Surgical neurology international最新文献

{"title":"Mini-open exoscopic surgery for C1 restenosis 7 years after decompression of Chiari malformation type 1 with atlas assimilation.","authors":"Yosuke Hashimoto, Hisaaki Uchikado, Yuko Baba, Takehiro Makizono, Jin Kikuchi, Motohiro Morioka","doi":"10.25259/SNI_480_2025","DOIUrl":"10.25259/SNI_480_2025","url":null,"abstract":"<p><strong>Background: </strong>Chiari malformation type 1 (CM1) associated with atlas assimilation (AA) is rarely encountered in children without syringomyelia. Here, a 13-year-old child underwent an original foramen magnum decompression (FMD) for a CM1. Seven years after the index surgery, at age 20, the patient required secondary surgery to address recurrent C1 stenosis attributed to CM1/AA performed without a duraplasty.</p><p><strong>Case description: </strong>A 13-year-old child originally presented with headaches and CM1 and AA, for which he underwent a FMD without duraplasty. Seven years later, at the age of 20, he developed recurrent C1 stenosis attributed to dorsal bony proliferation of the lamina of the atlas. Following a secondary mini-open exoscopic decompression without duraplasty, he became asymptomatic.</p><p><strong>Conclusion: </strong>For patients with CM1 without syringomyelia, recurrent stenosis may be successfully managed with repeated mini-open exoscopic bony decompression.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"294"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984480","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":"Using clinical and radiographic variables to predict intracranial aneurysm rupture status with machine learning.","authors":"Mark D Johnson, Pradyumna Elavarthi, Seth Street, Samer S Hoz, Anca L Ralescu, Charles J Prestigiacomo","doi":"10.25259/SNI_498_2025","DOIUrl":"10.25259/SNI_498_2025","url":null,"abstract":"<p><strong>Background: </strong>With excitement in the medical community around artificial intelligence, machine learning (ML) techniques have been applied to correlate clinical and radiographic variables with intracranial aneurysm (IA) rupture status. In this study, we applied various ML techniques, including random forest (RF), XGBoost (XGB), support vector machines (SVM), and multi-layer perceptron (MLP), to predict IA rupture status.</p><p><strong>Methods: </strong>The dataset consisted of 178 IAs each with 53 clinical and radiographic features for analysis. We removed features with high correlation (>0.8) with respect to the target variable to reduce redundancy. We applied grid search to fine-tune the hyperparameters for each model. Each model was evaluated across five iterations of 5-fold cross-validation. Overall performance metrics (accuracy, precision, recall, and F1-score) were extracted. The Wilcoxon signed-rank test was used to compare the area under the curve (AUC) scores between models.</p><p><strong>Results: </strong>The most common locations were internal carotid artery (42), anterior communicating artery (41), middle cerebral artery (32), and posterior communicating artery (25). The AUC for the RF (0.85) and XGB (0.76) models were significantly higher than those for the SVM (0.69) and MLP (0.65) models (<i>P</i> < 0.05). There was no statistical difference in accuracy between RF and XBG models (<i>P</i> = 0.144). Fractal dimension ranked as the most important feature for model performance across all models. Three-dimensional (3D) shape features made up 8 of the 15 most important features driving model performance.</p><p><strong>Conclusion: </strong>Among the models, RF achieved the highest accuracy (85%) with balanced precision and recall. Across models 3D geometric features drove model performance, highlighting the importance of these features in predicting rupture status.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"298"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984599","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":"Appearance of an anterior communicating artery aneurysm during vasospasm treatment after angiogram-negative subarachnoid hemorrhage: A case report.","authors":"Yuhei Ito, Chisae Tamogami, Megumi Koiwai, Tsuyoshi Ichikawa, Kyouichi Suzuki","doi":"10.25259/SNI_478_2025","DOIUrl":"10.25259/SNI_478_2025","url":null,"abstract":"<p><strong>Background: </strong>Initial angiography may not identify a bleeding source in some subarachnoid hemorrhage (SAH) cases. We report an instructive case of initially angiogram-negative SAH where an anterior communicating artery aneurysm became apparent during treatment for vasospasm, subsequently requiring successful endovascular embolization.