Asian journal of neurosurgery最新文献

{"title":"Bone Mineral Density Distribution in the Posterior Wall of the Lateral Mass Evaluated by Computed Tomography Osteoabsorptiometry.","authors":"Kazuma Doi, Nozomu Inoue, Satoshi Tani, Junichi Mizuno","doi":"10.1055/s-0044-1793929","DOIUrl":"10.1055/s-0044-1793929","url":null,"abstract":"<p><p><b>Objective</b>  Cervical open-door laminoplasty using plates and miniscrews is gaining popularity. One of the complications of this procedure is the loosening or back-out of the miniscrews inserted in the lateral mass (LM). Bone mineral density (BMD) measured by computed tomography (CT) has been used as a predictor of bone strength. However, bone density distribution in the LM remains unclear. <b>Materials and Methods</b>  We investigated bone density distribution in the posterior wall of the LM. A total of 120 LMs were analyzed from the patients who underwent laminoplasty. The distribution of BMD defined by Hounsfield unit (HU) in the posterior wall of the LM was measured by CT osteoabsorptiometry. The posterior wall was divided into nine zones, which consisted of three columns (lateral, center, and medial) and three rows (cranial, center, and caudal). BMD in each zone was averaged and compared by zones and cervical levels. <b>Results</b>  Overall mean ± standard deviation BMD was 1,092 ± 433 HU. Averaged BMD in the entire posterior wall was highest at C4 (1,365 ± 459 HU), second highest at C3 (1,239 ± 435 HU), and lower in the lower levels. BMD in the medial-center zone (1,357 ± 443 HU) was the highest in all zones. BMD in the medial-caudal region at C7 was only 59% of the highest BMD in the medial-center region at C4. <b>Conclusion</b>  The medial-center to the cranial region was most suitable for miniscrew fixation for laminoplasty. These biomechanical findings would be useful in the preoperative planning of laminoplasty especially for the determination of the LM screw entry points and in the design of laminoplasty implants.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"82-87"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560539","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 Severe Stenosis of Cavernous Internal Carotid Artery Stenting: A Case Report with Short Literature Review.","authors":"Mohan Karki, Girish Rajpal","doi":"10.1055/s-0044-1792161","DOIUrl":"10.1055/s-0044-1792161","url":null,"abstract":"<p><p>Intracranial internal carotid artery (ICA) stenosis is rarely reported as compared with extracranial ICA stenosis. Atherosclerosis is one of the major beginnings of stenosis of vasculatures, which may lead to ischemic stroke causing morbidity and mortality. We report the case of a 60 -year-old man presented to us with complaints of multiple episodes of dizziness, mild headache, and transient left arm weakness for 3 months and had history of smoking, hypercholesterolemia (high level of low-density lipoprotein level = 220 mg/dL), diabetes mellitus, and hypertension under medication. No neurological deficits were observed at the time of admission. Patient underwent angioplasty and stenting with drug-eluting balloon-expandable coronary stent. Patient was discharged well at the 3rd day of procedure. No recurrence of stroke and restenosis were noted till 3 months of follow-up period. Stenting following angioplasty for treatment of symptomatic severe cavernous ICA stenosis with everolimus-eluting coronary balloon-expandable stent, Xience Xpedition, is safe and effective.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"179-182"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560566","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 Unusual Case of Alarming Lactic Acidosis: Brain Metabolic Cross-Talk.","authors":"Sivakumar R, Sumit Roy Chowdhury, Karma Ongmu Bhutia, Suman Sokhal","doi":"10.1055/s-0044-1791999","DOIUrl":"10.1055/s-0044-1791999","url":null,"abstract":"<p><p>A 39-year-old male with a BMI of 30.8 kg/m ² and a normal medical history underwent excision of a left orbito-cavernal hemangioma (4 × 2 × 2 cm) under general anesthesia. Balanced anesthesia and fluid management guided by pulse pressure variation (kept below 12%) were employed. Despite stable hemodynamics and normal blood sugar levels, arterial blood gas (ABG) analysis revealed a progressive rise in lactate levels, reaching 10.6 mmol/L, accompanied by acidemia. Systemic hypoperfusion was ruled out by maintaining mean arterial pressure between 70-80 mm Hg, ensuring a capillary refill time of less than 3 seconds, and confirming a central venous oxygen saturation of 72%. With a total blood loss of 800 mL, one unit of packed red blood cells was transfused due to concerns about decreased microcirculation and tissue hypoxia. After 10 hours of surgery, sodium bicarbonate (NaHCO3) was administered to mitigate metabolic acidosis and its potential impact on intracranial pressure. Postoperatively, lactate levels remained elevated (8-9 mmol/L), but with continued NaHCO3 infusion, lactate reduced to 6.4 mmol/L, allowing extubation. The patient's lactate normalized by the evening, and recovery was uneventful. This case highlights the significant metabolic disturbances, particularly lactic acidosis, that can arise during brain tumor surgery due to prolonged operative times, large tumor size, higher BMI, and stress-induced metabolic derangements. Awareness and prompt management of these disturbances are crucial for successful patient outcomes.