Asian journal of neurosurgery最新文献

{"title":"<i>Aspergillus terreus</i> Fungal Spondylodiscitis in a Healthy Patient Post-Lumbar Spine Surgery: A Rare Case Report.","authors":"Raghava D Mulukutla, Phani Krishna Karthik Yelamarthy, Thiruvoipati Venkata Krishna Narayan, Ambadas Kathare, Vijay V Yeldandi","doi":"10.1055/s-0045-1802624","DOIUrl":"10.1055/s-0045-1802624","url":null,"abstract":"<p><p>We present a case of hospital-acquired <i>Aspergillus terreus</i> spondylodiscitis following lumbar spine surgery. The objective is to highlight the need for a high index of suspicion for rare fungal pathogens as causative organisms in postoperative spinal infections. A 39-year-old female underwent posterior decompression, stabilization, and interbody fusion at L4-5. Six weeks post-surgery she developed fever, back pain, and right leg pain. A diagnosis of postoperative spinal infection was made. On exploration and debridement of the wound, the fungal cultures grew positive for <i>A. terreus</i> . She was treated with voriconazole for 6 months. Following debridement and antifungal therapy, symptoms and inflammatory markers subsided over a period of time. There was no recurrence of infection till the last follow-up at three and half years. To the best of our knowledge, this is the only case report of an <i>A. terreus</i> spondylodiscitis following lumbar spine surgery. The possibility of fungal infection should be considered in elderly and immune-compromised patients. In our institution, all postoperative spinal infections, irrespective of age and comorbidities, are subjected to microbiological cultures including fungal cultures and sensitivities. Thorough debridement, involvement of infection control specialists, and use of long-term antifungal therapy help resolve these infections.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 2","pages":"383-386"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251709","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":"Brain Abscess Mimicking Brain Tumors: A Systematic Review of Individual Patient's Data.","authors":"Anis Choucha, Matteo De Simone, Nathan Beucler, Solenne Hulot, Jean-Christophe Lagier, Henry Dufour","doi":"10.1055/s-0045-1802623","DOIUrl":"10.1055/s-0045-1802623","url":null,"abstract":"<p><p><b>Objectives</b>  Brain abscess is a worrisome condition with a 1-year mortality rate of 21% and a 32% rate of new-onset epilepsy. Brain magnetic resonance imaging (MRI) is strongly recommended as a screening modality with contrast-enhanced T1-weighted images, diffusion-weighted imaging (DWI), and attenuated diffusion coefficient. However, there is a 10% rate of false negative, which could potentially impact management and prognosis. Our systematic review aims at identifying risk factors for false negative. <b>Materials and Methods</b>  A database search of our institutions plus a systematic literature review was conducted using MEDLINE/PubMed, including studies of brain abscesses misdiagnosed as brain tumors. Data on patient demographics, clinical presentations, imaging findings, pathogens, treatments, and outcomes were extracted and analyzed. We present a case of a 59-year-old male with HIV, who developed a brain abscess misdiagnosed as a tumor. Initial symptoms included left-side weakness and weight loss. Imaging showed a ring-enhancing lesion in the right thalamus. The abscess was caused by <i>T. gondii</i> , and the patient was treated with sulfadiazine, pyrimethamine, ceftriaxone, and metronidazole, achieving a GOS-E score of 8 at 1 year. <b>Results</b>  The review included 14 studies, with 1 additional illustrative case, encompassing a total of 15 cases. Patients ranged from 39 to 77 years, with a mean age of 59 years. Comorbidities included human immunodeficiency virus (HIV), glioblastoma, breast cancer, arthritis, gastric cancer, and nephrotic syndrome. Common symptoms were hemiparesis, generalized seizures, headache, and confusion. Imaging often revealed ring-enhancing lesions with restricted diffusion on DWI. Lesions were located in various brain regions. Pathogens identified included 40% <i>Nocardia</i> species, <i>Toxoplasma gondii</i> , <i>Mycobacterium tuberculosis</i> , <i>Aggregatibacter aphrophilus</i> , <i>Rickettsia typhi</i> , <i>Arcanobacterium haemolyticum</i> , <i>Aspergillus terreus</i> , and <i>Providencia rettgeri</i> . Treatments involved