</p><p><strong>Case description: </strong>A woman in her 60s presented with diffuse SAH (Fisher group 3); initial computed tomography angiography (CTA) and digital subtraction angiography were negative for aneurysms. Symptomatic vasospasm developed on day 4, and treatment including cilostazol and fasudil was initiated. A repeat CTA on day 8 revealed the aneurysm.</p><p><strong>Conclusion: </strong>This case underscores that even with negative initial angiography, an underlying aneurysm should be strongly suspected in patients with diffuse SAH or subsequent vasospasm. It highlights the critical importance of meticulous follow-up and appropriately timed, high-quality imaging re-evaluation, which can lead to accurate diagnosis and favorable outcomes.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"291"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984613","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":"Dandy's vein decompression for trigeminal neuralgia: A rare venous conflict causing intractable facial pain.","authors":"Md Moshiur Rahman, Robert Ahmed Khan, Muhtamim Chowdhury, Riad Habib, Md Mahbub Hasan, Md Ruhul Kuddus","doi":"10.25259/SNI_372_2025","DOIUrl":"10.25259/SNI_372_2025","url":null,"abstract":"<p><strong>Background: </strong>Trigeminal neuralgia (TN) is predominantly caused by arterial compression of the trigeminal nerve; however, venous conflicts, particularly involving Dandy's vein and the superior petrosal sinus (SPS), represent an uncommon but significant etiology.</p><p><strong>Case description: </strong>We report a case of a 40-year-old female suffering from debilitating right-sided facial pain due to a rare \"scissor effect\" produced by the superior petrosal sinus and Dandy's vein (vein of the cerebellomesencephalic fissure) compressing the trigeminal nerve. Surgical decompression was performed by interposing autologous skeletal muscle wrapped with Surgicel between the conflicting venous structures and the nerve. The patient achieved complete pain relief without neurological deficits.</p><p><strong>Conclusion: </strong>This case underscores the importance of recognizing venous causes of TN and highlights the effectiveness of Dandy's vein decompression.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"289"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984574","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":"Recovery of ocular motility after surgical intervention in orbital roof fracture-induced cranial nerve injuries.","authors":"Bob Irfan Syahputra, Farid Yudoyono, Sevline Estethia Ompusunggu, Helza Efriani, Dhany Febriantara, Ary Setio Hartanto","doi":"10.25259/SNI_271_2025","DOIUrl":"10.25259/SNI_271_2025","url":null,"abstract":"<p><strong>Background: </strong>Orbital roof fractures can lead to cranial nerve injuries, particularly affecting the oculomotor nerve (cranial nerve [CN] III) and abducens nerve (CN VI), resulting in impaired ocular motility. This case report discusses a patient with an orbital roof fracture causing CN III and CN VI paresis, who subsequently underwent surgical intervention and experienced significant improvement in ocular function.</p><p><strong>Case description: </strong>A 25-year-old male experienced a depressed orbital roof fracture resulting from a motorcycle accident. Postaccident, he reported double vision accompanied by restricted eye movement. Surgical intervention was performed to reconstruct the bone fragments compressing the ocular muscles. Postoperative day (POD) 1, the patient exhibited improved eye movement, and the double vision had resolved. POD 6 complete recovery.</p><p><strong>Conclusion: </strong>Timely and effective surgical intervention for orbital roof fractures involving cranial nerves can lead to significant improvements in ocular function, including resolution of diplopia and restoration of eye movement. This case underscores the importance of prompt evaluation and management of orbital injuries to prevent permanent neurological deficits.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"296"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984483","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":"Intracranial fungal mass imitating a high-grade glial lesion - is antifungal alone sufficient?","authors":"Warda Ahmed, Syed Ather Enam, Hafiza Fatima Aziz","doi":"10.25259/SNI_161_2025","DOIUrl":"10.25259/SNI_161_2025","url":null,"abstract":"<p><strong>Background: </strong>Intracranial fungal mass is rare among immunocompetent individuals with variable presentation and management algorithms making it challenging to achieve optimal outcomes.</p><p><strong>Case description: </strong>Herein, we report the presentation of a 34-year-old immunocompetent Pashtun female with acute-onset rapidly progressing generalized weakness, altered cognition, and motor and speech deficits. Although the radiological findings resembled a glioblastoma, the strong clinical suspicion of a fungal infection and her improvement on voriconazole treatment led to the decision to avoid surgical resection, thereby minimizing the risk of potential dissemination.