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"196-198"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560537","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":"Non-Neoformans Cryptococcal Infections in the Post-Coronavirus Disease-19 (COVID-19) Era: Are We Ready to Face the Emerging Challenge?","authors":"Umayra Fatima, Hina Ahmed, Gautam Singh, K Y Giri, Md Sania Azmi, Archana Meenakshi, Suresh Babu Jandrajupalli, Swarnalatha Chandolu, Abhishek Singh Nayyar","doi":"10.1055/s-0044-1791998","DOIUrl":"10.1055/s-0044-1791998","url":null,"abstract":"<p><p>Coronaviruses are a large group of viruses that infect animals as well as humans, while it is also suggested that, rarely, coronaviruses that infect animals can evolve and infect humans. Current evidence suggests that severe acute respiratory syndrome (SARS) coronavirus-2 leads to coronavirus disease-19 (COVID-19), the respiratory illness responsible for COVID-19 pandemic, while it has a zoonotic origin, closely related to the bat-origin SARS-like coronavirus. Also, as per the current knowledge, the disease may induce significant and persistent lymphopenia which in turn may increase the risk for various opportunistic infections. <i>Cryptococcus laurentii</i> is one such rare, but serious fungal infection which has been reported in post-COVID-19 disease and is a rising cause of concern since it can turn out to be fatal. The infection is caused by a non-neoformans rare human pathogen. The present case report describes the case of a 45-years old male patient who reported to the Outpatient Department (OPD) for a routine dental complaint with a grossly destructed tooth in left lower back tooth region due to extensive carious involvement, while, simultaneously, presenting with fever since 5 days in the post-COVID-19 phase, and was later diagnosed as being positive for <i>C. laurentii</i> infection on urine culture sensitivity test.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"190-195"},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560560","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":"Bow-Hunter Syndrome Due to Tandem Lesions; A Case Report.","authors":"Shigeomi Yokoya, Jun Nakauchi, Hidesato Takezawa","doi":"10.1055/s-0044-1792160","DOIUrl":"10.1055/s-0044-1792160","url":null,"abstract":"<p><p>Bow-Hunter syndrome (BHS) includes a form of stroke caused by dynamic factors affecting the extracranial vertebral artery (VA), such as rotation-induced flow disturbance at the atlantoaxial level. BHS is a rare condition that can result from a variety of factors, including abnormal bone compression and vertebral instability. So far, there have been no reports in which both vertebral instability and osteophytes compress the VA at different sites, leading to stroke. Herein, we present a rare case of stroke attributed to BHS involving thrombosis formation due to osteophyte compression at C3/4 and VA occlusion due to vertebral instability at the C4/5 overlapped. A 72-year-old male presented with rotational vertigo and vomiting associated with a cerebellar infarction. Digital subtraction angiography revealed severe stenosis of the left VA with an intra-arterial thrombus. Percutaneous transluminal angioplasty improved the stenosis; however, intravascular ultrasound revealed compression of the VA by osteophytes at C3/4. Additionally, left VA occlusion at C4/5 was confirmed because of vertebral instability. The osteophyte was removed via the anterolateral approach, and the VA was decompressed. The patient's postoperative course was uneventful, with no recurrence for more than 2 years. BHS can occur in the lower cervical spine when vertebral instability coincides with intimal arterial damage caused by osteophytes at other sites.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"174-178"},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560541","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":"Endoscopic Epilepsy Surgery: Systematic Review and Meta-Analysis.","authors":"F N U Ruchika, Jitender Chaturvedi, Malla Bhaskara Rao, Shiv Kumar Mudgal, Mritunjai Kumar, Mohit Gupta, Rahul Singh, Priyanka Gupta, Sanjay Agrawal","doi":"10.1055/s-0044-1791996","DOIUrl":"10.1055/s-0044-1791996","url":null,"abstract":"<p><p>Endoscopic epilepsy surgery is a fast emerging minimally invasive alternative to open surgery. The approach minimizes the extent of bone and brain resection and reduces surgical morbidity. This systematic review and meta-analysis sought to evaluate the favorable outcome of seizure improvement in patients undergoing endoscopic epilepsy surgery. The search was conducted by two independent researchers using PubMed and Web of Science until January 2023 to find studies reporting results of patients who underwent endoscopic epilepsy surgery. We extracted data on the clinical profile and outcomes of the patients from the eligible studies. Fifteen studies yielded 340 patients, of which 293 underwent endoscopic epilepsy surgery. The patient cohort consisted of 189 (55.6%) males. A total of 171 (58.3) patients had a favorable outcome of either Engel I or II or > 90% seizure control. Thirteen