Asian journal of neurosurgery最新文献

{"title":"Cocaine-Induced Midline Destructive Lesions-A Harbinger of Meningitis and Hydrocephalus.","authors":"Siddharth Srinivasan, Anna Craig-McQuaide, Mustafa Elsheikh, Dhanwanth Chigurupati, Rishikesh Ravindran, Shivani Rajkumar, Saif Khan, Christopher Pollard, Calan Mathieson","doi":"10.1055/s-0045-1808235","DOIUrl":"10.1055/s-0045-1808235","url":null,"abstract":"<p><p>Cocaine is among the most commonly used recreational drugs in Scotland, contributing to significant socioeconomic and severe health challenges. The prevalence of cocaine-induced midline destructive lesions (CIMDL) is rising due to increased cocaine insufflation. Here, we report a case of a patient who developed acute hydrocephalus and meningitis as complications of CIMDL due to long-term cocaine abuse. A 39-year-old woman with a history of chronic nasal cocaine abuse presented with fever, malaise, and gait imbalance. On arrival at accident and emergency department, she had altered sensorium, Glasgow coma scale (GCS) of 10, and left-sided hemiparesis, requiring emergency intubation. Imaging revealed acute hydrocephalus and brain edema. She underwent an emergency external ventricular drain (EVD) to temporize her raised intracranial pressure. Her constellation of problems and biochemical parameters directed toward a diagnosis of acute bacterial meningitis. Her blood cultures grew methicillin-sensitive <i>Staphylococcus aureus</i> , and she was started on broad-spectrum antibiotics. Her computed tomography scans showed air in the sphenoid sinus, clival erosion, and partial erosion of the anterior arch of C1, consistent with CIMDL. She developed posterior circulation ischemic strokes, which were attributed to her endocarditis and tricuspid valve vegetations that were detected on her transthoracic echocardiogram. Eventually, she underwent a ventriculoperitoneal shunt for permanent cerebrospinal fluid diversion. Neurologically, she was E4V5M6 with residual left hemiparesis at the time of discharge. She is on aggressive rehabilitation under the care of oral maxillofacial surgery, otorhinolaryngology, and a skull base team for her CIMDL. This case highlights the importance of multidisciplinary care and support in managing such cases, especially aiming to prevent the recurrence of infection leading to significant morbidity or even mortality.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 3","pages":"627-630"},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984859","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":"Comparison of Quality of Life in Postoperative High-Grade Glioma Patients Treated Using EORTC and RTOG Target Delineation Techniques for Postoperative Radiotherapy.","authors":"Shreyosi Mandal, Deepa Joseph, Ajay Krishnan, Pragya Singh, Rajnish Kumar Arora, Udit Chauhan, Sweety Gupta, Lekshmi R, Manoj Gupta","doi":"10.1055/s-0045-1807761","DOIUrl":"10.1055/s-0045-1807761","url":null,"abstract":"<p><strong>Introduction: </strong>High-grade gliomas (HGGs) have dismal prognosis even with multimodality treatment entailing surgery, radiotherapy, and chemotherapy. Hence, assessment of improvement in quality of life (QOL) for evaluating treatment is critical. Target delineation for radiotherapy in HGG is often done according to the European Organization for Research and Treatment of Cancer (EORTC) and Radiotherapy and Oncology Group (RTOG) contouring guidelines, which differs on exclusion and inclusion of peritumoral edema believed to harbor malignant cells; the guidelines have not been prospectively compared for probable difference in QOL, considering the probable difference in treated volume.</p><p><strong>Objective: </strong>This article compares QOL in HGG patients receiving postoperative radiotherapy using target volume delineation based on the RTOG or EORTC guidelines.</p><p><strong>Materials and methods: </strong>In this single-center, prospective randomized exploratory study, postoperative HGG patients were randomized to either receive radiotherapy according to the EORTC guidelines of target delineation (60 Gy/30 fractions to tumor bed and residual tumor) or the RTOG guidelines (46 Gy/23fractions to tumor bed, residual tumor, and peritumoral edema with 14 Gy/7 fraction boost to the tumor bed and residual tumor) with concurrent temozolomide (TMZ) followed by 6 months of adjuvant TMZ. The aim and primary endpoint of the study was to assess and compare QOL between the arms. Descriptive statistics were used to convey demographic data, proportions for categorical variables, and mean, median, range, and standard deviation for continuous variables. Effect size was assessed using partial eta squared test where values of 0.01, 0.06, and 0.14 signify small, medium, and large effect size, respectively. Repeated measures analysis of variance test was used for comparison of means and assessment of QOL between the EORTC and RTOG groups at 6 months. Absolute volume of planning target volume (PTV) receiving 46 and 60 Gy were described, PTV 46/60 was also described in terms of % of whole brain volume.