</p><p><strong>Conclusion: </strong>Our case emphasizes that any deviation from the typical presentation of high-grade tumors must be reviewed with the need for surgical resection being evaluated on a case-to-case basis while prioritizing patient outcomes.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"297"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984452","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":"Global trends and hotspots in recent neurotrauma-related research in war-stricken countries: A bibliometric and visualization analysis.","authors":"Minaam Farooq, Abdullah M Al-Qudah, Abdul Moiz Khan, Ahmed Muthana, Syeda Shahnoor, Haseeb Ahmad, Samer S Hoz","doi":"10.25259/SNI_1052_2024","DOIUrl":"10.25259/SNI_1052_2024","url":null,"abstract":"<p><strong>Background: </strong>The increase of interest in neurotrauma is growing worldwide due to the increase in military conflicts in war-stricken countries around the globe. There is an increasing trend of publishing about it worldwide. We aim to sort out the topic trends in the field of neurotrauma in countries experiencing military conflicts from the perspective of bibliometrics in the last 3 years, from 2020 to 2023. This will provide a status update on the current situation of publication productivity on the related topic, while simultaneously studying the potential effect of COVID-19 pandemic on it.</p><p><strong>Methods: </strong>We looked into articles and reviews published between 2020 and 2023 in Scopus based on predefined inclusion criteria which included neurotrauma-related publications sourced or co-authored by authors from war-stricken countries. 80 articles were included in the final analysis. The global research publication output, contributions of countries, institutions, journals, authors, average citation index (ACI), and keywords were analyzed.</p><p><strong>Results: </strong>There was a rise in publication productivity in 2020, which declined in 2021 and then again increased in 2022 onward. The United States published the largest number of articles either sourced or co-authored with authors from war-stricken countries (32/80, 40%) while Russia had the highest total citations (70). The order of countries with the highest ACI was Azerbaijan (18.5) followed by Spain and Egypt (14.7). The American University of Beirut was the most prolific institution. It had the highest number of publications (8) and citations (41). Gardner R.C. was the author with the most publications (3), followed by F. Anwar, M. N. Kravtsov, and R. Darwazeh. (2). World Neurosurgery had the most publications (6), but Frontiers in Surgery was the most impactful journal (ACI = 4.5). The most recent keywords predominantly revolve around topics such as \"traumatic brain injury\" (occurred 22 times) followed by rehabilitation' (6), veterans (4) and humanitarian activities (3). There were significant collaborations among developed countries and war-stricken countries for publications related to the topic.</p><p><strong>Conclusion: </strong>An increasing trend in publications regarding neurotrauma in war-stricken countries was seen. Enhanced collaborations tell us about the combined interest of countries, irrespective of being at peace or at war. Our findings could provide useful information to identify potential research fronts in the coming years.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"293"},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984378","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":"Arteriovenous malformation hemangioma of the ulnar artery: A case report highlighting challenges in diagnosis and surgical management.","authors":"Carlo Mandelli, Cinzia Mura, Andrea Bisoglio, Francesca Sanvito, Pietro Mortini","doi":"10.25259/SNI_437_2025","DOIUrl":"10.25259/SNI_437_2025","url":null,"abstract":"<p><strong>Background: </strong>Arteriovenous malformation hemangioma (AVMH) is a rare, benign vascular lesion, often located in the head and neck and less frequently in the limbs. Early symptoms are typically nonspecific, making the clinical differential diagnosis with other benign lesions, such as schwannomas, particularly challenging.</p><p><strong>Case description: </strong>We report the case of a 25-year-old male presenting with a lesion in the forearm. Initially, the clinical and imaging features suggested a schwannoma, due to its location along a peripheral nerve and the absence of distinctive vascular signs. The lesion was surgically excised. Histopathological examination revealed features consistent with AVMH, confirming the diagnosis.