antibiotics and, in some cases, surgical intervention. Outcomes measured by the Glasgow Outcome Scale-Extended (GOS-E) at 1 year indicated good recovery in most cases. <b>Conclusion</b>  Despite the high sensitivity and specificity of brain MRI in diagnosing brain abscesses, the standard protocol used for the past two decades still results in a 10% false-negative rate. Such inaccuracies can significantly impact the patient's management, potentially delaying antibiotic therapy and impacting the surgical planning, hence affecting the outcome. Immunocompromised patients are particularly vulnerable to misdiagnoses of brain abscesses as brain tumors. To improve diagnostic accuracy, new imaging techniques and computational tools are currently under investigation.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 2","pages":"291-300"},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251713","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 Vagoaccessory Triangle (VAT): The Arena of ELITE.","authors":"Nishanta M Liyadipita, Srinivasan S Uddanapalli, Lakmal K Hewage, Perera M Galappaththi, Ananda Lal C Dewa Pakshage","doi":"10.1055/s-0044-1801283","DOIUrl":"10.1055/s-0044-1801283","url":null,"abstract":"<p><p><b>Introduction</b>  Lesions in the cerebellomedullary angle, anterolateral aspect of lower brainstem, and anterior foramen magnum can be accessed through far lateral approach and extreme lateral infrajugular transcondylar exposure. Detailed anatomical knowledge of this region is of paramount importance to avoid untoward complications. <b>Objectives</b>  Comprehensive anatomy of this microsurgical corridor is sparse. Our aim was to define the anatomy of this region with relevance to the surgical approach, which would enable the surgeon to navigate this region with ease during surgery. <b>Materials and Methods</b>  Cadaveric dissection was performed with focus on the various anatomical structures, which are of relevance to the operating surgeon. The same was correlated with the computerized scan and magnetic resonance imaging brain findings and intraoperative findings. The observations are presented. <b>Discussion</b>  Through the far lateral approach, the vagoaccessory triangle (VAT) and three subtriangles within it are exposed. Lateral boundary of the VAT is formed by the spinal accessory nerve, which follows a superolateral trajectory toward the jugular foramen. Medial boundary is formed by the medulla oblongata. Superior boundary is formed by the vagus nerve, which courses horizontally toward the jugular foramen. Rootlets of the hypoglossal nerve divide the VAT into infra-hypoglossal, supra-hypoglossal, and hypoglossal-hypoglossal subtriangles. The floor is formed by the inferior clivus, anterior foramen magnum, occipital condyle, and jugular tubercle. The roof is formed by the dura covering the lower part of the posterior fossa, biventral lobule, and tonsil of the cerebellum. The VAT contains three cisterns compartmentalized by three membranes, three nerves, and a fourth segment of vertebral artery (V4) with its three branches, in three subtriangles. Cisterns are the premedullary, lateral cerebellomedullary, and posterior cerebellomedullary. Membranes are the medial pontomedullary membrane, lateral pontomedullary membrane, and denticulate ligament. Nerves are the rootlets of hypoglossal, cranial accessory, and first cervical nerve. Posterior inferior cerebellar artery, anterior spinal artery, and posterior spinal artery are the three branches of V4. <b>Conclusion</b>  Detailed knowledge of each anatomical structure and its relationship would enable the surgeon to operate safely within the corridors naturally present in this region.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 2","pages":"253-259"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251768","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":"Isolated Mega Cisterna Magna: A Preliminary Study from Eastern Iran.","authors":"Masoud Pishjoo, Mohammad Safdari, Zohre Safdari, Mahtab Ghaemi, Daniel Kheradmand, Ali Fathi Jouzdani, Sajjad Saghbdoust","doi":"10.1055/s-0044-1801281","DOIUrl":"10.1055/s-0044-1801281","url":null,"abstract":"<p><p><b>Background</b>  The clinical significance and incidence of isolated mega cisterna magna (MCM) have been thoroughly investigated. While MCM has been reported in association with psychiatric