</p><p><strong>Results: </strong>Eighteen patients underwent randomization (9 in EORTC and RTOG group each). Statistically significant improvement was noted in the overall posttreatment values in the physical well-being (PWB) domain ( <i>p</i>  = 0.007).</p><p><strong>Conclusion: </strong>This is the first study to compare the EORTC and RTOG delineation techniques in terms of QOL. No significant differences in QOL were noted between the two arms. Significant improvement was noted posttreatment in PWB of overall patients.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 3","pages":"506-513"},"PeriodicalIF":0.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984823","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":"Comparison of Surgical Time and Clinical Outcomes for Intravenous Regional Anesthesia (IVRA) versus Wide-Awake Local Anesthesia No Tourniquet (WALANT) in Open Carpal Tunnel Release Surgery: A Comparative Study.","authors":"Ali Guler, Yigit Can Senol","doi":"10.1055/s-0045-1807760","DOIUrl":"10.1055/s-0045-1807760","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the efficacy and safety of two anesthetic techniques in patients undergoing carpal tunnel release surgery: intravenous regional anesthesia (IVRA) and the wide-awake local anesthesia no tourniquet (WALANT) technique.</p><p><strong>Materials and methods: </strong>A retrospective observational dual-center study was conducted, including 102 patients diagnosed with moderate-to-severe carpal tunnel syndrome (CTS) unresponsive to conservative treatment. Outcomes were assessed using the visual analog scale (VAS) for pain and the Duruoz Hand Index (DHI) for hand functionality. Comparisons were made based on age, gender, preoperative VAS scores, incision length, and surgical procedure duration.</p><p><strong>Results: </strong>The outcomes of the WALANT ( <i>n</i>  = 51) and IVRA ( <i>n</i>  = 51) techniques in CTS surgery were compared. The IVRA group had a shorter operation time (2.49 ± 0.50 minutes) and faster return to daily activities (10.13 ± 9.50 days) compared with the WALANT group (operation time: 7.27 ± 1.35 minute, return to daily activities: 17.64 ± 2.52 days) ( <i>p</i>  < 0.05). Additionally, postoperative analgesic requirements were significantly lower in the IVRA group (8/51; 15.6%) than in the WALANT group (37/51; 72.5%) ( <i>p</i>  < 0.05). Both groups showed significant postoperative improvements in VAS and DHI scores ( <i>p</i>  < 0.05), with the IVRA group demonstrating a greater improvement in DHI scores (14.76 ± 0.43) compared with the WALANT group (12.76 ± 0.45) ( <i>p</i>  < 0.05).</p><p><strong>Conclusion: </strong>IVRA with small incisions demonstrated superior outcomes in CTS surgery compared with WALANT, including shorter operation times, faster recovery, and reduced postoperative analgesic requirements. These findings suggest that IVRA may be a more favorable option for both patients and surgeons in carpal tunnel release surgery.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 3","pages":"535-541"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984896","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":"Keyhole Brain Surgery without Neuronavigation: Innovative Usage of Limited Available Resources.","authors":"Adesh Shrivastava, Rakesh Mishra, Amol Mittal, Ranjith Chegondi, Mukesh Baniya, Amit Agrawal","doi":"10.1055/s-0045-1808061","DOIUrl":"10.1055/s-0045-1808061","url":null,"abstract":"<p><strong>Introduction: </strong>Neurosurgical practices have evolved from exploratory techniques requiring extensive craniotomies to more refined methods facilitated by advanced imaging technologies. The advent of neuronavigation systems and modern imaging modalities has enabled precise localization of intracranial lesions, allowing for minor skin and craniotomy flaps, thereby promoting minimally invasive approaches. This study aims to evaluate the efficacy of open-source Digital Imaging and Communications in Medicine (DICOM) software in preoperative planning for keyhole neurosurgical procedures, particularly in resource-limited settings where traditional navigation systems may not be available.</p><p><strong>Objective: </strong>The primary objective was to assess the utility of open-source DICOM software in planning keyhole surgeries, focusing on parameters such as incision length, lesion identification accuracy, operative time, blood loss, bone loss, craniotomy size, resection extent, recovery rate, and complication rates compared with traditional methods.