative video. “垂体手术增强接触内镜”在碰撞鞍区肿瘤(乳头状颅咽管瘤+无功能垂体腺瘤)中的应用:典型病例说明及二维手术视频。
Surgical neurology international Pub Date : 2024-12-20 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_741_2024
Erik Burgos-Sosa, Jose de Jesus Julian-Mendoza, Francisco Javier Mancilla-Mejía, Berenice García-Guzmán, Refugio Ramírez-Espíndola, Jose Jesus Curiel-Valdes, Mario A Taylor-Martínez, Agustín Dorantes-Argandar
{"title":"Use of \"enhanced contact endoscopy for pituitary surgery\" in a collision sellar tumor (papillary craniopharyngioma + non-functional pituitary adenoma): Representative case illustration and two-dimensional operative video.","authors":"Erik Burgos-Sosa, Jose de Jesus Julian-Mendoza, Francisco Javier Mancilla-Mejía, Berenice García-Guzmán, Refugio Ramírez-Espíndola, Jose Jesus Curiel-Valdes, Mario A Taylor-Martínez, Agustín Dorantes-Argandar","doi":"10.25259/SNI_741_2024","DOIUrl":"https://doi.org/10.25259/SNI_741_2024","url":null,"abstract":"<p><strong>Background: </strong>Collision sellar tumors are rare disease entities. Less than 30 cases have been reported in the literature in the last 20 years. We present the case of one patient diagnosed with a collision sellar tumor and describe the use of Enhanced Contact Endoscopy for pituitary gland and tumoral identification not previously described in the literature.</p><p><strong>Case description: </strong>The patient is a 57-year-old man who presented with visual field deficits and intense frontal headache accompanied by a slight hypothyroidism. Magnetic resonance imaging shows two different lesions in the sellar area, with a pendular effect of the pituitary stalk displaced to the side of the pituitary adenoma. The patient was operated on with an endoscopic endonasal subsellar approach, aiding with an enhanced contact endoscopy to demarcate the pituitary gland from the tumor adequately. Pathology diagnosis was compatible with pituitary adenoma (First lesion) and papillary craniopharyngioma (Second lesion). A short surgical video was added to complement the learning of the technique for enhanced contact endoscopy for a description of the microvasculature pattern.</p><p><strong>Conclusion: </strong>Collision sellar tumors are a rare pathology in the sellar region and could benefit from a variety of combined treatments for optimal outcomes. Enhanced contact endoscopy for pituitary surgery could be useful for distinguishing the normal pituitary gland from the tumor.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"470"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960850","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}
引用次数: 0
Craniosynostosis incidence with abnormalities of orbital axis on patients under 8 years old. 8岁以下伴眶轴畸形的颅缝闭合发生率。
Surgical neurology international Pub Date : 2024-12-20 eCollection Date: 2024-01-01 DOI: 10.25259/SNI_110_2024
Widiana Ferriastuti, Suresh Kumar Mukherji, Syahriar Muhammad, Rozalina Loebis
{"title":"Craniosynostosis incidence with abnormalities of orbital axis on patients under 8 years old.","authors":"Widiana Ferriastuti, Suresh Kumar Mukherji, Syahriar Muhammad, Rozalina Loebis","doi":"10.25259/SNI_110_2024","DOIUrl":"https://doi.org/10.25259/SNI_110_2024","url":null,"abstract":"<p><strong>Background: </strong>Craniosynostosis may result in malformations of the orbit, which can be observed in clinical presentations. Craniosynostosis impairs the normal growth of the skull, which typically occurs perpendicular to the fused suture. Craniosynostosis is classified into non-syndromic and syndromic, with an incidence of 1: 2000-2500 live births. It is commonly affects the sagittal suture (40-60%), followed by the coronal suture (20-30%), the metopic suture (<10%), and rarely the lambdoid suture. Computed tomography (CT) scan plays a crucial role in identifying the type of cranial abnormality and associated disruptions in the orbital axis (OX).</p><p><strong>Methods: </strong>The research sample was craniosynostosis patients who were examined at the Radiology Department of Dr. Soetomo General Hospital at Surabaya, Indonesia for the period January 2017-March 2022, male or female aged <8 years and have never had head surgery. Evaluation of the position and axis of the extraocular muscles within the orbits is drawn on the coronal section. In this study, pediatric CT images were acquired at 100 kVp (CTDIvol 2.3 mGy; DLP 84.8 mGy*cm; scan time 6.1 s; helical pitch 0.297). The research was conducted using a case-control method. The case group consisted of patients with craniosynostosis, while the control group included patients without craniosynostosis, encompassing those with conditions such as meningoencephalitis. After the data source is obtained, then the case and control data are matched and then the Chi-square correlation test is carried out through Statistical Package for the Social Sciences.</p><p><strong>Results: </strong>A significant correlation was found between the incidence of craniosynostosis and abnormalities of OX (<i>P</i>-value: 0.000; OR: 22.81; R: 0.635).</p><p><strong>Conclusion: </strong>There is a significant correlation between the incidence of craniosynostosis that has two or more sutural fusions and abnormalities of OX. Strabismus associated with craniosynostosis is typically detected in patients at an older age. Hopefully, by analyzing the eye angle through CT scans while craniosynostosis is established, abnormalities of the orbital axis can be identified. So the progression of strabismus can be prevented.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"15 ","pages":"466"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960875","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}
引用次数: 0
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