disorders in adults, current study sought to report its incidence and relationship with gender and age in a consecutive series of patients without psychiatric comorbidities. <b>Materials and Methods</b>  We retrospectively reviewed 1,016 consecutive computed tomography scans of patients between the age of 1 and 80 with a history of minor head trauma, headache, or vertigo from April to August 2023. Two perpendicular diameters inside the MCM were measured: the first diameter (D ₁ ) was measured longitudinally on the midsagittal plane (anteroposterior diameter), whereas the second one (D ₂ ) was measured transeversely (transverse diameter). An MCM with D ₁ > 20 mm was defined as \"huge MCM.\" The relationship between age, gender, and the two diameters were subsequently analyzed. <b>Results</b>  Over a course of 5 months, 92 cases with MCM, including 76 men, were evaluated. The mean age of MCM cases was 35.31 ± 26.14, with no significant relationship observed between age and MCM. No significant difference in D ₁ was found between genders, while D ₂ significantly differed between men and women ( <i>p</i>  < 0.029). \"Huge MCM\" was exclusively observed in 18 men ( <i>p</i>  < 0.035). There was also no significant correlation between D ₁ and D ₂ . <b>Conclusion</b>  MCM appears to be a normal variation in the general population with no clinical significance. Despite the small sample size, the current study can provide a foundation for further studies to investigate the correlation of isolated MCM with different aspects of cognitive functions and its potential clinical relevance.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 2","pages":"236-240"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251746","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":"Rare Presentation of Moyamoya Disease with an Acute Subdural Hemorrhage from a Rare Location of Aneurysm-Related Moyamoya Disease.","authors":"Surasak Komonchan, Yodkhwan Wattanasen","doi":"10.1055/s-0044-1801374","DOIUrl":"10.1055/s-0044-1801374","url":null,"abstract":"<p><p>Spontaneous acute subdural hematoma is uncommon and usually caused by coagulopathy or other bleeding disorders, malignancy, intracranial hypotension, and abnormal intracranial vessels. We present unique cases of acute spontaneous subdural hematoma from moyamoya disease. There are a few cases reported, and we review previous literature and describe bleeding sources from aneurysms related to moyamoya disease in highly unusual locations.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 2","pages":"367-372"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251762","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":"Cerebral Intricacies: Deciphering the Mystique of Primary Central Nervous System Angiosarcoma.","authors":"Sana Ahuja, Shaivy Malik, Charanjeet Ahluwalia","doi":"10.1055/s-0044-1801328","DOIUrl":"10.1055/s-0044-1801328","url":null,"abstract":"<p><p>Angiosarcoma of the central nervous system (CNS) is an exceptionally rare and aggressive vascular malignancy presenting significant diagnostic and therapeutic challenges. We report the case of a 22-year-old female with CNS angiosarcoma, highlighting diagnostic intricacies, therapeutic approaches, and management outcomes. Initial symptoms included headache and dizziness, with magnetic resonance imaging revealing a space-occupying lesion in the right parietal lobe, initially misinterpreted as cavernoma. Subsequent surgical resection confirmed angiosarcoma histologically, supported by immunohistochemical analysis showing endothelial markers. Treatment comprised local irradiation postoperatively, resulting in no recurrence or metastasis. Histopathological examination revealed an infiltrative growth pattern with atypical endothelial cells forming irregular vascular spaces. Challenges in diagnosis arise due to overlapping features with other intracranial lesions. Multimodal treatment approaches involving surgery, radiation, and chemotherapy were employed, although their efficacy remains uncertain. Prognosis remains poor, underscoring the imperative for collaborative efforts to enhance understanding and management of this rare malignancy. Our case contributes valuable insights to the limited literature on CNS angiosarcoma, emphasizing the need for comprehensive case studies to refine diagnostic and therapeutic strategies.