Asian journal of neurosurgery最新文献

{"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}

{"title":"Persistent Craniopharyngeal Canal (Type 3C) with Vertebrobasilar Dolichoectasia and Bilateral Sclerochoroidal Calcification.","authors":"Bheru Dan Charan, Savyasachi Jain, Shailesh B Gaikwad","doi":"10.1055/s-0044-1791948","DOIUrl":"10.1055/s-0044-1791948","url":null,"abstract":"<p><p>The persistent craniopharyngeal canal is a rare, well-corticated midline congenital bony defect through the sphenoid bone between the sellar floor and the nasopharyngeal roof. The prevalence of persistent craniopharyngeal canal is reported to be 0.42%. A 42-year-old male was evaluated for nasal discharge and progressive vision loss; and underwent computed tomography and magnetic resonance imaging, which revealed a large craniopharyngeal canal with ectopic pituitary, lipoma, encephalocele, deformed globe with sclerochoroidal calcification and vertebrobasilar dolichoectasia. The presence of orbital and optic tract malformation, craniofacial anomalies, and tumors can be associated with the craniopharyngeal canal.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"170-173"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560562","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":"A Prospective Study of CSF Flow Dynamics Across Foramen Magnum in Adult Chiari Malformation/Syringomyelia Complex and its Clinical Correlation with Outcomes after Surgery.","authors":"Manas Prakash, Adesh Shrivastava, Pradeep Chouksey, Sumit Raj, Rakesh Mishra, Amit Agrawal, Suresh Nair","doi":"10.1055/s-0044-1791710","DOIUrl":"10.1055/s-0044-1791710","url":null,"abstract":"<p><p><b>Introduction</b>  Chiari I malformation refers to cerebellar tonsillar descent below the foramen magnum and is frequently associated with syringomyelia. Prior cerebrospinal fluid (CSF) flow studies correlated the clinical severity of these lesions with general flow velocity or bulk flow at the foramen magnum; however, these techniques have not assessed the effect on surgical outcomes. The study aims to present clinical and radiological factors and CSF flow parameters (pre- and postoperative) that affect the surgical outcome. <b>Materials and Methods</b>  The institutional ethics committee approved the study. We collected the prospective clinical data, including pre- and postoperative symptoms. Functional grades were determined along with the change in clinical improvement based on clinical examination notes, the change in functional grade was calculated, and the radiologic data were analyzed according to the degree of clinical improvement. The surgical procedure included suboccipital bony decompression with duroplasty. Patients were followed up at 1 month, 3 months, and 1 year. <b>Results</b>  There were a total of 25 patients. The mean age of the patients was 45.52 ± 13.37 years, with 40% being males and 60% being females. After the surgery, there was a significant increase in the anterior and posterior CSF flows at the foramen magnum. Most had a resolution in the headache and sensory symptoms, while the lower cranial nerve and motor symptoms had a minor resolution at follow-up. Age, sex, and headache do not correlate with the outcome or syrinx improvement. Motor power in the lower limb (preintervention) and syrinx shape (preintervention) were significantly associated with the variable \"anterior flow at the foramen magnum\" (preintervention; <i>p</i>  < 0.05). Average flow, cervicomedullary angle (postintervention), sensory symptom progression, and CSF flow change anterior to the foramen magnum were significantly associated with the variable \"anterior flow at the foramen magnum\" (postintervention; <i>p</i>  < 0.05). <b>Conclusion</b>  Even after surgery, persistent foramen magnum CSF outflow obstruction has a robust negative correlation with the outcome. The Chiari outcome predictability index has shown a significant correlation with patient outcomes and can be used to inform patients about the expected outcome. The results of the present study will be helpful in stratifying patients according to their desired outcomes.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"43-51"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560535","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":"Effect of the Effective Metal Surface Area of Two Different Flow Diverter Stents on the Stagnation Region Formation Inside the Aneurysm Sac.","authors":"Muhammed Talha Gunaydin, Gorkem Guclu, Ali Bahadir Olcay, Atakan Orscelik, Cem Bilgin, Bahattin Hakyemez","doi":"10.1055/s-0044-1791842","DOIUrl":"10.1055/s-0044-1791842","url":null,"abstract":"<p><p><b>Objective</b>  Flow diversion (FD) is a relatively new technique for treating large, wide-necked, or fusiform aneurysms. Although FD is a more preferred option than coiling or clipping techniques in neurosurgery and neuroradiology clinics, the blood flow mechanism inside the aneurysm sac is not fully understood after the treatment. Besides, effective metal surface area (EMSA), a property of an FD related to porosity, shows variation at the patient's aneurysm neck by providing more or less blood flow inside an aneurysm sac than planned, causing nonstagnant or stagnant fluid region formation in the sac, respectively. Thus, the change in FD's EMSA can significantly affect the treatment's effectiveness, making even operation unsuccessful when variation in FD's EMSA at the aneurysm neck is overlooked. <b>Materials and Methods</b>  In this study, a large aneurysm of a 52-year-old female patient was numerically investigated by virtually placing two commercially available FDs with different EMSA values one by one into the aneurysm-carrying artery. <b>Results</b>  While FD stents at the aneurysm site substantially reduced the blood flow into the aneurysm, an FD with a 15.6% EMSA caused blood to flow in the aneurysm sac to have six times more kinetic energy than that of FD with a 29.5% EMSA. <b>Conclusion</b>  Although FD's EMSA value demonstrated nearly up to 20% reduction at the patient's aneurysm neck based on a product catalog value, numerical model results revealed that the stagnated region's formation inside the aneurysm sac could be determined within a 9% difference based on digital subtraction angiography reformat image.