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on 176 patients undergoing keyhole procedures using DICOM software versus a control group of 172 matched patients. Preoperative imaging requirements included high-resolution volumetric scans (magnetic resonance imaging and computed tomography) for accurate three-dimensional (3D) reconstruction. The DICOM software enabled interactive 3D visualization and variable windowing for enhanced preoperative and intraoperative planning.</p><p><strong>Results: </strong>The keyhole technique resulted in significantly smaller incision lengths (50 ± 12 vs. 200 ± 20 mm, <i>p</i>  = 0.001) and craniotomy surface areas (9 ± 2 vs. 120 ± 14 cm ² , <i>p</i>  = 0.001) compared with conventional methods. The mean duration of surgery was reduced (140 ± 28 vs. 345 ± 32 minutes, <i>p</i>  = 0.002), with a lower incidence of wound-related complications in the test group (3 vs. 21, <i>p</i>  = 0.001).</p><p><strong>Conclusion: </strong>This study demonstrates that accessible DICOM software can effectively support neurosurgeons in executing keyhole procedures and promoting minimally invasive techniques in settings with limited resources. Regular use of this method enhances surgical precision and improves patient outcomes by reducing surgical trauma and recovery times.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 3","pages":"529-534"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984910","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":"Microscopic Minimal Invasive Resection of Spinal Tumor with Tubular Retractor System: Case Studies of 70 Patients with Literature Review.","authors":"Mohan Karki, Rakesh Pandey, Manish Vaish, Girish Rajpal, Yaspal Singh Bundela, Hrishikesh Chakrabartty, Dipanshu Narula","doi":"10.1055/s-0045-1806866","DOIUrl":"10.1055/s-0045-1806866","url":null,"abstract":"<p><strong>Objective: </strong>Minimal invasive spine surgery with tubular retractor system avoids contralateral laminectomy, minimizes manipulation of midline supportive structures, and reduces surgical morbidity. The objective of this study was to evaluate the safety and efficacy of microscopic minimal invasive tubular retractor system for intradural spinal tumor resection.</p><p><strong>Materials and methods: </strong>A retrospective study was performed in 70 patients who were admitted between January 2017 and January 2024 with intradural spinal tumors and underwent excision with microscopic minimal invasive tubular retractor system. Patient's data including age, sex, clinical symptoms, and magnetic resonance imaging were collected. The extent of resection, surgical complications, estimated blood loss, estimated surgical time, and neurological outcomes were recorded. The neurological assessment was done by the modified McCormick grading scale pre- and postoperatively.</p><p><strong>Results: </strong>Out of 70 patients, there were 38 (54.28%) males and 32 (45.71%) females, with a mean age of 45.16 (range: 8-79) years. The histology of these cases was meningioma (34.28%), schwannoma (51.42%), astrocytoma (2.85%), ependymoma (2.85%), and neurofibroma (8.57%). The average volume of tumors was 1.98 cm ³ , and gross total resection was achieved in 64 (91.53%) cases and subtotal resection was achieved in 6 (8.57%) cases. One patient had neurological deterioration, which was improved on follow-up after 6 months, and cerebrospinal fluid (CSF) leakage was noted in one case, which recovered after keeping lumbar drain for 5 days. No permanent neurological deficits were observed compared with their preoperative status, with improvement noted in visual analog scale and modified McCormick grade in all cases in the long-term follow-up evaluation (6-24 months).</p><p><strong>Conclusion: </strong>Microscopic minimal invasive resection of intradural spinal tumor by the tubular retractor system is safe and effective with excellent neurological improvement as well as better resection rate, short hospital stay, and less surgical complication.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 3","pages":"491-497"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984846","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":"Mandibular Sagittal Split Osteotomy to High Carotid Pathology: Multidisciplinary Management.","authors":"Vladimir Victorovich Krylov, Victor Aleksandrovich Luk'ianchikov, Vadim Aleksandrovich Gorozhanin, Roman Nikolaevich Fedotov, Taras Andreevich Shatokhin, Dmitrii Nikolaevich Reshetov","doi":"10.1055/s-0045-1806857","DOIUrl":"10.1055/s-0045-1806857","url":null,"abstract":"<p><p>Surgical strategies for neck tumors extending to the skull base and high-lying carotid artery pathologies present significant challenges for surgeons, necessitating deviations from traditional neck surgery approaches. These tactics are adopted to expand