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 2","pages":"357-361"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251715","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":"Utilizing Diffusion Tensor Imaging to Differentiate High-Grade Gliomas and Solitary Brain Metastases.","authors":"Shreyas Reddy K, Sandeep S, Sunitha P Kumaran, Shravan Reddy K, Meghana Kancharla","doi":"10.1055/s-0044-1801782","DOIUrl":"10.1055/s-0044-1801782","url":null,"abstract":"<p><p><b>Background</b>  Brain tumors, encompassing a spectrum of neoplastic disorders, significantly impact patient morbidity and mortality. Distinguishing between high-grade gliomas (HGGs) and solitary brain metastases (SBMs) is crucial for tailored clinical management. Conventional structural magnetic resonance imaging (MRI) faces challenges in this differentiation, leading to the exploration of advanced imaging modalities such as diffusion tensor imaging (DTI). <b>Materials and Methods</b>  In this prospective study, 41 patients with solitary enhancing brain lesions underwent total or subtotal resection, confirmed by histopathology. Imaging involved a 3-Tesla MRI scanner, and DTI data were analyzed for metrics including mean diffusivity, fractional anisotropy (FA), axial diffusivity, radial diffusivity, as well as planar, spherical, and linear (CL) anisotropy coefficients. <b>Results</b>  Peritumoral FA and CL exhibited significant differences ( <i>p</i>  = 0.0217 and <i>p</i>  = 0.039, respectively) between HGG and SBM. The area under the curve for peritumoral FA and CL in differentiating HGG and SBM were 0.2791 and 0.6984, respectively. No significant differences were observed in the other diffusion metrics. <b>Conclusion</b>  This study contributes to understanding DTI-derived metrics for HGG and SBM differentiation. Peritumoral FA and CL show promise as potential discriminators, offering insights for enhanced clinical decision-making and treatment planning in brain tumor patients. Future research with larger cohorts and advanced diffusion imaging techniques could further refine these findings.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 2","pages":"278-284"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251771","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":"Factors Predicting Recurrence and Resolution of Chronic SDH after Surgery.","authors":"Shashin N Vyas, Achal Sharma","doi":"10.1055/s-0044-1796663","DOIUrl":"10.1055/s-0044-1796663","url":null,"abstract":"<p><p><b>Background</b>  Chronic subdural hematoma (SDH) is notoriously known to have high recurrence rates after surgery. We followed the course of 100 postoperative patients to determine the various stipulated factors associated with recurrence. <b>Materials and Methods</b>  In our study of 100 patients, there was a significant association with the size of SDH, amount of midline shift, increasing age, less duration of primary injury, and the increasing incidence of delayed resolution and recurrence. Also, the membrane of the patients with recurrent SDH was found to have a collection of neutrophils, plasma cells, histiocytes, and lymphocytes. <b>Conclusion</b>  Large size of SDH, increasing age, and recent injury were significant determining factors for delayed resolution and recurrence.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"112-118"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560520","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":"Cerebellar Mutism/Posterior Fossa Syndrome Following Resection of Posterior Fossa Tumor in Pediatric Patients: Assessing Pathophysiology, Risk Factors, and Neuroradiographic Features.","authors":"Vikrant Setia, Monirah Zeya, Arvind Kumar Srivastava, Anita Jagetia","doi":"10.1055/s-0044-1801404","DOIUrl":"10.1055/s-0044-1801404","url":null,"abstract":"<p><strong>Background: </strong>Cerebellar mutism syndrome (CMS) is a postoperative syndrome of decreased speech seen in children associated with neurobehavioral abnormalities, the incidence of which is up to 40%.</p><p><strong>Objectives: </strong>To evaluate pediatric patients with posterior fossa tumors for incidence, clinical characteristics, pathophysiology, risk factors, and neuroradiographic features of this syndrome.