studies were included in our meta-analysis, and demonstrated improved seizure control after endoscopic epilepsy surgery, with a pooled seizure freedom rate of 58% (95% CI: 0.43-0.71, I ²  = 77.1%, τ ²  = 0.6836). Studies focusing on pediatric populations reported a higher proportion of positive outcomes, with a rate of 73.27% (95% CI: 62-82%, I ²  = 0.0%). In comparison, mixed-age populations showed a lower success rate of 48% (95% CI: 32-65%, I ²  = 79.0%). Furthermore, there was significant difference in treatment outcomes between the pediatric and mixed age groups ( <i>p</i>  = 0.014). The hypothalamic hamartomas (HH) patient population demonstrated a favorable outcome proportion of 61.71% (95% CI: 48.92-73.06%), with a moderate level of heterogeneity ( <i>I</i> ²  = 62.9%, tau ²  = 0.4266). Five patients developed postoperative complications, and there were three deaths. Our findings suggest that endoscopic epilepsy surgery is particularly effective in pediatric populations and among patients with HH, underscoring the importance of considering patient demographics and disease characteristics in clinical decision-making. The heterogeneity across studies necessitates cautious interpretation of the pooled results, advocating for tailored approaches in treatment planning. Prospective trials are required to establish class I evidence for the role of endoscopic epilepsy surgery compared with the recognized open surgical techniques.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"10-19"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560514","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 Off-Midline Mature Teratoma and Pneumosinus Dilatans: A Unique Clinical Report.","authors":"Mustafa Kemal Demir, Ozlem Yapıcıer, Deniz Kılıç, Turker Kılıc","doi":"10.1055/s-0044-1791995","DOIUrl":"10.1055/s-0044-1791995","url":null,"abstract":"<p><p>Teratomas typically arise as midline lesions in the suprasellar and pineal regions. Pneumosinus dilatans is a rare condition characterized by the expansion of one or more of the paranasal sinuses and thinning of their bony walls with a normal covering mucosa. It usually involves the sphenoid and posterior ethmoid sinuses and has been associated with meningiomas and arachnoid cysts. Off-midline mature teratomas are uncommon, and no reports have described an association with pneumosinus dilatans. We present a rare association between an intracranial off-midline mature teratoma and pneumosinus dilatans in an 18-year-old male patient who presented with a second episode of a left-sided seizure, which has not yet been reported in the literature.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"165-169"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560552","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 Neck-Crossing Technique Using the Low-Profile Distal Access Catheter in Flow Diverter Placement for Dissecting Posterior Cerebral Artery Aneurysm: A Case Report.","authors":"Akiko Hasebe, Ichiro Nakahara, Kenichiro Suyama, Shoji Matsumoto, Jun Morioka, Tetsuya Hashimoto, Jun Tanabe, Sadayoshi Watanabe, Takeya Suzuki, Junpei Koge","doi":"10.1055/s-0044-1791711","DOIUrl":"10.1055/s-0044-1791711","url":null,"abstract":"<p><p>We report a case in which a novel distal access catheter proved successful in the placement of a flow diverter for a challenging distal cerebral artery lesion. We discuss the advantages and pitfalls of this technique and considerations for its use. A 74-year-old female presented with intermittent headaches, and was diagnosed with a dissecting aneurysm at the proximal right posterior cerebral artery with a sharp bleb, measuring 9.8 mm in diameter. Given the complex vascular anatomy, stent-assisted coil embolization was initially considered but deemed high risk for dual catheter for jailing technique with 6-Fr size guiding catheter due to the tortuosity and stenosis of the parent vessel. Therefore, we opted for flow diverter treatment, which presented its challenges during delivery. By employing a low-profile distal access catheter, Phenom Plus (outer diameter: 4.2-Fr. inner diameter: 1.13 mm; Medtronic, Minneapolis, Minnesota, United States), with a minimal ledge between it and the delivery catheter, Phenom 27 (outer diameter: 2.8-Fr, 0.91 mm; Medtronic), we successfully crossed the neck of the aneurysm with Phenom Plus and placed the flow diverter. While acknowledging potential risks, this case demonstrates the value of the neck-crossing technique using a low-profile distal access catheter as an alternative option for treating challenging peripheral artery aneurysms with flow diverters. This technique offers promise in specific situations where conventional methods pose challenges.