the surgical approach. Although the mandibular sagittal split osteotomy (MSSO) has been routinely utilized in maxillofacial surgery, its integration into combined surgical approaches for head and neck pathologies has not been widely explored. We present our experience using MSSO in patients with neck pathology. A retrospective analysis was conducted on 12 patients who underwent surgery between 2020 and 2022 for benign neck tumors and vascular pathologies that posed challenges for removal using traditional approaches. All patients underwent surgical treatment utilizing the technique of unilateral MSSO and fragment retraction to enhance the surgical approach for neck pathologies. An evaluation of early postoperative outcomes was performed. Based on the criteria presented, the study group consisted of 12 patients with various histological types of benign tumors ( <i>n</i>  = 11) and atherosclerotic plaque in the carotid artery ( <i>n</i>  = 1). Following the osteotomy step, mandibular advancement of an average distance of 17.2 ± 1.6 mm was achieved, allowing for an extended surgical approach on the lateral aspect of the neck measuring 48.7 ± 3.5 mm. This technique facilitated the successful total tumor resection in most of cases. Complications related to the osteotomy were observed in two patients during the early postoperative period, which included malocclusion necessitating plate refixation and hematoma formation in the soft tissues of the neck. The utilization of the unilateral intraoral technique of sagittal split osteotomy with mandibular abduction has demonstrated good outcomes in providing an extended surgical approach for tumors located in the distal neck segment of the internal carotid artery.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 3","pages":"597-604"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984897","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":"Exoscopes in Neurosurgery: A Bibliometric and Visualization Analysis.","authors":"Kaleem Ullah Ranjha, Syeda Shahnoor, Rimmel Abdul Ghaffar, Abdul Moiz Khan, Minaam Farooq","doi":"10.1055/s-0045-1806860","DOIUrl":"10.1055/s-0045-1806860","url":null,"abstract":"<p><p>Exoscopes, introduced as an alternative to operative microscopes in neurosurgery, aim to enhance intraoperative visualization, ergonomics, cost-effectiveness, and patient outcomes. This study employs bibliometric analysis to delineate topic trends and fields within neurosurgery utilizing exoscopes. Articles and reviews from January 1, 2002 to December 31, 2023, were manually retrieved from Scopus, based on predefined criteria encompassing publications related to exoscopes in neurosurgery. All publication records were imported and analyzed using Microsoft Excel and VOSviewer. A total of 186 articles were included for final analysis. While work on exoscopes was limited until 2015, there was an upsurge in publication output from 2018 to 2022. The United States led in the number of articles (72/186, 38.7%) and in total citations (1259). Brazil ranked first in average citation index (26.00). The Hospital of the University of Pennsylvania, United States, published the most articles (5), while Cedars-Sinai Medical Center USA accrued the highest number of citations (181). A.J. Schupper (4) and Constantinos Hadjipanayis (7) were the authors with the most publications as the first author and the last author, respectively. <i>World Neurosurgery</i> was the most prolific journal with 41 publications. Recent keywords centered around themes such as \"ergonomics\" (47 times) and \"three-dimensional imaging\" (44 times). Most collaboration occurred between developed countries such as the United States, Germany, Finland, and Austria. Most articles (87) focused on brain, with 25 articles focusing on spine. Our findings offer valuable insights to identify potential research frontiers within different fields of neurosurgery in the coming years.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 3","pages":"437-447"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984879","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":"Unstable Upper Cervical Spine Injury with Concomitant Bilateral Ponticulus Posticus: A Case Report.","authors":"Masashi Fujisawa, Sota Wakahara, Joji Inamasu","doi":"10.1055/s-0045-1806836","DOIUrl":"10.1055/s-0045-1806836","url":null,"abstract":"<p><p>Ponticulus posticus (PP), also known as arcuate foramen, is an anatomical variation of the atlas (C1), which is an ossification of the posterior atlanto-occipital membrane and through which the V3 segment of the vertebral artery (VA) runs. Placement of a polyaxial screw in the C1 lateral mass is considered risky in those with PP because of possible risk for VA injury. We report a case with bilateral PP in which posterior fixation for unstable