</p><p><strong>Materials and methods: </strong>The study included 60 pediatric patients with a posterior fossa tumor who underwent surgery by a telovelar approach. Detailed pre- and postoperative clinical and radiological evaluations were done. Patients with CMS were analyzed and compared with those without mutism to find risk factors for CMS. The presentation and characteristics of cerebellar mutism were studied along with the following risk factors:Clinical-age, sex, cranial nerve deficit, and adjuvant treatment.Radiological-tumor location, hydrocephalus, brainstem invasion, extent of tumor resection, peduncular and brainstem edema, and atrophy of posterior fossa structures.Pathological-histopathology of tumor.The preoperative, immediate postoperative, and 1-year postoperative imaging results were reviewed to assess the neuroradiographic features in the two groups.</p><p><strong>Results: </strong>The incidence of this syndrome was 20%. The mutism was accompanied by some neurobehavioral abnormalities ( <i>p</i> -value = 0.05). The most significant finding was the presence of a period of cerebellar dysarthria after the resolution of the muteness ( <i>p</i> -value < 0.001) in all cases. Brainstem and related structures' involvement was the most significant risk factor ( <i>p</i> -value = 0.03). The presence of brainstem and peduncular edema in the immediate postoperative period ( <i>p</i> -value = 0.04) and gross atrophy of posterior fossa structures at 1 year ( <i>p</i> -value = 0.01) showed significance toward the development of CMS. There was delayed neurological recovery in patients with CMS with a poor Glasgow Outcome Score at 1 year of follow-up.</p><p><strong>Conclusion: </strong>The clinical presentation of this syndrome in context with neuroradiographic features suggests that it results from transient impairment of the afferent and/or efferent pathways of dentate nuclei that are involved in initiating complex volitional movements and are associated with brainstem involvement of tumor and poor functional outcome.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 2","pages":"260-268"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251714","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":"Prognostic Serum Calcitonin Gene-Related Peptide Level Value in Patients Following Traumatic Brain Injury.","authors":"Seyed Ahmad Naseri Alavi, Mohammad Amin Habibi, Amir Rezakhah, Seyed Hamed Naseri Alavi, Parichehr Heydarian, Jafar Sadegh Mohammadi Torkan, Geena Jung, Margaret Keymakh, Andrew J Kobets","doi":"10.1055/s-0044-1801783","DOIUrl":"10.1055/s-0044-1801783","url":null,"abstract":"<p><p><b>Background</b>  Traumatic brain injury (TBI) is a significant cause of disability and death worldwide. It is important to have affordable and accessible biomarkers to assess the prognosis of patients. This study investigated the prognostic significance of calcitonin gene-related peptide (CGRP) serum levels in individuals with TBI. <b>Materials and Methods</b>  In this cross-sectional analytical study, CGRP levels were measured at admission, 24 hours, and 1 week after hospitalization. Patients were divided into two groups based on the Glasgow Coma Scale (GCS) score at admission: patients with mild/moderate TBI (GCS 9-15) and patients with severe TBI (GCS score 3-8), and CGRP levels were compared between the two groups. <b>Results</b>  A total of 102 patients with TBI were included. Higher levels of CGRP were observed in all three stages of measurement (at admission, 24 hours, and 1 week after hospitalization) in severe TBI patients. The occurrence of CGRP levels of 2 to 10 ng/L or higher than 10 ng/L in the mild/moderate and severe groups upon admission was 68.6 and 91%, respectively ( <i>p</i>  < 0.001). Within 24 hours of hospitalization, a more significant decrease in CGRP levels to lower ranges (> 0.5 and 0.5-2 ng/L) was observed in mild/moderate TBI patients (51.5%) compared with the severe group (19.4%). As indicated by logistic regression analysis, increased CGRP levels were directly associated with a higher risk of severe TBI. <b>Conclusion</b>  The increase in CGRP level is directly related to the risk of severe TBI. Investigating the ability of CGRP as an easy and accessible biomarker to predict the prognosis of TBI patients is recommended in future studies.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 2","pages":"285-290"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251760","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}