</p><p><strong>Conclusion: </strong>This case underscores the importance of including AVMH in the differential diagnosis of soft tissue lesions, especially when located along the course of a peripheral nerve and mimicking other benign tumors such as schwannomas.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"281"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984584","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":"Contrecoup raccoon sign following minor posterior head injury without visible injury: Diagnostic challenge in an asymptomatic older adult man.","authors":"Shintaro Tsuboguchi, Kouichirou Okamoto, Susumu Tokiguchi","doi":"10.25259/SNI_229_2025","DOIUrl":"10.25259/SNI_229_2025","url":null,"abstract":"<p><strong>Background: </strong>Traumatic raccoon sign (periorbital ecchymosis) typically results from facial or severe head trauma involving anterior skull base fractures. In contrast, contrecoup raccoon signs arising from minor posterior head injuries are extremely rare, particularly in older adults. In addition, spontaneous, nontraumatic raccoon signs may be associated with focal or systemic conditions, including malignancies, necessitating extensive diagnostic evaluation. Distinguishing between traumatic and nontraumatic causes is crucial in older patients presenting with raccoon sign following minor head trauma, especially when neurological deficits and visible external injuries are absent.</p><p><strong>Case description: </strong>An 85-year-old male with a 30-year history of insulin-treated type 2 diabetes presented with raccoon sign one morning, without additional symptoms. A comprehensive physical examination, including a detailed head assessment, revealed no abnormalities. However, computed tomography (CT) imaging identified a minor subarachnoid hemorrhage, and high-resolution CT imaging (1-mm bone slice thickness) detected a thin orbital roof fracture, confirming a traumatic contrecoup injury. This finding rendered the differential diagnosis for nontraumatic causes irrelevant. The patient's longstanding diabetes was considered a relevant factor in the development of the raccoon sign.</p><p><strong>Conclusion: </strong>In older adult patients presenting with raccoon sign but lacking overt symptoms, obtaining a thorough history of head trauma and diabetes is essential, even in cases of minor injury without visible external signs. High-resolution thin-slice bone CT imaging is vital for detecting subtle orbital roof fractures, which may otherwise go unnoticed. Early identification facilitates accurate diagnosis and prevents unnecessary evaluations for nontraumatic causes.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"286"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984535","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":"Symptomatic pseudotumor in Meckel cave mimics trigeminal schwannoma.","authors":"Tomoya Sofue, Megumi Chatani, Yoshihiro Kuga, Hiroyuki Ohnishi","doi":"10.25259/SNI_447_2025","DOIUrl":"10.25259/SNI_447_2025","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory pseudotumor is non-neoplastic lesions that form tumor-like masses, typically occurring in the lungs and orbits, with rare involvement of intracranial regions such as the Meckel cave. While neuroimaging can assist in differential diagnosis, definitive diagnosis may remain challenging. Some cases are associated with immunoglobulin G4 (IgG4)-related disease, highlighting the importance of histopathological confirmation to guide appropriate management.</p><p><strong>Case description: </strong>A case of a 42-year-old woman presented with facial numbness and headache. Magnetic resonance imaging revealed a 25-mm enhancing mass in the left Meckel cave, initially suspected to be a trigeminal schwannoma. Craniotomy and tumor resection were performed. Intraoperative findings and rapid pathology indicated marked inflammatory cell infiltration without features of schwannoma. The final diagnosis was inflammatory pseudotumor, with no evidence of IgG4-related disease or malignancy. Postoperative symptoms improved, and only a short course of steroids was administered.</p><p><strong>Conclusion: </strong>This case underscores the diagnostic difficulty of distinguishing inflammatory pseudotumor from neoplastic lesions in skull base regions. Surgical biopsy or resection is critical for definitive diagnosis, especially in cases with progressive symptoms. Individualized treatment planning based on disease activity and neurological impact remains essential due to the absence of standardized treatment guidelines.</p>","PeriodicalId":94217,"journal":{"name":"Surgical neurology international","volume":"16 ","pages":"280"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984539","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}