upper cervical spine injury was performed. The patient, a 70-year-old man, sustained a fall-induced unstable upper cervical spine injury (traumatic C2 spondylolisthesis with unilateral dislocation of the C3-4 facet joint). Following initial conservative treatment, a posterior fixation surgery was performed in the subacute phase. Preoperative images revealed the presence of bilateral PP. Therefore, an original plan to place the screws in the C1 lateral mass was discarded, and instead, placement of the laminar hook on one side and placement of the screw into the C1 posterior arch on the other side was performed. His postoperative course was uneventful, and he was transferred to a rehabilitation hospital 27 days after the injury. In cases of upper cervical spine instability with concomitant PP, it is essential to consider the fixation method based on the extent of the injury and the course of the VA on a case-by-case basis.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 3","pages":"610-614"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984876","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":"Spinal Robotics in Adult Spinal Deformity Surgery: Key Concepts and Technical Considerations.","authors":"Kareem Khalifeh, Carson P McCann, Nicholas S Hernandez, Martin H Pham","doi":"10.1055/s-0045-1806858","DOIUrl":"10.1055/s-0045-1806858","url":null,"abstract":"<p><p>Robotic assistance in spine surgery has long been pursued to innovate minimally invasive procedures and enhance patient safety, outcomes, operation time, and affordability. Over the past few decades, advancements in navigation and robotics have fundamentally transformed the role of technology in spine surgery, with their applications continuously expanding. In particular, this technology has made significant strides in the setting of adult spinal deformity (ASD), driving innovations for this technically challenging pathology. In this review, the authors explore key aspects of robotic assistance in ASD surgery, including software planning and construct design, pedicle screw placement, sacropelvic fixation, operative outcomes, and the learning curve associated with adopting this technology. Research articles for this qualitative review were indexed using PubMed and Google Scholar. The review also addresses the opportunities and challenges ahead in the field. Although this technology is in its relative infancy, the growing body of research is beginning to fully characterize its utility in surgery and its potential to redefine the standard of care.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 3","pages":"448-455"},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984882","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":"Recurrent Calcifying Pseudoneoplasm of the Neuraxis in Meckel's Cave with Cyst Extending into the Cerebellopontine Cistern after Resection of the Cystic Component: A Case Report.","authors":"Ryuta Yamada, Hiroki Kobayashi, Yuichi Nomura, Naoki Oka, Jouji Kokuzawa, Yasuhiko Kaku","doi":"10.1055/s-0045-1806859","DOIUrl":"10.1055/s-0045-1806859","url":null,"abstract":"<p><p>Calcifying pseudoneoplasms of the neuraxis (CAPNON) are rare non-neoplastic calcified lesions that can occur throughout the entire neuraxis. Cranial nerves may be involved in skull base lesions. Surgical resection usually has a good prognosis, with only a few cases of recurrence reported in the relevant literature. We experienced a recurrent case of CAPNON in Meckel's cave extending to the cerebellopontine cistern with involvement of the trigeminal nerve after initial resection of the cystic part of the lesion. A 48-year-old man presented with a 4-year history of right-sided ptosis. Magnetic resonance imaging revealed a calcified lesion arising in Meckel's cave, with a cystic lesion extending to the cerebellopontine cistern. The cystic part of the lesion was excised during the initial surgery using the right lateral suboccipital approach. However, the cystic lesion regrew to its preoperative size within 23 months. The right extradural subtemporal approach was used to successfully remove both the calcified mass in the right Meckel cave and the cystic lesion extending to the right cerebellopontine cistern during the resection of the lesion. The patient's neurological symptoms resolved postoperatively. CAPNON was identified during the histopathological examination. This report describes a rare case of CAPNON in Meckel's cave with a unique clinical course. After the first operation, cystic lesions recurred in the cerebellopontine cistern, but they were successfully treated by a second operation.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 3","pages":"605-609"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984822","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}