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"143-148"},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143559443","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":"Hyperbaric Oxygen Therapy (HBOT) in Moderate Traumatic Brain Injury (TBI): A Randomized Controlled Trial.","authors":"Jitender Chaturvedi, Vishal Mago, Mohit Gupta, Rahul Singh, Nishant Goyal, Rajneesh Arora, F N U Ruchika, Shiv Kumar Mudgal, Priyanka Gupta, Sanjay Agrawal, Dhaval Shukla","doi":"10.1055/s-0044-1791997","DOIUrl":"10.1055/s-0044-1791997","url":null,"abstract":"<p><p><b>Introduction</b>  Hyperbaric oxygen therapy (HBOT) is a novel technique recently under investigation with intention to improve outcomes in traumatic brain injury (TBI). It increases the partial pressure of oxygen in the blood and tissues by inhaling pure oxygen in an environment pressurized to at least 1.4 times normal atmospheric pressure (ATM) at sea level. The rationale behind the use of HBOT in TBI is its potential to mitigate the secondary brain injury cascade initiated by the primary mechanical trauma. Tissue damage and neuroinflammation secondary to intricate and complex cellular biochemical processes are expected to be counteracted by increased oxygen availability during HBOT, which reduces oxidative stress and improves neuroplasticity. <b>Materials and Methods</b>  All patients, except whose legal guardians denied informed consent, with moderate TBI presenting to the neurotrauma center, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India, were included within the study period of June 2022 to July 2023. Patient allocation was randomized into two arms: namely, treatment and control arm. Simple randomization was done using randomization mobile app, RRApp. Each patient received standard of care per the Brain Trauma Foundation guidelines. Patients randomized under the treatment arm additionally received adjuvant HBOT sessions. One session daily for 10 consecutive days. Session duration was for 60 minutes each at 1.4 ATM. The primary objective of the study was to compare the Glasgow Coma Score (GCS) at discharge and 3-month post-TBI Glasgow Outcome Scale-Extended (GOS-E) among patients in the treatment arm (those who received adjuvant HBOT) with those in the control arm (those who received only standard of care). <b>Results</b>  The mean GCS (±standard deviation [SD]) at discharge in the treatment arm was 14.37 (±00.51) with a median of 14 and a range of 14 to 15. Comparatively, the mean GCS (±SD) at discharge in the control arm was 13.40 (±00.84) with a median of 13 and a range of 12 to 15. The difference between the two arms was statistically significant ( <i>p</i>  < 0.001). GOS-E at 3 months postinjury for the treatment arm was 7.62 ± 00.51 (mean ± SD) with a median of 8 (range: 7-8). For the control arm, GOS-E at 3 months postinjury was 6.40 ± 1.50 (mean ± SD) with a median of 7 (range: 4-8). The difference between the two arms was statistically significant ( <i>p</i>  < 0.001). <b>Conclusion</b>  The current study concludes that early adjuvant HBOT using 1.4 ATM with one session of one-hour daily for 10 days among adults sustaining moderate TBI significantly improves GCS at 10 days. Early adjuvant HBOT is also associated with significantly improved GOS-E at 3 months postinjury compared to standard of care alone.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"69-74"},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560550","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":"Giant Olfactory Groove Meningiomas: A Case Series Demonstrating the Surgical Management and Functional Outcomes.","authors":"Ashraf Elbadry, Azza Abdelazeez, Mohamed Badran","doi":"10.1055/s-0044-1791840","DOIUrl":"10.1055/s-0044-1791840","url":null,"abstract":"<p><p><b>Objective</b>  Giant olfactory groove meningiomas (OGMs) present technical challenges in their management, especially when their size and location complicate the evaluation and planning process, making complete removal difficult. This study provides a comprehensive analysis of the surgical approaches and outcomes encountered in the management of giant OGMs at a single institution. <b>Materials and Methods</b>  This retrospective study evaluated surgical and functional outcomes in 71 patients diagnosed with giant OGMs larger than 6 cm. Tumors were excised using microsurgical resection via the bifrontal, pterional, or combined pterional and unifrontal approaches. <b>Results</b>  The study comprised 48 females (67.6%) and 23 males (32.4%), with a mean age of 54.1 years. The most common pathological type was meningothelial meningioma (45%). The bifrontal approach was the most frequently used ( <i>n</i>  = 47, 66.2%) and resulted in Simpson grade I or II resection in 41 patients (87.2%). The combined pterional and unifrontal approaches were used in 16 patients (22.5%), achieving Simpson grade I or II resection in 12 (75%). The pterional approach was the least commonly used ( <i>n</i>  = 8), with Simpson grade I or II resection achieved in 50% of these patients. Postoperatively, visual acuity and cognitive function improved during follow-up. Postoperative complications were frequently observed after the bifrontal approach. Three patients (4.2%) died. <b>Conclusion</b>  The bifrontal approach resulted in better resection of giant OGMs than other approaches but was associated with more complications. The combined pterional and unifrontal approach was superior to the pterional approach in terms of OGM resection, with no differences in complication rates. Significant postoperative improvements in functional outcomes, including visual acuity and cognitive function, were observed.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"52-60"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560548","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}