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"61-68"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560511","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":"Carotid Endarterectomy with Twisted Internal Jugular Vein Located Anterior to the Common Carotid Artery.","authors":"Arumu Endo, Terushige Toyooka, Kazuya Fujii, Satoru Takeuchi, Toru Yoshiura, Masaya Nakagawa, Yohei Otsuka, Arata Tomiyama, Kojiro Wada","doi":"10.1055/s-0044-1791841","DOIUrl":"10.1055/s-0044-1791841","url":null,"abstract":"<p><p>The knowledge of both normal and abnormal anatomy of the veins of the neck may be important for surgeons performing carotid endarterectomy (CEA), to avoid inadvertent injury to vascular structures. We present three cases of abnormal course of the internal jugular vein (IJV) which run anterior to the common carotid artery, named twisted IJV, that usually run posterolateral to the common carotid artery in patients undergoing CEA. These twisted IJV cases were detected by preoperative multidetector computed tomography angiography evaluation. During the CEA procedure, before identifying the common carotid artery, we dissected the retromandibular space to find the common facial vein. Then, dissection proceeded along the common facial vein caudally to find the IJV. After ligation and cutting of the common facial vein, a carotid sheath with the IJV turned laterally revealed the common carotid artery safely, and CEA was accomplished. Our clinical experience shows that knowledge of the anatomical anomaly of the IJV allows safe dissection of the carotid triangle avoiding inadvertent injury to the vasculature and vagus nerve.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"149-154"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560543","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":"Role of Advanced Magnetic Resonance Imaging in Differentiating among Glioma Subtypes and Predicting Tumor-Proliferative Behavior.","authors":"Gunalan Ganesan, Rajeswaran Rangasami, Anupama Chandrasekharan, Sahithi Marreddy, Rajoo Ramachandran","doi":"10.1055/s-0044-1790508","DOIUrl":"10.1055/s-0044-1790508","url":null,"abstract":"<p><p><b>Objective</b>  Gliomas are a devastating and heterogeneous group of primary brain tumors. Previously, the source of glioma was undetermined. Recent literature indicates that neural stem cells, or progenitors, are proposed to be the source of glioma. The prognosis of different types of gliomas differs due to their various biological tissue types. Besides the histological grade, the two useful immunohistochemistry markers that show the tumor's biological behavior are isocitrate dehydrogenase (IDH) labeling and the K _i -67 labeling index. We sought to determine the magnetic resonance imaging (MRI) characteristics associated with IDH mutational status and ascertain whether MRI combined with IDH mutational status, can better predict the clinical outcomes of gliomas. <b>Materials and Methods</b>  This period study was conducted in the Department of Radiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India for 5 years (May 2016-May 2021). The study cohort included 30 patients diagnosed with gliomas who underwent preoperative MRI followed by surgical resection and histopathological examination. Preoperative MRI images were done to assess qualitative tumor characteristics such as location, margin of tumor, extent, cortical involvement, cystic component, mineralization or hemorrhage, and contrast enhancement. <b>Discussion</b>  Differences in MRI features between IDH-mutant (MT) and IDH-wild-type (WT) groups were analyzed using the chi-square test for categorical variables and the Mann-Whitney <i>U</i> test for continuous variables. Statistical analysis was conducted using SPSS software. <b>Results</b>  Among the 30 patients evaluated, 18 had IDH-WT and 12 had IDH-MT type gliomas. Male predominance (73.33%) was noted in our study. Brainstem location, indistinct borders (83.33%), less cortical involvement (72.22%), less cystic changes (88.89%), more area of necrotic component (44.44%), significantly increased choline/creatine (Cho/Cr) ratio, and choline/N-acetyl aspartate (Cho/NAA) ratio favors IDH-WT tumors. Positive T2-fluid-attenuated inversion recovery mismatch sign is more frequently seen in IDH-MT (7/12; 58.33%) tumors than in IDH-WT (4/18; 22.22%) tumors. Whereas well-defined contours (66.67%), more cortical involvement (83.33%), more cystic changes (58.33%), and less area of necrotic component favor IDH-MT type tumors. <b>Conclusion</b>  MRI is a very promising and valuable tool for differentiating among glioma subtypes and predicting tumor-proliferative behavior in glioma cases. The combination of MRI characteristics with IDH mutation status enhances the predictive accuracy for clinical outcomes in glioma patients. This approach could potentially guide treatment planning and improve prognostic assessments.</p>","PeriodicalId":94300,"journal":{"name":"Asian journal of neurosurgery","volume":"20 1","pages":"34-42"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560563","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}